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1.
Rev Gastroenterol Peru ; 40(1): 95-99, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32369475

RESUMO

The SARS-CoV-2 coronavirus produces the disease called COVID-19, currently spreading in a rapidly evolving pandemic. It can be transmitted by contact, drops and aerosols, and has been isolated from gastrointestinal secretions and faeces. During digestive endoscopy, transmission by any of these mechanisms could occur. It is recommended to limit digestive endoscopy to cases of digestive bleeding, severe dysphagia, foreign body in the digestive tract, biliary obstruction with intractable pain or cholangitis, pseudocyst or complicated encapsulated pancreatic necrosis, gastrointestinal obstruction, and cases at risk of deterioration over time. It is recommended to screen patients based on temperature, symptoms, and epidemiological factors to classify them according to their risk of infection. For procedures in low risk patients, personnel must wear a disposable gown, gloves, eye or face shield, standard surgical mask, disposable hat, disposable shoe covers. In cases of intermediate or high risk, or confirmed COVID-19, protection should be increased using disposable waterproof gown, N95 respirator or similar, and double glove. In case of shortage it may be necessary to reuse N95 respirators for up to 5 uses, following CDC recommendations for donning, removing and storing to prevent secondary contact contamination. Likewise, all protective equipment should be put on and removed according to CDC recommendations. The presence of personnel in endoscopy should be limited to the bare minimum. Said personnel must have daily temperature control and if it is above 37.3ºC, the corresponding evaluation must be carried out. After each procedure, the stretcher and room surfaces should be properly disinfected. High-level disinfection of endoscopes eliminates SARS-CoV-2.


Assuntos
Infecções por Coronavirus , Endoscopia Gastrointestinal , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pandemias , Equipamento de Proteção Individual , Pneumonia Viral , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Desinfecção , Endoscopia Gastrointestinal/instrumentação , Endoscopia Gastrointestinal/métodos , Gastroenteropatias/diagnóstico , Humanos , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Peru , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Fatores de Risco
3.
Khirurgiia (Mosk) ; (4): 42-46, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32352667

RESUMO

Confocal laser endomicroscopy is an endoscopic diagnostic technique developed for real-time histological diagnosis of gastrointestinal diseases. This review is devoted to analysis of confocal laser endomicroscopy in diagnosis of gastrointestinal diseases, especially for screening or monitoring of gastrointestinal neoplasia.


Assuntos
Endoscopia Gastrointestinal/métodos , Gastroenteropatias/patologia , Microscopia Confocal , Gastroenteropatias/diagnóstico , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/patologia , Humanos , Programas de Rastreamento , Conduta Expectante
4.
Ned Tijdschr Geneeskd ; 1642020 Apr 02.
Artigo em Holandês | MEDLINE | ID: mdl-32391998

RESUMO

The SARS-CoV-2 virus and COVID-19 disease is of pandemic proportions and reached the Netherlands on February 27 2020. Here we present the first Dutch cohort of 29 hospitalized patients during the first two weeks of the epidemic in the Netherlands. Demographic characteristics of patients, clinical presentation and course of disease up to the moment of analysis showed similarity with what has been described in Chinese and Italian literature. However the higher proportion of patients presenting with gastro-intestinal symptoms and the high number of patients with overweight and obesity stood out. Based on the experience in our hospital very early on in the epidemic COVID-19 impresses as a severe illness with risk of acute respiratory deterioration.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Gastroenteropatias/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Comorbidade , Infecções por Coronavirus/diagnóstico , Feminino , Gastroenteropatias/virologia , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Obesidade/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Adulto Jovem
5.
Medicine (Baltimore) ; 99(19): e20098, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384482

RESUMO

Bacillus coagulans (PROBACI) bacteria have been examined for efficacy against infectious or inflammatory bowel diseases. The aim of this observational and cross-sectional study was to evaluate the effects of PROBACI against various functional bowel symptoms.Thirty-eight enrolled patients (36.5 ±â€Š12.6 years) with functional bowel disorders in a gastrointestinal clinic were administered PROBACI (300-mg formulation containing 1 × 10 colony-forming units of B coagulans) twice/day over a 4-week period. Abdominal pain, abdominal distention, and global assessment were evaluated using a 5-point visual analog scale. The defecation characteristics, discomfort level, and effort required for defecation were recorded. The gut-microbiota composition in terms of the Firmicutes/Bacteroidetes ratio was analyzed by 16S-ribosomal RNA gene sequencing with stool samples at days 0, 14, and 28 post-treatment.The 38 patients achieved significant improvements in abdominal pain (2.8 ±â€Š0.5 to 3.3 ±â€Š0.7, P = .0009), abdominal distention (2.5 ±â€Š0.7 to 3.2 ±â€Š0.8, P = .0002), and global assessment (2.7 ±â€Š0.6 to 3.6 ±â€Š0.7, P = .0001) from days 0 to 14. Compared with the diarrhea group, the constipation group achieved greater improvements in terms of discomfort during defecation (2.5 ±â€Š0.7 to 3.1 ±â€Š0.7, P = .02) and normalization of defecation style (50% vs 7.1%, P = .007) by day 28. A difference was observed in the Firmicutes/Bacteroidetes ratio between the constipation-dominant group (118.0) and diarrhea-dominant group (319.2), but this difference was not significant.PROBACI provided control of abdominal pain, less discomfort during defecation, and a more normalized defecation style, especially in the constipation-dominant group.


Assuntos
Bacillus coagulans , Terapia Biológica/métodos , Constipação Intestinal/terapia , Adulto , Constipação Intestinal/etiologia , Estudos Transversais , Feminino , Gastroenteropatias/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Rev. esp. enferm. dig ; 112(5): 389-396, mayo 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-FGT-3952

RESUMO

El objetivo de esta revisión rápida es una puesta al día sobre el impacto de la infección por SARS-CoV-2 en los servicios de Gastroenterología y Hepatología, en nuestros pacientes, y en nuestra nueva forma de trabajar. El tracto gastrointestinal y el hígado se ven afectados por el SARSCoV-2, especialmente en pacientes con terapias inmunosupresoras. Los pacientes con trasplante de hígado deben ser seguidos de cerca. La endoscopia digestiva es un procedimiento de alto riesgo para la transmisión de SARS-CoV-2. Mientras dure la pandemia, debemos adaptar sus indicaciones y promover medidas de protección para pacientes y profesionales de la salud. La pandemia de COVID-19 ha cambiado nuestras prioridades y nuestra forma de trabajar, aunque no sabemos cuáles serán las repercusiones después del regreso a la normalidad


No disponible


Assuntos
Humanos , Gastroenteropatias/virologia , Gastroenteropatias/diagnóstico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Endoscopia Gastrointestinal/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Desinfecção , Medição de Risco
7.
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
8.
World J Gastroenterol ; 26(14): 1546-1553, 2020 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-32327904

RESUMO

The current pandemic due to the severe acute respiratory syndrome coronavirus 2 has caused an extreme burden for health care systems globally, and the number of cases is expected to continue to increase, at least in the immediate future. The virus is estimated to have infected more than 1.5 million individuals. The available reports suggest that gastrointestinal (GI) involvement in coronavirus disease 2019 (COVID-19) is common and in some cases the GI symptoms may precede the respiratory symptoms. In addition to direct effects of severe acute respiratory syndrome coronavirus 2, the infected patients remain at risk for the complications commonly managed by gastroenterology and hepatology consultants. The most commonly reported GI manifestation of COVID-19 is diarrhea, which is reported in a third to up to more than half of the patients. Mild to moderate elevation of the liver enzymes are also common, although no case of acute liver failure has been reported so far. Many of the medications used for treatment of COVID-19 can also be associated with GI symptoms or liver injury and can be included in the differential diagnosis in these patients. Although the diagnosis of the infection is currently based on RNA analysis in respiratory samples, the available literature on fecal shedding of this virus suggests that fecal RNA testing might prove to be a useful diagnostic test. It is reasonable to delay all non-urgent endoscopic procedures during the peak of the pandemic and use additional protective equipment such as N95 respirators during endoscopy while most patients can be considered high risk for having been exposed to the virus.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gastroenteropatias/etiologia , Pneumonia Viral/complicações , Animais , Consultores , Diarreia/etiologia , Humanos , Pandemias
9.
Arab J Gastroenterol ; 21(1): 3-8, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32253172

RESUMO

Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of coronavirus disease 2019 (COVID-19), has posed a serious threat to global health and is currently causing a major pandemic. While patients typically present with fever and a respiratory illness, mounting evidence indicates that patients might also report extra-pulmonary manifestations, including those affecting the liver and gastrointestinal tract. This involvement may have important implications to the disease management, transmission, and prognosis, especially in patients with pre-existing hepatic or digestive co-morbidities. In this review, the characteristics and possible explanations of hepatic and gastrointestinal involvement caused by SARS-CoV-2 infection are summarized, adding to our knowledge of the spectrum of COVID-19. In addition, preventive measures implemented in endoscopy departments to prevent further dissemination of SARS-CoV-2 infection are proposed.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Gastroenteropatias , Hepatopatias , Pandemias , Pneumonia Viral , Animais , Infecções por Coronavirus/complicações , Gastroenteropatias/complicações , Humanos , Hepatopatias/complicações , Pneumonia Viral/complicações , Fatores de Risco
11.
Adv Exp Med Biol ; 1236: 87-107, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32304070

RESUMO

The gastrointestinal (GI) tract consists of a remarkable series of organs that spatially and temporally coordinate the vital process of digestion to extract key nutrients required to sustain our day-to-day functions. During development, it undergoes complex and highly specialized morphogenetic events to form functionally distinct organs. Its failure to develop properly leads to serious congenital diseases, which if left untreated are particularly devastating and often result in premature death. These GI diseases have been estimated to impact approximately 8-16 of every 10,000 newborns [1, 2]. Importantly, the clinical manifestations of these diseases are severe, with untreated cases having high mortality rates. While some disorders, such as Hirschsprung's disease, can be treated effectively with surgery, the efficacy of this management strategy is far lower for other diseases, such as necrotizing enterocolitis. Moreover, children often face complications from these surgical procedures, leading to secondary ailments. Consequently, a better understanding of gastrointestinal development is fundamental to the treatment and prevention of congenital GI maladies. This chapter will explore some of the most prevalent and biologically complex congenital diseases of the GI system, with emphasis on animal models that both elucidate their underlying causes and lay the essential groundwork for the advancement of translational medicine.


Assuntos
Modelos Animais de Doenças , Gastroenteropatias/congênito , Animais , Enterocolite Necrosante/congênito , Doença de Hirschsprung , Humanos
12.
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
13.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(4): 321-326, 2020 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-32306596

RESUMO

Acute abdomen, abdominal trauma, gastrointestinal bleeding and gastrointestinal tumors are the main conditions that are routinely treated in gastrointestinal surgery department with high incidence and critical condition. These conditions need emergency or selective operations. During the outbreak of the coronavirus disease 2019 (COVID-19), it's a great challenge for us to meet the patients' requirement under the situation. As the COVID-19 was brought under control in China, the Department of General Surgery in Nanfang Hospital resumed regular medical services gradually. Based on our clinical practice, the four major measures of strengthening pre-hospital screening, perioperative prevention and control, medical staff protection, and ward management were adopted. These main measures include the strict implementation of the appointment system and triage system before admission; the conduction of epidemiological and preliminary screening of viral nucleic acids; the chest CT examination during the perioperative period to re-screen COVID-19; the reduction of the risk of droplets and aerosol transmission; the minimally invasive surgery combined with enhanced recovery program in order to reduce patient's susceptibility and shorten the length of postoperative hospital stay; the reinforcement of specific infection control training for medical staff; the strict implementation of hierarchical protection; the establishment of gastrointestinal surgery prevention and control system; the rehearsal of emergency exercise; the installation of quarantine wards; the screening and management of family care-givers; the strict disinfection of environment and materials. Our preliminary practice shows that following the work guidelines issued by the Guangdong Province COVID-19 Prevention and Control Office and adopting precise management strategies in combination with the specific clinical features of gastrointestinal surgery, it is possible to safely resume regular care for the patients and comply to epidemic control at the same time.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Procedimentos Cirúrgicos do Sistema Digestório , Gastroenteropatias/cirurgia , Cirurgia Geral/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , China , Controle de Doenças Transmissíveis/métodos , Surtos de Doenças , Fidelidade a Diretrizes , Humanos , Tempo de Internação
15.
Ann Hematol ; 99(5): 1111-1119, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32253453

RESUMO

Acute graft-versus-host disease (aGVHD) of the lower gastrointestinal (GI) tract is the major cause of non-relapse mortality (NRM) in allogeneic hematopoietic stem cell transplantation (alloHSCT). This study aimed to identify variables associated with corticosteroid response and NRM in patients who developed lower GI aGVHD. We retrospectively analyzed the clinical data of patients treated at Yonsei University Severance Hospital between 2008 and 2017. Among 244 recipients of alloHSCT, 48 (19.7%) were diagnosed as lower GI aGVHD at a median of 22 days after alloHSCT. In these cases, 20 (41.6%) patients were resistant to corticosteroid therapy. Corticosteroid resistance was associated with advanced stage of lower GI aGVHD (P = 0.019), low serum albumin (P = 0.006), and elevated CRP (P = 0.030) on day 7 after corticosteroid therapy. NRM rate was significantly higher in the corticosteroid-resistant group compared with the sensitive group (HR 5.339, P = 0.003). Multivariate analysis revealed serum albumin (P = 0.046), and CRP levels (P = 0.032) were independent prognostic factors for NRM. When the patients were classified into 3 groups according to Glasgow prognostic score (GPS), the rate of corticosteroid resistance was significantly higher in the high GPS group compared with the intermediate or low GPS group (83.3 vs. 27.2 and 15.3%, respectively, P < 0.001). We demonstrated that low serum albumin and elevated CRP level on day 7 after corticosteroid therapy are objective biomarkers of corticosteroid resistance and a significant predictor for higher NRM. These simple and practical parameters could be valuable information predicting response and prognosis in lower GI aGVHD.


Assuntos
Proteína C-Reativa/metabolismo , Gastroenteropatias , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Albumina Sérica Humana/metabolismo , Adolescente , Adulto , Aloenxertos , Biomarcadores/sangue , Feminino , Gastroenteropatias/sangue , Gastroenteropatias/etiologia , Gastroenteropatias/mortalidade , Doença Enxerto-Hospedeiro/sangue , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Estudos Retrospectivos
16.
Medicine (Baltimore) ; 99(14): e19610, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243385

RESUMO

BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) refers to one of the common postoperative complications. Acupuncture can facilitate the recovery of PGD, whereas no therapeutic schedule of acupuncture has been internationally recognized for treating PGD. In the present study, a scientific trial protocol has been proposed to verify the feasibility of acupuncture in treating gastrointestinal dysfunction after laparoscopic cholecystectomy under general anesthesia. We conduct this protocol to investigate whether acupuncture recovery gastrointestinal dysfunction by influencing the expression of gastrointestinal hormone. METHOD: The present study refers to a randomized, evaluator blinded, controlled, multi-center clinical trial; it was designed complying with the Consolidated Standards of Reporting Trials (CONSORT 2010) as well as the Standard for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). The subjects will be taken from the inpatients having undergone laparoscopic surgery of Mianyang Affiliated Hospital of Chengdu University of traditional Chinese medicine, Mianyang Third Hospital and Mianyang Anzhou Hospital. Based on the random number yielded using SPSS 25.0 software, the qualified subjects will be randomly classified to the experimental group and the control group. Therapies will be performed 30 min once after operation, the experimental group will be treated with acupuncture, while the control group will receive intravenous injection of granisetron. The major outcome will be the time to first flatus, and the secondary outcomes will include the time to first defecation, abdominal pain, dosage of analgesia pump, abdominal distention, nausea, vomiting, gastrointestinal hormone, as well as mental state. The efficacy and safety of acupuncture will be also assessed following the principle of Good Clinical Practice (GCP). DISCUSS: A standardized and scientific clinical trial is conducted to assess the efficacy and safety of acupuncture for gastrointestinal dysfunction after laparoscopic cholecystectomy under general anesthesia. The aim is to objectively evidence and improves the clinical practice of acupoint prescription, as an attempt to promote the clinical application of this technology.


Assuntos
Terapia por Acupuntura/métodos , Anestesia Geral/efeitos adversos , Colecistectomia Laparoscópica/efeitos adversos , Gastroenteropatias/terapia , Hormônios Gastrointestinais/sangue , Complicações Pós-Operatórias/terapia , Adolescente , Adulto , Idoso , Estudos de Viabilidade , Feminino , Gastroenteropatias/sangue , Gastroenteropatias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
17.
Vaccimonitor (La Habana, Print) ; 29(1)ene.-abr. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1094637

RESUMO

Para el control y prevención del cólera humano se han llevado a cabo diferentes estrategias, entre las cuales, la vacunación es una de las medidas más eficaces. La evaluación preclínica de candidatos vacunales requiere de la demostración de la seguridad de los mismos, para lo cual los estudios toxicológicos son determinantes, al ser obligatorios y altamente regulados. Este estudio tuvo como objetivo demostrar la relevancia de las ratas Sprague Dawley como biomodelo a través de su respuesta inmunológica al candidato vacunal contra el cólera, vax-COLER®, utilizando la técnica de determinación de anticuerpos vibriocidas. Además, evaluar los efectos toxicológicos locales y sistémicos por la administración de una dosis de vax-COLER® a través de la evaluación de síntomas, del consumo de agua y alimentos, el peso corporal y estudios anatomopatológicos. La vacuna vax-COLER® resultó inmunogénica y no evidenció síntomas ni muertes, no hubo cambios en el peso corporal y los consumos de agua y alimentos se comportaron de forma similar entre todos los grupos. Los estudios anatomopatológicos solo mostraron cambios a nivel histológico en los ganglios linfáticos mesentéricos y placas de Peyer de los animales vacunados, con presencia de hiperplasia de los folículos secundarios subcapsulares, hallazgo que difirió significativamente con el resto de los grupos. Se concluye que la vacuna vax-COLER® es inmunogénica en ratas Sprague Dawley, demostrando la relevancia del biomodelo para la evaluación de la seguridad preclínica y que la aplicación de una dosis no produjo efectos tóxicos agudos generales ni locales(AU)


Different strategies have been carried out for the control and prevention of human cholera. Vaccination is one of the most effective strategies. Preclinical evaluation of vaccines needs to prove their safety; whereby toxicological studies are decisive. They are mandatory and highly regulated. This study was aimed to demonstrate the relevance of Sprague Dawley rats as a biomodel, through the immunological response to vax-COLER® cholera vaccine, using the technique of determination of vibriocidal antibodies. In addition, local and systemic toxicological effects were evaluated after administration of a dose of vax-COLER®; through the evaluation of symptoms, water and food consumption, body weight and anatomopathological studies. The vax-COLER® vaccine was immunogenic and showed no symptoms or deaths. No changes in body weight were detected, and food and water consumption were similar among all groups. The anatomopathological studies showed histological changes in the mesenteric lymph nodes and Peyer's patches of the vaccinated animals, with hyperplasia of the subcapsular secondary follicles, finding that differed significantly from the rest of the groups. It is concluded that vax-COLER® vaccine is immunogenic in Sprague-Dawley rats, demonstrating the relevance of the biomodel for the evaluation of preclinical safety, as well as that the application of a single dose did not produce acute general or local toxic effects(AU)


Assuntos
Animais , Ratos , Cólera/prevenção & controle , Medicamentos de Referência
18.
Gac Med Mex ; 156(2): 124-131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285860

RESUMO

From 1990 to 2012, the Sanitary and Tropical Diseases Institute experienced the most important changes. In 1989, its name and orientation were modified to become the National Institute of Epidemiological Diagnosis and Reference. Shortly before, it had been formalized as the apex of the National Network of Public Health Laboratories and had incorporated laboratories for preventive programs such as exfoliative cytology and rabies, malaria and tuberculosis diagnosis; subsequently, it would incorporate other networks that emerged as part of the response to major epidemic outbreaks and to the new epidemiological outlook. In this period, 27 priority diagnostic algorithms were defined, organized in 18 networks, some of which began to collaborate with global networks. In 2001, the Institute started working with pathogens related to bioterrorism. By then, space restrictions of the headquarter's building were evident; in 2008, starting the construction of new facilities was decided. The Institute and its diagnostic networks constitute a milestone in Latin American public health of the 21st century.


Assuntos
Academias e Institutos , Surtos de Doenças , Humanos , Malária/diagnóstico , Malária/epidemiologia , Saúde Pública , Fatores de Tempo , Tuberculose/diagnóstico , Tuberculose/epidemiologia
19.
Acta Med Indones ; 52(1): 63-67, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32291373

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently causing a widespread infection in the world. During the pandemic, physicians may need to raise the index of suspicion earlier in at-risk patients presenting with gastrointestinal symptoms, which are uncommon findings in coronavirus disease 2019 (COVID-19) patients. We report a patient in Indonesia with chest pain and gastrointestinal symptoms who was later confirmed to have SARS-CoV-2 infection after spending days of hospitalisation in the standard ward.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Gastroenteropatias/etiologia , Pneumonia Viral/diagnóstico , Dor no Peito/etiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Humanos , Indonésia , Pandemias , Pneumonia Viral/complicações
20.
Am J Gastroenterol ; 115(5): 766-773, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32287140

RESUMO

OBJECTIVE: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, various digestive symptoms have been frequently reported in patients infected with the virus. In this study, we aimed to further investigate the prevalence and outcomes of COVID-19 patients with digestive symptoms. METHODS: In this descriptive, cross-sectional, multicenter study, we enrolled confirmed patients with COVID-19 who presented to 3 hospitals from January 18, 2020, to February 28, 2020. All patients were confirmed by real-time polymerase chain reaction and were analyzed for clinical characteristics, laboratory data, and treatment. Data were followed up until March 18, 2020. RESULTS: In the present study, 204 patients with COVID-19 and full laboratory, imaging, and historical data were analyzed. The average age was 52.9 years (SD ± 16), including 107 men and 97 women. Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients (50.5%) reported a digestive symptom, including lack of appetite (81 [78.6%] cases), diarrhea (35 [34%] cases), vomiting (4 [3.9%] cases), and abdominal pain (2 [1.9%] cases). If lack of appetite is excluded from the analysis (because it is less specific for the gastrointestinal tract), there were 38 total cases (18.6%) where patients presented with a gastrointestinal-specific symptom, including diarrhea, vomiting, or abdominal pain. Patients with digestive symptoms had a significantly longer time from onset to admission than patients without digestive symptoms (9.0 days vs 7.3 days). In 6 cases, there were digestive symptoms, but no respiratory symptoms. As the severity of the disease increased, digestive symptoms became more pronounced. Patients with digestive symptoms had higher mean liver enzyme levels, lower monocyte count, longer prothrombin time, and received more antimicrobial treatment than those without digestive symptoms. DISCUSSION: We found that digestive symptoms are common in patients with COVID-19. Moreover, these patients have a longer time from onset to admission, evidence of longer coagulation, and higher liver enzyme levels. Clinicians should recognize that digestive symptoms, such as diarrhea, are commonly among the presenting features of COVID-19 and that the index of suspicion may need to be raised earlier in at-risk patients presenting with digestive symptoms. However, further large sample studies are needed to confirm these findings.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Gastroenteropatias/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Adulto , Idoso , China/epidemiologia , Infecções por Coronavirus/terapia , Estudos Transversais , Feminino , Gastroenteropatias/terapia , Gastroenteropatias/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/terapia , Prevalência , Resultado do Tratamento
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