To determine the effects of mild physical activity on intestinal gas transit and clearance.
In 8 healthy adults, a gas mixture was infused continuously into the jejunum (12 mL/min) for 120 minutes ...with simultaneous duodenal lipid perfusion (1 kcal/min). Gas evacuation, perception of abdominal sensations (on a scale of 0 none to 6 pain), and abdominal girth were measured at 15-minute intervals during rest and intermittent pedalling, with subjects in a supine position.
Mean (± SD) intestinal gas retention was lower during exercise than at rest (−84 ± 303 mL vs. 143 ± 219 mL,
P <0.05). Gas retention during rest was associated with significant abdominal distension (8 ± 6 mm,
P <0.01 vs. basal), which was decreased with exercise (3 ± 7 mm,
P <0.05 vs. rest). The gas challenge test was well tolerated both during exercise and rest (perception score: 0.6 ± 0.5 vs. 0.9 ± 0.4,
P = 0.25).
In healthy subjects, gut transit of intraluminal gas is enhanced by mild physical activity.
Osteopathy may decrease the severity of irritable bowel syndrome (IBS). About 35% of patients with quiescent Crohn's disease (CD) continue to suffer from IBS-like symptoms with impaired quality of ...life (Qol). We aimed to evaluate the effect of osteopathy on the severity of IBS-like symptoms in quiescent CD patients.
We prospectively included 38 patients with CD on remission over 12 months while receiving infliximab every 8 weeks. Patients were randomized 2/ 1 to receive three sessions of standardized osteopathy (n=25) at 15, 30, and 45 days after the last infusion of infliximab or simple follow-up. The severity of IBS-like symptoms, psychological factors, and its impact on Qol were assessed using questionnaires.
Compared with baseline, the severity of IBS-like symptoms was significantly reduced in patients receiving osteopathy. The decrease was significantly more pronounced in patients receiving osteopathy at day 30 -38.4 (-76.1 to 10.2) vs. 32.2 (-16.6 to 41.6), P=0.01, day 45 -36.7 (-74.4 to 25.3) vs. 32.2 (-16.6 to 41.6), P=0.04, and day 60 -39.5 (-60.9 to -9.2) vs. 6.1 (-38.7 to 28.5), P=0.05 with a concomitant increase in Qol (P=0.09 at day 30, P=0.02 at day 45, P=0.3 at day 60). Compared with baseline, the severity of fatigue was significantly reduced in patients receiving osteopathy, whereas depression and anxiety remained unchanged.
Three sessions of osteopathy reduced the severity of IBS-like symptoms associated with CD in remission. Osteopathy should be viewed as a helpful therapeutic option to reduce the severity of abdominal pain and discomfort in patients with CD but in remission with IBS-like symptoms.
Le rôle des réactions immuno-allergiques aux aliments au cours du syndrome de l’intestin irritable (SII) reste controversé, en raison d’une symptomatologie peu spécifique et des méthodes ...diagnostiques limitées par l’accessibilité difficile du tube intestinal. Dans la pratique clinique, les manifestations au niveau du tractus gastro-intestinal des allergies alimentaires sont difficiles à évaluer et à les différencier des plaintes à expression gastro-intestinale d’autre origine. Les hypothèses physiopathologiques concernant l’hypersensibilité allergique aux aliments reposent sur des mécanismes immunologiques immédiats (IgE et non IgE) et retardés, incluant les mastocytes et les éosinophiles. Les concepts physiopathologiques récents dans le SII suggèrent l’existence d’altérations de l’intégrité de la barrière épithéliale intestinale qui favoriseraient une présentation accrue d’antigènes luminaux, le développement et le maintien d’une activation définie de « bas grade » de l’immunité muqueuse et du système nerveux entérique, potentiellement à l’origine des troubles de la motricité/sensibilité et des douleurs digestives. Les tests diagnostiques utilisés en pratique clinique pour objectiver les réactions aux aliments rapportées par les patients (tests cutanés et IgE spécifiques sériques) sont souvent négatifs, comme le test de provocation par voie orale. Des manifestations d’atopie (rhinite, dermatite, asthme) semblent être le terrain favorisant le SII, au moins dans le sous-groupe de patients qui rapportent des symptômes cliniques après l’ingestion de certains aliments.
The role of immuno-allergic reactions to food in patients with irritable bowel syndrome (IBS) remains controversial because of non-specific symptoms and of diagnostic methods limited by difficult accessibility to the gut. In clinical practice, the manifestations of food hypersensitivity in the gastro-intestinal tract are difficult to assess and to differentiate from digestive symptoms due to other causes. Pathophysiological hypotheses based on immunological mechanisms of immediate hypersensitivity (IgE and non IgE) and of delayed hypersensitivity, including mast cells and eosinophils, have been proposed. Recent pathophysiological concepts concerning IBS suggest the existence of alterations in the integrity of the intestinal epithelial barrier that would promote increased presentation of luminal antigens, with the development and maintenance of “low grade” mucosal inflammation with involvement of the enteric nervous system, potentially being the origin of these sensitive motility disorders and the abdominal pain. The diagnostic tests used in clinical practice (skin tests and specific IgE serum) to identify the source of self-perceived reactions to food reported by patients are often negative, as are oral provocation tests. Classic manifestations of atopy (rhinitis, dermatitis, asthma) seem to be the background favoring IBS, at least in the subgroup of patients reporting clinical symptoms after ingestion of certain foods.
Objectives Fatigue is an important determinant of altered quality of life in patients affected by chronic hepatitis C (CHC) or the irritable bowel syndrome (IBS). In this study, we aimed at ...determining the contributory role of plasma levels of leptin and carnitine on fatigue in CHC and IBS. Methods We enrolled 70 patients with CHC, 42 with IBS and 44 healthy subjects. Fatigue was evaluated using the Fatigue Impact Scale questionnaire. Body composition was assessed through impedance analysis. Plasma carnitine and leptin were measured. Results Fatigue scores were significantly more elevated in patients with CHC and IBS than in healthy subjects. Patients with CHC, but not with IBS, had significant lower plasma levels of total and free carnitine adjusted for fat mass compared to healthy subjects. In patients with CHC, and not with IBS, fatigue scores were negatively correlated with plasma levels of carnitine. Levels of free carnitine were significantly and independently associated with the severity of fatigue in patients with CHC (OR=2.019, p=0.02, CI 95% 1.01-1.23).Conclusions In patients with CHC, the severity of fatigue is associated with low level of carnitine, suggesting that an oral supplementation may be effective to relieve fatigue in CHC. The underlying mechanism of fatigue in IBS does not seem to involve carnitine.
Bdckground The toxicity of styrene on the peripheral nervous system is still debated. Cases The paper presents two cases of peripheral sensorimotor neuropathy in styrene-exposed workers. Exposure, ...evaluated by biological monitoring, ranged between 100 and 150% of the current limits proposed by the American Conference of Governmental Industrial Hygienists (ACGIH). The subjects complained of leg weakness and numbness, cramps, and paresthesia. Electrophysiology revealed a moderate peripheral sensorimotor neuropathy of a demyelinating type. Color-vision testing showed a subclinical deficit. Common inherited and acquired causes of peripheral neuropathy and dyschromatopsia other than styrene were ruled out by personal history, medical examination, laboratory data, and chest X-ray. Conclusions The results suggest that long-term occupational exposure to environmental levels of styrene that are equal, or slightly above, the ACGIH limits can induce a clinical form of peripheral neuropathy and a subclinical impairment of color vision. As a consequence, a careful reappraisal of the real preventive meaning of the current ACGIH occupational limit for styrene, at least on an individual basis, is needed.
In multiple avulsions of the brachial plexus, the search for extraplexal donor nerves in the hope of achieving motor neurotization is a major goal. We explored the possibility of using the ...hypoglossal nerve as a transfer point to reanimate muscles in the upper limb.
The hypoglossal nerve was used as a donor nerve for neurotization in seven patients with avulsive injuries of the brachial plexus. The surgical technique--an end-to-side microsuture using approximately half of the nerve fascicles--is basically the same as that used in the hypoglossal nerve-facial nerve jump graft, which is a well-known technique in facial nerve reanimation. The recipient nerves were the suprascapular (two patients), the musculocutaneous (one patient), the posterior division of the upper trunk (two patients), and the medial contribution to the median nerve (two patients).
In spite of a connection documented by electromyography and selective activation in three of seven patients, the functional results in our patients were extremely disappointing: no patient had an outcome better than M1 in the reinnervated muscles.
This technique was of no help to the patients and thus has been abandoned at our institution.
Phenytoin (DPH) disposition was studied in normal subjects before and after treatment with folic acid for 14 days. Our results suggest that folic acid lowers (DPH) serum levels without significantly ...modifying its bound fraction and increases the rate of DPH and meta-hydroxydiphenylhydantoin excretion in urine.
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