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1.
Arq Gastroenterol ; 61: e23159, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39230089

RESUMO

BACKGROUND: A staggering 99% of infant undernutrition mortality comes from Sub-Saharan Africa and South Asia. Despite multiple interventions focusing on nutrition adequacy, 2.7 million children worldwide remain associated with undernutrition-related mortality. The lack of impact from multiple interventions toward undernutrition reflects a strong reason to believe that EED is the missing link that sustains undernutrition in low-to-middle-income countries (LMICs). EED is a sub-clinical condition caused by repeated oral enteropathogenic and non-pathogenic fecal microbes exposure that causes intestinal villous malformation, multi-omics changes, chronic intestinal and systemic inflammation, and gut dysbiosis. EED impacts the absorptive capacity and the integrity of the gut, causing a cycle of undernutrition in children. There is currently no protocol for the diagnosis and treatment of EED, hence EED is widely believed to be highly prevalent and underdiagnosed in LMICs. OBJECTIVE: To our knowledge, this is the first systematic review to study the impact of nutritional interventions on EED. Previous studies yielded inconsistent results, hence the synthesis of this information is essential in attaining a deeper understanding of EED to formulate new targets of intervention against child undernutrition. METHODS: This systematic review is registered to PROSPERO (CRD42022363157) in accordance to PRISMA, using keywords referring to nutrient supplementation, EED, and child growth failure. RESULTS: Eleven articles were eligible for review, comprising randomized controlled trials performed mainly in the African continent, with a total of 5689 healthy children eligible for analysis. CONCLUSION: The systematic review illustrates that nutritional interventions have a minimal impact on EED biomarkers and linear growth and reflects the importance of understanding better the mechanisms causing EED and its consequences. It appears that the anabolic contribution of nutrition intervention to child growth is negated by EED.


Assuntos
Suplementos Nutricionais , População Rural , Humanos , Lactente , Criança , Enteropatias/terapia , Enteropatias/fisiopatologia
2.
Arq Bras Cir Dig ; 37: e1806, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38958344

RESUMO

BACKGROUND: Deep penetrating endometriosis (DE) can affect abdominal and pelvic organs like the bowel and bladder, requiring treatment to alleviate symptoms. AIMS: To study and investigate clinical and surgical outcomes in patients diagnosed with DE involving the intestines, aiming to analyze the effectiveness of surgical treatments. METHODS: All cases treated from January 2021 to July 2023 were included, focusing on patients aged 18 years or older with the disease affecting the intestines. Patients without intestinal involvement and those with less than six months of post-surgery follow-up were excluded. Intestinal involvement was defined as direct invasion of the intestinal wall or requiring adhesion lysis for complete resection. Primary outcomes were adhesion lysis, rectal shaving, disc excision (no-colectomy group), and segmental resection (colectomy group) along with surgical complications like anastomotic leak and fistulas, monitored for up to 30 days. RESULTS: Out of 169 patients with DE surgically treated, 76 met the inclusion criteria. No colectomy treatment was selected for 50 (65.7%) patients, while 26 (34.2%) underwent rectosigmoidectomy (RTS). Diarrhea during menstruation was the most prevalent symptom in the RTS group (19.2 vs. 6%, p<0.001). Surgical outcomes indicated longer operative times and hospital stays for the segmental resection group, respectively 186.5 vs. 104 min (p<0.001) and 4 vs. 2 days, (p<0.001). Severe complications (Clavien-Dindo ≥3) had an overall prevalence of 6 (7.9%) cases, without any difference between the groups. There was no mortality reported. Larger lesions and specific symptoms like dyschezia and rectal bleeding were associated with a higher likelihood of RTS. Bayesian regression highlighted diarrhea close to menstruation as a strong predictor of segmental resection. CONCLUSIONS: In patients with DE involving the intestines, symptoms such as dyschezia, rectal bleeding, and menstrual period-related diarrhea predict RTS. However, severe complication rates did not differ significantly between the segmental resection group and no-colectomy group.


Assuntos
Endometriose , Humanos , Feminino , Endometriose/cirurgia , Adulto , Resultado do Tratamento , Estudos Retrospectivos , Enteropatias/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Pessoa de Meia-Idade , Colectomia/métodos , Adulto Jovem
3.
Front Public Health ; 12: 1412362, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39050603

RESUMO

Background: Intestinal infectious diseases are a global concern in terms of morbidity, and they are closely linked to socioeconomic variables such as quality of life, weather and access to healthcare services. Despite progress in spatial analysis tools and geographic information systems in epidemiology, studies in Ecuador that evaluate temporal trends, specific geographic groups, and their correlation with socioeconomic variables are lacking. The absence of such information makes it challenging to formulate public health policies. This study sought to identify the spatial and temporal patterns of these diseases in Ecuador, along with their correlation with socioeconomic variables. Methods: In Ecuador, the study was carried out in a continental territory, focusing on data related to intestinal infectious diseases collected from the National Institute of Statistics and Census (Instituto Nacional de Estadística y Censos) during the period from 2014 to 2019. This study involved spatial and temporal analyses using tools such as the global Moran's index and Local Indicators of Spatial Association to identify spatial clustering patterns and autocorrelation. Additionally, correlations between morbidity rates and socioeconomic variables were examined. Results: During the investigated period, Ecuador registered 209,668 cases of these diseases. Notable variations in case numbers were identified, with a 9.2% increase in 2019 compared to the previous year. The most impacted group was children under 5 years old, and the highest rates were centered in the southern and southwestern regions of the country, with Limón Indanza and Chunchi being the cantons with the highest rates, notably showing a significant increase in Limón Indanza. Additionally, there were significant correlations between morbidity rates and socioeconomic variables, school dropout rates, low birth weight, and access to water services. Conclusion: This study emphasizes the importance of considering socioeconomic variables when addressing these diseases in Ecuador. Understanding these correlations and geospatial trends can guide the development of health policies and specific intervention programs to reduce the incidence in identified high-risk areas. More specific research is needed to understand the underlying causes of variability in morbidity and develop effective prevention strategies.


Assuntos
Fatores Socioeconômicos , Análise Espaço-Temporal , Humanos , Equador/epidemiologia , Pré-Escolar , Adolescente , Criança , Lactente , Masculino , Feminino , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Enteropatias/epidemiologia , Idoso , Recém-Nascido , Doenças Transmissíveis/epidemiologia
4.
Arch. latinoam. nutr ; Arch. latinoam. nutr;74(2): 141-150, jun. 2024. ilus, tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1561627

RESUMO

Introducción: La celiaquía es una patología multisistémica con base autoinmune que provoca una reacción a la proteína gluten encontrada en alimentos como o trigo, centeno, triticale, cebada, espelta y avena. Los síntomas más comunes de la celiaquía son la pérdida de peso, pérdida de apetito y fatiga general entre otros. A consecuencia de estos síntomas el rendimiento deportivo puede verse afectado. Objetivo: Para comprender como la celiaquía impacta en el rendimiento de los deportistas, el objetivo de este estudio es realizar una revisión sistemática relacionada con el rendimiento deportivo en personas celíacas. Materiales y métodos: Para ello, se utilizó la siguiente frase final de búsqueda: "Celiac" AND "Sport" AND "Performance", que fue introducida por igual en las bases de datos: Web of Science, Scopus y PubMed. Resultados: Los resultados muestran la existencia de escasos documentos relacionados con el objeto de estudio (n=11), dónde se muestra una variabilidad de tipos de diseño en los trabajos seleccionados. Por otro lado, se extrae que la única solución para mantener un adecuado rendimiento deportivo en una persona celiaca es llevar una dieta libre de gluten de por vida. Conclusiones: Los documentos seleccionados subrayan la importancia de que los deportistas con enfermedad celiaca mantengan una dieta sin gluten de manera constante a lo largo de su vida. Debido a la escasez de estudios relacionados con la temática, se recomienda aumentar el número de investigaciones relacionadas con el objeto de estudio, con la finalidad de mejorar los estilos y hábitos de vida de los deportistas celíacos(AU)


Introduction: Celiac disease is a multisystem autoimmune disorder that triggers a reaction to the protein gluten found in foods such as wheat, rye, triticale, barley, spelt, and oats. The most common symptoms of coeliac disease are weight loss, loss of appetite and general fatigue among others. As a result of these symptoms, athletic performance may be affected. Objetive: To understand how celiac disease impacts athletes' performance, the aim of this study is to conduct a systematic review related to sports performance in individuals with celiac disease. Materials and method: To do so, the following search phrase was used: "Celiac" AND "Sport" AND "Performance", which was entered equally in the following databases: Web of Science, Scopus and PubMed. Results: The results show the existence of few documents related to the object of study (n=11), where a variability of design types is shown in the selected works. On the other hand, the only solution to maintain adequate sports performance in a person with coeliac disease is to follow a gluten-free diet for life. Conclusions: The selected documents emphasize the importance of athletes with celiac disease maintaining a gluten-free diet consistently throughout their lives. Due to the scarcity of studies related to this topic, it is recommended to increase the number of research studies on this subject in order to improve the lifestyles and habits of athletes with celiac disease(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Doença Celíaca/complicações , Desempenho Atlético , Dieta Livre de Glúten , Glutens , Sinais e Sintomas , Fadiga , Sistema Imunitário , Enteropatias , Estilo de Vida
6.
Rev. colomb. cir ; 39(3): 430-440, 2024-04-24. tab
Artigo em Espanhol | LILACS | ID: biblio-1554114

RESUMO

Introducción. El intestino primitivo rota durante la vida embrionaria. Cuando ocurre de forma inadecuada aparece la malrotación intestinal que puede llevar a la obstrucción o al vólvulo del intestino medio. La incidencia disminuye con el aumento de la edad. La malrotación intestinal es una de las principales causas de complicaciones del tracto gastrointestinal en la edad pediátrica. Métodos. Estudio retrospectivo, observacional, transversal y analítico, de la experiencia durante 10 años en pacientes menores de 15 años con diagnóstico de malrotación intestinal, tratados en el Hospital Infantil de San Vicente Fundación, en Medellín, Colombia. Se buscó la asociación entre variables demográficas, clínicas e imagenológicas con los desenlaces. Resultados. Se obtuvieron 58 pacientes con malrotación intestinal, 65 % menores de 1 año. En 29,3 % de los pacientes se hizo el diagnóstico con la presentación clínica; los síntomas predominantes fueron distensión abdominal y emesis. En el 24,1 % se confirmó el diagnóstico con imágenes. Las variables con una diferencia estadísticamente significativa a favor de encontrar una malrotación complicada fueron choque séptico (OR=11,7), síndrome de respuesta inflamatoria sistémica (OR=8,4) y deshidratación (OR=5,18). Conclusiones. La malrotación intestinal tiene complicaciones como perforación, peritonitis, vólvulo e intestino corto. El vólvulo se acompaña de shock y sepsis, con mortalidad hasta del 50 %. Las imágenes diagnósticas son una ayuda, pero no se puede basar la conducta médica en estas porque ninguna imagen garantiza el diagnóstico definitivo. Los signos de alarma son poco específicos. En menores de un año con emesis, distensión y dolor abdominal se debe sospechar malrotación intestinal.


Introduction. The primitive intestine rotates during embryonic life. When it occurs inappropriately, intestinal malrotation appears, which can lead to obstruction or midgut volvulus. The incidence decreases when age increases. Intestinal malrotation is one of the main causes of complications of the gastrointestinal tract in pediatric age. Method. Retrospective, observational, cross-sectional and analytical study of the experience over 10 years in patients under 15 years of age with a diagnosis of intestinal malrotation, treated at Hospital Infantil of San Vicente Fundación, in Medellín, Colombia. The association between demographic, clinical and imaging variables with the outcomes was sought. Results. There were 58 patients with intestinal malrotation, 65% under one year of age. In 29.3% of patients, intestinal malrotation was diagnosed clinically. The predominant symptoms were abdominal distension and emesis. In 24.1% the diagnosis was confirmed with imaging. The variables with a statistically significant difference in favor of finding a complicated malrotation were septic shock (OR=11.7), systemic inflammatory response syndrome (OR-8.4), and dehydration (OR=5.18). Conclusions. Malrotation has complications such as perforation, peritonitis, volvulus, and short bowel. Volvulus is accompanied by shock and sepsis, with mortality of up to 50%. Diagnostic images are helpful, but medical conduct cannot be based on them because no image guarantees a definitive diagnosis. The warning signs are not very specific. In children under one year of age with emesis, distension and abdominal pain, intestinal malrotation should be suspected.


Assuntos
Humanos , Trato Gastrointestinal , Volvo Intestinal , Enteropatias , Síndrome do Intestino Curto , Obstrução Intestinal , Perfuração Intestinal
7.
Clin Investig Arterioscler ; 36(4): 229-233, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38443216

RESUMO

Sitosterolemia is an autosomal recessive and very rare disease. Its main characteristic is that there is a greater absorption and a decrease in the excretion of sterols, which leads to them being deposited in tissues. It is given by mutations in the ABCG5 or ABCG8 genes found on chromosome 2p21. In this clinical note, we describe the first two patients with familial sitosterolemia described in Colombia, brothers, one of them with xanthomas in extremities as the only symptom, and the other, completely asymptomatic. Genetic studies were performed as a diagnostic test in both patients, where a pathogenic homozygous variant could be identified in the ABCG8 gene in the first case (symptomatic), and a heterozygous variant in the ABCG8 gene in the second case (asymptomatic); the first patient has responded to treatment with ezetimibe. In conclusion, xanthomas should be studied in depth in pediatric age as they may be the only visible sign of such complex and hereditary diseases as familial sitosterolemia, which can be controlled and prevent cardiovascular complications of the disease.


Assuntos
Membro 8 da Subfamília G de Transportadores de Cassetes de Ligação de ATP , Ezetimiba , Hipercolesterolemia , Enteropatias , Erros Inatos do Metabolismo Lipídico , Fitosteróis , Humanos , Erros Inatos do Metabolismo Lipídico/genética , Erros Inatos do Metabolismo Lipídico/diagnóstico , Masculino , Colômbia , Fitosteróis/efeitos adversos , Fitosteróis/genética , Enteropatias/genética , Enteropatias/diagnóstico , Membro 8 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/genética , Hipercolesterolemia/genética , Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/diagnóstico , Ezetimiba/uso terapêutico , Xantomatose/genética , Xantomatose/patologia , Xantomatose/diagnóstico , Anticolesterolemiantes/uso terapêutico , Anticolesterolemiantes/administração & dosagem , Mutação , Membro 5 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/genética , Homozigoto , Criança , Heterozigoto , Lipoproteínas/genética
8.
Brasília; CONITEC; fev. 2024.
Não convencional em Português | BRISA/RedTESA, Inca | ID: biblio-1551260

RESUMO

INTRODUÇÃO: Os tumores neuroendócrinos (TNE) são neoplasias, com origem mais comum no trato gastrointestinal, que podem cursar com liberação de hormônios associado a sintomas, levando a síndrome carcinoide, com incidência anual estimada em 0,25/1.000.000 na Europa (ano de 2008). As manifestações clínicas mais comuns incluem diarreia secretória e rubor súbito, mas a diarreia é considerada mais debilitante com potencial risco de morte. Quando o tratamento curativo com ressecção completa não é viável pela presença de doença metastática, o tratamento é direcionado para o controle dos sintomas da síndrome carcinoide e os análogos da somatostatina (octreotida ou lanreotida) são considerados terapia de primeira linha na SC. PERGUNTAS DE PESQUISA: O acetato de octreotida de liberação prolongada (octreotida LAR) e o acetato de lanreotida de liberação prolongada (lanreotida LP) são eficazes, seguros e custo-efetivos para o tratamento dos sintomas relacionados à SC associados ao TNE gastroenteropancreático funcional em pacientes adultos? EVIDÊNCIAS CLÍNICAS: Foram selecionados três ensaios clínico


Assuntos
Humanos , Sincalida/análogos & derivados , Octreotida/uso terapêutico , Neoplasias das Glândulas Endócrinas/etiologia , Trato Gastrointestinal/patologia , Enteropatias/patologia , Síndrome do Carcinoide Maligno/tratamento farmacológico , Sistema Único de Saúde , Brasil , Eficácia , Análise Custo-Benefício/economia
9.
J Zoo Wildl Med ; 54(4): 830-836, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38252009

RESUMO

Parasitism is one of the most important diseases in nonhuman primates (NHP). Parasitism by Prosthenorchis elegans can be a threat to health and conservation of NHP in Costa Rica. Surgical management of intestinal acanthocephalan infection in two squirrel monkeys (Saimiri oerstedii) and one white-faced monkey (Cebus imitator) is described as an alternative to the lack of pharmacologic control options when there is a high burden of parasites present. A complete physical evaluation, including medical ultrasound techniques, allow for diagnosis of the parasite and its lesions. When animals present with a high burden of parasites, surgical management has shown to promote good health outcomes and increase the probability of survival.


Assuntos
Enteropatias , Animais , Costa Rica , Enteropatias/parasitologia , Enteropatias/veterinária , Exame Físico , Primatas/parasitologia
11.
Cir Cir ; 91(4): 494-500, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37677952

RESUMO

PURPOSE: Early diagnosis of necrotic bowel segment resulting from incarcerated inguinal hernia (IIH) is crucial for reducing morbidity and mortality. The aim of this study was to investigate the efficacy of the De Ritis ratio (DRR), also known as the ratio of aspartate aminotransferase to alanine aminotransferase, as a biomarker for intestinal necrosis. METHODS: This retrospective study included 132 patients who underwent emergency surgery for IIH. Patients were divided into two groups: those who underwent bowel resection for necrosis (Group 1) and those who did not (Group 2). Patients' demographic and clinical data were recorded. Using laboratory test results, DRR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and lymphocyte-to-CRP ratio (LCR) were calculated. RESULTS: The morbidity and mortality rates and the length of stay for Group 1 were statistically significantly different (p < 0.0001). The DRR, NLR, PLR, LMR, and LCR values of the same group were also significantly different (p < 0.05). CONCLUSION: DRR can be used as a biomarker for early diagnosis of bowel necrosis in patients with IIH.


ANTECEDENTES: El diagnóstico temprano del segmento intestinal necrótico resultante de una hernia inguinal incarcerada es crucial para reducir la morbilidad y la mortalidad. OBJETIVO: Investigar la eficacia del índice de De Ritis (IDR), también conocido como cociente de aspartato aminotransferasa a alanina aminotransferasa, como biomarcador de necrosis intestinal. MÉTODO: Estudio retrospectivo que incluyó a 132 pacientes que fueron intervenidos de urgencia por hernia inguinal incarcerada. Los pacientes se dividieron en dos grupos: los que se sometieron a resección intestinal por necrosis (grupo 1) y los que no (grupo 2). Se registraron los datos demográficos y clínicos de los pacientes. Usando los resultados de las pruebas de laboratorio, se calcularon el IDR, el índice neutrófilos-linfocitos (INL), el índice plaquetas-linfocitos (IPL), el índice linfocitos-monocitos (ILM) y el índice linfocitos-proteína C reactiva (ILPCR). RESULTADOS: Las tasas de morbilidad, mortalidad y duración de la estancia para el grupo 1 fueron estadísticamente significativas (p < 0.0001). Los valores de IDR, INL, IPL, ILM, ILPCR del mismo grupo también fueron significativamente diferentes (p < 0.05). CONCLUSIONES: El IDR puede utilizarse como biomarcador para el diagnóstico precoz de necrosis intestinal en pacientes con hernia inguinal incarcerada.


Assuntos
Hérnia Inguinal , Enteropatias , Humanos , Alanina Transaminase , Aspartato Aminotransferases , Hérnia Inguinal/complicações , Hérnia Inguinal/cirurgia , Estudos Retrospectivos , Necrose
13.
Curr Atheroscler Rep ; 25(5): 181-187, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36897412

RESUMO

PURPOSE OF REVIEW: The purpose of this review was to summarize important and updated information on sitosterolemia. Sitosterolemia is an inherited lipid disorder consisting of high levels of plasma plant sterols. This sterol storage condition is caused by biallelic loss-of-function genetic variants in either ABCG5 or ABCG8, leading to increased intestinal absorption and decreased hepatic excretion of plant sterols. Clinically, patients with sitosterolemia usually exhibit xanthomatosis, high levels of plasma cholesterol, and premature atherosclerotic disease, but presentation can be highly heterogeneous. Therefore, recognition of this condition requires a high level of suspicion, with confirmation upon genetic diagnosis or through measurement of plasma phytosterols. Treatment of sitosterolemia with both a plant sterol-restricted diet and the intestinal cholesterol absorption inhibitor ezetimibe can reduce efficiently the levels of plasma plant sterols, consisting in the first-line therapy for this disease. RECENT FINDINGS: Since hypercholesterolemia is often present in individuals with sitosterolemia, it is important to search for genetic variants in ABCG5 and ABCG8 in patients with clinical criteria for familial hypercholesterolemia (FH), but no variants in FH implicated genes. Indeed, recent studies have suggested that genetic variants in ABCG5/ABCG8 can mimic FH, and even when in heterozygosis, they may potentially exacerbate the phenotype of patients with severe dyslipidemia. Sitosterolemia is a genetic lipid disorder characterized by increased circulating levels of plant sterols and clinically manifested by xanthomatosis, hematologic disorders, and early atherosclerosis. Awareness about this condition, a rare, but commonly underdiagnosed and yet treatable cause of premature atherosclerotic disease, is imperative.


Assuntos
Aterosclerose , Hipercolesterolemia , Hiperlipoproteinemia Tipo II , Enteropatias , Erros Inatos do Metabolismo Lipídico , Fitosteróis , Xantomatose , Humanos , Hipercolesterolemia/tratamento farmacológico , Fitosteróis/efeitos adversos , Fitosteróis/genética , Erros Inatos do Metabolismo Lipídico/diagnóstico , Erros Inatos do Metabolismo Lipídico/genética , Erros Inatos do Metabolismo Lipídico/terapia , Enteropatias/diagnóstico , Enteropatias/genética , Enteropatias/tratamento farmacológico , Hiperlipoproteinemia Tipo II/complicações , Colesterol , Xantomatose/etiologia , Aterosclerose/genética , Aterosclerose/complicações
14.
Parasitol Res ; 122(4): 903-914, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36820929

RESUMO

Diarrheal diseases are one of the main health problems worldwide, especially in developing countries with poor health systems, high rates of poverty, and poor nutrition. The main causative agents of diarrheal disease are bacteria, viruses, and parasites; among the latter, the intestinal protozoa Giardia and Entamoeba stand out. In the present work, a observational analysis of the national surveillance data of amebiasis, giardiasis, and other protozoan intestinal infections was carried out. The data issued by the Directorate General of Epidemiology was analyzed to establish its relationship with geography, socioeconomic, and environmental conditions in Mexico during the 2015-2019 period. New cases of amebiasis decreased by 25.03% between 2015 and 2019, while giardiasis and other protozoan intestinal infections remained constant; in all cases, incidence was higher in females than in males, and children under 5 years of age were the most affected. The contribution of environmental conditions (seasonality, temperature, and humidity) and socioeconomic factors in the number of protozoan intestinal infection cases was assessed by a multivariable regression model using a backward selection procedure. Peaks in cases were observed in spring and summer, which are characterized by warm and humid climates. Additionally, states with high humidity and annual average temperature contribute to a notably higher incidence of these parasites, especially annual average temperature, as demonstrated through multivariable linear regression models. Moreover, the majority of these states have the largest population living in poverty with inadequate measures for the distribution, dispensing, and sanitation of water. These data are essential to incidence rate monitoring and focus efforts on eliminating risk factors and improving health programs in Mexico.


Assuntos
Amebíase , Giardíase , Enteropatias Parasitárias , Enteropatias , Parasitos , Criança , Masculino , Animais , Feminino , Humanos , Pré-Escolar , Giardíase/parasitologia , Enteropatias Parasitárias/parasitologia , Incidência , México , Fatores Socioeconômicos , Diarreia , Fatores de Risco , Prevalência , Fezes/parasitologia
15.
J Infect Public Health ; 16(4): 603-610, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36842196

RESUMO

The Brazilian Amazon rainforest region has a significant prevalence of malarial and intestinal parasitic infections in indigenous populations, accounting for a disproportionate burden. Thus, a cross-sectional study was conducted to assess the prevalence and association between malarial and intestinal protozoan and helminth infections in four remote indigenous villages in the Brazilian Amazon Forest. A total of 430 individuals participated in the study, and Plasmodium infections were diagnosed by examination of thick blood smears and PCR. Stool samples 295 individuals (69%) were examined by direct smear and the Kato-Katz technique. The overall prevalence of malaria, intestinal protozoan infection, and intestinal helminth infection was 14.2%, 100%, and 39.3%, respectively. Polyparasitism was predominant (83.7%), and most infected individuals had at least two or more different species of intestinal protozoan and/or helminth parasites. The prevalence of co-infection was 49.5%, and in individuals with intestinal protozoa and helminth infections (34%), Entamoeba. coli, Entamoeba histolytica, and Ascaris lumbricoides were the most common parasites. In individuals with malaria and protozoa infections (10.2%), P. vivax, E. coli, and E. histolytica predominated, and in individuals with malaria, protozoa, and helminth infections (5.4%). P. vivax, E. coli, E. histolytica, and A. lumbricoides predominated. Intestinal polyparasitism was common in the study population, and the presence of helminths was associated with an increased number of intestinal parasitic species. However, Plasmodium infections were neither a risk nor a protective factor for helminth infections; the same was true for helminth infections in relation to Plasmodium. The high prevalence of intestinal polyparasitism with Plasmodium co-infections highlights the need for combining strategies that may help control both malaria and intestinal parasite and generate a health approach aligned with indigenous perspectives.


Assuntos
Coinfecção , Helmintíase , Helmintos , Enteropatias Parasitárias , Enteropatias , Malária Vivax , Malária , Animais , Humanos , Coinfecção/complicações , Estudos Transversais , Brasil/epidemiologia , Floresta Úmida , Escherichia coli , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Helmintíase/complicações , Helmintíase/epidemiologia , Malária/complicações , Malária/epidemiologia , Povos Indígenas , Prevalência , Fezes/parasitologia
16.
Nutr Clin Pract ; 38(3): 617-627, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36351616

RESUMO

BACKGROUND: This study aimed to investigate the relationship between acute gastrointestinal injury (AGI) and hemodynamic and perfusion parameters in the first week of intensive care unit (ICU) admission and evaluate the association of AGI with ICU and hospital outcomes in patients with septic shock undergoing mechanical ventilation. METHODS: This retrospective cohort study applied the criteria proposed by the European Society of Intensive Medicine to classify the participants into risk/dysfunction group (AGI grade I and II) and failure group (AGI grade III and IV). Hemodynamic and perfusion parameters data previously collected in the first 48 h after ICU admission (admission, 12, 24, 48 h) were analyzed. RESULTS: A total of 163 were included and classified into AGI grades I (n = 79), II (n = 64), III (n = 20), and IV (none). Groups consisted of AGI risk/dysfunction (n = 143, 87.8%) and AGI failure (n = 20, 12.2%) patients. Patients with AGI failure had higher heart rate and mottling score (MS) at admission, lower mean arterial pressure, and an oliguria incidence at 12 h compared with those without AGI failure. Skin MS and abdominal primary site of infection were risk factors for AGI failure. AGI failure tended to be a risk factor for ICU mortality (risk ratio [95% CI]: 1.37 [0.99-1.89]; P = 0.053). CONCLUSION: AGI was frequently observed in patients with septic shock in the first week of ICU admission. Higher heart rate and MS and lower mean arterial pressure and incidence of oliguria were identified in patients with AGI failure compared with those without. AGI failure was associated with ICU mortality.


Assuntos
Gastroenteropatias , Enteropatias , Choque Séptico , Humanos , Choque Séptico/complicações , Estudos Retrospectivos , Oligúria , Gastroenteropatias/epidemiologia , Hemodinâmica , Perfusão , Unidades de Terapia Intensiva , Prognóstico
17.
Front Cell Infect Microbiol ; 12: 918237, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36478676

RESUMO

Introduction: The gut microbiome is involved in multiple processes that influence host physiology, and therefore, disruptions in microbiome homeostasis have been linked to diseases or secondary infections. Given the importance of the microbiome and the communities of microorganisms that compose it (microbiota), the term biomarkers were coined, which are bacteria correlated with disease states, diets, and the lifestyle of the host. However, a large field in the study of intestinal biomarkers remains unexplored because the bacterial communities associated with a given disease state have not been exactly defined yet. Methods: Here, we analyzed public data of studies focused on describing the intestinal microbiota of patients with some intestinal inflammatory diseases together with their respective controls. With these analyses, we aimed to identify differentially abundant bacteria between the subjects with the disease and their controls. Results: We found that frequently reported bacteria such as Fusobacterium, Streptococcus, and Escherichia/Shigella were differentially abundant between the groups, with a higher abundance mostly in patients with the disease in contrast with their controls. On the other hand, we also identified potentially beneficial bacteria such as Faecalibacterium and Phascolarctobacterium, with a higher abundance in control patients. Discussion: Our results of the differentially abundant bacteria contrast with what was already reported in previous studies on certain inflammatory diseases, but we highlight the importance of considering more comprehensive approaches to redefine or expand the definition of biomarkers. For instance, the intra-taxa diversity within a bacterial community must be considered, as well as environmental and genetic factors of the host, and even consider a functional validation of these biomarkers through in vivo and in vitro approaches. With the above, these key bacterial communities in the intestinal microbiota may have potential as next-generation probiotics or may be functional for the design of specific therapies in certain intestinal diseases.


Assuntos
Bactérias , Enteropatias , Humanos , Bactérias/genética , Mineração de Dados
18.
Rev. chil. obstet. ginecol. (En línea) ; Rev. chil. obstet. ginecol;87(6): 412-418, dic. 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1423743

RESUMO

Reportar un caso de evisceración vaginal espontánea en paciente con antecedentes quirúrgicos de histerectomía vaginal y hacer una revisión de la literatura sobre los principales factores de riesgo asociados a la presentación de este evento. Se presenta el caso de una paciente de 74 años multípara de 12 partos vaginales con antecedente ginecológico de histerectomía vaginal en 2012, en el año 2014 una sacroespinocolpopexia con colocación de cinta transobturadora más colporrafia anterior, en 2018 presenta cuadro con asas intestinales protruyendo con signos de isquemia a través de defecto en cúpula vaginal, se realiza resección de intestino delgado y anastomosis termino-terminal, con posterior cierre de defecto por vía abdominal. Se realizó una búsqueda en las bases de datos PubMed, Scielo, Google Scholar y Science Direct para artículos publicados en inglés y español, de los últimos 22 años. Se identificaron 16 títulos que cumplieron con los criterios de selección, los resultados de la revisión muestran factores de riesgo comunes. La evisceración vaginal por dehiscencia de la cúpula vaginal es una patología poco prevalente, el abordaje mínimamente invasivo, que ha aumentado en los últimos años, ha conllevado un aumento de la incidencia, siendo la histerectomía por laparoscopia el de mayor riesgo.


To report a case of spontaneous vaginal evisceration in a patient with a surgical history of vaginal hysterectomy, and to review the literature on the main risk factors associated with the presentation of this event. We present the case of a 74-year-old multiparous patient with 12 vaginal deliveries with a gynecological history of vaginal hysterectomy in 2012, in 2014 a sacrospinocolpopexy with placement of transobturator tape plus anterior colporrhaphy, in 2018 she presented with intestinal loops protruding with signs of ischemia through a defect in the vaginal vault, resection of the small intestine and end-to-end anastomosis were performed, with subsequent closure of the defect through the abdomen. A search was made in the PubMed, Scielo, Google Scholar and Science Direct databases for articles published in English and Spanish, from the last 22 years. 16 titles that met the selection criteria were identified; the results of the review show common risk factors. Vaginal evisceration due to dehiscence of the vaginal vault is a rare pathology, the minimally invasive approach, which has increased in recent years, has led to an increase in incidence, with laparoscopic hysterectomy being of greater risk.


Assuntos
Humanos , Feminino , Idoso , Doenças Vaginais/cirurgia , Doenças Vaginais/etiologia , Histerectomia Vaginal/efeitos adversos , Enteropatias/cirurgia , Enteropatias/etiologia , Prolapso Visceral , Fatores de Risco
19.
Front Immunol ; 13: 933463, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36341360

RESUMO

Common variable immunodeficiency (CVID) is one of the inborn errors of immunity that have the greatest clinical impact. Rates of morbidity and mortality are higher in patients with CVID who develop liver disease than in those who do not. The main liver disorder in CVID is nodular regenerative hyperplasia (NRH), the cause of which remains unclear and for which there is as yet no treatment. The etiology of liver disease in CVID is determined by analyzing the liver injury and the associated conditions. The objective of this study was to compare CVID patients with and without liver-spleen axis abnormalities in terms of clinical characteristics, as well as to analyze liver and duodenal biopsies from those with portal hypertension (PH), to elucidate the pathophysiology of liver injury. Patients were divided into three groups: Those with liver disease/PH, those with isolated splenomegaly, and those without liver-spleen axis abnormalities. Clinical and biochemical data were collected. Among 141 CVID patients, 46 (32.6%) had liver disease/PH; 27 (19.1%) had isolated splenomegaly; and 68 (48.2%) had no liver-spleen axis abnormalities. Among the liver disease/PH group, patients, even those with mild or no biochemical changes, had clinical manifestations of PH, mainly splenomegaly, thrombocytopenia, and esophageal varices. Duodenal celiac pattern was found to correlate with PH (p < 0.001). We identified NRH in the livers of all patients with PH (n = 11). Lymphocytic infiltration into the duodenal mucosa also correlated with PH. Electron microscopy of liver biopsy specimens showed varying degrees of lymphocytic infiltration and hepatocyte degeneration, which is a probable mechanism of lymphocyte-mediated cytotoxicity against hepatocytes and enterocytes. In comparison with the CVID patients without PH, those with PH were more likely to have lymphadenopathy (p < 0.001), elevated ß2-microglobulin (p < 0.001), low B-lymphocyte counts (p < 0.05), and low natural killer-lymphocyte counts (p < 0.05). In CVID patients, liver disease/PH is common and regular imaging follow-up is necessary. These patients have a distinct immunological phenotype that may predispose to liver and duodenal injury from lymphocyte-mediated cytotoxicity. Further studies could elucidate the cause of this immune-mediated mechanism and its treatment options.


Assuntos
Imunodeficiência de Variável Comum , Hipertensão Portal , Enteropatias , Humanos , Imunodeficiência de Variável Comum/complicações , Esplenomegalia , Hipertensão Portal/etiologia , Testes de Função Hepática , Hiperplasia
20.
Am J Trop Med Hyg ; 107(4): 754-765, 2022 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-36096405

RESUMO

Metabolic syndrome is a cluster of risk factors for cardiovascular disease afflicting more than 1 billion people worldwide and is increasingly being identified in younger age groups and in socioeconomically disadvantaged settings in the global south. Enteropathogen exposure and environmental enteropathy in infancy may contribute to metabolic syndrome by disrupting the metabolic profile in a way that is detectable in cardiometabolic markers later in childhood. A total of 217 subjects previously enrolled in a birth cohort in Amazonian Peru were monitored annually from ages 2 to 5 years. A total of 197 blood samples collected in later childhood were analyzed for 37 cardiometabolic biomarkers, including adipokines, apolipoproteins, cytokines, which were matched to extant early-life markers of enteropathy ascertained between birth and 2 years. Multivariate and multivariable regression models were fitted to test for associations, adjusting for confounders. Fecal and urinary markers of intestinal permeability and inflammation (myeloperoxidase, lactulose, and mannitol) measured in infancy were associated with later serum concentrations of soluble CD40-ligand, a proinflammatory cytokine correlated with adverse metabolic outcomes. Fecal myeloperoxidase was also associated with later levels of omentin-1. Enteric protozoa exposure showed stronger associations with later cardiometabolic markers than viruses, bacteria, and overall diarrheal episodes. Early-life enteropathy markers were associated with altered adipokine, apolipoprotein, and cytokine profiles later in childhood consistent with an adverse cardiometabolic disease risk profile in this cohort. Markers of intestinal permeability and inflammation measured in urine (lactulose, mannitol) and stool (myeloperoxidase, protozoal infections) during infancy may predict metabolic syndrome in adulthood.


Assuntos
Doenças Cardiovasculares , Enteropatias , Síndrome Metabólica , Adipocinas , Apolipoproteínas , Biomarcadores/metabolismo , Coorte de Nascimento , Doenças Cardiovasculares/epidemiologia , Pré-Escolar , Citocinas , Humanos , Inflamação/complicações , Enteropatias/metabolismo , Lactulose/metabolismo , Ligantes , Manitol/metabolismo , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Peroxidase/metabolismo , Peru/epidemiologia
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