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BACKGROUND: The prevalence of medically compromised patients seeking dental care varies across different countries. There have been no published reports about this clinical topic in Mexico. OBJECTIVES: We aimed to determine the prevalence of systemic diseases in patients who attended the Diagnostic Clinic at the Faculty of Dentistry of the Autonomous University of San Luis Potosí in Mexico from 2011 to 2019. MATERIAL AND METHODS: The study was based on the analysis of electronic files from 82,363 medically compromised patients registered in the clinic during the aforementioned period. Each file was entered into an electronic medical record using the Microsoft Visual Basic.NET software and completed by an undergraduate student based on a personal interview. The collected information was then analyzed with the use of Stata 14 statistical package. RESULTS: The global prevalence of medically compromised patients among the patient population was 39.1%. Comorbidities were more prevalent in female patients (71.9%) compared to male patients (28.1%). The most prevalent diseases in adults were gastrointestinal diseases (16.5%), arterial hypertension (14.1%) and diabetes mellitus (8.6%). CONCLUSIONS: In a third of the registered cases, an associated comorbidity was identified. It is therefore necessary for dental undergraduate students to receive comprehensive training during their academic formation to facilitate the timely and accurate diagnosis of systemic diseases, as part of the dental care protocol for adult patients.
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Faculdades de Odontologia , Humanos , México/epidemiologia , Masculino , Feminino , Estudos Transversais , Prevalência , Adulto , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Faculdades de Odontologia/estatística & dados numéricos , Idoso , Criança , Comorbidade , Diabetes Mellitus/epidemiologia , Gastroenteropatias/epidemiologia , Hipertensão/epidemiologia , Pré-EscolarRESUMO
Neurogastroenterology and motility disorders are complex gastrointestinal conditions that are prevalent worldwide, particularly affecting women and younger individuals. These conditions significantly impact the quality of life of people suffering from them. There is increasing evidence linking these disorders to cirrhosis, with a higher prevalence compared to the general population. However, the link between neurogastroenterology and motility disorders and cirrhosis remains unclear due to undefined mechanisms. In addition, managing these conditions in cirrhosis is often limited by the adverse effects of drugs commonly used for these disorders, presenting a significant clinical challenge in the routine management of patients with cirrhosis. This review delves into this connection, exploring potential pathophysiological links and clinical interventions between neurogastroenterology disorders and cirrhosis.
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Motilidade Gastrointestinal , Cirrose Hepática , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/fisiopatologia , Motilidade Gastrointestinal/efeitos dos fármacos , Gastroenteropatias/fisiopatologia , Qualidade de VidaRESUMO
BACKGROUND: The most frequent early gastrointestinal (GI) toxicity symptoms are nausea (58%), diarrhea (46.7%), and vomiting (45.5%) in patients with cervical cancer (CC). Approximately 90% of patients undergoing abdominopelvic radiotherapy present with changes in the GI tract, such as degenerative alterations in mucosal epithelial cells and nutrient malabsorption. OBJECTIVE: To evaluate the effect of a diet modified in fiber, lactose, and fat on the prevention of chemoradiotherapy (QTRT)-induced GI toxicity compared to the usual prescription in women with locally advanced CC. METHODS: A total of 134 women with a confirmed diagnosis of CC in locally advanced stages (IB2-IVA) were included in a randomized clinical trial conducted between February 2017 and March 2020. The intervention group (IG) received a modified diet of fiber, lactose, and fat, while the usual prescription group (UP) followed habitual nutritional recommendations. Toxicity was measured using the Common Terminology Criteria for Adverse Events (CTCAE) v4. RESULTS: A total of 134 women were included in the IG (65) and UP (69) groups. The mean age in the IG and UP groups were 47.2±13.4 and 49.7±14.2 years, respectively. Radiotherapy doses received by the IG and UP groups were 50.1±6.7 and 49.9±4.6 Gy, respectively. IG had a lower risk of presenting with mild constipation compared to the UP (hazard ratio: 0.46, 95% confidence interval: 0.28-0.76, P<0.01). CONCLUSION: Patients with locally advanced stages of CC undergoing QTRT who received fiber, lactose, and fat-modified diet may have a lower risk of mild constipation during abdominal radiotherapy.
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Quimiorradioterapia , Fibras na Dieta , Lactose , Neoplasias do Colo do Útero , Humanos , Feminino , Fibras na Dieta/administração & dosagem , Pessoa de Meia-Idade , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/métodos , Adulto , Gastroenteropatias/etiologia , Gastroenteropatias/prevenção & controle , Gorduras na Dieta/administração & dosagemRESUMO
OBJECTIVE: Translating and cross-culturally adapting the CFAbd-Score, Cystic Fibrosis (CF) Abdominal Score, to use in Brazilian spoken Portuguese. The CFAbd-Score is a questionnaire for assessing CF-related abdominal symptoms and their influence on the quality of life (QoL). It comprises 28 questions on five domains: abdominal pain, bowel movements, eating and appetite, gastroesophageal reflux symptoms, and the impact of gastrointestinal (GI) symptoms on QoL. METHOD: Cross-cultural adaptation included assessment of conceptual and item equivalence, semantic, operational, and measurement equivalence. Content validity was assessed. The validation and psychometric analysis phase included 97 people with CF (pwCF), median age:14.58y (IQR 9/19), and 105 healthy individuals, 15.10y (IQR 9/20). Exploratory factor analysis (FA) identified retained factors. Internal consistency of the extracted domains was evaluated using Cronbach's α, and the Kaiser-Meyer-Olkin test (KMO) was used to check the sample adequacy. Bartlett's test tested the null hypothesis that the correlation matrix is an identity matrix. RESULTS: All items were considered relevant to the construct and good semantic equivalence of the version was recognized. FA showed the appropriate weight of all items and good internal consistency, with Cronbach's alpha 0.89. Bartlett's test significance level (p < 0.001) and KMO coefficient of 0.72 indicated good adequacy for structure. Internal consistency coefficients (Cronbach's alpha) were good for abdominal pain: 0.84; abdominal bloating: 0.73; flatulence: 0.76; heartburn: 0.81, and low for reflux: 0.54. CONCLUSION: The CFAbd-Score was adapted to the Brazilian spoken Portuguese and demonstrated content and semantic equivalence. The final version showed appropriate validity, and internal consistency, preserving the psychometric properties of the original version.
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Comparação Transcultural , Fibrose Cística , Gastroenteropatias , Psicometria , Qualidade de Vida , Traduções , Humanos , Fibrose Cística/complicações , Fibrose Cística/fisiopatologia , Feminino , Masculino , Adolescente , Brasil , Gastroenteropatias/diagnóstico , Inquéritos e Questionários/normas , Reprodutibilidade dos Testes , Criança , Adulto Jovem , Estudos de Casos e ControlesRESUMO
Background: This review investigates the impact of bioactive molecules produced by probiotics on child health, focusing on their roles in modulating gut microbiota, enhancing immune function, and supporting overall development. Key metabolites, including short-chain fatty acids (SCFAs), bacteriocins, exopolysaccharides (EPSs), vitamins, and gamma-aminobutyric acid (GABA), are highlighted for their ability to maintain gut health, regulate inflammation, and support neurodevelopment. Objectives: The aim of this review is to examine the mechanisms of action and clinical evidence supporting the use of probiotics and postbiotics in pediatric healthcare, with a focus on promoting optimal growth, development, and overall health in children. Methods: The review synthesizes findings from clinical studies that investigate the effects of probiotics and their metabolites on pediatric health. The focus is on specific probiotics and their ability to influence gut health, immune responses, and developmental outcomes. Results: Clinical studies demonstrate that specific probiotics and their metabolites can reduce gastrointestinal disorders, enhance immune responses, and decrease the incidence of allergies and respiratory infections in pediatric populations. Additionally, postbiotics-bioactive compounds from probiotic fermentation-offer promising benefits, such as improved gut barrier function, reduced inflammation, and enhanced nutrient absorption, while presenting fewer safety concerns compared to live probiotics. Conclusions: By examining the mechanisms of action and clinical evidence, this review underscores the potential of integrating probiotics and postbiotics into pediatric healthcare strategies to promote optimal growth, development, and overall health in children.
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Saúde da Criança , Microbioma Gastrointestinal , Probióticos , Humanos , Criança , Microbioma Gastrointestinal/efeitos dos fármacos , Pré-Escolar , Desenvolvimento Infantil , Gastroenteropatias/prevenção & controleRESUMO
In Mexico, 1.9% of child mortality among children aged 3 to 15 years is attributed to waterborne gastrointestinal diseases (WGD). This study employs a generalized bivariate logit econometric model to simulate the relationships between mortality risks and seven explanatory variables. Based on the model results and sensitivity analysis of the estimated parameters, a set of policies was designed to reduce the likelihood of child mortality. The proposed strategy involves implementing the following public policies, primarily targeting communities with extreme and high marginalization: increasing access to drinking water, improving housing conditions, expanding parental basic education coverage, and providing nutrition and healthcare to children from an early age. The findings reveal that children who speak an indigenous language face a mortality risk from WGD that is three times higher than those who do not, while children who receive medical services have a 29% lower risk of mortality compared to those who do not have access to them. It is recommended to offer free medical care in indigenous languages within high-marginalization communities. The combined impact of these policies is expected to significantly reduce child mortality due to WGD.
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Mortalidade da Criança , Gastroenteropatias , Fatores Socioeconômicos , Humanos , Criança , México/epidemiologia , Pré-Escolar , Mortalidade da Criança/tendências , Adolescente , Gastroenteropatias/mortalidade , Gastroenteropatias/epidemiologia , Doenças Transmitidas pela Água/mortalidade , Doenças Transmitidas pela Água/epidemiologia , Feminino , MasculinoRESUMO
Background: SARS-CoV-2 infection began in Wuhan, China, in December 2019, where the first cases of pneumonia were described. The infection spread rapidly and was established as a pandemic by the World Health Organization (WHO) in February 2020. In Mexico, the first cases were in March 2020. Although the classic symptoms are respiratory, gastrointestinal symptoms have been described in 17%, as well as hepatic disorders associated with pneumonia. Objective: To describe the gastrointestinal manifestations and hepatic alterations in patients with COVID-19 from July 2020 to January 2021 in a tertiary-care hospital. Material and methods: Clinical, cross-sectional, prolective, observational, analytical study, which included patients of 18 years or older hospitalized with COVID-19, confirmed by PCR for SARS-CoV-2. Results: 84 patients were included, 65% male (55). Mean age was of 59 (± 13.3) years. Reported comorbidities were systemic arterial hypertension (51%), type 2 diabetes (38%), and obesity (26%). The predominant pattern was hepatocellular with elevation of AST (38) 45%, ALT (36)42%, GGT (30) 34% and FA (11) 13%. The prevalence of gastrointestinal symptoms was 71% (60/84), with diarrhea being the most frequent 53% (4 bowel movements/day) and dysgeusia (36.9%). There were 12 patients (10.02%) who presented diarrhea as the initial symptom with respiratory complications 5-7 days later. Conclusions: Gastrointestinal and hepatic manifestations occurred in 71% of the patients.
Introducción: la infección por SARS-CoV-2 se dio por primera vez en Wuhan, China, en diciembre de 2019, donde se describieron los primeros casos de neumonía. La infección se diseminó rápidamente y se estableció como pandemia por la Organización Mundial de la Salud (OMS) en febrero de 2020. En México los primeros casos fueron en marzo del mismo año. Aunque los síntomas clásicos son respiratorios, también se han descrito síntomas gastrointestinales en 17% de los casos, así como alteraciones hepáticas. Objetivo: describir las manifestaciones gastrointestinales y las alteraciones hepáticas en pacientes con COVID-19 de julio del 2020 a enero del 2021 en un hospital de tercer nivel. Material y métodos: estudio clínico, transversal, prolectivo, observacional, analítico que incluyó mayores de 18 años, hospitalizados con COVID-19 con diagnóstico por PCR para SARS-CoV-2. Resultados: se incluyeron 84 pacientes, 65% (55) del sexo masculino. La edad media fue 59 años (± 13.38). Las comorbilidades reportadas fueron: hipertensión arterial sistémica (51%), diabetes tipo 2 (38%), obesidad (26%). El patrón que predominó fue el hepatocelular, con elevación de AST en 45% (38), ALT en 42% (36), GGT en 34% (30) y FA en 13% (11). La prevalencia de los síntomas gastrointestinales fue del 71% (60/84) y fueron los más frecuentes la diarrea 53% (4 evacuaciones/día) y la disgeusia 36.9%. Hubo 12 pacientes (10.02%) que presentaron diarrea como síntoma inicial con complicaciones respiratorias entre 5 y 7 días después. Conclusiones: las manifestaciones gastrointestinales y hepáticas se presentaron en 71% de los pacientes.
Assuntos
COVID-19 , Gastroenteropatias , Hepatopatias , Humanos , COVID-19/complicações , COVID-19/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Hepatopatias/etiologia , Hepatopatias/epidemiologia , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , México/epidemiologia , Idoso , Adulto , Prevalência , SARS-CoV-2 , ComorbidadeRESUMO
BACKGROUND: Gastrointestinal symptoms (GISs) can affect the performance of endurance athletes (EAs). This study aims to analyze the efficacy of carbohydrate (CHO), gluten-free, and low-mono-saccharide and polyol (FODMAP) diets in preventing GISs in adult EAs of both sexes. METHODS: A systematic search was conducted prior to 30 June 2024 in accordance with the PRISMA statement. We searched for original studies from the last eight years, in English or Spanish, that looked at the effect of CHO, gluten-free, or FODMAP diets on the GISs of EAs. In PubMed, the MeSH (medical subject heading) categories were used. The search was repeated in EBSCO, Google Scholar, and Web of Science. The inclusion criteria were determined using the PICOS framework and the risk of bias in each paper was assessed using the PEDro scale quality criteria checklist (systematic review registration: INPLASY202490080). RESULTS: Of 289 articles identified, only 3.5% met the eligibility criteria. All studies found that GISs are common in EAs. We found that 60% of the articles used an experimental method; moreover, based on 80% of the articles, following a bowel training diet, like CHO, reduced fiber and dairy products, or a low-FODMAP diet, has the potential to reduce gastrointestinal symptoms and improve the athletic performance of EA. CONCLUSIONS: We found that low-FODMAP diets, gut training with CHO intake, and decreased fiber and dairy intake may have favorable effects in preventing GISs. No studies support a gluten-free diet in reducing GISs in EAs.
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Atletas , Dieta Livre de Glúten , Carboidratos da Dieta , Gastroenteropatias , Humanos , Gastroenteropatias/prevenção & controle , Gastroenteropatias/dietoterapia , Carboidratos da Dieta/administração & dosagem , Resistência Física , Feminino , Masculino , Dieta com Restrição de Carboidratos/métodos , Adulto , Monossacarídeos/administração & dosagem , Polímeros/administração & dosagemRESUMO
OBJECTIVE: To assess common gastrointestinal symptoms in healthy Brazilian infants receiving goat milk-based formula (GMF) compared to cow's milk-based formula (CMF). METHODS: We performed a 24-weeks double-blind, randomized, controlled study in Brazil, enrolling healthy infants from 3 to 12 months of age. Primary outcome were the gastrointestinal (GI) symptoms stool consistency, regurgitation frequency and crying duration. Secondary outcomes were growth trajectories and hemoglobin levels. Repeated mixed models were used to compare outcomes variables between GMF and CMF groups, while adjusting for age at baseline. RESULTS: Fifty-six infants were recruited and randomly allocated in the GMF (n = 26) and the CMF (n = 30) group. Scores on all measured GI symptoms were low and similar among the groups throughout intervention period and improved over time. Average age- and sex-adjusted WHO z-scores of weight, length, head circumference, and weight-for-length were all within +/-1 SD and similar between groups, indicating adequate growth. Serum hemoglobin was 11.1 (SD 0.7) g/dL in infants fed GMF and 11.0 (SD 0.8) g/dL in infants fed CMF after the intervention and was similar between groups. CONCLUSION: GMF was well tolerated, safe and supported adequate growth in infants. This was shown by the low occurrence of GI symptoms, adequate blood hemoglobin levels and adequate growth within WHO standards. TRIAL REGISTRATION: The clinical trial was approved by the ethics committee of the Federal University of Bahia under number CAAE06923319.5.0000.5577. The study was retrospectively registered in clinicaltrials.gov on 02/05/2024 under identifier NCT06395571.
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Cabras , Fórmulas Infantis , Leite , Humanos , Método Duplo-Cego , Animais , Lactente , Masculino , Feminino , Leite/efeitos adversos , Bovinos , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Brasil , Choro , Hemoglobinas/análiseRESUMO
Telemedicine has grown during the COVID-19 pandemic. Gastroenterology at Clínica Universidad de los Andes has continued it post-pandemic. Usability is the measure by which users evaluate the effectiveness, efficiency, and satisfaction in telemedicine. The usability of this type of consultation in Chile is unknown. OBJECTIVE: To evaluate the level of usability among patients attended through teleconsultations in Gastroenterology at Clínica Universidad de los Andes (March-August 2023). MATERIALS AND METHODS: A cross-sectional descriptive study on the level of usability using the adapted and modified Telehealth Usability Questionnaire. It consists of 12 items (score range 12-84) and comprises 2 factors: effectiveness and ease of use. Sociodemographic characteristics were also evaluated. RESULTS: A total of 150 questionnaires were analyzed. A high level of usability was observed (median: 81; range 54-84), with high scores in effectiveness (median: 28; range 20-28) and ease of use (median: 53; range 30-56), without significant differences according to sex, age, educational level, geographic location, and health insurance. Of the respondents, 76.7% were aged 30 to 64 years. 36% resided in the metropolitan region, 61% were women, and 80% were from the private health system. 29% consulted for abdominal pain, 20% for inflammatory bowel disease, and 17% for abnormal liver function tests. For 53.3%, it was their first consultation, and 46.7% were in follow-up via this method. CONCLUSION: In this cohort, telemedicine is perceived as an effective and easy-to-use tool, with a high level of usability regardless of the patients' sociodemographic characteristics. Therefore, in gastroenterology, telemedicine appears to be a form of healthcare accepted by patients.
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COVID-19 , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Transversais , Adulto , COVID-19/epidemiologia , Chile , Idoso , Adulto Jovem , Satisfação do Paciente , Gastroenterologia , Telemedicina , Inquéritos e Questionários , Adolescente , Consulta Remota/estatística & dados numéricos , Gastroenteropatias/epidemiologia , Gastroenteropatias/diagnósticoRESUMO
OBJECTIVE: To analyze in-hospital and 1-year morbidity and mortality associated with acute gastrointestinal dysfunction in critically ill patients with COVID-19 via a prespecified scoring system. METHODS: Between March and July 2020, consecutive hospitalized patients with COVID-19 from a single institution were retrospectively analyzed by medical chart review. Only those who remained in the intensive care unit for more than 24 hours were included. Gastrointestinal dysfunction was assessed according to a predefined 5-point progressive gastrointestinal injury scoring system, considering the first 7 days of hospitalization. Laboratory data, comorbidities, the need for mechanical ventilation, the duration of intensive care unit stay, and subsequent in-hospital and 1-year mortality rates were also recorded. RESULTS: Among 230 patients who were screened, 215 were included in the analysis. The median age was 68 years (54 - 82), and 57.7% were male. The total gastrointestinal dysfunction scores were 0 (79.1%), I (15.3%), II (4.7%), III (0.9%), and IV (0%). Any manifestation of gastrointestinal dysfunction was present in 20.9% of all patients and was associated with longer lengths of stay (20 days [11 - 33] versus 7 days [4 - 16]; p < 0.001] and higher C-reactive protein levels on admission (12.8mg/mL [6.4 - 18.4] versus 5.7mg/mL [3.2 - 13.4]; p < 0.001). The gastrointestinal dysfunction score was significantly associated with mortality (OR 2.8; 95%CI 1.7 - 4.8; p < 0.001) and the need for mechanical ventilation (OR 2.8; 95%CI 1.7 - 4.6; p < 0.001). Both in-hospital and 1-year death rates progressively increased as gastrointestinal dysfunction scores increased. CONCLUSION: In the current series of intensive care unit patients with COVID-19, gastrointestinal dysfunction severity, as defined by a prespecified scoring system, was predictive of adverse in-hospital and 1-year outcomes.
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COVID-19 , Estado Terminal , Gastroenteropatias , Mortalidade Hospitalar , Unidades de Terapia Intensiva , Tempo de Internação , Humanos , COVID-19/mortalidade , COVID-19/complicações , COVID-19/fisiopatologia , Masculino , Feminino , Idoso , Estudos Retrospectivos , Pessoa de Meia-Idade , Gastroenteropatias/mortalidade , Gastroenteropatias/diagnóstico , Gastroenteropatias/virologia , Gastroenteropatias/etiologia , Prognóstico , Idoso de 80 Anos ou mais , Tempo de Internação/estatística & dados numéricos , Respiração Artificial , Índice de Gravidade de Doença , SARS-CoV-2RESUMO
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that combines genetic and environmental factors. The human microbiota is colonized by permanent or transitory microorganisms, depending on the host and the external factors controlling their permanence. The composition of the gut microbiota (GM) in ASD individuals is notably different from that in controls, which may contribute to the clinical conditions observed in these individuals. This study aimed to indirectly investigate the influence of GM on the gut-brain axis in individuals with ASD and controls by analyzing environmental factors that contribute to the microbiota composition. Two questionnaires were designed to collect data, one for the ASD Group (ASDG) and the other one for the Control Group (CG). The raw data from both questionnaires were collected from 2772 respondents. After triage, answers from 1687 ASD individuals, along with 466 respondents from the CG, were analyzed, resulting in a total of 2237 respondents. Our results showed that gastrointestinal problems (GP) escalate as individuals age and become more prominent in ASD individuals. In contrast, feeding problems (FP) did not appear to escalate in either group as individuals aged, even though the FP decreased in the CG. ANOVA revealed significant differences in breastfeeding status compared to GPs among preterm control individuals born via cesarean section (p-value = 0.027). The mean values of GP for breastfed and nonbreastfed individuals, for ASDG (0.257; 0.268) and CG (0.105; 0.248), highlighted the differences in breastfeeding effects on GP for the study groups. The use of antibiotics during pregnancy seemed to be significant for GPs in the ASDG only for breastfed individuals (p-value <0.001), but not in the CG group. In conclusion, variables such as mode of delivery, FPs, type of birth, and length of breastfeeding do not seem to be determining factors for GP in the ASDG but are relevant for the CG. However, for ASDG individuals whose mothers took antibiotics during pregnancy, breastfeeding may act as a protective factor, as maternal antibiotic administration during pregnancy seems to aggravate GP-values across the ages of the participants. Considering GP as a proxy for GM and recognizing the importance of GM composition for central nervous system (CNS) function, it appears that in individuals with ASD, GM seems to be more dependent on other factors, which might be linked to the genetic background of each one. These findings suggest that future studies of the gut-brain axis in individuals with ASD might consider the individual's genetic background, environmental factors, and GM.
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Transtorno do Espectro Autista , Gastroenteropatias , Microbioma Gastrointestinal , Humanos , Transtorno do Espectro Autista/fisiopatologia , Feminino , Masculino , Adulto , Microbioma Gastrointestinal/fisiologia , Gastroenteropatias/fisiopatologia , Criança , Adolescente , Inquéritos e Questionários , Adulto Jovem , Pré-Escolar , Pessoa de Meia-Idade , Aleitamento Materno , Gravidez , Eixo Encéfalo-Intestino/fisiologiaRESUMO
Diabetes is a public health problem with an estimated worldwide prevalence of 10% and a prevalence of 12% in Mexico. The costs resulting from this chronic-degenerative disease are significant. Treatment for diabetes involves different medication groups, some of which can cause significant gastrointestinal adverse effects, such as dyspepsia, nausea, vomiting, bloating, diarrhea, and constipation. The medications most frequently associated with said adverse effects are metformin, acarbose, and GLP-1 agonists. Gastrointestinal adverse effects negatively impact the quality of life and management of patients with diabetes. The factors of visceral neuropathy, acute dysglycemia, dysbiosis, and intestinal bacterial overgrowth contribute to the gastrointestinal symptoms in patients with diabetes, making it necessary to consider multiple etiologic factors in the presence of gastrointestinal symptoms, and not exclusively attribute them to the use of antidiabetics. Personalized treatment, considering gastrointestinal comorbidity and the type of drug utilized, is essential for mitigating the adverse effects and improving the quality of life in patients with diabetes. The aim of the present narrative review was to describe the gastrointestinal adverse effects of the antidiabetic drugs, their pathophysiologic mechanisms, and the corresponding therapeutic measures.
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Gastroenteropatias , Hipoglicemiantes , Humanos , Diabetes Mellitus/tratamento farmacológico , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/psicologia , Gastroenteropatias/terapia , Hipoglicemiantes/efeitos adversos , Qualidade de VidaRESUMO
In recent years, natural polysaccharides (PSs) have attracted increasing interest because of their remarkable biological properties and potential in various areas, such as medicine, and food. This study aimed to present a detailed review of the evidence on the therapeutic potential of PSs for the treatment of gastrointestinal diseases. The main evidence was correlated with their chemical composition, mechanism of action and therapeutic effect. The main results showed that the action can be attributed to their ability to suppress excessive inflammatory responses, regulating the expression of cytokines and interleukins, reducing intestinal inflammation and promoting wound healing. Furthermore, we discussed how PSs help in the repair of the intestinal mucosa and related these effects with the composition of monosaccharides. A detailed analysis was performed on the ability of PSs to modulate the intestinal microbiota, promoting the growth of beneficial bacteria and suppressing inflammatory bacteria, in addition to its probiotic action with production of short-chain fatty acids. All this evidence was also taken into a broader context, in which the main challenges in processing PSs were considered and strategies to circumvent them were pointed out. Therefore, this review sought to demonstrate the great potential and viability of PSs as innovative and effective therapeutic agents.
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Microbioma Gastrointestinal , Polissacarídeos , Humanos , Polissacarídeos/farmacologia , Polissacarídeos/química , Polissacarídeos/uso terapêutico , Microbioma Gastrointestinal/efeitos dos fármacos , Animais , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/metabolismo , Gastroenteropatias/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/metabolismoRESUMO
BACKGROUND: Gastrointestinal intolerance is common in rheumatoid arthritis (RA) patients using methotrexate and may lead to treatment discontinuation. AIM: To study the prevalence of gastrointestinal symptoms in a sample of RA methotrexate users as well as its possible association with clinical and epidemiological variables. METHODS: Cross-sectional study of 192 patients with gastrointestinal symptoms using the MISS (methotrexate intolerance severity score). Clinical and epidemiological variables were collected through chart review and direct questioning. Patients' adherence to methotrexate was evaluated through Moriski-Green-Levin questionnaire. RESULTS: The prevalence of gastrointestinal complaints was high with 55.7% of the sample classified as intolerant. Nausea and pain after drug ingestion were the most common reported complaints. This intolerance was associated with afro-descendant background (p=0.02); presence of associated fibromyalgia (p=0.04), concomitant use of glucocorticoids (p=0.03) and Jak inhibitors (0.03). A tendency towards association with leflunomide use was observed (p=0.06). Logistic regression was used to test drug associations with methotrexate intolerance, and showed that glucocorticoid use was independently associated with methotrexate intolerance OR=1.85; 95% CI=1.01-3.44; p=0.04. Route of administration, presence of previous gastric complaints, age and methotrexate dose did not interfere with MISS. MISS results were associated with moderate adherence to the drug. CONCLUSIONS: There is a high rate of methotrexate intolerance that is more common in afro-descendants, those with associated fibromyalgia, glucocorticoid and Jak inhibitors users.
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Antirreumáticos , Artrite Reumatoide , Gastroenteropatias , Metotrexato , Humanos , Estudos Transversais , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/complicações , Metotrexato/uso terapêutico , Metotrexato/efeitos adversos , Feminino , Masculino , Pessoa de Meia-Idade , Antirreumáticos/uso terapêutico , Antirreumáticos/efeitos adversos , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/epidemiologia , Idoso , Prevalência , AdultoRESUMO
Los postbióticos fueron definidos en 2021 por la Asociación Científica Internacional de Probióticos y Prebióticos (ISAPP) como "una preparación de microorganismos inanimados y/o sus componentes celulares capaces de conferir un efecto benéfico al hospedador". El campo de los postbióticos es un área nueva dentro de la familia de los bióticos; se han desarrollado ya numerosos productos con aplicaciones clínicas, como la estimulación inmunológica, el manejo de diarreas en niños y adultos, el abordaje del intestino irritable, además de tres fórmulas infantiles. En particular, las fórmulas infantiles con postbióticos obtenidos a partir de la fermentación de la leche con Bifidobacterium breve C50 y Streptococcus thermophilus O65, y sus metabolitos, incluido el oligosacárido 3'-GL, han demostrado seguridad y contribución al desarrollo de la microbiota intestinal y el sistema inmune asociado al intestino. Estas modificaciones contribuyen a la prevención y el manejo de los trastornos funcionales digestivos del lactante.
Postbiotics were defined in 2021 by the International Scientific Association for Probiotics and Prebiotics (ISAPP) as a "preparation of inanimate microorganisms and/or their cellular components that confers a health benefit to the host." The field of postbiotics is a new area within the biotics family; numerous products have already been developed for clinical applications, such as immune stimulation, the management of diarrhea in children and adults, the management of irritable bowel syndrome, and 3 infant formulas. In particular, infant formulas with postbiotics obtained from milk fermented with Bifidobacterium breve C50 and Streptococcus thermophilus O65 and their metabolites, including the oligosaccharide 3'-GL, have demonstrated to be safe and to contribute to the development of the gut microbiota and the gutassociated immune system. These modifications help to prevent and manage functional gastrointestinal disorders in infants.
Assuntos
Humanos , Lactente , Probióticos , Síndrome do Intestino Irritável/microbiologia , Síndrome do Intestino Irritável/terapia , Fórmulas Infantis , Streptococcus thermophilus , Diarreia/microbiologia , Diarreia/terapia , Prebióticos/administração & dosagem , Microbioma Gastrointestinal , Bifidobacterium breve , Gastroenteropatias/microbiologia , Gastroenteropatias/terapiaRESUMO
OBJECTIVES: To assess the relative frequency and associated factors of disorders of gut-brain interaction (DGBIs) in outpatient gastrointestinal (GI) clinics in young children of Latin America. METHODS: Cross-sectional study in 10 pediatric GI outpatient clinics (private and public) in five countries of Latin America (El Salvador, México, Colombia, Panamá, and Nicaragua). Parents of patients 1 month 4 years of age from outpatient clinics complete/d a diagnostic questionnaire for DGBIs per Rome IV criteria (QPGS-IV, Spanish version). We conducted descriptive analysis, two-sample t-tests and chi-square tests, univariate analyses, and logistic regression to evaluate risk factors. RESULTS: We collected data from 783 children. In total, 34.5% had a DGBI. Overall, functional constipation (FC) was the most common diagnosis (23.4%) in children of all ages (infants, 16.1%, 1-4-years-old, 32.7%). In infants, the second most common DGBI was regurgitation (6.6%) and in 1-4-years-old and cyclic vomiting syndrome (4.1%). The diagnosis of a DGBI was significantly associated with a family history of DGBIs (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.61-5.57, p = 0.0001). Patients who identified as black (OR 2.25, 95% CI 1.28-3.92, p = 0.0021) or mixed race (OR 1.76, 95% CI 1.25-2.48, p = 0.0006) were also significantly associated with a higher likelihood of DGBIs. CONCLUSIONS: DGBIs are a common diagnosis in pediatric GI clinics of Latin America. Overall, FC was the most common DGBI.
Assuntos
Gastroenteropatias , Humanos , Lactente , Estudos Transversais , Masculino , Pré-Escolar , Feminino , América Latina/epidemiologia , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Eixo Encéfalo-Intestino , Constipação Intestinal/diagnóstico , Constipação Intestinal/epidemiologia , Inquéritos e Questionários , Fatores de Risco , Gastroenterologia/estatística & dados numéricos , Modelos Logísticos , Vômito/diagnóstico , Vômito/epidemiologiaRESUMO
INTRODUCTION AND AIMS: Pandemic lockdown measures are a cause of concern, regarding their negative impact on the mental health of individuals. The results of numerous studies have associated the appearance of gastrointestinal symptoms with different psychologic disorders, such as stress, depression, and anxiety, due to gut-brain axis interaction. The aim of the present study was to determine the prevalence of, and factors associated with, gastrointestinal symptom onset related to the COVID-19 pandemic lockdown and various lifestyle modifications. METHODS: An analytic, observational, and cross-sectional study was conducted on an open population that agreed to participate within the time frame of January to May 2021. RESULTS: A total of 298 subjects, 165 of whom were women (55.4%), agreed to participate and the mean patient age was 36.1⯱â¯12.6 years. There was a significant increase in the frequency of several gastrointestinal symptoms: epigastric burning, early satiety, heartburn, regurgitation, constipation, and diarrhea. Changes in weight and modifications in lifestyle were found to be associated variables. CONCLUSIONS: The results of this study showed a significant increase in a wide variety of gastrointestinal symptoms related to lifestyle changes due to the pandemic lockdown. Weight change, supplement and multivitamin intake, and reduced physical activity were the main associated risk factors. Public healthcare systems should take a multidisciplinary approach into consideration for the care of affected individuals.