RESUMO
The effect of isosorbide dinitrate (5 mg, sublingually) and of atropine (12 micrograms/kg i.v.) on the lower esophageal sphincter pressure of chagasic patients with esophageal involvement and of control subjects was studied by the manometric method. The pressure was measured at 5 minute intervals for 60 minutes after drug administration. When the effect of isosorbide dinitrate was studied, basal sphincter pressure (mean +/- SEM) was 15.3 +/- 1.9 mmHg in chagasic patients (N = 15) and 25.4 +/- 5.6 mmHg in controls (N = 9) (P greater than 0.05). Isosorbide dinitrate reduced sphincter pressure between 10 and 20 minutes and at 40 minutes in controls, and froM 5 to 60 minutes in chagasics (P less than 0.05). The reduction was more intense in chagasics throughout the time of measurement (P less than 0.05). When the effect of atropine was studied, basal sphincter pressure was 20.6 +/- 1.8 mmHg in chagasic patients (N = 14) and 23.7 +/- 2.5 mmHg in controls (N = 9) (P greater than 0.05). Atropine reduced sphincter pressure both in chagasics and controls, but more intensely so in controls during the first 30 minutes of the study (P less than 0.05). The action of the musculature itself may be the main factor in the maintenance of sphincter pressure in chagasics, with secondary participation of the cholinergic excitatory system.
Assuntos
Atropina/farmacologia , Doença de Chagas/complicações , Acalasia Esofágica/fisiopatologia , Junção Esofagogástrica/efeitos dos fármacos , Dinitrato de Isossorbida/farmacologia , Administração Sublingual , Adolescente , Adulto , Doença de Chagas/fisiopatologia , Acalasia Esofágica/etiologia , Junção Esofagogástrica/fisiopatologia , Feminino , Humanos , Dinitrato de Isossorbida/administração & dosagem , Masculino , Manometria , Pessoa de Meia-IdadeRESUMO
The effect of isosorbide dinitrate (5 mg, sublingually) and of atropine (12 micrograms/kg i.v.) on the lower esophageal sphincter pressure of chagasic patients with esophageal involvement and of control subjects was studied by the manometric method. The pressure was measured at 5 minute intervals for 60 minutes after drug administration. When the effect of isosorbide dinitrate was studied, basal sphincter pressure (mean +/- SEM) was 15.3 +/- 1.9 mmHg in chagasic patients (N = 15) and 25.4 +/- 5.6 mmHg in controls (N = 9) (P greater than 0.05). Isosorbide dinitrate reduced sphincter pressure between 10 and 20 minutes and at 40 minutes in controls, and froM 5 to 60 minutes in chagasics (P less than 0.05). The reduction was more intense in chagasics throughout the time of measurement (P less than 0.05). When the effect of atropine was studied, basal sphincter pressure was 20.6 +/- 1.8 mmHg in chagasic patients (N = 14) and 23.7 +/- 2.5 mmHg in controls (N = 9) (P greater than 0.05). Atropine reduced sphincter pressure both in chagasics and controls, but more intensely so in controls during the first 30 minutes of the study (P less than 0.05). The action of the musculature itself may be the main factor in the maintenance of sphincter pressure in chagasics, with secondary participation of the cholinergic excitatory system.
RESUMO
The effect of 5 mg of sublingual isosorbide dinitrate on the lower esophageal sphincter pressure of 28 chagasic patients with esophageal involvement, was studied by continuous perfusion manometry. The pressure was measured at 5 minute intervals for 60 minutes after drug administration. Isosorbide dinitrate reduced sphincter pressure from 5 to 60 minutes (p less than 0.01). Only two patients hadn't sphincter pressure reduced lower than 50% of initial value at 20 minutes after drug administration. These results indicate that isosorbide dinitrate may be useful to reduce lower esophageal sphincter pressure in chagasic megaesophagus.
Assuntos
Doença de Chagas/fisiopatologia , Junção Esofagogástrica/efeitos dos fármacos , Dinitrato de Isossorbida/farmacologia , Adulto , Idoso , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , PressãoRESUMO
Esophageal motility was studied in 37 patients with progressive systemic sclerosis (PSS), 12 patients with mixed connective tissue disease (MCTD) and 40 controls by the manometry method, using an open tube and continuous perfusion, and by radiological examination. Radiology was normal in 17 patients with PSS and five patients with MCTD, and abnormal in 15 patients with PSS and three with MCTD. The most frequent abnormality was slow transit time of barium. Manometry of the esophageal body was normal in 20 patients with PSS and six patients with MCTD, and abnormal in 17 patients with PSS and six with MCTD. Lack of contraction in the middle lower segments of the esophagus was the abnormality most frequently observed. Lower esophageal sphincter pressure was significantly lower among patients with PSS and MCTD than among the controls. Dysphagia was reported by ten patients with PSS and by six patients with MCTD. Radiology and manometry showed similar changes in PSS and MCTD, but dysphagia was more frequent among patients with MCTD.
Assuntos
Esôfago/fisiopatologia , Doença Mista do Tecido Conjuntivo/fisiopatologia , Escleroderma Sistêmico/fisiopatologia , Adolescente , Adulto , Idoso , Criança , Esôfago/diagnóstico por imagem , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Peristaltismo , Pressão , RadiografiaAssuntos
Doença de Chagas/fisiopatologia , Esôfago/fisiopatologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , PeristaltismoRESUMO
The pharyngoesophageal time, the time interval between the peak pharyngeal pressure and the peak esophageal pressure ten centimeters apart, after wet deglutitions, was measured in 50 controls and 37 chagasic patients. The time was 2.90 +/- 0.64 seconds in controls and 3.69 +/- 1.32 seconds in chagasics (P less than 0.01). In Chagas' disease the esophagus shows a delay in contraction produced by wet deglutitions.
Assuntos
Doença de Chagas/fisiopatologia , Acalasia Esofágica/fisiopatologia , Esôfago/fisiopatologia , Faringe/fisiopatologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Peristaltismo , Fatores de TempoRESUMO
In a manometric study of esophageal motility, segmental absence of contraction was encountered in the upper third of the esophagus in five patients, although only two of them had complained about dysphagia. If the manometric patterns were identical in the patients with and without dysphagia, it is difficult to explain this symptom in all the cases.
Assuntos
Transtornos de Deglutição/fisiopatologia , Esôfago/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Peristaltismo , PressãoRESUMO
The opening of the lower esophageal sphincter (LES) were studied by intraluminal manometry in 23 control subjects, 10 chagasic patients with peristalsis in esophagus and 15 chagasic patients with aperistalsis in esophagus. The opening of the LES were 2,1 +/- 0,7 seconds after wet deglutitions in controls, 3,2 +/- 1,2 seconds in chagasic with peristalsis and 3,5 +/- 1,7 seconds in chagasic with aperistalsis. The duration of relaxation were 7,9 +/- 1,5 seconds in controls, 5,2 +/- 1,0 seconds in chagasic wih peristalsis and 5,9 +/- 1,3 seconds in chagasic with aperistalsis. In Chagas' disease the LES may open delay or incomplete in patients with peristalsis or aperistalsis.
Assuntos
Doença de Chagas/fisiopatologia , Junção Esofagogástrica/fisiopatologia , Motilidade Gastrointestinal , Adolescente , Adulto , Acalasia Esofágica/etiologia , Esôfago/fisiopatologia , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-IdadeRESUMO
The basal motility of the sigmoid colon and rectum was evaluated manometrically over 3 consecutive 10-minute periods in 29 control subjects, 14 chagasic patients without megacolon, and 32 chagasic patients with megacolon. The results indicated that the sigmoid colon of both chagasic groups had a lower motility index and lower wave frequency than that of the controls. Reduced wave frequency was observed in the rectum of patients with megacolon, out the rectum of the chagasic patients without megacolon showed manometric characteristics similar to those for the controls. The abnormalities observed were attributed to intramural denervation of the viscera under study. Waves of long duration were observed very frequently in megacolon, and were assumed to be caused by dilatation in itself and not by abnormal contraction of muscle fibers.
Assuntos
Doença de Chagas/fisiopatologia , Colo Sigmoide/fisiopatologia , Motilidade Gastrointestinal , Megacolo/fisiopatologia , Reto/fisiopatologia , Adolescente , Adulto , Constipação Intestinal/fisiopatologia , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-IdadeAssuntos
Esôfago/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Manometria , Peristaltismo , PressãoRESUMO
In adult male rats submitted during 12 weeks to a diet containing 2,5% protein the amount of hydrochloric acid and of pepsin was determined and the macro and microscopic morphology of the stomach was studied. A group fed a diet containing 20% protein was used as control. The statistical analysis of the data obtained showed that the apparent differences in the secretion of acid as well as pepsin could be attributed to the different body weights of the two groups. The morphological examination showed papillomas, frequently ulcerated occurring in the forestomach of the undernourished rats. In these areas, histological examination revealed hyperkeratosis and acanthosis. The glandular epithelium showed neither macroscopic nor microscopic alterations.