Management of inflammatory bowel diseases in urgent and emergency scenario / Manejo das doenças inflamatórias intestinais na urgência e emergência

Abstract Objective To review the main acute complications of inflammatory bowel disease in order to present the state of the art of their respective diagnosis and treatment. Methods A bibliographic search was conducted in Medline database using the following keywords: "inflammatory bowel disease", "Colitis Ulcerative", "Crohn Disease", "emergency" among others that had their variation evaluated by the MESH. Articles from the last 10 years conducted with humans, written in Portuguese or English, and published in journals with impact factor greater than 1 were selected. Results After carrying out the search phrase and selecting the filters, 20 articles were selected to be included in the research. The most common acute complications were evaluated, focusing on their current propaedeutic and management aspects. Conclusion Most emergencies related to inflammatory bowel disease should be treated non-operatively firstly, prioritizing patient hemodynamic state. In selected cases of life-threatening complications emergent operative treatment are mandatory. The timing of procedure is the most important aspect. As general rule, in Crohn's Disease, operative treatment should be postponed as much as possible and the resection as small as possible. In case of ulcerative rectocolitis, if the hemodynamic state of the patient allows, proctocolectomy should be expedited with curative intention.

Resumo Objetivo Revisar as principais complicações agudas das doenças inflamatórias intestinais, a fim de apresentar o estado da arte de seus respectivos diagnósticos e tratamentos. Métodos Foi realizada uma pesquisa bibliográfica no banco de dados Medline, utilizando as seguintes palavras-chave: "doença inflamatória intestinal", "Colite Ulcerativa", "Doença de Crohn", "emergência" entre outras que tiveram sua variação avaliada pelo MESH. Artigos dos últimos 10 anos realizados com seres humanos, escritos em português ou inglês, e publicados em periódicos com fator de impacto maior que um foram selecionados. Resultados Após a construção da frase de pesquisa e seleção dos filtros, 20 artigos foram selecionados para inclusão no estudo. As complicações agudas mais comuns foram avaliadas, enfocando seus atuais aspectos propedêuticos. Conclusão A maioria das emergências relacionadas à doença inflamatória intestinal deve ser tratada primariamente de forma não cirúrgica, priorizando a hemodinâmica do paciente. Em casos selecionados de complicações potencialmente fatais, tratamento cirúrgico de emergência é mandatório. O momento do procedimento é o aspecto mais importante. Como regra geral, na Doença de Crohn, o tratamento cirúrgico deve ser adiado ao máximo com ressecção menor possível. No caso de retocolite ulcerativa, se o estado hemodinâmico do paciente permitir, a proctocolectomia deve ser realizada com intenção curativa.

Nutritional quality and functional lipids in the free-range egg yolks of Brazilian family farmers / Calidad alimenticia y lípidos funcionales en las yemas de gallina del campo de agricultores de familias Brasileñas

ABSTRACT Nowadays consumers are more concerned about food quality as well as how food is produced. Moreover, consumer demand for more natural, nutritious, safer to eat, and environmentally sustainable food has drawn attention to alternative breeding systems, such as a free-range system. Hens' eggs represent a rich source of important nutrients, including lipids and carotenoids. A detailed characterization of the nutritional and lipid profile of free-range chicken eggs from family farms was carried out. The chemical composition of the free-range egg yolks confirmed the advantages of this farming system, as a relevant source of unsaturated fatty acids and carotenoids, functional compounds in the human diet. These findings can help improve income generation, food supplementation, and consolidation of the family farming system.

RESUMEN Cada vez más los consumidores se preocupan por la calidad de los alimentos, así como tambien de como ellos son producidos. Además, la demanda de los consumidores por alimentos más naturales, nutritivos, más seguros para el consumo y ambientalmente sostenibles ha llamado la atención a sistemas de cría de alternativa, como el sistema de gallina del campo. Los huevos de gallinas representan una fuente rica de sustancias nutritivas importantes, incluyendo lípidos y carotenoids. Fue realizada una caracterización detallada de los nutrientes y del perfil lipídicos de huevos de gallinas del campo de agricultores familiares. La composición química de yemas de gallinas del campo confirmó las ventajas de este sistema de producción, como una fuente importante compuestos funcionales como ácidos grasos insaturados y carotenoides, en la dieta humana. Además, estos hallados pueden ayudar a mejorar la generación de ingreso, la suplementación de alimentos y la consolidación de sistema de agricultura familiar.

The prevalence of intraepithelial lesions in preventive examinations carried out in the "legal amazon" region

Introduction: Cervical cancer is a public health problem, and tracking of the disease must follow a set of organized programmed actions, with populations and periodicity defined. Objective: Identifying the prevalence of intraepithelial lesions in preventive examinations performed in the municipality of Sinop-MT between 2010 and 2013. Methods: Statistical data obtained using the DATASUS/SISCOLO system were used. Results: When considering the descriptive diagnosis for cellular alterations, 412 and 167 altered exams with low- and high-grade intraepithelial lesions (respectively) were found. The prevalence of both low-grade (25.45%) and high-grade (10.32%) intraepithelial lesions were higher outside of the recommended age range (25-64 years). Conclusions: Studies on the prevention of cervical cancer are extremely relevant in order to analyze the coverage of screening in areas served by basic health units and to understand the factors associated with non-adherence of women to preventive examination. It is noteworthy that during the time period analyzed, women in the municipality of Sinop did not fulfill the municipal goal.(AU)

Introdução: O câncer do colo do útero é um problema de saúde pública e o rastreamento dessa doença deve seguir um conjunto de ações programadas, organizadas com populações e periodicidade definidas. Objetivo: este estudo teve como objetivo identificar a prevalência da lesão intraepitelial em exames preventivos coletados no município de Sinop-MT, entre 2010 e 2013. Métodos: Estudo retrospectivo realizado no Município de Sinop. Os dados utilizados foram obtidos por meio do sistema DATASUS/SISCOLO, entre 2010 e 2013. As variáveis analisadas foram: número de exames citopatológicos dentro dos limites de normalidade, lesão intraepitelial de baixo grau (LIBG) e lesão intraepitelial de alto grau (LIAG) e faixa etária de 25 a 64 anos. Resultados: ao considerar o diagnóstico descritivo para alterações celulares, foram constatados 412 e 167 exames alterados com lesão intraepitelial de baixo e alto grau, respectivamente. Tanto a prevalência de lesão intraepitelial de baixo grau (25,45%), quanto de alto grau (10,32%), foram maiores fora da faixa etária preconizada (25 a 64 anos). Portanto, estudos sobre a prevenção do câncer do colo do útero são de extrema relevância, a fim de analisar a cobertura do rastreamento em áreas atendidas pelas unidades básicas de saúde e compreender os fatores associados à não adesão das mulheres à realização do exame preventivo. Conclusão: Ressalta-se que o município de Sinop nos quatros anos analisados não cumpriu a meta municipal.(AU)

Stem cells derived from bone marrow and preclinical trials in Veterinary Medicine / Células-tronco derivadas da medula óssea e suas aplicações na Medicina Veterinária

The bone marrow is the largest reserve of stem cells into the body, consisting of stromal cells/mesenchymal niches and hematopoietic system. These cells can differentiate as different lineages as osteogenic, chondrogenic and adipogenic. The bone marrow stem cells population has widely used and an attractive target for potential therapeutic treatment for preclinical trials, due its high plasticity of differentiation. Thus, with this review we aimed to show an overview of stem cells and mainly bone marrow cells with basic concepts, as well as their potential new venues for treatment in regenerative veterinary medicine.

A medula óssea é a maior reserva de células-tronco do corpo, cujo consistem em células mesenquimais e hematopoiéticas. Estas células têm a capacidade de diferenciar-se em varias linhagens, como osteogênicas, condrogênicas e adipogênicas. A população de células-tronco derivadas da medula óssea tem sido um alvo atraente para tratamentos terapêuticos e ensaios pré-clínicos, devido sua elevada plasticidade e capacidade de diferenciação. Assim, esta revisão objetiva mostrar uma visão geral das célulastronco e principalmente conceitos básicos sobre as células da medula óssea, bem como os seus potenciais e novos espaços para o tratamento regenerativo na medicina veterinária.

Analysis of parahippocampal gyrus in 115 patients with hippocampal sclerosis

PURPOSE: Analysis of the parahippocampal gyrus (PHG) involvement in 115 patients with hippocampal sclerosis (HS) by MR imaging. The simultaneous occurrence of ipsilateral fornix (F) and mamillary body (MB) volume loss was checked also. These findings were correlated with the side of hippocampal involvement, the sex, patient s age, and the symptoms onset. METHOD: The MR images of 115 patients with HS were studied retrospectively. All the examinations were performed on 1.5 T units (SIGNA, GE, Milwaukee, WI) and included high resolution coronal T2-weighted images (3 mm thickness, 0.6 mm gap). RESULTS: The patient's age ranged between 3.5 and 80 years (mean 34.1); 62 (53.9 percent) were female and 53 (46.1 percent) were male. There were HS on the left side in 53 (46.0 percent), on the right side in 51 (44.3 percent), and bilateral in 11 (9.7 percent). In 43 (37.3 percent) cases there were ipsilateral PHG volume loss and signal hyper intensity on T2-weighted imaging. In 29 (25.2 percent) cases there were ipsilateral fornix volume loss and in 10 (34.5 percent) of this there were also ipsilateral MB changes. In abnormal PHG, 23 (53.4 percent) were on the left side, 17 (39.5 percent) were on the right side, and 3 (7.1 percent) were bilateral. There were fornix changes in 15 (34.8 percent) cases and MB volume loss in 5 (11.6 percent) cases. Pertinent clinical data were obtained in only 18 (41.8 percent) of the PHG lesion cases and 11 (61.1 percent) of these patients had epileptic attacks for more than 20 years before the examination. CONCLUSION: PHG involvement must be investigated in patients with HS and we suggest that the term mesial temporal sclerosis should be used only if there are also changes at this anatomical site