Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease

Objective:Inflammatory bowel disease (IBD) is associated with elevated levels of anxiety and depression and a reduction in health-related quality of life (HRQoL). Nonadherence to treatment is also frequent in IBD and compromises outcomes. Religious coping plays a role in the adaptation to several chronic diseases. However, the influence of religious coping on IBD-related psychological distress, HRQoL, and treatment adherence remains unknown.Method:This cross-sectional study recruited 147 consecutive patients with either Crohn’s disease or ulcerative colitis. Sociodemographic data, disease-related variables, psychological distress (Hospital Anxiety and Depression Scale), religious coping (Brief RCOPE Scale), HRQoL (WHOQOL-Bref), and adherence (8-item Morisky Medication Adherence Scale) were assessed. Hierarchical multiple regression models were used to evaluate the effects of religious coping on IBD-related psychological distress, treatment adherence, and HRQoL.Results:Positive RCOPE was negatively associated with anxiety (b = 0.256; p = 0.007) as well as with overall, physical, and mental health HRQoL. Religious struggle was significantly associated with depression (b = 0.307; p < 0.001) and self-reported adherence (b = 0.258; p = 0.009). Finally, anxiety symptoms fully mediated the effect of positive religious coping on overall HRQoL.Conclusion:Religious coping is significantly associated with psychological distress, HRQoL, and adherence in IBD.

A Case-Control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD) / Um estudo de caso-controle da prevalência de doenças neurológicas na doença inflamatória intestinal (DII)

Neurological diseases are common in inflammatory bowel disease (IBD) patients, but their exact prevalence is unknown. Method We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD) and 70 with ulcerative colitis (UC)] and 50 controls (gastritis and dyspepsia) over 3 years. Results Our standard neurological evaluation (that included electrodiagnostic testing) revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045), 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001) and 5.1 times more likely to develop autonomic complaints (p = 0.027). UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027) and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015). Conclusion In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia. .

Doenças neurológicas são comuns em pacientes com doença inflamatória intestinal (DII), mas sua prevalência exata é desconhecida. Métodos Nós estudamos prospectivamente a presença de distúrbios neurológicos em 121 pacientes com DII [51 com doença de Crohn (DC) e 70 com colite ulcerativa (RCU)] e 50 controles (gastrite e dispepsia) ao longo de 3 anos. Resultados A avaliação neurológica padronizada (que incluiu testes eletrodiagnósticos) demonstrou que pacientes com DC foram 7,4 vezes mais propensos a desenvolver neuropatias de fibras grossas do que os controles (p = 0,045), 7,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,001) e 5,1 vezes mais propensos a desenvolver queixas autonômicas (p = 0,027). Pacientes com RCU foram 5 vezes mais propensos de desenvolver neuropatia de fibras grossas (p = 0,027) e 3,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,015). Conclusão Em resumo, este é o primeiro estudo prospectivo a estabelecer que os pacientes tanto com DC quanto de RCU são mais propensos a doenças neuromusculares do que os pacientes com gastrite e dispepsia. .

Prevalence of Helicobacter pylori infection in Fortaleza, Northeastern Brazil

A prevalência da infecção pelo Helicobacter pylori foi avaliada em amostra randomizada de indivíduos de uma comunidade urbana de baixa renda em Fortaleza, Estado do Ceará. O H. pylori foi detectado em 384 (62.9 por cento) dos 610 participantes. A taxa de infecção foi de 47.5 por cento em indivíduos com seis meses a 10 anos de idade, aumentou para 73.3 por cento entre indivíduos com 11 a 20 anos, e continuou a aumentar com a idade, atingindo 87 por cento naqueles com aproximadamente 60 anos. Após essa idade, a prevalência diminuiu discretamente. A prevalência da infecção aumentou significantemente com a idade (p<0.0001).

Helicobacter pylori infection in adults from a poor urban community in northeastern Brazil: demographic, lifestyle and environmental factors

We investigated the prevalence and the risk factors for infection with Helicobacter pylori in a randomly-selected population of adults from a low-income community in Northeastern Brazil. Helicobacter pylori infection was determined by ELISA. Risk factors were assessed using a structured interview. Two hundred and four individuals were included in the study, including 49 males and 155 females, ranging from 18 to 80 years old. Overall, 165 of 204 participants (80 percent) were H. pylori positive, without significant gender differences (p= 0.49). The infection rate was of 84.7 percent in subjects 18 to 30 years of age, increasing to 92 percent in subjects 46-60 years old. Above 60 years old, the prevalence decreased slightly. As a whole, the prevalence of infection did not increase significantly (p=0.147) with age. There were no significant differences in the prevalence of H. pylori infection, when patients were classified by age, smoking habit, educational level, alcohol consumption, the number of persons per room, the number of children per household, the number of adults per household, cup-sharing, household pets, toilet location, number of persons per bed and medical history of antibiotic and raw vegetable ingestion. In conclusion, no risk factors associated with infection was found in these adults, suggesting that the infection, even in a poor population, may be acquired predominantly during childhood; the relatively high prevalence that we observed may be more due to a cohort effect than to acquisition of infection during adulthood.

Meteorismo gastrointestinal: aspectos fisiopatológicos, clínicos e terapêuticos / Gastrointestinal meteorism: pathophysiologic, clinical and therapeutic aspects

O excesso de gás no abdome é uma queixa extremamente comum na medicina. Existem poucos estudos científicos a respeito, razäo por que os médicos prescrevem tratamento sem conhecimento exato sobre a fisiopatología desta entidade. O objetivo dos autores é rever o problema do gás gastrointestinal, com particular ênfase sobre o diagnóstico etiológico e o tratamento, e apresentam sua experiência no tratamento desta condiçäo