RESUMO
BACKGROUND: Non-celiac wheat sensitivity (NCWS) most frequently presents clinically with irritable bowel syndrome (IBS)-like symptoms, although many extra-intestinal manifestations have also been attributed to it. No studies to date have evaluated the presence and frequency of gynecological symptoms in NCWS. AIM: To evaluate the frequency of gynecological disorders in patients with NCWS. PATIENTS AND METHODS: Sixty-eight women with NCWS were included in the study. A questionnaire investigating gynecological symptoms and recurrent cystitis was administered, and patients reporting symptoms were then examined by specialists. Three control groups were selected: 52 patients with IBS not related to NCWS, 56 patients with celiac disease (CD), and 71 healthy controls. RESULTS: 59% of the patients with NCWS showed gynecological symptoms, a higher frequency than in healthy controls (P = 0.04), IBS controls (P = 0.01) and CD controls (P = 0.02). Menstrual cycle alterations were more frequent in patients with NCWS than in healthy controls (26.5% vs 11.3%; P = 0.03); the patients with NCWS suffered from recurrent vaginitis (16%) and dyspareunia (6%) significantly more frequently than healthy controls. Twenty-nine percent of patients with NCWS reported recurrent cystitis, a finding higher than in the control groups (vs healthy P = 0.0001, vs IBS P = 0.001, vs CD controls P = 0.04). Microbiological examinations were negative in most of the patients with NCWS and recurrent vaginitis or cystitis. During the 1-year follow-up, 46% of patients with menstrual disorders and 36% with recurrent vaginitis reported resolution of symptoms on a wheat-free diet. CONCLUSIONS: Patients with NCWS showed a significantly higher frequency of gynecological symptoms and recurrent cystitis than patients with IBS.
Assuntos
Doença Celíaca , Cistite/epidemiologia , Síndrome do Intestino Irritável/epidemiologia , Vaginite/epidemiologia , Hipersensibilidade a Trigo/epidemiologia , Adulto , Cistite/diagnóstico , Cistite/dietoterapia , Dieta Livre de Glúten/métodos , Feminino , Seguimentos , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/dietoterapia , Pessoa de Meia-Idade , Estudos Prospectivos , Vaginite/diagnóstico , Vaginite/dietoterapia , Hipersensibilidade a Trigo/diagnóstico , Hipersensibilidade a Trigo/dietoterapia , Adulto JovemRESUMO
We describe a case of the isolation of Bartonella quintana from the parotid gland of an apparently healthy man. Pathological examination showed intraparotid granulomatous abscessual lymphadenitis. Diagnosis was made on the basis of high titers of immunoglobulin G (IgG) and IgM antibodies and of culture isolation of a causative agent from parotid aspirate.
Assuntos
Bartonella quintana/isolamento & purificação , Doenças Parotídeas/microbiologia , Glândula Parótida/microbiologia , Febre das Trincheiras/diagnóstico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Anticorpos Antibacterianos/sangue , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Linfadenite/patologia , Masculino , Pessoa de Meia-Idade , Doenças Parotídeas/tratamento farmacológico , Doenças Parotídeas/patologia , Glândula Parótida/patologia , Esteroides/uso terapêuticoRESUMO
Nasal turbinate hypertrophy is a major cause of nasal airway obstruction that affects up to 20% of the European general population. This study aims to determine the efficacy of radiofrequency treatment as perceived by patients during a 2-years period. From 2007 to 2009, an observational study was conducted on 36 patients who consecutively underwent temperature-controlled radiofrequency tissue volume reduction. A questionnaire was administered to each patient in order to collect demographic data, lifestyle habits, health status and visual analogue scale (VAS) score of perceived symptoms. Mean VAS scores of nasal obstruction, headache, rhinorrhoea and anosmia after treatment were significantly lower than that at baseline. Urban residence and allergic rhinitis were significantly associated with lower mean improvement (2.9 vs. 5.6; P = 0.04 and 2.3 vs. 5.3; P = 0.01, respectively). A non significant association with scarce nasal obstruction improvement was present in older aged patients, in patients other than students and in active and passive smokers. Our data enrich the general knowledge on radiofrequency treatment of turbinate hypertrophy identifying the rate of long-term efficacy of radiofrequency treatment as perceived by patients and focusing on several risk factors involved in patient prognosis after treatment.