RESUMO
Anastomotic dehiscence is the most severe complication of colorectal surgery. Metalloproteinases (MMPs) and interleukins (ILs) can be used to analyze the healing process of anastomosis. To evaluate the effects of bromopride on MMP and cytokine gene expression in left colonic anastomoses in rats with or without induced abdominal sepsis, 80 rats were divided into two groups for euthanasia on the third or seventh postoperative day (POD). They were then divided into subgroups of 20 rats for sepsis induction or not, and then into subgroups of 10 rats for administration of bromopride or saline. Left colonic anastomosis was performed and abdominal sepsis was induced by cecal ligation and puncture. A colonic segment containing the anastomosis was removed for analysis of gene expression of MMP-1α, MMP-8, MMP-13, IL-β, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). On the third POD, bromopride was associated with increased MMP-1α, MMP-13, IL-6, IFN-γ, and IL-10 gene expression. On the seventh POD, all MMP transcripts became negatively modulated and all IL transcripts became positively modulated. In the presence of sepsis, bromopride administration increased MMP-8 and IFN-γ gene expression and decreased MMP-1, TNF-α, IL-6, and IL-10 gene expression on the third POD. On the seventh POD, we observed increased expression of MMP-13 and all cytokines, except for TNF-α. In conclusion, bromopride interferes with MMP and IL gene expression during anastomotic healing. Further studies are needed to correlate these changes with the healing process.
Assuntos
Animais , Masculino , Antieméticos/farmacologia , Colo Descendente/cirurgia , Expressão Gênica/efeitos dos fármacos , Interleucinas/metabolismo , Metaloproteinases da Matriz/metabolismo , Metoclopramida/análogos & derivados , Anastomose Cirúrgica , Ceco/cirurgia , Interferon gama/análise , Interleucina-1beta/análise , /análise , /análise , Interleucinas/genética , Ligadura , Metaloproteinase 1 da Matriz/análise , /análise , /análise , Metaloproteinases da Matriz/genética , Metoclopramida/farmacologia , Punções , Ratos Wistar , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sepse/etiologia , Fator de Necrose Tumoral alfa/análise , Cicatrização/efeitos dos fármacosRESUMO
AIM: This study was carried out to determine how the partners of patients with a permanent colostomy perceive everyday life, particularly its sexual aspects. METHOD: Data were collected prospectively from October 2011 to May 2012 using a three-part questionnaire to obtain demographic, social and sexual information. Both multiple-choice and yes/no questions were used. RESULTS: One hundred and eight questionnaires were given to 36 partners of patients with a permanent colostomy (the ostomy group) and to 72 partners of normal individuals matched for age, sex and social class. The sexual performance of the spouse was significantly better in the control group (P = 0.004), sexual performance of the partner was also better in the control group (P = 0.023) and reduced frequency of sexual activity was higher in the ostomy group (P = 0.042). There was, however, no significant difference in sexual interest between the two groups (P = 0.507). CONCLUSION: The study demonstrated that about half of the partners of patients with a permanent colostomy experienced dissatisfaction with their spouse's performance, with a reduction in sexual interest and frequency of intercourse compared with the control group. Healthcare professionals should pay more attention to the partner of patients having a permanent colostomy.
Assuntos
Colostomia/psicologia , Relações Interpessoais , Sexualidade , Cônjuges/psicologia , Adulto , Idoso , Estudos de Casos e Controles , Coito/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Estudos Prospectivos , Qualidade de Vida , Sexualidade/psicologiaRESUMO
Anastomotic dehiscence is the most severe complication of colorectal surgery. Metalloproteinases (MMPs) and interleukins (ILs) can be used to analyze the healing process of anastomosis. To evaluate the effects of bromopride on MMP and cytokine gene expression in left colonic anastomoses in rats with or without induced abdominal sepsis, 80 rats were divided into two groups for euthanasia on the third or seventh postoperative day (POD). They were then divided into subgroups of 20 rats for sepsis induction or not, and then into subgroups of 10 rats for administration of bromopride or saline. Left colonic anastomosis was performed and abdominal sepsis was induced by cecal ligation and puncture. A colonic segment containing the anastomosis was removed for analysis of gene expression of MMP-1α, MMP-8, MMP-13, IL-ß, IL-6, IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ). On the third POD, bromopride was associated with increased MMP-1α, MMP-13, IL-6, IFN-γ, and IL-10 gene expression. On the seventh POD, all MMP transcripts became negatively modulated and all IL transcripts became positively modulated. In the presence of sepsis, bromopride administration increased MMP-8 and IFN-γ gene expression and decreased MMP-1, TNF-α, IL-6, and IL-10 gene expression on the third POD. On the seventh POD, we observed increased expression of MMP-13 and all cytokines, except for TNF-α. In conclusion, bromopride interferes with MMP and IL gene expression during anastomotic healing. Further studies are needed to correlate these changes with the healing process.
Assuntos
Antieméticos/farmacologia , Colo Descendente/cirurgia , Expressão Gênica/efeitos dos fármacos , Interleucinas/metabolismo , Metaloproteinases da Matriz/metabolismo , Metoclopramida/análogos & derivados , Anastomose Cirúrgica , Animais , Ceco/cirurgia , Interferon gama/análise , Interleucina-10/análise , Interleucina-1beta/análise , Interleucina-6/análise , Interleucinas/genética , Ligadura , Masculino , Metaloproteinase 1 da Matriz/análise , Metaloproteinase 13 da Matriz/análise , Metaloproteinase 8 da Matriz/análise , Metaloproteinases da Matriz/genética , Metoclopramida/farmacologia , Punções , Ratos Wistar , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sepse/etiologia , Fator de Necrose Tumoral alfa/análise , Cicatrização/efeitos dos fármacosRESUMO
To study the possible effects of diclofenac sodium on intestinal anastomoses, 48 rabbits were submitted to surgery consisting of two single-layer ileal anastomoses performed with separate propylene 5-0 sutures. The animals were divided at random into two groups (test and control). The animals in the test group were given intramuscular injections of diclofenac sodium at the dose of 3 mg/kg body weight at 24-hour intervals, and the control animals were given injections of an identical amount of 0.9 percent saline. The animals were sacrificed on the 3rd, 7th, and 14th postoperative days for macroscopic evaluation of the peritoneal cavity and of the anastomoses, tensile strength measurement, hydroxyproline determination, and histopathologic examination. The following results were observed: anastomotic dehiscence followed by peritonitis and death in five test animals (20.83 percent) and no control animals; decreased anastomotic tensile strength on the 7th day in test animals (P less than 0.05); delayed acute inflammatory response and onset of fibroblast proliferation in the test group; and similar hydroxyproline levels in both groups. On the basis of the results obtained, we conclude that diclofenac sodium had a negative effect on intestinal anastomotic healing.