Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 163
Filtrar
1.
Genes (Basel) ; 11(6)2020 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-32545271

RESUMO

There is increasing evidence of gastrointestinal (GI) infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We surveyed the co-expression of SARS-CoV-2 entry genes ACE2 and TMPRSS2 throughout the GI tract to assess potential sites of infection. Publicly available and in-house single-cell RNA-sequencing datasets from the GI tract were queried. Enterocytes from the small intestine and colonocytes showed the highest proportions of cells co-expressing ACE2 and TMPRSS2. Therefore, the lower GI tract represents the most likely site of SARS-CoV-2 entry leading to GI infection.


Assuntos
Betacoronavirus/metabolismo , Enterócitos/metabolismo , Trato Gastrointestinal Inferior/metabolismo , Peptidil Dipeptidase A/genética , Serina Endopeptidases/genética , Sequência de Bases , Células Cultivadas , Infecções por Coronavirus/patologia , Enterócitos/virologia , Gastroenteropatias/virologia , Humanos , Trato Gastrointestinal Inferior/virologia , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/patologia , Análise de Sequência , Serina Endopeptidases/metabolismo , Internalização do Vírus
2.
Mycotoxin Res ; 35(3): 293-307, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30949955

RESUMO

This study attempts to evaluate the potential aflatoxin binder activity of a molecularly imprinted polymer (TMU95) synthesized to target the aflatoxin B1 (AFB1) analog molecule in comparison to a commercial toxin binder (CTB). Adsorption experiments were carried out to assess the ability to bind to AFB1 at various pH values. The strength of binding was investigated by the chemisorption index. The isothermal analysis was used to determine the maximum adsorption capacity values. The ability of TMU95 and CTB to adsorb essential minerals was evaluated and the obtained data suggested that CTB would significantly reduce availability of them compared to TMU95. The in vivo efficacy of TMU95 as an aflatoxin (AF) binder in duckling exposed to aflatoxin-contaminated feed from 4 to 18 days of age in comparison to the CTB was also assessed. TMU95 and CTB were effective in reducing the adverse effects caused by AFs on feed conversion ratio of duckling (p ≤ 0.01), and also showed a minor reduction of injuries caused by AFs on visceral organs enlargement (p ≤ 0.01). It was concluded that TMU95 could absorb AFB1 in vitro efficiently and had beneficial health effects that could alleviate some of the toxic effects of AFs on growing duckling performance similar to CTB.


Assuntos
Aflatoxina B1/metabolismo , Ração Animal/análise , Metacrilatos/metabolismo , Polímeros/química , Adsorção , Aflatoxina B1/toxicidade , Ração Animal/toxicidade , Animais , Patos , Contaminação de Alimentos , Concentração de Íons de Hidrogênio , Cinética , Trato Gastrointestinal Inferior/efeitos dos fármacos , Trato Gastrointestinal Inferior/patologia , Baço/efeitos dos fármacos , Baço/patologia
3.
Appl Environ Microbiol ; 85(9)2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30824436

RESUMO

The digestive and respiratory tracts of chickens are colonized by bacteria that are believed to play important roles in the overall health and performance of the birds. Most of the current research on the commensal bacteria (microbiota) of chickens has focused on broilers and gut microbiota, and less attention has been given to layers and respiratory microbiota. This research bias has left significant gaps in our knowledge of the layer microbiome. This study was conducted to define the core microbiota colonizing the upper respiratory tract (URT) and lower intestinal tract (LIT) in commercial layers under field conditions. One hundred eighty-one chickens were sampled from a flock of >80,000 birds at nine times to collect samples for 16S rRNA gene-based bacterial metabarcoding. Generally, the body site and age/farm stage had very dominant effects on the quantity, taxonomic composition, and dynamics of core bacteria. Remarkably, ileal and URT microbiota were compositionally more related to each other than to that from the cecum. Unique taxa dominated in each body site yet some taxa overlapped between URT and LIT sites, demonstrating a common core. The overlapping bacteria also contained various levels of several genera with well-recognized avian pathogens. Our findings suggest that significant interaction exists between gut and respiratory microbiota, including potential pathogens, in all stages of the farm sequence. The baseline data generated in this study can be useful for the development of effective microbiome-based interventions to enhance production performance and to prevent and control disease in commercial chicken layers.IMPORTANCE The poultry industry is faced with numerous challenges associated with infectious diseases and suboptimal performance of flocks. As microbiome research continues to grow, it is becoming clear that poultry health and production performance are partly influenced by nonpathogenic symbionts that occupy different habitats within the bird. This study has defined the baseline composition and overlaps between respiratory and gut bacteria in healthy, optimally performing chicken layers across all stages of the commercial farm sequence. Consequently, the study has set the groundwork for the development of interventions that seek to enhance production performance and to prevent and control infectious diseases through the modulation of gut and respiratory bacteria.


Assuntos
Bactérias/isolamento & purificação , Galinhas/microbiologia , Trato Gastrointestinal Inferior/microbiologia , Microbiota , Sistema Respiratório/microbiologia , Fatores Etários , Criação de Animais Domésticos , Animais , Bactérias/classificação , Código de Barras de DNA Taxonômico/veterinária , Microbioma Gastrointestinal , RNA Bacteriano/análise , RNA Ribossômico 16S/análise
4.
Midwifery ; 69: 121-127, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30500727

RESUMO

INTRODUCTION: Diabetes Mellitus in pregnancy is increasing. No existing studies have examined Diabetes Mellitus as the primary exposure for lower genital tract tears after vaginal birth. The objective was to study the association between Diabetes Mellitus (all types combined), Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus and lower genital tract tears after vaginal birth. MATERIAL AND METHODS: A register-based cohort study of women with singleton pregnancy and without a previous cesarean section at near-term (≥ 35 + 0 weeks) and term (≥ 37 + 0 weeks) gestational age, n = 31,297 at Aarhus University Hospital, Denmark from 1 January 2004 to 31 December 2012. The associations between Diabetes Mellitus and lower genital tract tears were analysed using a fixed multiple logistic regression analyses. RESULTS: Approximately 32,000 women were eligible for the study; 796 women had diabetes (2.5%) and 1318 experienced anal sphincter injury (4.3%). The overall risk of lower genital tract tears was similar among women with a diagnosis of diabetes (Type1 Diabetes Mellitus, Type 2 Diabetes Mellitus, and Gestational Diabetes Mellitus) compared to women without diabetes, except for nulliparous women with Type1 Diabetes Mellitus who experienced a higher risk of episiotomies, crude and adjusted odds ratios (OR 2.13, 95% CI 1.14-3.97) and (OR 2.48, 95% CI 1.21-5.10), respectively. CONCLUSIONS: Women with Diabetes Mellitus without a previous cesarean section who gave birth vaginally to a single child at term or near term did not experienced an increased risk of lower genital tract tears. However, nulliparous women with Type 1 Diabetes Mellitus experienced a higher risk of episiotomy. These results may be used to individualised counselling of women with Diabetes Mellitus regarding mode of birth and may reduce worries about genital tract tears in women with Diabetes Mellitus considering vaginal birth.


Assuntos
Complicações do Diabetes/complicações , Lacerações/etiologia , Trato Gastrointestinal Inferior/lesões , Adulto , Índice de Massa Corporal , Estudos de Coortes , Dinamarca/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Lacerações/classificação , Lacerações/epidemiologia , Trato Gastrointestinal Inferior/fisiopatologia , Trato Gastrointestinal Inferior/cirurgia , Razão de Chances , Gravidez , Estudos Prospectivos , Sistema de Registros/estatística & dados numéricos , Fatores de Risco
5.
Surg Innov ; 26(2): 180-191, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30417742

RESUMO

OBJECTIVE: Colorectal surgeons report difficulty in positioning surgical devices in males, particularly those with a narrower pelvis. The objectives of this study were to (1) characterize the anatomy of the pelvis and surrounding soft tissue from magnetic resonance and computed tomography scans from 10 average males (175 cm, 78 kg) and (2) develop a model representing the mean configuration to assess variability. METHODS: The anatomy was characterized from existing scans using segmentation and registration techniques. Size and shape variation in the pelvis and soft tissue morphology was characterized using the Generalized Procrustes Analysis to compute the mean configuration. RESULTS: There was considerable variability in volume of the psoas, connective tissue, and pelvis and in surface area of the mesorectum, pelvis, and connective tissue. Subject height was positively correlated with mesorectum surface area (P = .028, R2 = 0.47) and pelvis volume ( P = .041, R2 = 0.43). The anterior-posterior distance between the inferior pelvic floor muscle and pubic symphysis was positively correlated with subject height ( P = .043, r = 0.65). The angle between the superior mesorectum and sacral promontory was negatively correlated with subject height ( P = .042, r = -0.65). The pelvic inlet was positively correlated with subject weight ( P = .001, r = 0.89). CONCLUSIONS: There was considerable variability in organ volume and surface area among average males with some correlations to subject height and weight. A physical trainer model created from these data helped surgeons trial and assess device prototypes in a controllable environment.


Assuntos
Trato Gastrointestinal Inferior , Pelve , Adulto , Idoso , Humanos , Trato Gastrointestinal Inferior/anatomia & histologia , Trato Gastrointestinal Inferior/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pelve/anatomia & histologia , Pelve/diagnóstico por imagem , Valores de Referência , Estereolitografia , Tomografia Computadorizada por Raios X
6.
Bone Marrow Transplant ; 54(2): 212-217, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29795429

RESUMO

Steroid-refractory (SR) acute gastrointestinal (GI) graft-versus-host disease (GVHD) is associated with significant mortality in allogeneic hematopoietic cell transplantation recipients. We retrospectively evaluated the efficacy of tocilizumab for the treatment of SR biopsy-proven acute lower GI GVHD in 16 consecutive adult transplant recipients between October 2015 and July 2016. Tocilizumab 8 mg/kg was administered every 2 weeks until achievement of complete response, defined as resolution of all manifestations of GI GVHD, or until patients had progression or initiation of other therapy. Ten of 16 patients (62.5%; 95% CI, 0.39-82) achieved a complete response after a median time of 11 days (range, 2-28 days) from tocilizumab initiation. The median time to response onset (improvement in stage by at least 1) was 1 day (range, 1-4 days). Tocilizumab was administered at a median of 9 days (range, 3-75 days) from GVHD diagnosis and 10 days (range, 3-75 days) from initiation of high-dose steroids. At a median follow-up of 7.6 months (range, 0.8-27.7 months) from initiation of tocilizumab, 6/16 (37.5%) patients are alive and free of their underlying hematologic malignancy. Tocilizumab appears to be a highly active agent for the treatment of severe SR lower GI acute GVHD.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Doença Enxerto-Hospedeiro/tratamento farmacológico , Esteroides/farmacologia , Adulto , Idoso , Anticorpos Monoclonais Humanizados/farmacologia , Feminino , Gastroenteropatias/mortalidade , Gastroenteropatias/patologia , Doença Enxerto-Hospedeiro/mortalidade , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/patologia , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Trato Gastrointestinal Inferior , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
7.
Virology ; 527: 77-88, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30468938

RESUMO

The composition of gastrointestinal tract viromes has been associated with multiple diseases. Our understanding of virus communities in the GI tract is still very limited due to challenges in sampling from different GI sites. Here we defined the GI viromes of 15 rhesus macaques with chronic diarrhea. Luminal content samples from terminal ileum, proximal and distal colon were collected at necropsy while samples from the rectum were collected antemortem using a fecal loop. The composition of and ecological parameters associated with the terminal ileum virome were distinct from the colon and rectum samples; these differences were driven by bacteriophages rather than eukaryotic viruses. The six contigs that were most discriminative of the viromes were distantly related to bacteriophages from three different families. Our analysis provides support for using fecal loop sampling of the rectum as a proxy of the colonic virome in humans.


Assuntos
Bacteriófagos/fisiologia , Biodiversidade , Diarreia/veterinária , Trato Gastrointestinal Inferior/virologia , Macaca mulatta , Doenças dos Primatas/virologia , Animais , Bacteriófagos/classificação , Bacteriófagos/genética , Doença Crônica , Colo/patologia , Colo/virologia , Mapeamento de Sequências Contíguas , Diarreia/virologia , Fezes/virologia , Íleo/patologia , Íleo/virologia , Trato Gastrointestinal Inferior/patologia , Metagenoma , Reto/virologia
8.
Chirurg ; 89(12): 960-968, 2018 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-30276428

RESUMO

BACKGROUND: Endoscopic vacuum therapy is a widespread method in the postoperative treatment of lower and upper gastrointestinal (GI) tract leakage. OBJECTIVE: There is an absence of further technical development of the standardized material from 2007 for the lower GI tract. MATERIAL AND METHODS: New strategies and new materials for endoscopic vacuum therapy are presented. RESULTS: Alternative strategies in sponge placement, use of open-pore film drainage, use of a multiple sponge system, rinsing catheter, electronic pumps etc. enable the successful treatment of very complex pelvic defects. CONCLUSION: The wide variability of pelvic defects often necessitates a change in therapeutic strategies during the course of treatment for an optimized outcome.


Assuntos
Endoscopia , Tratamento de Ferimentos com Pressão Negativa , Trato Gastrointestinal Superior , Fístula Anastomótica/terapia , Trato Gastrointestinal Inferior , Vácuo
9.
Surg Clin North Am ; 98(5): 1059-1072, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30243447

RESUMO

Lower gastrointestinal bleeding entails a range of severity and a multitude of options for localization and control of bleeding. With experience in trauma, critical care, endoscopy, and definitive surgical interventions, general surgeons are equipped to manage this condition in various clinical settings. This article examines traditional and emerging options for bleeding localization and control available to general surgeons.


Assuntos
Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Trato Gastrointestinal Inferior , Angiografia por Tomografia Computadorizada , Endoscopia Gastrointestinal , Procedimentos Endovasculares , Hemorragia Gastrointestinal/terapia , Humanos
10.
Dig Endosc ; 30(6): 730-738, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30075487

RESUMO

Molecular imaging is based on the labelling of defined molecular targets through the utilization of fluorescently linked probes and their subsequent detection with high-resolution endoscopic devices, thereby enabling visualization of single molecules including receptors. Whereas early studies have used molecular imaging for improved visualization and detection of early dysplasia and cancer as well as for assessing intestinal inflammation and inflammation-associated cancer within the gastrointestinal (GI) tract, more recent studies have impressively demonstrated that molecular imaging can also be used to characterize and visualize the molecular fingerprint of cancer and inflammation in vivo and in real time. With this, molecular imaging can be used to guide expression-tailored individualized therapy. With the rapid expansion and diversification of the repertoire of biological agents utilized in inflammatory bowel disease and cancer, this approach is gaining increasing attention. Within this review, we first summarize the technical components commonly used for molecular imaging and then review preclinical and clinical studies and evolving clinical applications on molecular imaging within the lower GI tract. Molecular imaging has the potential to significantly change endoscopic diagnosis and subsequent targeted therapy of gastrointestinal cancer and chronic gastrointestinal diseases.


Assuntos
Neoplasias Colorretais/diagnóstico por imagem , Endoscopia Gastrointestinal , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Trato Gastrointestinal Inferior , Imagem Molecular , Humanos
12.
Dig Dis Sci ; 63(11): 3020-3025, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30022452

RESUMO

BACKGROUND: Glasgow-Blatchford score (GBS) has been developed for risk stratification in management of acute upper gastrointestinal (GI) bleeding. However, the performance of GBS in patients with lower GI bleeding is unknown. AIM: To evaluate the performance of full or modified GBS and modified GBS in prediction of major clinical outcomes in patients with lower GI bleeding. METHODS: A retrospective study of patients admitted to a tertiary care center with either non-variceal upper GI bleeding or lower GI bleeding was conducted. The full and modified GBS were calculated for all patients. The primary outcome was a combined outcome of inpatient mortality, need for endoscopic, surgical, or radiologic procedure to control the bleed or treat the underlying source, and need for blood transfusion. RESULTS: A total of 1026 patients (562 cases for upper GI and 464 cases for lower GI) were included in the study. Hospital-based interventions and mortality were significantly higher in upper GI bleeding group. The performance of the full GBS in lower GI bleeding (area under the receiver operating curve (AUROC) 0.78, 95% CI 0.74-0.82) was comparable to full GBS in upper GI bleeding (AUROC 0.77, 95% CI 0.73-0.81) in predicting the primary outcome. Similarly, the performance of modified GBS in lower GI bleeding was shown to be comparable to modified GBS in upper GI bleeding (AUROC 0.78, 95% CI 0.74-0.83 vs. AUROC 0.76 95% CI 0.72-0.80). CONCLUSION: In patients with lower GI bleeding, both full GBS and modified GBS can predict the need for hospital-based interventions and mortality.


Assuntos
Hemorragia Gastrointestinal/mortalidade , Índice de Gravidade de Doença , Idoso , Transfusão de Sangue , Florida/epidemiologia , Hemorragia Gastrointestinal/terapia , Humanos , Trato Gastrointestinal Inferior , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Medição de Risco , Trato Gastrointestinal Superior
13.
J Dig Dis ; 19(5): 262-271, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29573336

RESUMO

The 2016 Global Burden of Disease report by WHO revealed that diseases of the gastrointestinal tract (GIT) had one of the highest incidence rates worldwide. The plethora of factors that contribute to the development of GIT-related illnesses can be divided into genetic, environmental and lifestyle factors. Apart from that, the role that infectious agents play in the development of GIT diseases has piqued the interest of researchers worldwide. The human gut harbors approximately 1014 bacteria in it with increasing concentration toward the lower GIT. Among the various microbiota that colonize the human gut, Gram-negative bacteria have been most notoriously linked to GIT-related diseases such as inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis and colorectal cancer (CRC). Some of the notable culprits that have been attributed to these diseases are Bacteroides fragilis, Fusobacterium nucleatum, Escherichia coli and Helicobacter pylori. However, studies in recent years are beginning to recognize a new player, Klebsiella pneumoniae (K. pneumoniae) in the causation and progression of GIT diseases. Once synonymous with infections and diseases of the upper respiratory tract, K. pneumoniae has now emerged as one of the pathogens commonly isolated from patients with GIT diseases. However, extensive studies attributing K. pneumoniae to GIT diseases, particularly that of CRC are scanty. Therefore, this review intends to shed light on the association of K. pneumoniae in gastrointestinal diseases such as Crohn's disease, ulcerative colitis as well as CRC.


Assuntos
Gastroenteropatias/etiologia , Infecções por Klebsiella/complicações , Klebsiella pneumoniae/isolamento & purificação , Trato Gastrointestinal Inferior/microbiologia , Farmacorresistência Bacteriana Múltipla , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/patogenicidade , Fatores de Virulência/análise
14.
Haematologica ; 103(4): 717-727, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29351985

RESUMO

We conducted a phase 2 study in which patients undergoing allogeneic hematopoietic stem cell transplantation received tocilizumab in addition to standard immune suppression with tacrolimus and methotrexate for graft-versus-host disease prophylaxis. Thirty-five patients were enrolled between January 2015 and June 2016. The median age of the cohort was 66 (range: 22-76). All patients received busulfan-based conditioning, and were transplanted with human leukocyte antigen-matched related or matched unrelated bone marrow or peripheral stem cell grafts. The cumulative incidences of grades II-IV and III-IV acute graft-versus-host disease were 14% (95% CI 5-30) and 3% (95% CI 0-11) at day 100, and 17% (95% CI 7-31) and 6% (95% CI 1-16) at day 180, respectively. Notably, there were no cases of graft-versus-host disease of the lower gastrointestinal tract within the first 100 days. A comparison to 130 matched controls who only received tacrolimus and methotrexate demonstrated a lower cumulative incidence of grades II-IV acute graft-versus-host disease (17% versus 45%, P=0.003) and a significant increase in grades II-IV acute graft-versus-host disease-free survival at six months (69% versus 42%, P=0.001) with tocilizumab, tacrolimus and methotrexate, which was the primary endpoint of the study. Immune reconstitution was preserved in patients treated with tocilizumab, tacrolimus and methotrexate, as T-cell and B-cell subsets recovered to near normal levels by 6-12 months post-transplantation. We conclude that tocilizumab has promising activity in preventing acute graft-versus-host disease, particularly in the lower gastrointestinal tract, and warrants examination in a randomized setting.


Assuntos
Quimioterapia Combinada/métodos , Gastroenteropatias/tratamento farmacológico , Doença Enxerto-Hospedeiro/prevenção & controle , Imunossupressores/uso terapêutico , Adulto , Idoso , Anticorpos Monoclonais Humanizados/uso terapêutico , Feminino , Sobrevivência de Enxerto/efeitos dos fármacos , Doença Enxerto-Hospedeiro/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Incidência , Trato Gastrointestinal Inferior , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Tacrolimo/uso terapêutico , Condicionamento Pré-Transplante/métodos , Adulto Jovem
15.
Emergencias ; 30(6): 419-423, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30638348

RESUMO

OBJECTIVES: The American College of Gastroenterology's 2016 clinical guidelines for treating lower gastrointestinal (GI) tract bleeding recommends evaluating of nasogastric tube aspiration and the ratio of blood urea nitrogen (BUN) to creatinine to differentiate upper from lower GI bleeds. However, the evidence base to support recommending these 2 diagnostic variables is low. This study aimed to evaluate the diagnostic utility of nasogastric tube aspiration and the BUN-to-creatinine ratio for distinguishing between upper and lower GI bleeding. MATERIAL AND METHODS: We conducted a systematic review of the literature to find studies reporting the diagnostic precision of the BUN-to-creatinine ratio and nasogastric aspiration in patients with GI bleeding without hematemesis. RESULTS: The sensitivity of both methods is low for detecting upper GI bleeding. Both blood in the aspirate and an elevated BUN-to-creatinine ratio significantly increase the probability of finding an upper GI source. The positive likelihood ratio varies from positive 2 to 11. However, the sensitivity of both tests for a diagnosis of upper GI bleeding is very low (negative likelihood ratio of 0.6). CONCLUSION: A negative result on either of the 2 diagnostic tests provides little useful information and does not firmly rule out an upper GI bleed. Nasogastric tube aspiration cannot be recommended for distinguishing between upper and lower GI bleeding. If the diagnosis is in doubt, endoscopic exploration of the upper GI tract is necessary.


Assuntos
Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Hemorragia Gastrointestinal/diagnóstico , Intubação Gastrointestinal , Biomarcadores/sangue , Diagnóstico Diferencial , Hemorragia Gastrointestinal/sangue , Humanos , Trato Gastrointestinal Inferior , Sensibilidade e Especificidade , Sucção , Trato Gastrointestinal Superior
16.
Chirurg ; 89(5): 365-373, 2018 May.
Artigo em Alemão | MEDLINE | ID: mdl-29188354

RESUMO

BACKGROUND: Endoscopic resection (ER) provides a minimally invasive treatment option for early gastrointestinal cancers. OBJECTIVE: Presentation of current guideline recommendations. Presentation and discussion of published data regarding ER of early esophageal cancer, early gastric cancer and early colorectal cancer. MATERIAL AND METHODS: Analysis of the current literature. Presentation of endoscopic case reports. RESULTS: New technologies, e. g. narrow-band imaging (NBI) have improved the endoscopic diagnosis of early gastrointestinal neoplasms. The development of endoscopic submucosal dissection (ESD) allowed higher R0 resection rates and minimized the recurrence risk leading to higher rates of curative endoscopic resection. Resection criteria are defined in national and international guidelines. Resection criteria for early gastric cancer are different between German (guideline criteria) and Asian guidelines (expanded criteria). New German data did not show a difference in long-term survival after ESD of early gastric cancers fulfilling the guideline criteria or the expanded criteria. In early colorectal cancer submucosal invasion exceeding 1000 µm is defined as the limit for ER in current guidelines. This threshold might be too strict for subgroups without further risk factors but further data are awaited. CONCLUSION: Substantial progress has been made in endoscopic diagnostics and treatment of early gastrointestinal cancers. First European data could confirm previous Asian results; however, further studies are urgently needed for a better definition of the possibilities and limitations of ER.


Assuntos
Neoplasias Colorretais , Ressecção Endoscópica de Mucosa , Neoplasias Esofágicas , Neoplasias Gástricas , Dissecação , Endoscopia , Neoplasias Esofágicas/cirurgia , Mucosa Gástrica , Humanos , Trato Gastrointestinal Inferior , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
17.
Dig Endosc ; 30(2): 192-197, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29055071

RESUMO

At each of the 89th to the 92nd congresses of the Japan Gastroenterological Endoscopy Society, a series of featured discussion sessions concerning advanced diagnostic endoscopy in the lower gastrointestinal tract were presented. In total, 45 lectures were presented in this subject area. It was shown that, in recent years, several convenient and less invasive colonoscopic modalities have been developed. This review article summarizes these core sessions and the efficacy of the techniques discussed.


Assuntos
Colonografia Tomográfica Computadorizada/métodos , Endoscopia Gastrointestinal/métodos , Trato Gastrointestinal Inferior/diagnóstico por imagem , Colonografia Tomográfica Computadorizada/tendências , Colonoscopia/métodos , Colonoscopia/tendências , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Consenso , Endoscopia Gastrointestinal/tendências , Feminino , Previsões , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/patologia , Japão , Masculino , Imagem de Banda Estreita/métodos , Imagem de Banda Estreita/tendências , Sociedades Médicas
18.
Virchows Arch ; 472(1): 149-158, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29124332

RESUMO

The World Health Organization estimates that there is greater than one million new cases of sexually transmitted infections (STIs) every day. In many countries, STIs are at an unprecedented high, including the USA, where nearly 20 million new cases were reported in 2016. Although morbidity associated with STIs is usually seen in the context of genitourinary disease, these pathogens may also affect the gastrointestinal tract and cause anal pain, abdominal pain, or diarrhea. It is important to recognize patterns of injury associated with these pathogens, especially those that may mimic other gastrointestinal diseases, such as idiopathic inflammatory bowel disease (IBD). This review focuses upon STIs of the lower gastrointestinal tract, organized by the most common site of involvement: the anus, rectum, and colon.


Assuntos
Gastroenteropatias/etiologia , Gastroenteropatias/patologia , Trato Gastrointestinal Inferior/microbiologia , Doenças Sexualmente Transmissíveis/complicações , Doenças Sexualmente Transmissíveis/patologia , Feminino , Humanos , Trato Gastrointestinal Inferior/patologia , Masculino
19.
Med Sci Monit ; 23: 4477-4481, 2017 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-28918430

RESUMO

The purpose of this study was to investigate the distribution of Chlamydia trachomatis (CT) genotypes in infective diseases of the female lower genital tract, especially in cervical diseases. This study included 128 CT-positive women. DNA was extracted from cervical swabs. Omp1 gene PCR-RFLP and sequencing were used to confirm the subtypes of CT. The association of subtypes with age, clinical symptoms, cervical cytology, and biopsy results was further analyzed. Omp1 gene PCR-RFLP and sequencing showed that the order of prevalent CT genotypes in the female lower genital tract was D (n=38, 29.69%), followed by E (n=28, 21.88%), G (n=21, 16.41%), and F (n=16,12.50%). Genotypes J, H, and K were comparatively rare. Genotype I was not identified in our samples. Further analysis showed that patients with genotype G were more frequently co-infected with other bacteria. Genotype G was also associated with mucopurulent cervicitis (MPC) and cervical intraepithelial neoplasia (CIN). Patients with genotype E were commonly co-infected with HR-HPV. Although genotype D was the most prevalent, it was a relatively low-risk type. These results provide information on distribution of CT genotypes in infective diseases of the female lower genital tract, which is instrumental to developing a vaccine for CT.


Assuntos
Chlamydia trachomatis/genética , Trato Gastrointestinal Inferior/microbiologia , Porinas/genética , Adulto , Neoplasia Intraepitelial Cervical/virologia , China/epidemiologia , Chlamydia trachomatis/patogenicidade , Doenças Transmissíveis/etiologia , Doenças Transmissíveis/microbiologia , Feminino , Genitália/microbiologia , Genótipo , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Porinas/análise , Análise de Sequência de DNA , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/métodos , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA