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1.
Medicina UPB ; 40(2): 67-74, 13 oct. 2021. tab, Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1342233

ABSTRACT

En los últimos años se ha evidenciado un aumento en la incidencia y prevalencia de la enfermedad inflamatoria intestinal, que comprende dos entidades: la enfermedad de Crohn y la colitis ulcerativa. Ambas, y paradójicamente su tratamiento, pueden desencadenar manifestaciones cutáneas con una amplia variedad de manifestaciones clínicas en piel, que son un reto diagnóstico para el médico. Solo el conocimiento de estos fenotipos clínicos permitirá el diagnóstico temprano, con el objetivo de lograr el abordaje diagnóstico y el tratamiento oportunos y de evitar secuelas a largo plazo.


In recent years, there is evidence of an increase in the incidence and prevalence of inflammatory bowel disease, in which two entities are involved: Chron disease and ul-cerative colitis. Both of these diseases and, paradoxically, their treatment with anti-TNF may trigger skin manifestations, whose variety of clinical presentations on the skin can represent a diagnostic challenge for the clinician. Only the knowledge of these clinical phenotypes will allow an early diagnosis to be carried out, in order to achieve a timely diagnostic approach and treatment, and to avoid long-term sequelae.


Nos últimos anos, tem havido um aumento na incidência e prevalência da doença infla-matória intestinal, que compreende duas entidades: doença de Crohn e colite ulcerosa. Ambos, e paradoxalmente o seu tratamento, podem desencadear manifestações cutâ-neas com uma grande variedade de manifestações clínicas na pele, o que constitui um desafio diagnóstico para o médico. Somente o conhecimento desses fenótipos clínicos permitirá o diagnóstico precoce, com o objetivo de alcançar uma abordagem diagnóstica e terapêutica oportuna e evitar sequelas a longo prazo.


Subject(s)
Humans , Inflammatory Bowel Diseases , Phenotype , Signs and Symptoms , Skin , Skin Manifestations , Disease , Colitis
2.
J. coloproctol. (Rio J., Impr.) ; 41(2): 138-144, June 2021. graf, ilus
Article in English | LILACS-Express | LILACS | ID: biblio-1286992

ABSTRACT

Abstract Due to the ethnopharmacological use of Campsiandra laurifolia (Fabaceae), popularly known as Acapurana, to treat wounds and ulcers, associated with the lack of alternative treatments for intestinal inflammations such as ulcerative colitis (UC), the present work sought to characterize its phytochemical and antioxidant activities, and to evaluate remedial action in experimental colitis with acetic acid. Phytochemical analyzes were performed through qualitative and quantitative colorimetric tests of the main secondary metabolites. In the colitismodel, 24male Wistar rats aged±60 days oldwere used, divided into 4 groups: Control (CO) control+aqueous extract of C. laurifolia 50mg/kg (CO+A50); Colitis (CL); and Colitis+aqueous extract of C. laurifolia 50 mg/kg (CL+ A50).Measurement of sphincter anal pressure and histological tests of the large intestine, lipoperoxidation (LPO), enzymeactivity of superoxide dismutase (SOD), and levels of glutathione (GSH)were performed. For statistical analysis, the oxidative stress (OS) results were expressed as means±standard error, adopting a significance level of p < 0.05. The screening indicated the presence of flavonoids, saponins and tannins in the extract, with high levels of phenolic


Resumo Devido ao uso etnofarmacológico de Campsiandra laurifolia (Fabaceae), popularmente conhecida comoAcapurana, para tratar feridas e úlceras, associado à falta dealternativas de tratamentos para as inflamações intestinais como a retocolite ulcerativa (RCU), o presente trabalho buscou caracterizar sua constituição fitoquímica, sua atividade antioxidante, e avaliar sua ação reparadora na colite experimental com ácido acético. As análises fitoquímicas foram realizadas por meio de ensaios colorimétricos qualitativos e quantitativos dos principaismetabólitos secundários.Nomodelo de colite, foramutilizados 24 ratos machos Wistar de±60 dias de idade, divididos em 4 grupos: Controle (CO), controle+ extrato aquoso de C. laurifolia 50mg/kg (CO+A50); Colite (CL); e Colite+extrato aquoso de C. laurifolia (CL+ A50). Foram realizadas aferições da pressão anal esfincteriana e avaliações histológicas do intestino grosso, lipoperoxidação (LPO), atividade da enzima superóxido dismutase (SOD) e níveis da glutationa (GSH). Para a análise estatística, resultados do estresse oxidativo (EO) foram expressos em médias±erro padrão, adotando um nível de significância de p < 0,05. O screening indicou no extrato a presença de flavonoides, saponinas e taninos com altos teores de compostos fenólicos e taninos, relacionando-os a uma elevada capacidade antioxidante. Na análise histológica, o grupo CL apresentou perda das criptas, do edema e do infiltrado inflamatório. O uso do extrato de C. laurifolia reestruturou as criptas, diminuiu o edema e aumentou a pressão anal esfincteriana, com diminuição da LPO, da SOD, e aumento da GSH. Sugere-se que o uso do extrato de C. laurifolia diminui o EO por seu poder antioxidante, conferido pelos compostos fenólicos presentes no extrato.


Subject(s)
Animals , Rats , Colitis/chemically induced , Antioxidants , Tannins , Rats, Wistar , Oxidative Stress , Acetic Acid , Phenolic Compounds , Fabaceae
3.
Article in Chinese | WPRIM | ID: wpr-878907

ABSTRACT

Berberine is the main extract of Coptis chinensis, and its anti-inflammatory, antioxidant, antibacterial and immunomodulatory effects have been confirmed by modern studies. Ulcerative colitis(UC) is a chronic, idiopathic inflammatory bowel disease with unknown etiology. Its causes involve genetics, intestinal microecology and mucosal immune system disorders. In this paper, literatures on relevant pathways and mechanism of berberine on ulcerative colitis in recent years were consulted and summarized to provide me-thods and ideas for developing berberine in the treatment of UC and exploring the mechanisms. The results showed that berberine protects the intestinal mucosal barrier, restores the body's normal immune response, and improves oxidative stress by regulating multiple signaling pathways, such as JAK-STAT, NK-κB, PI3 K-AKT, MAPK, Nrf2, ERS, and MLCK-MLC, so as to treat UC.


Subject(s)
Berberine/pharmacology , Colitis , Colitis, Ulcerative/genetics , Humans , Intestinal Mucosa , Signal Transduction
4.
Rev. chil. infectol ; 37(5): 599-603, nov. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144257

ABSTRACT

Resumen Introducción: La Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) han definido la amebiasis como la infección por Entamoeba histolytica, independientemente de los síntomas. La colitis amebiana necrosante es una forma rara de amebiasis que se asocia con una alta morbilidad y mortalidad. Caso clínico: Presentamos a un paciente femenino de 68 años, con antecedentes de diabetes mellitus tipo 2, con colitis amebiana necrosante con múltiples perforaciones, que fue sometida a una hemicolectomía derecha con íleo-transverso anastomosis. Conclusiones: Se necesitan intervenciones efectivas para prevenir la colitis amebiana y terapias adicionales para tratar la colitis amebiana fulminante y mejorar los resultados.


Abstract Background: Amebiasis has been defined by World Health Organization (WHO) and Pan American Health Organization (PAHO) as the infection with Entamoeba histolytica regardless of symptoms. Necrotizing amoebic colitis is a rare clinical form of amebosis that is associated with high morbidity and mortality. Case Report: We present a 68-years-old-female patient with necrotizing amoebic colitis with multiple perforations who survived after right hemicolectomy with ileus-transverse anastomosis. Conclusions: Effective interventions to prevent amebic colitis, and additional therapies to treat fulminant amebic colitis are needed to improve outcomes.


Subject(s)
Humans , Female , Aged , Colitis , Dysentery, Amebic/drug therapy , Dysentery, Amebic/diagnostic imaging , Entamoeba histolytica
6.
Rev. medica electron ; 42(4): 2121-2129,
Article in Spanish | LILACS, CUMED | ID: biblio-1139302

ABSTRACT

RESUMEN La enteritis eosinofílica consiste en la presencia de infiltrados eosinofílicos en el tracto digestivo. Constituye en la actualidad una entidad rara que puede localizarse en cualquier región del tubo digestivo. Su etiopatogenia se desconoce y en muchas ocasiones se relaciona con antecedentes de atopia. Las manifestaciones clínicas varían en función de las capas afectadas. Se presentó el caso de un paciente de 26 años de edad, con antecedentes de haber sido operado de apendicitis aguda, en el año 2011. Llegó al Cuerpo de Guardia refiriendo dolor intenso, fijo; en fosa iliaca derecha, acompañado de fiebre de 39°C, con escalofríos y síntomas dispéptico. Se orientó ingreso y se le realizó una videoendoscopia, se observó gastritis antral eritematosa exudativa con test para Helicobacter pylori positivo. Además, una videolaparoscopia arrojando presencia de asas delgadas apelotonadas y adherencias no recientes en fosa iliaca derecha. A pesar del tratamiento empleado el paciente continuó con dolor y fiebre, por lo que se decidió indicarle una enteroscopia de doble balón con biopsia de íleon. Se informó que a nivel del colon presentaba una colitis crónica inespecífica y en el íleon una hiperplasia linfoide. El estudio histopatológico confirmó la colitis inespecífica y una eosinofilia moderada en íleon. Se indicó tratamiento con prednisona y mesalazina con mejoría notable del cuadro clínico, fue dado de alta con el diagnóstico de una enteritis eosinofílica, con seguimiento por consulta externa de gastroenterología. En la actualidad se mantiene asintomático (AU).


ABSTRACT Eosinophilic enteritis is the presence of eosinophilic infiltrates in the digestive tract. Currently it is a rare entity than could be located in any region of the digestive tract. Its etiopathogenesis is unknown and is related, in many cases, to antecedents of atopy, Clinical manifestations may vary according to the affected layer. The authors present the case of a patient aged 26 years, with antecedents of having undergone an acute appendicitis surgery in 2011. He arrived to Emergency referring intense, steady pain in the right iliac fossa, accompanied by a 39o C fever, chills and dyspeptic symptoms. He was admitted and a video endoscopy was carried out. An exudative erythematous antral gastritis was observed with a positive test for Helicobacter pylori. In addition, video laparoscopy also showed the presence of thin, lumped loops and no-recent adherences in the right iliac fossa. In spite of the applied treatment, the patient continued with pain and fever, so the doctors indicated a double-balloon enteroscopy with ileum biopsy. It was informed an unspecific chronic colitis at the colon level and a lymphoid hyperplasia in the ileum. The histopathologic study confirmed the unspecific colitis and a moderate eosinophilia in the ileum. A prednisone and mesalazine treatment was indicated with a notable improvement of the clinical characteristics. The patient was discharged diagnosed with a eosinophilic enteritis and follow-up in out-patient consultation of Gastroenterology. Currently he keeps on asymptomatic (AU).


Subject(s)
Humans , Female , Young Adult , Enteritis/diagnosis , Eosinophilia/diagnosis , Signs and Symptoms , Therapeutics , Case Reports , Colitis/classification , Colitis/diagnosis , Gastroenterology
7.
Rev. colomb. gastroenterol ; 35(2): 232-235, abr.-jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1126314

ABSTRACT

Resumen Por definición, la colitis actínica incluye cambios inflamatorios de la mucosa colorrectal secundarios a radioterapia en cercanía a la región tratada. La localización más frecuente es el recto y la indicación más común de radioterapia corresponde a neoplasias de la región pélvica incluidos el recto, la próstata y el cérvix. Se estima que hasta la mitad de los pacientes que reciben radiación pélvica llega a desarrollar síntomas gastrointestinales asociados. Se presentan dos pacientes con metástasis óseas sacroilíacas y pélvicas secundarias a adenocarcinoma de próstata que recibieron radiación en la región lumbosacra y pélvica, ambos pacientes presentaron episodios de deposiciones con sangre que iniciaron tempranamente posterior a la radioterapia. La colonoscopia mostró eritema y ulceración. En el estudio histopatológico se observó un patrón de colitis isquémica, con núcleo y citomegalia, estroma fibroso con cambios reactivos y abundante infiltrado inflamatorio neutrofílico. Estos hallazgos son característicos de la colitis actínica aguda; sin embargo, la localización cecal no ha sido frecuentemente reportada. Aunque al ser el ciego y el íleon terminal móviles de localización pélvica, se convierten en un factor de riesgo para que estos segmentos anatómicos sean susceptibles al impacto directo de la radioterapia. Esta condición, en la fase aguda, es autolimitada y se suele resolver con medidas de soporte. Es indispensable que el personal involucrado en el manejo de estos pacientes conozca esta entidad y los posibles diagnósticos diferenciales.


Abstract By definition, actinic colitis includes inflammatory changes of the colorectal mucosa secondary to radiation therapy of nearby tissue. The most frequent location is the rectum, and the most common indication for radiation therapy is a pelvic region neoplasm in the rectum, prostate or cervix. It is estimated that up to half of patients receiving pelvic radiation go on to develop associated gastrointestinal symptoms. We present two patients with sacroiliac and pelvic bone metastases secondary to prostate adenocarcinoma who received radiation in the lumbosacral and pelvic region. Both patients developed bloody stools soon after radiation therapy. Colonoscopy showed erythema and ulceration, and histopathology found a pattern of ischemic colitis with nucleus and cytomegalovirus infection, fibrous stroma with reactive changes and abundant inflammatory infiltration of neutrophils. These findings are characteristic of acute actinic colitis, but the cecal location has not been reported frequently. Nevertheless, the pelvic location of the cecum and the terminal ileum puts these anatomical segments at risk from the direct impact of radiation therapy. In the acute phase, this condition, is self-limiting and usually resolves with support measures. It is essential that the personnel involved in the management of these patients be aware of this entity and its possible differential diagnoses.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Colitis , Pelvis , Prostate , Signs and Symptoms , Adenocarcinoma , Colitis, Ischemic
8.
Rev. colomb. nefrol. (En línea) ; 7(1): 113-120, ene.-jun. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1144378

ABSTRACT

Resumen La infección por citomegalovirus (CMV) es un riesgo latente en pacientes inmunocomprometidos por trasplante renal, asociándose con aumento del riesgo de rechazo del injerto y muerte. La infección por CMV puede manifestarse como infección activa o enfermedad por CMV (dividida en síndrome por CMV y enfermedad tisular invasiva por CMV). Presentamos dos casos de enfermedad tisular invasiva por CMV, la cual se presentó entre los primeros siete meses posteriores al trasplante. Ambos casos eran D+/R-; recibieron agentes depletores de linfocitos y micofenolato y profilaxis para CMV de acuerdo con las guías de práctica clínica. Los criterios para enfermedad por CMV incluyeron replicación viral detectable en sangre, hallazgos endoscópicos clásicos y confirmación histopatológica. Hacemos énfasis en la necesidad de identificar los factores de riesgo para la infección por CMV en pacientes con trasplante renal, especialmente el seroestatus donador/receptor y los medicamentos inmunosupresores. Aun cuando las guías de práctica clínica sugieren de uno a tres meses de profilaxis para CMV en casos de alto riesgo, debería considerarse la profilaxis extendida y el ajuste de los medicamentos inmunosupresores.


Abstract Cytomegalovirus infection is a latent risk among immunocompromised kidney transplant recipients and is associated with increased risk of allograft failure and death. CMV infection can manifest as active infection or as CMV disease (divided in CMV syndrome and CMV tissue-invasive disease). We present two cases of tissue invasive CMV disease, presenting within 7 months after kidney transplantation. Both cases were D+/R-, received lymphocyte-depleting agents and mycophenolate, and both received CMV prophylaxis according to General Practice Guidelines. CMV disease criteria included detectable viral replication in blood, classical endoscopic findings and histopathological confirmation. We emphasize the need of categorical identification of CMV infection risk factors among kidney transplantation recipients, specially CMV donor/recipient serostatus and immunosuppressive medication. Although clinical practice guidelines suggest 1 to 3 months CMV prophylaxis in high-risk cases, extended prophylaxis and immunosuppressive medication adjustment should be considered.


Subject(s)
Humans , Male , Adult , Kidney Transplantation , Patients , Colitis , Cytomegalovirus , Mexico
9.
J. coloproctol. (Rio J., Impr.) ; 40(2): 168-171, Apr.-Jun. 2020. tab
Article in English | LILACS | ID: biblio-1134970

ABSTRACT

ABSTRACT Background Non specific colitis is defined as inflammatory condition of the colon that when examined microscopically lacks any characteristic features of any specific form of colitis and is commonly seen in reports of colonoscopy biopsies. There are many factors that cause it like obesity and H pylori. Aim of the study To determine the association of obesity and H pylori as contributory factors to this disease. Patients and methods This is a case-controlled study was carried out in Al-Kindy College of Medicine from January 2017 to June 2018. Sixty individuals were included; forty of them had non specific colitis. The rest were healthy control group. Demographic information's were taken like age and sex. Anthropometric measurement like weight in kilograms (kg), height in meters (m), waist circumference in centimeters (cm), and body mass index was done. H pylori IgG was done to both groups. Results Study results indicated that this disease was more common with increasing age, there is a significant difference (p = 0.002) between patients (48.12 ± 1.50) and control group (41.00 ± 1.10) regarding age. BMI of the patients is significantly higher in patients group (29.21 ± 0.41; p = 0.000) than the control (22.23 ± 0.41). Patients with non specific colitis showed significant (p = 0.000) increased in H pylori infection 33 (82.5%) compared with control group 2 (10%). Conclusions Obesity and infection withH pylori may predispose to non specific colitis.


RESUMO Introdução Colite inespecífica é uma condição inflamatória do cólon que microscopicamente não apresenta características de qualquer forma específica de colite; é comumente observada em relatórios patológicos de biópsias de colonoscopia. Vários fatores podem causar colite inespecífica, dentre os quais obesidade e infecção por H. pylori. Objetivo do estudo Determinar o possível papel da obesidade e H. pylori como fatores contribuintes para esta doença. Pacientes e Métodos Este foi um estudo caso-controle, realizado na Al-Kindy College of Medicine entre janeiro de 2017 e junho de 2018. Um total de 60 indivíduos foram incluídos, 40 dos quais apresentavam colite inespecífica. Os demais foram incluídos no grupo de controles saudáveis. Foram coletadas informações demográficas, como idade e sexo. Medidas antropométricas, como peso (kg), altura (m), circunferência da cintura (cm) e índice de massa corporal, também foram coletadas. Nos dois grupos, foi feita serologia para H. pylori (IgG) Resultados Os presentes resultados indicaram que esta doença era mais comum entre pacientes de idade mais avançada; observou-se uma diferença significativa p = 0,002 entre os pacientes 48,12 ± 1,50 e o grupo controle 41,00 ± 1,10 quanto à idade. O IMC foi significativamente maior no grupo de pacientes 29,21 ± 0,41; p = 0,000 do que no grupo controle 22,23 ± 0,41. A infecção por H. pylori foi significamente mais frequentemente observada no grupo de pacientes (33; 82,5%) em comparação ao grupo controle (2; 10%; p = 0,000. Conclusões A obesidade e a infecção por H. pylori podem predispor à colite inespecífica.


Subject(s)
Humans , Male , Female , Helicobacter pylori , Colitis/pathology , Obesity , Risk Factors , Colonic Diseases
10.
J. coloproctol. (Rio J., Impr.) ; 40(1): 61-66, Jan.-Mar. 2020. tab, ilus
Article in English | LILACS | ID: biblio-1090837

ABSTRACT

Abstract Rationale: Disuse colitis is frequent in our country and the most effective treatment is high cost and there is a need for effective and low cost therapy. Objective: To evaluate the efficacy of Baccharis dracunculifolia (field rosemary) in the treatment of exclusion colitis in rats. Method: Eighteen Wistar rats were anesthetized and submitted to colostomy; they were then distributed into two groups: Control Group, receiving intrarectal saline infusion (n = 8) and Group BD receiving intrarectal infusion ofBaccharis dracunculifolia extract (n = 10); after 21 days of treatment they were euthanized, the intestinal segment excluded from intestinal transit was resected and submitted to histopathological study, classifying the degree of inflammation and degree of vascular congestion from 0 to 3. Results: Mean inflammation was 2.7 in Control Group versus 2.1 in BD Group (p = 0.049), while mean vascular congestion was 2.3 and 2, respectively, in Control and BD groups (p = 0.1642). Conclusion: Intra-rectal infusion ofBaccharis dracunculifolia extract significantly minimized the inflammatory process in the exclusion colitis of rats submitted to colostomy, without altering the degree of vascular congestion.


Resumo Racional A colite de desuso é frequente em nosso meio e o tratamento de maior eficácia é de alto custo, havendo necessidade de se encontrar uma terapêutica eficaz e de baixo custo. Objetivo Avaliar a eficácia da Baccharis dracunculifolia (alecrim-do-campo) no tratamento da colite de exclusão em ratos. Método Utilizou-se 18 ratos Wistar, os quais foram anestesiados e submetidos à colostomia; em seguida distribuídos em 2 grupos: Grupo Controle, recebendo infusão intrarretal de solução salina (n = 8) e Grupo BD, recebendo infusão intrarretal de extrato de Baccharis dracunculifolia (n = 10); após 21 dias de tratamento foram submetidos a eutanásia, o segmento intesinal excluso de trânsito intestinal foi ressecado e submetido a estudo histopatológico classificando-se o grau de inflamação e grau de congestão vascular de 0 a 3. Resultados Verificou-se média de inflamação 2,7 no Grupo Controle vs. 2,1 no Grupo BD (p = 0,049), enquanto as médias de congestão vascular foram 2,3 e 2, respectivamente, nos grupos controle e BD (p = 0,1642). Conclusão A infusão intrarretal do extrato de Baccharis dracunculifolia minimizou significantemente o processo inflamatório na colite de exclusão de ratos submetidos à colostomia, sem alterar o grau de congestão vascular.


Subject(s)
Animals , Rats , Colitis , Colitis/drug therapy , Plant Preparations , Vernonia , Phytotherapy , Plants, Medicinal , Colostomy , Vernonia/adverse effects
11.
Medisan ; 24(1)ene.-feb. 2020. tab
Article in Spanish | LILACS-Express | LILACS, CUMED | ID: biblio-1091166

ABSTRACT

Introducción: Las enfermedades inflamatorias intestinales representan un importante problema de salud pública por el aumento en su prevalencia e incidencia a nivel mundial. Objetivo: Identificar los principales factores de riesgo asociados a la enfermedad inflamatoria intestinal en ancianos. Métodos: Se realizó una investigación analítica, de casos y controles, de pacientes de 60 y más años, con diagnóstico y confirmación histológica de alguna enfermedad inflamatoria intestinal, ingresados en el Servicio de Medicina del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, durante el 2015. El grupo de estudio estuvo conformado por 61 pacientes y el de control por 122 integrantes (2 por cada caso), seleccionados de los consultorios de procedencia de los afectados. En el análisis estadístico se calculó el porcentaje para las variables cualitativas y, a fin de comprobar la existencia de asociación, se aplicó la prueba de independencia de la Χ2, con 95 % de confiabilidad. Cada variable se analizó calculando la oportunidad relativa, con intervalos límite de confianza superior e inferior. Resultados: Se obtuvo una asociación causal de 5,4 veces más posibilidades de padecer alguna enfermedad inflamatoria intestinal si estaba presente el antecedente familiar de colitis. Asimismo, existió una asociación significativa (p<0,05) entre el antecedente familiar de enfermedad de Crohn y la enfermedad inflamatoria intestinal (9,8 %), y fue 9,7 veces más posible que apareciera algún trastorno inflamatorio de los intestinos si se consumían alimentos inadecuados. Conclusiones: Los factores de riesgo mayormente relacionados con la enfermedad inflamatoria intestinal fueron los antecedentes familiares de colitis y de enfermedad de Crohn, así como el consumo inadecuado de alimentos, el uso prolongado de antibióticos y el tabaquismo.


Introduction: The intestinal inflammatory diseases represent an important problem of public health due to the increase in their prevalence and incidence worldwide. Objective: To identify the main risk factors associated with the intestinal inflammatory disease in elderly. Methods: An analytic cases and controls investigation of 60 years and over patients, with diagnosis and histological confirmation of some intestinal inflammatory disease was carried out. They were admitted to the Medicine Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, during 2015. The study group was conformed by 61 patients and the control group by 122 members (2 for each case), belonging to the family doctor´s office of the affected patients. In the statistical analysis the percentage for the qualitative variables was calculated and, in order to check the existence of any association, the chi-square test was implemented, with 95 % of confidence. Each variable was analyzed calculating the relative opportunity, with upper and lower limit intervals of confidence. Results: There was a causal association of 5.4 times more possibilities of suffering some intestinal inflammatory disease if the family history of colitis was present. Also, a significant association existed (p <0.05) between the family history of Crohn disease and the intestinal inflammatory disease (9.8 %), and it was 9.7 times more possible that some inflammatory disorder of the bowels appeared if inadequate foods were eaten. Conclusions: The risk factors mostly related to the intestinal inflammatory disease were the family history of colitis and Crohn disease, as well as the inadequate consumption of foods, the long use of antibiotics and nicotine addiction.


Subject(s)
Aged , Inflammatory Bowel Diseases , Crohn Disease , Colitis , Secondary Care , Risk Factors
12.
Rev. colomb. gastroenterol ; 35(1): 87-91, 2020. graf
Article in Spanish | LILACS | ID: biblio-1115603

ABSTRACT

Resumen La enfermedad gastrointestinal eosinofílica (EGIE) agrupa diversas patologías que pueden comprometer el tracto gastrointestinal. La más conocida de ellas es la esofagitis eosinofílica, mientras que la menos distinguida es la colitis eosinofílica (CE), que fue informada por primera vez en la literatura de 1959. La CE se caracteriza por la existencia de trastornos funcionales digestivos y la diarrea se constituye en el más importante de estos. Aunque no existen unos criterios diagnósticos claros, se considera que los pacientes deben presentar hemogramas con eosinofilia y hallazgos histológicos de infiltración eosinofílica, los cuales son determinados por el estudio histológico de las biopsias tomadas mediante la colonoscopia. Así pues, la CE afecta especialmente a neonatos y adultos jóvenes, y se ha relacionado con causas genéticas y alérgicas. El tratamiento inicial consiste en la suspensión de los alérgenos. Dentro del arsenal farmacológico, se emplea la prednisolona, así como medicamentos entre los que se incluyen la budesonida y los inmunomoduladores en los casos refractarios, con lo cual se logra una adecuada respuesta. Presentamos una actualización de este tema.


Abstract Eosinophilic gastrointestinal disorders (EGID) are a group of disorders that compromise the gastrointestinal tract. The best known is eosinophilic esophagitis while eosinophilic colitis which was first reported in the literature in 1959 is less well-known. Eosinophilic colitis is characterized by functional digestive disorders, most importantly diarrhea. Although there are no clear diagnostic criteria, blood should be tested for eosinophils and biopsies taken by colonoscopies should be studied for histological findings of eosinophilic infiltration. Eosinophilic colitis especially affects neonates and young adults and has been linked to genetic and allergic causes. Initial treatment consists of the suspension of allergens. Prednisolone is used to treat the disorder, and medications such as budesonide and immunomodulators can be used in refractory cases to achieve adequate response. We present an update.


Subject(s)
Humans , Colitis , Biopsy , Colonoscopy , Gastrointestinal Tract , Diarrhea , Gastrointestinal Diseases
13.
J. coloproctol. (Rio J., Impr.) ; 39(4): 319-325, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056642

ABSTRACT

Abstract Background and study aim: The term non-specific colitis refers to an inflammatory condition of the colon that microscopically lacks the characteristic features of any specific form of colitis and is commonly seen in pathology reports of colonoscopy biopsies. In fact, it has been questioned whether it is a separate pathological entity or it is merely an intermediate stage in the course of inflammatory bowel disease. This study was conducted to estimate the prevalence of non-specific colitis among patients with colitis and characterize its natural history over a 6 months year period. Patients and methods: Eighty adult patients presented for colonoscopy were enrolled. In the final analysis they were divided into Group A; the non-specific colitis Group and Group B; the inflammatory bowel disease Group. All patients were subjected to: full history taking, full clinical examination, laboratory investigations: which included stool analysis, CRP, ESR, complete colonoscopy and entire random colon biopsies for histopathological examination. Results: Group A included 67 patients (83.75%) while Group B included 13 (16.25%) patients. Patients with IBD had clinical and laboratory features of inflammation significantly higher than patients with non-specific colitis. Six patients (8.95%) of non-specific colitis group developed histologic features of florid inflammatory bowel disease after 6 months. There were no independent predictors of this conversion. Conclusion: Among our 80 patients with colonoscopy and biopsy 67 (83.75%) were diagnosed as non-specific colitis and out of them 6 patients (8.95%) were reexamined after 6 months and proved to have inflammtory bowel disese this change was not linked to predictive factors.


Resumo Introdução e objetivos: O termo colite inespecífica (CI) refere-se a uma condição inflamatória do cólon que microscopicamente não apresenta características de qualquer forma específica de colite; é comumente observada em relatórios patológicos de biópsias de colonoscopia. De fato, tem-se questionado se esta seria uma entidade patológica separada ou apenas um estágio intermediário no curso da DII. Este estudo foi realizado para estimar a prevalência de CI entre pacientes com colite e caracterizar seu curso durante um período de seis meses. Pacientes e métodos: O estudo incluiu 80 pacientes adultos que se apresentaram para colonoscopia. Na análise, os pacientes foram divididos em dois grupos: grupo A (CI) e grupo B (DII) Todos os pacientes foram submetidos a anamnese completa, exame clínico completo e investigações laboratoriais que incluíram análise de fezes, PCR, VHS, colonoscopia completa e biópsias aleatórias de cólon para exame histopatológico. Resultados: Do total de pacientes, 67 foram alocados no grupo A (83,75%) e 13 (16,25%) no grupo B. Os pacientes com DII apresentavam sinais clínicos e laboratoriais de inflamação significativamente maiores do que o observado em pacientes com CI. Seis pacientes (8,95%) do grupo CI desenvolveram características histológicas de DII florida após seis meses. Não foram identificados preditores independentes para essa conversão. Conclusão: Entre os 80 pacientes submetidos a colonoscopia e biópsia, o diagnóstico de CI foi feito em 67 (83,75%); destes, seis pacientes (8,95%) foram reexaminados após seis meses e apresentaram DII, sendo que essa conversão não foi associada a fatores preditivos.


Subject(s)
Humans , Male , Female , Inflammatory Bowel Diseases , Colonoscopy , Colitis/diagnosis , Colitis/epidemiology , Inflammatory Bowel Diseases/diagnosis , Colitis , Colitis/pathology
14.
Acta cir. bras ; 34(10): e201901004, Oct. 2019. graf
Article in English | LILACS | ID: biblio-1054674

ABSTRACT

Abstract Purpose: To evaluate the effects of infliximab on the inflammation of the colonic mucosa devoid from fecal stream. Methods: Twenty-four rats were submitted to a Hartmann's procedure. They remained for 12 weeks with the fecal derivation to development of diversion colitis on excluded colorectal stump. After this period, they were divided into 3 groups: one group received intervention with saline (2.0 mL / week), other group infliximab at doses of 5 mg/kg/week and the other 10 mg/kg/week for five consecutively weeks. Concluded the intervention period, the animals were euthanized to remove colon segments with and without fecal stream. Colitis was diagnosed by histological analysis and the degree of inflammation by validated score. The neutrophilic infiltrate was evaluated by tissue expression of myeloperoxidase identified by immunohistochemical. The tissue content of myeloperoxidase was measured by computer-assisted image analysis. Results: The inflammatory score was high in colonic segments without fecal stream. The intervention with infliximab reduced the inflammatory score in excluded colonic segments. The content of myeloperoxidase was reduced in colonic segments of animals treated with infliximab mainly in high concentrations. Conclusion: Intervention with infliximab reduced the inflammation and the neutrophil infiltrate in colonic segments devoid of the fecal stream.


Subject(s)
Animals , Male , Gastrointestinal Agents/pharmacology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Colitis/drug therapy , Infliximab/pharmacology , Time Factors , Image Processing, Computer-Assisted , Gastrointestinal Transit/drug effects , Immunohistochemistry , Reproducibility of Results , Rats, Wistar , Colitis/pathology , Colon/drug effects , Colon/pathology , Peroxidase/analysis , Neutrophil Infiltration/drug effects , Feces , Intestinal Mucosa/drug effects , Intestinal Mucosa/pathology
15.
Rev. bras. parasitol. vet ; 28(3): 443-450, July-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1042526

ABSTRACT

Abstract Diseases related to the alimentary system are the main cause of death in horses. This retrospective study aimed to describe the pathological findings of fatal parasite-induced enteritis and typhlocolitis caused by cyathostominae, Eimeria leuckarti, Balantidium coli, and Strongyloides westeri in horses. The records of parasite-induced intestinal lesions in horses necropsied in Southern Brazil between 2005 and 2017 were reviewed. Ten horses had fatal parasitic enteritis and/or typhlocolitis, and the main causes were: cyathostominae typhlocolitis (6/10), E. leuckarti enteritis (1/10), S. westeri enteritis (1/10), B. coli colitis related to cyathostominae (1/10), and infection by multiple agents (1/10). Cyathostominae typhlocolitis showed marked mucosal thickening, with multifocal elevated nodules containing tangled filiform parasites. Microscopic examination revealed that the mucosa and submucosa had encysted parasitic structures surrounded by eosinophilic and granulomatous inflammation. E. leuckarti enteritis was microscopically characterized by macrogamonts, microgamonts, and oocysts inside the host cells. S. westeri enteritis showed microscopic atrophy of the villi with numerous mucosal encysted parasitic structures. B. coli typhlocolitis showed severe diffuse mucosal reddening, with microscopic superficial mucosal necrosis associated with multiple protozoan trophozoites. Fatal parasite-induced enteritis and typhlocolitis are important causes of death in horses in Southern Brazil.


Resumo Doenças relacionadas ao sistema alimentar são as principais causas de morte em equinos. Esse estudo teve o objetivo de descrever aspectos patológicos de enterites e tiflocolites parasitárias fatais por ciatostomíneos, Eimeria leuckarti, Balantidium coli e Strongyloides westeri, em equinos. Foi revisado o banco de dados de lesões intestinais parasitárias em equinos necropsiados de 2005 a 2017, no Sul do Brasil. Dez equinos apresentaram enterite e/ou tiflocolite parasitária fatal, e as principais foram: tiflocolite por ciatostomíneos (6/10), enterite por E. leuckarti (1/10), enterite por S. westeri (1/10), colite por B. coli com ciatostomíneos (1/10), e infecção por múltiplos agentes (1/10). A tiflocolite por ciatostomíneos exibia acentuado espessamento da mucosa, com nódulos multifocais elevados contendo parasitas filiformes. Microscopicamente, a mucosa e submucosa apresentavam estruturas parasitárias encistadas envoltas por inflamação eosinofílica e granulomatosa. A enterite por E. leuckarti era caracterizada microscopicamente por macrogamontes, microgamontes e oocistos no interior de células do hospedeiro. Microscopicamente, a enterite por S. westeri apresentava atrofia de vilosidades com numerosas estruturas parasitárias encistadas na mucosa. A tiflocolite por B. coli exibia avermelhamento acentuado difuso da mucosa, e microscopicamente necrose superficial associada a múltiplos trofozoítos protozoáricos. Enterites e tiflocolites fatais parasitárias são importantes causas de morte em equinos no Sul do Brasil.


Subject(s)
Animals , Male , Female , Strongyloides/isolation & purification , Balantidium/isolation & purification , Colitis/parasitology , Eimeria/isolation & purification , Enteritis/parasitology , Typhlitis/parasitology , Horse Diseases/parasitology , Seasons , Retrospective Studies , Colitis/mortality , Enteritis/mortality , Typhlitis/mortality , Feces/parasitology , Horse Diseases/mortality , Horses
16.
Acta méd. colomb ; 44(1): 47-50, ene.-mar. 2019.
Article in Spanish | LILACS, COLNAL | ID: biblio-1019296

ABSTRACT

Resumen La colitis eosinofílica es una enfermedad rara e idiopática caracterizada por la infiltración eosinofílica del colon y que hace parte del espectro de la gastroenteritis eosinofílica. Esta entidad tiene síntomas inespecíficos y en la actualidad no hay estudios clínicos, por lo cual la evidencia científica se basa en series de casos o reportes aislados. Esta patología requiere de un enfoque diagnóstico adecuado para descartar otras causas de eosinofilia en el colon, para poder así ofrecer un manejo farmacológico y no farmacológico dirigido y especializado para lograr la remisión de la enfermedad, por lo cual para ofrecer una atención oportuna, se debe tener en cuenta dentro del diagnóstico diferencial de aquellos pacientes jóvenes con diarrea crónica para lograr mejorar el enfoque diagnóstico y promover la realización de estudios clínicos que mejoren la calidad de la evidencia científica actual. Presentamos el primer caso con compromiso exclusivo del colon reportado en Colombia de una mujer con antecedente de enfermedades atópicas. (Acta Med Colom 2019; 44: 47-50)


Abstract Eosinophilic colitis is a rare and idiopathic disease characterized by eosinophilic infiltration of the colon and is part of the spectrum of eosinophilic gastroenteritis. This entity has nonspecific symptoms and currently there are no clinical studies, so the scientific evidence is based on case series or isolated reports. This pathology requires an adequate diagnostic approach to rule out other causes of eosinophilia in the colon, in order to offer a directed and specialized pharmacological and non-pharmacological management to achieve remission of the disease, so that to offer timely care it should be considered in the differential diagnosis of those young patients with chronic diarrhea in order to improve the diagnostic approach and promote performance of clinical studies that improve the quality of current scientific evidence. This is the first case with exclusive involvement of the colon reported in Colombia of a woman with a history of atopic diseases. (Acta Med Colom 2019; 44: 47-50)


Subject(s)
Humans , Female , Adult , Colitis , Eosinophilia , Diarrhea , Food Intolerance , Gastroenteritis
17.
Infectio ; 23(1): 52-54, Jan.-Mar. 2019. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-975563

ABSTRACT

Resumen La infección por Clostridium difficile es la principal causa de diarrea asociada al cuidado de la salud. Durante los últimos años se ha incrementado la morbilidad y mortalidad por esta infección. Las recientes investigaciones se orientan a la búsqueda de tratamientos alternativos a la colectomía subtotal para los pacientes con infecciones severas por Clostridium difficile, es por esto que el presente artículo tiene como objetivo hacer la revisión del caso clínico de una paciente con colitis severa por Clostridium difficile refractaria al manejo de primera línea, que respondió satisfactoriamente al tratamiento con lavado colónico anterógrado con vancomicina vía ileostomía en asa.


Abstract Clostridium difficile infection is the main cause of diarrhea in health care settings. Such infections have led to an increase in morbidity and mortality in recent years. Alternative treatments to subtotal colectomy have been sought for patients with severe infections caused by Clostridium difficile. The objective of this article is to present a clinical case report of a patient with severe colitis caused by Clostridium difficile that was refractory to first-line management, which responded satisfac torily to treatment with anterograde colonic lavages with vancomycin via loop ileostomy.


Subject(s)
Humans , Female , Adult , Ileostomy , Clostridioides difficile , Clostridium Infections , Colectomy , Vancomycin , Colitis , Delivery of Health Care , Diarrhea , Infections
18.
Gut and Liver ; : 54-61, 2019.
Article in English | WPRIM | ID: wpr-719367

ABSTRACT

BACKGROUND/AIMS: Statins have been postulated to lower the risk of colorectal neoplasia. No studies have examined any possible chemopreventive effect of statins in patients with inflammatory bowel disease (IBD) undergoing colorectal cancer (CRC) surveillance. This study examined the association of statin exposure with dysplasia and CRC in patients with IBD undergoing dysplasia surveillance colonoscopies. METHODS: A cohort of patients with IBD undergoing colonoscopic surveillance for dysplasia and CRC at a single academic medical center were studied. The inclusion criteria were IBD involving the colon for 8 years (or any colitis duration if associated with primary sclerosing cholangitis [PSC]) and at least two colonoscopic surveillance exams. The exclusion criteria were CRC or high-grade dysplasia (HGD) prior to or at enrollment, prior colectomy, or limited ( < 30%) colonic disease. The primary outcome was the frequency of dysplasia and/or CRC in statin-exposed versus nonexposed patients. RESULTS: A total of 642 patients met the inclusion criteria (57 statin-exposed and 585 nonexposed). The statin-exposed group had a longer IBD duration, longer follow-up period, and more colonoscopies but lower inflammatory scores, less frequent PSC and less use of thiopurines and biologics. There were no differences in low-grade dysplasia, HGD, or CRC development during the follow-up period between the statin-exposed and nonexposed groups (21.1%, 5.3%, 1.8% vs 19.2%, 2.9%, 2.9%, respectively). Propensity score analysis did not alter the overall findings. CONCLUSIONS: In IBD patients undergoing surveillance colonoscopies, statin use was not associated with reduced dysplasia or CRC rates. The role of statins as chemopreventive agents in IBD remains controversial.


Subject(s)
Academic Medical Centers , Biological Products , Chemoprevention , Cholangitis, Sclerosing , Cohort Studies , Colectomy , Colitis , Colon , Colonic Diseases , Colonoscopy , Colorectal Neoplasms , Epidemiology , Follow-Up Studies , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Inflammatory Bowel Diseases , Prevalence , Propensity Score
19.
Article in English | WPRIM | ID: wpr-719282

ABSTRACT

BACKGROUND/AIMS: The Crohn's and Colitis Knowledge (CCKNOW) score does not reflect updated knowledge relating to inflammatory bowel disease (IBD). The aim of this study was to develop, validate, and apply a novel tool to measure disease-related knowledge in IBD patients. METHODS: A questionnaire composed of 24 items regarding knowledge of IBD was developed: Inflammatory Bowel Disease Knowledge (IBD-KNOW). Discriminate ability of IBD-KNOW was validated in three occupational groups (14 doctors, 20 nurses, and 19 clerks). The CCKNOW and IBD-KNOW were administered to IBD patients. Factors affecting the level of IBD-related knowledge were analyzed. RESULTS: The median Inflammatory Bowel Disease Knowledge (IBD-KNOW) score was significantly different among the three groups for validation (22 doctors, 20 nurses, and five clerks; p < 0.001). The IBD-KNOW showed excellent internal consistency (Cronbach α = 0.952) and high correlation with CCKNOW (Spearman ρ = 0.827, p = 0.01). A total of 200 IBD patients (120 Crohn's disease, 80 ulcerative colitis) completed questionnaires. Multivariate analysis showed that a higher IBD-KNOW score than the median was associated with hospitalization history (odds ratio [OR], 2.625; p = 0.003), high education level (OR, 2.498; p = 0.012), and information acquired from patient organization (OR, 3.305, p = 0.035). CONCLUSIONS: The IBD-KNOW demonstrated excellent test characteristics. Hospitalization history, education level, and information acquired from patient organization play an important role in correct IBD-related knowledge.


Subject(s)
Colitis , Crohn Disease , Education , Hospitalization , Humans , Inflammatory Bowel Diseases , Multivariate Analysis , Occupational Groups , Ulcer
20.
Intestinal Research ; : 285-310, 2019.
Article in English | WPRIM | ID: wpr-764161

ABSTRACT

The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.


Subject(s)
Adalimumab , Asia , Asian Continental Ancestry Group , Biological Factors , Biosimilar Pharmaceuticals , Colitis , Colitis, Ulcerative , Consensus , Cooperative Behavior , Crohn Disease , Gastroenterology , Hepatitis B , Humans , Immunologic Factors , Inflammatory Bowel Diseases , Infliximab , Pharmacogenetics , Philippines , Practice Guidelines as Topic , Tuberculosis , Ulcer
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