RESUMO
AIM: End-stage renal failure (ESRF) and renal transplant recipients are thought to be associated with an increased risk of colorectal complications. METHOD: A review of the literature was performed to assess the prevalence and outcome in both benign and malignant colorectal disease. RESULTS: No prospective randomized studies assessing colorectal complications in ESRF or renal transplant were identified. Case series and case reports have described the incidence and management of benign colorectal complications. Complications included diverticulitis,infective colitis, colonic bleeding and colonic perforation. There was insufficient evidence to associated iverticular disease with adult polycystic kidney disease.Three population-based studies have shown up to a twofold increased incidence of colonic cancer but not rectal cancer for renal transplant recipients. Bowel cancer screening (as per the general population) by faecal occult blood testing appears justified for renal transplant patients; however, evidence suggests that consideration of starting screening at a younger age may be worthwhile because of an increased risk of developing colonic cancer.Two population-based studies have shown a threefold and 10-fold increased incidence of anal cancer for renal transplant recipients. A single casecontrol study demonstrated significant increased prevalence of anal human papilloma virus (HPV) and intraepithelial neoplasia (AIN)in patients with established renal transplants. CONCLUSIONS: Despite the lack of high-level evidence,ESRF and renal transplantation were associated with colorectal complications that could result in major morbidity and mortality. Bowel cancer screening in this patient group appears justified. The effectiveness of screening for HPV, AIN and anal cancer in renal transplant recipients remains unclear.
Assuntos
Doenças do Colo/etiologia , Falência Renal Crônica/complicações , Transplante de Rim , Complicações Pós-Operatórias , Doenças Retais/etiologia , Doenças do Colo/diagnóstico , Doenças do Colo/epidemiologia , Doenças do Colo/terapia , Humanos , Falência Renal Crônica/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/terapia , Prevalência , Doenças Retais/diagnóstico , Doenças Retais/epidemiologia , Doenças Retais/terapia , Resultado do TratamentoRESUMO
Indonesia's peatlands experience frequent and intense wildfires, producing hazardous smoke with consequences for human health, yet there is a lack of research into adverse effects on wildlife. We evaluated the effects of smoke on the activity and energy balance of Bornean orangutans (Pongo pygmaeus wurmbii) in a peat swamp forest at the Tuanan Research Station, Central Kalimantan. We collected behavioural data and urine samples from four adult flanged males before, during, and after wildfires between March 2015 and January 2016. During fires, particulate matter (PM10) concentrations were hazardous. Orangutans increased rest time during and after the smoke period, and decreased travel time and distance and increased fat catabolism post-smoke. The increase in post-smoke ketones was not related to changes in caloric intake and was likely due to an increase in energy expenditure, possibly related to immune response. Results show that wildfire smoke negatively affects orangutan condition, and sustained research is needed to assess the magnitude of the threat to the long-term viability of this Critically Endangered species.