RESUMO
The comprehensive narrative review conducted in this study delves into the mechanisms of communication and action at the molecular level in the human organism. The review addresses the complex mechanism involved in the microbiota-gut-brain axis as well as the implications of alterations in the microbial composition of patients with neurodegenerative diseases. The pathophysiology of neurodegenerative diseases with neuronal loss or death is analyzed, as well as the mechanisms of action of the main metabolites involved in the bidirectional communication through the microbiota-gut-brain axis. In addition, interventions targeting gut microbiota restructuring through fecal microbiota transplantation and the use of psychobiotics-pre- and pro-biotics-are evaluated as an opportunity to reduce the symptomatology associated with neurodegeneration in these pathologies. This review provides valuable information and facilitates a better understanding of the neurobiological mechanisms to be addressed in the treatment of neurodegenerative diseases.
Assuntos
Microbioma Gastrointestinal , Doenças Neurodegenerativas , Humanos , Disbiose/terapia , Transplante de Microbiota Fecal , Doenças Neurodegenerativas/terapia , MetabolomaRESUMO
OBJECTIVES: Compliance in outpatients with gastrointestinal (GI) malabsorption is key in nutritional treatment. The objective of this study was to assess compliance in patients with GI impairment and malnutrition taking a high-calorie, high-protein, peptide-based oral nutritional supplement (ONS-PBD). METHODS: A prospective, multicenter, observational study was conducted in 19 medical sites in Spain where ONS-PBD were prescribed as standard of care. Patients consumed ONS-PBD daily for 12 wk. Compliance was calculated as the percentage consumed of the prescribed amount of ONS per day. RESULTS: A total of 90 adult patients were included in the study, of whom 64 completed the 12-wk regimine. Mean compliance was 78.8% ± 24.5%. Risk of malnutrition decreased in 56.3% of patients at 12 wk, as measured with the malnutrition universal screening tool. A reduction in abdominal pain was observed and stool consistency improved, with a mean of 54.7% and 27.5%, respectively. Improvements in quality of life and a decrease in percentage of patients with severe functional impairment were observed. CONCLUSIONS: These data show that ONS-PBD compliance in malnourished patients with GI symptoms is high, reducing GI symptoms and improving patients' nutritional status.
Assuntos
Desnutrição , Estado Nutricional , Adulto , Suplementos Nutricionais , Humanos , Cooperação do Paciente , Peptídeos/uso terapêutico , Estudos Prospectivos , Qualidade de VidaAssuntos
Hospitalização/estatística & dados numéricos , Doenças Inflamatórias Intestinais/epidemiologia , Corticosteroides/uso terapêutico , Adulto , Terapia Combinada , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Progressão da Doença , Feminino , Hemorragia Gastrointestinal/etiologia , Hospitais Universitários/estatística & dados numéricos , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Infecções/etiologia , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doenças Inflamatórias Intestinais/cirurgia , Icterícia Obstrutiva/induzido quimicamente , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pancreatite/induzido quimicamente , Admissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Espanha/epidemiologiaRESUMO
Multiseptate gallbladder is a congenital abnormality categorized as a gallbladder shape variant with some 20 cases reported thus far in the literature. Clinical presentation may be highly variable, ranging from asymptomatic to chronic pain in the right upper quadrant, cholecystitis, and even pancreatitis. It may be associated with other bile duct abnormalities such as choledochal cyst, ectopic gallbladder or anomalous biliopancreatic junction.
Assuntos
Doenças da Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/diagnóstico por imagem , Adulto , Doenças da Vesícula Biliar/terapia , Humanos , Masculino , Ultrassonografia , Conduta ExpectanteRESUMO
BACKGROUND: Beclometasone dipropionate (BDP) is a relatively new topically acting oral steroid to treat mild to moderately active ulcerative colitis (UC). We estimate that 20,000 patients have received oral BDP in Spain in the last two years. Our aim was to evaluate the efficacy and safety of oral BDP in clinical practice. METHODS: Retrospective and multicenter study that included 434 patients with active UC treated with BDP. The partial Mayo Clinic score (pMS, 0-9) was used to measure disease activity. Remission was defined as post-treatment pMS of 0 or 1; response as a decrease in pMS of 3 points or 2 points and >30%, and failure as lack of remission or response. RESULTS: BDP dose was 5 mg/day in 88% of patients and mean treatment duration was 6.2 weeks. BDP achieved remission in 44.4%, response in 22.3% and failed in 33.2% of patients. Mean pMS decreased from 4.9 ± 1.3 to 2.4 ± 2.3 (p<0.0001). Remission rate was higher in mild and moderate than in severe UC (p<0.043) and tended to be higher in left-sided and extensive UC than in proctitis (p<0.06). Failure was less frequent in patients treated for >4 weeks (p<0.02). Mild adverse events were reported in 7.6% of patients. CONCLUSION: BDP induces response or remission in two thirds of active UC patients, with a good safety profile. Patients with mild to moderate, left-sided or extensive UC, receiving BDP for more than 4 weeks are most likely to benefit from this treatment.
Assuntos
Anti-Inflamatórios/uso terapêutico , Beclometasona/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Administração Oral , Adulto , Anti-Inflamatórios/administração & dosagem , Beclometasona/administração & dosagem , Esquema de Medicação , Feminino , Humanos , Masculino , Indução de Remissão , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do TratamentoAssuntos
Doenças Transmissíveis Emergentes , Linfogranuloma Venéreo/diagnóstico , Adulto , Chlamydia trachomatis/classificação , Chlamydia trachomatis/isolamento & purificação , Sistemas Computacionais , Condiloma Acuminado/complicações , Hemorragia Gastrointestinal/etiologia , Infecções por HIV/complicações , Humanos , Linfogranuloma Venéreo/complicações , Linfogranuloma Venéreo/epidemiologia , Linfogranuloma Venéreo/microbiologia , Masculino , Reação em Cadeia da Polimerase , Proctite/complicações , Proctite/microbiologia , Sorotipagem , Espanha/epidemiologia , Úlcera/etiologiaAssuntos
Reação em Cadeia da Polimerase/métodos , Tropheryma/isolamento & purificação , Doença de Whipple/diagnóstico , Adulto , Artrite Infecciosa/etiologia , Biópsia , Colite Microscópica/etiologia , Diagnóstico Diferencial , Diarreia/etiologia , Duodeno/microbiologia , Fezes/microbiologia , Gastroenterite/diagnóstico , Humanos , Jejuno/microbiologia , Masculino , Saliva/microbiologia , Tropheryma/genética , Doença de Whipple/microbiologiaAssuntos
Endoscopia Gastrointestinal/métodos , Migração de Corpo Estranho/terapia , Gastroplastia/efeitos adversos , Obesidade Mórbida/cirurgia , Elastômeros de Silicone/efeitos adversos , Remoção de Dispositivo/métodos , Seguimentos , Migração de Corpo Estranho/diagnóstico , Gastroplastia/instrumentação , Gastroplastia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/diagnóstico , Falha de Prótese , Medição de Risco , Resultado do TratamentoAssuntos
Neoplasias das Glândulas Suprarrenais , Hemangioma , Neoplasias Pancreáticas/diagnóstico por imagem , Abdome/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/patologia , Idoso , Angiografia , Diagnóstico Diferencial , Hemangioma/diagnóstico , Hemangioma/diagnóstico por imagem , Hemangioma/patologia , Hemangioma/cirurgia , Humanos , Masculino , Neoplasias Pancreáticas/diagnóstico , Radiografia Abdominal , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
INTRODUCTION: Hepatic toxicity of breast cancer therapy is well known, usually consisting of elevation in the serum levels of hepatic enzymes or fatty infiltration of the liver. The chemotherapeutic agents most commonly linked to hepatotoxic effects are methotrexate, anthracyclines, taxanes and cyclophosphamide. There are few reports of patients with liver metastasis having radiological findings mimicking cirrhosis, both in the presence or the absence of prior systemic chemotherapy. Hepatotoxicity of antineoplastic drugs and cellular necrosis induced by response of liver metastases to chemotherapy may play a critical role in its physiopathology. MATERIALS AND METHODS: This article reports a series of ten women with breast cancer (nine with liver metastasis) treated with chemotherapy or hormonotherapy. RESULTS: They had low risk factors for hepatic disease, but developed a cirrhosis-like appearance in the computed tomography scan. The patient without liver metastasis is the second of this kind described in the literature. Relatively few reports have documented clinical sequelae of portal hypertension. In our series, three patients had oesophageal bleeding varices needing be hospitalised. To our knowledge, these are the first cases reported in the literature. CONCLUSIONS: This suggests that some manifestations of portal hypertension may develop in association with the cirrhosis- like pattern induced by breast cancer therapy.