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Chagasic Megacolon

Jefferson Alvim de Oliveira, Michelle A R Freitas, Enio Chaves de Oliveira, Samir Jabari, Axel Brehmer, Alexandre Barcelos Morais da Silveira
Chagas disease is caused by Trypanosoma cruzi and remains one of the most neglected diseases in Latin America. One of its clinical forms is Chagas megacolon. Despite being known for more than half a century, detailed causes are still obscure. Recent evidence indicates a close relationship between the immune system and the enteric nervous system in the etiology of chagasic megacolon pathology. It is believed that low expression of the 5-HT3A serotonin receptor on lymphocytes could be linked to megacolon development...
February 12, 2019: Parasitology Research
Mayra Gonçalves Menegueti, Gilberto Gambero Gaspar, Ana Maria Laus, Anibal Basile-Filho, Fernando Bellissimo-Rodrigues, Maria Auxiliadora-Martins
BACKGROUND: The Leuconostoc mesenteroides are members of the Streptococcae family and currently has been recognized as potential pathogens. This case describes a bacteremia caused by L. mesenteroides in an immunocompetent patient affected by Chagas disease. CASE PRESENTATION: A 67-year-old female patient with chagasic megaesophagus and megacolon was submitted to a Heller myotomy for achalasia in 2000 and endoscopic dilatation in 2015. Patient was admitted to the Nutrology Ward in May 2016 with protein-calorie malnutrition associated with achalasia and receiving enteral nutrition...
November 3, 2018: BMC Infectious Diseases
Elsa Bey, Maria Brigitte Paucara Condori, Olivier Gaget, Philippe Solano, Susana Revollo, Christian Saussine, Simone Frédérique Brenière
PURPOSE: To describe and give an estimation of the prevalence of urinary disorders in chronic Chagas disease, since most clinical research has been centered on the description of the cardiac and digestive forms. METHODS: To explore this topic, a cross-sectional study was conducted in 137 Bolivian adults of both sexes suffering from symptomatic chronic Chagas disease. All patients presenting confirmed chagasic cardiomyopathy, megacolon or both underwent a urologic symptom questionnaire, uroflowmetry, urinary tract ultrasonography and a creatinine assay...
October 9, 2018: World Journal of Urology
Vinicius Kannen, Juliana Y Sakita, Zumira A Carneiro, Michael Bader, Natalia Alenina, Regina R Teixeira, Enio C de Oliveira, Mariângela O Brunaldi, Bianca Gasparotto, Daniela C Sartori, Cleverson R Fernandes, João S Silva, Marcus V Andrade, Wilson A Silva, Sergio A Uyemura, Sérgio B Garcia
BACKGROUND: Trypanosoma cruzi (T. cruzi) infects millions of Latin Americans each year and can induce chagasic megacolon. Little is known about how serotonin (5-HT) modulates this condition. Aim We investigated whether 5-HT synthesis alters T. cruzi infection in the colon. MATERIALS AND METHODS: Forty-eight paraffin-embedded samples from normal colon and chagasic megacolon were histopathologically analyzed (173/2009). Tryptophan hydroxylase 1 (Tph1) knockout (KO) mice and c-KitW-sh mice underwent T...
June 2018: Digestive Diseases and Sciences
Manuel Fresno, Núria Gironès
Chagas disease is a multisystemic disorder caused by the protozoan parasite Trypanosoma cruzi , which affects ~8 million people in Latin America, killing 7,000 people annually. Chagas disease is one of the main causes of death in the endemic area and the leading cause of infectious myocarditis in the world. T. cruzi infection induces two phases, acute and chronic, where the infection is initially asymptomatic and the majority of patients will remain clinically indeterminate for life. However, over a period of 10-30 years, ~30% of infected individuals will develop irreversible, potentially fatal cardiac syndromes (chronic chagasic cardiomyopathy [CCC]), and/or dilatation of the gastro-intestinal tract (megacolon or megaesophagus)...
2018: Frontiers in Microbiology
Patrícia Rocha Martins, Rodolfo Duarte Nascimento, Aline Tomaz Dos Santos, Enio Chaves de Oliveira, Patricia Massara Martinelli, Débora d'Avila Reis
Chagas disease is an infection caused by the parasite Trypanosoma cruzi that affects millions of people worldwide and is endemic in Latin America. Megacolon is the most frequent complication of the digestive chronic form and happens due to lesions of the enteric nervous system. The neuronal lesions seem to initiate in the acute phase and persist during the chronic phase, albeit the mechanisms involved in this process are still debated. Among the cells of the immune system possibly involved in this pathological process is the mast cell (MC) due to its well-known role in the bi-directional communication between the immune and nervous systems...
April 2018: Parasitology Research
Mauro Bafutto, Alejandro Ostermayer Luquetti, Salustiano Gabriel Neto, Felix Andre Sanches Penhavel, Enio Chaves Oliveira
BACKGROUND: Constipation is the main symptom of acquired chagasic megacolon. However, a number of patients with Chagas disease without colon involvement also have the same complain. This study evaluated the role of small bowel in constipated patients with Chagas disease with and without megacolon. METHODS: Orocecal transit time (OCTT) and oral glucose tolerance test (OGTT) in constipated non-chagasic and chagasic patients with and without megacolon were performed...
August 2017: Gastroenterology Research
Marcela Beghini, Márcia Fernandes de Araújo, Viviane Oliveira Severino, Renata Margarida Etchebehere, Denise Bertulucci Rocha Rodrigues, Sanívia Aparecida de Lima Pereira
OBJECTIVE AND DESIGN: The aim of the present study was to evaluate the immunohistochemical expression of Gal-1, Gal-3 and Gal-9 in the colon of chronic chagasic patients compared to biopsied non-chagasic patients. MATERIAL OR SUBJECTS: Thirty-two colon fragments were selected from chagasic patients with megacolon (n=25) and nonchagasic patients without megacolon (n=7). METHODS: Immunohistochemistry for Gal-1, Gal-3 and Gal-9 was performed using a common light microscope and the results were scored 0-3 according to labeling intensity...
September 2017: Pathology, Research and Practice
Camila França Campos, Silvia Dantas Cangussú, Ana Luiza Cassin Duz, Christiane Teixeira Cartelle, Maria de Lourdes Noviello, Vanja Maria Veloso, Maria Terezinha Bahia, Camila Megale Almeida-Leite, Rosa Maria Esteves Arantes
[This corrects the article DOI: 10.1371/journal.pone.0153038.].
2017: PloS One
Christian Koch, Alexandre B M da Silveira, Enio C de Oliveira, Karl Quint, Winfried Neuhuber, Axel Brehmer, Samir Jabari
Patients suffering from chagasic megacolon must have an intact mucosal barrier as they survive this chronic disease for decades. A key structure of the mucosal barrier are epithelial cells. Vasoactive-intestinal-peptide (VIP)-positive nerve fibres are involved in influencing, e.g., epithelial cell proliferation, mucus secretion (e.g., mucin 2 and trefoil factor 3 of goblet cells) and inflammation or autoimmunity, all putative and/or known factors altered in chagasic megacolon. We analyzed qualitatively and quantitatively goblet cells, their specific markers, such as mucin 2 (MUC2) and trefoil factor 3 (TFF3) and enterocytes, the relation of VIP-immunoreactive nerve fibres to the epithelia, the distribution of gelsolin, a protein involved in chronic inflammation processes in the epithelia, and the proliferation rate of epithelial cells by combined 4',6-diamidino-2-phenylindole (DAPI) and phosphohistone-H3 (PHH3) staining...
August 2017: Histochemistry and Cell Biology
M A R Freitas, N Segatto, N Tischler, E C de Oliveira, A Brehmer, A B M da Silveira
Chagas' disease is still reaching about 10 million people in the world. In South America, one of the most severe forms of this disease is the megacolon, characterized by severe constipation, dilated sigmoid colon and rectum and severe malnutrition. Previous data suggested that mast cells and serotonin (5-hydroxytryptamine [5-HT]) expression could be involved in intestinal homeostasis control, avoiding the chagasic megacolon development. The aim at this study was to characterize the presence of mast cells and expression of serotonin in chagasic patients with and without megacolon and evaluate the relation between mast cells, serotonin and megacolon development...
March 2017: Parasite Immunology
Carmen Lara Romero, Blanca Ferreiro Argüelles, Eduardo Romero Pérez
We present the case of a young bolivian woman who suffered two acute and impressive colonic complications due to a Chagasic megacolon.
December 2016: Revista Española de Enfermedades Digestivas
Camila França Campos, Silvia Dantas Cangussú, Ana Luiza Cassin Duz, Christiane Teixeira Cartelle, Maria de Lourdes Noviello, Vanja Maria Veloso, Maria Terezinha Bahia, Camila Megale Almeida-Leite, Rosa Maria Esteves Arantes
We developed a novel murine model of long-term infection with Trypanosoma cruzi with the aim to elucidate the pathogenesis of megacolon and the associated adaptive and neuromuscular intestinal disorders. Our intent was to produce a chronic stage of the disease since the early treatment should avoid 100% mortality of untreated animals at acute phase. Treatment allowed animals to be kept infected and alive in order to develop the chronic phase of infection with low parasitism as in human disease. A group of Swiss mice was infected with the Y strain of T...
2016: PloS One
Vinicius Kannen, Enio C de Oliveira, Bruno Zene Motta, Annuar Jose Chaguri, Mariângela Ottoboni Brunaldi, Sérgio B Garcia
BACKGROUND: Trypanosomiasis induces a remarkable myenteric neuronal degeneration leading to megacolon. Very little is known about the risk for colon cancer in chagasic megacolon patients. To clarify whether chagasic megacolon impacts on colon carcinogenesis, we investigated the risk for colon cancer in Trypanosoma cruzi (T. cruzi) infected patients and rats. METHODS: Colon samples from T. cruzi-infected and uninfected patients and rats were histopathologically investigated with colon cancer biomarkers...
April 2015: PLoS Neglected Tropical Diseases
Samir Jabari, Enio C de Oliveira, Axel Brehmer, Alexandre B M da Silveira
Megacolon, the irreversible dilation of a colonic segment, is a structural sign associated with various gastrointestinal disorders. In its hereditary, secondary form (e.g. in Hirschsprung's disease), dilation occurs in an originally healthy colonic segment due to an anally located, aganglionic zone. In contrast, in chronic Chagas' disease, the dilated segment itself displays pathohistological changes, and the earliest and most prominent being found was massive loss of myenteric neurons. This neuron loss was partial and selective, i...
September 2014: Histochemistry and Cell Biology
Samir Jabari, Alexandre B M da Silveira, Enio C de Oliveira, Karl Quint, André Wirries, Winfried Neuhuber, Axel Brehmer
Chagasic megacolon is accompanied by extensive myenteric and, simultaneously, moderate submucosal neuron loss. Here, we examined changes of the innervation pattern of the lamina propria (LP) and muscularis mucosae (MM). Two alternating sets of cryosections were taken from seven non-chagasic colonic and seven chagasic megacolonic specimens (the latter included both the dilated megacolonic and the non-dilated transitional oral and anal zones) and were immunohistochemically triple-stained for smooth-muscle actin (SMA), synaptophysin (SYN) and glial acid protein S100 and, alternatively, for SMA, vasoactive intestinal peptide (VIP) and somatostatin (SOM)...
October 2014: Cell and Tissue Research
Carmela Di Martino, Gabriella Nesi, Francesco Tonelli
BACKGROUND: Migration from Latin American countries has increased the number of cases of chagasic megacolon in Western countries. Megacolon is a late complication of Chagas disease, resulting from irreversible destruction of the intramural intestinal nervous system with extensive loss of neurons, ganglionitis, and myositis at the sites of the myenteric and submucosal plexuses. Several surgical procedures involving partial or total resection of the dilated colon have been proposed for treating chagasic megacolon, but intra-operative evaluation of neuronal degeneration in the residual colon has not been commonly done...
August 2014: Surgical Infections
Sergio E A Araujo, Alexandre B Bertoncini, Sergio C Nahas, Ivan Cecconello
The effectiveness of anterior resection for the surgical treatment of Chagasic megacolon and the advantages of laparoscopy for performing colorectal surgery are well known. However, current experience with laparoscopic surgery for Chagasic megacolon is restricted. Moreover, associated long-term results remain poorly analyzed. The aims of the present study were to ascertain the immediate results of laparoscopic anterior resection for the surgical treatment of Chagasic megacolon, to identify risk factors associated with adverse outcomes, and to settle late results...
June 2014: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Gesner Pereira Lopes, Márcia Maria Ferreira-Silva, Angel Anibal Ramos, Helio Moraes-Souza, Aluízio Prata, Dalmo Correia
INTRODUCTION: In this study, we investigated radiological changes in the sigmoid colon in chagasic patients by comparing their colon lengths and caliber with those of non-chagasic living in the same region and non-chagasic living at high altitudes. METHODS: A total of 317 individuals were evaluated using clinical, serological and radiological methods and divided into three groups: 1) one hundred and nine non-chagasic individuals from Uberaba, Brazil; 2) sixty-one non-chagasic from Puno, Peru; 3) one hundred forty-seven chagasics examined in Uberaba, being 62 without megacolon (3A), 72 with megacolon (3B) and 13 with doubtful diagnosis of megacolon (3C)...
November 2013: Revista da Sociedade Brasileira de Medicina Tropical
Nívia Carolina Nogueira-Paiva, Kátia da Silva Fonseca, Paula Melo de Abreu Vieira, Lívia Figueiredo Diniz, Ivo Santana Caldas, Sandra Aparecida Lima de Moura, Vanja Maria Veloso, Paulo Marcos da Matta Guedes, Washington Luiz Tafuri, Maria Terezinha Bahia, Cláudia Martins Carneiro
Chagasic megaoesophagus and megacolon are characterised by motor abnormalities related to enteric nervous system lesions and their development seems to be related to geographic distribution of distinct Trypanosoma cruzi subpopulations. Beagle dogs were infected with Y or Berenice-78 (Be-78) T. cruzi strains and necropsied during the acute or chronic phase of experimental disease for post mortem histopathological evaluation of the oesophagus and colon. Both strains infected the oesophagus and colon and caused an inflammatory response during the acute phase...
February 2014: Memórias do Instituto Oswaldo Cruz
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