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1.
Clin Nutr ; 39(7): 1988-1991, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32487434

RESUMO

The management of patients with chronic intestinal failure requiring home parenteral nutrition has been and will continue to be impaired during the SARS-CoV-2 pandemic. Multidisciplinary intestinal failure teams may have to adapt their clinical approaches to home care, outpatient care as well as hospital admission and discharge in order to keep this vulnerable group of patients as safe and well as possible during the unprecedented challenges that countries are facing during the pandemic. Equally, it is important that expert advice from intestinal failure teams is available when home parenteral nutrition (HPN)-dependent patients require admission with SARS-CoV-2 infection. The Home Artificial Nutrition & Chronic Intestinal Failure Special Interest Group of the European Society for Clinical Nutrition and Metabolism (ESPEN) has developed a position paper to outline areas for intestinal failure teams to consider when managing patients with chronic intestinal failure during the SARS-CoV-2 pandemic.


Assuntos
Infecções por Coronavirus , Enteropatias , Pandemias , Nutrição Parenteral no Domicílio , Pneumonia Viral , Betacoronavirus , Doença Crônica , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Hospitalização , Humanos , Enteropatias/complicações , Enteropatias/terapia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto
4.
Rev Esp Salud Publica ; 942020 Jun 16.
Artigo em Espanhol | MEDLINE | ID: mdl-32541647

RESUMO

OBJECTIVE: Decision making in hospitals, and especially in their own healthcare services, is hardly referenced in the literature. During the pandemic period, healthcare services have put in place contingency plans to minimize the consequences of the coronavirus on professionals and patients. However, the deployment of contingency plans and results are hardly shared, depriving other services of references to refute, compare or emulate the aforementioned plans. The objective of this work was the description of the implementation and evaluation of Contingency Plans in the Covid-19 pandemic in a unit of inflammatory bowel disease of a Digestive Service in the Sanitary Area of Pontevedra and O Salnés. METHODS: A team of managers and professionals adapted the 10 measures recommended by Deloitte to face a pandemic to the healthcare environment. The measures were then formulated as a checklist. From the Plan-Do-Check-Act improvement cycle, they were grouped into categories: risk management, organizational management and decision-making. Finally, an external team carried out a qualitative evaluation of the implementation of the contingency plan carried out. RESULTS: The Intestinal Inflammatory Disease Unit of the Digestive Service has obtained an assessment of compliance with the 10 recommended measures to confidently face a pandemic. CONCLUSIONS: Sharing the deployment of the contingency plan and its results is useful to identify good practices. This article shows a method to evaluate decision-making in pandemic situations. The outcomes faces the The Intestinal Inflammatory Disease Unit in an excelent position.


Assuntos
Infecções por Coronavirus/prevenção & controle , Administração Hospitalar , Departamentos Hospitalares/organização & administração , Doenças Inflamatórias Intestinais/terapia , Enteropatias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Lista de Checagem , Infecções por Coronavirus/complicações , Tomada de Decisões , Assistência à Saúde , Planejamento em Desastres , Fidelidade a Diretrizes , Humanos , Doenças Inflamatórias Intestinais/complicações , Enteropatias/complicações , Pneumonia Viral/complicações , Avaliação de Programas e Projetos de Saúde , Saúde Pública , Gestão de Riscos , Espanha/epidemiologia
5.
Br J Nurs ; 29(7): 393-398, 2020 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-32279546

RESUMO

Historically, the use of colonic irrigation or transanal irrigation (TAI) has been viewed as an alternative therapy for the treatment of a wide variety of conditions not relating to bowel dysfunction, including nausea, fatigue, depression, headache, anxiety and rheumatism. However, these days it is viewed as an effective treatment in individuals who may present with bowel dysfunction and related symptoms of constipation and faecal incontinence. Such individuals would include people with neuropathic bowel disorders, conditions that affect sphincter control or bowel motility disorders. injury to the rectum, sphincter or bowel, slow transit times, evacuation difficulties or prolapse due to a weak/damaged pelvic floor, and chronic faecal incontinence. TAI may be performed by the person with bowel dysfunction, or by a carer or health professional. An individual's ability to use a device to undertake the procedure will be influenced by a range of factors, which are explored in this article.


Assuntos
Enteropatias/terapia , Irrigação Terapêutica/métodos , Canal Anal , Constipação Intestinal/terapia , Incontinência Fecal/terapia , Humanos , Resultado do Tratamento
6.
Curr Gastroenterol Rep ; 22(1): 2, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31930437

RESUMO

PURPOSE OF REVIEW: Probiotics are promising remedial treatments for symptoms of small intestine (SI) diseases and promoters of overall good health. Probiotics play an important role in supporting a healthy SI microbiome (eubiosis), and in preventing establishment of unhealthy microbiota. SI eubiosis promotes optimal nutrient uptake, and optimal nutritional status maintains a healthy SI, reducing the likelihood of SI diseases. It is important to understand the advantages and limitations of probiotic therapies. RECENT FINDINGS: Microbial dysbiosis decreases the capacity of the small bowel to utilize and absorb dietary compounds. In some studies, probiotic supplements containing lactic acid bacteria and Bifidobacterium have been demonstrated effective in supporting beneficial microbes in the SI while improving barrier integrity and reducing nutrient malabsorption and SI disease-related pathology. Strain-specific probiotic therapy may be a natural and effective approach to restoring SI barrier integrity and eubiosis, resulting in improved nutrient absorption and better health, including reducing the incidence of and severity of SI diseases.


Assuntos
Enteropatias/terapia , Probióticos/uso terapêutico , Permeabilidade da Membrana Celular , Dieta , Disbiose/microbiologia , Microbioma Gastrointestinal/fisiologia , Humanos , Enteropatias/microbiologia , Enteropatias/fisiopatologia , Intestino Delgado/microbiologia , Intestino Delgado/fisiopatologia , Estado Nutricional
7.
Curr Gastroenterol Rep ; 22(1): 4, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31940112

RESUMO

PURPOSE OF REVIEW: Small bowel diverticulosis is a well-known clinical entity whose diagnosis and management has evolved in recent years. This review covers pathophysiology, incidence, and prevalence, and it also provides an update on modern diagnosis and management. Meckel's diverticula are covered elsewhere in this volume. RECENT FINDINGS: CT scan and MRI have largely supplanted barium follow-through for diagnosis. No intervention is needed in asymptomatic individuals. Endoscopic management is playing an increasing role for both bleeding and resection of intraduodenal diverticula, but surgical intervention remains the only definitive intervention for other complications like diverticulitis and small bowel obstruction. Small bowel diverticulosis is an uncommon condition which is associated with numerous possible complications. While endoscopy is playing an increasingly large role in management, surgical resection remains the treatment of choice for most complications. A high index of suspicion is needed in order to diagnose this entity.


Assuntos
Divertículo/diagnóstico , Enteropatias/diagnóstico , Divertículo/epidemiologia , Divertículo/etiologia , Divertículo/terapia , Humanos , Enteropatias/epidemiologia , Enteropatias/etiologia , Enteropatias/terapia , Intestino Delgado/fisiopatologia
8.
J Infect Public Health ; 13(4): 502-508, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31818708

RESUMO

BACKGROUND: Infectious intestinal disease affects 25% of the UK population annually; 1 in 50 affected people consult health professionals about their illness. AIMS: We tested if anticipated treatment-seeking decisions for suspected infectious intestinal disease could be related to emotional response, tolerance of symptoms, or beliefs about the consequential benefits and harms of seeking treatment (or not). METHODS: Questionnaire survey of adults living in the UK with statistical analysis of responses. A vignette was presented about a hypothetical gastrointestinal illness. People stated their emotional reactions, expected actions in response and beliefs about possible benefits or harms from seeking treatment (or not getting treatment). Multinomial regression looked for predictors of anticipated behaviour. RESULTS: People were inclined to consult a GP when they believed that seeking treatment would be beneficial and that its absence would be harmful. Seeking treatment was less anticipated if the condition was expected to improve quickly. Respondents were also more likely to consult if they strongly disliked fever or headache, and/or if the illness made them feel anxious or angry. Treatment-seeking (or lack of it) was not linked to harms from treatment-seeking, other specific symptoms and emotional responses. CONCLUSION: It was possible to link anticipated treatment-seeking behaviour to specific factors: expected prognosis, perceived benefits of seeking treatment, some emotions and some specific symptoms.


Assuntos
Doenças Transmissíveis/terapia , Enteropatias/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , Atitude Frente a Saúde , Doenças Transmissíveis/psicologia , Emoções , Humanos , Enteropatias/psicologia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Inquéritos e Questionários , Reino Unido
9.
Curr Gastroenterol Rep ; 21(11): 55, 2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31720893

RESUMO

PURPOSE OF REVIEW: Most drugs are given by the oral route. Oral intake allows direct contact between the drug and the entire GI tract mucosa, exposing it to potential topical damage until absorption. Medication-induced GI symptoms and lesions are therefore commonly encountered in clinical practice. This review will examine the most common drugs or classes of drugs affecting small bowel function and/or structure. RECENT FINDINGS: Since non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used medicines, NSAID enteropathy is highly prevalent and brings about considerable morbidity. Antimicrobials and proton-pump inhibitors profoundly modify intestinal microbiota, affecting gut sensory and motor functions, while other drugs (like iron and gold derivatives) impair intestinal permeability. Olmesartan (and likely ACE inhibitors) induce villous atrophy and consequent malabsorption. Mycophenolate mofetil, cancer chemotherapeutic agents, and immune checkpoint inhibitors cause intestinal inflammation, abdominal pain, and diarrhea. Potassium chloride supplements may induce small bowel ulceration, stenosis, and perforation while the cotraceptive pill and anticoagulants are associated with intestinal ischemia and spontaneous intramural hematoma, respectively. In clinical practice, a deep knowledge of clinical pharmacology and toxicology and a high degree of suspicion of drug-related adverse events are mandatory. Only then, the practicing physician will be able to diagnose medication-induced small bowel lesions correctly and will implement the best strategies to treat them.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Enteropatias/induzido quimicamente , Intestino Delgado/efeitos dos fármacos , Anti-Infecciosos/efeitos adversos , Antineoplásicos/efeitos adversos , Humanos , Enteropatias/terapia , Mucosa Intestinal/efeitos dos fármacos , Intestino Delgado/fisiopatologia , Inibidores da Bomba de Prótons/efeitos adversos
10.
Semin Immunopathol ; 41(6): 655-664, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31673757

RESUMO

Allogeneic transplantation of hematopoietic stem cells (allo-HCT) represents an increasingly employed therapeutic approach to potentially cure patients suffering from life-threatening malignant and autoimmune disorders. Despite its lifesaving potential, immune-mediated allo-reactivity inherent to the allogeneic transplantation can be observed within up to 50% of all allo-HCT patients regularly resulting in the manifestation of acute and/or chronic graft-versus-host disease (GvHD). Mechanistically, especially donor T cells are assumed to chiefly drive inflammation that can occur in virtually all organs, with the skin, liver, and gut representing as the most frequently affected anatomic sites. Especially in the presence of intestinal manifestations of GvHD, the risk that the disease takes a life-threatening, potentially fatal course is significantly increased. In the light of a rapid gain of knowledge in respect to decode innate and adaptive immunity related mechanisms as, e.g., cytokine networks, intracellular signaling pathways or environmental triggers as, e.g., the intestinal microbiota and the development of novel therapeutic approaches, detailed insight into endogenous mechanisms seeking to counterbalance the proinflammatory machinery or to proactively foster signals promoting the resolution of allo-driven intestinal inflammation is emerging. Here, we seek to highlight the key aspects of those mechanisms involved in and contributing to the resolution of GvHD-associated intestinal inflammation. Concomitantly, we would like to briefly outline and discuss promising future experimental targets suitable to be therapeutically employed to directionally deflect the tissue response from a proinflammatory to an inflammation-resolving type of intestinal GvHD after allo-HCT.


Assuntos
Doença Enxerto-Hospedeiro/etiologia , Enteropatias/etiologia , Doença Aguda , Animais , Gerenciamento Clínico , Suscetibilidade a Doenças , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/epidemiologia , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Homeostase , Humanos , Enteropatias/diagnóstico , Enteropatias/epidemiologia , Enteropatias/terapia
11.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(11): 1021-1026, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31770832

RESUMO

Radiation-induced bowel injury is a common complication of radiation therapy for pelvic malignancy. Given the huge number of patients diagnosed with pelvic malignancy, the number of patients diagnosed with radiation-induced bowel injury increased year by year, which put a great burden on the clinical diagnosis and treatment of radiation-induced bowel injury. In particular, chronic radiation-induced bowel injury, which is manifested in the process of prolonged, repeated and progressive aggravation, seriously affects the physical and mental health of patients and makes clinical diagnosis and treatment difficult. However, due to insufficient attention and understanding from doctors and patients, standardized diagnosis and treatment of radiation-induced bowel injury still have a long way to go. Radiation-induced bowel injury is self-limited but irreversible. During diagnosis, we should pay attention to overall evaluation of the stage of disease based on clinical symptoms, endoscopic examination, imaging examination, pathology and nutritional risk. The treatment methods include health education, drug therapy, enema therapy, formalin local treatment, endoscopic treatment and surgical treatment, etc. The treatment decision-making should be based on clinical symptoms, endoscopic or imaging findings to alleviate the clinical symptoms of patients as the primary goal and to improve the long-term quality of life of patients as the ultimate goal.


Assuntos
Enteropatias/terapia , Neoplasias Pélvicas/radioterapia , Lesões por Radiação/terapia , Radioterapia/efeitos adversos , Doença Crônica , Humanos , Enteropatias/diagnóstico , Enteropatias/etiologia , Intestinos/efeitos da radiação , Qualidade de Vida , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia
12.
Am J Physiol Gastrointest Liver Physiol ; 317(6): G845-G852, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31589468

RESUMO

Intestinal organoid cultures provide an in vitro model system for studying pathways and mechanisms involved in epithelial damage and repair. Derived from either embryonic or induced pluripotent stem cells or adult intestinal stem cells or tissues, these self-organizing, multicellular structures contain polarized mature cells that recapitulate both the physiology and heterogeneity of the intestinal epithelium. These cultures provide a cutting-edge technology for defining regenerative pathways that are induced following radiation or chemical damage, which directly target the cycling intestinal stem cell, or damage resulting from viral, bacterial, or parasitic infection of the epithelium. Novel signaling pathways or biological mechanisms identified from organoid studies that mediate regeneration of the epithelium following damage are likely to be important targets of preventive or therapeutic modalities to mitigate intestinal injury. The evolution of these cultures to include more components of the intestinal wall and the ability to genetically modify them are key components for defining the mechanisms that modulate epithelial regeneration.


Assuntos
Células-Tronco Adultas , Enteropatias , Intestinos , Organoides , Regeneração/fisiologia , Animais , Células Cultivadas/fisiologia , Células Cultivadas/transplante , Humanos , Enteropatias/etiologia , Enteropatias/metabolismo , Enteropatias/terapia , Intestinos/efeitos dos fármacos , Intestinos/efeitos da radiação , Modelos Biológicos , Organoides/fisiologia , Organoides/transplante , Engenharia Tecidual/métodos
13.
Expert Opin Biol Ther ; 19(12): 1343-1355, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31570017

RESUMO

Introduction: Alteration in the intestinal microbiota also termed as intestinal dysbiosis has been demonstrated in numerous gastrointestinal disorders linked to aberrant immune processes, acquisition of pathogenic organisms and often administration of antibiotics. Restoration of microbiota through probiotics and fecal microbiota transplantation (FMT) has gained tremendous popularity among researchers in the prevention and treatment of gastrointestinal diseases.Areas covered: In this review, studies testing the safety and efficacy of probiotics and FMT for the treatment of various infectious and inflammatory luminal gastrointestinal diseases are reviewed. Randomized control studies are given priority while important uncontrolled studies are also highlighted.Expert opinion: Probiotics have demonstrated efficacy in the prevention of antibiotic-associated diarrhea and in the eradication of Helicobacter pylori infection. Their utility in the primary and secondary prevention of Clostridioides difficile infection is debatable. The future of medicine should bring forth a personalized approach to probiotic use. FMT has revolutionized the treatment of recurrent CDI as well as severe and fulminant CDI. At the same time, it has galvanized gut microbiota research in the last decade. While FMT in ulcerative colitis appears promising, further studies on the durability and long-term safety are needed before it can be recommended in clinical practice.


Assuntos
Disbiose/terapia , Transplante de Microbiota Fecal , Microbioma Gastrointestinal , Enteropatias/terapia , Probióticos/uso terapêutico , Animais , Transplante de Microbiota Fecal/efeitos adversos , Humanos , Enteropatias/microbiologia , Probióticos/efeitos adversos
14.
Rev Bras Enferm ; 72(5): 1203-1210, 2019 Sep 16.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31531642

RESUMO

OBJECTIVE: To analyze the playful educational interventions in the knowledge of schoolchildren about intestinal parasitosis. METHOD: This is a quasi-experimental, non-randomized study, based on pre- and post-intervention, conducted in a public elementary school in a peripheric neighborhood in the city of Ribeirão Preto (SP). The study population consisted of 101 students enrolled in the 5th and 6th grade. For comparison, we used the generalized version of the McNemar chi-squared test. RESULTS: Of the 101 schoolchildren who participated in the study, 48 (47.5%) were female and 53 (52.5%) were male, aged from 9 to 14 years. Students' knowledge on intestinal parasitic infections has increased significantly after the playful educational intervention. CONCLUSION: Playful educational interventions are an excellent didactical resource in the teaching-learning process of schoolchildren.


Assuntos
Educação em Saúde/métodos , Enteropatias/psicologia , Ludoterapia/métodos , Adolescente , Amebíase/psicologia , Criança , Feminino , Giardíase/psicologia , Educação em Saúde/estatística & dados numéricos , Humanos , Enteropatias/terapia , Masculino , Ludoterapia/instrumentação , Ludoterapia/estatística & dados numéricos , Instituições Acadêmicas/organização & administração , Instituições Acadêmicas/estatística & dados numéricos , Inquéritos e Questionários
15.
Altern Ther Health Med ; 25(5): 30-38, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31550680

RESUMO

Context: Small intestinal bacterial overgrowth (SIBO) has gained popularity on the internet in addition to certain clinical and research circles. This interest has expanded awareness of important new dietary, nutraceutical, and pharmaceutical treatments in addition to laboratory evaluation assessment options. Concomitantly, there appears a loss of parsimony regarding how to use these tools resulting in an untenable degree of testing and treatment for this condition. Objectives: A balanced review of the data regarding SIBO testing, treatment, and management with the goal of establishing non-biased best practices. Design: Non-systematic review. Results: The results for the review fall into two categories. Ineffective Action: Treat only SIBO labs; Treat for SIBO if no symptoms are exhibited; Recommending eating or avoiding foods because they might be good or bad for SIBO; Recommending treatments that are non-validated. Effective Action: Use SIBO breath results, in addition to history and current symptoms, to determine the best treatment; Find foods that work for patients based on dietary elimination and reintroduction; Apply validated treatment for SIBO and IBS in a logical 'step-up' like treatment approach. Conclusions: Testing and treating for SIBO can offer patients clinically significant relief. However, these tests and treatments must be applied with circumspection to prevent over-testing, over-treatment, squandering resources, or creating a fear around certain foods.


Assuntos
Infecções Bacterianas/diagnóstico , Enteropatias/microbiologia , Intestino Delgado/microbiologia , Síndrome do Intestino Irritável/microbiologia , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Testes Respiratórios , Dietoterapia , Fármacos Gastrointestinais , Humanos , Enteropatias/diagnóstico , Enteropatias/terapia
16.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(9): 861-868, 2019 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-31550826

RESUMO

Objective: To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for intestinal disorders. Methods: A retrospectively descriptive cohort study was carried out. Clinical data of 2010 patients who underwent FMT and received follow-up for more than 3 months from May 2014 to November 2018 were collected, including 1,206 cases from Tongji University Shanghai Tenth People's Hospital and 804 cases from Nanjing Eastern Military General Hospital. Of the 2,010 patients, 797 were male and 1,213 were female, with a mean age of (49.4±16.5) years old. Inclusion criteria were those with indications for FMT and voluntary treatment of FMT. Pregnant or lactating women, patients with end-stage disease, cases who were participating or participated in other clinical trials within 3 months, and patients with previous bowel history of pathogen infection, oral antibiotics or proton pump inhibitors (PPI) for the recent2 weeks, and those at immunosuppressive state were excluded. Informed consent was obtained from the enrolled patients and their families. There were 1,356 cases of constipation, 175 cases of inflammatory bowel disease, 148 cases of chronic diarrhea, 127 cases of radiation enteritis, 119 cases of irritable bowel syndrome, and 85 cases of autism (complicating with intestinal disorders). FMT donor requirements: (1) 18 to 30 years old non-relatives, non-pregnant healthy adults with healthy lifestyle and good eating habits as volunteers to participate in fecal donation; (2) no administration of antibiotics within 3 months; (3) no chronic diseases such as constipation, irritable bowel syndrome, inflammatory bowel disease, etc., no autoimmune disease, not in immunosuppressive state, no history of malignant disease; (4) negative pathogen examination of infectious diseases (hepatitis B virus, hepatitis C virus, syphilis, HIV, etc.); (5) negative fecal examination (C.difficile, dysentery bacillus, Shigella, Campylobacter, parasites, etc.). The donor requirements after enrollment: (1) physical examination was reviewed once every two months, and the result still met the above requirements; (2) 16S rRNA sequencing was performed for every fecal donation in order to ensure that the composition and diversity of the fecal flora was stable and reliable. The preparation of the stool suspension referred to the Amsterdam criteria and the preparation process was less than 1 hour. The preparation of the FMT capsule was processed by pre-freezing the stool suspension after the preparation of the above suspension, and the frozen sample was transferred into a freeze dryer for freezing. The dried and lyophilized powder was encapsulated in capsules, and the capsule shell was made of acid-resistant hypromellose capsule (No.0) and pediatric-specific capsule (No.3), sealed and packaged in a-20℃ refrigerator. Three ways of accepting FMT treatment pathways included 6-day transplantation after the placement of the nasointestinal tube, 6-day oral FMT capsule transplantation and one-time transplantation through colonoscopy. Intestinal preparation (nasointestinal tube feeding of polyethylene glycol until watery stool) was carried out before transplantation. Other treatments were stopped during treatment and follow-up, and any medication was not recommended when necessary. Results: Of the 2010 patients, 1,497 cases received nasointestinal tube transplantation (nasointestinal tube group), 452 cases oral capsule transplantation (oral capsule group) and 61 cases colonoscopy (colonoscopy group). At 3 time points of 3, 12, and 36 months after FMT, the clinical cure rates and the clinical improvement rates were 41.3% (560/1 356), 35.2% (320/909), 31.4% (69/220), and 29.0% (393/1 356), 27.8% (253/909), 29.1% (64/220), respectively in constipation patients; 33.1% (58/175), 29.9% (35/117), 24.5% (12/49), and 31.4% (55/175), 27.4% (32/117), 57.1% (28/49), respectively in inflammatory bowel disease patients; 87.8% (130/148), 81.8% (81/99), 78.3% (36/46), and 8.1% (12/148), 7.1% (7/99), 4.3% (2/46), respectively in chronic diarrhea patients; 61.4% (78/127), 56.5% (48/85), 47.6% (20/42), and 21.2% (27/127), 15.3% (13/85), 14.3% (6/42), respectively in radiation enteritis patients; 53.8% (64/119), 45.0% (36/80), 6/15, and 21.0% (25/119), 26.2% (21/80), 4/15, respectively in irritable bowel syndrome patients; 23.5% (20/85), 22.8% (13/57), 20.0%(5/25), and 55.3% (47/85), 49.1% (28/57), 40.0% (10/25), respectively in autism patients. Meanwhile the clinical cure rates and the clinical improvement rates at 3, 12, and 36 months were 47.7% (714/1 497), 42.8% (425/994), 39.1% (128/327), and 29.1% (436/1 497), 27.0% (268/994), 28.1% (92/327), respectively in the nasointestinal tube group; 38.7% (175/452), 30.2% (91/301), 33.3% (16/48), and 24.3% (110/452), 26.2% (79/301), 25.0% (12/48), respectively in the oral capsule group; 34.4% (21/61), 32.7% (17/52), 18.2% (4/22), and 21.3% (13/61), 13.5% (7/52), 45.5% (10/22), respectively in colonoscopy group. No serious adverse events occurred during treatment and follow-up period. The adverse event of nasointestinal tube group presented higher ratio of discomfort in respiratorytract accounting for 13.1% (196/1497); the oral capsule group had a higher proportion of nausea and vomiting when swallowing capsules accounting for 7.1% (32/452); the colonoscopy group was mainly diarrhea, accounting for 37.7% (23/61). The above symptoms disappeared after the nasointestinal tube was removed, or after treatment ended, or within 1 to 3 days after hospitalization. Conclusion: FMT is a safe and effective method for the treatment of intestinal dysfunction.


Assuntos
Transplante de Microbiota Fecal , Enteropatias , Adolescente , Adulto , Idoso , Bactérias/genética , China , Estudos de Coortes , Fezes/microbiologia , Feminino , Humanos , Enteropatias/terapia , Masculino , Pessoa de Meia-Idade , RNA Ribossômico 16S , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
17.
J Microbiol Biotechnol ; 29(9): 1335-1340, 2019 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-31434172

RESUMO

Probiotics, including bacteria and yeast, are live microorganisms that have demonstrated beneficial effects on human health. Recently, probiotic bacteria are constantly being studied and their applications are also being considered in promising adjuvant treatments for various intestinal diseases. Clinical trials and in vivo experiments have extended our current understanding of the important roles that probiotics play in human gut microbiomeassociated diseases. It has been documented through many clinical trials that probiotics could shape the intestinal microbiota leading to potential control of multiple bowel diseases and promotion of overall wellness. In this review, we focused on the relationship between probiotics and the human gut microbiota and its roles in gut microbiome-associated diseases. Here, we also discuss future directions and research areas that need further elucidation in order to better understand the roles of probiotics in the treatment of intestinal diseases.


Assuntos
Microbioma Gastrointestinal/efeitos dos fármacos , Enteropatias/terapia , Probióticos/uso terapêutico , Ensaios Clínicos como Assunto , Disbiose/microbiologia , Disbiose/terapia , Homeostase , Humanos , Enteropatias/microbiologia , Probióticos/administração & dosagem , Probióticos/farmacologia
18.
Cir Cir ; 87(5): 559-563, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448804

RESUMO

Background: Intestinal failure (IF) was first defined as "a reduction in the functioning gut mass below the minimal amount necessary for adequate digestion and absorption." In our environment, there are no statistical data for IF in adult patients' extended length of stay (LOS), nor the economic impact that it implies. Objective: The objective of the study was to describe the association between the IF type and extended LOS. Methods: Patients admitted to our IF Unit between March 2016 and March 2018 were enrolled. We conducted a 2-year retrospective cross-sectional study. Results: From the total of 53 patients, 35% corresponded to type I IF, 58.5% to type II IF, and 7.5% to type III IF. The mean LOS, according to the type of functional IF was 51 days for type I, 77.48 days for type II, and 68.25 days for type III. The mean LOS for the three IF types was 67.79 days. Conclusion: Extended LOS occurs in an important proportion of patients with IF, resulting in increased morbidity and mortality, as well as in costs and associated side effects. Future research should focus on economic studies, to know the economic impact that this subject entails for our health systems.


Assuntos
Hospitalização/estatística & dados numéricos , Enteropatias/classificação , Escores de Disfunção Orgânica , Estudos Transversais , Custos Hospitalares/estatística & dados numéricos , Unidades Hospitalares/economia , Unidades Hospitalares/estatística & dados numéricos , Hospitalização/economia , Humanos , Enteropatias/epidemiologia , Enteropatias/cirurgia , Enteropatias/terapia , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , México/epidemiologia , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
19.
Biomed Res Int ; 2019: 3469754, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467881

RESUMO

Intestinal microbial dysbiosis is associated with various intestinal and extraintestinal disorders. Fecal microbiota transplantation (FMT), a type of fecal bacteriotherapy, is considered an effective therapeutic option for recurrent Clostridium difficile infection (rCDI) and also has important value in other intestinal diseases including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The purpose of this review is to discuss promising therapeutic value in extraintestinal diseases associated with gut microbial dysbiosis, including liver, metabolic, chronic kidney, neuropsychiatric, allergic, autoimmune, and hematological diseases as well as tumors.


Assuntos
Transplante de Microbiota Fecal/tendências , Doenças Inflamatórias Intestinais/terapia , Enteropatias/terapia , Síndrome do Intestino Irritável/terapia , Infecções por Clostridium/microbiologia , Infecções por Clostridium/patologia , Infecções por Clostridium/terapia , Clostridium difficile/patogenicidade , Fezes/microbiologia , Microbioma Gastrointestinal , Humanos , Doenças Inflamatórias Intestinais/microbiologia , Enteropatias/microbiologia , Enteropatias/patologia , Intestinos/microbiologia , Síndrome do Intestino Irritável/microbiologia
20.
Nutrients ; 11(7)2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31315186

RESUMO

The aim of this study was to evaluate the effect of milk fermented with Lactobacillus fermentum J20 (FMJ20) or J28 (FMJ28) on ameliorating indomethacin-induced inflammation. Twenty-eight male C57Bl/6 mice were divided into four experimental groups: indomethacin, indomethacin + FMJ20, indomethacin + FMJ28, and untreated (control). Groups were fed fermented milk for 15 days, followed by administration of indomethacin supplied in three sub-doses over experimental period. Body weight, and food consumption were recorded. Additionally, spleen, kidney, and liver were weighed, and the small intestine length was measured. The cytokines in serum (IL-2, IL-4, IL-6, IL-10, IL-17, IL-23 and TNFα) and in intestinal mucosa (IL-17 and IFNγ) were also determined. Compared to the control, all indomethacin-supplemented groups lost weight (~2.7 g; p < 0.05), but no changes were found in the organ-specific morphometry analysis. FMJ28 showed better results in attenuating serum and intestinal IL-17 levels. Furthermore, showed less epithelial cell loss and inflammatory infiltrates than the other indomethacin-treated groups. These results suggest that FMJ28 may be effective in reducing intestinal and systemic acute inflammation, specifically in mice.


Assuntos
Indometacina/toxicidade , Inflamação/induzido quimicamente , Enteropatias/induzido quimicamente , Lactobacillus fermentum/fisiologia , Animais , Anti-Inflamatórios não Esteroides/toxicidade , Citocinas/genética , Citocinas/metabolismo , Fermentação , Regulação da Expressão Gênica/efeitos dos fármacos , Inflamação/terapia , Enteropatias/terapia , Intestinos/efeitos dos fármacos , Intestinos/patologia , Rim/efeitos dos fármacos , Rim/patologia , Fígado/efeitos dos fármacos , Fígado/patologia , Camundongos Endogâmicos C57BL , Leite , Tamanho do Órgão , Baço/efeitos dos fármacos , Baço/patologia
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