Francisco Lopes Paulo

Influência da administração da Plantago ovata (fibra dietética) na proteção da parede colônica em colite inflamatória induzida por ácido acético: estudo estereológico experimental em ratos

BACKGROUND: The objective of this paper was to study the role of the dietetic fiber (Plantago ovata) in the protection and recovery of the intestinal wall of rats submitted to acetic acid induced inflammatory colitis. METHODS: 30 Wistar male rats were studied, weighing between 260 and 300g, divided in three groups of 10 individuals. The distribution of the groups was made as follows: Group I (n 10), named control group, received a standard diet during the whole experiment. Group II (n 10), named colitis group, received an equally standard diet during the whole experiment and 8% acetic acid that induced inflammatory colitis. Group III (n 10), named colitis + fiber, received a standard diet with addition of dietetic fiber ( 10 g of seeds and peels of Plantago ovata for each 90 g of standard diet) and 8% acetic acid that induced inflammatory colitis. The experiment lasted 21 days and the inflammatory colitis induction was introduced on the fourteenth day in groups II and III. Twenty-one days after the start of the experiment the animals were sacrificed and total colectomies were performed. The specimens were submitted to stereologic and histological analysis, and they statistically evaluated by the Mann-Whitney test. The weight variation of the animals was also measured during the experiment. The studied parameters were: mucosa, muscularis mucosa, submucosa, lamina propria, epithelial and proper epithelial layer partial volumes. CONCLUSION: The results, through stereologic, histological and weight analysis, lead us to conclude that the addition of Plantago ovata (dietetic fiber) prevents the alterations caused by the 8% acetic acid induced colitis in the experimental animals.

Doença de Crohn e farmacobezoar intestinal: relato de caso

Bezoars are masses composed of foreign material, partially digested or not, found in any portion of the gastrointestinal tract. Rarely bezoars are composed by medication tablets, becoming known as Pharmacobezoars. This article reports a patient with the Crohns disease complicated by enteric fistulae and stenotic areas in the ileum presenting Mesalazine pharmacobezoars. The author emphasizes the multi-factorial origin of pharmacobezoars, the wide range of clinical presentations and the diagnostic tools useful in these cases. The individualized treatment necessary to obtain the satisfactory clinical results is also highlighted.

Hemorroidopexia por grampeamento parcial: aspectos clínicos e impacto sob a fisiologia anorretal

Objective: to evaluate the impact of partial stapled hemorrhoidopexy on anorectal physiology, the complications related to this surgical technique, pain, postoperative bleeding and recurrence of hemorrhoidal disease one year after surgery. Methods: this is a prospective, descriptive study in consecutive patients with mixed or internal hemorrhoidal disease, the internal component being classified as grade III or IV, undergoing partial stapled hemorrhoidopexy. Results: we studied 17 patients, 82% of them with internal hemorrhoids grade III and 18% grade IV. The mean operative time was 09:09 minutes (07:03 to 12:13). The median pain in the immediate postoperative period evaluated by the numerical pain scale was one (0 to 7). The median time to return to work was nine days (4 to 19). No patient had anal stenosis and 76% were satisfied with the surgery 90 days postoperatively. When comparing the preoperative manometry data with that measured 90 days after surgery, none of the variables studied showed statistically significant difference. There was no recurrence of hemorrhoidal disease with one year of postoperative follow-up. Conclusion: partial stapled hemorrhoidopexy showed no impact on anorectal physiology, presenting low levels of complications and postoperative pain, without recurrence of hemorrhoidal disease in one year of follow-up.

Doença de bowen perianal - diagnóstico e tratamento: relato de caso

The authors report a case and aimed at discussing about Bowens disease, an unusual pathology, especially in perianal area. It is an in situ carcinoma with invasive potential. Epidermals histological abnormalities with basal membrane preservation is its main characteristic. This disease presents a slow progression, few or no specific symptoms and variable macroscopic aspect. These facts lead in several times to a late diagnosis. Biopsies and histopathological study confirm the diagnosis. The treatment of choice is wide surgical resection. Often it is necessary to utilize grafts or flaps to correct the cutaneous defects and allows a satisfactory cicatrization.