RESUMO
OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1% x 51.2 years-old, SE 4.1) and 58 females (69.9%, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: Colonic Double-contrasted Rx, rectum-sigma endoscopy, and eventually a Colonofibroscopy Historic facts and syndromic protocol. Diagnosis criteria: 1) Perineal inspection: perineal contraction with pujo; 2) Rectal tact; 3) Ano-Rectum manometry with perfused system; 4) 150 ml Rectal balloon expulsion dynamic; 5) Utoreported signs and symptoms from a cuestionnaire ad hoc. Division into evolutive groups (continuous and intermittent). Division by age (< = 5, 5.1-25, > 25 years old). EXPERIMENT DESIGN: descriptive, comparative, correlation, prospective, simple blind. STATISTICS: Levene, descriptive, chi square, ANOVA, Kruskall-Wallis, Kendal tau b. RESULTS: 1) Difference in sex proportion was significative (p = 0.0001); 2) There were not differences between sexes in age media at the moment of the study (p = 0.92; 3) The continue evolutive form represented 77.1%, (p = 0.0001) but there weren't differences between sexes (p = 0.19) There weren't evolutive differences between age groups. (p = 0-78) 4) Age of onsec: x = 24.04 years-old, SE 2.02 (4-80 years-old), without differences between sexes (p = 0.16). 14.5% started before age of 5, 85% after that age, without differences between sexes (p = 0.07); 5) The time of evolution x = 26.7 years, SE 2.21, without differences between sexes (p = 0.25); 6) Potential causes were divides into tree categories: I "the patient doesn't remember associated facts" (30.1%, II: psychological or physical stress (39.8%), III: facts related to sexual trauma (30.1%). The differences (p = 0.0001); 7) Analyzed in general by sec, the most common cause was psychological-physical stress rather than sexual trauma in men, while among women sexual trauma was most common than psychological-physical stress (p = 0.03); 8) Analyzed by age groups: in the under 5 years-old group: main cause was "I don't remember". In 5.1-25-years-old group: sexual trauma; and psychological-physical stress was the main cause in > 25 years-old group (p 0.0001). CONCLUSIONS: 1) Women suffer from or consult much more frequently than man; 2) Once the disease is present, there would not be differences in age, age of onset, or time or evolution into proportions by sex; 3) The continue forms were the predominant ones; 4) The probable associated causes vary for each age group; 5) The sub-group "I don't remember" could represent in many cases a mismatch learning, but not constantly (there are cases of stress in familiar context); 6) In the subgroup "late childhood-adolescence" the predominant causes were traumatic experiences in erotic zones (rapping intent, sexual abuse, fantasies, elimination of parasites by the anus); 7) in the subgroup "older than 25 years-old" the predominant causes were physical stress, (violence, accidents, surgery) or emotional stress (familiar environment, social environment, affective losses). Some paradigmatic cases are presented. Anismus would be a complex situation involving an striated, voluntary, automatizated muscle (puborectalis) controlling independently genital-sexual, urinary and ano-rectal functions.
Assuntos
Constipação Intestinal/etiologia , Doenças Musculares/complicações , Diafragma da Pelve , Adolescente , Adulto , Distribuição por Idade , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Criança , Constipação Intestinal/diagnóstico , Constipação Intestinal/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Distribuição por Sexo , Delitos Sexuais , Método Simples-Cego , Estresse Fisiológico/complicaçõesRESUMO
OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1
x 51.2 years-old, SE 4.1) and 58 females (69.9
, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: Colonic Double-contrasted Rx, rectum-sigma endoscopy, and eventually a Colonofibroscopy Historic facts and syndromic protocol. Diagnosis criteria: 1) Perineal inspection: perineal contraction with pujo; 2) Rectal tact; 3) Ano-Rectum manometry with perfused system; 4) 150 ml Rectal balloon expulsion dynamic; 5) Utoreported signs and symptoms from a cuestionnaire ad hoc. Division into evolutive groups (continuous and intermittent). Division by age (< = 5, 5.1-25, > 25 years old). Experiment design: descriptive, comparative, correlation, prospective, simple blind. STATISTICS: Levene, descriptive, chi square, ANOVA, Kruskall-Wallis, Kendal tau b. RESULTS: 1) Difference in sex proportion was significative (p = 0.0001); 2) There were not differences between sexes in age media at the moment of the study (p = 0.92; 3) The continue evolutive form represented 77.1
, (p = 0.0001) but there werent differences between sexes (p = 0.19) There werent evolutive differences between age groups. (p = 0-78) 4) Age of onsec: x = 24.04 years-old, SE 2.02 (4-80 years-old), without differences between sexes (p = 0.16). 14.5
started before age of 5, 85
after that age, without differences between sexes (p = 0.07); 5) The time of evolution x = 26.7 years, SE 2.21, without differences between sexes (p = 0.25); 6) Potential causes were divides into tree categories: I [quot ]the patient doesnt remember associated facts[quot ] (30.1
, II: psychological or physical stress (39.8
), III: facts related to sexual trauma (30.1
). The differences (p = 0.0001); 7) Analyzed in general by sec, the most common cause was psychological-physical stress rather than sexual trauma in men, while among women sexual trauma was most common than psychological-physical stress (p = 0.03); 8) Analyzed by age groups: in the under 5 years-old group: main cause was [quot ]I dont remember[quot ]. In 5.1-25-years-old group: sexual trauma; and psychological-physical stress was the main cause in > 25 years-old group (p 0.0001). CONCLUSIONS: 1) Women suffer from or consult much more frequently than man; 2) Once the disease is present, there would not be differences in age, age of onset, or time or evolution into proportions by sex; 3) The continue forms were the predominant ones; 4) The probable associated causes vary for each age group; 5) The sub-group [quot ]I dont remember[quot ] could represent in many cases a mismatch learning, but not constantly (there are cases of stress in familiar context); 6) In the subgroup [quot ]late childhood-adolescence[quot ] the predominant causes were traumatic experiences in erotic zones (rapping intent, sexual abuse, fantasies, elimination of parasites by the anus); 7) in the subgroup [quot ]older than 25 years-old[quot ] the predominant causes were physical stress, (violence, accidents, surgery) or emotional stress (familiar environment, social environment, affective losses). Some paradigmatic cases are presented. Anismus would be a complex situation involving an striated, voluntary, automatizated muscle (puborectalis) controlling independently genital-sexual, urinary and ano-rectal functions.
RESUMO
OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1% x 51.2 years-old, SE 4.1) and 58 females (69.9%, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: ... (AU)
Assuntos
Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Feminino , Diafragma da Pelve/fisiopatologia , Constipação Intestinal/etiologia , Constipação Intestinal/diagnóstico , Constipação Intestinal/epidemiologia , Estresse Fisiológico/complicações , Distribuição por Idade , Distribuição por Sexo , Estudos Prospectivos , Método Simples-Cego , Idade de Início , Idoso de 80 Anos ou mais , Prevalência , Argentina/epidemiologiaRESUMO
OBJECTIVES: 1) To determine differences between sexes; 2) To determine differences by sex and age groups in symptom onset, time of evolution, clinical forms and probable associated causes. POPULATION AND SAMPLE: 83 consecutive patients with diagnosed PCP (X age = 50.9 SE 2.21). 25 males (30.1% x 51.2 years-old, SE 4.1) and 58 females (69.9%, X 50.8 years-old, SE 2.2). Patients with organic colon-rectum pathology (with the exception of hemorrhoidal pathology, proctologic surgery and active anus fissure) had been excluded. METHODS: ...
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Constipação Intestinal/etiologia , Diafragma da Pelve/fisiopatologia , Estresse Fisiológico , Distribuição por Idade , Idade de Início , Argentina/epidemiologia , Constipação Intestinal/diagnóstico , Constipação Intestinal/epidemiologia , Prevalência , Estudos Prospectivos , Distribuição por Sexo , Método Simples-CegoRESUMO
UNLABELLED: Patients with non ulcer dyspepsia (NUD) and lowered mechano sensitivity thresholds in stomach may have lowered mechano sensitivity thresholds in oesophagus also. The aim was to check this hypothesis. METHODS: 39 patients with NUD (11 men and 24 women, mean age 57 years, SEM 3.72, range 17-86) and 20 controls (10 men, 10 women, mean age 49.3 years, SEM 3.72, range 31-66) were studied. Organis diseases were discarded. Gastric mechano sensitivity was studied with a latex balloon of low compliance, 8 cm length, connected to a manometer. Balloon was inflated "in ramp" at 10 ml/sec, and "first sensation", discomfort", and "pain" were registered. At 900 ml inflation was stopped if pain was not evoked. Oesophageal mechano sensitivity was studied with another latex balloon of low compliance which, after inflated with 15 ml. of air, was 3.5 cm. in diameter. Esophageal balloon was inflated "in ramp" (1 ml/sec) up 15 ml. and deflated in 2 cm step from 36 to 22 cm from SDA. Inflation was stopped when symptoms (pain or discomfort were evoked. Oesophageal acid perfusion test was performed. RESULTS: 83.4% of controls completed up 700 ml. of gastric distension vs. 35.9% of patients with NUD (p > 0.001). No significative differences in intra-balloon pressure slope were observed between both groups. 79.2% of NUD patients had chest pain with oesophageal ballon distension = < 7 ml. vs. 5% in controls (p > 0.001). Mean volumes were 7.03 ml. (NUD) and 11.9% (controls) (p = 0.001), 63% of dyspeptic patients with lowered gastric sensitivity thresholds (< 700 ml) had oesophagic symptoms with inflation volumes = < 7 ml. There was a positive correlation in stomach and oesophageal mechano sensitivities variations (r = 0.75, +/- 0.58, p > 0.01). When analyzed with that results, oesophageal acid perfusion test showed 38.5% of "mixed sensitivities" (both mechano- and chemo-), 30.7% of "mechano sensorials" (negative acid test, positive balloon test), and 10.3% of :chemo sensorials" (positive acid test only). In 20.5% both tests were normal at the moment they were done. These results agreed with our previous experiences in oesophagus. CONCLUSIONS: It was concluded that a significative proportion of NUD patients had lowered thresholds for mechano stimulation of stomach and oesophagus at the time that both tests were done. Such alterations support the hypothesis that a more general mechano-sensitivity alteration is present in patients with NUD.
Assuntos
Dispepsia/fisiopatologia , Esôfago/fisiopatologia , Estômago/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção/fisiologia , Estudos Prospectivos , Sensação/fisiologiaRESUMO
UNLABELLED: Electrogastrography allows to determinate the dominant frequency of gastric E.C.A. (electrical control activity). The aim was to investigate the gastric E.C.A. in a population of patients suffering from non-organic dispepsia (N.O.D.). Eighteen controls (9 males, 9 females, mean age 46.4 years old, SEM 3.72, range 24-72) and 52 dyspeptic patients (18 males, 34 females, mean age 54.19 years old, SEM 2.38, range 17-86) were studied. Two skin surface electrodes Ag-2ClAg were placed on epigastric area following a probabilistic antral axe. Reference electrode was placed on the right quadrant skin. In 5 patients, recordings with needle and cutaneous electrode were compared. Analogic waves were filtered, digitalized and processed. Signals were analyzed using F.F.T. (Fast Fourier Transformated) Only the predominant frequency in each block was considered, and percentage of total abnormalities on total recording time lesser than 2 c.p.m. or more than 4 c.p.m. was accepted. Recording were taken in fast time during 30 minutes, and 30 minutes after a meal containing 230 Cal. Running spectral analysis with F.F.T. In 43 non-selected patients the gastric emptying time of a mixed meal marked with 99 Tc in the solid phase was studied. RESULTS: 60.45% showed delayed gastric emptying. Mean of fast E.C.A. was 2.99 c.p.m. in controls, Vs 3.34 c.p.m. in dispeptic patients (p > 0.001). In the post-prandial period, mean of E.C.A. was 3.53 c.p.m. in N.O.D., and these differences were not significatives ("t", NS). 22% of controls showed isolated periods of tachygastria, but never more than 8% of the total recording time. It was seen seven six and forty five percent of arrhythmias were observed (71.15% tachygastria, 4.76% bradygastria, and 19.23% mixed) during post prandial recording in N.O.D. 48% of tachygastrias were between the range 30-60% of the time recording. Ninety six and one percent of patients with abnormal gastric emptying had gastric arrhythmias (0.05 > p > 0.02) Vs 50% in patients with normal gastric emptying. Needle recording increased about 200-300% the signal power. It would be the better choice in cases of hairy abdominal skin. CONCLUSIONS: a) More than 76% of patients with N.O.D. had abnormal recording of E.C.A. beyond these observed in controls; b) tachygastria was the more frequent abnormality observed; c) the more severe clinical cases were associated with bradygastria; d) No association between symptoms and abnormal gastric emptying was found; e) E.G.G. abnormalities were seen in 96% of patients with abnormal gastric emptying, Vs 50% in normal gastric emptying; f) Needle electrodes let a better recording of E.G.G. signal; g) No association was found between abnormalities in gastric emptying and/or E.G.G., and clinical subtypes of Dyspepsia.
Assuntos
Dispepsia/fisiopatologia , Esvaziamento Gástrico/fisiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Distribuição de Qui-Quadrado , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Patients with non ulcer dyspepsia (NUD) and lowered mechano sensitivity tresholds in stomach may have lowered mechano sensitivity treholds in oesophagus also. The aim was to check this hypothesis. Methods: 39 patients with NUD (11 men and 24 women, mean age 57 years, SEM 3.72, range 17-86) and 20 controls (10 men, 10 women, mean age 49.3 years, SEM 3.72, range (31-66) were studied. Organis diseases were discarded. Gastric mechano sensitivity was studied with a latex ballon of low compliance, 8 cm lenght, conected to a manometer. Ballon was inflated "in ramp"at 10 ml/sec. and "first sensation", disconfort", and "pain" were registered. At 900 ml inflation was stopped if pain was not evoked. Oesophageal mechano sensitivity was studied with another latex ballon of low compliance which, after inflated with 15 ml. of air, was 3.5 cm. in diameter. Esophageal ballon was inflated "in ramp" (1 ml/sec) up 15 ml. and deflated in 2 cm step from 36 to 22 cm from SDA. Infaltion was stopped whrn symptoms (pain or disconfort were evoked. Oesophageal acid perfusion test was performed. Results: 83.4 per cent of controls completed up 700 ml. of gastric distension vs. 35.9 per cent of patients with NUD (p>0.001). No significatives differences in intra-ballon pressure slope were observed between both groups. 79.2 per cent of NUD patients had chest pain with oesophageal ballon distension =<7 ml. vs. 5 per cent in controls (p>0.001). Mean volumes were 7.03 ml. (NUD) and 11.9 per cent (controls) (p=0.001). 63 per cent of dyspeptic patients with lowered gastric sensitivity tresholds (< 700 ml) had oesophagic symptoms with inflation volumes =< 7 ml. There was a positive correlation is stomach and oesophageal mechano sensiticities variations (r= 0.75 +/-0.58, p>0.01). Whem analyzed with that results, oesophageal acid perfusion test showed 38.5 per cent of "mixed sensitivities" (both mechano-and chemo-), 30.7 per cent of "mechano sensorials" (negative acid test, positive ballon test), and 10.3 per cent of schemo sensorials" (positive acid test only). In 20.5 per cent both tests were normal at the moment they were done. These results agreed with our previous experiences in oesophagus. Conclusions: It was concluded that a significative proportion of NUD patients had lowered tresholds for mechano stimulation of stomach and oesophagus at the time that both tests were done. Such alterations support the hypothesis that a more general mechano-sensitivity alteration in present in patients with NUD.
Assuntos
Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Adolescente , Dispepsia/fisiopatologia , Esôfago/fisiopatologia , Estômago/fisiopatologia , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Insuflação , Manometria , Medição da Dor , Estudos ProspectivosRESUMO
La Electrogastrografía (EGG) permite establecer la frecuencia dominante del Ritmo Eléctrico B sico (REB) del estómago. El objetivo fue investigar la EGG en un grupo de pacientes con dispepsia no org nica (DNO). Se estudiaron 18 pacientes control (9 hombres y 9 mujeres, edad X 46.4 años, SEM 3.72, rango 24-72) y 52 con DNO (18 hombres y 34 mujeres, edad X 54.19 años, SEM 2.38, rango 17-86). Se utilizaron 2 electrodos de superficie Ag-CI2Ag en epigastrio y una referencia. An lisis de la señal con FFT. Sólo se tuvo en cuenta la frecuencia predominante en cada bloque y el por ciento total de tiempo de las frecuencias anormales (<2 y >4 cpm). Registro en ayunas por 30 minutos, y otros 30 minutos luego de la ingesta de 250 Cal. En 43 pacientes no sleccionados se estudió el tiempo de vaciamiento g strico por gammografía, con comida mixta marcada en la fase sólida con 99Tc. RESULTADOS: el X del REB en los controles fue de 2.99 cpm. En el 22 por ciento se observaron episodios aislados de frecuencias >4 cpm, pero < de 6 cpm, y nunca mayores del 8 por ciento del tiempo de registro. En los DNO el promedio en ayunas fue de 3.34 cpm (DS 0.67, p= 0.001). EN el 76.47 por ciento se observaron arritmias: 71.15 por ciento taquigastrias puras, 4.76 por ciento de bradigastrias puras, y 19.26 por ciento de alteraciones "mixtas". 48 por ciento de las taquigastrias se encontraron en el rango entre 30-60 por ciento del tiempo de registro. En el 96.1 por ciento de los pacientes con retardos en el vaciamiento g strico se observó E.G.G. anormal, Vs el 50 por ciento de los casos con vaciamiento en límites normales. No se encontraron diferencias significativas en la incidencia de arritmias g stricas entre los 3 grupos clínicos propuestos de dispepsia (tipos "ulcera", "dismotilidad" e "inespecíficos"). CONCLUSIONES: a) en m s de 76 por ciento de las DNO se observaron anormalidades en el REB m s all de los observado en los controles; b) predominio franco de taquigastrias; c) los casos clínicos m s severos se observaron en las bradisgastrias; d) no fue posible encontrar un asociación entre los síntomas y las alteraciones en el vaciamiento g strico; e)Las alteraciones del E.G.G. se asociaron en el 96 por ciento con las anormalidades en el vaciamiento g strico; f) no fue posible establecer una asociación entre los tipos clínicos propuestos de dispepsia y las alteraciones en el vaciamiento g strico y/o las anormalidades del E.G.G.
Assuntos
Feminino , Humanos , Idoso , Pessoa de Meia-Idade , Adulto , Adolescente , Dispepsia/fisiopatologia , Eletromiografia/métodos , Esvaziamento Gástrico , Fatores Etários , Idoso de 80 Anos ou mais , Análise de Variância , Distribuição de Qui-Quadrado , Estudos Prospectivos , Estômago/fisiologiaRESUMO
Patients with non ulcer dyspepsia (NUD) and lowered mechano sensitivity tresholds in stomach may have lowered mechano sensitivity treholds in oesophagus also. The aim was to check this hypothesis. Methods: 39 patients with NUD (11 men and 24 women, mean age 57 years, SEM 3.72, range 17-86) and 20 controls (10 men, 10 women, mean age 49.3 years, SEM 3.72, range (31-66) were studied. Organis diseases were discarded. Gastric mechano sensitivity was studied with a latex ballon of low compliance, 8 cm lenght, conected to a manometer. Ballon was inflated "in ramp"at 10 ml/sec. and "first sensation", disconfort", and "pain" were registered. At 900 ml inflation was stopped if pain was not evoked. Oesophageal mechano sensitivity was studied with another latex ballon of low compliance which, after inflated with 15 ml. of air, was 3.5 cm. in diameter. Esophageal ballon was inflated "in ramp" (1 ml/sec) up 15 ml. and deflated in 2 cm step from 36 to 22 cm from SDA. Infaltion was stopped whrn symptoms (pain or disconfort were evoked. Oesophageal acid perfusion test was performed. Results: 83.4 per cent of controls completed up 700 ml. of gastric distension vs. 35.9 per cent of patients with NUD (p>0.001). No significatives differences in intra-ballon pressure slope were observed between both groups. 79.2 per cent of NUD patients had chest pain with oesophageal ballon distension =<7 ml. vs. 5 per cent in controls (p>0.001). Mean volumes were 7.03 ml. (NUD) and 11.9 per cent (controls) (p=0.001). 63 per cent of dyspeptic patients with lowered gastric sensitivity tresholds (< 700 ml) had oesophagic symptoms with inflation volumes =< 7 ml. There was a positive correlation is stomach and oesophageal mechano sensiticities variations (r= 0.75 +/-0.58, p>0.01). Whem analyzed with that results, oesophageal acid perfusion test showed 38.5 per cent of "mixed sensitivities" (both mechano-and chemo-), 30.7 per cent of "mechano sensorials" (negative acid test, positive ballon test), and 10.3 per cent of schemo sensorials" (positive acid test only). In 20.5 per cent both tests were normal at the moment they were done. These results agreed with our previous experiences in oesophagus. Conclusions: It was concluded that a significative proportion of NUD patients had lowered tresholds for mechano stimulation of stomach and oesophagus at the time that both tests were done. Such alterations support the hypothesis that a more general mechano-sensitivity alteration in present in patients with NUD. (AU)
Assuntos
Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Adolescente , Estudo Comparativo , Esôfago/fisiopatologia , Estômago/fisiopatologia , Dispepsia/fisiopatologia , Estudos Prospectivos , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Insuflação , Manometria , Medição da DorRESUMO
La Electrogastrografía (EGG) permite establecer la frecuencia dominante del Ritmo Eléctrico B sico (REB) del estómago. El objetivo fue investigar la EGG en un grupo de pacientes con dispepsia no org nica (DNO). Se estudiaron 18 pacientes control (9 hombres y 9 mujeres, edad X 46.4 años, SEM 3.72, rango 24-72) y 52 con DNO (18 hombres y 34 mujeres, edad X 54.19 años, SEM 2.38, rango 17-86). Se utilizaron 2 electrodos de superficie Ag-CI2Ag en epigastrio y una referencia. An lisis de la señal con FFT. Sólo se tuvo en cuenta la frecuencia predominante en cada bloque y el por ciento total de tiempo de las frecuencias anormales (<2 y >4 cpm). Registro en ayunas por 30 minutos, y otros 30 minutos luego de la ingesta de 250 Cal. En 43 pacientes no sleccionados se estudió el tiempo de vaciamiento g strico por gammografía, con comida mixta marcada en la fase sólida con 99Tc. RESULTADOS: el X del REB en los controles fue de 2.99 cpm. En el 22 por ciento se observaron episodios aislados de frecuencias >4 cpm, pero < de 6 cpm, y nunca mayores del 8 por ciento del tiempo de registro. En los DNO el promedio en ayunas fue de 3.34 cpm (DS 0.67, p= 0.001). EN el 76.47 por ciento se observaron arritmias: 71.15 por ciento taquigastrias puras, 4.76 por ciento de bradigastrias puras, y 19.26 por ciento de alteraciones "mixtas". 48 por ciento de las taquigastrias se encontraron en el rango entre 30-60 por ciento del tiempo de registro. En el 96.1 por ciento de los pacientes con retardos en el vaciamiento g strico se observó E.G.G. anormal, Vs el 50 por ciento de los casos con vaciamiento en límites normales. No se encontraron diferencias significativas en la incidencia de arritmias g stricas entre los 3 grupos clínicos propuestos de dispepsia (tipos "ulcera", "dismotilidad" e "inespecíficos"). CONCLUSIONES: a) en m s de 76 por ciento de las DNO se observaron anormalidades en el REB m s all de los observado en los controles; b) predominio franco de taquigastrias; c) los casos clínicos m s severos se observaron en las bradisgastrias; d) no fue posible encontrar un asociación entre los síntomas y las alteraciones en el vaciamiento g strico; e)Las alteraciones del E.G.G. se asociaron en el 96 por ciento con las anormalidades en el vaciamiento g strico; f) no fue posible establecer una asociación entre los tipos clínicos propuestos de dispepsia y las alteraciones en el vaciamiento g strico y/o las anormalidades del E.G.G. (AU)
Assuntos
Feminino , Humanos , Idoso , Pessoa de Meia-Idade , Adulto , Adolescente , Esvaziamento Gástrico , Eletromiografia/métodos , Dispepsia/fisiopatologia , Estudos Prospectivos , Fatores Etários , Estômago/fisiologia , Análise de Variância , Distribuição de Qui-Quadrado , Idoso de 80 Anos ou maisRESUMO
UNLABELLED: Mechano--and chemo--sensitivity were studied in 20 normal control patients and 73 patients suffering from pirosis, chest pain or both symptoms. Upper endoscopy, balloon and acid perfussion tests were performed. Balloon was inflated up to 15 ml. and deflated, in 2 cm. steps from 38 to 22 cm. from S.D.A. The number of patients with response, volume of balloon distension that evoked symptoms, place and irradiation of pain or discomfort were registered and plotted on 13 frontal and 10 dorsal zones. The total number of areas involved in pain irradiation was considered as "number of responses". Nine levels were stimulated. Acid perfusion and clearance tests were performed at the same session. Test positivity was accepted when some test evoked spontaneous patient's symptoms. RESULTS: When 9 levels were stimulated, balloon reproduced symptoms in 77.5%. If only one level was considered, the maximal rate was 51%. There were "silent areas" interposed between "trigger zones". In 66.6%, responses with volumes of + < 7 ml. were obtained. In all patients with chest pain upper endoscopy was normal. In 70% of the total group and in 62.5% of patients with pirosis the acid perfusion test was "positive". Esophagitis increased the probability of a positive test. In sixty per cent, patients with combined pirosis and chest pain responded separately with each test. In 6% acid perfusion evoked pain. In 6.1% balloon evoked pirosis. CONCLUSION: 1) Balloon test could be considered the most useful test in mechano-sensitivity investigation. 2) acid perfussion was useful for chemo-sensitivity investigation. As esophagitis increases chemosensitivity, it could be a conditionant factor in some patients. 3) Patients with combined symptoms responded as a mixed sensorial dysfunction with each test. 4) sub-population of patients had atypical responses to the provocative tests.
Assuntos
Dor no Peito/fisiopatologia , Esôfago/fisiopatologia , Azia/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Cateterismo , Feminino , Humanos , Ácido Clorídrico/farmacologia , Masculino , Pessoa de Meia-Idade , Perfusão , Estudos ProspectivosRESUMO
Se investigó la mecano y quimio-sensibilidad del esófago en 20 sujetos control y en 73 pacientes con purisus, D.T.N.C. y la combinación simultánea de dolor y pirosis. Se utilizó la prueba de distensión de un balón hasta 15 ml., en escalas de 2 cm. desde los 38 hasta los 22 cm. de la A.D.S. Se registró el número de pacientes que respondieron, volúmenes de distensión necesarios para evocar el sintoma, sitio de aparición y propagación del mismo. Las zonas de propagación fueron ubicadas en 13 zonas frontales y 10 dorsales. Se consideró como número de respuestas a la suma de las zonas de propagación para cada nivel estimulado (9 en total). En la misma sesión se realizó la prueba de perfusión ácida y el clearance ácido de es£fago. Se consideró como prueba positivo cuando se reprodujo el síntoma espontáneo. Se realizó endoscopía previa en todos los pacintes. RESULTADOS: La prueba de balón reprodujo el síntoma dolor en el 77.5 por ciento, cifra alcanzada estimulando los 9 niveles. De haberse estimulado un solo nivel la proporción no hubiera superado el 51 por ciento. Existen zonas "mudas" con relativa frecuencia. El 66.6 por ciento respondió con volúmenes < de 7 ml. La endoscopía fue normal en todos ellos. El test de perfusión ácida reprodujo la pirosis en el 62.5 por ciento. La presencia de esofagitis determinó una tendencia a aumentar la probabilidad de prueba positiva. Los pacientes con la combinación pirosis-dolor respondieron por separado ante cada prueba en el 60 por ciento. La perfusión ácida reprodujo el D.T.N.C. en el 6 por ciento. La prueba del balón reprodujo la pirosis en el 6.1 por ciento. CONCLUSIONES: 1) La prueba del balón sería la más útil en el estudio de la mecano-sensibilidad con altos porcentajes de reproducción cuando se estimulan al menos 9 niveles. 2) el test de perfusión sería útil para investigar quimio-sensibilida. La esofagitis aumentaria la posibilidad de test positivo. 3) Los pacientes con síntomas combinados se comportarían ante los tests de provocación como una disfunción sensorial mixta . 4) Una subpoblación de pacientes mostraría comportamientos atípicos ante los tests de...
Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Dor no Peito/etiologia , Esôfago/fisiopatologia , Azia/etiologia , Estudos de Casos e Controles , Balão Gástrico , Perfusão , Estudos ProspectivosRESUMO
Mechano--and chemo--sensitivity were studied in 20 normal control patients and 73 patients suffering from pirosis, chest pain or both symptoms. Upper endoscopy, balloon and acid perfussion tests were performed. Balloon was inflated up to 15 ml. and deflated, in 2 cm. steps from 38 to 22 cm. from S.D.A. The number of patients with response, volume of balloon distension that evoked symptoms, place and irradiation of pain or discomfort were registered and plotted on 13 frontal and 10 dorsal zones. The total number of areas involved in pain irradiation was considered as [quot ]number of responses[quot ]. Nine levels were stimulated. Acid perfusion and clearance tests were performed at the same session. Test positivity was accepted when some test evoked spontaneous patients symptoms. RESULTS: When 9 levels were stimulated, balloon reproduced symptoms in 77.5
. If only one level was considered, the maximal rate was 51
. There were [quot ]silent areas[quot ] interposed between [quot ]trigger zones[quot ]. In 66.6
, responses with volumes of + < 7 ml. were obtained. In all patients with chest pain upper endoscopy was normal. In 70
of the total group and in 62.5
of patients with pirosis the acid perfusion test was [quot ]positive[quot ]. Esophagitis increased the probability of a positive test. In sixty per cent, patients with combined pirosis and chest pain responded separately with each test. In 6
acid perfusion evoked pain. In 6.1
balloon evoked pirosis. CONCLUSION: 1) Balloon test could be considered the most useful test in mechano-sensitivity investigation. 2) acid perfussion was useful for chemo-sensitivity investigation. As esophagitis increases chemosensitivity, it could be a conditionant factor in some patients. 3) Patients with combined symptoms responded as a mixed sensorial dysfunction with each test. 4) sub-population of patients had atypical responses to the provocative tests.
RESUMO
Se investigó la mecano y quimio-sensibilidad del esófago en 20 sujetos control y en 73 pacientes con purisus, D.T.N.C. y la combinación simultánea de dolor y pirosis. Se utilizó la prueba de distensión de un balón hasta 15 ml., en escalas de 2 cm. desde los 38 hasta los 22 cm. de la A.D.S. Se registró el número de pacientes que respondieron, volúmenes de distensión necesarios para evocar el sintoma, sitio de aparición y propagación del mismo. Las zonas de propagación fueron ubicadas en 13 zonas frontales y 10 dorsales. Se consideró como número de respuestas a la suma de las zonas de propagación para cada nivel estimulado (9 en total). En la misma sesión se realizó la prueba de perfusión ácida y el clearance ácido de esúfago. Se consideró como prueba positivo cuando se reprodujo el síntoma espontáneo. Se realizó endoscopía previa en todos los pacintes. RESULTADOS: La prueba de balón reprodujo el síntoma dolor en el 77.5 por ciento, cifra alcanzada estimulando los 9 niveles. De haberse estimulado un solo nivel la proporción no hubiera superado el 51 por ciento. Existen zonas "mudas" con relativa frecuencia. El 66.6 por ciento respondió con volúmenes < de 7 ml. La endoscopía fue normal en todos ellos. El test de perfusión ácida reprodujo la pirosis en el 62.5 por ciento. La presencia de esofagitis determinó una tendencia a aumentar la probabilidad de prueba positiva. Los pacientes con la combinación pirosis-dolor respondieron por separado ante cada prueba en el 60 por ciento. La perfusión ácida reprodujo el D.T.N.C. en el 6 por ciento. La prueba del balón reprodujo la pirosis en el 6.1 por ciento. CONCLUSIONES: 1) La prueba del balón sería la más útil en el estudio de la mecano-sensibilidad con altos porcentajes de reproducción cuando se estimulan al menos 9 niveles. 2) el test de perfusión sería útil para investigar quimio-sensibilida. La esofagitis aumentaria la posibilidad de test positivo. 3) Los pacientes con síntomas combinados se comportarían ante los tests de provocación como una disfunción sensorial mixta . 4) Una subpoblación de pacientes mostraría comportamientos atípicos ante los tests de...(AU)
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Feminino , Dor no Peito/etiologia , Azia/etiologia , Esôfago/fisiopatologia , Balão Gástrico , Perfusão , Estudos Prospectivos , Estudos de Casos e ControlesRESUMO
Mechano--and chemo--sensitivity were studied in 20 normal control patients and 73 patients suffering from pirosis, chest pain or both symptoms. Upper endoscopy, balloon and acid perfussion tests were performed. Balloon was inflated up to 15 ml. and deflated, in 2 cm. steps from 38 to 22 cm. from S.D.A. The number of patients with response, volume of balloon distension that evoked symptoms, place and irradiation of pain or discomfort were registered and plotted on 13 frontal and 10 dorsal zones. The total number of areas involved in pain irradiation was considered as [quot ]number of responses[quot ]. Nine levels were stimulated. Acid perfusion and clearance tests were performed at the same session. Test positivity was accepted when some test evoked spontaneous patients symptoms. RESULTS: When 9 levels were stimulated, balloon reproduced symptoms in 77.5
. If only one level was considered, the maximal rate was 51
, responses with volumes of + < 7 ml. were obtained. In all patients with chest pain upper endoscopy was normal. In 70
of the total group and in 62.5
of patients with pirosis the acid perfusion test was [quot ]positive[quot ]. Esophagitis increased the probability of a positive test. In sixty per cent, patients with combined pirosis and chest pain responded separately with each test. In 6
balloon evoked pirosis. CONCLUSION: 1) Balloon test could be considered the most useful test in mechano-sensitivity investigation. 2) acid perfussion was useful for chemo-sensitivity investigation. As esophagitis increases chemosensitivity, it could be a conditionant factor in some patients. 3) Patients with combined symptoms responded as a mixed sensorial dysfunction with each test. 4) sub-population of patients had atypical responses to the provocative tests.