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Irodalom 1. J Hill , S Stott , I MacLennan : 1994 Antegrade enemas for the treatment of severe idiopathic constipation . Br J Surg. 81 10 1490 – 1

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whether these interventions actually reduce CV risk in patients with CKD. As another gut microbiota targeted intervention for CVD in CKD, laxatives may be a potentially novel treatment option. In patients with CKD, the prevalence of constipation

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tract infections, dental disease, broncho-pulmonary disorders, constipation, kidney stones, and impaired cognitive function. High fluid intake can decrease the risk of urinary tract stones, colon and urinary tract cancer, or mitral valve prolapse

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, perturbations in appetite and sexual desire, constipation, crying, and suicidal thoughts ( 5 ). The pharmacotherapy of MDD consists of the use of antidepressants, which operate on the central neurotransmitter system and modulate its action ( 19 ). Antidepressant

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A modified surgical technique has been developed for repairing third-degree perineal lacerations in mares. Complications of the currently used methods include rectovaginal fistula formation, urine pooling, complete dehiscence of the repair, constipation, tenesmus and difficulty of performance in the practice. The modified method is simpler and more practical. This method was performed on eight Thoroughbred mares with third-degree perineal lacerations after delivery. The rectovestibular septum was reconstructed by three lines of sutures in a transverse direction in relation to the longitudinal axis of the rectum. In one of the eight cases pneumorectum was observed after using the new method. The conception rate obtained after using the new surgical technique was 62.5%. Pregnant mares delivered normally without any new lacerations at the subsequent parturition. It can be concluded that this new surgical technique can be used successfully for repairing third-degree perineal lacerations in mares.

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In the past twenty years, the main interest in increasing dietary fibre intake has been to reduce risk of coronary heart disease. In addition to the reduction of blood cholesterol by soluble viscous dietary fibre, this risk is also reduced by antioxidative and fibrinolytic effects. Attenuating levels and fluctuations of blood glucose and insulin have interest not only for diabetic people, but also for improving endurance in sports or physical work, and because of the multitude of physiological effects of insulin as well. Dietary fibre is also in a key position in weight control due to its effect on satiety. New data on the effects of fibre on the intestinal function have shown advantages of soluble fibre sources, partly due to their ability to support selectively the growth of beneficial bacteria, and partly by alleviating constipation. Both soluble and insoluble fibres have effects which reduce risks of cancers, not only colorectal cancer. In applications, the trend is now towards a more specific use of the different types and sources of dietary fibre.

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Linaclotide, a first-in-class guanylate cyclase-C agonist, was recently approved by US Food and Drug Administration (FDA) as a promising pharmacotherapy for the management of constipation-predominant irritable bowel syndrome (IBS). In this communication, we present a novel stability-indicating reverse-phase high-performance liquid chromatography (RP-HPLC) method for the quantitative determination of linaclotide along with its degradation products. During the International Conference on Harmonization (ICH) prescribed stress study, linaclotide was found susceptible to degrade under hydrolytic (acid and base) and oxidative (peroxide) conditions. The separation of the degradants from the analyte was achieved on a Zorbax Eclipse XDB C8 Column (250 mm × 4.6 mm, 5 μm) using 0.01 N potassium dihydrogen orthophosphate buffer and acetonitrile (80:20 v/v) as mobile phase at a flow rate of 1.00 mL min−1 at column temperature of 40 °C. The detection of the column effluents was realized on a photodiode array detector set at 220 nm. Under the above optimal condition, the method was validated with respect to specificity, linearity, range, precision, robustness, and sensitivity in compliance to the regulatory requirements.

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Orvosi Hetilap
Authors: István Pregun, László Herszényi, Márk Juhász, Pál Miheller and Zsolt Tulassay

Fujita, T., Yokota, S., Sawada, M. és mtsai: Effect of MKC-733, a 5-HT receptor partial agonist, on bowel motility and symptoms in subjects with constipation: an exploratory study. J. Clin. Pharm. Ther., 2005, 30 , 611

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Magyar Sebészet
Authors: Katalin Kalmár, József Baracs, Anita Illés, József Czimmer, Csaba Weninger and Örs Péter Horváth

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Bevezetés: A Pécsi Tudományegyetemen kb. 15 éve vezették be a funkcionális proktológiai vizsgálatokat, és alakították meg a Medencefenék Multidiszciplináris Csoportot, mely több év szünetelés után másfél éve újraalakult. Ennek tárgykörében a szerzők elsősorban a székletinkontinencia és a kimeneti obstructiós székrekedés gyógyításával kapcsolatos tapasztalataikról számolnak be. Beteganyag: Az elmúlt három évben inkontinencia tárgykörében sebészi kezelésre 9 beteg került. Az elmúlt másfél évben 31 olyan beteget kezeltünk, akinél constipatio miatt sebészi kezelés merült fel. Részletes kivizsgálás után 10 beteg került műtétre, a többiek konzervatív kezelésben részesültek. Hét betegnél perinealis rekonstrukció történt hálóbeültetéssel. Három betegnél laparoscopos anterior recto- és levatoropexiát végeztünk. Eredmények: Az inkontinencia miatt operált betegek 78%-a teljes kontinenciáról számol be, 88%-uk javulásról. A kimeneti obstructiós székrekedésben szenvedő betegeink panaszainak objektivizálására egy új funkcionális pontrendszert alkottunk. A maximálisan 20 pontos score-t a műtét előtt és után kikérdezve a 7 perinealis rekonstrukción átesett betegünknél preoperatíve 14 ± 2,83, posztoperatíve 5,4 ± 4,62 pontot találtunk. A különbség szignifikáns (p = 0,0075). Konklúzió: A funkcionális proktológiai betegek szakértelmet igényelnek az anamnaesis felvételétől kezdve a speciális műszeres vizsgálatokon keresztül a kezelésig. A betegek túlnyomó része kellően profitál a konzervatív kezelésből. A sikeres sebészi kezelés fontos előfeltétele a megfelelő betegszelekció. Tüneti pontrendszerek alkalmazásával, megfelelő betegválasztással jó eredmények érhetők el.

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281 Pimentel, M., Lembo, A., Chey, W. D.: Rifaximin therapy for patients with irritable bowel syndrome without constipation. N. Engl. J. Med., 2011, 364 , 22

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