A303 SIMULTANEOUS PRESSURE WAVES ARE A KEY COMPONENT OF HUMAN COLON MOTOR FUNCTION ASSESSMENT, USING HIGH-RESOLUTION COLONIC MANOMETRY (HRCM)
Notice bibliographique
Résumé
Colonic dysmotility is common, yet its nature is not fully understood through low-resolution manometry. High-Resolution Colonic Manometry (HRCM) is capable of revealing detailed motor patterns and their functions can be tested in the clinical setting. Our objective was to identify clinically relevant propulsive motor patterns in healthy volunteers and to improve interpretation of motor pattern functions through an in vitro study of equivalent patterns in the proximal rabbit colon. Healthy adult volunteers (n=13) received 84-sensor HRCM with different stimuli: balloon distention in proximal and transverse colon, a meal, and bisacodyl in the proximal colon and rectum. In rabbits (n=7) pressure patterns (by HRCM) and motor patterns (by video-recorded diameter changes expressed as spatio-temporal maps) were recorded simultaneously, in vitro, to characterize propulsive pressure patterns. In adult volunteers, High Amplitude Propagating Pressure Waves (HAPCs) were only observed after stimulation (balloon distention or bisacodyl administration). In contrast, Simultaneous Pressure Waves (SPWs) were observed at baseline. SPWs ranged in amplitude from 5 mmHg to >100 mmHg. SPWs were associated with gas and/or content expulsion and internal sphincter relaxation, consistent with a propulsive and neurogenic nature. Gas expulsion never occurred without SPWs. SPWs spanned between 80% and 100% of the colon. Proximal HAPCs sometimes developed into SPWs. SPWs increased in response to a meal and became prominent in amplitude during balloon distention and after bisacodyl administration. In response to bisacodyl, higher amplitude SPWs were associated with an urge to defecate. SPWs were found to occur in isolation or forming a rhythmic pattern with a dominant frequency of ~ 1 wave/min. When forming a rhythmic pattern, SPWs could inhibit non-propulsive motor patterns suggesting that the absence of a motor pattern can be due to competition from propulsive activity. Studies in the rabbit model identified SPWs similar to those found in humans, with SPWs caused by fast propagating contractions with velocities greater than 5 cm/s and associated with expulsion of colonic contents. The literature suggests that SPWs are artifacts or inhibit transit. Here we report that SPWs are the most common propulsive motor activity of the human colon, associated with internal anal sphincter relaxation and gas or content expulsion. SPWs should be considered, together with HAPCs, as an important propulsive motility pattern to characterize when evaluating motor patterns in patients with colonic dysmotility. CIHRHamilton Academic Health Sciences Organization (Ratcliffe)
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».