BACKGROUND: Colitis describes inflammation in the colon and is classified into defined diseases: Inflammatory bowel disease (IBD), Microscopic colitis, Ischemic colitis and Infectious colitis. The clinical significance of non-specific colitis is unclear as there are limited analysis which report the issue. Notteghem et al. (1993) showed that of 104 patients with non-specific colitis, 52.3% had another episode of symptoms within 3 years. Of these patients 54% were diagnosed with ulcerative colitis, 33% with Crohn's disease, and 13% remained unclassified, suggesting that non-specific colitis could be undiagnosed IBD. The objective of this analysis is to determine the clinical course of non-specific colitis through colonoscopy and histologic findings. METHODS: Retrospective observational study with patients underwent colonoscopies during the period from 2009 to 2019, whose biopsies were reported as non-specific colitis. RESULTS: 24 patients (18 women and 6 men) with non-specific colitis undergoing follow-up by the Gastroenterology outpatient clinic were included. The most frequent indications for colonoscopy were abdominal pain (43.7%), blood in stools (26.8%), diarrhea (21.6%) and anemia (7.9%). The mean age was 56.5 years. During follow-up, patients had at least 2 colonoscopies and 4 biopsies per colonic segment. In the male population ascending colon cancer was later diagnosed in 16.7%, another 16.7% were diagnosed with nonspecific chronic ulcerative colitis, 33.3% with eosinophilic colitis, and the rest of the patients were diagnosed with non-specific colitis. From the female group, 5.6% had lymphocytic colitis, 5.6% eosinophilic colitis, 5.6% collagenous colitis, 5.6% Crohn's disease, 5.6% mixed irritable bowel syndrome, and the rest of the patients (72%) had biopsy report of non-specific colitis. CONCLUSIONS: All patients with a histopathological diagnosis of non-specific colitis underwent a second colonoscopy with biopsy, which resulted in a definitive diagnosis of Crohn's disease in 5.6% of women and Ulcerative Colitis in 16.7% of men. This study comes to show that there is an important subgroup of patients who are underdiagnosed. We suggest that patients with non-specific colitis reported on a histopathology report must continue their follow-up by a specialized ward.
The magnitude which sleep has on personal well-being is similar to the effects of diet and exercise. Sleep deprivation has severe negative effects on an individual's overall health, and this is usually overseen. From 30 to 40 % of the population has presented insomnia at a certain moment of life and from 9 to 15 % have evolved into a chronic and severe insomnia. Recent investigations have related sleep deprivation with obesity, metabolic disorders, heart disease, mental health problems and dementia. Recently, more investigations have focused on the multiple alterations suffered by the immune system in cases of sleep deprivation. In order to make an opportune diagnosis of insomnia, it is vital to obtain a detailed history of the patients' sleep habits. In the physical exam one must search for signs and symptoms which might suggest an organic cause that generates the patient's insomnia. One of the pillars in treatment of these patients consists in acquiring an adequate sleep hygiene based on the optimization of the environment and the behavior that are associated with sleep.
La magnitud que tiene el sueño en el bienestar integral de una persona es similar a los efectos de la dieta y el ejercicio. La privación del sueño tiene efectos deletéreos graves en la salud del individuo y por lo general estos son ignorados. Entre un 30 y un 40 % de la población ha presentado insomnio en algún momento de su vida y del 9 al 15 % ha desarrollado insomnio crónico grave. Diversos estudios vinculan la falta de sueño con obesidad, enfermedades metabólicas, problemas cardiacos, desórdenes psiquiátricos y demencia. Existen actualmente grupos que se enfocan en las alteraciones en la respuesta inmune que genera la falta de sueño. Para realizar un diagnóstico oportuno de insomnio, es indispensable que durante la consulta se obtenga una historia clínica detallada de los hábitos del sueño. En la exploración física se debe enfatizar la búsqueda de signos y síntomas que sugieran una causa orgánica específica que contribuya a la alteración del sueño. Uno de los pilares del tratamiento es establecer en todos los pacientes una buena higiene del sueño con base en la optimización del ambiente y de las conductas asociadas con el mismo.
Sleep Initiation and Maintenance Disorders , Acute Disease , Antidepressive Agents/therapeutic use , Chronic Disease , Combined Modality Therapy , Global Health , Health Behavior , Humans , Hypnotics and Sedatives/therapeutic use , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/therapy
