Functional gastrointestinal disorders frequency by Rome IV criteria.

INTRODUCTION: Functional gastrointestinal disorders (FGIDs) are a very common pediatric disease, with strong implications for children and their families. We aimed to determine their frequency in our environment (per Rome IV criteria) and to establish if there is seasonal variability in diagnosis. METHODS: Descriptive, prospective study. For 12 months, children under 16 years of age with suspected FGIDs who had a first pediatric gastroenterology consultation were included and classified according to Rome IV criteria. Statistical analysis was done with SPSS v22. RESULTS: 574 children received consultations, 67% were >4 years of age. FGIDs were suspected in 44.6% of the patients, 32.4% were diagnosed according to Rome IV criteria (16.4% <4 years, 40.3% >4 years). 51.1% were female, average age of 8.4 ±â€¯4.2 years and mean of 7 months of symptoms until diagnosis (range 3-150). In patients <4 years, the most common disorders were functional constipation (48.4%), regurgitation (22.5%) and functional diarrhea (16.1%); in patients >4 years of age, functional abdominal pain (29%), functional dyspepsia (28.4%) and functional constipation (16.8%) were most frequent. We didn't discern seasonal variations in diagnosis in the global study population (p = 0.96) or by age group (<4 p = 0.51; >4 p = 0.57). CONCLUSIONS: FGIDs account for one third of our patients' consultations. While the Rome IV criteria are more inclusive than before, almost 30% of patients with suspected FGIDs don't meet said criteria. Although a seasonal difference regarding diagnosis was observed, it wasn't statistically significant either in the sample group as a whole or by age group.

Rumination syndrome: Critical review. / Síndrome de rumiación, revisión crítica.

Rumination syndrome is a functional disorder characterized by the involuntary regurgitation of recently swallowed food from the stomach into the mouth, from where it can be re-chewed or expelled. Clinically, it is characterized by repeated episodes of effortless food regurgitation. The most usual complaint is frequent vomiting. The physical mechanism that generates regurgitation events is dependent on an involuntary process that alters abdominal and thoracic pressures accompanied by a permissive oesophageal-gastric junction. The diagnosis of rumination syndrome is clinical, highlighting the importance of performing an exhaustive anamnesis on the characteristics of the symptoms. Complementary tests are used to corroborate the diagnosis or rule out organic pathology. Treatment is focused on behavioural therapies as the first line, reserving pharmacological and surgical therapies for refractory cases.

[Functional gastrointestinal disorders frequency by Rome IV criteria]. / Frecuencia de trastornos gastrointestinales funcionales según criterios Roma IV.

INTRODUCTION: Functional gastrointestinal disorders (FGIDs) are a very common pediatric disease, with strong implications for children and their families. We aimed to determine their frequency in our environment (per Rome IV criteria) and to establish if there is seasonal variability in diagnosis. MATERIAL AND METHODS: Descriptive, prospective study. For 12 months, children under 16 years of age with suspected FGIDs who had a first pediatric gastroenterology consultation were included and classified according to Rome IV criteria. Statistical analysis was done with SPSS v22. RESULTS: 574 children received consultations, 67% were >4 years of age. FGIDs were suspected in 44.6% of the patients, 32.4% were diagnosed according to Rome IV criteria (16.4%, <4 years; 40.3%, >4 years). 51.1% were female, average age of 8.4±4.2 years and mean of 7 months of symptoms until diagnosis (range 3-150). In patients <4 years, the most common disorders were functional constipation (48.4%), regurgitation (22.5%) and functional diarrhea (16.1%); in patients >4 years of age, functional abdominal pain (29%), functional dyspepsia (28.4%) and functional constipation (16.8%) were most frequent. We did not discern seasonal variations in diagnosis in the global study population (p=.96) or by age group (< 4, P=.51; > 4, P=.57). CONCLUSIONS: FGIDs account for one third of our patients' consultations. While the Rome IV criteria are more inclusive than before, almost 30% of patients with suspected FGIDs do not meet said criteria. Although a seasonal difference regarding diagnosis was observed, it was not statistically significant either in the sample group as a whole or by age group.

Estresse e Características Resilientes em Alunos com Deficiência e TFE na UFPA / Stress and Resilience Characteristics of Students with Disability and with Specific Functional Disorders at UFPA / Estrés y Características Resilientes en Alumnos con Discapacidad y TFE en la UFPA

Poucos são os pesquisadores que tratam da presença do estresse e da resiliência em alunos com deficiência e com Transtornos Funcionais Específicos no ensino superior, o que sinaliza a necessidade dessas duas temáticas serem mais estudadas e melhor compreendidas no ambiente universitário. A presente pesquisa visou descrever as características sociodemográficas e acadêmicas de 50 estudantes universitários participantes da pesquisa e correlacioná-las com os níveis de estresse e de resiliência. Os instrumentos utilizados foram um questionário semiestruturado e duas escalas: Escala de Estresse Percebido e Escala de Resiliência. Os resultados foram analisados por meio da estatística descritiva e da técnica estatística exploratória. Os resultados apontaram que alunos com níveis elevados de estresse têm níveis moderados e baixos de resiliência. A partir desse resultado, concluiu-se a necessidade de desenvolvimento de programas que visem à manutenção de estratégias eficazes de enfrentamento diante de situações adversas dentro do contexto acadêmico. Espera-se que este estudo possa contribuir com a construção de políticas institucionais que favoreça a inclusão de fato de estudantes com deficiência e com TFE na Universidade Federal do Pará e em outras instituições de ensino superior....(AU)

There are few studies dealing with the presence of stress and resilience on undergraduate students with disabilities and with specific functional disorders in higher education, which indicates the need for these two themes to be more studied and better understood in the university environment. The present study aimed to describe the sociodemographic and academic characteristics of 50 university students who participated in the study and correlate them with levels of stress and resilience. The instruments used were a semi-structured questionnaire and two scales: Perceived Stress Scale and Resilience Scale. The results were analyzed through descriptive statistics and the exploratory statistical technique. The results showed that students with high levels of stress have moderate and low levels of resilience. From this result, it was concluded the need to develop programs that aim at the maintenance of effective coping strategies in adverse situations within the academic context. It is expected that this study may contribute to the construction of institutional policies that favor the inclusion in fact of students with disabilities and with specific functional disorders at the Federal University of Pará and other higher education institutions....(AU)

Pocos son los investigadores que tratan de la presencia del estrés y de la resiliencia en alumnos con discapacidad y con trastornos funcionales específicos en la enseñanza superior, lo que señala la necesidad de que estas dos temáticas sean más estudiadas y mejor comprendidas en el ambiente universitario. La presente investigación apunta a describir las características sociodemográficas y académicas de 50 estudiantes universitarios participantes de la investigación y correlacionarlas con los niveles de estrés y de resiliencia. Los instrumentos utilizados fueron un cuestionario semiestructurado y dos escalas: Escala de estrés percibido y Escala de Resiliencia. Los resultados se analizaron mediante la estadística descriptiva y la técnica estadística exploratoria. Los resultados apuntaron que los alumnos con niveles elevados de estrés tienen niveles moderados y bajos de resiliencia. A partir de ese resultado, se concluyó la necesidad de desarrollar programas que apunten al mantenimiento de estrategias eficaces de enfrentamiento ante situaciones adversas dentro del contexto académico. Se espera que este estudio pueda contribuir con la construcción de políticas institucionales que favorezca la inclusión de hecho de estudiantes con discapacidad en la Universidad Federal de Pará y en otras instituciones de enseñanza superior. Los resultados fueron analizados por medio de la estadística descriptiva y de la técnica estadística exploratoria....(AU)

Faecal calprotectin, an useful marker in discriminating between inflammatory bowel disease and functional gastrointestinal disorders. / Calprotectina fecal, marcador eficaz en la diferenciación de enfermedades inflamatorias intestinales y trastornos funcionales gastrointestinales.

INTRODUCTION: Diagnostic discrimination between inflammatory bowel disease (IBD) and functional gastrointestinal disorders is complex, as they cause similar signs and symptoms. Faecal calprotectin (FC) is a useful marker in this context, and can be used to select patients who will most benefit from colonoscopy. The aim of this study was to evaluate the utility of FC in discriminating between organic disease and functional disorders. MATERIAL AND METHODS: The study included 264 patients presenting with gastrointestinal complaints consistent with an organic pathology. FC levels were determined and diagnostic accuracy was assessed using the area under the curve obtained from the final diagnosis. RESULTS: Calprotectin levels in organic bowel disease patients were significantly higher (median 254µg/g; 95% confidence interval [CI], interquartile range 105-588.5) than in functional disease patients (95µg/g; 95% CI, 47.25-243.92) (P<.0001). Similarly, in patients with IBD, the values obtained were higher (270.85µg/g; 95% CI, 96.85-674.00) than in those with irritable bowel syndrome (79.70µg/g; 95% CI, 36.50-117.25) (P<.0001). For a cut-off of 150µg/g, FC had an area under the ROC curve to discriminate between organic and functional disease of 0.718, and 0.872 to discriminate between irritable bowel syndrome and IBD. CONCLUSION: Our study supports the importance of FC as a marker in the evaluation of patients with IBD. The best diagnostic accuracy is obtained at a cut-off value of 150µg/g.