Prevalence of Functional Gastrointestinal Disorders in Brazilian Infants Seen in Private Pediatric Practices and Their Associated Factors.

OBJECTIVES: To assess the prevalence of the most frequent functional gastrointestinal disorders (FGIDs) in Brazilian infants seen in private pediatric clinics and their relationship with cesarean delivery, breastfeeding, and history of prematurity. METHODS: This cross-sectional study enrolled 5080 infants under 12 months old with routine visits in private pediatric clinics in Brazil. The mothers answered questions about the type of delivery, type of feeding (breast milk, infant formula, cow milk, mixed feeding), history of prematurity, and gastrointestinal symptoms. Rome IV criteria were used to diagnose FGIDs. RESULTS: The prevalence of infant regurgitation was 10.7% (487/4560); infant colic, 6.1% (131/2162); infant dyschezia, 4.0% (157/3895); functional constipation, 7.6% (341/4506); and functional diarrhea, 0.09% (2/2186). Prematurity was associated ( P < 0.05) with infant regurgitation (odds ratio [OR] = 1.41; 95% confidence interval [CI]: 1.05, 1.90), infant colic (OR = 1.97; 95% CI: 1.19, 3.24), infant dyschezia (OR = 1.64, 95% CI: 1.02, 2.64), and functional constipation (OR = 1.44; 95% CI: 1.02, 2.02). Prematurity was associated ( P < 0.001) with two or more FGIDs between 21 days and 150 days of age (OR = 3.06; 95% CI: 1.74, 5.37). CONCLUSION: FGIDs are common in infants seen in the private pediatric practice in Brazil. History of prematurity was associated with infant regurgitation, infant colic, functional dyschezia, and functional constipation.

Heavy metal contamination in Peru: implications on children's health.

Cerro de Pasco, Peru, has been excessively contaminated with heavy metals due to high mining activities in the region. We investigated the presence of chronic exposure to heavy metals in children living in Cerro de Pasco and its effect on health. Heavy metal concentrations were determined in hair samples collected from 78 children living in a region exposed to an open-pit mine (Paragsha region) and from other 16 children unexposed to mine activities (Carhuamayo region). Children exposed to the mine showed statistically significant higher concentration of aluminum, antimony, arsenic, cadmium, chromium, iron, lead, tin and thallium (p < 0.05) than control children. Hair samples collected from the same children in two occasions (2016 and 2018) showed that the exposure is chronic with higher levels of heavy metals observed in 2018. The concentration of heavy metals was higher in hair tip than in hair root samples. Heavy metals are associated with substantial higher risk of nosebleed (odds ratio, OR = 15.40), chronic colic (OR = 7.30), dermatologic alterations (OR = 6.16), mood alterations (OR = 7.07), presence of white lines on nails (OR = 12.10), reduced visual camp (OR = 3.97) and other symptoms (OR = 5.12). Chronic heavy metal exposure implies various negative consequences on children's health. Preventive measures are crucial to protect children's health.

Lack of Association Between Barometric Pressure and Incidence of Colic in Equine Academic Ambulatory Practice.

Anecdotal accounts correlate equine colic onset to changing weather conditions; however, atmospheric effects on colic have not been studied extensively. We hypothesized that changes in barometric pressure would increase the likelihood of a colic diagnosis compared with other noncolic sick events. Multivariable logistic regression analysis was used to look for associations between colic diagnosis and barometric pressure. The University of Pennsylvania Field Service electronic medical records were searched by identifiable examination type via billing procedure codes collecting 3,108 emergent and nonemergent medical events along with corresponding weather data from the National Weather Service from January 1, 2005, through January 1, 2017. Barometric pressure values and changes were not found to be statistically associated with a diagnosis of colic (P = .1). Horses that did not survive were almost 12 times more likely to have a diagnosis of colic (odds ratio [OR]: 11.97; P < .0001). Horses with disease recurrence were 30% more likely to have a diagnosis of colic (OR: 1.29; P = .006). The likelihood of colic diagnosis increased with increasing latitude (OR: 2.43; P = .04). Horses were more likely to be diagnosed with colic in the fall (OR: 1.72; P < .0001), spring (OR: 1.29; P = .04), and summer (OR: 1.85; P < .0001), compared with winter. Stallions were 48% less likely to colic compared with mares (OR: 0.52; P = .016) and Quarter Horses were 32% less likely to colic compared with Thoroughbreds and Arabians (OR: 0.68; P = .047). This study provided evidence that changes in barometric pressure were not a contributing risk factor for colic, although seasons with changing weather and latitude may play a role.

Epidemiology of colic syndrome in horses over 15 years of care / Epidemiologia da síndrome cólica em equinos ao longo de 15 anos de atendimento

Colic syndrome is a condition of great importance in equine production, a syndrome considered to be complex and multifactorial in nature. In this way epidemiological studies have been acting to contribute to the identification of risk factors in the development of wind power. This study evaluated the clinical epidemiology of the colic syndrome according to race, gender, diagnosis, affected segment, therapeutic decision and outcome of the cases treated at the Veterinary Hospital "Dr Halim Atique", interior of São Paulo.  The medical records of the animals assisted from January 2004 to July 2018, whose complaint was abdominal discomfort, were evaluated. Of the 535 animals, the most affected breed was the Quarter Horses (69.3%) followed by the Mangalarga (6.9%); females (53.1%) were more prone to the development of the syndrome. Compaction (28.8%), gastritis (11.8%), followed by gas distension (10.3%) were the most frequent changes; the affected segments being the stomach (21.9%), major colon (17.2%), and small intestine (15.7%). Clinical treatment (64.7%) was the most instituted and in the outcome of the cases, the discharge (77.4%) prevailed. The study presents data that can support epidemiological research in the area, assisting in the identification of causal and predictive factors for the colic syndrome.(AU)

A síndrome cólica é uma afecção de grande importância na equideocultura, síndrome essa considerada de natureza complexa e multifatorial. Desta forma os estudos epidemiológicos vêm atuando para contribuir na identificação de fatores de risco no desenvolvimento da cólica. Este estudo avaliou a epidemiologia clínica da síndrome cólica de acordo com a raça, sexo, diagnóstico, segmento acometido, decisão terapêutica e desfecho dos casos atendidos no Hospital Veterinário “Dr Halim Atique”, interior de São Paulo. Foram avaliados os prontuários dos animais atendidos no período de janeiro de 2004 a julho de 2018, cuja queixa foi o desconforto abdominal. Dos 535 animais, a raça mais acometida foi a Quarto de Milha (69,3%) seguido do Mangalarga (6,9%); quanto ao sexo, fêmeas (53,1%) se mostraram mais propensas ao desenvolvimento da síndrome. Compactação (28,8%), gastrite (11,8%) seguidoda distensão por gás (10,3%) foram às alterações mais frequentes; sendo os segmentos acometidos, o estômago (21,9%), cólon maior (17,2%) e intestino delgado (15,7%). O tratamento clínico (64,7%) foi o mais instituído e no desfecho dos casos, a alta (77,4%) prevaleceu. O estudo apresenta dados que podem subsidiar pesquisas epidemiológicas na área auxiliando na identificação de fatores causais e preditivos para a síndrome cólica.(AU)

Epidemiology of colic syndrome in horses over 15 years of care / Epidemiologia da síndrome cólica em equinos ao longo de 15 anos de atendimento

Colic syndrome is a condition of great importance in equine production, a syndrome considered to be complex and multifactorial in nature. In this way epidemiological studies have been acting to contribute to the identification of risk factors in the development of wind power. This study evaluated the clinical epidemiology of the colic syndrome according to race, gender, diagnosis, affected segment, therapeutic decision and outcome of the cases treated at the Veterinary Hospital "Dr Halim Atique", interior of São Paulo.  The medical records of the animals assisted from January 2004 to July 2018, whose complaint was abdominal discomfort, were evaluated. Of the 535 animals, the most affected breed was the Quarter Horses (69.3%) followed by the Mangalarga (6.9%); females (53.1%) were more prone to the development of the syndrome. Compaction (28.8%), gastritis (11.8%), followed by gas distension (10.3%) were the most frequent changes; the affected segments being the stomach (21.9%), major colon (17.2%), and small intestine (15.7%). Clinical treatment (64.7%) was the most instituted and in the outcome of the cases, the discharge (77.4%) prevailed. The study presents data that can support epidemiological research in the area, assisting in the identification of causal and predictive factors for the colic syndrome.

A síndrome cólica é uma afecção de grande importância na equideocultura, síndrome essa considerada de natureza complexa e multifatorial. Desta forma os estudos epidemiológicos vêm atuando para contribuir na identificação de fatores de risco no desenvolvimento da cólica. Este estudo avaliou a epidemiologia clínica da síndrome cólica de acordo com a raça, sexo, diagnóstico, segmento acometido, decisão terapêutica e desfecho dos casos atendidos no Hospital Veterinário “Dr Halim Atique”, interior de São Paulo. Foram avaliados os prontuários dos animais atendidos no período de janeiro de 2004 a julho de 2018, cuja queixa foi o desconforto abdominal. Dos 535 animais, a raça mais acometida foi a Quarto de Milha (69,3%) seguido do Mangalarga (6,9%); quanto ao sexo, fêmeas (53,1%) se mostraram mais propensas ao desenvolvimento da síndrome. Compactação (28,8%), gastrite (11,8%) seguidoda distensão por gás (10,3%) foram às alterações mais frequentes; sendo os segmentos acometidos, o estômago (21,9%), cólon maior (17,2%) e intestino delgado (15,7%). O tratamento clínico (64,7%) foi o mais instituído e no desfecho dos casos, a alta (77,4%) prevaleceu. O estudo apresenta dados que podem subsidiar pesquisas epidemiológicas na área auxiliando na identificação de fatores causais e preditivos para a síndrome cólica.

Multicountry cross-sectional study found that functional gastrointestinal disorders such as colic and functional dyschezia were common in South American infants.

AIM: Our aim was to perform a population-based study using Rome III criteria to describe the prevalence of functional gastrointestinal disorders (FGIDs) in infants in three countries in South America. METHODS: We conducted a multicountry, cross-sectional study to investigate the epidemiology of functional gastrointestinal disorders in children aged 0-12 months of age, using the Rome III criteria, in Colombia, Panama and Nicaragua. These patients presented for well-child visits in primary care clinics in the three countries between May 2015 and October 2016. A Spanish version of the Questionnaire on Paediatric Gastrointestinal Symptoms for Infants and Toddlers was used for the data collection. RESULTS: We included questionnaires completed by 351 parents, and they reported at least one FGID in 141 (40%) infants. The majority were male (56%), with a median age of seven months. Colic and functional dyschezia were the most commonly diagnosed disorders in the whole cohort, at 23% and 15%, respectively. The risk of developing FGIDs was not affected by the marital status of the mother, number of siblings, birth order and history of diarrhoea. CONCLUSION: Functional gastrointestinal disorders were common in infants from the South American countries of Colombia, Panama and Nicaragua, particularly colic and functional dyschezia.

Características clínicas y manejo de lactantes menores de 1 año con sospecha de alergia a proteína de leche de vaca / Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein

Introducción: La alergia a proteína de leche de vaca (APLV) es frecuente en lactantes (2-5% en < 1 año). Tiene múltiples formas de presentación y un amplio diagnóstico diferencial, por lo que es relevante confirmar el diagnóstico. El estándar de oro del diagnóstico es el test de provocación oral (TPO), que en la práctica no siempre se realiza. En Chile hay escasa literatura respecto a esta entidad. Objetivo: Describir características demográficas, clínicas y manejo de lactantes < 1 año con sospecha de APLV. Pacientes y Método: Estudio retrospectivo en menores de 1 año atendidos por sospecha de APLV entre 2009-2011. Se registraron datos demográficos, historia perinatal, antecedentes de atopia, alimentación al momento del diagnóstico, síntomas de sospecha de APLV, estudios realizados para su confirmación, y respuesta a tratamiento. Se consideró como estándar de diagnóstico la respuesta a la dieta y la contraprueba. Se definió como respuesta a la dieta la ausencia de los síntomas atribuidos a la APLV al menos 4 semanas desde el cambio de leche. Se realizó estadística descriptiva mediante programa Epiinfo™. Resultados: Se incluyeron 106 lactantes, 51% varones, 80% recién nacidos de término, 74% con al menos un progenitor atópico, 34% con alguno de los padres o algún hermano con alergia alimentaria. La mediana de edad al inicio fue 1,5 meses (rango: 1,5-2 m). El 15% recibió fórmula desde el período neonatal y el 50% antes del tercer mes. Los síntomas más frecuentes fueron: vómitos (63%), cólicos (50%) y rectorragia (40%); el 61% presentó ≥ 2 síntomas al comienzo. Solo en el 34% se hizo TPO, en el resto se evaluó la respuesta a la dieta de exclusión y se realizaron exámenes. La realización de exámenes no cambió la conducta. Tratamiento: 43% lactancia materna con dieta de exclusión, 24% solo fórmula extensamente hidrolizada, 26% solo fórmula aminoacídica y 7% otros. Conclusión: Las características demográficas y antecedentes de los pacientes concuerdan con lo descrito en la literatura extranjera. El inicio clínico fue precoz, predominando los síntomas digestivos. Se realizaron exámenes en una proporción alta de pacientes, sin contribuir a un cambio de conducta; el TPO fue subutilizado como herramienta diagnóstica.

Introduction: Cow's milk protein allergy (CMPA) is highly prevalent in infants (2-5%). It has a wide clinical spectrum, and confirmation through an oral food challenge (OFC) is relevant for its differential diagnosis. Information on this topic is scarce in Chile. Objective: To describe the demographic and clinical features of infants with suspected CMPA. Patients and Method: A retrospective study of patients < 1 year-old, treated for suspected CMPA between 2009 and 2011. Demographic data, symptoms of atopy, nutrition at the time of diagnosis, CMPA symptoms, diagnostic studies, and response to treatment were recorded. Diet response at least 4 weeks after milk modification, and clinical behavior when suspected foods were added back to the diet were considered standard diagnostic criteria. Descriptive statistics were performed using Epiinfo ™ software. Results: The study included 106 infants, of whom, 51% male, 80% term newborns, 74% with ≥ 1 atopic parent, and 34% with ≥ 1 parent/sibling with food allergy. The median age at onset of symptoms was 1.5 months (range 1.5-2 m). Almost half (46%) were breast-feeding ≥ 6 m, with 15% receiving formula milk since the neonatal period, and 49% before the third month. Common symptoms were: vomiting (63%), colic (49%), and bleeding on passing stools (41%). No anaphylaxis was identified, and 61% had ≥ 2 symptoms at debut. Only 34% were subjected to OFC. The most frequently requested tests were, test patch (43%), prick test (40%), and blood in stools (37%). Treatment: 43% breast feeding with exclusion diet, 24% extensively hydrolysed formula, 26% amino acid formula, and 7% others. Conclusion: Demographic characteristics and risk factors were similar to those previously described in international literature. Clinical presentation was early in life, and digestive symptoms predominated. OFC was underused for diagnosis, and most of the tests requested did not change management.

[Clinical characteristics and management of infants less than 1-year-old suspected with allergy to cow's milk protein]. / Características clínicas y manejo de lactantes menores de 1 año con sospecha de alergia a proteína de leche de vaca.

INTRODUCTION: Cow's milk protein allergy (CMPA) is highly prevalent in infants (2-5%). It has a wide clinical spectrum, and confirmation through an oral food challenge (OFC) is relevant for its differential diagnosis. Information on this topic is scarce in Chile. OBJECTIVE: To describe the demographic and clinical features of infants with suspected CMPA. PATIENTS AND METHOD: A retrospective study of patients<1 year-old, treated for suspected CMPA between 2009 and 2011. Demographic data, symptoms of atopy, nutrition at the time of diagnosis, CMPA symptoms, diagnostic studies, and response to treatment were recorded. Diet response at least 4 weeks after milk modification, and clinical behavior when suspected foods were added back to the diet were considered standard diagnostic criteria. Descriptive statistics were performed using Epiinfo ™ software. RESULTS: The study included 106 infants, of whom, 51% male, 80% term newborns, 74% with≥1 atopic parent, and 34% with ≥1 parent/sibling with food allergy. The median age at onset of symptoms was 1.5 months (range 1.5-2m). Almost half (46%) were breast-feeding≥6m, with 15% receiving formula milk since the neonatal period, and 49% before the third month. Common symptoms were: vomiting (63%), colic (49%), and bleeding on passing stools (41%). No anaphylaxis was identified, and 61% had≥2 symptoms at debut. Only 34% were subjected to OFC. The most frequently requested tests were, test patch (43%), prick test (40%), and blood in stools (37%). TREATMENT: 43% breast feeding with exclusion diet, 24% extensively hydrolysed formula, 26% amino acid formula, and 7% others. CONCLUSION: Demographic characteristics and risk factors were similar to those previously described in international literature. Clinical presentation was early in life, and digestive symptoms predominated. OFC was underused for diagnosis, and most of the tests requested did not change management.

Developmental Coordination Disorder in Children with a History of Infantile Colic.

OBJECTIVE: To investigate whether children with a history of infantile colic showed impaired motor development at age 7 years compared with unaffected peers. STUDY DESIGN: We studied 27,940 children from the Danish National Birth Cohort (1997-2002), including 1879 (6.8%) with a history of infantile colic. Infantile colic was defined according to the modified Wessel criteria as crying for more than 3 hours per day and more than 3 days per week. We compared the parental Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) scores in children with and without infantile colic after adjustment for intrauterine exposures, feeding type, parity, maternal age, socioeconomic status, Apgar score, gestational age, and birth weight. RESULTS: Children with a history of infantile colic had an elevated risk of scoring above the predefined cutoff limit of possible or suspected developmental coordination disorder (OR, 1.3; 95% CI, 1.0-1.7; P = .034). The mean total DCDQ'07 score was -0.4 point (95% CI, -0.8 to 0) lower in children with a history of infantile colic. Moreover, they were at higher risk for a low total score (OR for a 10-point decrease, 1.1; 95% CI, 1.0-1.1; P = .006) and a low general coordination score (OR, 1.3; 95% CI, 1.1-1.5, P = .000) in the DCDQ'07. All associations appeared to be stronger among boys, but no statistically significant effect measure modification between infantile colic and sex was found. CONCLUSION: We found no evidence of a strong association between infantile colic and developmental coordination disorder in this large Danish cohort.

Rapid animal welfare assessment: an archaeological approach.

The welfare of an individual depends on its capacity to overcome suboptimal conditions in its environment; otherwise, its physical and psychological health becomes compromised. A situation that clearly indicates lack of control of the environment is the expression of abnormal behaviours, such as stereotypies. This study aimed to verify the well-being of police horses using a new rapid form of welfare assessment: an archaeological approach. To this end, we sampled and quantified marks found on the stables, deposited as a result of abnormal behaviour. We cross-referenced these physical marks with veterinary records of diseases, such as colic, known to be associated with stress. A total of 46 horses were sampled and the results showed a significant medium-strength, positive correlation between bite mark frequency on stable doors and the incidence of colic. A weak significant positive correlation was found between length of scratch marks (from pawing) and the incidence of lameness. We conclude that these marks reflect the accumulated expression of abnormal behaviour and can provide rapid insight into the welfare of individual animals.

Colic in equidae from Rio Grande do Norte: retrospective study of the main clinical and epidemiological findings in 25 cases / Cólica em equídeos no Rio Grande do Norte: estudo retrospectivo dos principais achados clínico-epidemiológicos de 25 casos

The present article aimed to conduct a retrospective study of the main clinical and epidemiological findings in 25 cases of colic in equidae from Rio Grande do Norte. Twenty five equidae (21 horses, three mules and one donkey) were included. Clinical treatment was performed in 15 equidae with moderate large colon impaction (n = 6), cecal bloat (n = 4), gastric overload (n = 3), cecal impaction (n = 1) and gastric ulcers (n = 1). Six horses with severe large colon impaction (n = 2), meconium impaction (n = 2), left dorsal displacement of the large colon (n = 1) and verminotic arteritis (n = 1) were submitted to exploratory laparotomy. Four horses were not treated due to severe systemic disturbances and poor prognosis. Higher incidence occurred in Quarter horses and crossbreed horses followed by mules and single cases in a pony and a donkey. Impactions of the large intestine and cecal bloat were the major causes of colic in equidae from this study; and mainly resulted from erroneous feeding management by the owners or handlers.(AU)

O presente artigo teve como objetivo realizar um estudo retrospectivo dos principais achados clínicos-epidemiológicos em 25 casos de cólica em equídeos do Rio Grande do Norte. Vinte e cinco equídeos (21 cavalos, três muares e um asinino) foram incluídos. O tratamento clínico foi realizado em 15 equídeos com compactação do cólon moderada (n = 6), timpanismo cecal (n = 4), sobrecarga gástrica (n = 3), compactação de ceco (n = 1) e úlceras gástricas (n = 1). Seis equinos com compactação do cólon grave (n = 2), retenção de mecônio (n = 2), deslocamento dorsal do cólon maior esquerdo (n = 1) e arterite verminótica (n = 1) foram submetidos à laparotomia exploratória. Quatro equinos não foram tratados devido aos distúrbios sistêmicos graves e prognóstico ruim. A maior incidência ocorreu em equinos Quarto de Milha e seus mestiços, seguidos por muares e casos únicos em um pônei e um asinino. Compactações do intestino grosso e o timpanismo cecal foram as principais causas de cólica em equídeos deste estudo, e, principalmente, como consequência do manejo alimentar errôneo por parte dos proprietários ou tratadores.(AU)

Colic in equidae from Rio Grande do Norte: retrospective study of the main clinical and epidemiological findings in 25 cases / Cólica em equídeos no Rio Grande do Norte: estudo retrospectivo dos principais achados clínico-epidemiológicos de 25 casos

The present article aimed to conduct a retrospective study of the main clinical and epidemiological findings in 25 cases of colic in equidae from Rio Grande do Norte. Twenty five equidae (21 horses, three mules and one donkey) were included. Clinical treatment was performed in 15 equidae with moderate large colon impaction (n = 6), cecal bloat (n = 4), gastric overload (n = 3), cecal impaction (n = 1) and gastric ulcers (n = 1). Six horses with severe large colon impaction (n = 2), meconium impaction (n = 2), left dorsal displacement of the large colon (n = 1) and verminotic arteritis (n = 1) were submitted to exploratory laparotomy. Four horses were not treated due to severe systemic disturbances and poor prognosis. Higher incidence occurred in Quarter horses and crossbreed horses followed by mules and single cases in a pony and a donkey. Impactions of the large intestine and cecal bloat were the major causes of colic in equidae from this study; and mainly resulted from erroneous feeding management by the owners or handlers.

O presente artigo teve como objetivo realizar um estudo retrospectivo dos principais achados clínicos-epidemiológicos em 25 casos de cólica em equídeos do Rio Grande do Norte. Vinte e cinco equídeos (21 cavalos, três muares e um asinino) foram incluídos. O tratamento clínico foi realizado em 15 equídeos com compactação do cólon moderada (n = 6), timpanismo cecal (n = 4), sobrecarga gástrica (n = 3), compactação de ceco (n = 1) e úlceras gástricas (n = 1). Seis equinos com compactação do cólon grave (n = 2), retenção de mecônio (n = 2), deslocamento dorsal do cólon maior esquerdo (n = 1) e arterite verminótica (n = 1) foram submetidos à laparotomia exploratória. Quatro equinos não foram tratados devido aos distúrbios sistêmicos graves e prognóstico ruim. A maior incidência ocorreu em equinos Quarto de Milha e seus mestiços, seguidos por muares e casos únicos em um pônei e um asinino. Compactações do intestino grosso e o timpanismo cecal foram as principais causas de cólica em equídeos deste estudo, e, principalmente, como consequência do manejo alimentar errôneo por parte dos proprietários ou tratadores.

Pentoxifylline for the treatment of non-alcoholic steatohepatitis: a randomized controlled trial.

INTRODUCTION: The burden of non-alcoholic steatohepatitis (NASH) is growing and current pharmacologic treatments are limited by side effects and inconsistent efficacy. Pilot studies suggest that pentoxifylline (PTX) can reduce liver injury in patients with NASH. OBJECTIVE: We sought to determine the tolerability of PTX and its effect on aminotransferases and liver histology in patients with NASH. MATERIAL AND METHODS: Thirty patients with biopsy proven NASH were randomized in a 2:1 fashion to receive 1,200 mg PTX or placebo for 12 months. Metabolic parameters, aminotransferases, liver histology and hepatic gene expression changes were compared. RESULTS: At baseline the groups were similar. Adverse events were mild, most frequently headache and abdominal cramps, and did not differ between groups (p = NS). After 12 months, ALT and AST decreased from 92 ± 12 IU/L to 67 ± 13 IU/L and 67 ± 6 IU/L to 47 ± 6 IU/L (p < 0.05), respectively in patients treated with PTX. No significant effect was seen with placebo. Steatosis and cellular ballooning improved in the PTX group (p < 0.05), whereas no histological feature of steatohepatitis improved with placebo. However, between groups comparison of both biochemical and histological features were nonsignificant. CONCLUSION: Pentoxifylline is safe, well tolerated and improves transaminases and histology in patients with NASH when compared to baseline and may be a reasonable therapeutic modality for the treatment of NASH. However PTX failed to reduce transaminases compared to placebo and did not positively affect any of the metabolic markers postulated to contribute to NASH. Although animal data and small pilot studies in humans have suggested that PTX may be effective as a treatment for NASH, translating this therapy to clinical practice may prove challenging.

Cólico nefrítico en el servicio de urgencias: estudio epidemiológico, diagnóstico y etiopatogénico / Renal colic at emergency departments: epidemiologic, diagnostic andetiopathogenic study

Objetivo: Estudiar los factores epidemiológicos, etiopatogénicos y clínicos del cólico nefrítico (CN). Método/resultados: Se realizó un estudio prospectivo, multicéntrico, transversal con 146 pacientes (n=146) tratados en el Servicio de Urgencias por CN y 146 casos control sin CN (n=146). Se valoraron: edad, sexo, antecedentes patológicos, factores etiopatogénicos de la litiasis renal, cuadro clínico, urianálisis, composición química de la litiasis y radiología. Se hizo un análisis comparativo estadístico (hallazgo p) entre ambos grupos de pacientes. El CN fue más frecuente en varones, el pico máximo de incidencia fue de 31-50 años, con 36,30 por ciento en hombres y 21,23 por ciento de mujeres, el 60,27 por ciento catalogaron el dolor como intensidad severa, 140 pacientes con CN (95,89 por ciento) presentaron antecedentes urológicos vs. 15 (10,27 por ciento) en los sin CN (p=0,001), fue más frecuente la presentación con dolor intenso, brusco, lumboabdominal o lumbar (93,83 por ciento), tenían historia familiar de enfermedad litiásica 23,28 por ciento de pacientes con CN vs. 6,16 por ciento en los sin CN (p<0,001), el mayor número de CN se vio en los meses de verano (36,58 por ciento), 80,82 porciento de pacientes con CN ingerían < de 2L agua/día vs. 18,49% en los sin CN (p<0,001). Hubo hematuria en un 90,41por ciento de CN vs. 11,64 por ciento de los sin CN (p<0,001). Se visualizó litiasis (Rx) en un 42,10 por ciento vs. 57,89 por ciento donde no se visualizó. La litiasis más frecuente fue la de oxalato cálcico mono o dihidratado (61,2 por ciento). Conclusiones: La incidencia de CN en nuestra área de salud es mayor en el sexo masculino. El dolor característico del CN es agudo, severo, de aparición súbita, localizado en la región lumbar, por debajo de las costillas, irradiado hacia el flanco abdominal, región inguinal y genitales externos (testículo o labios mayores) del lado afecto...(AU)

Objectives: To investigate epidemiologic, etiopathogenic and clinical factors associated with emergency renal colic (RC). Methods ands results: We performed a prospective cross-sectional multicenter case-control study of 146 patients treated for RC at emergency departments. Data collected included age, sex, localization/severity of pain, symptoms, personal/family medical history, urine analysis, etiopathogenic factors, chemical composition of the lithiasis, and x-ray studies. Comparative statistical analysis was performed using SPSS 12.2 software. RC was more frequent in men; maximum incidence was between 31-50 years for both sex, with 36.3 percent in men and 21.23 percent in women; 60.27 percent of patients rated pain as severe; 140 RC patients (95.89 percent) had urologic antecedents vs. 15 (10.27 percent) controls without RC (p<0.001). The most frequent presentation (93.83 percent) was sudden intense lumbar-abdominal or lumbar pain; 23.28 percent of RC patients had family history for urinary lithiasis vs. 6.16 percent controls (p<0,001). Most RC patients were seen during summer (36.58 percent), 82 percent of RC patients drank <2L of water daily vs. 18.49 percent in non-RC patients (p<0.001). Hematuria was found in 132 (90.41 percent) patients with RC vs. 17 (11.64 percent) in those without (p<0.001). Lithiasis was observed by KUB x-ray in 42.10 percent of RC patients vs. 57.89 percent controls, most frequent calculi composition was calcium oxalate monohydrate and dehydrate (61,2 percent). Conclusions: The incidence of urinary lithiasis and RC in our health care area shows a male predominance. The characteristic pain of RC is severe and appears suddenly. It starts in the back (lumbar region), below the ribs, radiating towards the groin and external genitals (testicles in man or major lips in woman) on the same side. Nausea and vomiting are frequent. Family history of urinary lithiasis and low water intake are risk factors that need to be investigate...(AU)

Colic caused by Panicum maximum toxicosis in equidae in northern Brazil.

In the Amazon region of northern Brazil, Panicum maximum cultivars Mombaça, Tanzânia, and Massai cause severe colic and death in horses and mules. The disease occurs in the rainy season, when sprouting pastures are grazed by equidae. In the 8 separate disease outbreaks studied, a total of 52 out of 153 equidae were affected, including 19 that died (10 mules and 9 horses). Clinical signs were colic and abdominal dilatation, with a clinical manifestation period of 12 hr to 4 days. Serum activities of gamma-glutamyl transferase and aspartate aminotransferase were within reference intervals; however, serum urea nitrogen and creatinine concentrations were occasionally elevated. The primary gross and histologic lesions were observed in the digestive system. The stomach, small intestine, and large intestine had severe hemorrhages and occasional mucosal erosions and ulcerations. Ulceration and hemorrhage of the urinary bladder were rarely observed. Histologic examination revealed diffuse lymphoplasmacytic gastritis and enteritis with severe congestion, hemorrhage, and occasional epithelial necrosis and ulceration. Lymphocellular necrosis was occasionally observed within gut-associated lymphoid tissue. Tubular nephrosis occurred in some animals. Degeneration and occasional necrosis of bile duct epithelial cells and degeneration of hepatocytes were observed in the liver. Toxic pastures were negative for diosgenin- and yamogenin-based saponins, and oxalate concentrations were within reference intervals for the species. The toxin or toxins causing disease and the reason for the toxicity of the plant in the northern region are unknown.

Quality of life of patients with nephrolithiasis and recurrent painful renal colic.

BACKGROUND: Quality of life (QoL) has not been a priority goal for patients with recurrent painful colic of renal lithiasis. AIM: To evaluate QoL in patients with recurrent painful symptoms due to renal colic. METHODS: In this case-control study, 194 subjects (97 cases/97 controls) were matched according to age and gender. Cases were patients at an outpatient clinic with a confirmed diagnosis of nephrolithiasis with recurrent painful renal colic. The control group consisted of patients seen at an ophthalmology outpatient clinic for refraction symptoms. MAIN OUTCOME MEASURES: QoL was measured using the SF-36. RESULTS: Average SF-36 dimension scores for cases and controls, respectively, were: physical function 70/95, role-emotional function 33.3/100, role limitations due to physical problems 25/100, bodily pain 41/84, general health status 52/82, vitality 45/80, social function 62.5/100 and mental health 52/84. All values were statistically different (p < 0.001). Using multiple linear regression, there was a statistically significant QoL drop in subjects with lithiasis. Low social and economic levels were associated with the following SF-36 domains: physical function, general health status, vitality and mental health. The influence of the diagnosis on role-physical and role-emotional domains. Analysis of the physical and mental components of the SF-36 Scale showed significantly lower averages between cases and controls: PCS (p < 0.001) and MCS (p < 0.001). CONCLUSION: The QoL of patients with painful recurrent symptoms due to renal colic was substantially impaired.

[Infantile colic incidence and associated risk factors: a cohort study]. / Incidência de cólica no lactente e fatores associados: um estudo de coorte.

OBJECTIVE: To assess the incidence of infantile colic and its determinants. METHODS: Between May and July 1999, the research team performed daily visits to the three main maternities of Pelotas. All women were interviewed after the delivery and their infants were targeted for follow-up at three months. Colic was defined according to Wessel. The following risk factors were evaluated: social class, mother's educational level, parents' age, parents' divorce, changes in the parents' relationship during pregnancy, type of delivery, reproductive history, quality of prenatal care, previous abortion, previous stillbirths, previous newborn with health problems, gender, and infant's feeding pattern. Chi-square test was used to compare proportions and conditional logistic regression was applied in the multivariate model. RESULTS: We managed to follow 1,086 of the 1,195 infants. At the three months visit, 80.1% of the mothers reported that their infants had had colic. On the other hand, only 16.3% was considered as having colic according to Wessel criteria. Mother's educational level, father's age, type of delivery and breast-feeding duration remained in the multivariate model. Even after controlling for possible-confounding factors, the chances of having colic was 1.86 times higher among non-breastfed infants than among breastfed infants. CONCLUSIONS: Most mothers misclassify the occurrence of colic. Breastfeeding is the main protective factor.

Prevalencia de síntomas digestivos en mujeres adultas normales y su asociación a la litiasis biliar / Prevalence ofdigestive symptoms in normal adult women and it association with biliary lithiasis

The aim of this work was to study the prevalence of biliary diseases and digestive symptoms in normal adult women. Four hundred nineteen women were chosen; of these 145 were discarded due to previous gastrointestinal disease (20), previous gastrointestinal complaints (38) and previous cholecystectomy (85). Two hundred seventy six women were subjected to abdominal ultrasound examination; of these, 53 had cholelithiasis and in three a gallbladder cancer was suspected (and confirmed by surgery). Considering women with previous cholecystectomy, cholelithiasis and gallbladder cancer, a 33.6 per cent prevalence of biliary diseases can be inferred. An interrogation about gastrointestinal symptoms was performed to women subjected to ultrasound examinations by 2 professionals unware of ultrasound results. A high frequency of pyrosis, food intolerance and constipation was found, not observing differences between women with or without cholelithiasis. However, these last women had a higher frequency of upper abdominal pain. Both groups had also a high rate of previous surgical procedures