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Esvaziamento gastrico de refeição liquida em crianças com constipação cronica funcional grave, com impactação fecal e escapes fecais retentivos; Gastric emptying of a liquid meal in children with severe functional constipation, fecal impaction and soiling

Vanessa Pacini Inaba Fernandes
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 11/02/2009 Português
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Distúrbios da motilidade do trato digestório podem estar envolvidos na fisiopatologia da constipação funcional. Retarde no esvaziamento gástrico tem sido observado em associação à constipação funcional e a relação de causa e efeito entre as condições não está definida. O objetivo desse estudo foi avaliar a motilidade gástrica antes da remoção da impactação fecal e após a regularização do hábito intestinal em crianças com constipação funcional. Casuística e métodos: Crianças (N= 22; 18 meninos, 10±2,2 anos) com constipação funcional e escape fecal retentivo, início da constipação aos 6,8±1,6 anos, acompanhadas no ambulatório de gastropediatria do Hospital das Clinicas da Universidade de Campinas. Estudo prospectivo, desenvolvido no período de 2000 a 2003. Os sintomas gastrintestinais foram registrados e estudos de esvaziamento gástrico foram conduzidos antes da remoção da impactação fecal (EG1) e após a regularização do hábito intestinal (EG2). O esvaziamento gástrico foi avaliado por método cintilográfico usando volumes individualizados de água. O T ½ do esvaziamento gástrico foi obtido para todos os pacientes nos dois momentos. Resultados: Vinte e um pacientes relataram sintomas gastrintestinais ao início do estudo...

Effect of baclofen on liquid and solid gastric emptying in rats

Collares,Edgard Ferro; Vinagre,Adriana Mendes
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2010 Português
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CONTEXT: Gamma-aminobutyric acid (GABA) is a potent inhibitory neurotransmitter. There is evidence that GABA B receptors located in the dorsal complex and in afferent fibers of the vagus nerve participate in the control of gastrointestinal motility. OBJECTIVE: To assess the intracerebroventricularly (ICV) and intravenously (IV) effect of baclofen, a GABA B receptor agonist, on liquid and solid gastric emptying in rats. METHODS: Adult male Wistar rats weighing 250-300 g (n = 6-8 animals) were used. Gastric emptying of liquid test meals labeled with phenol red was evaluated by the determination of percent gastric retention (%GR) 10 and 15 min after orogastric administration of saline and 10% glucose meals, respectively. Baclofen was injected ICV (1 and 2 µg/animal) through a tube implanted into the lateral ventricle of the brain and was injected IV (1 and 2 mg/kg) into a tail vein. The gastric emptying of liquid was determined 10 or 30 min after ICV and IV baclofen administration, respectively. The gastric emptying of the solid meal was assessed by the determination of percent gastric retention 2 h after the beginning of the ingestion of the habitual ratio by the animal, consumed over a period of 30 min. Baclofen was administered ICV (1 and 2 µg/animal) or IV (1 and 2 mg/kg) immediately after the end of the ingestion of the solid meal. The control groups received vehicle (sterile saline solution) ICV or IV. RESULTS: The group of animals receiving baclofen ICV (2 mg/animal) presented a significantly lower (P<0.05...

Faster gastric emptying of a liquid meal in rats after hypothalamic dorsomedial nucleus lesion

Denofre-Carvalho,S.; Collares,E.F.; Fernandes,G.A.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/1997 Português
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The effects of dorsomedial hypothalamic (DMH) nucleus lesion on body weight, plasma glucose levels, and the gastric emptying of a liquid meal were investigated in male Wistar rats (170-250 g). DMH lesions were produced stereotaxically by delivering a 2.0-mA current for 20 s through nichrome electrodes (0.3-mm tip exposure). In a second set of experiments, the DMH and the ventromedial hypothalamic (VMH) nucleus were lesioned with a 1.0-mA current for 10 s (0.1-mm tip exposure). The medial hypothalamus (MH) was also lesioned separately using a nichrome electrode (0.3-mm tip exposure) with a 2.0-mA current for 20 s. Gastric emptying was measured following the orogastric infusion of a liquid test meal consisting of physiological saline (0.9% NaCl, w/v) plus phenol red dye (6 mg/dl) as a marker. Plasma glucose levels were determined after an 18-h fast before the lesion and on the 7th and 15th postoperative day. Body weight was determined before lesioning and before sacrificing the rats. The DMH-lesioned rats showed a significantly faster (P<0.05) gastric emptying (24.7% gastric retention, N = 11) than control (33.0% gastric retention, N = 8) and sham-lesioned (33.5% gastric retention, N = 12) rats, with a transient hypoglycemia on the 7th postoperative day which returned to normal by the 15th postoperative day. In all cases...

Effects of chronic exercise intervention on gastric emptying

Horner, Katy
Fonte: University of Limerick Publicador: University of Limerick
Tipo: info:eu-repo/semantics/masterThesis; all_ul_research; ul_published_reviewed; ul_theses_dissertations
Português
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peer-reviewed; Many studies have linked altered gastric emptying (the rate at which food empties from the stomach into the small intestine) to increased food intake and obesity. Although findings comparing lean and obese individuals are inconsistent, previous research in non-obese adults indicates an inverse association between gastric emptying rate and body mass index. Physical activity has been implicated as a modifiable lifestyle factor which may alter the delivery of nutrients to the small intestine. However this is based on limited cross sectional research comparing physically active and sedentary individuals. Surprisingly, no longitudinal studies could be found. In addition, gastric emptying has received little investigation as a potential mechanism which may explain changes in appetite and food intake with exercise. The aim of this thesis therefore is to determine changes in gastric emptying, appetite sensations and food intake with chronic exercise interventions. Two longitudinal experimental studies are presented, the first involving a 7- week exercise intervention in a cohort of 19 adolescent schoolgirls, and the second a 10- week intervention study in a cohort of 12 Multiple Sclerosis patients. Gastric emptying was assessed using the 13C-octanoic acid breath test. Increasing BMI was demonstrated to be signficantly associated with slower gastric emptying for the first time in a population of female adolescents. A 7 week exercise intervention had no effect on gastric emptying or food intake at an ad libitum buffet meal but hunger sensations at 30 minutes after the test meal assessed by visual analogue scales were significantly reduced following intervention when compared to a control group. Using heart rate variability analysis as an additional indicator of autonomic nervous system function in Multiple Sclerosis patients...

The effect of short-term dietary supplementation with glucose on gastric emptying of glucose and fructose and oral glucose tolerance in normal subjects.

Horowitz, M.; Cunningham, K.; Wishart, J.; Jones, K.; Read, N.
Fonte: SPRINGER VERLAG Publicador: SPRINGER VERLAG
Tipo: Artigo de Revista Científica
Publicado em //1996 Português
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Recent observations indicate that gastric emptying may be influenced by patterns of previous nutrient intake. The aims of this study were to determine the effects of a high glucose diet on gastric emptying of glucose and fructose, and the impact of any changes in gastric emptying on plasma concentrations of glucose, insulin and gastric inhibitory polypeptide in response to glucose and fructose loads. Gastric emptying of glucose and fructose (both 75 g dissolved in 350 ml water) were measured in seven normal volunteers on separate days while each was on a ‘standard’ diet and an identical diet supplemented with 440 g/day of glucose for 4–7 days. Venous blood samples for measurement of plasma glucose, insulin and gastric inhibitory polypeptide levels were taken immediately before and for 180 min after ingestion of glucose and fructose loads. Dietary glucose supplementation accelerated gastric emptying of glucose (50% emptying time 82±8 vs 106±10 min, p=0.004) and fructose (73±9 vs 106±9 min, p=0.001). After ingestion of glucose, plasma concentrations of insulin (p<0.05) and gastric inhibitory polypeptide (p<0.05) were higher during the glucose-supplemented diet. In contrast, plasma glucose concentrations at 60 min and 75 min were lower (p<0.05) on the glucose-supplemented diet. We conclude that short-term supplementation of the diet with glucose accelerates gastric emptying of glucose and fructose...

Effect of cisapride on gastric emptying of oil and aqueous meal components, hunger and fullness.

Jones, K.; Horowitz, M.; Carney, B.; Sun, W.M.; Chatterton, B.
Fonte: BRITISH MED JOURNAL PUBL GROUP Publicador: BRITISH MED JOURNAL PUBL GROUP
Tipo: Conference paper
Publicado em //1996 Português
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To evaluate the effects of cisapride on gastric emptying of extracellular fat and hunger and fullness 10 volunteers consumed a meal consisting of 60 ml technectium-99m (99mTc)-V-thiocyanate labelled olive oil and 290 ml indium-113m (113mIn) labelled soup after taking cisapride (10 mg four times daily orally) and placebo, each for four days, in randomised, double blind fashion. Gastric emptying was quantified scintigraphically. Hunger and fullness before and after the meal were evaluated using visual analogue scales. Cisapride accelerated gastric emptying of oil and aqueous components by reducing the lag phase mean (SEM) (20.3 (7.0) min v 40.7 (4.1) min (p < 0.05) for oil and 4.1 (2.5) min v 10.0 (3.1) min (p < 0.05) for aqueous). Cisapride had no effect on the post-lag emptying rate of oil. Treatment with cisapride was associated with reduced retention of oil in the proximal stomach (p < 0.05). Subjects were more hungry before ingestion of the meal while receiving cisapride (6.7 (0.9) v 3.9 (0.7), p < 0.001). The scores for hunger at 120 and 180 minutes were inversely related to gastric emptying of oil on both cisapride (r > -0.62, p < 0.05) and placebo (r > -0.86, p < 0.001). Fullness increased after the meal while receiving placebo (p < 0.01)...

Relationships between gastric emptying, intragastric meal distribution and blood glucose concentrations in diabetes mellitus

Jones, K.; Horowitz, M.; Wishart, J.; Maddox, A.; Harding, P.; Chatterton, B.
Fonte: Society of Nuclear Medicine Publicador: Society of Nuclear Medicine
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
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The aim of this study was to evaluate the prevalence of disordered intragastric meal distribution and the relationships between gastric emptying, intragastric distribution, glycemic control and gastrointestinal symptoms in diabetes mellitus. METHODS: Eighty-six patients with diabetes mellitus had measurements of gastric emptying and intragastric distribution of a radioisotopically labeled solid/liquid meal (100 g beef and 150 ml 10% dextrose), glycemic control (plasma glucose concentrations), upper gastrointestinal symptoms (questionnaire) and autonomic nerve function (cardiovascular reflexes). Results were compared to those obtained in 20 normal volunteers. RESULTS: Solid and liquid gastric emptying were delayed in the diabetic patients and correlated weakly. Intragastric meal distribution was also often abnormal, with increased retention of both solid and liquid in the proximal stomach and increased retention of solid but not liquid in the distal stomach. In all patients with increased retention of solid in the proximal stomach, emptying from the total stomach was delayed. Gastric emptying of liquid was slower in those subjects who had a mean plasma glucose > 15 mmol/liter during the gastric emptying measurement, when compared to the remainder of the group. CONCLUSION: In patients with diabetes mellitus...

Gastric emptying in "early" non-insulin dependent diabetes mellitus

Jones, K.; Horowitz, M.; Carney, B.; Wishart, J.; Guha, S.; Green, L.
Fonte: SOC NUCLEAR MEDICINE INC Publicador: SOC NUCLEAR MEDICINE INC
Tipo: Artigo de Revista Científica
Publicado em //1996 Português
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The aims of this study were to determine in early noninsulin-dependent diabetes mellitus (NIDDM): (a) the prevalence of disordered gastric emptying of glucose; (b) the relationship between the blood glucose response to an oral glucose load and gastric emptying; and (c) the relationship between appetite and gastric emptying. METHODS: Sixteen patients (ages 39-79 yr) with recently diagnosed NIDDM consumed 350 ml water containing 75 g glucose and 99mTc-sulfur colloid while sitting in front of a gamma camera. Blood glucose concentrations were monitored immediately before and after the drink. Hunger and fullness were evaluated using visual analog scales. The results were compared to those obtained in 13 normal subjects of similar age and body mass index. All patients and control subjects were white and non-Hispanic. RESULTS: Gastric emptying was slightly slower in the NIDDM patients when compared to the control subjects (retention at 180 min 15.9 +/- 2.3% versus 3.8 +/- 1.0%, p < 0.001), but there was no significant difference in the 50% emptying time between the two groups. In the NIDDM patients, there was an inverse relationship between the magnitude of the increase in the blood glucose concentration and gastric emptying, e.g., between the area under the curve for blood glucose from 0-60 min and the intragastric retention of the drink at 60 min (r = -0.60...

Measurement of gastric emptying by intragastric gamma scintigraphy

Malbert, C.H.; Mathis, C.; Bobillier, E.; Laplace, J.; Horowitz, M.
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Artigo de Revista Científica
Publicado em //1997 Português
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Gastric emptying is usually measured in animals and humans by dilution/sampling or external scintigraphy. These methods are either time consuming or require expensive equipment. The capacity of a miniature gamma counter positioned in the stomach to measure emptying of liquid and solid meals was evaluated. In eight conscious pigs fitted with gastric and duodenal cannulae, gastric emptying of saline (500 mL), dextrose (20%, 500 mL), porridge (300 g) and scrambled eggs (300 g), all labelled with 3.5 MBq 99mTC, was evaluated. When positioned in the antrum the probe was unable to quantify gastric emptying. In contrast, measurements of the fractional emptying of saline over 4-min periods by the probe positioned in the corpus and quantification of radioactivity in the duodenal effluent correlated closely (r = 0.88, P < 0.05). Gastric emptying (50% emptying time) of saline and both solid meals measured by the probe was not significantly different from quantification of the duodenal effluent volume. No difference was observed also for the dextrose meal but only while gastric acid secretion was suppressed by omeprazole. We conclude that an intragastric gamma counter permits measurement of gastric emptying of homogeneous meals provided meal stimulation of gastric secretion was not extensive. This was possible probably by monitoring emptying from the proximal stomach.; C. H. Malbert...

Predictors of delayed gastric emptying in diabetes

Jones, K.; Russo, A.; Stevens, J.; Wishart, J.; Berry, M.; Horowitz, M.
Fonte: Amer Diabetes Assoc Publicador: Amer Diabetes Assoc
Tipo: Artigo de Revista Científica
Publicado em //2001 Português
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Objective — To define the predictors of the rate of gastric emptying in patients with diabetes. Research design and methods — A total of 101 outpatients with diabetes (79 type 1 and 22 type 2) underwent measurements of gastric emptying of a solid/liquid meal (scintigraphy), upper gastrointestinal symptoms (questionnaire), glycemic control (blood glucose concentrations during gastric emptying measurement), and autonomic nerve function (cardiovascular reflexes). Results— The gastric emptying of solid and/or liquid was delayed in 66 (65%) patients. Solid (retention at 100 min 64 6 3.2 vs. 50.2 6 3.6%, P , 0.005) and liquid (retention at 100 min 22.761.7 vs. 16.061.8%, P,0.001) gastric emptying was slower in women than in men. Of all upper gastrointestinal symptoms (including nausea and vomiting), only abdominal bloating/ fullness was associated with slower gastric emptying (P , 0.005). A multiple regression analysis demonstrated that both abdominal bloating/fullness and female sex were predictors of slower gastric emptying of both solids and liquids. Conclusions — We conclude that the presence of abdominal bloating/fullness but not any other upper gastrointestinal symptom is associated with diabetic gastroparesis and that gastric emptying is slower in diabetic women than in diabetic men.; Karen L. Jones...

Relationship between the effects of cisapride on gastric emptying and plasma glucose concentrations in diabetic gastroparesis

Horowitz, M.; Jones, K.; Harding, P.; Wishart, J.
Fonte: Karger Publicador: Karger
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
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BACKGROUND/AIMS: The effect of erythromycin on gastric emptying is attenuated during hyperglycaemia. The aim of this study was to determine in patients with diabetic gastroparesis whether the effect of cisapride on gastric emptying of solids and liquids is influenced by the plasma glucose concentration. METHODS: Nineteen patients with type 1 diabetes mellitus, who had delayed gastric emptying of solids and/or liquids, were studied. On 2 separate days, each patient received cisapride (20 mg) or placebo orally 60 min before scintigraphic measurement of gastric emptying of a mixed solid (ground beef) and liquid (dextrose) meal. The plasma glucose concentrations were measured at -5, 30, 60, 90, and 120 min during each gastric emptying measurement. RESULTS: Cisapride accelerated both solid (retention at 100 min 43 +/- 4 vs. 69 +/- 4%, p < 0.001) and liquid (T50 27 +/- 2 vs. 39 +/- 2 min, p < 0.001) gastric emptying. The mean plasma glucose level was not significantly different after placebo when compared with cisapride (19.5 +/- 1.1 vs. 18.2 +/- 1.0 mmol/l). The change in the 50% emptying time (T50) for liquid, but not solid, emptying was related (r = 0.55, p = 0.01) to the change in the plasma glucose AUC from 0 to 30 min between the placebo and cisapride tests...

Assessment of gastric emptying in the mouse using the [13C]-octanoic acid breath test

Symonds, E.; Butler, R.; Omari, T.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2000 Português
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1. Gastric emptying studies in small laboratory animals are hampered by the deficiency of a technique that is non-invasive and repeatable. The aim of the present study was to adapt the non-invasive [13C]-octanoic acid breath test, which has been validated in humans, to assess both liquid and solid gastric emptying in the mouse. 2. Gastric emptying rates were investigated for a liquid meal (Intralipid®; Kabi Pharmacia AB, Stockholm, Sweden; n = 7) and two solid meals (egg yolk and mouse chow; n = 7) incorporating [13C]-octanoic acid. All meals were analysed for natural enrichment of [13C]. Mathematical analysis of the 13CO2 excretion rate allowed the determination of gastric emptying parameters. 3. Gastric emptying of Intralipid® was more rapid than egg yolk (P < 0.0001). Gastric emptying of mouse chow could not be assessed due to intragastric separation of [13C]-octanoic acid and natural [13C] enrichment of the pellet. 4. The [13C]-octanoic acid breath test can reproducibly assess both liquid and solid gastric emptying non-invasively in the mouse. This method can now be used to assess gastric emptying in drug studies and disease studies for which there are established mouse models; Website © 2009 Ingenta. Article copyright remains with the publisher...

Erythromycin dose of 70 mg accelerates gastric emptying as effectively as 200 mg in the critically ill

Ritz, M.; Chapman, M.; Fraser, R.; Finnis, M.; Butler, R.; Cmielewski, P.; Davidson, G.; Rea, D.
Fonte: Springer Publicador: Springer
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
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OBJECTIVE: To compare the effectiveness of 70-mg and 200-mg doses of intravenous erythromycin in improving gastric emptying in critically ill patients. DESIGN: Gastric emptying was measured on consecutive days; day 1 (pre-treatment), day 2 (post-treatment) after an intravenous infusion of either 70 or 200 mg erythromycin or saline placebo (0.9%), in a randomized double-blind fashion. SETTING: Mixed medical/surgical intensive care unit, tertiary referral. PATIENTS AND PARTICIPANTS: Thirty-five randomly selected, mechanically ventilated, enterally fed critically ill patients (median APACHE II score 19 on admission). INTERVENTIONS: On day 2 either 70 or 200 mg erythromycin or saline was administered intravenously over 20 min. MEASUREMENTS AND RESULTS: Gastric emptying was measured using the [13C]octanoic acid breath test. The gastric emptying coefficient (GEC) and half-emptying time (t1/2) were calculated from the area under the 13CO2-recovery curve. Pre-treatment gastric emptying measurements were similar in all three patient groups. Treatment with both doses of erythromycin significantly reduced the gastric t1/2: 70 mg, 98 min (IQR 88-112); 200 mg, 86 min (75-104); vs. placebo, 122 min (102-190) (p<0.05). The GEC was higher with both doses of erythromycin: 70 mg...

Insulin-induced hypoglycemia accelerates gastric emptying of solids and liquids in long-standing type 1 diabetes

Russo, A.; Stevens, J.; Chen, R.; Gentilcore, D.; Burnet, R.; Horowitz, M.; Jones, K.
Fonte: Endocrine Society Publicador: Endocrine Society
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
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CONTEXT: The rate of gastric emptying of carbohydrate is a major determinant of postprandial glycemia. In healthy subjects and patients with uncomplicated type 1 diabetes, there is evidence that gastric emptying may be accelerated by insulin-induced hypoglycemia. OBJECTIVE: The objective was to determine the effects of acute hypoglycemia on gastric emptying in long-standing type 1 diabetes and evaluate whether the response to hypoglycemia is influenced by the rate of gastric emptying during euglycemia and/or autonomic dysfunction. DESIGN: Gastric emptying of a solid/liquid meal (100 g (99m)Tc-minced beef and 150 ml 67Ga-EDTA-labeled water) was measured by scintigraphy on 2 separate days, during hypoglycemia and euglycemia. SETTING: These studies took place at the Department of Nuclear Medicine, Positron Emission Tomography, and Bone Densitometry at the Royal Adelaide Hospital. PATIENTS: Twenty type 1 patients (4 female, 16 male; age, 45.9 +/- 2.3 yr; duration of known diabetes, 18.0 +/- 2.7 yr) were recruited from outpatient clinics and the Diabetes Centre at the Royal Adelaide Hospital. INTERVENTION: Hypoglycemia (approximately 2.6 mmol/liter) was established 15 min before and maintained for 45 min after meal consumption. On one of the days...

Validation of gastric-emptying scintigraphy of solids and liquids in mice using dedicated animal pinhole scintigraphy

Bennink, Roelof J.; de Jonge, Wouter J.; Symonds, Erin Leigh; van den Wijngaard, Rene M.; Spijkerboer, Astrid L.; Benninga, Marc A.; Boeckxstaens, Guy E.
Fonte: Soc Nuclear Medicine Publicador: Soc Nuclear Medicine
Tipo: Artigo de Revista Científica
Publicado em //2003 Português
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Gastric emptying in small laboratory animals is a useful parameter to assess gastrointestinal motility for physiologic, pharmacologic, or other research purposes. In mice, phenol red recovery is considered the gold standard for determination of gastric emptying. However, this method requires sacrifice of the animal and yields data of gastric emptying at only 1 time point. Gastric-emptying scintigraphy, the gold standard technique in humans, allows sequential and serial measurements in the same subject. In this study, we developed and validated a novel method of gastric-emptying scintigraphy applied in mice, by comparing it with phenol red photospectrometry. Methods: A dedicated animal pinhole gamma camera was equipped with a specially designed mouse application device. Gastric emptying was measured in unanesthetized mice using pinhole scintigraphy. First, gastric emptying determined with scintigraphy was compared with gastric phenol red recovery simultaneously within the same population. Subsequently, normal values for gastric emptying of solids and liquids in mice were established, and finally, the effects of handling stress and the late effects of frequently used anesthetics or sedatives on gastric emptying were assessed by scintigraphy. Results: Gastric emptying of liquids measured by pinhole scintigraphy did not significantly differ from that measured by phenol red recovery. For the same information...

Effects of exogenous glucagon-like peptide-1 on gastric emptying and glucose absorption in the critically ill: Relationship to glycemia

Deane, A.; Chapman, M.; Fraser, R.; Summers, M.; Zaknic, A.; Storey, J.; Jones, K.; Rayner, C.; Horowitz, M.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2010 Português
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Objective: To determine the acute effects of exogenous glucagon-like peptide-1 on gastric emptying, glucose absorption, glycemia, plasma insulin, and glucagon in critically ill patients. Design: Randomized, double-blind, crossover study. Setting: Intensive care unit. Subjects: Twenty-five mechanically ventilated patients, without known diabetes, studied on consecutive days. Interventions: Intravenous glucagon-like peptide-1 (1.2 pmol/kg/min) or placebo was infused between -30 and 330 mins. At 0 min, 100 mL liquid nutrient (1 kcal/mL) including 100 µg of 13C-octanoic acid and 3 grams of 3-O-methyl-glucose was administered. Measurements and Main Results: Blood glucose, serum 3-O-methyl-glucose (as an index of glucose absorption), insulin and glucagon concentrations, as well as exhaled 13CO2 were measured. The gastric emptying coefficient was calculated to quantify gastric emptying. Data are presented as mean (sd). There was a nonsignificant trend for glucagon-like peptide-1 to slow gastric emptying (gastric emptying coefficient) (glucagon-like peptide-1, 2.45 [0.93] vs. placebo, 2.75 [0.83]; p = .09). In 11 of the 25 patients, gastric emptying was delayed during placebo infusion and glucagon-like peptide-1 had no detectable effect on gastric emptying in this group (1.92 [0.82] vs. 1.90 [0.68]; p = .96). In contrast...

Glucagon-like peptide 1 attenuates the acceleration of gastric emptying induced by hypoglycemia in healthy subjects

Plummer, M.P.; Jones, K.L.; Annink, C.E.; Cousins, C.E.; Meier, J.J.; Chapman, M.J.; Horowitz, M.; Deane, A.M.
Fonte: American Diabetes Association Publicador: American Diabetes Association
Tipo: Artigo de Revista Científica
Publicado em //2014 Português
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OBJECTIVE: Exogenous GLP-1 slows gastric emptying in health and diabetes leading to diminished glycemic excursions. Gastric emptying is markedly accelerated by hypoglycemia. The primary objective was to determine whether GLP-1 attenuates the acceleration of gastric emptying induced by hypoglycemia. RESEARCH DESIGN AND METHODS: Ten healthy volunteers were studied on four separate days in a randomized double-blind fashion. Blood glucose was stabilized using a glucose/insulin clamp at hypoglycemia (2.6 mmol/L on two occasions [hypo]) or euglycemia (6.0 mmol/L on two occasions [eu]) between T = -15 and 45 min before clamping at 6.0 mmol/L until 180 min. During hypoglycemia and euglycemia, subjects received intravenous GLP-1 (1.2 pmol/kg/min) or placebo. At T = 0 min, subjects ingested 100 g beef mince labeled with 20 MBq (99m)Tc-sulfur-colloid and 3 g of 3-O-methyl-glucose (3-OMG), a marker of glucose absorption. Gastric emptying was measured scintigraphically from T = 0 to 180 min and serum 3-OMG taken at 15-min intervals. The areas under the curve for gastric emptying and 3-OMG concentration were analyzed using one-way repeated-measures ANOVA with Bonferroni-Holm adjusted post hoc tests. RESULTS: Gastric emptying was accelerated during hypoglycemia (hypo/placebo vs. eu/placebo; P < 0.001)...

Avaliação cintilográfica do esvaziamento gástrico e do trânsito intestinal após cirurgia bariátrica; Scintigraphic evaluation of gastric emptying and of intestinal transit after bariatric surgery

Xavier, Marcia Arruda Fajardo
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 31/10/2013 Português
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O presente estudo teve como objetivo avaliar o esvaziamento gástrico e o trânsito intestinal em 31 pacientes (sendo 10 controle e 21 com vômitos) após cirurgia bariátrica de DGYR e a relação das alterações destas duas variáveis entre si e com quadro sintomático e ainda tentar definir o tempo de esvaziamento gástrico desejável. O esvaziamento gástrico e o trânsito gastrintestinal foram avaliados mediante cintilografia, segundo técnicas padronizadas e previamente empregadas em outros estudos. A análise das imagens obtidas e armazenadas foi feita mediante o delineamento de regiões de interesse (ROI, da expressão, em Lingua Inglesa, region of interest) correspondendo ao coto gástrico, para a quantificação do esvaziamento gástrico, e para este segmento e também para as porções proximal e distal do intestino delgado e para a região ileocecal, para o trânsito gastrintestinal. A mesma região de interesse foi utilizada para as contagens de todas as imagens consecutivas, para a mesma projeção e para o mesmo paciente. Para a determinação do esvaziamento gástrico, a atividade em cada momento do estudo foi expressa pela média geométrica das contagens das imagens anteriores e posteriores, para correção do efeito da eventual movimentação intragástrica das partículas do radiotraçador (30...

Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis

Russo, A.; Stevens, J.; Giles, N.; Krause, G.; O'Donovan, D.; Horowitz, M.; Jones, K.
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
Publicado em //2004 Português
Relevância na Pesquisa
68.89672%
Background: KC 11458, a motilin agonist without antibiotic properties, accelerates gastric emptying in animals and healthy humans. Aim: To evaluate the acute effects of KC 11458 on gastric emptying in diabetic gastroparesis. Methods: Twenty-nine patients (6 type 1 and 23 type 2) with gastroparesis underwent assessments of: (i) gastric emptying of a solid/liquid meal using scintigraphy, (ii) glycaemic control (blood glucose at 0, 30, 60, 90 and 120 min during the gastric emptying measurement) and (iii) upper gastrointestinal and ‘meal-related’ symptoms (questionnaire), at baseline and after treatment with KC 11458 in a dose of 8 mg t.d.s., or placebo for 8 days. Results: KC 11458 had no statistically significant or clinically relevant effect on gastric emptying of either the solid intragastric retention at 100 min (T100) (P ¼ 0.87) or liquid 50% emptying time (T50) (P ¼ 0.17) components of the meal. KC 11458 slightly worsened (P ¼ 0.04) upper gastrointestinal symptoms when compared with placebo. The magnitude of the change in solid gastric emptying correlated with the change in the blood glucose concentration (r ¼ 0.49; P < 0.05). Conclusions: KC 11458, in a dose of 8 mg t.d.s. for 8 days, does not accelerate gastric emptying in patients with diabetic gastroparesis. The absence of efficacy may relate to an effect of hyperglycaemia.; A. Russo...

Timing and Mechanism of Sepsis-Induced Delayed Gastric Emptying in a Novel Mouse Model

Samis, Andrew James Willis
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
Português
Relevância na Pesquisa
68.945054%
Sepsis-induced delayed gastric emptying is a significant clinical problem for patients in intensive care units worldwide. A series of studies were carried out to examine the nature and mechanisms of sepsis-induced delayed gastric emptying using a novel mouse model which used a standard food source and was devoid of upper gastrointestinal tract trauma and restraint. Using this model, lipopolysaccharide (LPS) injection produced a dose-dependent decrease in gastric emptying which onset by one hour. LPS produced an alteration in mouse behavior and piloerection at 30 minutes, increased resting respiratory rate at 3 hours, and did not impact body temperature. The onset of sepsis-induced delayed gastric emptying was closer to those centrally-mediated clinical signs of sepsis (altered behavior and piloerection) than to the peripherally-mediated clinical signs (respiratory rate) suggesting a central mechanism. C-Fos activation of the area postrema (AP), the nucleus of the solitary tract (NTS), and the dorsal motor nucleus of the vagus (DMV) was examined 30 minutes after LPS injection which is the onset time for sepsis-induced delayed gastric emptying. LPS exposure produced significantly more activated neurons in the AP and NTS, and less in the DMV. These results may suggest a central mechanism with the AP and NTS inhibiting the DMV. Examination of isolated strips of gastric antrum in a tissue bath showed a decreased contractile response to electrical field stimulation and carbachol after injection of LPS. This occurred at 18 hours post LPS injection...