Helicoidal enteromyotomy in rats: An experimental model of intestinal lengthening

Short bowel syndrome (SBS) is a congenital or acquired condition of poor absorption resulting from a reduced surface of the enteric mucosa. in most cases, it spontaneously resolves via an adaptive process in the remaining intestine. Intestinal lengthening is one therapeutic method used for refractory SBS. the present study evaluates the intestinal changes and weight gains following a new lengthening technique (helicoidal enteromyotomy) performed in growing rats. Thirty Wistar rats underwent enteromyotomy (group I) in a 5-cm jejunal segment or laparotomy only (group II). No animal underwent intestinal resection. Postoperatively monitored weight was animals were sacrificed on the day 28. Measurements were made of the anterior and middle half-perimeters and the length of the marked-out intestinal segment. Two animals in group I were excluded due to infraction of the technique (perforation of the mucosa). Group I had an initial weight loss, although variance analysis (ANOVA) showed that the speed of the weight gain was similar in the two groups after the postoperative day 4 (P = .245). When the half-perimeter dimensions and length of the manipulated intestinal segment were compared, group I showed an increased caliber and length (P < .001, for both comparisons). There was no baseline difference in caliber between the two groups (P = .127). Our results led us to conclude that helicoidal enteromyotomy increases intestinal length and caliber without causing upstream dilatation or interfering in weight gain.Escola Paulista Med, Dept Surg, São Paulo, BrazilEscola Paulista Med, Dept Surg, São Paulo, BrazilWeb of Scienc

Different Intervals of Ischemic Preconditioning on Small Bowel Ischemia-Reperfusion Injury in Rats

Purpose. the purpose of this study was to establish morphologically the best time of vascular occlusion to induce ischemic preconditioning (IPC) for rat small bowel undergoing ischemia and reperfusion injury.Methods. After approval by the Ethics Committee, 36 EPM-1 young adult Wistar rats from 300-350 g were distributed into 6 groups: sham (S); ischemia and reperfusion (IR), with 50 minutes of cranial mesenteric artery occlusion and 30 minutes of reperfusion; IPC with 1 cycle of 2 minutes (IPC-2), 5 minutes (IPC-5), 10 minutes (IPC-10), or 15 minutes (IPC-15), followed by sustained IR. the animals anesthetized with ketamine (60 mg/kg) and xylazine (10 mg/kg) intramuscular (IM), were maintained on mattress heat, hydrated with saline (80 mL/kg), and injected with 100 IU heparin. Samples of jejunum were stained with hematoxylin and eosin (HE) and classified according to Park et al. Statistical analysis of results was performed using Kruskal-Wallis tests (P <.05).Results. the histological evaluation showed no difference between IR and IPC15 rats (5.2 and 5, respectively; P =.84). Greater jejunal injury was observed with IPC15 (5) compared with other groups (IPC2 = 3, P =.03; IPC5 = 3.2, P =.05; IPC10 = 2.8, P = .02, respectively). There was no difference between groups IPC2 X IPC5 X IPCIO.Conclusion. Morphologically, IPC with short times promoted greater intestinal protection against the IR lesion in rats.Univ Fed Rio Grande do Norte, Dept Surg, BR-59072970 Natal, RN, BrazilUniversidade Federal de São Paulo, Surg & Res Postgraduating Program, Div Pediat Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Surg & Res Postgraduating Program, Div Pediat Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilWeb of Scienc

Unusual case of epigastric heteropagus twinning

Asymmetrical conjoined twins or heteropagus twins are extremely rare. They are characterized by an incomplete component (parasite) that is normally smaller and dependent on the host (autosite). in cases of an epigastric heteropagus twin, the insertion occurs in the epigastrium. There are few reports of epigastric heteropagus twinning in the English-language literature. ne authors report an extremely rare case of epigastric heteropagus twinning in which the parasite presented with head, thorax, and a rudimentary heart. (c) 2005 Elsevier Inc. All rights reserved.Universidade Federal de São Paulo, Div Pediat Surg, Pediat Surg Sect, BR-04025000 São Paulo, BrazilUniversidade Federal de São Paulo, Sect Fetal Med, BR-04025000 São Paulo, BrazilUniversidade Federal de São Paulo, Div Pediat Surg, Pediat Surg Sect, BR-04025000 São Paulo, BrazilUniversidade Federal de São Paulo, Sect Fetal Med, BR-04025000 São Paulo, BrazilWeb of Scienc

Early Empiric Antibiotic Use Is Associated With Delayed Feeding Tolerance in Preterm Infants: A Retrospective Analysis

The causative factors of neonatal feeding intolerance are poorly understood, but potentially related to clinical practices such as empiric antibiotic usage. The objective of this study was to evaluate whether early empiric antibiotic exposure negatively affects preterm infants' enteral feeding tolerance. Data from infants without risk factors for sepsis, 500 to 1499 g birth weight and 24 to 34 weeks gestational age were analyzed. The primary outcomes were the empiric antibiotic exposure effects on the infants' total parenteral nutrition usage duration and prevalence of necrotizing enterocolitis (NEC). Among the 901 infants included, 67 were exposed to early empiric antibiotic. A 50% increase in parenteral nutrition usage duration and a 4-fold greater prevalence of NEC was seen in the early empiric antibiotic-exposed neonates, when compared with control infants (P<0.01). Early empiric antibiotic exposure appears to negatively influence preterm infant feeding tolerance and possibly contributes to NEC.Brazilian Ministry of HealthUniv Sao Paulo, Fac Med Ribeirao Preto, Sao Paulo, BrazilUniv Sao Paulo, Fac Med Sau Paulo, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilInst Med Integral Prof Fernando Figueira IMIP, Recife, PE, BrazilUniv Fed Maranhao, Hosp Univ, Sao Luis, BrazilUniv Estadual Campinas, Fac Ciencias Med, Sao Paulo, BrazilUNESP, Fac Med Botucatu, Botucatu, SP, BrazilFiocruz MS, Inst Fernandes Figueira, Rio De Janeiro, BrazilPUC Porto Alegre, Fac Med, Porto Alegre, RS, BrazilUniv Fed Rio Grande do Sul, Porto Alegre, RS, BrazilUniv Estado Rio De Janeiro, Rio De Janeiro, BrazilUniv Fed Minas Gerais, Belo Horizonte, MG, BrazilUniv Fed Uberlandia, Uberlandia, MG, BrazilFac Ciencias Med Minas Gerais, Belo Horizonte, MG, BrazilUniv Sao Paulo, Hosp Univ, Sao Paulo, BrazilHosp Estadual Sumare, Sumare, BrazilHosp Geral Pirajussara, Taboao De Serra, BrazilHosp Estadual Diadema, Diadema, BrazilUniv Estadual Londrina, Londrina, BrazilUniv Fed Parana, Curitiba, Parana, BrazilUniv Toronto, Toronto, ON, CanadaUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilBrazilian Ministry of HealthWeb of Scienc