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1.
Pan Afr Med J ; 36: 257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33014253

RESUMO

Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term, it is essential to pay attention to the diagnosis and surveillance of asymptomatic patients with SARS-COV2 infection. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspected or probable asymptomatic cases with negative RT-PCR for SARS-COV2. This study aimed to detect incidentally COVID-19 pneumonia on medical imaging for patients consulting for other reasons.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico por imagem , Dor Abdominal/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Lesões Encefálicas/complicações , Dor no Peito/complicações , Criança , Pré-Escolar , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Achados Incidentais , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/etiologia , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Pneumonia Viral/complicações , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos , Tunísia/epidemiologia , Adulto Jovem
2.
Clin Imaging ; 67: 1-4, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32492557

RESUMO

As the 2019 novel coronavirus disease (COVID-19) continues to spread, some patients are presenting with abdominal symptoms without respiratory complaints. Our case series documents four patients who presented with abdominal symptoms whose abdominopelvic CT revealed incidental pulmonary parenchymal findings in the imaged lung bases and were subsequently confirmed positive for COVID-19 via laboratory testing. It remains to be seen whether these patients will eventually develop respiratory symptoms. While it is possible that the patients' abdominal complaints are coincidental with CT findings, it is interesting that patients can have such extensive incidental disease in the lungs on CT without respiratory symptoms.


Assuntos
Dor Abdominal/complicações , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Pulmão/patologia , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Adulto , Betacoronavirus , Coronavirus , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/virologia , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
3.
J Pediatr ; 222: 134-140.e2, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32381468

RESUMO

OBJECTIVES: To test the hypothesis that the prevalence of joint hypermobility is greater in children with irritable bowel syndrome and functional abdominal pain than in healthy control children and is related to gastrointestinal symptoms and psychosocial distress (anxiety, depression, and somatization). STUDY DESIGN: Children (irritable bowel syndrome, n = 109; functional abdominal pain, n = 31; healthy control, n = 69), 7-12 years of age completed prospective 2-week pain and stooling diaries and child- and parent-reported measures of anxiety, depression, and somatization. Joint hypermobility was determined using Beighton criteria (score of ≥4 or 6). We also examined possible relationships between Beighton score, race, body mass index, gastrointestinal symptoms, and psychosocial distress. RESULTS: Beighton scores were similar between groups, as was the proportion with joint hypermobility. Scores were higher in girls (3.1 ± 2.4) than boys (2.3 ± 1.8; P = .004) and decreased with age (P < .001; r = -0.25). Race and body mass index did not impact joint hypermobility prevalence. Beighton scores were not related to abdominal pain or stooling characteristics. Participants with a score of ≥4 and ≥6 had greater somatization and depression by child report (P = .017 and P = .048, respectively). No association was seen for anxiety. There was no significant association between joint hypermobility and psychosocial distress measures per parent report. CONCLUSIONS: Contrary to the adult literature, the prevalence of joint hypermobility does not differ among children with irritable bowel syndrome, functional abdominal pain, or healthy control children. The presence or severity of joint hypermobility does not correlate with abdominal pain or stooling characteristics. Somatization and depression by child report appear to have a relationship with joint hypermobility.


Assuntos
Dor Abdominal/complicações , Síndrome do Intestino Irritável/complicações , Instabilidade Articular/complicações , Instabilidade Articular/epidemiologia , Ansiedade/etiologia , Criança , Depressão/etiologia , Feminino , Humanos , Masculino , Prevalência , Transtornos Somatoformes/etiologia
5.
Sci Rep ; 10(1): 1646, 2020 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-32015372

RESUMO

Abdominal pain is a common reason for medical visits. We examined the prevalence, gastrointestinal, and emotional significance of abdominal pain in a population-based cohort serially followed up from birth to 17 years. Children and adolescents from Generation 2 of the Raine Study participated in comprehensive cross-sectional assessments at ages 2, 5, 8, 10, 14 and 17 years. At 17 years, medical history, general health, gastrointestinal symptoms, medications, health practitioner attendance, and self-rated unhappiness were recorded. Longitudinal data regarding abdominal pain or unhappiness, from serial questionnaires, were analysed to identify factors associated with abdominal pain and adverse emotional health at age 17 years. Females experienced more abdominal pain than males at all ages (p < 0.05). Seventeen-year-old adolescents with abdominal pain reported a higher prevalence of depression, anxiety, being bullied at school, and poorer health status than those without abdominal pain (p < 0.05 for all). Abdominal pain and unhappiness during childhood and mid-adolescence were prospectively associated with recurrent abdominal pain, anxiety, depression and unhappiness during late adolescence (p < 0.05 for all). In conclusion, abdominal pain in children and adolescents associates with depression, anxiety, being bullied, unhappiness and reduced overall health-rating during adolescence. Awareness of these factors may guide management decisions.


Assuntos
Dor Abdominal/psicologia , Saúde Mental , Dor Abdominal/complicações , Dor Abdominal/epidemiologia , Adolescente , Ansiedade/complicações , Ansiedade/epidemiologia , Austrália/epidemiologia , Bullying , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Depressão/complicações , Depressão/epidemiologia , Emoções , Feminino , Humanos , Estudos Longitudinais , Masculino , Prevalência , Fatores de Risco , Tristeza , Inquéritos e Questionários
8.
BMC Pediatr ; 19(1): 466, 2019 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-31779607

RESUMO

BACKGROUND: Gastrointestinal (GI) problems are one of the most frequent comorbidities in Autism Spectrum Disorder (ASD) but can be under-recognized due to the concomitant communication difficulties of this population. Accordingly, some associated behaviors (AB) such as verbal and motor behaviors (VB and MB, respectively) have been identified as a possible expression of an underlying GI problem and evaluated through an ad hoc questionnaire (the Associated Behaviors Questionnaire -ABQ-). The aims of this study were to investigate the presence and the type of AB in an Italian sample of ASD preschoolers, and to determine their correlations with GI problems. METHODS: We included 85 ASD preschoolers (mean age 4.14 years; SD 1.08) splitted into two groups (GI and No-GI) through the GI Severity Index instrument. AB were evaluated through the ABQ that includes VB, MB and Changes in overall state (C) clusters. Specific tools were administered to evaluate the ASD core ad associated symptoms, as well as the intellective and adaptive functioning. RESULTS: The GI group (N = 30) showed significantly higher scores in all the three ABQ areas (VB, MB and C) than the No-GI group (N = 55), with a positive correlation between GI symptoms and some specific AB as well as ABQ Total score. By dividing the whole sample in verbal and non-verbal individuals, both specific and shared AB emerged in the two groups. CONCLUSIONS: Our results alert clinicians to consider behavioral manifestations as a possible expression of GI problems in ASD subjects. Therefore, the evaluation of AB may be useful to identify the presence of GI problems in the ASD populations, and especially in non-verbal ASD children.


Assuntos
Transtorno do Espectro Autista/complicações , Gastroenteropatias/diagnóstico , Atividade Motora , Comportamento Verbal , Dor Abdominal/complicações , Dor Abdominal/diagnóstico , Análise de Variância , Pré-Escolar , Feminino , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Gastroenteropatias/complicações , Humanos , Masculino , Índice de Gravidade de Doença , Inquéritos e Questionários
10.
Nurs Stand ; 34(5): 76-81, 2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31468816

RESUMO

Irritable bowel syndrome (IBS) is an umbrella term for a common range of symptoms such as abdominal pain, distension (bloating), diarrhoea and constipation. Nurses will often encounter patients with IBS in their day-to-day practice. As well as patients who present to healthcare services seeking assistance in managing their IBS, nurses may also encounter patients who were initially seeking assistance for other conditions, but were also found to be exhibiting symptoms of IBS. This article outlines the causes of IBS and the range of symptoms that people with IBS may experience. It details the pharmacological therapies available for IBS, and examines the range of management interventions that nurses can use to ameliorate the underlying factors that contribute to IBS.


Assuntos
Síndrome do Intestino Irritável/enfermagem , Síndrome do Intestino Irritável/terapia , Enfermeiras e Enfermeiros , Dor Abdominal/complicações , Constipação Intestinal/complicações , Diarreia/complicações , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/epidemiologia , Reino Unido
11.
Gastroenterol Hepatol ; 42(10): 622-623, 2019 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31324464
13.
J Nutr Sci ; 8: e18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080591

RESUMO

Functional gastrointestinal disorders including constipation affect up to 14 % of the world's population. Treatment is difficult and challenging resulting in a need for alternative safe and effective therapies. The present study investigated whether daily consumption of three gold-fleshed kiwifruit could alleviate constipation and improve gastrointestinal discomfort in mildly constipated individuals with and without pain. A total of thirty-two participants were enrolled in a 16-week randomised, single-blind, crossover study. Participants received either three 'Zesy002' kiwifruit or 14·75 g Metamucil® (5 g dietary fibre/d (a positive control)) for 4 weeks each with a 4-week washout between treatments. A 2-week washout period was included at the beginning and end of the study. Daily bowel habit diaries were kept throughout the study. The primary outcome measure was differences in the number of complete spontaneous bowel movements (CSBM). Secondary outcome measures were bowel movement frequency and stool form as well as digestive symptoms and comfort. The number of CSBM per week was significantly greater during daily consumption of three kiwifruit compared with the baseline (6·3 v. 3·3; P < 0·05) and the Metamucil® treatment (6·3 v. 4·5; P < 0·05). Stool consistency was also improved, with kiwifruit producing softer stools and less straining (P < 0·05). Gastrointestinal discomfort was also improved compared with baseline for abdominal pain, constipation and indigestion (P < 0·05) during the kiwifruit intervention and constipation during the Metamucil® intervention (P < 0·05). This randomised controlled trial demonstrates that daily consumption of three gold-fleshed kiwifruit is associated with a significant increase of two CSBM per week and reduction in gastrointestinal discomfort in mildly constipated adults.


Assuntos
Actinidia/química , Constipação Intestinal/tratamento farmacológico , Frutas/química , Trato Gastrointestinal/efeitos dos fármacos , Extratos Vegetais/uso terapêutico , Psyllium/uso terapêutico , Dor Abdominal/complicações , Adolescente , Adulto , Idoso , Estudos Cross-Over , Defecação , Método Duplo-Cego , Fezes , Feminino , Trânsito Gastrointestinal/efeitos dos fármacos , Humanos , Intestinos/efeitos dos fármacos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
14.
Neurogastroenterol Motil ; 31(7): e13595, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30957319

RESUMO

BACKGROUND: Nausea frequently co-exists with functional abdominal pain disorders (FAPDs) and may be linked to a higher disease burden. This study aimed to prospectively compare multisystem symptoms, quality of life, and functioning in FAPDs with and without nausea. METHODS: Adolescents ages 11-18 years fulfilling Rome III criteria for a FAPD were grouped by the presence or absence of chronic nausea. Subjects completed validated instruments assessing nausea (Nausea Profile Questionnaire = NPQ), quality of life (Patient-Reported Outcome Measurement Information System), functioning (Functional Disability Inventory), and anxiety (State-Trait Anxiety Inventory for Children). Group comparisons were performed for instruments, multisystem symptoms, school absences, and clinical diagnoses. KEY RESULTS: A total of 112 subjects were included; 71% reported chronic nausea. Patients with Nausea compared to No Nausea had higher NPQ scores (P ≤ 0.001), worse quality of life (P = 0.004), and greater disability (P = 0.02). State and trait anxiety scores were similar (P = 0.57, P = 0.25). A higher NPQ score correlated with poorer quality of life, more disability, and higher anxiety. Specific comorbidities were more common in Nausea vs No Nausea group: dizziness (81% vs 41%; P ≤ 0.001), concentrating difficulties (68% vs 27%; P ≤ 0.001), chronic fatigue (58% vs 20%; P = 0.01), and sleep disturbances (73% vs 48%; P = 0.02). The Nausea group reported more school absences (P = 0.001) and more commonly met criteria for functional dyspepsia (P = 0.034). CONCLUSION AND INFERENCES: Nausea co-existing with FAPDs is associated with a higher extra-intestinal symptom burden, worse quality of life, and impaired functioning in children. Assessing and targeting nausea therapeutically is essential to improve outcomes in FAPDs.


Assuntos
Gastroenteropatias/complicações , Náusea/etiologia , Náusea/psicologia , Qualidade de Vida , Dor Abdominal/complicações , Dor Abdominal/psicologia , Adolescente , Doença Crônica , Feminino , Humanos , Masculino
15.
Ned Tijdschr Geneeskd ; 1632019 03 14.
Artigo em Holandês | MEDLINE | ID: mdl-30945820

RESUMO

BACKGROUND: Non-celiac gluten sensitivity (NCGS) is a diagnosis that is increasingly being reported. Psychiatric symptoms can be a rare but serious manifestation of this new clinical entity. CASE REPORT: A 13-year-old girl consulted the paediatrician with abdominal pain, diarrhoea, bloating, and compulsive thoughts and fears; these disappeared on a gluten-free diet. Celiac disease and wheat allergy were excluded. Double-blind placebo-controlled gluten challenge confirmed the diagnosis NCGS. CONCLUSION: Consider a diagnosis of NCGS in patients with psychiatric symptoms in combination with abdominal symptoms.


Assuntos
Dor Abdominal/complicações , Doença Celíaca/complicações , Dieta Livre de Glúten/métodos , Medo/psicologia , Glutens/efeitos adversos , Transtornos Mentais/etiologia , Adolescente , Doença Celíaca/diagnóstico , Doença Celíaca/dietoterapia , Feminino , Humanos
16.
Pediatr Transplant ; 23(4): e13392, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30888108

RESUMO

Nocardia infection after RT is uncommon. The most common modes of exposure are inhalation of dust containing nocardia or contaminated soil/water and surgical instruments. Isolated abdominal nocardiosis following RT has not been reported. We report an 11-year-old female who developed nocardia abscesses of the abdomen post-RT. ESRD was secondary to FSGS and she had received multiple immunosuppressive agents prior to transplant. Induction immunosuppression consisted of thymoglobulin and maintenance was with tacrolimus, mycophenolate, and prednisone. There were construction activities in the hospital ward during her hospital stay. Due to immediate recurrence of FSGS in the allograft, she received plasma exchange, rituximab, and IVIG. Anti-infective prophylaxis consisted of TMP-SMX, valganciclovir, and nystatin. She developed multiple loculated fluid collections in the abdomen 6 weeks later. Histology of lesions demonstrated suppurative caseating granulomatous inflammation and the AFB culture showed Nocardia farcinica. With the reduction of immunosuppressive agents along with usage of TMP-SMX, imipenem-cilastatin, and linezolid, she had a partial recovery after 9 months with persistent small abscesses but remained asymptomatic clinically. There was no evidence of nocardia infection in lungs and brain. Repeat AFB culture from the lesions was negative. Allograft function remained stable throughout. She remains on oral TMP-SMX therapy. We postulated that she could have acquired nocardia either from the contaminated air particles in the hospital from the construction activities or reactivation of nocardia from prior colonization. Nocardia infection should be suspected in immunocompromised patients with unexplained fever and abdominal pain.


Assuntos
Imunossupressores/efeitos adversos , Falência Renal Crônica/complicações , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Nocardiose/complicações , Dor Abdominal/complicações , Criança , Feminino , Febre/complicações , Humanos , Hospedeiro Imunocomprometido , Imunossupressão/efeitos adversos , Nocardiose/tratamento farmacológico , Complicações Pós-Operatórias , Transplantados
17.
Clin Res Hepatol Gastroenterol ; 43(5): 614-622, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30772327

RESUMO

BACKGROUND/AIMS: Psychological factors are involved in many functional gastrointestinal disorders including globus. The aim of the present study was to assess the clinical and psychological correlates associated with globus. PATIENTS AND METHODS: 707 patients (69% female, 45.2 ± 16.5 years, BMI 27.2 ± 11.7 kg/m2) filled an MMPI-2 questionnaire and a standard Rome III clinical questionnaire and were included in this cross sectional study. Data analysis was performed using a univariate analysis and a multivariate logistic regression with a backwards selection procedure on significant scales after a univariate analysis. RESULTS: 140 patients (20%) reported suffering from globus. Globus appeared to be associated with older age (P = 0.001; OR = 1.022; 95% CI = [1.009-1.035]), increased BMI (P = 0.007; OR = 1.029; 95% CI = [1.008-1.051]), higher prevalence of regurgitations (P = 0.008; OR = 2.189; 95% CI = [1.228-3.902]), heartburn (P = 0.001 OR = 2.227; 95% CI = [1.406-3.530]), dysphagia (P < 0.001; OR = 2.399; 95% CI = [1.500-3.837]), epigastric pain (P < 0.001; OR = 3.768; 95% CI = [1.880-7.552]) and nonspecific dyspepsia (P = 0.018; OR = 1.786; 95% CI = [1.106-2.881]), and a higher score of hysteria (P = 0.008 OR = 1.034; 95% CI = [1.009-1.059]). By comparison with patients who reported globus and scores of hysteria in the normal range (n = 73), patients complaining of globus associated with high scores of hysteria (n = 67) have high scores of hypochondriasis (P < 0.001; OR = 1.235; 95% CI = [1.142-1.336]), high levels of Psychopathic deviate (P = 0.005; OR = 1.091; 95% CI = [1.026-1.161]) and a higher, but not significant, prevalence of complaints of regurgitation (P = 0.052; OR = 4.022; 95% CI = [0.989-16.351]). CONCLUSION: Approximately 50% of the patients complaining of globus have a high score of hysteria associated with other personality disorders, and complain more frequently of regurgitation than other patients complaining of globus. These results tend to confirm that globus has a strong, although not systematic, connections with some specific personality disorders.


Assuntos
Sensação de Globus/complicações , Sensação de Globus/psicologia , Dor Abdominal/complicações , Fatores Etários , Índice de Massa Corporal , Estudos Transversais , Transtornos de Deglutição/complicações , Dispepsia/complicações , Feminino , Azia/complicações , Humanos , Hipocondríase/complicações , Histeria/complicações , Refluxo Laringofaríngeo/complicações , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
BMC Gastroenterol ; 19(1): 34, 2019 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-30782128

RESUMO

BACKGROUND: This study was conducted to analyze the association between digestive symptoms and sleep disturbance, and to determine if any digestive symptoms are related to sleep disturbance. METHODS: This was a cross-sectional study of 5792 subjects surveyed in a community-based cohort. Subjects provided information regarding the quality of sleep as assessed by the Pittsburgh Sleep Quality Index (PSQI), as well as digestive symptoms as assessed by the Gastrointestinal Symptom Rating Scale (GSRS). Logistic regressions were used to examine factors associated with sleep quality. RESULTS: The mean PSQI global score of the no sleep disturbances group (n = 4948) was 3.92 (SD = 2.14), while that of the sleep disturbance group (n = 844) was 11.18 (SD = 2.17). The association between digestive symptoms and sleep disturbance was evaluated by logistic regression after adjusting for cofounding factors. The results revealed that sleep disturbances were associated with digestive symptoms (aOR = 1.29, 95% CI = 1.22-1.36), especially abdominal pains (aOR = 1.63, 95% CI = 1.19-2.25), acid regurgitation (aOR = 1.48, 95% CI = 1.17-1.86), abdominal distension (aOR = 1.80, 95% CI = 1.42-2.28), and eructation (aOR = 1.59, 95% CI = 1.24-2.03). CONCLUSIONS: Digestive symptoms and sleep disturbances seem to be associated. These results will help medical professionals to effectively diagnose and manage patients with sleep disturbance. Furthermore, subsequent studies using comprehensive longitudinal data should be conducted to confirm the results of the present study.


Assuntos
Doenças do Sistema Digestório/complicações , Transtornos do Sono-Vigília/complicações , Dor Abdominal/complicações , Idoso , Constipação Intestinal/complicações , Estudos Transversais , Dispepsia/complicações , Eructação/complicações , Feminino , Refluxo Gastroesofágico/complicações , Humanos , Masculino , Pessoa de Meia-Idade
19.
J Magn Reson Imaging ; 49(3): 621-631, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30701610

RESUMO

There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging pregnant patients is provided, and multiple common indications for MRI in pregnancy are discussed. Level of Evidence 5. Technical Efficacy Stage 5. J. Magn. Reson. Imaging 2019;49:621-631.


Assuntos
Imagem por Ressonância Magnética , Gravidez , Dor Abdominal/complicações , Dor Abdominal/diagnóstico por imagem , Descolamento Prematuro da Placenta/diagnóstico por imagem , Doenças dos Anexos/complicações , Doenças dos Anexos/diagnóstico por imagem , Apendicite/complicações , Apendicite/diagnóstico por imagem , Meios de Contraste/efeitos adversos , Feminino , Gadolínio/efeitos adversos , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico por imagem , Segurança do Paciente , Doenças Placentárias/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Complicações na Gravidez/prevenção & controle , Diagnóstico Pré-Natal/métodos , Urolitíase/complicações , Urolitíase/diagnóstico por imagem , Ruptura Uterina/diagnóstico por imagem
20.
Neurogastroenterol Motil ; 31(4): e13542, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30657233

RESUMO

BACKGROUND: The role of persistent immune activation in postinfectious irritable bowel syndrome (PI-IBS) remains controversial. Here, we prospectively studied healthy subjects traveling to destinations with a high-risk to develop infectious gastroenteritis (IGE) in order to identify immune-mediated mechanisms and risk factors of PI-IBS. METHODS: One hundred and one travelers were asked to complete questionnaires on psychological profile and gastrointestinal (GI) symptoms before travel, 2 weeks, 6 months and 1 year after travel. At each visit, blood was collected for PBMC isolation and rectal biopsies were taken. PI-IBS was diagnosed using the Rome III criteria and subjects with persistent postinfectious abdominal complaints (PI-AC) were identified using 3 GSRS symptoms (ie, loose stools, urgency and abdominal pain). RESULTS: Forty-seven of the 101 subjects reported IGE during travel. After 1 year, two subjects were diagnosed with PI-IBS and eight subjects were presented with PI-AC versus two subjects with IBS and two with abdominal complaints in the non-infected group. PBMC analysis showed no differences in T and B cell populations in subjects with PI-AC vs healthy. Additionally, no differences in gene expression were observed in the early postinfectious phase or after 1 year. Regression analysis identified looser stools, higher anxiety and somatization before infection and several postinfectious GI symptoms as risk factors for PI-AC. CONCLUSIONS: The incidence of PI-IBS is low following travelers' diarrhea and there is need for larger studies investigating the role of immune activation in PI-IBS. Psychological factors before infection and the severity of symptoms shortly after infection are risk factors for the persistence of PI-AC.


Assuntos
Dor Abdominal/complicações , Diarreia/complicações , Gastroenterite/complicações , Síndrome do Intestino Irritável/etiologia , Adulto , Ansiedade/complicações , Feminino , Humanos , Síndrome do Intestino Irritável/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Viagem
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