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1.
Rev. colomb. cancerol ; 24(3): 113-123, jul.-set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144330

ABSTRACT

Resumen Objetivo: Realizar la traducción y adaptación transcultural del componente de síntomas gastrointestinales (SGI) de la escala CTCAE versión 4.02 en pacientes ambulatorios tratados con quimioterapia en el Instituto Nacional de Cancerología en Bogotá. Métodos: Se realizó una búsqueda manual en medios electrónicos de escalas en idioma inglés o español que evaluarán la presencia, frecuencia o intensidad de SGI en pacientes oncológicos. La selección de los ítems fue efectuada por consenso informal de un comité técnico, el cual verificó la concordancia entre los principales SGI descritos en la literatura y los incluidos en la escala, ya que estos podrían afectar el estado nutricional. Posteriormente, para la adaptación transcultural, se siguieron los pasos y recomendaciones del manual ISPOR y del grupo de calidad de vida EORTC. La prueba piloto se efectuó en 30 pacientes seleccionados por conveniencia, quienes cumplieron los criterios de inclusión. Resultados: El 52% eran hombres; la edad promedio fue de 54,2 años (+/- 15,3 años). Los cánceres más frecuentes fueron: colorrectal (28%), estómago (16%) y mama (12%). Los 14 SGI incluidos en la escala fueron experimentados por todos los pacientes, por lo cual se conservaron, y no se requirió adicionar ningún otro. El tiempo promedio de aplicación del instrumento fue de 5 minutos y el 90% de los participantes lo consideró adecuado. Conclusiones: Se generó un instrumento de 14 ítems para medir SGI en pacientes oncológicos ambulatorios sometidos a quimioterapia, el cual es de rápida aplicación y utiliza lenguaje de fácil comprensión para el paciente. Aunque todavía quedan por definir sus propiedades clinimétricas.


Abstract Objective: To carry out the translation and transcultural adaptation of the gastrointestinal symptoms component (GIS) of the CTCAE, scale version 4.02, in outpatient patients treated with chemotherapy at the National Cancer Institute, Bogotá (Colombia). Methods: It was performed a manual search of scales on electronic media, in English or Spanish languages, which will evaluate the presence and intensity of GIS in oncological patients. The selection of the items was made by an informal consensus of a technical committee, which verified the concordance between the main GIS described in the literature and those included in the scale, all of which could affect the nutritional status. For transcultural adaptation, there were followed the steps and recommendations of the ISPOR Handbook, as well as those of the EORTC quality of life group. The pilot test was conducted in 30 patients selected for convenience, who met the inclusion criteria. Results: 52% were men; the average age was 54.2 years (+/-15.3 years). The most frequent cancers were: colorectal (28%), stomach (16%) and breast (12%). The 14 GIS included in the scale were experienced by all patients, so they were retained, and no other addition was required. The average time of application of the instrument was 5 minutes, and 90% of the participants considered it appropriate. Conclusions: A 14-item instrument was generated to measure GIS in cancer patients who undergo outpatient chemotherapy, which is of fast application and uses a language that is easily understood by patients. Its clinimetrics properties remain to be defined.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cross-Cultural Comparison , Surveys and Questionnaires , Drug-Related Side Effects and Adverse Reactions/classification , Gastrointestinal Diseases/chemically induced , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Outpatients , Translating , Colombia , Comprehension , National Cancer Institute (U.S.) , Gastrointestinal Diseases/classification , Gastrointestinal Diseases/diagnosis
2.
Rev. chil. pediatr ; 91(4): 623-630, ago. 2020.
Article in Spanish | LILACS | ID: biblio-1138681

ABSTRACT

Resumen: SARS-CoV-2 es un virus de alta estabilidad ambiental. Es principalmente un patógeno respiratorio que también afecta el tracto gastrointestinal. El receptor ACE2 es el principal receptor de SARS- CoV-2, hay evidencia de su elevada presencia en intestino, colon y colangiocitos; igualmente se en cuentra expresado en hepatocitos pero en menor proporción. SARS-CoV-2 tiene un tropismo gas trointestinal que explica los síntomas digestivos y la diseminación viral en deposiciones. Las caracte rísticas de SARS-CoV-2 incluyen a la proteína S (Spike o Espícula) que se une de forma muy estable al receptor ACE2. La infección por SARS-CoV-2 produce disbiosis y alteraciones en el eje pulmón- intestino. A nivel intestinal y hepático produce una respuesta Linfocitos T evidente y una respuesta de citocinas que producirían daño intestinal inflamatorio. Las manifestaciones a nivel intestinal en orden de frecuencia son pérdida de apetito, diarrea, náuseas, vómitos y dolor abdominal. Éste último podría ser un marcador de gravedad. En niños la diarrea es habitualmente leve y autolimitada. A nivel hepático la hipertransaminasemia ocurre en 40-60% de los pacientes graves. SARS-CoV-2 puede per manecer en deposiciones un tiempo más prolongado que en secreciones respiratorias, este hallazgo influiría en la diseminación de enfermedad. En esta revisión se destaca la importancia de efectuar un reconocimiento precoz de las manifestaciones gastrointestinales y hepáticas, aumentar el índice de sospecha, efectuar un diagnóstico oportuno y reconocer eventuales complicaciones de la enferme dad. La potencial transmisión fecal oral puede influir en la diseminación de enfermedad. Reconocer este hallazgo es importante para definir aislamiento.


Abstract: SARS-CoV-2 is a high environmental stable virus. It is predominantly a respiratory pathogen that also affects the gastrointestinal tract. The ACE 2 receptor is the main receptor of SARS-CoV-2, with evidence of its high presence in the intestine, colon and cholangiocytes, and, in smaller proportion, in hepatocytes. SARS-CoV-2 has a gastrointestinal tropism that explains digestive symptoms and viral spread in stools. The characteristics of this virus include the S (Spike) protein that binds very stably to the ACE-2 receptor and, at the same time, SARS-CoV-2 produces dysbiosis and alterations in the gut-lung axis. It produces a clear T-cell response and a cytokines storm in the intestine and liver that would produce inflammatory bowel damage. Intestinal manifestations by order of frequency are loss of appetite, diarrhea, nausea and vomiting, and abdominal pain, where the latter could be a severity marker. In children, diarrhea is the most frequent symptom, usually mild and self-limiting. In the liver, hypertransaminasemia occurs in severe patients ranging from 40 to 60%. SARS-CoV-2 can re main in stools longer than in respiratory secretions, which would influence the spread of disease. This article highlights the importance of an early diagnosis of gastrointestinal and hepatic manifestations, increase the index of suspicion, make a timely diagnosis, and recognize eventual complications of the disease. The potential oral-fecal route of transmission may influence the disease spread. Recognizing this finding is important to define isolation.


Subject(s)
Humans , Child , Pneumonia, Viral/complications , Coronavirus Infections/complications , Gastrointestinal Diseases/virology , Liver Diseases/virology , Pneumonia, Viral/diagnosis , Severity of Illness Index , Cytokines/metabolism , Coronavirus Infections/diagnosis , Peptidyl-Dipeptidase A/metabolism , Clinical Laboratory Techniques , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/physiopathology , Liver Diseases/diagnosis , Liver Diseases/physiopathology
5.
Rev. bras. parasitol. vet ; 28(1): 168-171, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-1042496

ABSTRACT

Abstract Animals reared in restricted environments are highly susceptible to gastrointestinal infection by helminths and protozoa and therefore zoos are characterized as being parasite-rich environments. Successful implementation of control programs of these parasites in zoo environment depends upon precise and rapid diagnosing of gastrointestinal infections. The aim of this study was to demonstrate the role of the Mini-FLOTAC technique in combination with Fill-FLOTAC for rapidly diagnosing parasitic infections in zoo mammals. Fecal samples were collected from 70 animals in four different zoos located in central and southern Italy. All the samples were analyzed using Mini-FLOTAC in combination with Fill-FLOTAC. Out of the 70 pooled samples examined, 80% (24/30) were positive for at least one parasite. Among the gastrointestinal nematodes, Strongyles were the most frequent (40%), followed by Trichuris spp. (23.3%), Parascaris spp. (13.3%) and Capillaria spp. (3.3%). Among the protozoa, Blastocystis spp., Giardia spp. and Eimeria spp. were detected in 6.6%, 3.3% and 3.3%, respectively. These results show that Mini-FLOTAC in combination with Fill-FLOTAC can be used, not only for rapidly diagnosing parasitic infections in zoo mammals, but also for monitoring control programs in which large numbers of fecal samples need to be examined rapidly and reliably.


Resumo Animais criados em ambiente restritos são altamente suscetíveis a infecção gastrointestinal por helmintos e protozoários, constituindo os zoológicos em ambientes com alta contaminação por parasitos. O sucesso da implementação de programas de controle contra estes parasitos em zoológicos depende do rápido diagnóstico das infecções por parasitas gastrointestinais. O objetivo deste estudo foi demonstrar o papel da técnica do Mini-FLOTAC em combinação com o Fill-FLOTAC no diagnóstico rápido das infecções parasitárias em mamíferos em zoológicos. Amostras de fezes foram coletadas de 70 animais de quatro diferentes zoológicos no centro e sudoeste da Itália. Todas as amostras foram analisadas pela técnica do Mini-FLOTAC em combinação com o Fill-FLOTAC. Do total de 70 pools de fezes examinadas, 80% (24/30) foram positivas para pelo menos um parasito. Entre os nematoides gastrointestinais a maior frequência foi observada para estrongilídeos (40%), seguida por Trichuris spp. (23,3%), Parascaris spp. (13,3%) e Capillaria spp. (3,3%). Entre os protozoários Blastocystis spp., Giardia spp. e Eimeria spp. foram detectados em 6,6%, 3,3% e 3,3%, respectivamente. Estes resultados demonstram que a técnica do Mini-FLOTAC em combinação com o Fill-FLOTAC pode ser utilizada não somente para o diagnóstico rápido das infecções parasitárias em mamíferos em zoológicos, mas também no monitoramento de programas de controle onde grande número de amostras fecais devem ser examinadas de forma rápida e confiável.


Subject(s)
Animals , Parasitic Diseases, Animal/diagnosis , Protozoan Infections/diagnosis , Gastrointestinal Diseases/veterinary , Helminthiasis, Animal/diagnosis , Animals, Zoo/parasitology , Mammals/parasitology , Parasitic Diseases, Animal/parasitology , Protozoan Infections/parasitology , Reagent Kits, Diagnostic , Sensitivity and Specificity , Feces/parasitology , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/parasitology , Helminthiasis, Animal/parasitology
6.
Rev. chil. pediatr ; 89(6): 726-731, dic. 2018. tab
Article in Spanish | LILACS | ID: biblio-978147

ABSTRACT

Resumen: Introducción: Hay pocos estudios sobre Desórdenes Gastrointestinales Funcionales superpuestos (DGFs-s). Objetivo: Describir la prevalencia y posibles factores de riesgo en niños Latinoamericanos (Latam) para presentar DGFs-s. Pacientes y Método: Estudio de prevalencia en niños escolares La tam entre 8-18 años. Se incluyeron variables sociodemográficas; se utilizaron los Criterios de Roma III en español, y se consideró DGFs-s cuando se presentaron 2, 3 o 4 y más DGFs en un mismo niño. El análisis estadístico incluyó t de student, chi cuadrado, prueba exacta de Fisher, análisis uni y multivariados y cálculo de los ORs e IC95%, siendo considerada una p < 0,05 significativa. Resul tados: Fueron analizados 6193 niños Latam (11,8 ± 2,2 años; 62,2% entre 8-12 años; 50,4% niñas; 68,0% colegio público), con diagnóstico de algún DGFs del 23,4%. Hubo superposición de DGFs en un mismo niño, en 8,4% (5,5% con 2 DGFs; 2,1% con 3 DGFs y 0,9% con 4 o más DGFs), siendo las principales superposiciones el Síndrome de intestino irritable (SII) + Dolor abdominal funcio nal (DAF) (2,6%) y el SII + DAF + Estreñimiento funcional (1,1%). Hubo predomino del género femenino. Conclusión: Hay una baja prevalencia de DGFs-s en escolares y adolescentes Latam, con predominio en el sexo femenino y de presentación muy variable.


Abstract: Introduction: There are few studies on overlapping Functional Gastrointestinal Disorders (FGIDs). Objective: To describe the prevalence and possible risk factors in Latin American children (Latam) to present overlapping FGIDs. Patients and Method: Prevalence study in Latam schoolchildren bet ween 8-18 years of age. Sociodemographic variables were included; the Rome III Criteria in Spanish were used, and overlapping FGIDs were considered when two, three or four and more FGIDs were presented in the same child. The statistical analysis included Student's T-test, chi-square test, Fisher's exact test, univariate and multivariate analysis, and calculation of ORs and 95% CI, being considered a significant p < 0.05. Results: 6,193 Latam children were analyzed (11.8 ± 2.2 years, 62.2% between 8-12 years of age, 50.4% girls, 68.0% public school), and 23.4% with a diagnosis of some kind of FGIDs. There was overlap of FGIDs in the same child, in 8.4% (5.5% with 2 FGIDs, 2.1% with 3 FGIDs and 0.9% with 4 or more FGIDs), the main overlaps were irritable bowel syndrome (IBS) + functional abdominal pain (FAP) (2.6%), and IBS + FAP + functional constipation (1.1%). There was predominance of the female gender. Conclusion: There is a low prevalence of overlapping FGIDs in Latam schoolchildren and adolescents, with a predominance in females and of very variable pre sentation.


Subject(s)
Humans , Male , Female , Child , Adolescent , Gastrointestinal Diseases/epidemiology , Comorbidity , Prevalence , Cross-Sectional Studies , Risk Factors , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/etiology , Latin America/epidemiology
7.
Rev. méd. Chile ; 146(5): 555-561, mayo 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-961431

ABSTRACT

Background: Helicobacter pylori (HP) is the most widespread chronic human infection worldwide and the most important pathogenic factor of gastric cancer. The calculated prevalence at the Clinical Hospital of the University of Chile from 2002 to 2005 was 44.9%. Aim: To determine the current prevalence of HP in patients undergoing an upper gastrointestinal endoscopy (UGI) and analyze its distribution according to age and endoscopic findings. Material and Methods: We reviewed 3.433 UGI performed during the year 2015, selecting those in which rapid urease test (RUT) was done. A positive RUT or a positive gastric biopsy (GB) were considered as HP infection. Results: RUT was done in 1862 UGI (55%) performed in patients aged 51 ± 17 years, (66% women). In 23% of these endoscopies, the RUT was positive. A GB was obtained 43% of endoscopies and 30% were positive for HP. In 105 patients the RUT was negative and the GB positive (rendering a 19.5% false negative rate). HP was detected by RUT and GB in 29% of endoscopies. The highest prevalence of infection (38.1%) was found between 40 and 49 years. HP infection had odds ratio of 4.24 for nodular gastropathy, 2.63 for gastric ulcer and 2.14 for duodenal ulcer (p < 0.05). Conclusions: HP prevalence in our center decreased significantly from 44.9% to 28.9% in 11 years. False negative RUT results may bias this finding. The use of proton pump inhibitors and antimicrobials that can interfere with the detection of HP should be registered to properly analyze the results of the RUT.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Gastrointestinal Diseases/microbiology , Biopsy , Chile/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies , Endoscopy, Gastrointestinal , Helicobacter Infections/epidemiology , Age Distribution , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/epidemiology
8.
Gastroenterol. latinoam ; 29(supl.1): S24-S27, 2018. tab
Article in Spanish | LILACS | ID: biblio-1117650

ABSTRACT

Acute infectious diarrhea is still a major public health problem, both in developing and developed countries, causing morbidity, mortality and high costs. Acute diarrhea particularly affects people in extrema age ranges, travelers and immunosuppressed individuals. Traditional microbiological study, based on cultures, direct microscope analysis, and antigen tests show poor performance, due to low sensitivity and specificity, slowness and the diversity of bacteria, viruses and parasites that complicate getting the results. New molecular techniques based on multiple polymerase chain reaction (PCR) kits allow for the identification, in few hours and simultaneously, of many agents, such as bacteria, viruses and parasites, with high sensitivity and specificity; which will probably transform etiological diagnosis of acute diarrhea


La diarrea aguda infecciosa continúa siendo un problema de salud pública tanto en países en vías de desarrollo como en países desarrollados, causando morbi-mortalidad y grandes gastos económicos. Las diarreas agudas son especialmente importantes en personas con edades extremas, viajeros e inmunodeprimidos. El estudio microbiológico tradicional basado en cultivos, análisis microscópico directo y pruebas de antígenos tiene un rendimiento pobre, dado por su baja sensibilidad y especificidad, lentitud y la gran diversidad de bacterias, virus y parásitos que dificultan la obtención de resultados. Las nuevas técnicas de diagnóstico molecular basadas en kits de reacción de polimerasa en cadena (PCR) múltiple permiten identificar en pocas horas y en forma simultánea una gran cantidad de agentes, tanto bacterias, virus, como parásitos, con alta sensibilidad y especificidad, lo que probablemente transformará el diagnóstico etiológico de las diarreas agudas.


Subject(s)
Humans , Dysentery/diagnosis , Dysentery/etiology , Polymerase Chain Reaction , Molecular Diagnostic Techniques , Dysentery/microbiology , Gastrointestinal Diseases/complications , Gastrointestinal Diseases/diagnosis
9.
Gastroenterol. latinoam ; 29(supl.1): S21-S23, 2018.
Article in Spanish | LILACS | ID: biblio-1117633

ABSTRACT

The gastrointestinal lymphoid system plays a relevant role. The daily and continuous interaction between gastrointestinal lymphocytes with food and intestinal microbes requires precise functioning. The pathologic spectrum of lymphocyte malfunction results in lymphomas. MALT lymphoma is the most frequently diagnosed lymphoma, but there are other lymphoproliferative diseases such as diffuse large B cell lymphoma, mantle cell lymphoma and T associated lymphoma. The gastroenterologist and the endoscopist need to know these diseases in detail to achieve early diagnosis and treatment.


El sistema linfoide de defensa abdominal tiene un relevante rol en el buen funcionamiento sistémico. La interacción diaria y continua con patógenos alimentarios y microbios comensales intestinales precisa un estrecho funcionamiento. Las alteraciones linfoides clonales favorecen el desarrollo de linfomas de diversos tipos. Si bien, el linfoma asociado a tejido linfoide de mucosas (MALT) es el más conocido en contexto de su asociación con Helicobacter pylori, el tracto gastrointestinal se puede ver afectado por otros linfomas como el linfoma difuso de células grandes B y linfomas indolentes como el linfoma folicular, el linfoma del manto y el linfoma T asociado a enteropatía. El gastroenterólogo y endoscopista precisan conocer en detalle estas entidades para un oportuno diagnóstico y adecuado tratamiento.


Subject(s)
Humans , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/therapy , Lymphoproliferative Disorders/diagnosis , Lymphoproliferative Disorders/therapy , Helicobacter pylori , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/therapy , Lymphoma, B-Cell, Marginal Zone/diagnosis , Lymphoma, B-Cell, Marginal Zone/therapy , Lymphoma, Mantle-Cell/therapy , Enteropathy-Associated T-Cell Lymphoma/diagnosis , Enteropathy-Associated T-Cell Lymphoma/therapy
10.
Gastroenterol. latinoam ; 29(supl.1): S45-S48, 2018.
Article in Spanish | LILACS | ID: biblio-1117779

ABSTRACT

Chagas disease is an endemic zoonosis that can cause chronic medical complications in a third of those infected, usually decades after infection. It mainly affects the peripheral nervous system of heart, esophagus and colon. At digestive level, motor dysfunction leads to the development of megaesophagus and megacolon whose predominant symptoms are dysphagia and constipation. It should be suspected in patients with epidemiological history and compatible symptoms. In the chronic phase it is confirmed with the detection of specific antibodies. The etiological treatment is effective in early stages after infection. In the chronic stage the management is symptomatic, medical and/or surgical.


La enfermedad de Chagas es una zoonosis endémica que puede producir complicaciones médicas crónicas en un tercio de los infectados, habitualmente décadas luego de la infección. Afecta principalmente el sistema nervioso periférico de corazón, esófago y colon. A nivel digestivo la disfunción motora lleva a la formación de megaesófago y megacolon cuyos síntomas predominantes son disfagia y constipación. Debe sospecharse en pacientes con antecedentes epidemiológicos y síntomas compatibles. En la fase crónica se confirma con la detección de anticuerpos específicos. El tratamiento etiológico es efectivo en las fases tempranas post-contagio. En la etapa crónica el manejo es sintomático, médico y/o quirúrgico.


Subject(s)
Humans , Chagas Disease/complications , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/parasitology , Gastrointestinal Diseases/therapy , Trypanosoma cruzi/pathogenicity , Esophageal Achalasia/parasitology
11.
Arq. bras. med. vet. zootec. (Online) ; 69(6): 1451-1455, nov.-dez. 2017.
Article in English | LILACS, VETINDEX | ID: biblio-910029

ABSTRACT

The study has been conducted over a period of 4 years, on a total number of 133 dogs, all of those expressing gastrointestinal disorders. Ultrasound and endoscopic examinations were performed in all dogs in order to assess any significant correlations between ultrasonographic and endoscopic findings. The results confirm a significant correlation between the presence of diarrhoea and increased thickness of the large bowel wall, with P<0.5. Another extremely significant correlation we observed is the one between increased thickness of large bowel wall and loss of layering at this level, with P<0.5. Upper GI endoscopy revealed that dilated lacteals in the duodenum are significantly associated with the presence of diarrhoea, P<0.5 and, more importantly, there is a very significant correlation between dilated lacteals and the presence of striations (P<0.5), which confirms previous studies (Sutherland-Smith et al., 2007) that say the striated aspect of the intestinal mucosa is due to dilated lacteals.(AU)


O estudo foi conduzido durante um período de quatro anos, em um número total de 133 cães, todos os que expressam distúrbios gastrointestinais. Exames ultrassonográficos e endoscópicos foram realizados em todos os cães, a fim de se avaliarem as correlações significativas entre os achados ultrassonográficos e endoscópicos. Os resultados confirmam uma correlação significativa entre a presença de diarreia e o aumento da espessura da parede do intestino grande, com P<0,5. Outra correlação extremamente significativa observada é a única entre o aumento da espessura da parede do intestino grosso e a perda de camadas a esse nível, com P<0,5. GI superior endoscopia revelou que lacteals dilatados no duodeno estão significativamente associados com a presença de diarreia, P<0,5 e mais importante, não há uma correlação muito significativa entre lacteals dilatados e a presença de estrias (P<0,5), o que confirma estudos anteriores (Sutherland-Smith et al., 2007) que dizem que o aspecto estriado da mucosa intestinal está a ser dada pelos lacteals dilatados.(AU)


Subject(s)
Animals , Dogs , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/diagnostic imaging , Endoscopy/veterinary , Romania , Ultrasonography/veterinary
12.
ABCD arq. bras. cir. dig ; 30(2): 83-87, Apr.-June 2017. tab
Article in English | LILACS | ID: biblio-885717

ABSTRACT

ABSTRACT Background: The double balloon enteroscopy is an important method for the endoscopic approach of the small bowel that provides diagnosis and therapy of this segment's disorders, with low complication rate. Aim: Analysis of patients undergoing double balloon enteroscopy. The specific objectives were to establish the indications for this method, evaluate the findings by the double balloon enteroscopy, analyze the therapeutic options and the complications of the procedure. Methods: It is a retrospective analysis of 65 patients who underwent double balloon enteroscopy. Results: Sixty-five procedures were performed in 50 patients, 63.1% were women and 36.9% were men. The mean age was 50.94 years. The main indication it was gastrointestinal bleeding, followed by abdominal pain and Crohn's disease. Most procedures were considered normal. Polyps were the most prevalent finding, followed by angioectasias and duodenitis. In 49.2% of the cases, one or more therapeutic procedures were performed, (biopsy was the most prevalent). There was only one case of acute pancreatitis, which was treated clinically. Conclusion: The enteroscopy is good and safe method for the evaluation of the small bowel, and its main indications are gastrointestinal bleeding and abdominal pain. It has low complications rates and reduces the necessity of surgery.


RESUMO Racional: A enteroscopia por duplo balão é importante método endoscópico para abordagem do intestino delgado, permitindo o diagnóstico e a terapêutica de afecções com baixa taxa de complicações. Objetivo: Análise de pacientes submetidos à enteroscopia por duplo balão, estabelecendo as indicações para realização do exame e seus achados, analisando a terapêutica realizada e observando as complicações decorrentes do procedimento. Métodos: Estudo retrospectivo de análise de 65 prontuários de pacientes submetidos à enteroscopia por duplo balão. Os dados foram armazenados em planilhas e foi realizada a análise estatística. Resultados: Foram 65 enteroscopias em 50 pacientes, sendo 63,1% mulheres e 36,9% homens, com média de idade de 50,94 anos. A principal indicação foi sangramento intestinal, seguida por dor abdominal e doença de Crohn. A maioria dos procedimentos foi considerada normal, sendo que o achado mais prevalente foram os pólipos, seguido por angioectasias e duodenites. Em 49,2% dos exames foi realizado algum procedimento terapêutico, sendo a biópsia o mais prevalente. Houve apenas um caso de complicação de pancreatite aguda. Conclusão: A enteroscopia por duplo balão é bom e seguro método para a avaliação do intestino delgado, possuindo como principais indicações o sangramento intestinal e a dor abdominal. Possui baixas taxas de complicações e, por meio de suas opções terapêuticas, diminui a necessidade de procedimentos cirúrgicos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Double-Balloon Enteroscopy/adverse effects , Gastrointestinal Diseases/surgery , Gastrointestinal Diseases/diagnosis , Intestine, Small , Postoperative Complications/etiology , Retrospective Studies
13.
Rev. paul. pediatr ; 34(3): 388-392, July-Sept. 2016. graf
Article in English | LILACS | ID: lil-794960

ABSTRACT

Abstract Objective: To describe the case of an infant with Hirschsprung's disease presenting as total colonic aganglionosis, which, after surgical resection of the aganglionic segment persisted with irreversible functional intestinal obstruction; discuss the difficulties in managing this form of congenital aganglionosis and discuss a plausible pathogenetic mechanism for this case. Case description: The diagnosis of Hirschsprung's disease presenting as total colonic aganglionosis was established in a two-month-old infant, after an episode of enterocolitis, hypovolemic shock and severe malnutrition. After colonic resection, the patient did not recover intestinal motor function that would allow enteral feeding. Postoperative examination of remnant ileum showed the presence of ganglionic plexus and a reduced number of interstitial cells of Cajal in the proximal bowel segments. At 12 months, the patient remains dependent on total parenteral nutrition. Comments: Hirschsprung's disease presenting as total colonic aganglionosis has clinical and surgical characteristics that differentiate it from the classic forms, complicating the diagnosis and the clinical and surgical management. The postoperative course may be associated with permanent morbidity due to intestinal dysmotility. The numerical reduction or alteration of neural connections in the interstitial cells of Cajal may represent a possible physiopathological basis for the condition.


Resumo Objetivo: Descrever o caso de um lactente portador de doença de Hirschsprung na forma aganglionose colônica total que, após a ressecção cirúrgica do segmento agangliônico, manteve quadro irreversível de obstrução intestinal funcional; discutir as dificuldades no manejo dessa forma da aganglionose congênita e apontar um mecanismo patogenético plausível para o caso. Descrição do caso: O diagnóstico de doença de Hirschsprung na forma aganglionose colônica total foi definido em lactente aos dois meses de vida, após episódio de enterocolite, choque hipovolêmico e desnutrição grave. Após ressecção colônica, o paciente não recuperou a função motora intestinal que possibilitasse a alimentação via enteral. O exame do íleo remanescente pós-operatório mostrou presença de plexos ganglionares e redução numérica das células intersticiais de Cajal em segmentos proximais do intestino. Aos 12 meses de vida, o paciente mantém-se dependente de nutrição parenteral total. Comentários: A doença de Hirschsprung na forma aganglionose colônica total tem particularidades clínico-cirúrgicas que a diferenciam das formas clássicas e dificultam o diagnóstico e o manejo clínico-cirúrgico. A evolução pós-operatória pode associar-se à morbidade permanente decorrente de dismotilidade intestinal. A redução numérica ou as alterações das conexões neurais das células intersticiais de Cajal podem representar uma possível base fisiopatológica para a condição.


Subject(s)
Humans , Male , Infant , Gastrointestinal Motility , Hirschsprung Disease/surgery , Postoperative Complications/diagnosis , Gastrointestinal Diseases/diagnosis
14.
Arq. gastroenterol ; 53(3): 146-151, tab, graf
Article in English | LILACS | ID: lil-787354

ABSTRACT

ABSTRACT Background - Bowel function is a widely evaluated parameter in interventional and longitudinal studies since it is associated with good maintenance of health. The evaluation of intestinal function has been performed by many questionnaires, however, there are few options validated in Brazilian Portuguese. Objective - The aim of this work was to translate and validate into Brazilian Portuguese the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Methods - Translation and cultural adaptation were performed according to a previously established methodology followed by reliability calculations. Results - The final translated GSRS questionnaire showed an adequate value of overall reliability of Cronbach's alpha of 0.83, and its domains were classified from acceptable to adequate. The overall test-retest reliability by intraclass correlation coefficient (ICC) was 0.84, considered excellent. Conclusion - The GSRS was translated and validated into Brazilian Portuguese, with appropriate internal consistency and reliability and is available to be used in assessments of bowel function.


RESUMO Contexto - O funcionamento intestinal é um dos parâmetros amplamente avaliado em estudos intervencionais e longitudinais, pois está associado à manutenção da saúde. A avaliação do funcionamento intestinal tem sido realizada por diferentes questionários, mas são poucas as alternativas validadas em português. Objetivo - O objetivo deste trabalho foi traduzir e validar para a língua portuguesa (Brasil) o questionário Gastrointestinal Symptom Rating Scale (GSRS). Métodos - A tradução e adaptação cultural foram realizadas de acordo com metodologia previamente estabelecida, seguida dos cálculos de confiabilidade. Resultados - A aplicação do questionário GSRS traduzido apresentou valor de confiabilidade geral alfa de Cronbach de 0,83, classificado como adequado, e seus domínios foram classificados de aceitável a adequado; o teste-reteste geral apresentou coeficiente de correlação intraclasse de 0,84, considerado excelente. Conclusão - O GSRS foi traduzido e validado para Português (Brasil), apresentando confiabilidade e reprodutibilidade apropriadas, e está disponível para ser utilizado em avaliações de funcionamento intestinal.


Subject(s)
Humans , Male , Female , Adult , Translations , Surveys and Questionnaires/standards , Symptom Assessment , Gastrointestinal Diseases/diagnosis , Psychometrics , Brazil , Cross-Cultural Comparison , Reproducibility of Results , Language , Middle Aged
15.
Braz. j. microbiol ; 47(1): 167-171, Jan.-Mar. 2016. tab, graf
Article in English | LILACS | ID: lil-775116

ABSTRACT

Abstract Helicobacter pylori infection is usually acquired in early childhood and it can persist throughout life without antibiotic treatment. This study aimed to compare the accuracy of the noninvasive H. pylori Stool Antigen Test-applied on the stool samples with the invasive gold standart Rapid Urease Test-applied on the gastric biopy samples of patients with upper gastrointestinal complaints. After endoscopy, biopsy and stool specimens were taken in 122 patients. The infection was detected with rapid urease test which is accepted as gold standart test. Rapid, one-step H. pylori card test was applied to all patients stool specimens. In this study 106 of the 122 patients (86.8%) were positive for H. pylori infection, while 16 of the 122 patients (13.2%) were negative. H. pylori card test was negative in 13 of the 16 patients and was positive in 98 of the 106. The sensitivity, specifity, positive and negative predictive values were 92.45%, 81.25%, 97.02%, and 61.90%, respectively. H. pylori card test is rapid, easy, noninvasive and inexpensive methods for detection H. pylori infection. This test showed high sensitivity and specificity. Additionally, it may be a good alternative to invasive tests for the detection of H. pylori infections especially in children.


Subject(s)
Humans , Antigens, Bacterial/analysis , Feces/microbiology , Gastrointestinal Diseases/diagnosis , Helicobacter pylori/isolation & purification , Feces/chemistry , Predictive Value of Tests , Sensitivity and Specificity
16.
Journal of the Egyptian Society of Parasitology. 2016; 46 (1): 145-156
in English | IMEMR | ID: emr-180170

ABSTRACT

Upper gastrointestinal tract [GIT] symptoms are not disease specific and of limited value in the differentiation of GIT disorders. The present study aimed to determine the etiology of chronic unspecific symptoms in children and to test the need for upper endoscopy in diagnosis


This is a prospective study for 30 Egyptian children presented with chronic upper GIT symptoms for at least 2 months. History regarding severity and frequency of GIT symptoms were asked for. Children with known disorder that explains presenting symptoms were excluded. Upper GIT endoscopy was performed and 5 biopsies were obtained for pathological examination and for H pylori testing


The results showed that children age ranged between 2.5-18 years with mean +/- SD of 13.6 +/- 3.4 and 63.3% were females. The main complaints were epigastric pain in 43.3%, hematemesis in 30% and vomiting in 26.7%. Motility disorders were diagnosed in 66.7% children; in the form of GERD in 63.3% and achalasia in one. Complication of GERD in the form of erosive esophagitis was present in 15.8% children, while Barrett's esophagus was not observed. H. pylori infection was diagnosed in 80% histologically. Eosinophilic esophagitis was not detected


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Chronic Disease , Pilot Projects , Gastrointestinal Diseases/diagnosis , Prospective Studies
17.
Braz. j. vet. res. anim. sci ; 53(2): 127-137, 2016. tab
Article in English | LILACS | ID: lil-789925

ABSTRACT

Enumeration of nematode eggs in fecal samples using the McMaster technique and morphological identification of third stage larvae from fecal cultures have been extensively used with satisfactory results in the diagnosis of the gastrointestinal nematode infections in ruminants. In order to improve sensitivity and accuracy, other approaches for quantification of eggs have been employed, like the FLOTAC and Mini-FLOTAC techniques. Results obtained in different studies indicate that fecal egg counts are a reliable measure of the size of the worm burden. However, the immunological status of the animals should be taken into consideration to interpret the results of the fecal examination. Molecular techniques have also been useful in the diagnosis of parasitic diseases. The ultimate in diagnosis has been the development of robotic platforms that enable separation of eggs from feces. Because manipulation is minimal, good quality DNA from eggs is obtained, which is used for amplification, and finally, produces a result indicating the degree of the infection by the different parasite species in mix infections. The ideal method should be reliable, friendly to non-experts and quick to perform. With the advance in robotics, bioinformatics and molecular biology, methods with such characteristics are expected to become available and affordable to be used in laboratories for the routine diagnosis of gastrointestinal nematodes of ruminants...


A quantificação de ovos de nematoides em amostras de fezes e a identificação morfológica das larvas de terceiro estágio a partir de culturas de fezes têm sido amplamente utilizadas, com resultados satisfatórios para o diagnóstico das infecções por nematoides gastrintestinais em ruminantes. Com o intuito de melhorar a sensibilidade na detecção dos ovos, outras técnicas, tais como Flotac e Miniflotac, têm sido empregadas. Resultados obtidos em diferentes estudos indicam que a contagem de ovos nas fezes é uma medida confiável e representativa da magnitude da carga parasitária. No entanto, o estado imunológico dos animais deve ser considerado na interpretação dos resultados coproparasitológicos. As técnicas moleculares também têm sido úteis no diagnóstico das enfermidades parasitárias. Os maiores avanços no diagnóstico têm sido propiciados pelo desenvolvimento de plataformas robóticas, que separam os ovos das fezes com pouca manipulação, propiciando a obtenção de DNA de ovos de boa qualidade, o que resulta em uma amplificação que possibilita indicar o grau da infecção pelas diferentes espécies de parasitas em infecções mistas. O método ideal deve ser preciso, rápido e de fácil execução por não-especialistas. Com o avanço da robótica, bioinformática e biologia molecular, espera-se que equipamentos com tais características se tornem disponíveis e acessíveis para serem utilizados na rotina laboratorial para o diagnóstico de nematoides gastrintestinais deruminantes...


Subject(s)
Animals , Parasite Egg Count/classification , Parasite Egg Count/veterinary , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/veterinary , Haemonchus/isolation & purification , Ruminants , Nematode Infections/veterinary
18.
Yonsei Medical Journal ; : 22-32, 2016.
Article in English | WPRIM | ID: wpr-199917

ABSTRACT

Behcet's disease (BD) is a multi-systemic inflammatory disorder of an unknown etiology and shows a chronic recurrent clinical course. When the disease involves the alimentary tract, it is called intestinal BD because of its clinical importance. Intestinal BD is more frequently reported in East Asian countries than in Western or Middle Eastern countries. While any part of the gastrointestinal tract can be involved, the most common location of intestinal BD is the ileocecal area. A few, large, deep ulcerations with discrete border are characteristic endoscopic findings of intestinal BD. Currently, there is no single gold standard test or pathognomonic finding of intestinal BD. However, recently developed novel diagnostic criteria and a disease activity index have helped in assessing intestinal BD. As intestinal BD shares a lot of characteristics with inflammatory bowel disease, including genetic background, clinical manifestations, and therapeutic strategies, distinguishing between the two diseases in clinical practice is quite difficult. However, biologic agents such as anti-tumor necrosis factor alpha antibody shows a considerable efficacy similar to inflammatory bowel disease cases. It is important to distinguish and treat those two disease entities separately from the standpoint of precise medicine. Clinicians should require comprehensive knowledge regarding the similarities and differences between intestinal BD and inflammatory bowel disease for making an accurate clinical decision.


Subject(s)
Behcet Syndrome/diagnosis , Diagnosis, Differential , Gastrointestinal Diseases/diagnosis , Humans , Inflammatory Bowel Diseases , Male , Middle Aged , Systemic Vasculitis/diagnosis , Treatment Outcome , Tumor Necrosis Factor-alpha/therapeutic use
19.
Rev. latinoam. enferm ; 23(2): 315-322, Feb-Apr/2015. tab
Article in English | LILACS, BDENF | ID: lil-747169

ABSTRACT

OBJECTIVE: To analyse the perception of psychosocial factors and mental workload of nurses who work in intensive care units. It is hypothesised that nurses in these units could perceive psychosocial risks, manifesting in a high mental work load. The psychosocial dimension related to the position's cognitive demands is hypothesised to mostly explain mental work load. METHOD: Quantitative study, with a descriptive, cross-sectional, and comparative design. A total of 91% of the intensive care unit populations of three Chilean hospitals was surveyed, corresponding to 111 nurses. The instruments utilised included (A) a biosociodemographic history questionnaire; (b) the SUSESO-ISTAS 21 questionnaire; and (c) the Mental Work Load Subjective Scale (ESCAM, in Spanish). RESULTS: In total, 64% and 57% of participants perceived high levels of exposure to the psychosocial risks Psychosocial demands and Double shift, respectively. In addition, a medium-high level of overall mental load was observed. Positive and significant correlations between some of the SUSESO-ISTAS 21 and ESCAM dimensions were obtained. Using a regression analysis, it was determined that three dimensions of the psychosocial risk questionnaire helped to explain 38% of the overall mental load. CONCLUSION: Intensive care unit nurses felt that inadequate psychosocial factors and mental work overload existed in several of the tested dimensions. .


OBJETIVO: analisar a percepção de fatores psicossociais e a carga mental de trabalho de enfermeiros que trabalham em unidades de terapia intensiva. A hipótese é que os enfermeiros dessas unidades podem perceber os riscos psicossociais e manifestar uma alta carga mental de trabalho. Além disso, a dimensão psicossocial relacionada às demandas cognitivas do cargo explicaria a maior parte da carga mental de trabalho. MÉTODO: estudo quantitativo, com delineamento descritivo, transversal e comparativo. Foi examinada 91% da população das Unidades de Terapia Intensiva de três hospitais chilenos, correspondente a 111 enfermeiros. Os instrumentos utilizados incluíram (a) um questionário do histórico biossociodemográfico; (b) o questionário SUSESO-ISTAS 21; e (c) a Escala Subjetiva de Carga Mental de Trabalho (ESCAM). RESULTADOS: no total, 64% e 57% dos participantes perceberam um alto nível de exposição aos riscos psicossociais Demanda psicológica e Jornada dupla, respectivamente. Além disso, foi observado um nível de médio para alto de carga mental global. Foram obtidas correlações positivas e significativas entre algumas das dimensões do SUSESO-ISTAS 21 e do ESCAM. Utilizando uma análise de regressão, determinou-se que três dimensões do questionário de risco psicossocial ajudaram a explicar 38% da carga mental total. CONCLUSÃO: os enfermeiros das unidades de terapia intensiva percebem os fatores psicossociais e a sobrecarga mental de trabalho em várias de suas dimensões. .


OBJETIVO: analizar la percepción de Factores psicosociales y Carga mental de trabajo de enfermeras/os que laboran en Unidades Críticas. Se hipotetiza que los/as enfermeros/as de estas unidades pudieran percibir riesgos psicosociales; Mostrarán una Carga mental de trabajo alta; y la dimensión psicosocial relacionada con exigencias cognitivas del puesto explicará en mayor medida la Carga Mental. MÉTODO: estudio cuantitativo, de diseño descriptivo, transversal y comparativo. Se censó el 91% de la población de Unidades Críticas de tres hospitales chilenos, correspondiente a 111 enfermeras/os. Los instrumentos utilizados fueron: (a) Cuestionario de antecedentes biosociodemográficos; (b) Cuestionario SUSESO-ISTAS 21; y (c) Escala Subjetiva de Carga Mental de Trabajo (ESCAM). RESULTADOS: el 64% y el 57% de los/as participantes perciben un alto nivel de exposición a los riesgos psicosociales Demandas psicológicas y Doble presencia, respectivamente. Además, se obtiene un nivel de Carga mental global media-alta. Se obtuvo correlaciones positivas y significativas entre algunas dimensiones de SUSESO-ISTAS 21 y ESCAM, y mediante un análisis de regresión se obtuvo que tres dimensiones del cuestionario de riesgos psicosociales contribuyen a explicar un 38% de la Carga mental global. CONCLUSIÓN: las/os enfermeras/os de unidades críticas, perciben factores psicosociales inadecuados y sobrecarga mental de trabajo, en varias de sus dimensiones. .


Subject(s)
Humans , Female , Aged, 80 and over , Gastrointestinal Agents/therapeutic use , Gastrointestinal Diseases/drug therapy , Mastocytosis, Systemic/diagnosis , Octreotide/therapeutic use , Bone Marrow/pathology , Gastrointestinal Diseases/complications , Gastrointestinal Diseases/diagnosis , Mast Cells/immunology , Mast Cells/metabolism , Mast Cells/pathology , Mastocytosis, Systemic/complications , Tomography, X-Ray Computed
20.
Article in English | IMSEAR | ID: sea-159392

ABSTRACT

The mouth is a unique site, due to the presence of hard and soft tissues in close approximation. It serves in various purposes of speech, mastication and digestion. It is an important entry point for many pathogens in the body. Many systemic diseases manifest in the oral cavity and mouth can show early signs or the only signs of a disease process at a site elsewhere. As the mouth is an easily accessible site, the indicators it shows of various diseases should not be overlooked. A dentist thus can frequently be exposed to such conditions and play a key role in the diagnostic procedure of various systemic diseases. Appropriate knowledge of these oral manifestations is essential for early diagnosis, treatment and referral of cases.


Subject(s)
Endocrine System Diseases/diagnosis , Gastrointestinal Diseases/diagnosis , Hematologic Diseases/diagnosis , Humans , Metabolic Diseases/diagnosis , Mouth/pathology , Nutritional and Metabolic Diseases/diagnosis , Oral Manifestations/diagnosis , Oral Manifestations/epidemiology , Oral Manifestations/etiology , Rheumatic Heart Disease/diagnosis
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