Relationship between Quality of Life and Oral Health Status of Patients with Chronic Liver Disease

ABSTRACT Objective: To investigate the relationship between the quality of life and work ability related to the oral health status of patients with chronic liver diseases. Material and Methods: The sample size contains all patients referred to the internal ward of Afzalipour and Bahonar hospitals due to chronic liver disease from 2019 to 2020. Patient selection was based on a simple census and a questionnaire that contained characteristics information of the patient, Work Ability Index questionnaire and SF-36 questionnaire were completed by the patients and some information was extracted from medical file. The SF-36 questionnaire assesses the quality of life in two general dimensions (physical health and mental health) with the physical function subscale. DMFT, Gingival index, and Periodontal disease index are used to evaluate the severity and extent of gingivitis and periodontitis. For data analysis, ANOVA, Spearman correlation coefficients were used and the significant level was p<0.05. Results: a total of 108 patients were examined. The mean age of participants was 41.2 ± 4.3 years. The DMFT index in patients was also reported as 22.6 ± 7.35. Also, 32.4% of people described their ability to do work as poor, 21.3% as good, and 7.4% as excellent. Patients with poor or moderate workability reported a higher index of DMFT. Among the participants, 61 and 21 patients had gingivitis and periodontitis, respectively. Mean results of total SF-36 indices were reported at a low level in patients with increased DMFT and gum diseases. Patients with poor or moderate workability had a higher index of DMFT. There was a significant relationship between these two variables (p=0.001). However, they were not significantly associated with periodontitis. Conclusion: There was a significant relationship between the SF-36 index, the ability to work and the type of liver disease.

Alterações gastrointestinais causadas pela infecção do Sars-Cov-2 / Gastrointestinal changes caused by infection do Sars-Cov-2 / Cambios gastrointestinales causados por la infección de Sars-Cov-2

A pandemia de COVID-19 se propagou rapidamente pelo mundo, causada pela infecção do novo coronavírus (SARS-CoV-2), que surgiu na China no final de 2019. Apesar da porta de entrada mais comum do agente etiológico ser pelo trato respiratório, evidências demonstram que a doença pode apresentar sintomas extrapulmonares, como os do trato gastrointestinal. Descrever sobre possíveis alterações gastrointestinais ocasionadas em pacientes infectados pelo SARS-CoV-2. Tratou-se de uma revisão bibliográfica, que utilizou artigos científicos disponíveis na íntegra em bases de dados Medical Literature Analysis and Retrieval System Online, Google Acadêmico, Scientific Electronic Library Online, nos meses de abril a outubro de 2021, além de monografias, dissertações, teses e livros. Foram utilizados como descritores as palavras: SARS-CoV-2 e intestino, COVID-19 e intestino, alterações intestinais na COVID-19. Os distúrbios gastrointestinais mais prevalentes são náuseas, vômitos e diarreia e dor abdominal. O papel da microbiota intestinal em influenciar as doenças pulmonares foi bem articulado, devido à existência do eixo intestino-pulmão, a inflamação em um desses órgãos interfere diretamente no perfil inflamatório no outro. Embora ainda não esteja totalmente esclarecido se os sintomas gastrointestinais indicam maior viremia ou um processo fisiopatológico alternativo, observa-se que a presença destes configura um fator de risco para a maior severidade da doença.

The COVID-19 pandemic has spread rapidly around the world, caused by the infection of the new coronavirus (SARS-CoV-2), which emerged in China at the end of 2019. respiratory evidence shows that the disease can present extrapulmonary symptoms, such as those in the gastrointestinal tract. Objective: To describe possible gastrointestinal alterations caused in patients infected by SARS-CoV-2. Methodology: this was a literature review, which used scientific articles available in full in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Academic Google, Scientific Electronic Library Online (SciELO) databases, as well as monographs, dissertations, theses and books. The words used as descriptors were: SARS-CoV-2 and intestine, COVID-19 and intestine, intestinal alterations in COVID-19. Development: The most prevalent gastrointestinal disorders are nausea, vomiting and diarrhea and abdominal pain. The role of the intestinal microbiota in influencing lung diseases was well articulated, due to the existence of the gut- lung axis, inflammation in one of these organs directly interfering with the inflammatory profile in the other. Conclusion: Although it is not yet fully understood whether the gastrointestinal symptoms

La pandemia COVID-19 se ha extendido rápidamente por todo el mundo, causada por la infección del nuevo coronavirus (SARS-CoV-2), que surgió en China a finales de 2019. Las evidencias respiratorias muestran que la enfermedad puede presentar síntomas extrapulmonares, como los del tracto gastrointestinal. Objetivo: Describir las posibles alteraciones gastrointestinales causadas en pacientes infectados por SARS-CoV-2. Metodología: se trató de una revisión bibliográfica, que utilizó artículos científicos disponibles en su totalidad en las bases de datos Medical Literature Analysis and Retrieval System Online (MEDLINE), Academic Google, Scientific Electronic Library Online (SciELO), así como monografías, disertaciones, tesis y libros. Las palabras utilizadas como descriptores fueron: SARS-CoV-2 e intestino, COVID-19 e intestino, alteraciones intestinales en COVID-19. Desarrollo: Las alteraciones gastrointestinales más prevalentes son náuseas, vómitos y diarrea y dolor abdominal. Se articuló bien el papel de la microbiota intestinal en la influencia de las enfermedades pulmonares, debido a la existencia del eje intestino-pulmón, la inflamación en uno de estos órganos interfiere directamente en el perfil inflamatorio del otro. Conclusiones: Aunque aún no se comprenda del todo si los síntomas gastrointestinales indican una mayor viremia o un proceso fisiopatológico alternativo, se observa que su presencia es un factor de riesgo para la mayor gravedad de la enfermedad.

Diseases of the digestive system of agoutis (Dasyprocta leporina) raised in captivity in the Brazilian semiarid region / Doenças do sistema digestivo de cutias (Dasyprocta leporina) criadas em cativeiro na região semiárida brasileira

The objective of this study was to describe the clinical and pathological aspects of diseases of the digestive system in agoutis (Dasyprocta leporina Linnaeus, 1758) diagnosed by the "Laboratório de Patologia Veterinária" (Veterinary Pathology Laboratory) of the "Universidade Federal Rural do Semi-Árido" (UFERSA), from January 2018 to February 2020. During the study period, necropsy and a survey of the clinical history of 27 agoutis were performed, 25.93% (7/27) of which were diagnosed with digestive system diseases. The percentages of digestive tract diseases among the diagnosed were: acute carbohydrate overload (11.12%), gastric ulcer (7.41%), gastric volvulus (3.70%), and intestinal volvulus (3.70%). Studies on the occurrence rate of these diseases, as well as the description of their clinical and anatomopathological aspects, may serve as a basis for guiding the appropriate management in the breeding of these animals.(AU)

O objetivo deste estudo foi descrever os aspectos clínicos e patológicos das doenças do aparelho digestivo em cutias (Dasyprocta leporina Linnaeus, 1758) diagnosticadas pelo Laboratório de Patologia Veterinária da Universidade Federal Rural do Semiárido (UFERSA), de janeiro 2018 a fevereiro de 2020. Durante o período do estudo, foram realizadas necropsias e levantamento da história clínica de 27 cutias, sendo 25,93% (7/27) diagnosticadas com doenças do aparelho digestivo. Os percentuais de doenças do aparelho digestivo foram: sobrecarga aguda de carboidratos (11,12%), úlcera gástrica (7,41%), vólvulo gástrico (3,70%) e vólvulo intestinal (3,70%). Estudos sobre a taxa de ocorrência dessas doenças, bem como a descrição de seus aspectos clínicos e anatomopatológicos, podem servir de base para orientar o manejo adequado na criação dessa espécie.(AU)

Diseases of the digestive system of agoutis (Dasyprocta leporina) raised in captivity in the Brazilian semiarid region / Doenças do sistema digestivo de cutias (Dasyprocta leporina) criadas em cativeiro na região semiárida brasileira

The objective of this study was to describe the clinical and pathological aspects of diseases of the digestive system in agoutis (Dasyprocta leporina Linnaeus, 1758) diagnosed by the "Laboratório de Patologia Veterinária" (Veterinary Pathology Laboratory) of the "Universidade Federal Rural do Semi-Árido" (UFERSA), from January 2018 to February 2020. During the study period, necropsy and a survey of the clinical history of 27 agoutis were performed, 25.93% (7/27) of which were diagnosed with digestive system diseases. The percentages of digestive tract diseases among the diagnosed were: acute carbohydrate overload (11.12%), gastric ulcer (7.41%), gastric volvulus (3.70%), and intestinal volvulus (3.70%). Studies on the occurrence rate of these diseases, as well as the description of their clinical and anatomopathological aspects, may serve as a basis for guiding the appropriate management in the breeding of these animals.

O objetivo deste estudo foi descrever os aspectos clínicos e patológicos das doenças do aparelho digestivo em cutias (Dasyprocta leporina Linnaeus, 1758) diagnosticadas pelo Laboratório de Patologia Veterinária da Universidade Federal Rural do Semiárido (UFERSA), de janeiro 2018 a fevereiro de 2020. Durante o período do estudo, foram realizadas necropsias e levantamento da história clínica de 27 cutias, sendo 25,93% (7/27) diagnosticadas com doenças do aparelho digestivo. Os percentuais de doenças do aparelho digestivo foram: sobrecarga aguda de carboidratos (11,12%), úlcera gástrica (7,41%), vólvulo gástrico (3,70%) e vólvulo intestinal (3,70%). Estudos sobre a taxa de ocorrência dessas doenças, bem como a descrição de seus aspectos clínicos e anatomopatológicos, podem servir de base para orientar o manejo adequado na criação dessa espécie.

Understanding Nutritional Support in Digestive Diseases / 대한소화기학회지

The prevalence of hospital malnutrition is still high in patients with digestive diseases, especially for those suffering from cancer and bowel diseases which cause malabsorption. It is well known that malnutrition is associated with delayed wound healing, impaired immunity, infection, increased complication, and poor convalenscence. Recently, nutrition screening and assessment by nutrition support team has become essential for nutrition management, and gastroenterologists comprise a dominant member of the nutrition support team. In critically ill patients and older people with chronic disease, nutritional support with enteral feeding and early feeding contributes to recovery and rehabilitation of patients. Securing enteral feeding routes, such as feeding tube insertion and placement of percutaneous endoscopic gastrostomy/jejunostomy, is an essential part of nutrition care that should be accomplished by gastroenterologists without much difficulty. It will also be necessary to recommend nutrition care as one of the clinical routines in gastrointestinal clinical practices. Therefore, education on nutrition care is strongly required as a part of gastroenterologist's training.

Heterotopia pancreática: análise clínico-patológica de 18 doentes / Pancreatic heterotopias: clinicopathological analysis of 18 patients

OBJETIVO: Analisar as características clínico-patológicas do tecido pancreático heterotópico em órgãos digestivos abdominais. MÉTODOS: Realizamos estudo retrospectivo analisando 18 portadores de pâncreas heterotópico diagnosticados histologicamente. Seus dados clínicos e histopatológicos foram revistos. O tecido pancreático heterotópico foi classificado em três modelos histológicos: tipo I constituído por três componentes do pâncreas normal (ácinos, ductos e ilhotas), tipo II com dois componentes e tipo três com somente um componente. RESULTADOS: A média de idade foi de 52,7 anos, variando de 34 a 73 anos, com nove homens e nove mulheres. Sintomas foram observados em somente quatro doentes, sendo suas lesôes diagnosticadas por gastroscopia. Os 14 restantes eram assintomáticos e suas anomalias descobertas acidentalmente. A maioria das lesões situava-se no trato superior: sete (38,9%) no estômago, seis (33,3%) no duodeno e três (16,6%) no jejuno. A heterotopia localizou-se preferencialmente na submucosa (83,3%), mas também foi observada na muscular própria e na sub-serosa. Em sete (38,9%) espécimes todos os componentes pancreáticos foram constatados (tipo I), em oito (44,4%) estavam presentes glândulas exócrinas e ductos excretores (tipo II) e em três (16,7%) somente o tecido exócrino foi observado (tipo III). CONCLUSÃO: A heterotopia pancreática é rara. Doentes com ectopia pancreática diagnosticadas pelo estudo patológico, assintomáticos ou com sintomas discretos devem permanecer em observação. As lesões detectadas acidentalmente durante procedimentos cirúrgicos necessitam ser removidas por procedimentos conservadores.

OBJECTIVE: To analyze the clinical and pathological features of heterotopic pancreatic tissue in abdominal digestive organs. METHODS: We retrospectively studied 18 patients with histologically diagnosed heterotopic pancreas. Clinical and histopathologic data were reviewed. Heterotopic pancreatic tissues were classified in three histological models: Type I consists of three components of normal pancreas (acini, ducts and islets), type II with two components and type three with only one component. RESULTS: The mean age was 52.7 years, ranging from 34 to 73 years, nine of them men and nine women. Symptoms were observed in only four patients, and their lesions were diagnosed by gastroscopy. The remaining 14 were asymptomatic and their anomalies were discovered accidentally. Most of the lesions were located in the upper gastrointestinal tract: seven (38.9%) in the stomach, six (33.3%) in the duodenum and three (16.6%) in the jejunum. Heterotopia was mostly located in the submucosa (83.3%) but was also observed in the muscularis propria and in the sub-serosa. In seven specimens (38.9%) all pancreatic components were found (type I), in eight (44.4%) exocrine glands and excretory ducts were present (type II) and in three (16.7%) only exocrine tissue was observed (type III). CONCLUSION: Pancreatic heterotopia is rare. Patients with pancreatic ectopia diagnosed by pathological study, whether asymptomatic or with mild symptoms, should be observed. Lesions incidentally detected during surgeries need to be removed by conservative procedures.

Frequency of abnormalities detected by upper abdominal ultrasound.

OBJECTIVE: The present study was undertaken to categorize frequency of abnormalities detected by upper abdominal ultrasound. MATERIAL AND METHOD: The present study was conducted on 3,398 people between the ages of 16 and 93 years old, who had the annual health check-up between October 2003 and May 2004 at the Health Promotion Center Bangkok Hospital Medical Center (all of those participating were defined as "patients"). Of these, 1,930 are men (56.8%) and 1,468 are women (43.2%). In the present study, the data of age, gender, and upper abdominal ultrasound findings were assessed. RESULTS: Of the 3,398 subjects, 1,782 patients (52.4%) had positive findings; 1,147 of which were men (64.4%) and 635 were women (35.6%). Fatty liver, being the most common positive finding, was observed in 1,219 patients (35.9%); 831 of which were men (68.2%) and 388 were women (31.8%). The finding of a liver mass, as the second positive finding, was observed in 209 patients (6.2%); of which were 124 patients (59.3%) with hepatic cyst, 51 patients (24.4%) with hemangioma, 16 patients (7.7%) with indetermined nodule, 11 patients (5.3%) with calcification, and 7 patients (3.4%) with malignant tumor while 664 patients (19.5%) had other positive findings. The top four included gallbladder polyp observed in 181 patients (5.3%), renal cyst observed in 155 patients (4.6%), gallstone observed in 141 patients (4.2%), and renal stone observed in 101 patients (3.0%). CONCLUSION: The prevalence of abnormalities detected by upper abdominal ultrasound was 52.44%. The most common finding was fatty liver (35.87%). Although the majority of positive findings were benign conditions, some of them might have an adverse effect to the health condition of patients in the long run. The ultrasound findings also yielded the patient management to prevent subsequent disease and to perform medical treatment or follow up.

Tumores neuroendocrinos digestivos: clínica e histología: Hospital de San José, enero 2005 a mayo 2007 / clinical and histological behavior of neuroendocrine tumors of the gastrointestinal tract: San José Hospital, january 2005 - may 2007

Objetivo: los tumores neuroendocrinos son entidades infrecuentes por lo cual su historia natural y desenlace son poco conocidos. En el presente estudio se describen las características clínicas e histológicas de los diagnosticados en un período de dos años. Metodología: estudio descriptivo, retrospectivo de serie de casos. Se define como caso todo paciente con diagnóstico de TNE digestivo realizado por el servicio de patología entre enero 2005 y mayo 2007. Resultados: en el Hospital de San José de enero de 2005 a mayo 2007 se diagnosticaron nueve casos de pacientes con TNE, 33.3% en mujeres y 66.7% en hombres. La edad promedio fue 50,3 años (rango 12 a 77 años). El tipo histológico más frecuente según la clasificación de la OMS fue el TNE bien diferenciado en el 77.8%. El 66,7% fueron asintomáticos y el 33.3% presentaron algún tipo de manifestación, como diarrea y enfermedad acidopéptica con 22,2% cada uno. En las mujeres el 100% de las lesiones fueron asintomáticas y 50% en hombres. En la serie se presentó una metástasis que ocurrió en el sexo masculino. La infiltración de la pared en la muscular se vió en 55,6%. La angioinvasión solamente se presentó en un paciente de sexo masculino que además presentó metástasis a hígado. Cuando el valor de Ki67 es menor de 1% no se presentan metástasis. Los sitios de localización primaria de los tumores neuroendocrinos digestivos más frecuentes fueron duodeno y apéndice (22,2% cada uno) y en los extragastrointestinales fue el pulmón (22,2%). El 77,8% de los pacientes tuvieron algún procedimiento, de ellos el más común fue la polipectomía (42,9%). Posterior al procedimiento el 50% de los pacientes presentaron mejoría total de la sintomatología y el resto en forma parcial. El cumplimiento al seguimiento posterior fue mayor en las mujeres con 66,6% y de 33,3% para los hombres.

Objective: neuroendocrine tumors (NETs) are rare, thus their natural history and outcomes are poorly understood. This study describes the clinical and histological behavior of NETs diagnosed in a two-year period. Methodology: case series retrospective descriptive study. Any patient diagnosed with a NET of the gastrointestinal tract confirmed by pathology between January 2005 and May 2007 was defined as a case. Results: from January 2005 to May 2007, vine cases were diagnosed in the San José Hospital, 33.3% in females and 66.7% in males. Mean age was 50.3 years (range 12 to 77 years). Most of them (77.8%) were classified as well-differentiated tumors according to the WHO histological classification, 66.7% were asymptomatic and 33.3% presented some kind of manifestation, such as diarrhea and peptic ulcer disease (22.2% each). Lesions were asymptomatic in 100% of females and 50% of males. One of the male patients presented a metastasis. Infiltration of the muscular wall was observed in 55.6%. Invasion to blood vessels was observed in only 1 male patient who also presented a liver me-tastasis. No metastases occur when the value of Ki67 is less than 1%. The most frequent primary sites were the duodenum and appendix (22.2% respectively) and the lung (22.2%) was the most frequent extra-gastrointestinal site. In 77.8% of all cases patients underwent some kind of procedure the most common being polypectomy (42.9%). Symptoms disappeared completely after the procedure in 50% and the rest showed at least partial improvement. Compliance to follow-up was greater in females (66.6%) and 33.3% in males.

Diagnóstico sorológico nas doenças do trato digestivo / Serologic Tests on the digestive diseases

Os autores fazem uma revisão bibliográfica sobre os diversos marcadores sorológicos do trato digestivo abordando sua importância e auxílio no diagnóstico das patologias que acometem o trato gastrintestinal

Os medicamentos e o sistema digestório / Drugs and the Digestive System

A introdução de novos medicamentos para o tratamento de doenças do trato digestório foi marcante para a terapia de patologias que antes necessitavam de intervenção cirúrgica. Os antagonistas de receptores H2 de histamina; os inibidores da bomba de próton; os compostos de bismuto; o sucralfato; os análogos de prostaglandinas associados aos antibióticos claritromicina e amoxicilina somaram-se aos antiácidos para o tratamento da úlcera péptica, do refluxo gastro-esofágico e de lesões da mucosa gástrica produzidas pelo uso crônico de antiinflamatórios não esteroidais. Contudo, recentes descobertas estão trazendo novas perspectivas para a farmacologia do sistema digestório, inclusive a utilização do óxido nítrico e de outras citocinas, da vacina contra a bactéria Helicobacter pylori e dos agentes bioterapêuticos

Manifestaciones digestivas del Sindrome de Inmunodeficiencia Adquirida / Digestive manifestations of AIDS

En la actualidad el Síndrome de Inmunodeficiencia Adquirida, concita la atención de los investigadores, por ser una enfermedad que no tiene curación, su propagación es muy rápida a nivel mundial, en consecuencia el diagnóstico y prevención son de la mayor importancia. En el Hospital Nro. 1 de la C.N.S. se han diagnosticado 3 casos que ya fallecieron. Se hace incapie en las manifestaciones digestivas de estos casos. Tambien se muestran las estadísticas de la Secretaría Nacional de salud a nivel nacional.

The height of the diaphragm domes in pathologies of abdominal organs of the digestive apparatus

The present study reports on diaphragmatic changes observed in 226 patients with diseases of abdominal organs of the digestive system. The group consisted of 121 males (53.5%) and 105 females (46.5%) (mean age: 44.1 +/- 4.3 years; range 15-83 years). The parameter of reference for comparisons between normal and pathological conditions was the normal average difference in height between the hemidiaphragms, which was obtained from 220 postero-anterior chest radiographs. These radiographs were obtained from 99 males (49.5%) and 101 females (50.5%) (mean age; 41.1 +/- 5.6 years; range: 15-78 years) who did not present any symptoms compatible with diseases of the digestive system. Several diseases which affect different abdominal organs were found to cause various differences in height between the left and right hemidiaphragms. The mechanism and clinical applications of the alterations observed are discussed

Alteraciones fisioanatómicas en el sistema digestivo del viejo

Se revisan algunos tópicos relacionados con los cambios fisioanatómicos del sistema gastrointestinal, pancreático, biliar, hepático con el envejecimiento y sus implicaciones en la evaluación y tratamiento de las patologías de los pacientes ancianos

Neurofibromatose VI: Aparelhos cardiovascular, digestivo e genitourinário / Neurofibromatosis VI. Cardiovascular system, digestive and genito-urinary tract

Estudamos 11 pacientes portadores de neurofibromatose previamente diagnosticada. Seis pacientes pertenciam ao sexo masculino, quatro eram pardos e três negros. O mais jovem tinha 17 anos e o mais idoso 53. Submetemos os oito pacientes ambulatoriasi a exames clínico, otorrinolaringológico e eletrocardiográfico e os três restantes foram estudados através de suas necrópsias. Os quatro pacientes ambulatoriais do sexo feminino foram submetidos a exame ginecológico