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1.
PLoS One ; 15(9): e0237676, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32946449

RESUMO

OBJECTIVES: Proton pump inhibitors (PPIs) are commonly prescribed for prevention and treatment of gastrointestinal conditions or for gastroprotection from other drugs. Research suggests they are linked to increased dementia risk. We use linked national health data to examine the association between PPI use and the development of incident dementia. METHODS AND FINDINGS: A population-based study using electronic health-data from the Secure Anonymised Information Linkage (SAIL) Databank, Wales (UK) from 1999 to 2015. Of data available on 3,765,744 individuals, a cohort who had ever been prescribed a PPI was developed (n = 183,968) for people aged 55 years and over and compared to non-PPI exposed individuals (131,110). Those with prior dementia, mild-cognitive-impairment or delirium codes were excluded. Confounding factors included comorbidities and/or drugs associated with them. Comorbidities might include head injury and some examples of medications include antidepressants, antiplatelets and anticoagulants. These commonly prescribed drugs were investigated as it was not feasible to explore all drugs in this study. The main outcome was a diagnosis of incident dementia. Cox proportional hazard regression modelling was used to calculate the Hazard ratio (HR) of developing dementia in PPI-exposed compared to unexposed individuals while controlling for potential confounders. The mean age of the PPI exposed individuals was 69.9 years and 39.8% male while the mean age of the unexposed individuals was 72.1 years and 41.1% male. The rate of PPI usage was 58.4% (183,968) and incident dementia rate was 11.8% (37,148/315,078). PPI use was associated with decreased dementia risk (HR: 0.67, 95% CI: 0.65 to 0.67, p<0.01). CONCLUSIONS: This study, using large-scale, multi-centre health-data was unable to confirm an association between PPI use and increased dementia risk. Previously reported links may be associated with confounders of people using PPI's, such as increased risk of cardiovascular disease and/or depression and their associated medications which may be responsible for any increased risk of developing dementia.


Assuntos
Demência/induzido quimicamente , Inibidores da Bomba de Prótons/efeitos adversos , Idoso , Estudos de Coortes , Demência/epidemiologia , Feminino , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/prevenção & controle , Humanos , Masculino , Modelos de Riscos Proporcionais , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de Risco , País de Gales/epidemiologia
2.
Einstein (Sao Paulo) ; 18: eAO5314, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32785451

RESUMO

Objective To estimate the prevalence of use of drugs to treat gastrointestinal disorders, according to demographic, socioeconomic, and health characteristics of the Brazilian population. Methods This is a population-based survey that interviewed individuals residing in cities of the five regions in Brazil. The study sample was composed of 32,348 individuals aged 20 or more years. The profile of use of drugs for gastrointestinal disorders was evaluated considering the variables sex, age, healthcare plan, region, and number of chronic diseases. We also analyzed the frequency of individuals who declared using other drugs, besides those already employed for treatment of gastrointestinal disorders. Additionally, the estimated frequencies of the drug classes used were determined. Results The prevalence of use of drugs for gastrointestinal disorders in Brazil was 6.9% (95% confidence interval - 6.4-7.6), higher in females, among persons aged over 60 years, in those who had a private healthcare insurance, and presented with two or more chronic diseases. It was noted that 42.9% of the aged who used drugs for gastrointestinal disorders were also on polypharmacy. As to the classes of drugs, 82% corresponded to drugs for the food tract and metabolism, particularly proton pumps inhibitors. Conclusion The use of drugs for treatment of gastrointestinal disorders was significant among women and elderly. In this age group, consumption may be linked to gastric protection due to polypharmacy. This study is an unprecedented opportunity to observe the self-reported consumption profile of these drugs in Brazil and, therefore, could subsidize strategies to promote their rational use.


Assuntos
Uso de Medicamentos/estatística & dados numéricos , Medicamentos Essenciais/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adulto , Idoso , Brasil , Cidades , Estudos Transversais , Medicamentos Essenciais/provisão & distribução , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Preparações Farmacêuticas/provisão & distribução , Medicamentos sob Prescrição/provisão & distribução , Fatores Socioeconômicos , Adulto Jovem
3.
Medicine (Baltimore) ; 99(28): e20675, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664064

RESUMO

INTRODUCTION: Gwakhyangjeonggi-san (GJS) is an herbal formula with anti-inflammatory and anti-allergic properties that is broadly used to treat a wide range of diseases including gastrointestinal disorders and allergic diseases. There have been several clinical studies conducted on its effects on atopic dermatitis (AD). So far, no randomized controlled trials have been conducted. Here, we describe the protocol for a randomized controlled study designed to investigate the efficacy and safety of GJS for treating patients with AD that have gastrointestinal symptoms. METHODS AND ANALYSIS: A randomized, double-blind, placebo-controlled, parallel-group, clinical trial has been designed to investigate the clinical efficacy and safety of GJS on patients with AD that have gastrointestinal symptoms. A total of 58 participants with AD will be recruited and randomly allocated to the GJS or placebo group in a 1:1 ratio. The participants will be administered GJS or placebo granules 3 times a day for 8 weeks. Data will be collected from the participants at baseline and after 4 and 8 weeks. The primary outcome measure will be the mean change in the SCORing of Atopic Dermatitis (SCORAD) index from baseline to 8 weeks. The secondary outcomes will include the eczema area and severity index (EASI), dermatology life quality index (DLQI), EuroQoL 5 dimensions 5 levels (EQ-5D-5L), and immunological factors. The Korean Gastrointestinal Symptom Rating Scale (KGSRS), Nepean Dyspepsia Index will also be obtained for assessing the gastrointestinal status. DISCUSSION: The findings of this study are expected to provide evidence on the safety and effectiveness of GJS and for treating patients with AD that have gastrointestinal symptoms. Additionally, the study will explore the mechanism of GJS action via gut microbiome. This study will provide new perspectives on approaching treatment for AD. ETHICS AND DISSEMINATION: The study protocol was approved by the Institutional Review Board of Kyung Hee University Korean Medicine Hospital at Gangdong (KHNMCOH2019-06-002-001). TRIAL REGISTRATION NUMBER: This study has been registered at the Korean National Clinical Trial Registry, Clinical Research Information Service (KCT0004299).


Assuntos
Dermatite Atópica/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Gastroenteropatias/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Dermatite Atópica/complicações , Método Duplo-Cego , Medicamentos de Ervas Chinesas/farmacologia , Gastroenteropatias/imunologia , Humanos , Fitoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
BMC Infect Dis ; 20(1): 479, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631331

RESUMO

BACKGROUND: The study aimed to assess whether gastrointestinal (GI) symptoms at admission are associated with increased short-term mortality in patients with invasive pneumococcal disease (IPD). METHODS: We included all patients with IPD at Aker University Hospital in Oslo, Norway, from 1993 to 2008. Clinical data were registered. Survival data were retrieved from official registries. We used Cox regression and Kaplan-Meier curve to compare mortality within 28 days of admission in patients with and without GI symptoms. RESULTS: Four hundred sixteen patients were included. Of these, 108 patients (26%) presented with GI symptoms, and 47 patients (11%) with GI symptoms only. Patients with GI symptoms were younger (p < 0.001) and had less cardiovascular disease (p < 0.001), pulmonary disease (p = 0.048), and cancer (p = 0.035) and received appropriate antibiotic treatment later. After adjusting for risk factors, we found an increased hazard ratio of 2.28 (95% CI 1.31-3.97) in patients presenting with GI symptoms. In patients with GI symptoms only there was an increased hazard ratio of 2.24 (95% CI 1.20-4.19) in univariate analysis, which increased to 4.20 (95% CI 2.11-8.39) after multivariate adjustment. Fewer patients with GI symptoms only received antibiotics upon admission. CONCLUSIONS: A large proportion of IPD patients present with GI symptoms only or in combination with other symptoms. GI symptoms in IPD are associated with increased short-term mortality.


Assuntos
Gastroenteropatias/epidemiologia , Gastroenteropatias/microbiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/mortalidade , Streptococcus pneumoniae/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Comorbidade , Feminino , Gastroenteropatias/tratamento farmacológico , Hospitalização , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Infecções Pneumocócicas/tratamento farmacológico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Streptococcus pneumoniae/isolamento & purificação , Resultado do Tratamento , Adulto Jovem
6.
Adv Exp Med Biol ; 1207: 529-556, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32671773

RESUMO

Normal gastrointestinal physiology is fundamental for all the living beings. Gastrointestinal diseases mainly include gastrointestinal motility disorders, infectious inflammation (such as Helicobacter pylori infection, cholera, and intestinal parasites), non-infectious inflammation (such as chronic gastritis and Crohn's disease), and gastrointestinal cancers. In addition, intestinal microbial disorder is also an important cause of intestinal diseases, so intestinal microecological treatment (fecal microbiota transplantation) is an important mean of treating gastrointestinal diseases. In recent years, the role of autophagy in gastrointestinal diseases has been studied extensively. Autophagy is observed under various pathological processes of the gastrointestinal tract. For example, it has been demonstrated that autophagy plays an important role in maintaining the homeostasis and integrity of intestinal epithelium. Additionally, autophagy regulates host response to H. pylori infection and development of gastrointestinal cancers. Therefore, we will discuss pivotal roles of autophagy in various gastrointestinal diseases and analyze the underlying molecular mechanisms, which may provide new therapeutic targets applicable for the treatment of gastrointestinal diseases.


Assuntos
Autofagia , Gastroenteropatias , Autofagia/efeitos dos fármacos , Cólera , Doença de Crohn , Gastrite Atrófica , Gastroenteropatias/tratamento farmacológico , Neoplasias Gastrointestinais , Infecções por Helicobacter , Humanos
7.
Eur Rev Med Pharmacol Sci ; 24(13): 7506-7511, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32706091

RESUMO

OBJECTIVE: The Coronavirus Disease 2019 (COVID-19) pandemic mainly involves respiratory symptoms, though gastrointestinal (GI) symptoms are increasingly being recognized. In this context, the presence of comorbidities appears to be associated with adverse outcomes. However, the role of digestive manifestations is not yet well defined. The primary aim of this study was to assess the prevalence of GI symptoms and digestive comorbidities in a cohort of patients with COVID-19 compared to controls. The secondary aim was to determine the association of GI-symptoms and digestive comorbidities with clinical outcomes. PATIENTS AND METHODS: Inpatients with COVID-19 and controls with similar symptoms and/or radiological findings were enrolled. Symptoms at admission and throughout hospitalization were collected as they were comorbidities. The measured clinical outcomes were mortality, intensive care unit admission and cumulative endpoint. RESULTS: A total of 105 patients were included: 34 with COVID-19 and 71 controls. At admission, the prevalence of GI symptoms among COVID-19 patients was 8.8%. During hospitalization, the frequency of GI symptoms was higher in patients with COVID-19 than in controls (p=0.004). Among patients with COVID-19, the mortality and a cumulative endpoint rates of those with GI symptoms were both lower than for those without GI symptoms (p=0.016 and p=0.000, respectively). Finally, we found digestive comorbidities to be associated with a milder course of COVID-19 (p=0.039 for cumulative endpoint). CONCLUSIONS: Our results highlighted the non-negligible frequency of GI symptoms in patients with COVID-19, partly attributable to the therapies implemented. In addition, the presence of GI symptoms and digestive comorbidities is associated with better outcomes. Most likely, digestive comorbidities do not hinder the host's immune response against SARS-COV-2, and the occurrence of GI symptoms might be linked to a faster reduction of the viral load via the faecal route.


Assuntos
Antivirais/farmacologia , Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Gastroenteropatias/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Humanos , Itália , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Estudos Prospectivos
8.
Pharm. pract. (Granada, Internet) ; 18(2): 0-0, abr.-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-194065

RESUMO

BACKGROUND: There is an acknowledged lack of robust and rigorous research focusing on the perspectives of those prescribing direct acting oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF). OBJECTIVE: The objective was to describe prescribers' experiences of using DOACs in the management of non-valvular AF, including perceptions of benefits and limitations. METHODS: A cross-sectional survey of prescribers in a remote and rural area of Scotland. Among other items, the questionnaire invited free-text description of positive and negative experiences of DOACs, and benefits and limitations. Responses were independently analysed by two researchers using a summative content analysis approach. This involved counting and comparison, via keywords and content, followed by interpretation and coding of the underlying context into themes. RESULTS: One hundred and fifty-four responses were received, 120 (77.9%) from physicians, 18 (11.7%) from nurse prescribers and 10 (6.4%) from pharmacist prescribers (6 unidentified professions). Not having to monitor INR was the most cited benefit, particularly for prescribers and patients in remote and rural settings, followed by potentially improved patient adherence. These benefits were reflected in respondents' descriptions of positive experiences and patient feedback. The main limitations were the lack of reversal agents, cost and inability to monitor anticoagulation status. Many described their experiences of adverse effects of DOACs including fatal and non-fatal bleeding, and upper gastrointestinal disturbances. CONCLUSIONS: While prescribers have positive experiences and perceive benefits of DOACs, issues such as adverse effects and inability to monitor anticoagulation status merit further monitoring and investigation. These issues are particularly relevant given the trajectory of increased prescribing of DOACs


No disponible


Assuntos
Humanos , Fibrilação Atrial/tratamento farmacológico , Anticoagulantes/administração & dosagem , Percepção , Prescrições/normas , Estudos Transversais , Inquéritos e Questionários , Gastroenteropatias/complicações , Gastroenteropatias/tratamento farmacológico
12.
Artigo em Inglês | MEDLINE | ID: mdl-32401957

RESUMO

Immunosuppression is an important risk factor for leishmaniasis. We assessed the clinical profile, geographic distribution and prevalence of leishmaniasis in patients undergoing immunosuppressive therapy for dermatological, rheumatological or gastroenterological autoimmune diseases. We identified relevant studies in PubMed, EMBASE, Scopus, Web of Science and LILACS on July 3rd, 2018. We included articles that reported at least one case of leishmaniasis in patients undergoing immunosuppressive treatment for dermatological, rheumatological or gastroenterological diseases. Our protocol was registered in PROSPERO (CRD42018103050). We assessed the quality of the included studies with the Joanna Briggs Institute Critical Appraisal Tool. After the removal of duplicates, 5,431 articles were collected and screened. We included 138 articles; the prevalence of leishmaniasis in six methodologically similar studies varied from three to 1,282 cases per 100,000 patients using anti-TNFα drugs, but the results were significantly heterogeneous . Leishmaniasis in patients treated with immunosuppressive drugs is a health problem mostly reported in European countries bordering the Mediterranean Sea; sporadic activities, such as travelling, seem not to be associated with a significant risk of leishmaniasis, although effective control measures must always be observed.


Assuntos
Hospedeiro Imunocomprometido/imunologia , Imunossupressores/efeitos adversos , Leishmaniose/imunologia , Gastroenteropatias/tratamento farmacológico , Humanos , Imunossupressores/imunologia , Imunossupressores/uso terapêutico , Doenças Reumáticas/tratamento farmacológico , Dermatopatias/tratamento farmacológico
13.
Vet Parasitol ; 281: 109121, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32361524

RESUMO

The search of novel strategies for anthelmintic control is a crucial need considering the widespread increase in resistant parasitic populations in livestock. Bioactive phytochemicals may contribute to improve parasite control by enhancing the effect of existing anthelmintic drugs. The aim of the current work was to evaluate the in vivo and in vitro pharmaco-chemical interaction and the in vivo efficacy of the combination of albendazole (ABZ) with thymol (TML) in lambs naturally infected with resistant gastrointestinal nematodes. Thirty (30) lambs were allocated into three experimental groups. Each group was treated orally with either ABZ (5 mg/kg), TML (150 mg/kg, twice every 24 h) or the co-administration of both compounds. Blood samples were collected between 0 and 51 h post-treatment and TML, ABZ and its metabolites were measured by HPLC. Individual faecal samples were collected at days -1 and 14 post-treatment to perform the faecal egg count reduction test. Additionally, the effect of TML on the sulphoreduction and sulphonation of ABZ sulphoxide was assessed in vitro using ruminal content and liver microsomes, respectively. The metabolism of TML in the ruminal content was very low and the monoterpene exhibited a low degree of association with the particulate phase of the ruminal content. No changes in the pharmacokinetic behavior of ABZ sulphoxide were observed in the presence of the natural product (TML). In contrast, the ABZ sulphone Cmax and AUC were lower (P 0.002 and 0.001 respectively) in the co-administered animals (0.16 ±â€¯0.07 µg/mL and 3.63 ±â€¯1.21 µg.h/mL) compared with those that received ABZ alone (0.45 ±â€¯0.15 µg/mL and 9.50 ±â€¯2.84 µg.h/mL). TML was detected in the bloodstream between 1 and 48 h post-treatment, which indicates the time of target nematodes being exposed to the bioactive monoterpene. However, the in vivo efficacy of TML was 0% and the presence of this terpene did not increase the efficacy of ABZ. The presence of TML significantly inhibited the ruminal sulphoreduction (P 0.001) and the hepatic sulphonation (P 0.001) of ABZ sulphoxide. These observations point out that in vivo pharmaco-parasitological studies are relevant to corroborate the adverse kinetic/metabolic interactions and the efficacy of bioactive natural products combined with synthetic anthelmintics.


Assuntos
Albendazol/administração & dosagem , Resistência a Medicamentos/efeitos dos fármacos , Gastroenteropatias/tratamento farmacológico , Helmintíase Animal/tratamento farmacológico , Doenças dos Ovinos/tratamento farmacológico , Timol/administração & dosagem , Animais , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/farmacologia , Quimioterapia Combinada , Gastroenteropatias/parasitologia , Helmintíase Animal/parasitologia , Compostos Fitoquímicos/farmacologia , Ovinos , Doenças dos Ovinos/parasitologia , Resultado do Tratamento
14.
Medicine (Baltimore) ; 99(20): e20188, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443339

RESUMO

INTRODUCTION: The Chinese herb da huang (DH) (Rhubarb) is commonly used for GIF intensive care unit (ICU)/pediatric intensive care unit (PICU) gastrointestinal failure (GIF) patients in China. However, the potential preventive and therapeutic effect of DH in these patients has not yet been studied systematically. OBJECTIVES: The aim of this study was to evaluate the preventive and therapeutic effects of DH in treating ICU/PICU GIF patients with the most recent evidence. METHODS: We systematically searched 7 databases from inception to March 30, 2018. RevMan 5.3 software was used to perform a meta-analysis. GRADE methodology was applied to evaluate the quality of evidence for each outcome. The review protocol was registered on PROSPERO (CRD42018092710) in advance. RESULTS: Seven studies comprising 788 pediatric or adult participants were included in this analysis. Three indicators, including GIF occurrence rates (gastrointestinal mucosal hemorrhage, enteroplegia), multiple organ dysfunction syndrome (MODS)-related items (occurrence rates of MODS, mortality rates of MODS) and duration in the ICU was analyzed. The GIF occurrence rate meta-analysis result was (RR 0.47, CI 95% 0.37-0.60; P = .95); MODS related items indicator result was (RR 0.44, CI 95% 0.33-0.59; P = .41); ICU duration ICU result was (RR -2.87, CI 95% -3.53--2.21; P = .40). The safety of Chinese herb DH (Rhubarb) remains unclear. CONCLUSION: Current evidence suggests that the Chinese herb rhubarb (DH) powder combined with Western medicine was inferior to Western medicine alone in terms of preventive and therapeutic effects in ICU/PICU patients in terms of decreasing GIF occurrence rates (gastrointestinal mucosal hemorrhage and enteroplegia), occurrence rates of MODS, mortality from MODS, and shortened duration time in the ICU/PICU. However, larger sample sizes and rigorously-designed studies are necessary to conclusively determine the association between DH powder and outcomes in ICU/PICU GIF patients.


Assuntos
Gastroenteropatias/tratamento farmacológico , Unidades de Terapia Intensiva Pediátrica/normas , Unidades de Terapia Intensiva/normas , Rheum/efeitos adversos , Adulto , Criança , China/epidemiologia , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Gastroenteropatias/patologia , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal/prevenção & controle , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Masculino , Insuficiência de Múltiplos Órgãos/epidemiologia , Insuficiência de Múltiplos Órgãos/mortalidade , Resultado do Tratamento
15.
Med Clin North Am ; 104(3): 439-454, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32312408

RESUMO

Anorexia and cachexia, nausea and vomiting, and constipation are gastrointestinal symptoms that commonly accompany serious illness. Basic science and clinical research continue to improve the understanding of their pathophysiology. Thorough assessment necessitates history, physical examination, and laboratory and diagnostic testing. Pharmacologic management attempts to counteract or reverse the underlying pathophysiologic mechanisms that accompany each symptom, which may benefit from a multimodal approach to achieve adequate control. Future improvements in management require investments in clinical research to determine the efficacy of novel agents along with comparator studies to better understand which treatments should be used in what sequence or combination.


Assuntos
Anorexia/tratamento farmacológico , Caquexia/tratamento farmacológico , Constipação Intestinal/tratamento farmacológico , Gastroenteropatias/tratamento farmacológico , Náusea/tratamento farmacológico , Vômito/tratamento farmacológico , Analgésicos Opioides/efeitos adversos , Anorexia/epidemiologia , Anorexia/fisiopatologia , Biomarcadores/metabolismo , Caquexia/epidemiologia , Caquexia/fisiopatologia , Terapia Combinada/métodos , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/epidemiologia , Constipação Intestinal/fisiopatologia , Estado Terminal , Gastroenteropatias/epidemiologia , Gastroenteropatias/patologia , Gastroenteropatias/fisiopatologia , Humanos , Inflamação/metabolismo , Inflamação/prevenção & controle , Náusea/epidemiologia , Náusea/fisiopatologia , Cuidados Paliativos/métodos , Exame Físico/métodos , Exame Físico/normas , Qualidade de Vida/psicologia , Receptores de Neurotransmissores/efeitos dos fármacos , Vômito/epidemiologia
16.
Rev Bras Parasitol Vet ; 29(1): e015819, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236331

RESUMO

An evaluation was made of the effect of anthelmintic treatments on the performance of Simmental X Nellore crossbred calves before and after weaning. To this end, the calves were divided into three groups: (1) treated monthly with a low efficacy anthelmintic drug, ivermectin; (2) treated monthly with a highly effective anthelmintic drug, albendazole; and (3) untreated control group. All the groups in this experiment showed an average fecal egg count of less than 400 eggs per gram (EPG), and no clinical signs of parasitic gastroenteritis. The blood variables were within the normal range and no calf presented anemia. In most of the samplings, mean EPGs were significantly lower (P<0.05) in the group treated with albendazole. The calves received dietary supplementation before and after weaning, which enabled them to gain weight in every month of the experiment and reach a body weight of about 250 kg on the last sampling date, before turning one year old. The anthelmintic treatments did not affect body weight gain, leading to the conclusion that, when fed with suitable dietary supplements, Simmental X Nellore crossbred calves are not affected by gastrointestinal nematode parasites acquired by grazing.


Assuntos
Albendazol/administração & dosagem , Anti-Helmínticos/administração & dosagem , Doenças dos Bovinos/tratamento farmacológico , Gastroenteropatias/veterinária , Ivermectina/administração & dosagem , Infecções por Nematoides/veterinária , Animais , Bovinos , Fezes/parasitologia , Feminino , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/parasitologia , Masculino , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Contagem de Ovos de Parasitas/veterinária
17.
Infection ; 48(3): 471-475, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32128685

RESUMO

BACKGROUND: While Campylobacter jejuni represents the most common cause of bacterial gastroenteritis, Yersinia pseudotuberculosis infections are very rarely diagnosed in adults. CASE: We report on a previously healthy patient who presented several times at our hospital with fever, Guillain-Barré syndrome, recurrent abdominal symptoms and distinct mesenteric lymphadenopathy, respectively. This complicated and diagnostically challenging course of disease was caused by a C. jejuni and Y. pseudotuberculosis coinfection. Antibiotic treatment with doxycycline was effective. CONCLUSION: Broad serology testing was crucial to discover that two concomitant infections were causing the symptoms. This case demonstrates that when a clinical picture is not fully explained by one known infection, another infection with the same underlying risk factor has to be considered, hence "a horse and a zebra".


Assuntos
Infecções por Campylobacter/diagnóstico , Coinfecção/diagnóstico , Gastroenteropatias/diagnóstico , Síndrome de Guillain-Barré/diagnóstico , Infecções por Yersinia pseudotuberculosis/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Infecções por Campylobacter/diagnóstico por imagem , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Campylobacter jejuni/isolamento & purificação , Coinfecção/diagnóstico por imagem , Coinfecção/tratamento farmacológico , Coinfecção/microbiologia , Doxiciclina/uso terapêutico , Febre/microbiologia , Gastroenteropatias/diagnóstico por imagem , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/microbiologia , Alemanha , Síndrome de Guillain-Barré/diagnóstico por imagem , Síndrome de Guillain-Barré/microbiologia , Humanos , Linfadenopatia/diagnóstico , Linfadenopatia/microbiologia , Masculino , Recidiva , Resultado do Tratamento , Yersinia pseudotuberculosis/isolamento & purificação , Infecções por Yersinia pseudotuberculosis/diagnóstico por imagem , Infecções por Yersinia pseudotuberculosis/tratamento farmacológico , Infecções por Yersinia pseudotuberculosis/microbiologia
18.
South Med J ; 113(3): 119-124, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32123926

RESUMO

OBJECTIVES: Acid suppression therapy (AST), composed of proton pump inhibitors (PPIs), histamine-2 receptor blockers, and antacids, is one of the most common medication groups used in the United States. Long-term AST is concerning, however, because it is linked with an increased risk of community-acquired pneumonia, Clostridium difficile infections, bone fractures, and nutritional deficiencies. The potentially harmful biological and economic consequences associated with the improper use of acid suppression medications presents a great deal of risk to those in underserved communities. We sought to determine the prevalence of AST in an underserved population and the common diagnoses and symptoms associated with therapy. In addition, we studied the frequency of suboptimal usage of PPIs in an indigent care population and the potential factors related to high-risk behaviors. METHODS: The study was a cross-sectional study using a survey that was distributed to participants during their regularly scheduled visits to a public sector provider of health care for low-income patients. RESULTS: Of the 176 participants surveyed, 70 (40%) were using AST. Esophagitis and gastroesophageal reflux disease were the most prevalent in our sample population. PPIs were the most common acid suppression medication used in our population. Of those using PPIs, 85% were never instructed to cease use. Of the 27 patients with PPI prescriptions, 26 used it in a suboptimal manner, and of those without prescriptions, 7 used it in a suboptimal manner. CONCLUSIONS: ASTs are prevalent in low-income populations, and patients are not being managed appropriately to minimize their risk for complications of AST.


Assuntos
Gastroenteropatias/tratamento farmacológico , Antagonistas dos Receptores Histamínicos H2/uso terapêutico , Populações Vulneráveis/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Feminino , Florida , Gastroenteropatias/economia , Antagonistas dos Receptores Histamínicos H2/economia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
19.
Aliment Pharmacol Ther ; 51(6): 582-602, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32056247

RESUMO

BACKGROUND: Helicobacter pylori is the most infamous constituent of the gastric microbiota and its presence is the strongest risk factor for gastric cancer and other gastroduodenal diseases. Although historically the healthy stomach was considered a sterile organ, we now know it is colonised with a complex microbiota. However, its role in health and disease is not well understood. AIM: To systematically explore the literature on the gastric microbiota in health and disease as well as the gut microbiota after bariatric surgery. METHODS: A systematic search of online bibliographic databases MEDLINE/EMBASE was performed between 1966 and February 2019 with screening in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomised controlled trials, cohort studies and observational studies were included if they reported next-generation sequencing derived microbiota analysis on gastric aspirate/tissue or stool samples (bariatric surgical outcomes). RESULTS: Sixty-five papers were eligible for inclusion. With the exception of H pylori-induced conditions, overarching gastric microbiota signatures of health or disease could not be determined. Gastric carcinogenesis induces a progressively altered microbiota with an enrichment of oral and intestinal taxa as well as significant changes in host gastric mucin expression. Proton pump inhibitors usage increases gastric microbiota richness. Bariatric surgery is associated with an increase in potentially pathogenic proteobacterial species in patient stool samples. CONCLUSION: While H pylori remains the single most important risk factor for gastric disease, its capacity to shape the collective gastric microbiota remains to be fully elucidated. Further studies are needed to explore the intricate host/microbial and microbial/microbial interplay.


Assuntos
Mucosa Gástrica/microbiologia , Gastroenteropatias/etiologia , Microbioma Gastrointestinal/fisiologia , Saúde , Neoplasias Gástricas/etiologia , Estudos de Coortes , DNA Bacteriano/análise , Mucosa Gástrica/patologia , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/epidemiologia , Gastroenteropatias/microbiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/fisiologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de Risco , Análise de Sequência de DNA/métodos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/microbiologia
20.
J Helminthol ; 94: e125, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32036795

RESUMO

Our objective was to measure the efficacy of ivermectin (IVM) and benzimidazoles (BZ, i.e. fenbendazole and albendazole) in 15 cattle farms in western France and southern Italy. A total of 11 groups were treated with IVM and 11 with BZ. Efficacy was assessed by calculating the percentage of faecal egg count reduction (%FECR) using the pre- and post-treatment arithmetic means. Anthelmintic resistance was considered to be present when the %FECR was <95% and the lower limit of the 95% confidence interval <90%. For IVM, the percentages of FECR ranged from 73% to 100%. Lack of efficacy to IVM was detected in two farms out of four in France, but was not detected in any of the seven farms in Italy. For BZ, the percentages of FECR ranged from 95% to 100%. No case of BZ resistance was detected in the five farms in France and the six farms in Italy.


Assuntos
Anti-Helmínticos/uso terapêutico , Doenças dos Bovinos/tratamento farmacológico , Gastroenteropatias/veterinária , Nematoides/efeitos dos fármacos , Infecções por Nematoides/veterinária , Animais , Benzimidazóis/uso terapêutico , Bovinos , Doenças dos Bovinos/parasitologia , Fazendas , Fezes/parasitologia , França , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/parasitologia , Trato Gastrointestinal/parasitologia , Itália , Ivermectina/uso terapêutico , Infecções por Nematoides/tratamento farmacológico , Contagem de Ovos de Parasitas
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