RESUMO
The concept of consuming microorganisms in the treatment of a medical condition and in health maintenance has gained much attraction, giving rise to an abundance of medical claims and of health supplements. This study identified relevant clinical questions on the therapeutic use of probiotics and reviewed the literature in irritable bowel syndrome, inflammatory bowel disease, impaired intestinal immunity, liver disease, intestinal infections, and common childhood digestive disorders. Statements were developed to address these clinical questions. A panel of experienced clinicians was tasked to critically evaluate and debate the available data. Both consensus and contentious statements are presented to provide to clinicians a perspective on the potential of probiotics and importantly their limitations.
Assuntos
Consenso , Doenças do Sistema Digestório/terapia , Gastroenterologia/organização & administração , Gastroenteropatias/terapia , Probióticos , Relatório de Pesquisa , Sociedades Médicas/organização & administração , Sudeste Asiático , Humanos , Probióticos/administração & dosagem , Probióticos/uso terapêuticoAssuntos
Diabetes Mellitus Tipo 1/terapia , Medicina Baseada em Evidências , Educação de Pacientes como Assunto , Medicina de Precisão , Autocuidado , Adolescente , Medicina do Adolescente/tendências , Criança , Pré-Escolar , Terapia Combinada/efeitos adversos , Desidratação/prevenção & controle , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/terapia , Cetoacidose Diabética/prevenção & controle , Monitoramento de Medicamentos , Família , Humanos , Hiperglicemia/prevenção & controle , Hipoglicemia/induzido quimicamente , Hipoglicemia/prevenção & controle , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/uso terapêutico , Lactente , Insulina/administração & dosagem , Insulina/efeitos adversos , Insulina/uso terapêutico , Agências Internacionais , Pediatria/tendências , Sociedades CientíficasRESUMO
BACKGROUND/AIMS: X-linked adrenal hypoplasia congenita (AHC) is typically associated with DAX-1 mutations and hypogonadotropic hypogonadism. However, atypical cases of X-linked AHC in association with central precocious puberty and even normal puberty have rarely been reported, although the mechanism of action remains unknown. CASE REPORT: This is a case report of a boy with X-linked AHC associated with Duchenne muscular dystrophy, whose clinical presentation led to analysis of the DAX-1, glycerol kinase (GK1) and dystrophin genes, which were amplified by polymerase chain reaction, with Southern blot analysis of the AHC locus. RESULTS: There was a non-contiguous deletion of the DAX-1 and GK1 genes, with deletion of the dystrophingene from exons 3 to 79. CONCLUSION: This is the first report of X-linked AHC, central precocious puberty in the absence of the DAX-1 gene. The fact that a 'loss of function' DAX-1 mutation can be associated with hypogonadotropic hypogonadism, precocious and normal puberty, suggests that DAX-1 is but one of several transcription factors which regulate puberty, and provides further evidence that other transcription factors may interact with DAX-1 and influence gonadal regulation in a complex, but hierarchical fashion.