Roberto Dantas - Academia.edu (original) (raw)
Papers by Roberto Dantas
PubMed, Jul 1, 1985
Esophageal motility was studied in 37 patients with progressive systemic sclerosis (PSS), 12 pati... more Esophageal motility was studied in 37 patients with progressive systemic sclerosis (PSS), 12 patients with mixed connective tissue disease (MCTD) and 40 controls by the manometry method, using an open tube and continuous perfusion, and by radiological examination. Radiology was normal in 17 patients with PSS and five patients with MCTD, and abnormal in 15 patients with PSS and three with MCTD. The most frequent abnormality was slow transit time of barium. Manometry of the esophageal body was normal in 20 patients with PSS and six patients with MCTD, and abnormal in 17 patients with PSS and six with MCTD. Lack of contraction in the middle lower segments of the esophagus was the abnormality most frequently observed. Lower esophageal sphincter pressure was significantly lower among patients with PSS and MCTD than among the controls. Dysphagia was reported by ten patients with PSS and by six patients with MCTD. Radiology and manometry showed similar changes in PSS and MCTD, but dysphagia was more frequent among patients with MCTD.
Journal of Pediatric Gastroenterology and Nutrition, 2000
Programa Oficial, 2001
Objective: To evaluate anorectal manometry results in children with chronic functional intestinal... more Objective: To evaluate anorectal manometry results in children with chronic functional intestinal constipation refractory to conventional treatment regarding mean anal sphincter resting pressure, presence of recto-anal inhibitory reflex (RAIR), expulsion capability of the intra-rectal balloon and behavior during the defecation maneuver. Methods: Retrospective study by review of medical records from January 2003 to June 2007 with 31 patients who presented chronic functional constipation refractory to standard treatment. Anorectal manometry was performed by a four-channel catheter (MPX 816 processor and Proctomaster 5.0 software, Dynamed). Results: Among the 31 studied children, 24 (77%) were male. The mean age was 8.9±2.6 years. The mean maximal squeeze pressure of the anal sphincter was 82±38 mmHg. Among the patients, 15 (48%) had normotonic anal sphincter and 16 (52%) hypertonic anal sphincter. RAIR was present in all patients. Intra-rectal balloon expulsion was positive in 12⁄31 patients, being 4/12 with normotonic sphincter and 8/12 with hypertonic sphincter (p=0.22). Anism was detected in 6/15 patients with normotonic sphincter (40%) and in 4/16 patients with hypertonic sphincter (25%) (p=0.45). Conclusions: There was a predominance of normotonic anal sphincter in children with refractory chronic functional constipation. More than 1/3 of the patients were able to expulse the balloon during the defecation test, regardless of anal sphincter resting pressure, and about half of them presented anism not related to the anal sphincter tonus. The anorectal manometry is appropriate to study physiology and evacuatory dynamic, and can be useful to guide the treatment.
Revista Brasileira De Reumatologia, 1996
A doença de Chagas afeta um grande número de pessoas na América Latina. As mais importantes manif... more A doença de Chagas afeta um grande número de pessoas na América Latina. As mais importantes manifestações clínicas são consequentes ao comprometimento do coração, esôfago e cólon. No esôfago a doença causa alterações motoras que estão associadas com dilatação do órgão, dificuldade no trânsito, retenção de alimentos e sintomas, principalmente disfagia e regurgitação. Embora o comprometimento do esôfago seja a principal causa da disfagia, alterações no trânsito oral e faringeano podem contribuir para sua ocorrência. O objetivo deste estudo foi consultar estudos que indicaram alterações na fase oral e faringeana da deglutição e alguns trabalhos que descreveram as alterações esofágicas. CONTEÚDO: Os trabalhos que estudaram as fases oral e faringeana da deglutição na doença de Chagas descreveram aumento da duração dos trânsitos oral e faringeano, aumento na duração da depuração da faringe, aumento do resíduo oral e aumento na duração do trânsito pelo esfíncter superior do esôfago. No esôfago observa-se, após a deglutição, relaxamento parcial ou ausente do esfíncter inferior e a ocorrência de aumento da pressão intraesofágica que é isobárica (mesma pressão em todo corpo do esôfago), simultânea e de baixa amplitude. Ao contrário do que se observa em pessoas normais não há diferença entre a pressão gerada dentro do esôfago após deglutição de 5 mL de bolo líquido e de pequeno volume de saliva. CONCLUSÃO: Na doença de Chagas o trânsito do alimento deglutido pela boca e faringe é mais longo, o que deve ser uma adaptação à resistência ao trânsito pelo esôfago. Descritores: Deglutição, Disfagia, Doença de Chagas, Megaesôfago. Alterações da deglutição na doença de Chagas*
PubMed, Apr 1, 1996
Gastroesophageal reflux in children is a frequent problem of pediatrics. According to a literatur... more Gastroesophageal reflux in children is a frequent problem of pediatrics. According to a literature review, it was showed and discussed some pathophysiological factors related to the genesis of gastroesophageal reflux in infancy: which facilitates the reflux episodes more frequently, interferes in esophageal clearance, makes the reflux more aggressive or which facilitates upper airway aspiration. Some questions are pointed: gastroesophageal reflux in children is different from the adult; the genesis is multiple and gastroesophageal reflux is part of a gastrointestinal motility disorder as a whole.
Arquivos De Gastroenterologia, Sep 1, 2014
Context-Sour acidic liquid has a slower distal esophageal transit than a neutral liquid. Our hypo... more Context-Sour acidic liquid has a slower distal esophageal transit than a neutral liquid. Our hypothesis was that an acidic sour bolus has a different ingestion dynamic than a neutral bolus. Method-In 50 healthy volunteers and 29 patients with gastroesophageal reflux disease (GERD), we evaluated the ingestion dynamics of 100 mL of acidic sour liquid (concentrated lemon juice, pH: 3.0) and 100 mL of water (pH: 6.8). The time to ingest the total volume, the number of swallows to ingest the volume, the interval between swallows, the flux of ingestion and the volume ingested in each swallow was measured. Results-In both groups, healthy volunteers and patients in treatment for GERD, the acidic liquid took longer to be ingested, a higher number of swallows, a slower flux of ingestion and a smaller volume in each swallow than the neutral bolus. There was no difference between healthy volunteers and patients with GERD. The ingestion in women was longer than in men for acidic and neutral liquids. Conclusion-Acidic liquid has a different dynamic of ingestion than the neutral liquid, which may be consequence of the slower transit through the distal esophageal body or an anticipation to drink a sour bolus. Patients with GERD have the same prolonged ingestion of the acidic liquid bolus as seen in healthy volunteers. HEADINGS-Gastroesophageal reflux. Deglutition disorders. Acidity.
Lung, Feb 23, 2008
Among the possible mechanisms explaining the worsening of asthma due to gastroesophageal reflux d... more Among the possible mechanisms explaining the worsening of asthma due to gastroesophageal reflux disease (GERD) is the increase in bronchial hyperresponsiveness. The effects of GERD on bronchial hyperresponsiveness in patients with bronchial asthma have yet to be studied in significant detail. The aim of this study was to determine the effects of esophageal acid perfusion on bronchial responsiveness to bradykinin in patients with both asthma and GERD. In 20 patients with asthma and GERD disease, esophageal pH was monitored with a pH meter and bronchial responsiveness was evaluated by aerosol inhalation of bradykinin during esophageal acid perfusion and, 24 h earlier or later the patients were submitted to another bronchial provocation test without acid infusion. No significant changes were observed in FEV(1), FEF(25-75%), FVC, or PEF during acid perfusion. The response to the bronchial provocation test did not differ between the control day and the day of acid infusion (p = 0.61). The concentration provoking a 20% fall in FEV(1) (geometric mean +/- geometric SD) was 1.09 +/- 5.84 on the day of acid infusion and 0.98 +/- 5.52 on the control day. There is no evidence that acid infusion changes bronchial responsiveness to bradykinin. These findings strongly question the significance of acid infusion as a model to study the pathogenesis of GERD-induced asthma.
Arquivos De Gastroenterologia, Aug 21, 2018
tions showed, using the water-drinking test, that healthy women, compared with healthy men, have ... more tions showed, using the water-drinking test, that healthy women, compared with healthy men, have lower swallowing capacity and volume per swallow (10,11). In addition, aging process causes a decline in the volume per swallow and in swallowing capacity (10). However, the effect of age and sex have not been reported in achalasia. Our hypothesis was that sex and age have influence on the dynamics of water ingestion in patients with achalasia. Our aim in this investigation was to: a) evaluate the dynamics of water ingestion in patients with achalasia and healthy volunteers; b) evaluate the effect of sex and age in water ingestion; c) evalu
Revista brasileira de medicina, 1996
Rev. Soc. Bras. Clín. Méd, 2014
Background: Esophageal Chagas' disease causes a longer pharyngeal bolus clearance, which may be a... more Background: Esophageal Chagas' disease causes a longer pharyngeal bolus clearance, which may be an adaptation to the impairment of esophageal bolus transit. This adaptation should be present when we change volume or consistency of the swallowed bolus. Methods: By the videofluoroscopic method, the correlation was calculated between bolus volumes of 5 and 10mL, and consistencies liquid and paste on pharyngeal clearance duration and hyoid movement duration using the Pearson correlation coefficient (r). It was evaluated 17 patients with Chagas' disease and 15 normal volunteers. Results: In both groups, there was no correlation between the pharyngeal clearance duration and the hyoid movement duration. In pharyngeal clearance there was a positive correlation between the volumes of 5 and 10mL and between liquid and paste boluses in patients with Chagas' disease, but not in controls. In hyoid movement duration the correlation between the volumes of 5 and 10mL was positive and significant in Chagas' disease patients for liquid and paste bolus, and only for paste in controls. Conclusion: Patients with Chagas' disease have a positive correlation of bolus flow through the pharynx related to change in bolus volume and bolus consistency, which suggested that they have a more important control of pharyngeal flow related to bolus volume and consistency than normal volunteers.
Annals of Gastroenterology, 2019
Background Proximal esophagus is composed of striated muscle replaced by smooth muscle in the dis... more Background Proximal esophagus is composed of striated muscle replaced by smooth muscle in the distal section. Sildenafil, an inhibitor of phosphodiesterase type 5, causes a decrease in the amplitude of contractions in distal smooth muscle esophagus, with no effect on the proximal esophageal striated muscle. The aim of this investigation was to evaluate the hypothesis that proximal contractions are affected by changes in distal contractions caused by sildenafil. Methods Esophageal motility was assessed by high resolution manometry in 22 healthy volunteers (12 women) aged 22-50 years (mean 38.1±7.7 years). All volunteers performed, in the sitting position, 10 swallows of liquid (5 mL of saline) and 10 swallows of solid boluses (1 cm 3 pieces of bread), before and after ingestion of 50 mg of sildenafil. We evaluated the proximal esophageal contractions in response to the changes in distal esophageal motility induced by sildenafil. Results Sildenafil caused a significant reduction in distal contractile integral and integrated relaxation pressure in the lower esophageal sphincter. In the proximal esophagus the alteration in distal esophageal contraction caused a significant increase in contraction length, contractile integral, and contraction duration. Conclusion Induction of ineffective distal esophageal motility by sildenafil in healthy volunteers causes an increase in proximal esophageal motility, suggesting that proximal esophagus adapts to an induced impairment of distal esophageal motility.
Arquivos De Gastroenterologia, Dec 1, 2009
Context-There are reports showing that gender has an influence on swallowing and on the contracti... more Context-There are reports showing that gender has an influence on swallowing and on the contractions of the distal esophageal body. Objective-In this investigation we studied the effect of gender on proximal esophageal contraction. Methods-We studied 20 men (22-68 years old, median 39 years) and 44 women (18-61 years old, median 41 years) without symptoms and without gastrointestinal or respiratory diseases. We measured the time interval between the onset of pharyngeal contraction 1 cm proximal to the upper esophageal sphincter and the onset of the proximal esophageal contraction 5 cm from the pharyngeal recording. We also measured the amplitude, duration and area under the curve of the proximal esophageal contractions. The recording was performed by the manometric method with continuous perfusion. The contractions were recorded in duplicate after swallows of a 5 mL bolus of water. Results-There were no differences between men and women in the interval between the onset of pharyngeal and of esophageal contractions or in the amplitude of esophageal contractions. The duration of contractions was longer in women (2.35 ± 0.60 s) than in men (2.07 ± 0.62 s) but the difference did not reach statistical significance (P = 0.087). The area under the curve of the esophageal contraction was higher in women (130.2 ± 55.2 mm Hg x s) than in men (97.4 ± 49.4 mm Hg x s, P = 0.026). Conclusion-We conclude that there is a difference between men and women in the proximal esophageal contractions in response to wet swallows, although this difference is of no clinical relevance. HEADINGS-Esophagus, physiology. Gender identity.
Chagas’ disease is caused by the infection of the protozoan Trypanosoma cruzi with important impa... more Chagas’ disease is caused by the infection of the protozoan Trypanosoma cruzi with important impairment of esophageal function. Manifestations of the disease include changes in esophageal motility and megaesophagus, with symptoms of dysphagia and regurgitation, caused by nerve cells loss in the esophageal myenteric plexus. Although the motility of pharynx, upper esophageal sphincter and a short segment of the proximal esophagus are controlled by the central nervous system rather than by the myenteric plexus impairment in bolus transport through the thoracic esophagus may affect the pharyngeal and upper esophageal sphincter transit. We conducted a review of the literature concerning changes in contractions and transit in the pharynx, upper esophageal sphincter and proximal esophagus in patients with Chagas’ disease. No data about the amplitude of pharyngeal contraction in Chagas’ disease were found in the literature. Pharyngeal transit time is longer and the electromiographic activit...
PubMed, Jul 1, 1985
Esophageal motility was studied in 37 patients with progressive systemic sclerosis (PSS), 12 pati... more Esophageal motility was studied in 37 patients with progressive systemic sclerosis (PSS), 12 patients with mixed connective tissue disease (MCTD) and 40 controls by the manometry method, using an open tube and continuous perfusion, and by radiological examination. Radiology was normal in 17 patients with PSS and five patients with MCTD, and abnormal in 15 patients with PSS and three with MCTD. The most frequent abnormality was slow transit time of barium. Manometry of the esophageal body was normal in 20 patients with PSS and six patients with MCTD, and abnormal in 17 patients with PSS and six with MCTD. Lack of contraction in the middle lower segments of the esophagus was the abnormality most frequently observed. Lower esophageal sphincter pressure was significantly lower among patients with PSS and MCTD than among the controls. Dysphagia was reported by ten patients with PSS and by six patients with MCTD. Radiology and manometry showed similar changes in PSS and MCTD, but dysphagia was more frequent among patients with MCTD.
Journal of Pediatric Gastroenterology and Nutrition, 2000
Programa Oficial, 2001
Objective: To evaluate anorectal manometry results in children with chronic functional intestinal... more Objective: To evaluate anorectal manometry results in children with chronic functional intestinal constipation refractory to conventional treatment regarding mean anal sphincter resting pressure, presence of recto-anal inhibitory reflex (RAIR), expulsion capability of the intra-rectal balloon and behavior during the defecation maneuver. Methods: Retrospective study by review of medical records from January 2003 to June 2007 with 31 patients who presented chronic functional constipation refractory to standard treatment. Anorectal manometry was performed by a four-channel catheter (MPX 816 processor and Proctomaster 5.0 software, Dynamed). Results: Among the 31 studied children, 24 (77%) were male. The mean age was 8.9±2.6 years. The mean maximal squeeze pressure of the anal sphincter was 82±38 mmHg. Among the patients, 15 (48%) had normotonic anal sphincter and 16 (52%) hypertonic anal sphincter. RAIR was present in all patients. Intra-rectal balloon expulsion was positive in 12⁄31 patients, being 4/12 with normotonic sphincter and 8/12 with hypertonic sphincter (p=0.22). Anism was detected in 6/15 patients with normotonic sphincter (40%) and in 4/16 patients with hypertonic sphincter (25%) (p=0.45). Conclusions: There was a predominance of normotonic anal sphincter in children with refractory chronic functional constipation. More than 1/3 of the patients were able to expulse the balloon during the defecation test, regardless of anal sphincter resting pressure, and about half of them presented anism not related to the anal sphincter tonus. The anorectal manometry is appropriate to study physiology and evacuatory dynamic, and can be useful to guide the treatment.
Revista Brasileira De Reumatologia, 1996
A doença de Chagas afeta um grande número de pessoas na América Latina. As mais importantes manif... more A doença de Chagas afeta um grande número de pessoas na América Latina. As mais importantes manifestações clínicas são consequentes ao comprometimento do coração, esôfago e cólon. No esôfago a doença causa alterações motoras que estão associadas com dilatação do órgão, dificuldade no trânsito, retenção de alimentos e sintomas, principalmente disfagia e regurgitação. Embora o comprometimento do esôfago seja a principal causa da disfagia, alterações no trânsito oral e faringeano podem contribuir para sua ocorrência. O objetivo deste estudo foi consultar estudos que indicaram alterações na fase oral e faringeana da deglutição e alguns trabalhos que descreveram as alterações esofágicas. CONTEÚDO: Os trabalhos que estudaram as fases oral e faringeana da deglutição na doença de Chagas descreveram aumento da duração dos trânsitos oral e faringeano, aumento na duração da depuração da faringe, aumento do resíduo oral e aumento na duração do trânsito pelo esfíncter superior do esôfago. No esôfago observa-se, após a deglutição, relaxamento parcial ou ausente do esfíncter inferior e a ocorrência de aumento da pressão intraesofágica que é isobárica (mesma pressão em todo corpo do esôfago), simultânea e de baixa amplitude. Ao contrário do que se observa em pessoas normais não há diferença entre a pressão gerada dentro do esôfago após deglutição de 5 mL de bolo líquido e de pequeno volume de saliva. CONCLUSÃO: Na doença de Chagas o trânsito do alimento deglutido pela boca e faringe é mais longo, o que deve ser uma adaptação à resistência ao trânsito pelo esôfago. Descritores: Deglutição, Disfagia, Doença de Chagas, Megaesôfago. Alterações da deglutição na doença de Chagas*
PubMed, Apr 1, 1996
Gastroesophageal reflux in children is a frequent problem of pediatrics. According to a literatur... more Gastroesophageal reflux in children is a frequent problem of pediatrics. According to a literature review, it was showed and discussed some pathophysiological factors related to the genesis of gastroesophageal reflux in infancy: which facilitates the reflux episodes more frequently, interferes in esophageal clearance, makes the reflux more aggressive or which facilitates upper airway aspiration. Some questions are pointed: gastroesophageal reflux in children is different from the adult; the genesis is multiple and gastroesophageal reflux is part of a gastrointestinal motility disorder as a whole.
Arquivos De Gastroenterologia, Sep 1, 2014
Context-Sour acidic liquid has a slower distal esophageal transit than a neutral liquid. Our hypo... more Context-Sour acidic liquid has a slower distal esophageal transit than a neutral liquid. Our hypothesis was that an acidic sour bolus has a different ingestion dynamic than a neutral bolus. Method-In 50 healthy volunteers and 29 patients with gastroesophageal reflux disease (GERD), we evaluated the ingestion dynamics of 100 mL of acidic sour liquid (concentrated lemon juice, pH: 3.0) and 100 mL of water (pH: 6.8). The time to ingest the total volume, the number of swallows to ingest the volume, the interval between swallows, the flux of ingestion and the volume ingested in each swallow was measured. Results-In both groups, healthy volunteers and patients in treatment for GERD, the acidic liquid took longer to be ingested, a higher number of swallows, a slower flux of ingestion and a smaller volume in each swallow than the neutral bolus. There was no difference between healthy volunteers and patients with GERD. The ingestion in women was longer than in men for acidic and neutral liquids. Conclusion-Acidic liquid has a different dynamic of ingestion than the neutral liquid, which may be consequence of the slower transit through the distal esophageal body or an anticipation to drink a sour bolus. Patients with GERD have the same prolonged ingestion of the acidic liquid bolus as seen in healthy volunteers. HEADINGS-Gastroesophageal reflux. Deglutition disorders. Acidity.
Lung, Feb 23, 2008
Among the possible mechanisms explaining the worsening of asthma due to gastroesophageal reflux d... more Among the possible mechanisms explaining the worsening of asthma due to gastroesophageal reflux disease (GERD) is the increase in bronchial hyperresponsiveness. The effects of GERD on bronchial hyperresponsiveness in patients with bronchial asthma have yet to be studied in significant detail. The aim of this study was to determine the effects of esophageal acid perfusion on bronchial responsiveness to bradykinin in patients with both asthma and GERD. In 20 patients with asthma and GERD disease, esophageal pH was monitored with a pH meter and bronchial responsiveness was evaluated by aerosol inhalation of bradykinin during esophageal acid perfusion and, 24 h earlier or later the patients were submitted to another bronchial provocation test without acid infusion. No significant changes were observed in FEV(1), FEF(25-75%), FVC, or PEF during acid perfusion. The response to the bronchial provocation test did not differ between the control day and the day of acid infusion (p = 0.61). The concentration provoking a 20% fall in FEV(1) (geometric mean +/- geometric SD) was 1.09 +/- 5.84 on the day of acid infusion and 0.98 +/- 5.52 on the control day. There is no evidence that acid infusion changes bronchial responsiveness to bradykinin. These findings strongly question the significance of acid infusion as a model to study the pathogenesis of GERD-induced asthma.
Arquivos De Gastroenterologia, Aug 21, 2018
tions showed, using the water-drinking test, that healthy women, compared with healthy men, have ... more tions showed, using the water-drinking test, that healthy women, compared with healthy men, have lower swallowing capacity and volume per swallow (10,11). In addition, aging process causes a decline in the volume per swallow and in swallowing capacity (10). However, the effect of age and sex have not been reported in achalasia. Our hypothesis was that sex and age have influence on the dynamics of water ingestion in patients with achalasia. Our aim in this investigation was to: a) evaluate the dynamics of water ingestion in patients with achalasia and healthy volunteers; b) evaluate the effect of sex and age in water ingestion; c) evalu
Revista brasileira de medicina, 1996
Rev. Soc. Bras. Clín. Méd, 2014
Background: Esophageal Chagas' disease causes a longer pharyngeal bolus clearance, which may be a... more Background: Esophageal Chagas' disease causes a longer pharyngeal bolus clearance, which may be an adaptation to the impairment of esophageal bolus transit. This adaptation should be present when we change volume or consistency of the swallowed bolus. Methods: By the videofluoroscopic method, the correlation was calculated between bolus volumes of 5 and 10mL, and consistencies liquid and paste on pharyngeal clearance duration and hyoid movement duration using the Pearson correlation coefficient (r). It was evaluated 17 patients with Chagas' disease and 15 normal volunteers. Results: In both groups, there was no correlation between the pharyngeal clearance duration and the hyoid movement duration. In pharyngeal clearance there was a positive correlation between the volumes of 5 and 10mL and between liquid and paste boluses in patients with Chagas' disease, but not in controls. In hyoid movement duration the correlation between the volumes of 5 and 10mL was positive and significant in Chagas' disease patients for liquid and paste bolus, and only for paste in controls. Conclusion: Patients with Chagas' disease have a positive correlation of bolus flow through the pharynx related to change in bolus volume and bolus consistency, which suggested that they have a more important control of pharyngeal flow related to bolus volume and consistency than normal volunteers.
Annals of Gastroenterology, 2019
Background Proximal esophagus is composed of striated muscle replaced by smooth muscle in the dis... more Background Proximal esophagus is composed of striated muscle replaced by smooth muscle in the distal section. Sildenafil, an inhibitor of phosphodiesterase type 5, causes a decrease in the amplitude of contractions in distal smooth muscle esophagus, with no effect on the proximal esophageal striated muscle. The aim of this investigation was to evaluate the hypothesis that proximal contractions are affected by changes in distal contractions caused by sildenafil. Methods Esophageal motility was assessed by high resolution manometry in 22 healthy volunteers (12 women) aged 22-50 years (mean 38.1±7.7 years). All volunteers performed, in the sitting position, 10 swallows of liquid (5 mL of saline) and 10 swallows of solid boluses (1 cm 3 pieces of bread), before and after ingestion of 50 mg of sildenafil. We evaluated the proximal esophageal contractions in response to the changes in distal esophageal motility induced by sildenafil. Results Sildenafil caused a significant reduction in distal contractile integral and integrated relaxation pressure in the lower esophageal sphincter. In the proximal esophagus the alteration in distal esophageal contraction caused a significant increase in contraction length, contractile integral, and contraction duration. Conclusion Induction of ineffective distal esophageal motility by sildenafil in healthy volunteers causes an increase in proximal esophageal motility, suggesting that proximal esophagus adapts to an induced impairment of distal esophageal motility.
Arquivos De Gastroenterologia, Dec 1, 2009
Context-There are reports showing that gender has an influence on swallowing and on the contracti... more Context-There are reports showing that gender has an influence on swallowing and on the contractions of the distal esophageal body. Objective-In this investigation we studied the effect of gender on proximal esophageal contraction. Methods-We studied 20 men (22-68 years old, median 39 years) and 44 women (18-61 years old, median 41 years) without symptoms and without gastrointestinal or respiratory diseases. We measured the time interval between the onset of pharyngeal contraction 1 cm proximal to the upper esophageal sphincter and the onset of the proximal esophageal contraction 5 cm from the pharyngeal recording. We also measured the amplitude, duration and area under the curve of the proximal esophageal contractions. The recording was performed by the manometric method with continuous perfusion. The contractions were recorded in duplicate after swallows of a 5 mL bolus of water. Results-There were no differences between men and women in the interval between the onset of pharyngeal and of esophageal contractions or in the amplitude of esophageal contractions. The duration of contractions was longer in women (2.35 ± 0.60 s) than in men (2.07 ± 0.62 s) but the difference did not reach statistical significance (P = 0.087). The area under the curve of the esophageal contraction was higher in women (130.2 ± 55.2 mm Hg x s) than in men (97.4 ± 49.4 mm Hg x s, P = 0.026). Conclusion-We conclude that there is a difference between men and women in the proximal esophageal contractions in response to wet swallows, although this difference is of no clinical relevance. HEADINGS-Esophagus, physiology. Gender identity.
Chagas’ disease is caused by the infection of the protozoan Trypanosoma cruzi with important impa... more Chagas’ disease is caused by the infection of the protozoan Trypanosoma cruzi with important impairment of esophageal function. Manifestations of the disease include changes in esophageal motility and megaesophagus, with symptoms of dysphagia and regurgitation, caused by nerve cells loss in the esophageal myenteric plexus. Although the motility of pharynx, upper esophageal sphincter and a short segment of the proximal esophagus are controlled by the central nervous system rather than by the myenteric plexus impairment in bolus transport through the thoracic esophagus may affect the pharyngeal and upper esophageal sphincter transit. We conducted a review of the literature concerning changes in contractions and transit in the pharynx, upper esophageal sphincter and proximal esophagus in patients with Chagas’ disease. No data about the amplitude of pharyngeal contraction in Chagas’ disease were found in the literature. Pharyngeal transit time is longer and the electromiographic activit...