scholarly journals Diversion Colitis and Probiotic Stimulation: Effects of Bowel Stimulation Prior to Ileostomy Closure

2021 ◽  
Vol 8 ◽  
Author(s):  
Ángela Rodríguez-Padilla ◽  
Germán Morales-Martín ◽  
Rocío Pérez-Quintero ◽  
Ricardo Rada-Morgades ◽  
Juan Gómez-Salgado ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Reconstructive Surgery ◽  
Controlled Study ◽  
Short Term ◽  
Double Blind ◽  
Diversion Colitis ◽  
Colonic Flora ◽  
Protective Ileostomy ◽  
Index Of Severity ◽  
Stimulation Of

Background: Diversion colitis is a non-specific inflammation of a defunctionalised segment of the colon after a temporary stoma has been performed. This inflammation is associated with a change in the colonic flora.Aim: To evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to closure of the protective ileostomy in patients operated on colorectal carcinoma and its effect on diversion colitis. A prospective, randomised, double-blind, controlled study is carried out.Methods: Patients who underwent surgery for colorectal carcinoma with protective ileostomy pending reconstructive surgery and with diversion colitis as diagnosis are included. Randomised and divided into two groups. Histological and endoscopic changes were evaluated after stimulation, after restorative surgery and during the short-term follow-up after surgery.Results: Patients in CG were distributed according to the endoscopic index of severity in pre-stimulation/post-stimulation as follows: severe n = 9/9 (25.7%), moderate n = 23/23 (65.7%), and mild n = 3/3 (8.6%); compared to the distribution in SG, severe n = 9/0 (26.5/0%), moderate n = 23/3 (67.6/8.8%), mild n = 2/19 (5.9/55.9%) and normal colonoscopy in 0/12 patients (0/35.3%).Conclusion: Probiotic stimulation of the efferent loop is a safe and effective method, managing to reduce both macroscopic and microscopic colitis, as well as a decrease in symptoms in the short term after reconstructive surgery.

scholarly journals Diversion Colitis: Macro and Microscopic Findings after Probiotics Stimulation

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 303
Author(s):  
Ángela Rodríguez-Padilla ◽  
Germán Morales-Martín ◽  
Rocío Pérez-Quintero ◽  
Juan Gómez-Salgado ◽  
Ricardo Rada-Morgades ◽  
...  
Keyword(s):  
Loop Ileostomy ◽  
Controlled Study ◽  
Control Group ◽  
Short Term ◽  
Double Blind ◽  
Diversion Colitis ◽  
Follicular Hyperplasia ◽  
Protective Ileostomy ◽  
And Function ◽  
Stimulation Of

The use of a loop ileostomy as the defunctioning procedure of choice to protect a distal colonic anastomosis causes histological and endoscopic changes in the intestinal mucosal architecture, which have been related to chronic inflammation and changes in the microflora that consequently impact the intestinal structure and function following fecal stream diversion. The aim of this study was to evaluate the histological and endoscopic changes on the colonic mucosa in patients with diversion colitis after stimulation of the efferent loop with probiotics prior to closure of the protective ileostomy. A prospective, randomized, double-blind, controlled study was designed. All patients who underwent surgery for colorectal carcinoma with protective ileostomy between January 2017 and December 2018 were included. These patients were pending reconstructive surgery and were diagnosed with endoscopic and histological diversion colitis. Divided into two groups, a group stimulated with probiotics (SG) and a control group (CG). 34 cases and 35 controls were included in the study. Histological and endoscopic changes were evaluated after stimulation, after restorative surgery and during the short-term follow-up after surgery. A decrease in endoscopic pathological findings (mucosal friability, mucous erosions, polyps, edema, erythema and stenosis) and in histological findings (follicular hyperplasia, eosinophils, cryptic abscesses, lymphocyte infiltration, plasma cell infiltration and architecture distortion) was observed in SG. These results were statistically significant with a p < 0.001. The stimulation of the efferent loop of the ileostomy in patients with diversion colitis produced a decrease of the endoscopic and histological severity of colitis in the short term.

scholarly journals Postoperative Ileus after Stimulation with Probiotics before Ileostomy Closure

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 626
Author(s):  
Ángela Rodríguez-Padilla ◽  
Germán Morales-Martín ◽  
Rocío Pérez-Quintero ◽  
Juan Gómez-Salgado ◽  
Rafael Balongo-García ◽  
...  
Keyword(s):  
Colorectal Carcinoma ◽  
Postoperative Ileus ◽  
Loop Ileostomy ◽  
Bowel Function ◽  
Ileostomy Closure ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Colorectal Cancer Surgery ◽  
Stimulation Of

Loop ileostomy closure after colorectal surgery is often associated with Postoperative ileus, with an incidence between 13–20%. The aim of this study is to evaluate the efficacy and safety of preoperative stimulation of the efferent loop with probiotics prior to ileostomy closure in patients operated on for colorectal carcinoma. For this, a prospective, randomized, double-blind, controlled study is designed. All patients who underwent surgery for colorectal carcinoma with loop ileostomy were included. Randomized and divided into two groups, 34 cases and 35 controls were included in the study. Postoperative ileus, the need for nasogastric tube insertion, the time required to begin tolerating a diet, restoration of bowel function, and duration of hospital stay were evaluated. The incidence of Postoperative ileus was similar in both groups, 9/34 patients stimulated with probiotics and 10/35 in the control group (CG) with a p = 0.192. The comparative analysis showed a direct relationship between Postoperative ileus after oncological surgery and Postoperative ileus after reconstruction surgery, independently of stimulation. Postoperative ileus after closure ileostomy is independent of stimulation of the ileostomy with probiotics through the efferent loop. There seem to be a relationship between Postoperative ileus after reconstruction and the previous existence of Postoperative ileus after colorectal cancer surgery.

scholarly journals Serological Biomarkers and Diversion Colitis: Changes after Stimulation with Probiotics

Biomolecules ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 684
Author(s):  
Ángela Rodríguez-Padilla ◽  
Germán Morales-Martín ◽  
Rocío Pérez-Quintero ◽  
Juan Gómez-Salgado ◽  
Carlos Ruiz-Frutos
Keyword(s):  
Reconstructive Surgery ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Inflammatory Biomarkers ◽  
Controlled Study ◽  
Control Group ◽  
Diversion Colitis ◽  
Lymphocyte Ratio ◽  
Protective Ileostomy

Diversion colitis is a non-specific inflammation of a defunctionalised segment of the colon after a temporary stoma has been performed. This inflammation is associated with an alteration of certain inflammatory serum markers. The aims of this study were, firstly, to evaluate the modification of inflammatory biomarkers after stimulation with probiotics prior to closure of the protective ileostomy. Secondly, to identify if a relationship could be established between the severity of diversion colitis and the alteration of inflammatory biomarkers in the blood. A prospective, randomized, double-blind, controlled study was conducted. Patients who underwent surgery for colorectal carcinoma with protective ileostomy between January 2017 and December 2018 were included, pending reconstructive surgery and with diversion colitis as diagnosis. The sample was randomly divided into a group stimulated with probiotics (SG) (n = 34) and a control group (CG) (n = 35). Histological and endoscopic changes were evaluated after stimulation, after restorative surgery and during the short-term follow-up after surgery, including the correlation with pro-inflammatory biomarkers in blood. As main findings, a significant decrease in C-reactive protein (CRP), Neutrophil/lymphocyte ratio (NLR ratio), and monocyte/lymphocyte ratio (LMR ratio) was observed in the SG versus the CG with a p < 0.001. A significant increase in transferrin values and in the platelet/lymphocyte ratio (PLR) was observed in the SG versus CG after stimulation with probiotics with a p < 0.001. A normalisation of CRP and transferrin levels was observed in the third month of follow-up after closure ileostomy, and NLR, LMR and PLR ratios were equal in both groups. Decreased modified Glasgow prognostic score was found in SG compared to CG after probiotic stimulation (p < 0.001). The endoscopic and histological severity of diversion colitis is associated with a greater alteration of blood inflammatory biomarkers. The stimulation with probiotics prior to reconstructive surgery promotes an early normalization of these parameters.

Analysis of acute naproxen administration on memory in young adults: A randomized, double-blind, placebo-controlled study

2017 ◽  
Vol 31 (10) ◽  
pp. 1374-1376
Author(s):  
Jack H Wilson ◽  
Amy H Criss ◽  
Sean A Spangler ◽  
Katherine Walukevich ◽  
Sandra Hewett
Keyword(s):  
Young Adults ◽  
Healthy Adult ◽  
Adult Population ◽  
Critical Role ◽  
Random Order ◽  
Controlled Study ◽  
High Dose ◽  
Short Term ◽  
Double Blind ◽  
Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs work by non-selectively inhibiting cyclooxygenase enzymes. Evidence indicates that metabolites of the cyclooxygenase pathway play a critical role in the process of learning and memory. We evaluated whether acute naproxen treatment impairs short-term working memory, episodic memory, or semantic memory in a young, healthy adult population. Participants received a single dose of placebo or naproxen (750 mg) in random order separated by 7–10 days. Two hours following administration, participants completed five memory tasks. The administration of acute high-dose naproxen had no effect on memory in healthy young adults.

scholarly journals Acupuncture and Postoperative Vomiting in Day-Stay Paediatric Patients

1996 ◽  
Vol 24 (6) ◽  
pp. 674-677 ◽  
Author(s):  
K. L. Schwager ◽  
D. B. Baines ◽  
R. J. Meyer
Keyword(s):  
Adult Population ◽  
Acupuncture Point ◽  
Controlled Study ◽  
Control Group ◽  
Postoperative Vomiting ◽  
Double Blind ◽  
Paediatric Patients ◽  
Transcutaneous Stimulation ◽  
Significant Difference ◽  
Stimulation Of

The stimulation of the acupuncture point P6 has been used to prevent nausea and vomiting in the adult population. It has, however, been subject to limited comparative evaluation in children. We proposed that stimulation of P6 and the analgesic point Li4 would reduce the incidence of postoperative vomiting. Eighty-four unpremedicated paediatric patients having day-stay surgery (circumcision or herniotomy/orchidopexy) were included in a randomized, double-blind, placebo-controlled study of transcutaneous stimulation of P6 and Li4 or no stimulation. The incidence of vomiting was recorded for 24 hours postoperatively. There was no statistically significant difference in total postoperative vomiting in those patients who were stimulated, compared with the control group (P=0.909), or between any group for postoperative vomiting in the recovery ward, day-stay ward or at home. For all groups, vomiting was more common within the first four hours and more likely to occur in the day-stay ward.

scholarly journals Rituximab vs placebo induction prior to glatiramer acetate monotherapy in multiple sclerosis

Neurology ◽  
2019 ◽  
Vol 92 (7) ◽  
pp. e723-e732 ◽  
Author(s):  
Justin M. Honce ◽  
Kavita V. Nair ◽  
Stefan Sillau ◽  
Brooke Valdez ◽  
Augusto Miravalle ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Glatiramer Acetate ◽  
Controlled Study ◽  
Short Term ◽  
Double Blind ◽  
T2 Lesions ◽  
Time To Treatment Failure ◽  
Sustained Change ◽  
Baseline Characteristics ◽  
Relapsing Multiple Sclerosis

ObjectiveTo examine whether rituximab induction followed by glatiramer acetate (GA) monotherapy is more effective than GA alone for the treatment of relapsing multiple sclerosis with active disease.MethodsThis was a single-center, double-blind, placebo-controlled study. Fifty-five participants were randomly assigned (1:1 ratio) to either rituximab (R-GA) or placebo (P-GA) induction, followed by GA therapy initiated in all participants. Participants were followed up to 3 years. The primary endpoint was the number of participants with no evidence of disease activity (NEDA): those without relapse, new MRI lesions, and sustained change in disability.ResultsTwenty-eight and 27 participants received rituximab and placebo induction, respectively, with one participant in each arm withdrawing before 6-month MRI. There were no significant differences in baseline characteristics. At end of study, 44.44% of R-GA participants demonstrated NEDA vs 19.23% of P-GA participants (p = 0.049). Treatment failed for a smaller proportion of R-GA participants (37.04% R-GA vs 69.23% P-GA, p = 0.019), and time to treatment failure was longer (23.32 months R-GA vs 11.29 months P-GA, p = 0.027). Fewer participants in the R-GA arm had new lesions (25.93% R-GA vs 61.54% P-GA, p = 0.009), and there were fewer new T2 lesions (0.48 R-GA vs 1.96 P-GA, p = 0.027). Probability of demonstrating NEDA in the R-GA arm returned to baseline within the study period. There were no differences in adverse events.ConclusionsInduction therapy with rituximab followed by GA may provide superior efficacy in the short term than GA alone in relapsing multiple sclerosis, but this benefit appears to wane within the study period. Larger studies are needed to assess sustainability of results.ClinicalTrials.gov identifierNCT01569451.

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