J Gastrointest Surg. 2003 Sep-Oct;7(6):809-13.
Stapled hemorrhoidectomy: initial experience of a Latin American group.
Habr-Gama A, e Sous AH Jr, Rovelo JM, Souza JV, Benicio F, Regadas FS, Wainstein C, da Cunha TM, Marques CF, Bonardi R, Ramos JR, Pandini LC, Kiss D.
Department of Gastroenterology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
The purpose of the present study was to determine the value of circular hemorrhoidectomy (procedure for prolapse and hemorrhoids [PPH]) on the basis of data collected prospectively during the initial experience of a group of Latin American surgeons. Between 2000 and 2001, PPH was performed using a circular stapler in 177 patients who had third- and fourth-degree hemorrhoidal disease. The average age of the patients was 47.7 years (range 26 to 85 years). Anal bleeding was the most common preoperative complaint (93.2%) followed by anal pain (60.2%), anal itching (43%), and constipation (41%). Hemorrhoids were classified as third degree in 132 patients (74%) and fourth degree in 45 patients (25.4%). Skin tags were detected in 86 patients (48.8%) and rectocele in 14 patients (7.9%). Data collected included patient demographics, type of anesthesia, and specific details of the surgery such as duration of the operation, distance from the staple line to the dentate line, need for complementary hemostasis, and any unexpected occurrences. Postoperative data collected included the degree of pain, which was evaluated on the basis of the type and dosage of analgesics required, laxative consumption, and the presence of bleeding, fever, urinary retention, or hematomas. Each patient completed a written questionnaire addressing these events. Patients returned for follow-up visits on days 7, 15, 30, and 90. Responses to pain, bleeding, fever, anal continence, recurrence of hemorrhoids, and level of satisfaction were compiled. The duration of the procedure ranged from 6 minutes to 2 hours (average 23 minutes), and most operations lasted no more than 20 minutes, w
Geburtshilfe Frauenheilkd. 1989 Nov;49(11):958-62.
[Senna-containing laxatives: excretion in the breast milk?]
[Article in German]
Faber P, Strenge-Hesse A.
Frauenklinik Prosper-Hospital, Recklinghausen.
The excretion of rhein, a cathartic with active metabolite from sennosides, was investigated in breast milk samples of 15 post-partum women for at least 24 h after the intake of a therapeutic dose (15 mg sennosides/day) of a standardized, fiber containing senna laxative (Agiolax). Rhein was analyzed by a HPLC-method with a lower limit of detection at 1 ng/ml rhein, taking into account a possible binding as monoglucuronide and monosulfate. Maximal concentrations up to 27 ng/ml and in 89% values below 10 ng/ml were measured. Related to the daily milk volume, 73% of the women excreted less than 2 ng rhein/day. Based on median values, 0.017% of the sennoside intake (calculated as rhein) was excreted in breast milk. The amount of rhein transmitted to the infant is therefore 0.3% of the rhein intake of the mother. This is far below the oral rhein dose necessary for inducing a laxative effect. Accordingly, none of the breast-fed infants (n = 8) showed any difference in stool consistency in comparison with the non breast-fed infants.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2583443&dopt=Abstract constipation laxative
Afr J Med Med Sci. 2001 Mar-Jun;30(1-2):9-12.
Microscopic evaluation and seasonal variations of anthraquinone glycosides of cultivated Cassia fistula Linn.
Abo KA, Adeyemi AA, Sobowale AO.
Department of Pharmacognosy, Faculty of Pharmacy, College of Medicine, University of Ibadan, Ibadan, Nigeria.
In this report, we present the results of the microscopy, seasonal variations and spectrophotometric estimation of hydroxy-anthraquinone glycosides of culitivated Cassia fistula Linn. The total glycoside contents ofthe morphological parts of this species at different stages of growth are also presented. The study shows that anthraquinone glycosides are concentrated in the leaves (1.75%) and flowers (1.58%) at peak flowering. Notable seasonal variations were observed in the cultivated species. Hydroxyanthraquinones reached peak levels druing the months of September (1.08%) and October (2.20%). There was a significant drop (P < 0.05) in glycoside content during most part of the rainy season. It has been established that anthraquinone glycosides, rather than the aglycones, are the active forms and hence an estimation of the total glycoside content of a sample is a reliable indication of biological activity. The advantages of using the natural anthraquinone laxative when the glycoside content is highest are discussed. The study has provided useful information on the best period for harvesting the morphological parts of C. fistula for drug development.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14510141&dopt=Abstract constipation laxative
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