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1.
J Med Virol ; 94(1): 298-302, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34491581

RESUMO

For preventing the spread of the coronavirus disease 2019 (COVID-19) pandemic, measures like wearing masks, social distancing, and hand hygiene played crucial roles. These measures may also have affected the expansion of other infectious diseases like respiratory tract infections (RTI) and gastro-intestinal infections (GII). Therefore, we aimed to investigate non-COVID-19 related RTI and GII during the COVID-19 pandemic. Patients with a diagnosis of an acute RTI (different locations) or acute GII documented anonymously in 994 general practitioner (GP) or 192 pediatrician practices in Germany were included. We compared the prevalence of acute RTI and GII between April 2019-March 2020 and April 2020-March 2021. In GP practices, 715,440 patients were diagnosed with RTI or GII in the nonpandemic period versus 468,753 in the pandemic period; the same trend was observed by pediatricians (275,033 vs. 165,127). By GPs, the strongest decrease was observed for the diagnosis of influenza (-71%, p < 0.001), followed by acute laryngitis (-64%, p < 0.001), acute lower respiratory infections (bronchitis) (-62%, p < 0.001), and intestinal infections (-40%, p < 0.001). In contrast, the relatively rare viral pneumonia strongly increased by 229% (p < 0.001). In pediatrician practices, there was a strong decrease in infection diagnoses, especially influenza (-90%, p < 0.001), pneumonia (-73%, p < 0.001 viral; -76%, p < 0.001 other pneumonias), and acute sinusitis (-66%, p < 0.001). No increase was observed for viral pneumonia in children. The considerable limitations concerning social life implemented during the COVID-19 pandemic to combat the spread of SARS-CoV-2 also resulted in an inadvertent but welcome reduction in other non-Covid-19 respiratory tract and gastro-intestinal infections.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Gastroenteropatias/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Alemanha/epidemiologia , Higiene das Mãos/métodos , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , Distanciamento Físico , Prevalência , Adulto Jovem
2.
Eur Rev Med Pharmacol Sci ; 25(18): 5836-5842, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34604975

RESUMO

OBJECTIVE: Functional gastrointestinal disorders are common gastrointestinal diseases. The pathophysiology is multifactorial and psychosocial distress worsens symptoms severity. Since the end of 2019 the world has been facing COVID-19 pandemic. The associated control measures have affected the psychological health of people. The aim of the present study is to evaluate the impact of the COVID-19 pandemic on the prevalence of functional gastrointestinal disorders among Italian children and adolescents. PATIENTS AND METHODS: The study sample is composed of 407 patients (187 males, 220 females), aged from 10 to 17 years. The mean age is 14.27 ± 2.24 years. The study was conducted through the Italian version of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version.  The prevalence of each disorder has been calculated as the ratio of affected subjects for each disease and the total number of effective cases for that specific disease. RESULTS: The study demonstrates that the prevalence of Functional Gastrointestinal Disorder in Italian children, during the COVD-19 pandemic, is higher, compared with the one reported in the previous studies. The most frequent disorders are Abdominal Migraine and Irritable Bowel Syndrome. CONCLUSIONS: Our study is the first one which provides data of the prevalence of Functional gastrointestinal disorders in sample of Italian adolescents, during the COVID-19 pandemic. The study underlines the need to focus on stress management, in order to reduce the effects of the lockdown on the psychological wellness of the youngest.


Assuntos
COVID-19/psicologia , Gastroenteropatias/etiologia , Gastroenteropatias/psicologia , Quarentena/psicologia , Isolamento Social/psicologia , Estresse Psicológico/complicações , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Dor Abdominal/psicologia , Adolescente , Aerofagia/epidemiologia , Aerofagia/etiologia , Aerofagia/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Constipação Intestinal/epidemiologia , Constipação Intestinal/etiologia , Constipação Intestinal/psicologia , Dispepsia/epidemiologia , Dispepsia/etiologia , Dispepsia/psicologia , Incontinência Fecal/epidemiologia , Incontinência Fecal/etiologia , Incontinência Fecal/psicologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Síndrome do Intestino Irritável/epidemiologia , Síndrome do Intestino Irritável/etiologia , Síndrome do Intestino Irritável/psicologia , Itália , Masculino , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/psicologia , Prevalência , Síndrome da Ruminação/epidemiologia , Síndrome da Ruminação/etiologia , Síndrome da Ruminação/psicologia , Estresse Psicológico/diagnóstico , Inquéritos e Questionários , Vômito/epidemiologia , Vômito/etiologia , Vômito/psicologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-34639595

RESUMO

BACKGROUND: Effect sizes are the most useful quantities for communicating the practical significance of results and helping to facilitate cumulative science. We hypothesize that the selection of the best-fitted controls can significantly affect the estimated effect sizes in case-control studies. Therefore, we decided to exemplify and clarify this effect on effect size using a large data set. The objective of this study was to investigate the association among variables in functional gastrointestinal disorders (FGIDs) and mental health problems, common ailments that reduce the quality of life of a large proportion of the community worldwide. METHOD: In this methodological study, we constitute case and control groups in our study framework using the Epidemiology of Psychological, Alimentary Health and Nutrition (SEPAHAN) dataset of 4763 participants. We devised four definitions for control in this extensive database of FGID patients and analyzed the effect of these definitions on the odds ratio (OR): 1. conventional control: without target disorder/syndrome (sample size 4040); 2. without any positive criteria: criterion-free control (sample size 1053); 3. syndrome-free control: without any disorder/syndrome (sample size 847); 4. symptom-free control: without any symptoms (sample size 204). We considered a fixed case group that included 723 patients with a Rome III-based definition of functional dyspepsia. Psychological distress, anxiety, and depression were considered as dependent variables in the analysis. Logistic regression was used for association analysis, and the odds ratio and 95% confidence interval (95%CI) for OR were reported as the effect size. RESULTS: The estimated ORs indicate that the strength of the association in the first case-control group is the lowest, and the fourth case-control group, including controls with completely asymptomatic people, is the highest. Ascending effect sizes were obtained in the conventional, criterion-free, syndrome-free, and symptom-free control groups. These results are consistent for all three psychological disorders, psychological distress, anxiety, and depression. CONCLUSIONS: This study shows that a precise definition of the control is mandatory in every case-control study and affects the estimated effect size. In clinical settings, the selection of symptomatic controls using the conventional definition could significantly diminish the effect size.


Assuntos
Dispepsia , Gastroenteropatias , Ansiedade , Estudos de Casos e Controles , Gastroenteropatias/epidemiologia , Humanos , Qualidade de Vida
4.
Arq. bras. med. vet. zootec. (Online) ; 73(5): 1029-1038, Sept.-Oct. 2021. tab, ilus
Artigo em Inglês | ID: biblio-1345270

RESUMO

The present study aimed to investigate the morbidity and mortality associated with the most common diseases during the rearing period of Holstein calves in a high-production dairy farm. The calves (n = 600) were allocated to three groups based on age: G1 (1-7 days, n = 216), G2 (30-40 days, n = 188), and G3 (69-85 days, n = 196). They were evaluated over 60 days at eight different times. The morbidity rates were 47.67% (286/600) for diarrhea, 73.00% (438/600) for bovine respiratory disease (BRD), and 3.83% (23/600) for umbilical inflammation (UI). The mortality rate was 2.33% (14/600) for all the animals studied. The morbidity differed in the groups, with higher rates of diarrhea (78.85%, 166/216) and UI (6.94%, 15/216) in G1, and the highest rate of BRD in G3 (79.59%, 156/196). Diarrhea was associated with the occurrence of BRD in G1 and G2. Even in farms with good management practices, there is high morbidity associated with diarrhea and BRD, with the morbidity rate for diarrhea decreasing and that for BRD increasing as the animals get older. In addition, diarrhea is an important risk factor for BRD, especially in younger animals.(AU)


O presente estudo objetivou investigar a morbidade e a mortalidade associadas às doenças mais comuns no período de criação de bezerras da raça Holandesa, em uma fazenda leiteira de alta produção. As bezerras (n = 600) foram alocadas em três grupos de acordo com a idade: G1 (1-7 dias, n = 216); G2 (30-40 dias, n = 188); G3 (69-85 dias, n = 196). Os animais foram avaliados durante 60 dias, em oito momentos diferentes. A morbidade foi de 47,67% (286/600) para diarreia, 73,00% (438/600) para doença respiratória bovina (DRB) e 3,83% (23/600) para inflamação umbilical (IU). A taxa de mortalidade foi de 2,33% (14/600), para o total de animais avaliados. A morbidade foi diferente entre os grupos, com maior frequência de diarreia (78,85%, 166/216) e IU (6,94%, 15/216) no G1, sendo a maior ocorrência de DRB no G3 (79,59%, 156/196). A diarreia foi associada à DRB no G1 e no G2. Mesmo em fazendas com boas práticas de manejo, há alta morbidade por diarreia e DRB, com a taxa de morbidade por diarreia diminuindo e a de DRB aumentando à medida que os animais envelhecem. Além disso, a diarreia é um importante fator de risco para DRB, especialmente em animais mais jovens.(AU)


Assuntos
Animais , Feminino , Bovinos , Doenças dos Bovinos/mortalidade , Doenças dos Bovinos/epidemiologia , Complexo Respiratório Bovino/mortalidade , Complexo Respiratório Bovino/epidemiologia , Gastroenteropatias/mortalidade , Gastroenteropatias/epidemiologia
5.
BMC Med ; 19(1): 214, 2021 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-34526042

RESUMO

BACKGROUND: Studies on allergy-related diseases in relation to abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) in children are few and results are contradictory. We examined the associations between childhood allergy-related diseases and adolescent AP-FGIDs in general and irritable bowel syndrome (IBS) in particular. METHOD: Prospective population-based birth cohort study of 4089 children born in Sweden 1994-1996. We analysed data from 2949 children with complete follow-up at 16 years (y) and no diagnosis of inflammatory bowel disease or coeliac disease at 12y or 16y. Asthma, rhinitis, eczema, and food hypersensitivity (FH) were assessed through questionnaires at 1-2y, 4y, 8y, 12y, and 16y. AP-FGIDs and IBS were assessed through questionnaires at 16y and defined according to the Rome III criteria. Associations between childhood allergy-related diseases and any AP-FGID and IBS and 16y respectively were examined using binomial generalized linear models with a log link function and described as relative risk with 95% confidence intervals. RESULTS: The prevalence of any AP-FGID and IBS at 16y were 12.0% and 6.0% respectively. Eczema at 1-2y, 4y, and 8y, and FH at 12y and 16y were associated with an increased risk for any AP-FGID at 16y. Asthma and FH at 12y and 16y were associated with an increased risk for IBS at 16y. The relative risk for IBS at 16y increased with increasing number of concurrent allergy-related diseases at 16y, but linear trend for relative risk was only borderline statistically significant (P for trend = 0.05). CONCLUSIONS: This prospective population-based study demonstrated positive associations between childhood allergy-related diseases and adolescent AP-FGIDs, including IBS, implicating shared pathophysiology among these disorders.


Assuntos
Doença Celíaca , Gastroenteropatias , Hipersensibilidade , Síndrome do Intestino Irritável , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Adolescente , Criança , Estudos de Coortes , Feminino , Gastroenteropatias/epidemiologia , Humanos , Hipersensibilidade/epidemiologia , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/epidemiologia , Prevalência , Estudos Prospectivos , Inquéritos e Questionários
6.
PLoS Med ; 18(9): e1003773, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34582441

RESUMO

BACKGROUND: Long-COVID refers to a variety of symptoms affecting different organs reported by people following Coronavirus Disease 2019 (COVID-19) infection. To date, there have been no robust estimates of the incidence and co-occurrence of long-COVID features, their relationship to age, sex, or severity of infection, and the extent to which they are specific to COVID-19. The aim of this study is to address these issues. METHODS AND FINDINGS: We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression). Their co-occurrence network was also analyzed. Comparison with a propensity score-matched cohort of patients diagnosed with influenza during the same time period was achieved using Kaplan-Meier analysis and the Cox proportional hazard model. The incidence of atopic dermatitis was used as a negative control. Among COVID-19 survivors (mean [SD] age: 46.3 [19.8], 55.6% female), 57.00% had one or more long-COVID feature recorded during the whole 6-month period (i.e., including the acute phase), and 36.55% between 3 and 6 months. The incidence of each feature was: abnormal breathing (18.71% in the 1- to 180-day period; 7.94% in the 90- to180-day period), fatigue/malaise (12.82%; 5.87%), chest/throat pain (12.60%; 5.71%), headache (8.67%; 4.63%), other pain (11.60%; 7.19%), abdominal symptoms (15.58%; 8.29%), myalgia (3.24%; 1.54%), cognitive symptoms (7.88%; 3.95%), and anxiety/depression (22.82%; 15.49%). All 9 features were more frequently reported after COVID-19 than after influenza (with an overall excess incidence of 16.60% and hazard ratios between 1.44 and 2.04, all p < 0.001), co-occurred more commonly, and formed a more interconnected network. Significant differences in incidence and co-occurrence were associated with sex, age, and illness severity. Besides the limitations inherent to EHR data, limitations of this study include that (i) the findings do not generalize to patients who have had COVID-19 but were not diagnosed, nor to patients who do not seek or receive medical attention when experiencing symptoms of long-COVID; (ii) the findings say nothing about the persistence of the clinical features; and (iii) the difference between cohorts might be affected by one cohort seeking or receiving more medical attention for their symptoms. CONCLUSIONS: Long-COVID clinical features occurred and co-occurred frequently and showed some specificity to COVID-19, though they were also observed after influenza. Different long-COVID clinical profiles were observed based on demographics and illness severity.


Assuntos
COVID-19/complicações , Sobreviventes , Adulto , Idoso , COVID-19/epidemiologia , Estudos de Coortes , Dispneia/epidemiologia , Dispneia/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Humanos , Incidência , Influenza Humana/complicações , Influenza Humana/epidemiologia , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Dor/epidemiologia , Dor/etiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Estados Unidos/epidemiologia , Adulto Jovem
7.
Clin Otolaryngol ; 46(6): 1331-1338, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34358409

RESUMO

OBJECTIVES: This study investigated the relationship between viral load and the incidence of olfactory and gustatory dysfunction (OD and GD), the incidence of respiratory and gastrointestinal symptoms and the recovery of OD and GD in COVID-19 patients. DESIGN: A retrospective cohort study. SETTING AND PARTICIPANTS: This study was conducted on 599 outpatients' cases in Golestan province between February and June 2020. MAIN OUTCOME MEASURES: The incidence, severity (complete or partial) and recovery time of OD and GD and their associations with cycle threshold (CT) values of SARS-CoV-2 polymerase chain reaction were assessed. RESULTS: The mean age of patients was 38.27 ± 13.62 years. The incidence of general symptoms included myalgia 70.1%, headache 51.8%, fever 47.7% and dyspnoea 21.4%. 41.9% of patients had gastrointestinal symptoms, including abdominal pain 26.5%, diarrhoea 25.2%, nausea 20.5% and vomiting 12.9%. 12.2% of patients had comorbidity. The trimester recovery rates of OD and GD were 93.94% and 94.74% respectively. The mean recovery time of OD and GD was 14.56 ± 13.37 and 13.8 ± 3.77 days respectively. The mean CT value in all patients was 27.45 ± 4.55. There were significant associations between the mean of CT value with headache (p = 0.04), GD (p = 0.002) and OD (p = 0.001). CONCLUSIONS: The finding of this study indicates a possible association between viral load with incidence of OD and GD in COVID-19 patient's cases and assures the recovery of OD/GD in these patients.


Assuntos
COVID-19/complicações , Gastroenteropatias/epidemiologia , Transtornos do Olfato/epidemiologia , Doenças Respiratórias/epidemiologia , Distúrbios do Paladar/epidemiologia , Carga Viral , Adulto , Feminino , Gastroenteropatias/virologia , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Transtornos do Olfato/virologia , Doenças Respiratórias/virologia , Estudos Retrospectivos , SARS-CoV-2 , Distúrbios do Paladar/virologia
8.
World J Gastroenterol ; 27(28): 4504-4535, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34366621

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered the causative pathogen of coronavirus disease 2019 (COVID-19) and has become an international danger to human health. Although respiratory transmission and symptoms are still the essential manifestations of COVID-19, the digestive system could be an unconventional or supplementary route for COVID-19 to be transmitted and manifested, most likely due to the presence of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract. In addition, SARS-CoV-2 can trigger hepatic injury via direct binding to the ACE2 receptor in cholangiocytes, antibody-dependent enhancement of infection, systemic inflammatory response syndrome, inflammatory cytokine storms, ischemia/reperfusion injury, and adverse events of treatment drugs. Gastrointestinal symptoms, including anorexia, nausea, vomiting, and diarrhea, which are unusual in patients with COVID-19, and some digestive signs may occur without other respiratory symptoms. Furthermore, SARS-CoV-2 can be found in infected patients' stool, demonstrating the likelihood of transmission through the fecal-oral route. In addition, liver function should be monitored during COVID-19, particularly in more severe cases. This review summarizes the evidence for extra-pulmonary manifestations, mechanisms, and management of COVID-19, particularly those related to the gastrointestinal tract and liver.


Assuntos
COVID-19 , Gastroenteropatias , Hepatopatias , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Trato Gastrointestinal , Humanos , Hepatopatias/epidemiologia , Hepatopatias/terapia , Pandemias , SARS-CoV-2
9.
Artigo em Inglês | MEDLINE | ID: mdl-34446439

RESUMO

BACKGROUND: The rapid growth of the probiotic industry suggests patients will continue to seek advice from gastroenterologists about probiotics. To best address patient questions and concerns, we must first understand who uses probiotics and why. METHODS: This was a cross-sectional study conducted in the endoscopy suite of an academic hospital from June to October of 2019. Surveys were anonymous and contained a combination of multiple choice, free text and Likert scale questions. Participants privately completed a paper survey in English or Spanish and the results were reviewed with them by study personnel to clarify responses. Descriptive statistics were generated and multivariable logistic regression modelling was used to compare characteristics of probiotic users versus non-users. RESULTS: During the 5-month study period, 600 patients were approached and 537 (90%) agreed to participate. Among participants, 89% completed at least 24 survey items and were included in the analysis. Overall, 27% of patients reported probiotic use. Bloating, rather than diarrhoea, was the main gastrointestinal symptom associated with use of probiotics (aOR 2.59, 95% CI 1.52 to 4.44 for bloating; aOR 1.03, 95% CI 0.55 to 1.94 for diarrhoea). Frequent reasons cited for taking probiotics were the beliefs that they improved overall health and longevity (54%) and that they improved gastrointestinal symptoms (45%). CONCLUSIONS: Probiotic use is common among general gastroenterology patients, many of whom believe that probiotics confer general rather than specific gastrointestinal health benefits. Symptoms-especially bloating-and not sociodemographic factors seem to motivate probiotic use. By understanding patient expectations for probiotics, clinicians can better advise them.


Assuntos
Gastroenterologia , Gastroenteropatias , Probióticos , Estudos Transversais , Diarreia , Gastroenteropatias/epidemiologia , Humanos , Probióticos/uso terapêutico
10.
J Clin Gastroenterol ; 55(9): 757-765, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34420001

RESUMO

The 2019 coronavirus disease (COVID-19), an airborne infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a global pandemic. SARS-CoV-2 relies on the angiotensin-converting enzyme 2 receptor for cellular entry and the abundance of this receptor in the gastrointestinal (GI) tract may help explain the GI manifestations, including dysgeusia, nausea, vomiting, diarrhea, and abdominal pain, present in over 40% of infected patients. GI tract involvement also raises the concern for oral-fecal transmission which is poorly understood. Outcome studies in COVID-19 patients with preexisting liver disease and inflammatory bowel disease show predominantly mild transaminase elevations and no increased risk from the use of biological agents in inflammatory bowel disease patients. High-dose corticosteroids, however, should be avoided. As endoscopic procedures are aerosol-generating, modifications to clinical practice is necessary to minimize the spread of COVID-19. We have reviewed current literature to describe the impact of COVID-19 in gastroenterology and hepatology as well as targets of future research.


Assuntos
COVID-19 , Gastroenterologia , Gastroenteropatias , Gastroenteropatias/epidemiologia , Humanos , Pandemias , SARS-CoV-2
11.
World J Gastroenterol ; 27(29): 4900-4912, 2021 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-34447234

RESUMO

BACKGROUND: Intestinal mucosal barrier injury and gastrointestinal dysfunction are important causes of sepsis. However, few studies have investigated the effects of enteral underfeeding on gastrointestinal function in sepsis. Moreover, no consensus on goal enteral caloric intake has been reached in sepsis. AIM: To investigate the effects of different goal caloric requirements of enteral nutrition on the gastrointestinal function and outcomes in the acute phase of sepsis. METHODS: Patients were randomly assigned to receive 30% (defined as group A), 60% (group B), or 100% (group C) of goal caloric requirements of enteral nutrition in this prospective pilot clinical trial. The acute gastrointestinal injury (AGI) grades, incidence of feeding intolerance (FI), daily caloric intake, nutritional and inflammatory markers, and biomarkers of mucosal barrier function were collected during the first 7 d of enteral feeding. The clinical severity and outcome variables were also recorded. RESULTS: A total of 54 septic patients were enrolled. The days to goal calorie of group C (2.55 ± 0.82) were significantly longer than those of group A (3.50 ± 1.51; P = 0.046) or B (4.85 ± 1.68; P < 0.001). The FI incidence of group C (16.5%) was higher than that of group A (5.0%) or B (8.7%) (P = 0.009). No difference in the incidence of FI symptoms was found between groups A and B. The serum levels of barrier function biomarkers of group B were significantly lower than those of group A (P < 0.05) on the 7th day of feeding. The prealbumin and IL-6 levels of group A were lower than those of group B (P < 0.05) on the 7th day of feeding. No significant differences in the clinical outcome variables or 28-d mortality were found among the three groups. CONCLUSION: Early moderate enteral underfeeding (60% of goal requirements) could improve the intestinal barrier function and nutritional and inflammatory status without increasing the incidence of FI symptoms in sepsis. However, further large-scale prospective clinical trials and animal studies are required to test our findings. Moreover, the effects of different protein intake on gastrointestinal function and outcomes should also be investigated in future work.


Assuntos
Gastroenteropatias , Sepse , Ingestão de Energia , Nutrição Enteral/efeitos adversos , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Humanos , Recém-Nascido , Estudos Prospectivos , Sepse/epidemiologia , Sepse/terapia
12.
Gastroenterology ; 161(6): 2047-2050.e3, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34418440

RESUMO

One year into the coronavirus disease 2019 (COVID-19) pandemic, the African continent still seems to be spared from the devastating effects the disease had in other continents. Africa's COVID-19 seems to be of a milder nature both in adults and children. However, lack of data from Africa is significant, and more studies are needed to validate the disease status, clinical manifestations, and future implications for Africa. In this study, we report pediatric COVID-19 features in Africa represented by 8 countries.


Assuntos
COVID-19/epidemiologia , Saúde da Criança/estatística & dados numéricos , Gastroenteropatias/epidemiologia , Gastroenteropatias/virologia , SARS-CoV-2 , Adolescente , África/epidemiologia , COVID-19/complicações , COVID-19/patologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Adulto Jovem
13.
Nutrients ; 13(8)2021 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-34445048

RESUMO

This study evaluates the prevalence of autistic behaviors in fragile X syndrome as a function of infant diet. Retrospective survey data from the Fragile X Syndrome Nutrition Study, which included data on infant feeding and caregiver-reported developmental milestones for 190 children with fragile X syndrome enrolled in the Fragile X Online Registry with Accessible Database (FORWARD), were analyzed. Exploratory, sex-specific associations were found linking the use of soy-based infant formula with worse autistic behaviors related to language in females and self-injurious behavior in males. These findings prompt prospective evaluation of the effects of soy-based infant formula on disease comorbidities in fragile X syndrome, a rare disorder for which newborn screening could be implemented if there was an intervention. Gastrointestinal problems were the most common reason cited for switching to soy-based infant formula. Thus, these findings also support the study of early gastrointestinal problems in fragile X syndrome, which may underly the development and severity of disease comorbidities. In conjunction with comorbidity data from the previous analyses of the Fragile X Syndrome Nutrition Study, the findings indicate that premutation fragile X mothers should be encouraged to breastfeed.


Assuntos
Transtorno do Espectro Autista/epidemiologia , Comportamento Alimentar/psicologia , Síndrome do Cromossomo X Frágil/psicologia , Fórmulas Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente/genética , Adolescente , Transtorno do Espectro Autista/genética , Comorbidade , Feminino , Síndrome do Cromossomo X Frágil/fisiopatologia , Gastroenteropatias/epidemiologia , Gastroenteropatias/genética , Humanos , Lactente , Masculino , Inquéritos Nutricionais , Pais , Prevalência , Estudos Retrospectivos
14.
Turk J Pediatr ; 63(3): 461-470, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34254491

RESUMO

BACKGROUND: Functional gastrointestinal disorders (FGID) may affect or may be affected by postpartum depression (PPD), mode of feeding and postpartum life quality. We aimed to evaluate the interaction between FGID and these parameters in infants. METHODS: The study group consisted of babies attending our outpatient clinics. There were three age groups: 4-6 weeks, 3-4 months and 6-7 months. Demographic data of the babies and mothers, and data of feeding were collected. For the diagnosis of FGID, Rome III criteria were used. Mothers were screened with the Edinburgh Depression Scale. Quality of life (QoL) scores were obtained by using the `Maternal Postpartum Quality of Life Questionnaire`. Factors affecting the presence of FGID, PPD and quality of life were analyzed. RESULTS: Two hundred thirteen infants were enrolled during the study period. FGID was present with similar rates in both genders and was lower (31.5%) in the 6-7 month-old group (p=0.001). Infantile colic was higher in girls (68.6% vs. 31.4%, p=0.016). In 4-6 week-old infants with infantile dyschesia, the delivery route was mostly cesarean (83.3% vs. 16.7%, p=0.006). Similarly, regurgitation was more frequent in 6-7 month-old infants born by cesarean (88.9% vs. 11.1%, p=0.035), and was more frequent in infants being exclusively breastfed (60.9%, p=0.037). QoL scores were lower in mothers with depression (20.9±3.4 vs. 23.9±3.6, p=0.003). Infantile colic was higher in mothers with depression, but not significantly (29.3% vs. 11.4%, p=0.057). CONCLUSIONS: Caesarian section delivery and breastfeeding were influential on infantile dyschesia and regurgitation subgroups. No other studied factor seemed to affect FGID.


Assuntos
Depressão Pós-Parto , Gastroenteropatias , Aleitamento Materno , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Mães , Período Pós-Parto , Gravidez , Qualidade de Vida
15.
Dtsch Med Wochenschr ; 146(13-14): 891-893, 2021 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-34256402

RESUMO

During COVID 19 pandemic patients typically present with respiratory symptoms. However, in a significant number of patients the gastrointestinal tract is also involved in the disease. Up to 20 % of patients suffering from gastrointestinal symptoms. New insights in pathophysiological aspects might open new therapeutic concepts. This up-date includes current data regarding epidemiology of gastrointestinal symptoms in COVID 19, its role for prognosis and specific risks in relation to immunosuppressive therapies and underlying diseases.


Assuntos
COVID-19/complicações , Gastroenteropatias/etiologia , Hepatopatias/virologia , Pancreatopatias/virologia , SARS-CoV-2/fisiologia , Gastroenteropatias/epidemiologia , Gastroenteropatias/terapia , Humanos , Prevalência , Prognóstico , Fatores de Risco , SARS-CoV-2/patogenicidade
16.
Parasitol Int ; 84: 102418, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34245917

RESUMO

The Eurasian otter (Lutra lutra) is a protected species in Denmark and at present, the population is recovering due to conservation efforts. The Danish otters are mainly found in the continental part of Denmark (Jutland), but establishment in the main islands (Fyn and Zealand) has been observed. While there is a lack of systematic studies on the parasite fauna of otters in Denmark, this study aims to screen otters for their parasite fauna, especially those of zoonotic and/or veterinary importance. Thirty-three otter carcasses, road-killed (n = 30), found dead (n = 2) and shot (n = 1), were collected between June 2013 and May 2014 and examined for cardiopulmonary, urogenital, gastrointestinal, and muscle helminths by post mortem examination. Faecal samples were analysed by modified concentration McMaster technique and direct immunofluorescence test for Giardia and Cryptosporidium. At least one parasite was found in 75.8% of animals. The parasite fauna included 13 species, consisting of five nematodes: Molineus patens (30.3%), Aonchotheca putorii (27.3%), Strongyloides sp. (24.2%), Physaloptera sp. (12.1%), Eucoleus aerophilus (10.0%); one cestode: Schistocephalus solidius (6.1%); four trematodes: Metorchis bilis (33.3%), Isthimiophora melis (15.2%), Cryptocotyle sp. (3.0%), Plagiorchis sp. (3.0%); one acanthocephalan: Acanthocephalus ranae (18.2%); and two protozoans: Giardia spp. (3.1%), and Eimeria spp. (3.1%). The study showed that otters carry parasites of zoonotic and veterinary importance. Many of these parasites can also infect native carnivores and birds, and the distribution of these parasites may be affected if the otter population continue to increase in Denmark.


Assuntos
Lontras , Doenças Parasitárias em Animais/epidemiologia , Animais , Dinamarca/epidemiologia , Espécies em Perigo de Extinção , Feminino , Doenças Urogenitais Femininas/epidemiologia , Doenças Urogenitais Femininas/parasitologia , Doenças Urogenitais Femininas/veterinária , Gastroenteropatias/epidemiologia , Gastroenteropatias/parasitologia , Gastroenteropatias/veterinária , Cardiopatias/epidemiologia , Cardiopatias/parasitologia , Cardiopatias/veterinária , Pneumopatias/epidemiologia , Pneumopatias/parasitologia , Pneumopatias/veterinária , Masculino , Doenças Urogenitais Masculinas/epidemiologia , Doenças Urogenitais Masculinas/parasitologia , Doenças Urogenitais Masculinas/veterinária , Doenças Musculares/epidemiologia , Doenças Musculares/parasitologia , Doenças Musculares/veterinária , Doenças Parasitárias em Animais/parasitologia
17.
Arch Phys Med Rehabil ; 102(11): 2165-2171, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34252394

RESUMO

OBJECTIVE: To investigate the association between the Simple Swallowing Provocation Test (SSPT) and the incidence of aspiration pneumonia in patients with dysphagia in long-term care (LTC) wards. DESIGN: The study design was a prospective cohort study. Participants were followed for 60 days from admission. SETTING: LTC wards. PARTICIPANTS: Study participants were patients with dysphagia aged ≥65 years who were admitted to LTC wards between August 2018 and August 2019. In total, 39 participants were included in the analysis (N=39; 20 male, 19 female; mean age, 83.8±8.5y). Participants were divided into 2 groups based on SSPT results: normal swallowing reflex (SSPT normal group) and abnormal swallowing reflex (SSPT abnormal group). The covariates were age and sex, primary disease, history of cerebrovascular disease, Glasgow Coma Scale, body mass index, Geriatric Nutritional Risk Index, the Mann Assessment of Swallowing Ability, Food Intake Level Scale, FIM, and Oral Health Assessment Tool. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The outcome was the incidence of aspiration pneumonia during the first 60 days of hospitalization, and the predictive factor was SSPT: 0.4 mL. RESULTS: The incidence of aspiration pneumonia was 33.3% in the SSPT normal group and 76.2% in the SSPT abnormal group. The φ coefficient (a measure of association for 2 binary variables) was 0.43, the risk ratio (the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group) was 2.29, and the 95% confidence interval was 1.14-4.58 for the SSPT abnormal group. CONCLUSIONS: Our findings suggest that the SSPT provides a valid index for the development of aspiration pneumonia in older patients with dysphagia admitted to LTC wards.


Assuntos
Transtornos de Deglutição/epidemiologia , Pneumonia Aspirativa/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Transtornos Cerebrovasculares/epidemiologia , Feminino , Gastroenteropatias/epidemiologia , Humanos , Assistência de Longa Duração , Masculino , Doenças do Sistema Nervoso/epidemiologia , Estado Nutricional , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores Sexuais
19.
Environ Health ; 20(1): 83, 2021 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-34271918

RESUMO

BACKGROUND: The occurrence of cyanobacterial blooms in freshwater presents a threat to human health. However, epidemiological studies on the association between cyanobacterial blooms in drinking water sources and human health outcomes are scarce. The objective of this study was to evaluate if cyanobacterial blooms were associated with increased emergency room visits for gastrointestinal (GI), respiratory and dermal illnesses. METHODS: Satellite-derived cyanobacteria cell concentrations were estimated in the source of drinking water for the Greater Boston area, during 2008-2011. Daily counts of hospital emergency room visits for GI, respiratory and dermal illnesses among drinking water recipients were obtained from an administrative record database. A two-stage model was used to analyze time-series data for an association between cyanobacterial blooms and the occurrence of illnesses. At the first stage, predictive autoregressive generalized additive models for Poisson-distributed outcomes were fitted to daily illness count data and daily predictive variables. At the second stage, residuals from the first stage models were regressed against lagged categorized cyanobacteria concentration estimates. RESULTS: The highest cyanobacteria concentration (above the 75th percentile) was associated with an additional 4.3 cases of respiratory illness (95% confidence interval: 0.7, 8.0, p = 0.02, n = 268) compared to cyanobacteria concentrations below the 50th percentile in a two-day lag. There were no significant associations between satellite derived cyanobacterial concentrations and lagged data on GI or dermal illnesses. CONCLUSION: The study demonstrated a significant positive association between satellite-derived cyanobacteria concentrations in source water and respiratory illness occurring 2 days later. Future studies will require direct measures of cyanotoxins and health effects associated with exposure to cyanobacteria-impacted drinking water sources.


Assuntos
Cianobactérias , Serviço Hospitalar de Emergência/estatística & dados numéricos , Eutrofização , Gastroenteropatias/epidemiologia , Doenças Respiratórias/epidemiologia , Dermatopatias/epidemiologia , Poluentes da Água , Doença Aguda , Poluentes Atmosféricos/análise , Água Potável/microbiologia , Monitoramento Ambiental , Humanos , Massachusetts/epidemiologia , Imagens de Satélites
20.
Br J Radiol ; 94(1124): 20210242, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34282946

RESUMO

OBJECTIVES: The present multicenter Phase II study evaluated the rate of late grade ≥2 gastrointestinal (GI) toxicities at 3 years, after hypofractionated radiotherapy (HFR) of prostate cancer with injection of hyaluronic acid (HA) between the prostate and the rectum. METHODS: Between 2010 and 2013, 36 patients with low- or intermediate-risk prostate cancer were treated by HFR/IMRT-IGRT. 20 fractions of 3.1 Gy were delivered, 5 days per week for a total dose of 62 Gy. A transperineal injection of 10cc of HA was performed between the rectum and the prostate. Late toxicities were evaluated between 3 and 36 months after the end of treatment (CTCAE v4). RESULTS: Median pretreatment prostate-specific antigen was 8 ng ml-1. Among the 36 included patients, 2 were not evaluated because they withdrew the study in the first 3 months of follow-up, and 4 withdrew between 3 and 36 months, the per protocol population was therefore composed.Late grade ≥2 GI toxicities occurred in 4 (12%) patients with 3 (9%) Grade 2 rectal bleedings and one diarrhoea. Therefore, the inefficacy hypothesis following Fleming one-stage design cannot be rejected. None of the patients experienced late Grade 3-4 toxicities. Among the 30 patients completing the 36 months' visit, none still had a grade ≥2 GI toxicity. Late grade ≥2 genitourinary (GU) toxicities occurred in 14 (41%) patients. The most frequent toxicities were dysuria and pollakiuria. Four patients still experienced a grade ≥2 GU toxicity at 36 months.The biochemical relapse rate (nadir +2 ng ml-1) was 6% (2 patients). Overall, HA was very well tolerated with no pain or discomfort. CONCLUSION: Despite the inefficacy of HA injection was not rejected, we observed the absence of Grade 3 or 4 rectal toxicity as well as a rate of Grade 2 rectal bleeding below 10% at 36 months of follow-up. Late urinary toxicities are the most frequent but the rate decreases largely at 3 years. ADVANCES IN KNOWLEDGE: With an injection of HA, hypofractionated irradiation in 4 weeks is well tolerated with no Grade 3 or 4 GI toxicity and a rate of Grade 2 rectal bleeding below 10% at 36 months of follow-up.


Assuntos
Gastroenteropatias/prevenção & controle , Ácido Hialurônico/administração & dosagem , Neoplasias da Próstata/radioterapia , Hipofracionamento da Dose de Radiação , Lesões por Radiação/prevenção & controle , Idoso , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Lesões por Radiação/complicações , Lesões por Radiação/epidemiologia , Dosagem Radioterapêutica , Fatores de Tempo
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