RESUMO
La perforación estercorácea es una entidad poco frecuente, es el resultado de las necrosis isquémica del colon causado por varias entidades clínicas como las de origen traumático causado principalmente por colonoscopia o restosigmoidoscopia, por enfermedad divertícular generalmente de origen de malformaciones, las de tipo vascular como el síndrome de Ehrles Danlos tipo IV, debido a la rotura de las arterias principales del colon, las de origen inflamatorio como la colitis ulcerativa y las de origen idiopático. Su forma de presentación no es característica, por lo general el dolor es el síntoma más constante aunque no es más relevante en pacientes jóvenes tratados con glucocorticoides.
Assuntos
Humanos , Masculino , Adulto , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/patologia , Colonoscopia/efeitos adversos , Colostomia/métodos , Enteropatias/diagnóstico , Isquemia/diagnóstico , Proctocolite/etiologia , Cirurgia Geral/métodos , Inflamação/diagnóstico , Perfuração Intestinal/etiologiaRESUMO
One hundred and seventy four human subjects were studied to find out the interaction of vitamin A or beta-carotene with the inhibitors of iron absorption, from a basal breakfast containing bread from either 100 g of precooked corn flour or 100 g of white wheat flour, 50 g of cheese and 10 g of margarine. Bread was labeled with either 55Fe or 59Fe. This bread was made from commercially flours fortified with iron as ferrous fumarate and vitamins. It was noticed that the percentage of iron absorption from the breakfast prepared with precooked corn flour given alone and with different concentrations of coffee was practically the same, while the iron absorption from the breakfast prepared from wheat flour decreased from 6% when the breakfast was given alone, to less than 2% when it was given with different concentrations of coffee. The only ingredient present in precooked corn flour and not in wheat flour was vitamin A. This difference encouraged the authors to perform further experiments using precooked corn and wheat flours fortified only with ferrous fumarate. These studies demonstrated that vitamin A inhibits the effect of the polyphenol and partially inhibits the effect phytate on iron absorption. HPLC and spectrophotometric studies demonstrated an interaction between vitamin A and iron. Other experiments, which included 100 volunteers, were performed to test the effect of vitamin A and beta-carotene on iron absorption from corn, wheat and rice. The presence of vitamin A increased iron absorption up to 3 times for rice, 2.4 times for wheat and 1.8 times for corn. beta-carotene increased absorption almost 3 times for the three cereals tested, showing that both compounds were capable of preventing the inhibitory effect of phytates on iron absorption. This information suggest that vitamin A and beta-carotene form a complex with iron keeping it soluble in the intestinal lumen and preventing the inhibitory effect of phytates and polyphenols on iron absorption.
Assuntos
Antioxidantes/farmacocinética , Ferro da Dieta/farmacocinética , Ácido Fítico/farmacocinética , Polímeros/farmacocinética , Vitamina A/farmacocinética , beta Caroteno/farmacocinética , Antioxidantes/administração & dosagem , Pão , Feminino , Humanos , Absorção Intestinal , Masculino , Ácido Fítico/administração & dosagem , Vitamina A/administração & dosagem , beta Caroteno/administração & dosagemRESUMO
After the rapid decrease in the prevalence of iron deficiency and iron-deficiency anemia in the Venezuelan population when a national program for fortification of flours with iron and vitamins was instituted, we studied micronutrient interactions in Venezuelan diets. One hundred human adults were fed three cereal-based diets, labelled with either 59Fe or 55Fe in six studies. Each diet contained different concentrations of vitamin A (from 0.37 to 2.78 micromol/100 g cereal) or beta-carotene (from 0.58 to 2.06 micromol/100 g cereal). The presence of vitamin A increased iron absorption up to twofold for rice, 0.8-fold for wheat and 1.4-fold for corn. beta-carotene increased absorption more than threefold for rice and 1.8-fold for wheat and corn, suggesting that both compounds prevented the inhibitory effect of phytates on iron absorption. Increasing the doses of vitamin A or beta-carotene did not further significantly increase iron absorption. We measured the iron remaining in solution performing in vitro studies in which the pH of solutions was adjusted from 2 to 6 in the presence of vitamin A or beta-carotene. All of the iron from ferrous fumarate was soluble after changing the pH of the solution containing 3.4 micromol of beta-carotene to 6.0. Vitamin A was less effective. However, 78 +/- 18% of iron was soluble in the presence of 3.3 micromol of vitamin A, whereas with no vitamin addition, only 26 +/- 13% of iron was soluble (<0.05). Vitamin A and beta-carotene may form a complex with iron, keeping it soluble in the intestinal lumen and preventing the inhibitory effect of phytates and polyphenols on iron absorption.