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1.
Sao Paulo Med J ; 142(4): e2023069, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38655990

RESUMEN

BACKGROUND: Infantile colic has a multifactorial etiology. Recent studies have suggested that probiotics may be effective in its management. OBJECTIVE: This study was carried out to evaluate the effect of the Actiregularis strain (5×106 cfu\ml) included in maternal nutrition on gastrointestinal problems, growth development, and breastfeeding outcomes in infantile colic. DESIGN AND SETTING: The study was a randomized controlled trial conducted in the neonatal outpatient clinic of a training and research hospital in Turkey. METHODS: A probiotic drink containing the Actiregularis (5×106 cfu\ml) strain was added to the diet of mothers in the probiotics group once daily for 15 consecutive days. Data were collected for each infant's 0th (birth), 1st, 4th, and 6th months. RESULTS: Infants whose mothers were administered Actiregularis for 15 days had decreased crying intensity (P = 0.000). When the difference in breastfeeding rates between the groups was significant at the 4th and 6th months (P = 0.044; P = 0.035). There was no difference in anthropometric values except the babies' weights at the 6th month. (P < 0.001). CONCLUSION: Infants treated with Actiregularis, which was added to their mothers' diet for 15 days, showed a decrease in the frequency of crying, and the difference in breastfeeding rates between the groups was significant at the 4th and 6th months. There was no difference in anthropometric values except the babies' weights at the 6th month. CLINICAL TRIALS REGISTRATION: NCT04374955 (https://clinicaltrials.gov/ct2/show/).


Asunto(s)
Lactancia Materna , Cólico , Probióticos , Humanos , Probióticos/uso terapéutico , Probióticos/administración & dosificación , Femenino , Lactante , Recién Nacido , Masculino , Factores de Tiempo , Antropometría , Resultado del Tratamiento , Adulto , Llanto
2.
Rev Med Liege ; 79(3): 129-130, 2024 Mar.
Artículo en Francés | MEDLINE | ID: mdl-38487904

RESUMEN

Intussusception is rare in adults, accounting for 1 to 5 % of mechanical bowel obstructions. It is due to pathologic lead point within the bowel which is malignant in up to 77 % of cases. Benign lesions may also be responsible for intussusception (polyp, Meckel diverticulum). The lead point is pulled forward by normal peristaltism, prolapsing the affected segment of bowel into another segment. The most common presentation in adults is intermittent abdominal pain and bowel obstruction (nausea, vomiting, inability to pass gas or stools). Abdominal scanner is the key exam for the diagnosis and the treatment is always surgical resection.


Les invaginations grêles et coliques sont rares chez l'adulte, représentant 1 à 5 % des causes d'obstruction digestive mécanique. Elles sont le plus souvent causées par une masse intra-digestive, le péristaltisme entraînant un prolapsus du segment malade vers un segment intestinal adjacent. Elles sont généralement le reflet d'une pathologie maligne du tube digestif (tumeur maligne découverte dans plus de 77 % des cas), mais il peut également exister des causes béniqnes (polype, diverticule de Meckel, adénopathie) . Elles se manifestent sous forme de douleurs abdominales et d'occlusion (nausées, vomissements, arrêt des selles et des gaz). Le scanner abdominal est l'examen de choix pour poser le diagnostic. Le traitement est toujours une résection chirurgicale.


Asunto(s)
Cólico , Obstrucción Intestinal , Intususcepción , Divertículo Ileal , Neoplasias , Adulto , Humanos , Intususcepción/diagnóstico por imagen , Intususcepción/etiología , Cólico/complicaciones , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Divertículo Ileal/cirugía
3.
Eur J Pediatr ; 183(5): 2311-2324, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38427038

RESUMEN

Infantile functional gastrointestinal disorders, such as colic, constipation, diarrhea, and gastroesophageal reflux (regurgitation), often occur in early infancy and, representing one of the causes of significant parental anxiety, lead to a significant strain on the healthcare resources. In this study, we aimed to evaluate the effects of Lactobacillus reuteri drops (L. reuteri NCIMB 30351) on the symptoms of infantile colic, constipation, diarrhea, and gastroesophageal reflux, as well as on the levels of intestinal microbiota in full-term newborns during the first months of life. A randomized, placebo-controlled, single-masked (blinded), post-marketing clinical study was conducted in two clinical units-Children's City Clinical Hospital of Moscow and Medical Center "St. Andrew's Hospitals-NEBOLIT" from March 2020 to May 2022 in 90 infants aged from 1 to 4 months (mean age (± SD) 12.3 ± 5.09 weeks; 53.3% females, 46.7% males). Patients with colic, regurgitation (single symptom or combination of several symptoms), and constipation or diarrhea were randomly allocated in two parallel arms to receive either 5 drops (2 × 108 colony forming unit) of L. reuteri NCIMB 30351 (n = 60) or masked placebo (n = 30) for 25 consecutive days. Two treatment arms had equal numbers of patients with constipation and diarrhea (n = 30 each). Daily crying times and their duration, evacuations, and regurgitations were recorded in a structured diary. The levels of gut microbiota were analyzed by deep sequencing of bacterial 16S rRNA gene. Infants with colic receiving supplementary L. reuteri NCIMB 30351 for 25 days had significant reduction in the numbers of colic (change from baseline - 6.3 (7.34) vs - 3.0 (7.29) in placebo, P < 0.05) and numbers of crying cases and mean duration of crying (decrease from baseline - 144 (70.7) minutes, lower in the diarrhea subgroup than in constipation infants, compared with - 80 (58.9) in placebo, P < 0.0001), as well as regurgitation numbers (decreased by - 4.8 (2.49) with L. reuteri vs - 3 (7.74) with placebo). We also observed increased numbers of evacuations in infants with constipation (L. reuteri 2.2 (2.4) vs 0.9 (1.06) in placebo, P < 0.05). There was a remarkable reduction of evacuations in infants with diarrhea, while not statistically significant. The analysis of bacterial 16S rRNA gene in the collected samples showed that L. reuteri positively influences the proportions of prevalent species, while it negatively affects both conditionally pathogenic and commensal microbes. Additional in vitro test for formation of Clostridium colonies in the presence of the probiotic demonstrated that L. reuteri effectively inhibits the growth of pathogenic Clostridium species. No adverse events were reported in this study.   Conclusion: The uptake of L. reuteri NCIMB 30351 leads to a significant reduction in the number of regurgitations, feeding-induced constipations, and diarrhea as well as mean daily numbers of crying and crying duration in infants during the first months of life. Our results suggest that L. reuteri NCIMB 30351 represents a safe and effective treatment for colic in newborns.  Trial registration: ClinicalTrials.gov : NCT04262648. What is Known: • Infantile functional gastrointestinal disorders, such as colic, constipation, diarrhea, and gastroesophageal reflux (regurgitation), often occur in early infancy and, represent one of the causes of significant parental anxiety. • A number of studies have shown that both the composition and diversity of the intestinal microbiota play important roles in the development and function of the gastrointestinal tract. What is New: • The uptake of L. reuteri NCIMB 30351 leads to a significant reduction in the number of regurgitations, feeding-induced constipations, and diarrhea as well as mean daily numbers of crying and crying duration in infants during the first months of life. • L. reuteri positively influences the proportions of prevalent species, while it negatively affects both conditionally pathogenic and commensal microbes in gut microbiota.


Asunto(s)
Enfermedades Gastrointestinales , Microbioma Gastrointestinal , Limosilactobacillus reuteri , Probióticos , Humanos , Masculino , Femenino , Lactante , Probióticos/uso terapéutico , Probióticos/administración & dosificación , Método Simple Ciego , Enfermedades Gastrointestinales/microbiología , Enfermedades Gastrointestinales/terapia , Estreñimiento/terapia , Estreñimiento/microbiología , Recién Nacido , Cólico/terapia , Cólico/microbiología , Resultado del Tratamiento , Diarrea/microbiología , Diarrea/terapia , Reflujo Gastroesofágico/microbiología , Reflujo Gastroesofágico/terapia
4.
Psychoneuroendocrinology ; 164: 106965, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38493596

RESUMEN

This study examines the long-term impact of infant colic on Hypothalamic-Pituitary-Adrenal (HPA) axis development and the moderating role of attachment security, in a low-risk Dutch sample of 193 children. We assessed infant colic at 6 weeks, circadian cortisol concentrations at ages 1, 2.5, 6, and 10 years, and attachment security at 1 year. Findings indicated that infant colic was associated with steeper diurnal cortisol slopes and slightly higher cortisol concentrations throughout childhood. Attachment security did not moderate these associations. This is the first study to reveal a link between infant colic and the development of the HPA axis in healthy children beyond infancy. These findings have important implications for understanding early risk and protective factors in the stress system's development.


Asunto(s)
Cólico , Lactante , Humanos , Niño , Sistema Hipotálamo-Hipofisario , Hidrocortisona , Sistema Hipófiso-Suprarrenal , Ritmo Circadiano , Saliva , Estrés Psicológico
6.
J Am Vet Med Assoc ; 262(4): 543-551, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38324997

RESUMEN

OBJECTIVE: To determine breed, age, and sex predispositions for fecalith obstruction and to evaluate short-term survival and prognostic factors following surgical treatment of fecalith intestinal obstruction in equids. ANIMALS: 151 equids. METHODS: Medical records of equids undergoing surgery for fecalith obstruction from 2000 to 2020 were reviewed. Signalment, history, presenting clinicopathological data, surgical findings, complications, and short-term survival were recorded and compared between survivors and nonsurvivors. Signalment of the fecalith population was compared to a contemporaneous colic population. Clinical factors were assessed for association with outcome. RESULTS: 64 females, 53 castrated males, and 31 intact males were included. Three equids presented twice. Miniature horses, ponies, and miniature donkeys/mules represented 48% (71/148) of fecalith population and full-sized breeds represented 52% (77/148). Miniature horses and ponies were overrepresented and equids ≤ 1 year of age were overrepresented in the fecalith population compared to the colic population. One hundred thirty-nine equids (92%) survived to discharge, 6% (9/148) were euthanized intraoperatively, and 2% (3/148) were euthanized during hospitalization. Nonsurvivors showed more severe colic signs on admission, tachycardia on admission, and hyperlipemia. Equids with postoperative colic (P = .01) and complications (P = .002) were less likely to survive. CLINICAL RELEVANCE: Miniature horses and ponies were overrepresented compared to the colic population; however, full-sized breeds were also affected. Surgical treatment had an excellent short-term prognosis. Severe colic signs, tachycardia, hyperlipemia, postoperative colic, and surgical complications negatively affected short-term survival.


Asunto(s)
Cólico , Impactación Fecal , Enfermedades de los Caballos , Hiperlipidemias , Masculino , Femenino , Caballos , Animales , Cólico/cirugía , Cólico/veterinaria , Cólico/etiología , Impactación Fecal/complicaciones , Impactación Fecal/veterinaria , Estudios Retrospectivos , Equidae , Enfermedades de los Caballos/epidemiología , Hiperlipidemias/complicaciones , Hiperlipidemias/veterinaria , Taquicardia/veterinaria , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/veterinaria , Complicaciones Posoperatorias/etiología
7.
Nutrients ; 16(3)2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38337634

RESUMEN

Different nutraceuticals are often considered by parents of infants and children with abdominal pain and disorders of the gut-brain interaction. Herb extracts and natural compounds have long been used in traditional medicine, but clinical pediatric trials are very limited. This narrative review based on relevant studies identified through a search of the literature in Pubmed and Medline updated to October 2023 focused on the effect of nutraceuticals in infantile colic, functional abdominal pain, and irritable bowel syndrome in children and adolescents. Significant reductions in colic episodes and crying time were reported in two studies on fennel (seeds oil or tea), in three studies on different multiple herbal extracts (all including fennel), in one study on Mentha piperita, and in at least two double-blind randomized controlled studies on Lactobacillus reuteri DSM 17938 and Bifidobacterium lactis BB-12 (108 CFU/day for at least 21 days) in breast-fed infants. Compared to a placebo, in children with functional abdominal pain or irritable bowel syndrome, a significant reduction in pain was reported in two studies supplementing peppermint oil capsules or psyllium fibers, and in one study on corn fiber cookies, partial hydrolyzed guar gum, a specific multiple herbal extract (STW-5), or vitamin D supplementation. To date, there is moderate-certainty evidence with a weak grade of recommendation on Lactobacillus reuteri DSM 17938 (108 CFU/day) in reducing pain intensity in children with functional abdominal pain and for Lactobacillus rhamnosus GG (1-3 × 109 CFU twice daily) in reducing pain frequency and intensity in children with IBS. Further large and well-designed pediatric studies are needed to prove the efficacy and safety of different herbal extracts and prolonged use of studied products in infants and children with pain disorders of the gut-brain interaction.


Asunto(s)
Bifidobacterium animalis , Cólico , Síndrome del Colon Irritable , Limosilactobacillus reuteri , Probióticos , Lactante , Adolescente , Humanos , Niño , Probióticos/uso terapéutico , Dolor Abdominal , Cólico/terapia , Cólico/microbiología , Suplementos Dietéticos , Encéfalo , Resultado del Tratamiento , Ensayos Clínicos Controlados Aleatorios como Asunto
9.
Am J Case Rep ; 25: e943206, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38408028

RESUMEN

BACKGROUND Nephro-colic fistulas are uncommon, generally caused by local inflammation, trauma, or neoplasia affecting the kidney or the colon. Their association with a coralliform stone is described in a few case reports, but their management is difficult and differs quite a lot, depending on the clinical situation. We report an atypical clinical case of a reno-colic fistula associated with a staghorn calculus. This case adds to the literature an iconography rarely found. CASE REPORT A 68-year-old woman presented to the Emergency Department with respiratory symptoms and chronic abdominal pain. The biological results showed a high inflammatory syndrome. The radiological assessment revealed a retroperitoneal and left retro-renal abscess, attributed to a left nephro-colic fistula associated with the partial passage of a lithiasis within the colonic lumen. Colonoscopy confirmed the diagnosis. Multiple recurrences of diverticulitis in this region could be the origin of the complication. First, the patient was treated with antibiotic therapy and radiological drainage. Second, she benefited from a left nephrectomy, left segmental colectomy, and splenectomy. The clinical and radiological evolution were favorable after surgery. The follow-up was disrupted by hospitalizations in the Cardiology Department for cardiac decompensation. CONCLUSIONS Kidney stones along with local inflammatory phenomena can be the cause of a nephro-colic fistula. Due to the lack of guidelines in such cases, their diagnosis and management are difficult to ascertain. Surgery is the right course of treatment.


Asunto(s)
Absceso Abdominal , Cólico , Fístula Intestinal , Cálculos Renales , Cálculos Coraliformes , Femenino , Humanos , Anciano , Cálculos Coraliformes/complicaciones , Cólico/complicaciones , Absceso/complicaciones , Absceso Abdominal/diagnóstico por imagen , Absceso Abdominal/etiología , Fístula Intestinal/diagnóstico por imagen , Fístula Intestinal/etiología , Fístula Intestinal/cirugía
10.
J Anat ; 244(4): 628-638, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38168875

RESUMEN

Odontocetes primarily rely on fish, cephalopods, and crustaceans as their main source of nutrition. In the digestive system, their polygastric complex exhibits similarities to that of their closest terrestrial relatives such as cows, sheep, and giraffes, while the entero-colic tract shares similarities with terrestrial carnivores. The morphology, caliber, and structure of the odontocete intestine are relatively constant, and, since there is no caecum, a distinction between the small and large intestine and their respective subdivisions is difficult. To address this issue, we used the intestinal vascularization pattern, specifically the course and branching of the celiac artery (CA) and the cranial and caudal mesenteric arteries (CrMA and CdMA). A series of pictures and dissections of 10 bottlenose dolphins (Tursiops truncatus) were analyzed. Additionally, we performed a cast by injecting colored polyurethane foam in both arteries and veins to measure the caliber of the arteries and clarify their monopodial or dichotomous branching. Our results showed the presence of multiple duodenal arteries (DAs) detaching from the CA. The CrMA gave origin to multiple jejunal arteries, an ileocolic artery (ICA), and, in six cases, a CdMA. In four specimens, the CdMA directly originated from the abdominal aorta. The ICA gave rise to the mesenteric ileal branches (MIB) and mesenteric anti-ileal branches and the right colic arteries (RCA) and the middle colic arteries. From the CdMA originated the left colic and cranial rectal arteries (LCA and CrRA). The measurements revealed a mixed monopodial and dichotomous branching scheme. The analysis of the arteries and their branching gave us an instrument, based on comparative anatomy, to distinguish between the different intestinal compartments. We used the midpoint of anastomoses between MIB and RCA to indicate the border between the small and the large intestine, and the midpoint of anastomoses between LCA and CrRA, to tell the colon from the rectum. This pattern suggested an elongation of the duodenum and a shortening of the colic tract that is still present in this species. These findings might be related to the crucial need to possess a long duodenal tract to digest prey ingested whole without chewing. A short aboral part is also functional to avoid gas-producing colic fermentation. The rare origin of the CdMA on the CrMA might instead be a consequence of the cranial thrust of the abdominopelvic organs related to the loss of the pelvic girdle that occurred during the evolution of cetaceans.


Asunto(s)
Delfín Mular , Cólico , Femenino , Animales , Bovinos , Ovinos , Intestinos , Arterias Mesentéricas/anatomía & histología , Venas
11.
J Emerg Med ; 66(2): 83-90, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38267297

RESUMEN

BACKGROUND: The optimal pain relief method for acute renal colic in the emergency department remains controversial. OBJECTIVE: We compared the safety and efficacy of intradermal sterile water injection (ISWI) to treatment with intramuscular (IM) diclofenac, intravenous (IV) opioids, and IV paracetamol in patients with acute renal colic. METHODS: This randomized, single-blind study included 320 patients with renal colic to one of four treatment groups. The first group received ISWI at four different points around the most painful flank area. Patients in the DI, PARA, and TRAM groups received 75 mg IM diclofenac, 1 g IV paracetamol, and 100 mg IV tramadol, respectively. Pain intensity was measured using a visual analog scale (VAS) before treatment and 15, 30, and 60 min after treatment. RESULTS: VAS scores 15 and 30 min after treatment were significantly lower in group ISWI than in groups DI, PARA, and TRAM. However, there were no significant differences in the decrease in the pain score at baseline and at 60 min after treatment. In addition, fewer patients required rescue analgesia in group ISWI than in group TRAM. However, no significant differences were observed between group ISWI and group DI or PARA in terms of the need for rescue analgesia. Finally, there were significantly fewer adverse events in group ISWI than in groups DI and TRAM. CONCLUSIONS: ISWI had similar efficacy, faster pain relief, and lower need for rescue analgesia compared with diclofenac, paracetamol, and tramadol for the management of acute renal colic. In addition, ISWI was well-tolerated and had no adverse effects.


Asunto(s)
Cólico , Cólico Renal , Tramadol , Humanos , Acetaminofén/farmacología , Acetaminofén/uso terapéutico , Cólico Renal/tratamiento farmacológico , Diclofenaco/farmacología , Diclofenaco/uso terapéutico , Tramadol/farmacología , Tramadol/uso terapéutico , Método Simple Ciego , Dolor , Servicio de Urgencia en Hospital , Agua , Método Doble Ciego
12.
J Equine Vet Sci ; 134: 105010, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38286193

RESUMEN

The aim of the study was to compare and correlate levels of ferritin, transferrin, iron and APPs in healthy horses and those surgically treated for strangulating colic. On admission, measurements of inflammatory markers related to iron and total protein, fibrinogen, albumin, haptoglobin and ceruloplasmin were made. The study comprised 22 horses, divided into a control group (CG) of healthy horses (n = 10) and horses with surgically treated acute abdomen (n = 12), obstruction group (OG). The OG was subdivided according to the affected intestinal segment (small vs. large) and according to outcome (survivors vs. non survivors). The OG had higher haptoglobin (34.8±14.2 mg/dL vs 20.8±7.21 mg/dL) and transferrin (487±161 mg/dL vs 369±71.4 mg/dL) values and lower iron (96.9±65 µg/dL vs 218±105 µg/dL) values than the CG. The OG horses with large intestine obstruction had lower values of transferrin (374.6±130 mg/dL) than horses with small intestinal obstruction (598.6±98.9 mg/dL). There was no difference in outcome between horses with large and small intestinal obstruction. Ferritin levels were moderately correlated with total protein (r = 0.594; P = 0.042) and albumin (r = 0.584; P = 0.046) in OG. In the multivariate exploratory analysis, fibrinogen levels were higher in animals that did not survive. In conclusion, haptoglobin, transferrin and iron were useful inflammatory markers for colic in horses. The correlation of ferritin with other APPs shows a possible role of ferritin as an APP in horses. Fibrinogen levels are higher in horses with greater risk of death from strangulating obstructions.


Asunto(s)
Cólico , Enfermedades de los Caballos , Obstrucción Intestinal , Animales , Caballos , Haptoglobinas/metabolismo , Hierro/metabolismo , Cólico/veterinaria , Fibrinógeno/metabolismo , Inflamación/veterinaria , Obstrucción Intestinal/veterinaria , Ferritinas , Albúminas/metabolismo , Transferrinas , Enfermedades de los Caballos/metabolismo
13.
Acta Paediatr ; 113(2): 170-182, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37962097

RESUMEN

AIM: This study is a systematic review and meta-analysis of randomised controlled trials that employed probiotics and symbiotics for treating infantile colic. METHODS: We performed electronic systematic literature searches in Embase, PubMed and Web of Science, to identify articles published between 1950 and April 2023. Only RCT involving infants with infantile colic under 3 months were included. The treatment plan comprised 15 probiotics, which included Lactobacillus reuteri DSM 17938 and Bifidobacterium animalis lactis BB-12. The probiotics were administered alone or in combination with a prebiotic, vs. no intervention or a placebo. RESULTS: Probiotics resulted in an average reduction of 51 min of crying per day (p = 0.001). Further analysis of subgroups showed that the reduction was -39.30 min for vaginal delivery (p = 0.003), -64.66 min for Lactobacillus reuteri DSM 17938 (p = 0.03), -40.45 min for other strains (p < 0.00001), -74.28 min for exclusively breastfed infants (p = 0.0003) and -48.04 min for mixed feeding (p < 0.00001). CONCLUSION: All probiotic strains seem effective in treating infantile colic. Exclusively breastfed infants have demonstrated more significant reduction in crying time. However, the available evidence on the effectiveness of probiotics in formula-fed and caesarean-born infants is limited.


Asunto(s)
Cólico , Limosilactobacillus reuteri , Probióticos , Lactante , Embarazo , Femenino , Humanos , Cólico/terapia , Lactancia Materna , Probióticos/uso terapéutico , Emociones , Prebióticos
14.
Pediatr Res ; 95(1): 43-51, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37700163

RESUMEN

Postbiotics, as emerging products, were added to infant formula, but their safety and efficacy are unclear. To clarify this issue, we wrote this meta-analysis. We searched PubMed, Embase, Web of Science and ProQuest from its establishment to February 2023. The review was registered on PROSPERO database (CRD42022352405). The effects of infant formula with and without postbiotics were compared, and the incidence of serious adverse events (SAEs), digestive symptoms, concentration of stool secretory immunoglobulin A (SIgA), and growth and development indexes were analyzed. Nine randomized controlled trials with 2065 participants were included. The addition of postbiotics to infant formula was found to increase the concentration of stool SIgA (P < 0.05) with very low certainty of evidence, without significantly impacting the incidence of SAEs, infantile colic, flatulence, diarrhea, vomiting, abdominal pain and gastrointestinal disorders, the daily weight gain, the total gain in body length and the daily head circumference gain (all P > 0.05). Adding postbiotics to the formula is safe for infants, which would not increase the incidence of SAEs, infantile colic, flatulence, diarrhea, vomiting, abdominal pain, and gastrointestinal disorders, and could increase the concentration of stool SIgA. IMPACT: Our study provides evidence that the addition of postbiotics to infant formula is safe but not effective. This is the first systematic review and meta-analysis of postbiotics. This study provides strong evidence for the safety of postbiotics and lays a foundation for related clinical trials.


Asunto(s)
Cólico , Enfermedades Gastrointestinales , Lactante , Humanos , Fórmulas Infantiles , Flatulencia , Dolor Abdominal , Vómitos/prevención & control , Diarrea/prevención & control , Inmunoglobulina A Secretora , Ensayos Clínicos Controlados Aleatorios como Asunto
15.
J Equine Vet Sci ; 132: 104979, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38072227

RESUMEN

Equine colic is an important condition associated with acute abdominal pain and one of the leading causes of death in horses. As such, objectively evaluating pain is of interest for attending veterinarians. Pain scales for assessment are present, but no single pain-specific biomarker has been reported. The aim of this study was to determine if substance P (SP) could be a reliable biomarker to reflect pain and serve as a parameter to predict outcome in equine colic. The hypothesis was that horses displaying severe colic signs present with higher values of SP in contrast to those with mild colic signs. Thirty warmblood horses, aged between 3 and 20 years were recruited; evenly distributed (10 horses each) in three colic groups (mild, moderate, severe). To classify the colic signs, the horses were graded by the Equine Acute Abdominal Pain Scale (EAAPS). Clinical examination and EAAPS were performed at arrival in the hospital. Blood samples were collected four times in hourly intervals commencing from arrival. For comparison, already established parameters for prognosticating equine colic (heart rate, serum cortisol, and blood lactate concentration) were also measured. The assumption of increasing SP concentrations along with pain could not be confirmed. SP did not show any association with heart rate, cortisol, lactate, or EAAPS. Whereas the established parameters increased according to the EAAPS, SP remained stable in individual horses regardless of clinical signs, treatment, and disease progression. Consequently, SP was not a reliable parameter to reflect painful conditions or to predict outcome in equine colic.


Asunto(s)
Cólico , Enfermedades de los Caballos , Animales , Caballos , Cólico/diagnóstico , Cólico/veterinaria , Sustancia P , Hidrocortisona , Enfermedades de los Caballos/diagnóstico , Biomarcadores , Ácido Láctico , Dolor Abdominal/diagnóstico , Dolor Abdominal/veterinaria
16.
Ann Emerg Med ; 83(3): 217-224, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37999652

RESUMEN

STUDY OBJECTIVE: Atomized intranasal (IN) drug administration offers an alternative to the intravenous (IV) route. We aimed to evaluate the analgesic efficacy of IN versus IV ketorolac in emergency department patients with acute renal colic. METHODS: We conducted a double-blind, randomized controlled trial on adult patients (aged 18 to 64 years) with severe renal colic and numerical rating scale pain ratings ≥7.0. They were randomly assigned (1:1) to receive single doses of either IN or IV ketorolac. Our main outcomes were differences in numerical rating scale reduction at 30 and 60 minutes. A 95% confidence interval (CI) was calculated for each mean difference, with a minimum clinically important difference set at 1.3 points. Secondary outcomes included treatment response, adverse events, rescue medications, and emergency department revisits. We analyzed using intention-to-treat. RESULTS: A total of 86 and 85 patients with similar baseline characteristics were allocated to the IV and IN groups, respectively. Mean numerical rating scale scores were 8.52 and 8.65 at baseline, 3.85 and 4.67 at 30 minutes, and 2.80 and 3.04 at 90 minutes, respectively. The mean numerical rating scale reduction differences between the IV and IN groups were 0.69 (95% CI -0.08 to 1.48) at 30 minutes and 0.10 (95% CI -0.85 to 1.04) at 60 minutes. There were no differences in secondary outcomes. CONCLUSION: Neither IN or IV ketorolac was superior to the other for the treatment of acute renal colic, and both provided clinically meaningful reductions in pain scores at 30 to 60 minutes.


Asunto(s)
Cólico , Cólico Renal , Adulto , Humanos , Ketorolaco/uso terapéutico , Cólico Renal/tratamiento farmacológico , Administración Intravenosa , Dolor/tratamiento farmacológico , Método Doble Ciego , Servicio de Urgencia en Hospital , Antiinflamatorios no Esteroideos/uso terapéutico , Cólico/tratamiento farmacológico
17.
Handb Clin Neurol ; 198: 203-207, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38043962

RESUMEN

Infant colic is characterized by excessive and often inconsolable crying in an otherwise healthy and well-fed infant. Infant crying follows a developmental pattern, starting to increase around 2 weeks of age (corrected for gestational age at birth), peaking at 5 to 6 weeks, and trailing down by about 12 weeks. There is also a circadian component in that infants cry more in the evening than at other times. Infant colic can be thought of as an amplified version of the maturational, circadian-influenced behavior of infant crying. There is substantial evidence for an association between infant colic and migraine. Children with migraine are more likely to have been colicky as infants, and in a prospective, population-based study, young adults with migraine without aura were more than twice as likely to have been colicky as infants. Mothers with migraine are more likely to have infants with colic, particularly those mothers with higher headache frequency. Clinicians should be aware of these associations in order to be able to counsel appropriately pregnant women with migraine about the possibility of having an infant with colic (and its time-limited nature), and to help make an accurate diagnosis of migraine in children and adolescents presenting with recurrent headaches.


Asunto(s)
Cólico , Trastornos Migrañosos , Lactante , Recién Nacido , Niño , Adolescente , Adulto Joven , Humanos , Femenino , Embarazo , Cólico/diagnóstico , Cólico/epidemiología , Estudios Prospectivos , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/epidemiología , Cefalea , Llanto
18.
Breastfeed Med ; 18(12): 908-912, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-38100441

RESUMEN

Objective: Immaturity of the digestive tract and enteric nervous system is a widely accepted theory for infantile colic (IC) etiopathogenesis. The study aimed to show whether neurotrophins that are necessary for normal functioning and development of the gastrointestinal system have a role in the pathogenesis of IC. Materials and Methods: The IC group (n = 75) comprising the mothers of infants with IC and the control group (n = 75) were included to this cross-sectional case-control study. Brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), ciliary neurotrophic factor (CNTF), and nerve growth factor (NGF) levels of breast milk samples were evaluated by immunosorbent analysis method. Results: The mean age of infants with IC was 7.3 ± 2.8 weeks, while the mean age of the control group was 8.1 ± 2.9 weeks (p = 0.110). No significant difference was found between the breast milk BDNF, GDNF, CNTF, and NGF levels of two groups (p = 0.941, p = 0.510, p = 0.533, p = 0.839, respectively). Conclusions: This is the first report comparing the neurotrophin levels of the breast milk samples taken from the mothers of infants with and without IC. The study demonstrated that breast milk neurotrophin levels of the mothers did not differ significantly between the infants with and without IC.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo , Cólico , Lactante , Femenino , Humanos , Factor Neurotrófico Derivado del Encéfalo/metabolismo , Leche Humana/metabolismo , Factor de Crecimiento Nervioso/metabolismo , Factor Neurotrófico Ciliar/metabolismo , Factor Neurotrófico Derivado de la Línea Celular Glial/metabolismo , Cólico/metabolismo , Estudios Transversales , Estudios de Casos y Controles , Lactancia Materna
19.
J Vet Sci ; 24(6): e81, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38031518

RESUMEN

BACKGROUND: The incidence of colic and the outcomes of colic surgery have not been surveyed in racetracks in Korea. OBJECTIVES: This study examined the incidence, mortality, and case fatality of colic and investigated the effects of age and sex after an exploratory celiotomy on the long-term survival rate (return to racing), subsequent racing performance, and career longevity. METHODS: The incidence, mortality, and case fatalities of colic were examined over an 11-year period. The records of 40 horses that had undergone a celiotomy, after participating in at least one race and 75 race-matched control horses were analyzed. The racing performance and career length of the horses that returned to racing post-surgery were compared with a control group. RESULTS: The annual incidence, fatality rate of colic, and annual mortality rate at Seoul Racecourse were 6.5, 2.8 per 100 horse-years, and 0.2 deaths cases per 100 horse-years, respectively. Of the 40 horses that underwent colic surgery, 26 (65%) returned to racing. The likelihood of returning to racing decreased with increasing age of the horses, and geldings had a lower probability of returning. While the performance in the five preoperative races between the two groups was not significantly different, a significant decrease in racing performance was observed after the surgery date (p < 0.01). Horses that underwent colic surgery did not show a significant decrease in career length. CONCLUSIONS: Surgical treatment for colic at the age of three and four years had a negative impact on the racing performance. On the other hand, there was no significant difference in career longevity between the two groups.


Asunto(s)
Cólico , Enfermedades de los Caballos , Animales , Caballos , Masculino , Estudios Transversales , Cólico/epidemiología , Cólico/cirugía , Cólico/veterinaria , Seúl , Enfermedades de los Caballos/epidemiología , Enfermedades de los Caballos/cirugía , Incidencia , Estudios Retrospectivos
20.
Multimedia | Recursos Multimedia | ID: multimedia-12325

RESUMEN

Para falar sobre o tema “O aleitamento materno é a melhor forma de alimentação da criança com cólica e alergia alimentar” o programa da série “RP Convida”, da revista Residência Pediátrica, contou com a participação da dra. Graciete Vieira, membro do Departamento Científico de Aleitamento Materno da Sociedade Brasileira de Pediatria (SBP).


Asunto(s)
Cólico , Nutrición del Lactante , Lactancia Materna , Hipersensibilidad a los Alimentos , Difusión por la Web , Promoción de la Salud
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