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1.
Repert. med. cir ; 31(2): 123-132, 2022. ilus., tab.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1381091

ABSTRACT

Introducción: la enfermedad celíaca (EC) es una patología sistémica inmunomediada por el gluten en la dieta en personas genéticamente susceptibles con un amplio rango de manifestaciones clínicas, respuesta serológica específica y un daño variable de la mucosa intestinal. Objetivo: revisar la fisiopatología, manifestaciones clínicas, diagnóstico, tratamiento, seguimiento y pronóstico de la EC, resaltando la importancia de reconocerla y proponer un algoritmo diagnóstico para la población colombiana. Materiales y métodos: revisión crítica de la literatura científica en las bases de datos Medline y buscadores específicos PUBMED, SCIENCE DIRECT, SCIELO, filtrando resultados a revisiones sistemáticas, metaanálisis, ensayos controlados aleatorios y guías de práctica clínica, con un total de 1209 artículos, de los cuales se priorizaron 53. Resultados y discusión: la prevalencia de la EC viene en aumento en países en vía de desarrollo. El diagnóstico tiene tres pilares fundamentales: la identificación de casos de alto riesgo o sospecha por manifestaciones clínicas, un perfil serológico de anticuerpos específicos y hallazgos histológicos característicos. El tratamiento se basa en una dieta sin gluten, en la detección temprana de complicaciones y el manejo de las alteraciones nutricionales. Conclusión: en Colombia no existen protocolos de diagnóstico y tratamiento de la EC, como tampoco una legislación clara con respecto al etiquetado de productos libres de gluten. Hay que establecer estrategias para impactar el curso natural de la enfermedad, las morbilidades asociadas y la calidad de vida de los pacientes.


Introduction: celiac disease (CD) is a systemic diet-gluten-immune-mediated enteropathy occurring in genetically susceptible individuals featuring a broad range of clinical manifestations, a specific serological response and variable intestinal mucosal damage. Objective: to review CD pathophysiology, clinical manifestations, diagnosis, treatment, follow-up and prognosis, highlighting the importance of awareness about this disorder and development of a diagnostic algorithm for Colombian population. Materials and methods: scientific literature critical review in the Medline databases and PUBMED, SCIENCE DIRECT, SCIELO specific search engines, using filters to retrieve systematic reviews, metanalyses, randomized controlled trials and clinical practice guidelines, finding 1209 articles, prioritizing 53. Results and discussion: the prevalence of CD is increasing in developing countries. Diagnosis is based on 3 fundamental pillars: identification of higher-risk populations or suspicion based on clinical manifestations, serological profile of specific antibodies and characteristic histological findings. Treatment is based on a gluten-free diet, early detection of complications and nutritional alterations management. Conclusion: there are no CD diagnosis and treatment protocols, nor clear regulations on labelling gluten-free products, in Colombia. Establishing strategies to impact the natural course of CD, associated morbidities and quality of life, is required


Subject(s)
Celiac Disease , Algorithms , Serologic Tests , Diet , Diet, Gluten-Free , Intestinal Diseases
2.
Rev. bras. ciênc. vet ; 28(4): 176-180, out./dez. 2021.
Article in Portuguese | LILACS | ID: biblio-1363173

ABSTRACT

A doença gastrintestinal relacionada à areia, também conhecida como enteropatia arenosa, é uma enfermidade gastrintestinal comum nos equinos mantidos a campo em regiões com solo arenoso frouxo resultando em sinais clínicos variáveis incluindo dor abdominal aguda, perda de peso, diarréia intermitente e baixa performance. Este artigo tem por objetivo relatar três casos de diarreia crônica em equinos associada à enteropatia arenosa. Três equinos da raça Quarto de Milha, dois garanhões e uma égua, com idades variando de 3 a oito anos, e peso médio de 433,33 + 41,66 kg foram examinados para diagnóstico de diarreia crônica. Nenhum dos animais apresentou sinais clínicos de dor abdominal aguda ou cólica recorrente que necessitasse de atendimento emergencial nesse período. Os animais foram manejados clinicamente por meio da utilização de Psyllium em pó na dose de 1g/kg de peso vivo por via oral a cada 24 horas durante 21 dias, além do fornecimento de 8 gramas de probiótico comercial. O tratamento foi eficaz na resolução do quadro clínico dos três animais.


Sand related gastrointestinal disease, also known as sandy enteropathy, is a common gastrointestinal disease in horses kept in regions with loose sandy soil resulting in variable clinical signs including acute abdominal pain, weight loss, intermittent diarrhea and poor performance. This article aims to report three cases of chronic diarrhea in horses associated with sandy enteropathy. Three Quarter Horses, two stallions and one mare, with ages ranging from 3 to eight years, and a mean weight of 433.33 ± 41.66 kg were examined for diagnosis of chronic diarrhea. None of the animals showed clinical signs of acute abdominal pain or recurrent colic that required emergency care during this period. The animals were clinically managed using Psyllium powder at a dose of 1g/kg bodyweight orally every 24 hours for 21 days, in addition to providing 8 grams of commercial probiotic. The treatment was effective in resolving the clinical status of the three animals.


Subject(s)
Animals , Diarrhea/veterinary , Horse Diseases , Gastrointestinal Tract/pathology , Horses , Intestinal Diseases/veterinary
3.
Rev. cuba. pediatr ; 93(3): e1160, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347543

ABSTRACT

Introducción: La ascariasis es una enteroparasitosis con alta prevalencia en la población pediátrica tercermundista, la cual puede asociarse a otras enfermedades intestinales y tener graves complicaciones que requieren tratamiento quirúrgico. Objetivo: Informar el caso de un infante operado por coinfección de ascariasis intestinal y fiebre tifoidea complicadas. Presentación del caso: Paciente masculino de 9 años de edad asistido y operado en el hospital provincial N´gola Kimbanda de la provincia Namibe, Angola, por presentar evidencia clínica de peritonitis aguda generalizada por perforación intestinal de causa tifoidea y por cuyo orificio salían además áscaris lumbricoides vivos. Su evolución no fue satisfactoria y falleció 24 horas después de la operación. Conclusiones: El diagnóstico y tratamiento quirúrgico oportuno de la coinfección letal de ascariasis y fiebre tifoidea complicadas permitirá disminuir la morbilidad y mortalidad por esta prevalente asociación(AU)


Introduction: Ascariasis is an enteroparasitosis with high prevalence in the third-world pediatric population, which can be associated with other bowel diseases and have serious complications that require surgical treatment. Objective: Report the case of an infant operated by the co-infection of complicated intestinal ascariasis and typhoid fever. Case presentation: 9-year-old male patient attended and operated at N'gola Kimbanda Provincial Hospital in Namibe Province, Angola, after presenting clinical evidence of generalized acute peritonitis due to intestinal perforation of typhoid-causing and through which live ascaris lumbricoide also came out. His evolution was unsatisfactory and he died 24 hours after the operation. Conclusions: The timely diagnosis and surgical treatment of lethal co-infection of complicated ascariasis and typhoid fever will reduce morbidity and mortality from this prevalent association(AU)


Subject(s)
Humans , Male , Child , Peritonitis/etiology , Ascariasis/epidemiology , Ascaris lumbricoides/parasitology , Intestinal Diseases/complications , Intestinal Perforation/surgery , Research Report , Coinfection/mortality
4.
Rev. cuba. pediatr ; 93(1): e1384, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251753

ABSTRACT

Introducción: Los probíóticos de próxima generación son novedosa bioterapia activa surgida en el último decenio basados en bacterias comensales desconocidas, aisladas por métodos de biología molecular y que representan nuevo desafío para ser usadas en afecciones específicas relacionadas con severas alteraciones de disbiosis en la microbiota intestinal. Objetivo: Analizar las características de los candidatos a probióticos de próxima generación por sus mecanismos de acción y valor de su aplicación para el tratamiento de afecciones metabólicas y sistémicas específicas. Métodos: Se revisaron publicaciones en español e inglés en PubMed, Scimago, ScIELO, desde enero 2010 a julio 2020, se usaron los términos: probiótico de próxima generación, probióticos, microbiota intestinal, disbiosis. Resultados: Se actualizaron criterios sobre probióticos de próxima generación, concepto, mecanismos de acción, especificidades, resultados de investigaciones en ratones y limitados estudios en humanos en enfermedades específicas sistémicas y síndromes metabólicos, como obesidad, diabetes mellitus tipo 2, enfermedades inflamatorias intestinales y cáncer. Se revisaron antecedentes históricos, indicaciones como bioterapéuticos en enfermedades intestinales y rasgos diferenciales de probióticos de próxima generación con probióticos tradicionales. Consideraciones finales: Los conocimientos surgidos en el último decenio en estudios con bacterias comensales intestinales, no aisladas previamente, surgen como probióticos de próxima generación para bioterapia activa en el tratamiento de elección en alteraciones de disbiosis severa de la microbiota intestinal, asociadas a enfermedades específicas sistémicas que cursan con síndrome metabólico. Las evidencias experimentales abren promisorio camino para influir en mejoría o resolución de dichas afecciones(AU)


Introduction: Next-generation probiotics are novel active biotherapy that has emerged over the past decade based on unknown commensal bacteria, isolated by molecular biology methods and representing a new challenge to be used in specific conditions related to severe alterations of dysbiosis in the gut microbiota. Objective: Analyze the characteristics of next generation probiotic candidates due to their mechanisms of action and the value of their application for the treatment of specific metabolic and systemic conditions. Methods: Publications from January 2010 to July 2020 in Spanish and English were reviewed on PubMed, Scimago, ScIELO, and were used the terms: next generation probiotics, probiotics, gut microbiota, dysbiosis. Results: There were updated criteria on next-generation probiotics, concept, mechanisms of action, specificities, results of research in mice and limited human studies in specific systemic diseases and metabolic syndromes, such as obesity, type 2 diabetes mellitus, inflammatory bowel diseases and cancer. Historical background, indications such as biotherapeutics in bowel diseases and next-generation probiotic differential traits with traditional probiotics were reviewed. Final Considerations: Knowledge gained over the past decade in studies with non-previously isolated intestinal commensal bacteria emerges as next-generation probiotics for active biotherapy as the treatment of choice in severe intestinal microbiota dysbiosis alterations, associated with specific systemic diseases that lead to metabolic syndrome. Experimental evidence opens up promising path to influence improvement or resolution of such conditions(AU)


Subject(s)
Humans , Inflammatory Bowel Diseases , Intestinal Diseases , Molecular Biology , Probiotics , Obesity
5.
Rev. colomb. cir ; 36(2): 338-343, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1247568

ABSTRACT

Introducción. El objetivo de este artículo es dar a conocer el caso de un paciente con diagnóstico de mesenteritis esclerosante quien cursó con cuadro de obstrucción intestinal. Descripción del caso. Paciente masculino de 28 años de edad, quien se presenta con cuadro clínico sugestivo de obstrucción intestinal, por lo que se decide resolución quirúrgica. Durante la cirugía se observa una zona fibrótica y adherente del intestino delgado, asociada a un mesenterio engrosado. El examen histopatológico de la pieza quirúrgica confirmó el diagnóstico de mesenteritis esclerosante. Discusión. La mesenteritis esclerosante es una patología de baja incidencia, y su forma de presentación es inespecífica, por lo que el diagnóstico definitivo es histopatológico. La tomografía es útil para el diagnóstico cuando se tiene la sospecha clínica. Puede optarse por el tratamiento quirúrgico para los casos que se presenten con clínica de obstrucción intestinal, o en caso contrario, el tratamiento médico a base de fármacos inmunosupresores e inmunomoduladores ha demostrado ser efectivo. De acuerdo con los diferentes estudios publicados hasta el momento, se observa una adecuada respuesta, independientemente del tratamiento empleado


Introduction. The objective of this article is to present the case of a patient diagnosed with sclerosing mesenteritis who presented with intestinal obstruction.Case description. A 28-year-old male patient, who presented with a clinical picture suggestive of intestinal obstruction, for which a surgical resolution was decided. During surgery, a fibrotic and adherent area of the small intestine is observed, associated with a thickened mesentery. The histopathological examination of the surgical specimen confirmed the diagnosis of sclerosing mesenteritis. Discussion. Sclerosing mesenteritis is a low incidence pathology, and its presentation is nonspecific, so the definitive diagnosis is histopathological. Tomography is useful for diagnosis when there is clinical suspicion. Surgical treatment can be chosen for cases that present with symptoms of intestinal obstruction, or otherwise medical treatment based on immunosuppressive and immunomodulatory drugs has proven to be effective. According to the different studies published so far, an adequate response is observed, regardless of the treatment used


Subject(s)
Humans , Panniculitis, Peritoneal , Intestinal Diseases , Intestinal Obstruction , Lipodystrophy
6.
Article in Chinese | WPRIM | ID: wpr-921570

ABSTRACT

Olmesartan,an angiotensin Ⅱ receptor blocker,is a commonly used antihypertensive drug.Several case reports and cohort studies in recent years have described a severe gastrointestinal adverse event with chronic diarrhea,intestinal malabsorption,and weight loss after the administration of olmesartan.In such cases,the patients recovered after discontinuing olmesartan.This adverse effect is called olmesartan-associated enteropathy(OAE).This article reviews the potential pathogenesis and clinical characteristics of OAE,which broadens the disease spectrum for the differential diagnosis of chronic diarrhea and intestinal malabsorption.


Subject(s)
Angiotensin Receptor Antagonists , Humans , Imidazoles , Intestinal Diseases/diagnosis , Tetrazoles/adverse effects
7.
Epidemiol. serv. saúde ; 30(spe1): e2020598, 2021.
Article in English, Portuguese | LILACS | ID: biblio-1154162

ABSTRACT

O tema infecções entéricas sexualmente transmissíveis é um dos capítulos que compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta aspectos epidemiológicos e clínicos relacionados a essas infecções, bem como orientações para os gestores quanto ao seu manejo programático e operacional. Objetiva-se auxiliar os profissionais de saúde na triagem, diagnóstico e tratamento das pessoas com infecções entéricas sexualmente transmissíveis e suas parcerias sexuais, além de subsidiar estratégias para ações de vigilância, prevenção e controle desses agravos.


The topic of sexually transmitted enteric infections is one of the chapters of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects related to these infections, as well as guidance for service managers on their programmatic and operational management. The aim is to assist health professionals with screening, diagnosis and treatment of people with sexually transmitted enteric infections and their sexual partners, in addition to supporting strategies for their surveillance, prevention and control.


El tema de las infecciones entéricas de transmisión sexual es uno de los capítulos del Protocolo Clínico y Directrices Terapéuticas para Atención Integral a las Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. El documento fue desarrollado en base a evidencia científica y validado en discusiones con especialistas. Este artículo presenta aspectos epidemiológicos y clínicos relacionados a esas infecciones, así como pautas para los administradores en cuanto a su gestión programática y operativa. El objetivo es ayudar el personal de salud en la detección, diagnóstico y tratamiento de personas con infecciones entéricas de transmisión sexual y sus parejas sexuales, además de contribuir con estrategias para acciones de monitoreo epidemiológico, prevención y control de esas enfermedades.


Subject(s)
Humans , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , Intestinal Diseases/prevention & control , Intestinal Diseases/epidemiology , Sexual Behavior , Brazil/epidemiology , Clinical Protocols , Health Personnel/organization & administration , Diarrhea/prevention & control
8.
Rev. méd. Urug ; 37(2): e37209, 2021. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1289848

ABSTRACT

Resumen: Introducción: en el paciente crítico el intestino es protagonista de la respuesta al estrés. Los síntomas de insuficiencia intestinal en las unidades de cuidados intensivos no son específicos y no se incluyen en escalas de gravedad comúnmente usadas, sin embargo, el 62% de los pacientes críticos presenta síntomas gastrointestinales al menos una vez al día. Demostrándose la relación existente entre la aparición de problemas gastrointestinales y la mortalidad en pacientes críticos. Objetivo: proporcionar el conocimiento teórico necesario sobre el fallo intestinal como entidad exclusiva, su reconocimiento en el paciente grave, clasificación y enfoque multidisciplinario del tratamiento. Métodos: se realizó una revisión cualitativa y sistemática en los idiomas inglés y español de la literatura publicada y actualizada hasta febrero del 2020. Conclusiones: las alteraciones gastrointestinales son frecuentes en el paciente crítico y un determinante en su mortalidad. Reconocer el fallo y disfunción intestinal permite optimizar el tratamiento, reducir la mortalidad e incidencia de complicaciones, las unidades dedicadas con un equipo de experiencia en el manejo del fallo intestinal agudo constituyen un aspecto clave en este sentido.


Summary: Introduction: in critically ill patients, intestine function expresses the response to stress. Symptoms of intestinal failure in intensive care units are not specific and are not included in commonly used severity scales. However, 62% of critically ill patients present gastrointestinal symptoms at least once a day, demonstrating the relationship between the appearance of gastrointestinal problems and mortality in critical patients. Objective: to provide the necessary theoretical knowledge about intestinal failure as an exclusive entity and how to recognize it in critically ill patients, classification and a multidisciplinary approach to treatment of this condition. Methods: a qualitative and systematic review was carried out of the literature published and updated until February 2020 both in English and in Spanish. Conclusions: gastrointestinal disorders are frequent in critically ill patients and constitute a determining factor in their mortality. Recognizing intestinal failure and dysfunction allows the optimization of treatment, reduces mortality and the incidence of complications. The creation of dedicated units with experienced staff in the management of acute intestinal failure is a key aspect in this regard.


Resumo: Introdução: em pacientes críticos, o intestino é o protagonista da resposta ao estresse. Os sintomas de insuficiência intestinal em unidades de terapia intensiva não são específicos e não estão incluídos nas escalas de gravidade comumente usadas; no entanto, 62% dos pacientes criticamente enfermos apresentam sintomas gastrointestinais pelo menos uma vez ao dia, demonstrando a relação entre o aparecimento de problemas gastrointestinais e mortalidade em pacientes críticos. Objetivo: proporcionar o conhecimento teórico necessário sobre a insuficiência intestinal como entidade exclusiva, seu reconhecimento em pacientes críticos, classificação e abordagem multidisciplinar do tratamento. Métodos: foi realizada uma revisão qualitativa e sistemática nos idiomas inglês e espanhol da literatura publicada e atualizada até fevereiro de 2020. Conclusões: as alterações gastrointestinais são frequentes em pacientes críticos e determinam sua mortalidade. O reconhecimento da insuficiência e disfunção intestinal permite otimizar o tratamento, reduzindo a mortalidade e a incidência de complicações; contar com unidades dedicadas e com equipe experiente no manejo da insuficiência intestinal aguda são um aspecto fundamental nesse sentido.


Subject(s)
Intensive Care Units , Intestinal Diseases , Critical Care
9.
Pesqui. vet. bras ; 40(12): 970-976, Dec. 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1155033

ABSTRACT

Several pathogens and antibodies derived from serum or produced in tissues associated with the oral cavity are present in the oral fluid (OF). Considering the applicability of this alternative sample, recent studies in veterinary medicine have tested OF as a replacement for serum in diagnostic assays. The aim of this study was to standardize the immunoperoxidase monolayer assay (IPMA) to detect anti-Lawsonia intracellularis immunoglobulin A (IgA) and immunoglobulin G (IgG) in OF samples from experimentally infected pigs. Sixty-two pigs were divided into two groups: control (T1, n=30) and inoculated with L. intracellularis (T2, n=32). Blood, OF and fecal samples were collected at 0, 7, 14, 21, 28 and 42 days post-inoculation (dpi). Some adaptations of the standard technique for serum were made to IPMA for the detection of IgA and IgG in OF. The IPMA showed high specificity and sensitivity for serum samples and high specificity and moderate sensitivity for the detection of IgA and IgG in OF. There was high agreement between the results of serum IgG and OF IgA and IgG. Based on our results, oral fluid samples may be used for the evaluation and determination of anti-L. intracellularis antibodies in pigs, but not for individual diagnosis of swine proliferative enteropathy.(AU)


Vários patógenos e anticorpos derivados do soro ou produzidos em tecidos associados a cavidade oral estão presentes no fluido oral (FO). Considerando a aplicabilidade dessa amostra alternativa, estudos recentes em medicina veterinária têm testado o FO como substituto do soro para testes diagnósticos. O objetivo desse estudo foi padronizar a imunoperoxidase em monocamada de célula (IPMC) para a detecção de imunoglobulina A e imunoglobulina G anti-Lawsonia intracellularis em amostras de FO de suínos experimentalmente infectados. Um total de 62 suínos foram divididos em dois grupos: controle (T1, n=30) e inoculados com L. intracellularis (T2, n=32). Sangue, FO e amostras de fezes foram coletados aos 0, 7,14, 21, 28 e 42 dias após a inoculação (dpi). Algumas adaptações da técnica foram realizadas na técnica padrão da IPMC para a detecção de IgA e IgG. A IPMC demostrou alta especificidade e sensibilidade para amostras de soro e alta especificidade de moderada sensibilidade para a detecção de IgA e IgG em FO. Houve alta concordância entre resultados de detecção de IgG em soro com a IgA e IgG em amostras de FO. Baseado em nossos resultados, amostras de fluido oral podem ser usadas em avaliações e detecção de anticorpos anti-L. intracellularis em suínos, porém não de forma individual.(AU)


Subject(s)
Animals , Swine/microbiology , Lawsonia Bacteria/immunology , Intestinal Diseases/diagnosis , Serology , Antibodies
10.
Acta méd. colomb ; 45(3): 70-74, jul.-set. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1130702

ABSTRACT

Resumen La obstrucción intestinal en pacientes jóvenes es poco frecuente. La mayor parte de los casos se presentan en mujeres jóvenes (premenopáusicas) y suelen estar relacionados a enfermedad inflamatoria intestinal tipo enfermedad de Crohn, o endometriosis con compromiso intestinal. En esta serie de casos presentamos tres pacientes mujeres en etapa reproductiva, con síntomas de obstrucción intestinal, quienes tienen patologías y desenlaces diferenciales. En el abordaje inicial de la obstrucción, se realizó enterorresonancia. Hacemos la presentación de casos, discusión y revisión de la literatura del diagnóstico diferencial de la estenosis en íleon distal y del uso de la enterorresonancia en ese escenario.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1327).


Abstract Intestinal obstruction is uncommon in young patients. Most cases present in young (premenopausal) women and tend to be related to inflammatory intestinal disease such as Crohn's disease or endometriosis with intestinal involvement. In this case series we present three female patients of reproductive age with intestinal obstruction symptoms who have differential diseases and outcomes. The initial approach to the obstruction included magnetic resonance enterography. We present the cases, discussion and review of the literature on the differential diagnosis of distal ileal stenosis and the use of magnetic resonance enterography in this scenario.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1327).


Subject(s)
Humans , Female , Adult , Crohn Disease , Intestinal Obstruction , Women , Magnetic Resonance Spectroscopy , Ileum , Intestinal Diseases
11.
Rev. argent. coloproctología ; 31(2): 54-63, jun. 2020. ilus
Article in English, Spanish | LILACS | ID: biblio-1117010

ABSTRACT

La endometriosis es una de las patologías ginecológicas benignas más frecuente, ocurre en un 7-10% de las mujeres en edad reproductiva y es causal de dolores crónicos e infertilidad. Se trata de una población joven y sana por lo demás. La sospecha diagnóstica de esta entidad debe ser alta y su manejo multidisciplinario.La endometriosis colorrectal representa una variable altamente incapacitante y es aquí donde se plantea la necesidad de un tratamiento más agresivo para su resolución. Frente a esto nos preguntamos, ¿qué rol tiene la cirugía?, ¿cuáles serían sus ventajas y desventajas?, ¿por qué deberíamos elegirla como método terapéutico?.La presente monografía fue inspirada en todas las pacientes que nos plantearon esta controversia. Que motivaron interconsultas, ateneos, búsqueda de bibliografía. Que generaron discusiones, dudas e incertidumbres y nos hicieron salir del rol de cirujanos al que estamos habituados y nos enseñaron a acompañar, cuando no pudimos curar


Subject(s)
Humans , Female , Digestive System Surgical Procedures/methods , Endometriosis/surgery , Intestinal Diseases/surgery , Patient Care Team , Diagnostic Imaging , Treatment Outcome , Laparoscopy/methods , Diet Therapy , Endometriosis/diagnosis , Endometriosis/drug therapy , Hormone Antagonists/therapeutic use , Intestinal Diseases/diagnosis , Intestinal Diseases/drug therapy
12.
Rev. argent. coloproctología ; 31(2): 42-50, jun. 2020. ilus, tab
Article in English, Spanish | LILACS | ID: biblio-1117006

ABSTRACT

Se trató de redactar una guía para la práctica segura de la especialidad en tiempos de COVID-19. Se realizó una búsqueda de las publicaciones recientes disponibles en Pub-Med y en otros buscadores, se utilizó la experiencia de expertos a través de diferentes conferencias o comunicados de sociedades científicas. Esta pandemia nos ha obligado a aprender de una manera vertiginosa el manejo de una nueva enfermedad, donde especialistas en cirugía comenzamos a hablar de terminología clínica, virológica, entre otras completamente nueva y desconocida para la mayoría de nosotros. Tuvimos que adaptar nuestra práctica habitual a nuevos estándares, cometiendo diferentes errores en el manejo inicial, provocados por la falta de información previa. La guía trata de abarcar los tópicos considerados más relevantes en este momento, como son el manejo del consultorio, recomendaciones de que patologías se recomienda operar y cuáles no. Recomendaciones de tratamientos alternativos al quirúrgico mientras dura la pandemia. Métodos de diagnósticos utilizados para evaluar infección en pacientes que se someterán a una cirugía, etc. Se agregaron links y apéndices para aquellos que deseen ampliar algún tema en particular, esto evita que la guía sea más extensa y pierda su practicidad con la que fue pensada. Esperamos esta guía sirva para facilitar la compresión de esta nueva enfermedad y su manejo para cualquier cirujano que necesite asistir a pacientes con patología colorrectal. Seguramente al finalizar estas líneas habrá nueva evidencia que deberá ser adaptada e incorporada a la presentada actualmente.


An attempt was made to write a guide for the safe practice of the specialty in times of COVID-19. A search of recent publication available in Pub-Med and other platforms was performed. Experts' opinions and experiences were taken into account from various conferences or communications of scientific societies. This pandemic has forced us to learn the management of a new disease in a sudden way. Surgical specialists began to learn clinical and virologic terminology, among other new concepts previously ignored by most of us. We were forced to adapt our usual practice to new standards, making different mistakes in the initial handling, caused by the lack of prior information.The present guide tries to cover the topics considered most relevant at this time, such as outpatients ́ management, recommendations of which patients we should operate on and which procedures should be postponed. Recommendations for alternative treatments to surgery while the pandemic lasts. Diagnostic methods used to assess infection in patients who will undergo surgery, etc. Links and appendices have been added for those who wish to expand on a particular topic, this prevents the guide from being too extensive and losing the practicality with which it was intended. We hope this guide will facilitate the understanding of this new disease and its management for any surgeon who needs to assist patients with colorectal pathology. By the time we would have finished these lines there will be new evidence that must be adapted and incorporated into those currently presented.


Subject(s)
Humans , Pneumonia, Viral , Safety/standards , Colorectal Surgery/standards , Coronavirus Infections , Colonoscopy/methods , Colonoscopy/standards , Perioperative Care/standards , Endoscopy/standards , Pandemics , Ambulatory Care/standards , Personal Protective Equipment/standards , Intestinal Diseases/surgery
13.
Sci. med. (Porto Alegre, Online) ; 30(1): e-34764, 2020.
Article in English | LILACS | ID: biblio-1087324

ABSTRACT

Aims: This research aims to determine the epidemiology and the spatial distribution of intestinal parasitosis in the city of Teresina, Brazil. Methods: A cross-sectional study was carried out based on the data of parasitological fecal exams performed in the Laboratory Raul Bacelar between January, 2014 and July, 2017. In addition to the prevalence of intestinal parasitosis and polyparasitism, we verified the association of these diseases with gender, zone and period of the year by means of the chi-squared test, whereas the relation with age was analyzed by the Mann-Kendall tests and multiple comparisons of age classes. The spatial distribution was performed using the QGIS georeferencing software. Results: The prevalence of enteroparasitosis in Teresina was 17.8% with Ascaris lumbricoides being the most common species. The prevalence of individuals with polyparasitism was 3.1%, in which an association between the species Entamoeba coli and Entamoeba histolytica/dispar was found. There was no relation between intestinal parasitosis with gender, but we verified that individuals in rural areas were more susceptible to these diseases. The species Ascaris lumbricoides and Entamoeba histolytica/dispar occured more frequently in the first and second semester, respectively. We observed that there was an apparent tendency to increase cases of Entamoeba histolytica/dispar and reduction of cases of Giardia sp. according to aging. Mapping intestinal parasitosis showed us that there was a prevalence between 1 and 20% in most of Teresina's neighborhoods, and Ascariasis embodies at least 40% of cases of enteroparasitosis in these neighborhoods. Conclusions: Investments in basic sanitation and new epidemiological investigations must be carried out to control intestinal parasitosis in Teresina, emphasizing that children and the elderly should be considered priority groups in these programs


Objetivo: Determinar a epidemiologia e a distribuição espacial das parasitoses intestinais no município de Teresina, Brasil. Métodos: Foi realizado um estudo transversal com base nos resultados dos exames parasitológicos de fezes executados no laboratório Raul Bacelar, entre janeiro de 2014 e julho de 2017. Além da prevalência de parasitoses intestinais e de poliparasitismo, verificou-se a associação destas doenças com sexo, zona e período do ano, por meio do teste do qui-quadrado, enquanto a relação com a idade foi analisada pelos testes de Mann-Kendall e comparações múltiplas de faixas etárias. A distribuição espacial foi realizada utilizando o software de georreferenciamento QGIS. Resultados: A prevalência de enteroparasitoses em Teresina foi de 17,8%, sendo Ascaris lumbricoides a espécie mais comum. A prevalência de indivíduos com poliparasitismo foi de 3,1%, na qual foi encontrada uma associação entre as espécies Entamoeba coli e Entamoeba histolytica/dispar. Não houve relação entre parasitoses intestinais e sexo, mas verificou-se que indivíduos na zona rural foram mais suscetíveis a essas doenças. As espécies Ascaris lumbricoides e Entamoeba histolytica/dispar ocorreram com maior frequência, respectivamente, no primeiro e no segundo semestre. Observou-se que houve aparente tendência de aumento de casos de E. histolytica/dispar e de redução de casos de Giardia sp. de acordo com o envelhecimento. O mapeamento das parasitoses intestinais demostrou que houve uma prevalência entre 1 e 20% na maioria dos bairros de Teresina, e a ascaridíase representou pelo menos 40% dos casos de enteroparasitose nesses bairros. Conclusões: Investimentos em saneamento básico e novas investigações epidemiológicas devem ser realizados para o controle das parasitoses intestinais em Teresina, enfatizando que crianças e idosos devem ser considerados grupos prioritários nessas ações.


Subject(s)
Parasitology , Intestinal Diseases , Public Health
14.
Article in Chinese | WPRIM | ID: wpr-828629

ABSTRACT

OBJECTIVE@#To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint.@*METHODS@#A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups.@*RESULTS@#There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%).@*CONCLUSIONS@#Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.


Subject(s)
Capsule Endoscopy , Child , Gastrointestinal Hemorrhage , Humans , Intestinal Diseases , Jejunum , Meckel Diverticulum , Retrospective Studies
15.
Rev. colomb. reumatol ; 27(1): 3-8, 2020. tab, graf
Article in English | LILACS | ID: biblio-1144394

ABSTRACT

ABSTRACT Introduction: Registries are essential to keep track of inflammatory bowel disease (IBD) and related arthritis epidemiology, and to provide better care to patients. In Colombia, the health ministry has adopted a tool, SISPRO, to gather all information coming from the whole health system structure. Given that the information collected from SISPRO is available for anyone, it provides an opportunity to get an insight into health topics. Objectives: The data collected from SISPRO were used to analyse the prevalence and specific characteristics of patients with IBD and related arthritis registered between 2012 and 2016. Methods: This is a descriptive epidemiological study using the International Statistical Classification of Diseases and Related Health Problem as keywords related to IBD and related arthritis during the analysis of SISPRO data. Results: National records report 42,647 patients with a diagnosis of IBD for an estimated prevalence of 87/100,000 subjects, being more frequent in women. The prevalence of Crohn's disease was 17/100,000 subjects, and 113/100,000 subjects for ulcerative colitis. The prevalence of arthritis related to inflammatory bowel disease was 5/100,000 subjects. Conclusions: This is the first study that describes the demographic characteristics of IBD in Colombia. This study is in accordance with that previously described in the available literature, which supports the theory about increasing global prevalence of IBD. Also, there are some differences between Colombian regions, which could be related to environmental factors and ancestry, which deserve further study.


RESUMEN Introducción: Los registros son esenciales para seguir la epidemiología de la enfermedad inflamatoria intestinal (EII) y el compromiso articular asociado y brindar mejor atención a los pacientes. En Colombia, el Ministerio de Salud y de la Protección Social utiliza la herramienta SISPRO para recolectar información del sistema de salud, la cual es de dominio público y amerita un análisis como el realizado en este trabajo. Objetivos: Utilizando los datos de SISPRO se realizó un análisis de la prevalencia y las características de los pacientes con EII y artritis relacionada, con los registros correspondientes a los arios 2012 a 2016. Métodos: Estudio descriptivo de corte transversal en el que se tomaron los datos de SISPRO, utilizando como palabras clave los diagnósticos del manual internacional de enfermedades relacionados con el diagnóstico de EII y la artritis asociada. Resultados: Se documentaron 42.647 individuos con diagnóstico de EII, con una pre-valencia estimada de 87 casos por 100.000 habitantes, más frecuente en mujeres. La prevalencia de la enfermedad de Crohn fue de 17 por 100.000 habitantes y la colitis ulcerativa de 113 por 100.000 habitantes. La prevalencia del compromiso articular asociado a EII fue de 5 por 100.000 habitantes. Conclusión: Este es el primer estudio que describe las características demográficas de la EII en Colombia. Los resultados son acordes con lo reportado en la literatura mundial y la teoría del aumento de la prevalencia de la EII. Así mismo, existen diferencias entre regiones que pueden estar relacionadas con ancestría y factores medioambientales que requieren estudios complementarios.


Subject(s)
Humans , Inflammation , Intestinal Diseases , Information Systems , Colombia
16.
Rev. venez. cir ; 73(1): 18-24, 2020.
Article in Spanish | LILACS, LIVECS | ID: biblio-1283949

ABSTRACT

La falla intestinal (FI) se define como la disminución de la función del intestino por debajo de lo mínimo necesario para la absorción de los macronutrientes y / o agua y electrolitos, de tal manera que se requiere de la suplementación intravenosa (SIV) para mantener la salud y el crecimiento. Desde el punto de vista funcional se clasifica en tres tipos. FI tipo I: condición aguda, de corto duración y generalmente auto limitada, FI tipo II: estado agudo prolongado, a menudo en pacientes metabólicamente inestables, que requieren cuidado multidisciplinario y SIV durante períodos de una semana o meses, acompañada de complicaciones sépticas, metabólicas y nutricionales y FI tipo III: condición crónica, en pacientes metabólicamente estables, que requieren SIV durante meses o años. Su manejo requiere de terapia nutricional y en casos seleccionados cirugía autóloga de reconstrucción(AU)


Intestinal failure (FI) is defined as the decrease in intestinal function below the minimum necessary for the absorption of macronutrients and / or water and electrolytes, in such a way that intravenous supplementation (IVS) is required to maintain health and growth. From a functional point of view, it is classified into three types. FI type I: acute condition, of short duration and generally self-limited, FI type II: prolonged acute state, often in metabolically unstable patients, requiring multidisciplinary care and SIV for periods of a week or months, accompanied by septic, metabolic and nutrition and FI type III: chronic condition, in metabolically stable patients, who require SIV for months or years. Its management requires nutritional therapy and in selected cases autologous reconstruction surgery(AU)


Subject(s)
Short Bowel Syndrome/therapy , Intestinal Diseases/complications , Intestinal Diseases/diagnosis , Intestinal Diseases/etiology , Quality of Life , Chronic Disease , Dietary Supplements , Intestinal Failure , Ischemia/complications
17.
An. venez. nutr ; 33(1): 61-66, 2020. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1361684

ABSTRACT

La salud intestinal se ha convertido en un factor importante en el estado de salud de un individuo. El factor alérgico juega un papel fundamental en el crecimiento, desarrollo y ganancia de peso en las primeras etapas de la vida. La prevalencia de alergias alimentarias en niños es del 4 % al 6 %. La malnutrición es la principal causa de enfermedad a nivel mundial. Los niños menores de 5 años son más vulnerables, 150,8 millones de niños sufren retraso del crecimiento y 50,5 millones padecen emaciación. Se presenta el caso clínico: Niño preescolar masculino de 5 años con 2 meses de edad, diagnosticado con: Hipercalciuria, Desnutrición actual con talla baja según combinación de indicadores, Sensibilidad al gluten no celiaca, Síndrome de Intestino hiperpermeable, síndrome de sobrecrecimiento fúngico (SIFO), intolerancia a azúcares, disbiosis grado IV, anemia ferropénica, enteropatías alimentarias por gluten, cítricos, maní, caseína, huevo y soya, y rinitis alérgica moderada persistente contra ácaros y hongos, cursando con sintomatología amplia y variada. Recibió tratamiento con una alimentación centrada en aporte calórico y de nutrientes acorde a mejorar el estado nutricional, la exclusión de alérgenos alimentarios y de azúcares, tratamiento con antibiótico de amplio espectro, ketoconazol 3 ciclos, inmunoglobulina humanizada y probióticos (Lactobacillus acidophillus). Mostró mejoría del estado nutricional, la salud intestinal y la actividad inmunológica, acompañada de mejoría en la sintomatológica asociada(AU)


Malnutrition is the leading cause of poor health worldwide. Children under the age of 5 are most vulnerable. 150.8 million infants are stunted and 50.5 million are wasted (1). On the other hand, the estimated prevalence of food allergies in children is 4 % to 6 %. However, studies reveal that the allergic factor plays a fundamental role in growth, development and weight gain in the early stages of life. Similarly, in the last decade, intestinal health has become an important factor in the health of an individual, especially at a critical stage of growth and development. Clinical case: 5-year-old male preschool boy with 2 months of age, diagnosed with: hypercalciuria, current malnutrition with short stature combination of indicators (2), Leaky Gut Syndrome, Fungal Overgrowth Syndrome (SIFO), Sugar Intolerance, Grade IV Dysbiosis, Iron Deficiency Anemia, Alimentary Enteropathies due to gluten, citrus, peanuts, casein, egg and soy, and moderate persistent allergic rhinitis against mites and fungi, with wide and varied symptomatology. The treatment is supplemented with a diet focused on a caloric and nutrient intake in accordance with improving the nutritional status, the exclusion of food allergens and sugars. Treatment with a broad-spectrum antibiotic, 3-cycle ketoconazole, humanized immunoglobulin, and probiotics (Lactobacillus acidophillus) was indicated. Conclusions: An improvement was shown in the nutritional status, intestinal health, and immunological activity, accompanied by the improvement of the associated symptoms(AU)


Subject(s)
Humans , Male , Child, Preschool , Nutritional Status , Feeding Behavior , Food Hypersensitivity/complications , Intestinal Diseases , Allergens , Body Mass Index , Malnutrition , Growth and Development
19.
Rev. bras. enferm ; 72(5): 1203-1210, Sep.-Oct. 2019. tab
Article in English | LILACS, BDENF | ID: biblio-1042139

ABSTRACT

ABSTRACT Objective: To analyze the playful educational interventions in the knowledge of schoolchildren about intestinal parasitosis. Method: This is a quasi-experimental, non-randomized study, based on pre- and post-intervention, conducted in a public elementary school in a peripheric neighborhood in the city of Ribeirão Preto (SP). The study population consisted of 101 students enrolled in the 5th and 6th grade. For comparison, we used the generalized version of the McNemar chi-squared test. Results: Of the 101 schoolchildren who participated in the study, 48 (47.5%) were female and 53 (52.5%) were male, aged from 9 to 14 years. Students' knowledge on intestinal parasitic infections has increased significantly after the playful educational intervention. Conclusion: Playful educational interventions are an excellent didactical resource in the teaching-learning process of schoolchildren.


RESUMEN Objetivo: Analizar las intervenciones educativas lúdicas en el conocimiento de escolares sobre enteroparasitosis. Método: Se trata de estudio casi-experimental, no aleatorizado, basado en la pre y pos-intervención, que ha sido ocurrido en escuela pública de enseñanza primaria de un barrio de la periferia en la ciudad de Ribeirão Preto (SP). La población del estudio ha sido conformada por 101 alumnos que cursaban el 5º y el 6º año. Para realizar la comparación ha sido utilizada la versión generalizada de la prueba chi-cuadrada de McNemar. Resultados: De los 101 escolares que han participado del estudio, 48 (el 47,5%) eran del sexo femenino y 53 (el 52,5%) del sexo masculino, con edad entre 9 a 14 años. El conocimiento de los alumnos sobre enteroparasitosis después de la intervención educativa lúdica se ha incrementado significativamente. Conclusión: Las intervenciones educativas lúdicas son un excelente recurso didáctico en el contexto del proceso enseñanza-aprendizaje de escolares.


RESUMO Objetivo: Analisar as intervenções educativas lúdicas no conhecimento de escolares sobre enteroparasitoses. Método: Trata-se de estudo quase-experimental, não randomizado, baseado na pré e pós-intervenção, ocorrido em escola pública de ensino fundamental de um bairro da periferia na cidade de Ribeirão Preto (SP). A população do estudo foi composta por 101 alunos que cursavam o 5º e o 6º ano. Para efetuar a comparação foi utilizada a versão generalizada do teste qui-quadrado de McNemar. Resultados: Dos 101 escolares que participaram do estudo, 48 (47,5%) eram do sexo feminino e 53 (52,5%) do sexo masculino, com idade entre 9 a 14 anos. O conhecimento dos alunos sobre enteroparasitoses após a intervenção educativa lúdica aumentou significativamente. Conclusão: As intervenções educativas lúdicas são um excelente recurso didático no contexto do processo ensino-aprendizagem de escolares.


Subject(s)
Humans , Male , Female , Child , Adolescent , Play Therapy/methods , Health Education/methods , Intestinal Diseases/psychology , Play Therapy/instrumentation , Play Therapy/statistics & numerical data , Schools/organization & administration , Schools/statistics & numerical data , Health Education/statistics & numerical data , Surveys and Questionnaires , Giardiasis/psychology , Amebiasis/psychology , Intestinal Diseases/therapy
20.
Rev. Soc. Bras. Clín. Méd ; 17(3): 147-152, jul.-set. 2019. ilus.
Article in Portuguese | LILACS | ID: biblio-1284216

ABSTRACT

A síndrome de Ehlers-Danlos é estabelecida por distúrbios hereditários do tecido conjuntivo que tem como manifestações principais a hipermobilidade articular, a hiperextensibilidade da pele e a fragilidade de tecidos, como articulações, ligamentos, pele, vasos sanguíneos e órgãos internos. São reconhecidos 13 subtipos, de acordo com Classificação Internacional de 2017. Dentre estes, abordamos o hipermóvel, cujo diagnóstico é eminentemente clínico, com manifestações sistêmicas distintas. Esse artigo refere-se ao caso de uma paciente diagnosticada com síndrome de Ehlers-Danlos hipermóvel, tendo como intuito a atualização acerca dos novos critérios diagnósticos, assim como o diagnóstico precoce de tal raropatia.


Ehlers-Danlos syndrome is established through hereditary disorders of connective tissue, and has as its manifestations: joint hypermobility, skin hyperextensibility, and fragility of tissues such as joints, ligaments, skin, blood vessels, and internal organs. Thirteen subtypes have been recognized according to the 2017 International Classification. Among these, the hypermobile type, the diagnosis of which is eminently clinical, with distinct systemic manifestations, will be addressed. This article refers to the case of a patient diagnosed with hypermobile Ehlers-Danlos syndrome, with the objective of updating the new diagnostic criteria, as well as the early diagnosis of such a rare disease.


Subject(s)
Humans , Female , Adult , Rare Diseases/diagnosis , Ehlers-Danlos Syndrome/diagnosis , Joint Instability/diagnosis , Physical Education and Training , Physical Therapy Department, Hospital , Echocardiography, Doppler , Tomography, X-Ray Computed , Cognitive Behavioral Therapy , Fatigue Syndrome, Chronic/etiology , Cardiology Service, Hospital , Exercise Tolerance/genetics , Muscle Weakness/etiology , Dilatation, Pathologic/diagnostic imaging , Joint Dislocations/etiology , Ehlers-Danlos Syndrome/complications , Ehlers-Danlos Syndrome/genetics , Ehlers-Danlos Syndrome/therapy , Osteoarthritis, Spine/diagnostic imaging , Striae Distensae/etiology , Musculoskeletal Pain/etiology , Chronic Pain/etiology , Intestinal Diseases/etiology , Joint Instability/complications , Joint Instability/genetics , Joint Instability/therapy , Anesthesia Department, Hospital , Mitral Valve Insufficiency/diagnostic imaging , Occupational Therapy Department, Hospital
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