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J J Cerda

Publications and source records attributed to J J Cerda.

101 records · Page 6Linked to original sources
PubMedDate not supplied

Rectal perflubron: new application in MRI of perirectal fistulae.

PURPOSE: Our goal was to determine the efficacy of MRI with rectal administration of perflubron in the evaluation of perirectal and pelvic fistulae, with an emphasis on development of an improved method for fistula visualization. METHOD: Fourteen pelvic and/or perirectal fistulae were evaluated in nine patients with MRI after the rectal administration of 200 ml of perflubron. Images were reviewed by two independent readers and evaluated for the presence or absence of fistulae. Qualitative assessment was also performed, rating the examinations for the ability to visualize the fistulae. Comparison was made with the clinical examination and/or operative findings, as well as available preperflubron imaging studies (CT = 10; fluoroscopy = 1; preperflubron MRI = 4). RESULTS: MRI with rectal perflubron demonstrated all 14 fistulae (100%), while preperflubron imaging demonstrated only 7 of 14 (50%) fistulae (p < or = 0.008, Wilcoxon signed rank test). In addition, MRI with perflubron resulted in significantly improved qualitative visualization of fistulae (overall very good rating versus poor rating for preperflubron imaging, p < or = 0.006, Wilcoxon signed rank test). CONCLUSION: MRI with rectal perflubron is a superior modality for imaging of fistulae, compared with conventional methods, since it allows a noninvasive means of demonstrating the presence of a fistula as well as offers improved qualitative assessment of fistulous disease.

Administration, Rectal↗
PubMedDate not supplied

Dietary fiber: fact and fiction.

There have been many conflicting reports about the benefits of dietary fiber. Dietary fiber has been touted to provide remarkable benefits: from the control of functional bowel disease to the prevention of cancer. We have reviewed all prominent studies on the benefits of dietary fiber and examined the nature of their conflicting results. Recommendations for dietary fiber intake are also discussed.

Colonic Diseases↗
PubMedDate not supplied

Total parenteral nutrition in the mouse: development of a technique.

A method for total parenteral nutrition in the mouse was developed using commercially available supplies and equipment. The mouse's inferior vena cava was catheterized and the catheter was exteriorized from the tail. Mice (average body weight 22.5 g) were not tethered but instead were partially restrained by immobilizing the tail to protect the infusion tubing. A solution was formulated to contain 40% dextrose and 4.3% amino acids plus vitamins, electrolytes, and trace elements. It was administered via pump in graded fashion for the first 3 days to allow the mice to adapt, and then at a rate of 8 ml/day thereafter. This volume provided approximately 12 kcal and 54 mg nitrogen per day and was calculated to meet the needs of the mouse fed per os according to guidelines of the National Research Council. During the adaptation period mice lost weight but they were in positive N balance thereafter. At the end of 12 days body weight was not different than at the start, indicating the adequacy of nutrient input. Further, there were no differences in nitrogen balance or body weight in total parenteral nutrition fed mice in comparison with tail-restrained mice given the same solution per os. All mice appeared to tolerate the partial restraint without incidence and showed no untoward side effects. The rationale and validity of this technique is discussed in detail.

Animals↗
PubMedDate not supplied

Total parenteral nutrition in the mouse: body composition and plasma chemistries.

Mice that were maintained in energy and nitrogen (N) balance by total parenteral nutrition (TPN) for 12 days were analyzed for changes in organ weight, carcass and liver N and fat, and plasma glucose, urea N, and total protein. The results are compared with two other groups: (1) PO, which consisted of mice that were given the TPN solution per os in amounts equivalent to the TPN group, and (2) AL, which consisted of mice allowed to consume a stock diet ad libitum. In comparison with group AL, the TPN-fed mice had normal liver, kidney, and lung weights but heavier spleens and hearts. Group PO had an increase in liver weight only. Hepatic lipid content declined in group TPN but increased markedly in PO-fed mice. The latter group also demonstrated a 35% increase in carcass fat whereas it was unchanged in the TPN group. No differences were found in plasma urea N and total protein among the groups but plasma glucose increased 2-fold in group PO. It appears that our technique of parenteral feeding in mice maintains fairly normal body composition and plasma chemistries. However, mice drinking the TPN solution (group PO) exhibited the greatest number of alterations. These results are discussed in relation to differences in route of feeding, diet composition, feeding pattern, and the possible influence of circadian rhythms. The dilemma of choosing appropriate control groups in TPN studies is also discussed.

Animals↗
PubMedDate not supplied

Cost containment using cysteine HCl acidification to increase calcium/phosphate solubility in hyperalimentation solutions.

The purpose of this study was to determine if (1) the calcium/phosphate insoluble product was inversely related to pH [when cysteine HC1 (CH) was added as neonatal supplementation at 0.5 mM/kg/day to hyperalimentation (HAL) solutions] and (2) the potential cost savings to the hospital. The pH of the HAL solutions was adjusted by adding various amounts of CH to the HAL solution. HAL solutions containing 27 mEq of calcium/liter and 30 mEq (15 mM) of phosphate/liter were compounded. Ten-milliliter aliquots were analyzed at 0, 12, 24, and 48 hr. All samples (n = 56) were filtered (0.22 mu), viewed with 7-10,000 X magnification scanning electron microscopy, and qualitatively analyzed with a Philips Energy Dispersive X-Ray Analysis System equipped with a SW9100 Microprocessor. Calcium/phosphate insoluble product was present in the 0-, 12-, 24-, and 48-hr samples from the CH-free solutions. The solutions containing 759 mg (4.17 mM)/liter of CH however, remained free of precipitant. This investigation demonstrated that addition of CH to HAL can foster significant cost containment (projected $82,000/yr tangible hospital savings) by the elimination of current calcium/phosphate separation procedures for neonates on parenteral nutrition.

Calcium↗
PubMedDate not supplied

Unstirred water layers in rabbit intestine: effects of guar gum.

Guar gum has been shown to affect the absorption of several different nutrients in clinical studies; however, the mechanisms for decreased absorption have not been defined. A possibility not studied with regard to guar gum, but previously demonstrated to be important in absorption, is the effect of change in the unstirred water layer. As the unstirred water layer increases in thickness, the rate of absorption decreases for certain nutrients. The effect of guar gum on the unstirred water layer in the lumen of rabbit jejunum was examined by previously described techniques. It was observed that: increases in guar gum concentration resulted in an increased thickness of the unstirred water layer; for any stir rate, the addition of guar gum increased the thickness of the unstirred water layer; and stir rate is inversely related to the thickness of the unstirred water layer. It was concluded from these results that guar gum increases the thickness of the unstirred water layer in rabbit jejunum. This mechanism may explain, in part, the reduction of the rate of absorption of certain nutrients seen following guar gum ingestion.

Animals↗
PubMedDate not supplied

Metoclopramide: an analysis of inappropriate long-term use in the elderly.

OBJECTIVE: To present a case of possible metoclopramide-induced tardive dyskinesia and document the frequent use of metoclopramide for inappropriate lengths of treatment in elderly, ambulatory subjects. DESIGN: Descriptive study that identified long-term users of metoclopramide among a population of 4515 elderly subjects. SETTING: Participants in an ambulatory health-screening program in Florida (Florida Geriatric Research Program). PARTICIPANTS: Individuals (2898 women and 1617 men) over the age of 65 years who volunteered for annual health screening. INTERVENTIONS: All medication histories for participants were reviewed to identify subjects who reported metoclopramide use on at least one visit to the program. RESULTS: Thirty-four participants (0.75 percent) reported the use of metoclopramide during at least one visit. Eleven subjects (32.4 percent) reported that they had used this drug for longer than one year. Nine of the 34 subjects (26.5 percent) also reported the use of metoclopramide at their next annual visit. CONCLUSIONS: Results from this study suggest that metoclopramide is frequently prescribed inappropriately to treat gastrointestinal disorders. Long-term use of this drug exposes patients to an unnecessary risk of adverse drug reactions.

Aged↗