Characteristics of digestive system symptoms and abdominal computed tomography imaging of patients infected with severe acute respiratory syndrome coronavirus 2 Omicron variant / 中华消化杂志

Objective:To investigate the characteristics of digestive system symptoms and its relation with the time of nucleic acid continuous positive in population infected with severe acute respiratory syndrome coronavirus 2 Omicron variant, and to analyze the abdominal computed tomography (CT) features of patients infected with Omicron variant.Methods:From April 11 to May 23, 2022, a questionnaire survey was conducted in patients infected with Omicron variant admitted to the Shanghai National Convention and Exhibition Center Fangcang Hospital. The questionnaire included basic information, the start time of nucleic acid positive, respiratory symptoms, digestive system syptoms and outcomes, etc.Combined with the clinical data, the relation between digestive tract symptoms and the time of nucleic acid continuous positive were analyzed. Thoracic and abdominal CT were performed for patients with continuous positive nucleic acid results ≥10 d, and the relationship between the abdominal CT imaging characteristics and the time of nucleic acid continuous positive was analyzed. Independent sample t-test and multivariate logistic regression were used for statistical analysis. Results:A total of 4 360 valid questionnaires were collected, including 2 475 males and 1 885 females, with a hospital stay of (6.8±4.9) d. Among the 4 360 patients, 1 979 patients (45.4%) had gastrointestinal symptoms such as loss of appetite, abdominal discomfort or pain, constipation and diarrhea. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms was (7.4±5.5) d, which was longer than that of patients without gastrointestinal symptoms (6.5±3.6) d, and the difference was statistically significant ( t=3.78, P<0.001). During the isolation period in the Fangcang Hospital, the time of nucleic acid continuous positive in patients with complete remission of digestive tract symptoms was shorter than that of patients with no remission of digestive tract symptoms ((7.3±5.2) d vs. (8.5±5.7) d), and the difference was statistically significant ( t=2.25, P=0.025). The results of multivariate logistic regression analysis showed that the combination of gastrointestinal symptoms was an independent risk factor for continuous positive nucleic acid result ≥10 d ( OR=1.316, 95% confidence interval 1.294 to 2.205, P=0.046). Among the 299 patients with continuous positive nucleic acid results≥10 d, 187 cases (62.5%) had gastrointestinal symptoms, and 146 cases (48.8%) had abdominal CT findings of thickening of the gastroduodenal wall, thickening of the small intestinal wall, indistinct mesenteric vessels of the small intestine, and dilatation and pneumatosis of the colon. In patients with continuous positive nucleic acid results ≥10 d, abdominal CT indicated that patients with gastrointestinal imaging changes had a longer time of nucleic acid continuous positive than those without gastrointestinal imaging changes ((16.0±2.8) d vs. (13.0±2.1) d), and the difference was statistically significant ( t=2.62, P=0.009). Conclusions:Digestive system symptoms are common in patients infected with Omicron variant. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms is longer than those without gastrointestinal symptoms. Some patients may have gastrointestinal lesions on abdominal CT.

Correlation of endoscopy findings with symptoms in patients undergoing gastroscopy: a prospective study / 中华消化内镜杂志

Objective:To investigate the correlation of endoscopy findings with symptoms in patients undergoing gastroscopy.Methods:Patients who underwent gastroscopy for the first time in Renji Hospital of Shanghai Jiao Tong University School of Medicine from January to December 2017 were included in the questionnaire survey. The participants were asked to report their main symptoms of the digestive tract in details, and gastroscopy was completed within 2 weeks. Final gastroscopic diagnosis was made based on both gastroscopy and pathology, then patients were divided into the major-lesion (peptic ulcer and malignancy) group and the non-major-lesion (chronic gastritis, reflux esophagitis and others) group. The correlation of gastrointestinal symptoms with gastroscopic findings was analyzed. The risk for major gastroscopic lesions (peptic ulcer and malignant tumors) was assessed by multivariate Logistic regression analysis.Results:A total of 5 885 patients completed the questionnaire, 5 496 (93.4%) of whom completed gastroscopy. The detection rates of peptic ulcer were 12.3% (373/3 028), 12.6% (52/412), 17.9% (49/273), 9.5% (64/675) and 9.2% (102/1 108) in patients with dyspepsia, reflux, alarm, other symptoms and no symptoms, respectively, the detection rates of malignant tumors were 1.2% (36/3 028), 0.7% (3/412), 7.7% (21/273), 0.7% (5/675) and 0.4% (4/1 108), respectively in these patients. The most common symptoms was dyspepsia, accounted for 58.3% (373/640) and 52.2% (36/69) patients with peptic ulcer and malignant tumors, respectively. Alarm symptoms were found in 30.4% (21/69) patients with malignant tumors, and 15.9% (102/640) peptic ulcer patients and 5.8% (4/69) malignant tumor patients had no gastrointestinal symptoms. Compared to asymptomatic individuals, patients with dyspepsia ( P<0.001, OR=1.52, 95% CI: 1.21-1.92) and those with warning symptoms ( P<0.001, OR=2.87, 95% CI: 2.02-4.08) had significantly increased risk for major lesions (peptic ulcer and malignant tumors) detected by gastroscopy. Conclusion:Although dyspepsia and alarm symptoms are positively associated with upper gastrointestinal malignancy and peptic ulcer, they are of limited predictive value for upper gastrointestinal diseases.

Detection of anti-tissue transglutaminase IgA antibodies (tTG IgA) in children with type 1 diabetes mellitus / Detección de anticuerpos IgA antitransglutaminasa tisular (IgA-TGT) en niños con diabetes mellitus tipo 1

Abstract Introduction: Children with type 1 diabetes mellitus (DM1) are more likely to develop celiac disease (CD), which is an underdiagnosed condition due to its variable clinical presentation. Therefore, children with DM1 require periodic monitoring to achieve an early diagnosis of CD. Objectives: To identify positivity for the detection of anti-tissue transglutaminase IgA antibodies (tTG-IgA) in children with DM1, as well as to describe gastrointestinal (GI) symptoms, anthropometric status indicators and gluten intake levels. Materials and methods: Descriptive cross-sectional study. The population was composed of children with DM1 who attended the outpatient service of two pediatric endocrinology centers in Bogotá, Colombia. The Biocard-Celiac® test was used to detect the presence of tTG-IgA. In addition, participants were asked about their GI symptoms and underwent an anthropometric nutritional assessment. Gluten intake was assessed by recording dietary intake for 72 hours. A statistical data analysis was performed using the SPSS software version 22.0. Results: The final sample included 45 children with an average age of 10.6±4.1 years, of which 53% were males. None of the participants had a positive result in the tTG-IgA test. The most frequent GI symptoms were flatulence (48.9%) and abdominal pain (28.9%). Only 3 children (6.7%) were below the height-for-age standard. The average gluten intake was 5.29±3.02 g/day. Conclusions: Although children with DM1 are at increased risk of developing CD, none of the participants tested positive for tTG-IgA.

Resumen Introducción. Los niños con diabetes mellitus tipo 1 (DM1) tienen mayor probabilidad de desarrollar enfermedad celiaca (EC), la cual es una condición subdiagnosticada debido a que su presentación clínica varía; por lo tanto, es necesario monitorear periódicamente a esta población con el objetivo de diagnosticar a tiempo la EC. Objetivos. Identificar la positividad para la detección de anticuerpos IgA antitransglutaminasa tisular (IgA-TGT) en población pediátrica con DM1, así como describir los síntomas gastrointestinales (SGI), los indicadores antropométricos y los niveles de ingesta de gluten. Materiales y métodos. Estudio descriptivo de corte transversal. La población estuvo compuesta por niños con DM1 que asistieron al servicio de consulta externa en dos centros de endocrinología pediátrica en Bogotá D.C., Colombia. Para detectar la presencia de IgA-TGT se aplicó el test Biocar-dTM Celiac®. Además, se indagó sobre los SGI y se realizó valoración nutricional antropométrica de los participantes. Para evaluar la ingesta de gluten se llevó a cabo un registro dietético de 72 horas. El análisis estadístico de los datos se realizó con el programa SPSS versión 22.0. Resultados. La muestra final estuvo compuesta por 45 niños con una edad promedio de 10.6±4.1 años, de los cuales 53% eran varones. Ninguno de los pacientes presentó positividad cualitativa en el test aplicado para detección de IgA-TGT. Los SGI más frecuentes fueron flatulencias (48.9%) y dolor abdominal (28.9%). Solo en 3 niños (6.7%) se observó talla baja con respecto a su edad. La ingesta promedio de gluten fue 5.29±3.02 g/día. Conclusiones. Pese a que los niños con DM1 tienen mayor riesgo de desarrollar EC, ninguno de los participantes presentó positividad para IgA-TGT.

Factores de Riesgo de Cáncer de Estómago, Hospital Abel Gilbert Pontón / Stomach Cancer Risk Factors, Abel Gilbert Ponton Hospital

Introducción:El cáncer de estómago es una de las neoplasias malignas más frecuentes, siendo la segunda causa de muerte en hombres y la tercera en mujeres. Ocupa el segundo lugar como causa de muerte por cáncer en el mundo. En Ecuador, representa el 12% de todos las canceres. El objetivo del presente estudio fue establecer la prevalencia, incidencia, mortalidaden un centro de referencia regional del sistema Público. Métodos:El presente estudio transversal se realizó en el Hospital Abel Gilbert Pontónde la Ciudad de Guayaquil. Se revisaron expedientes clínicos delos años 2014 al 2016 de pacientes con diagnóstico de cáncer gástrico. Se analizan variables demográficas, clínicas y de resultados. Se utiliza estadística descriptiva. Resultados:Se identificaron 99 casos de Cáncer gástrico. Fueron 38 mujeres (38.4%). El 43.4% tuvo más de 65 años.El 69.7% de pacientes con hábito de consumo de alcohol, 63.6% con consumo de tabaco, 70.7% con antecedentes de ingesta de carnes ahumadas en forma recurrente.Un 75.8% de pacientes tuvieron infección por H. pylori. La mayor prevalencia de localización fue el antro gástrico y el síntoma prevalente en el grupo fue la epigastralgia.La incidencia fue de 0.14 por 1.000 pacientes del hospital, la prevalencia fue de 1.22 por 1.000 pacientes. La mortalidad fue de 18 casos, 2.16 por 100 mil pacientes. Conclusiones:El paciente típico fue hombre, con edad >65 años, sin antecedentes de cáncer gástrico, con infección por H. pylori, consumo de dieta rica en con grasa,carne ahumada, alcohol y tabaco. Con cáncer gástrico localizado en el antro y el debut más prevalente epigastralgia.

Introduction:Stomach cancer is one of the most frequent malignant neoplasms in the world, it is the second cause of death in men and the third in women. It ranks fifth in frequency and second cause of death from cancer in the world. Cancer being one of the most frequent and investigated pathologies on the planet and in Ecuador, it represents 12% of all cancers. The objective of this study is to establish the prevalence, incidence, and mortality in a regional reference center of the Public system. Methods: The present cross-sectional study was conducted at the Abel Gilbert Pontón Hospital in the City of Guayaquil. Medical records from 2014 to 2016 of patients diagnosed with gastric cancer were reviewed. Demographic, clinical and outcome variables areanalyzed. Descriptive statistics are used. Results: 99 cases of gastric cancer were identified. There were 38 women (38.4%) and 61 men (61.6%). 43.4% of patients with gastric cancer were older than 65 years. 70.7% of patients had no family history of gastric cancer, 69.7% of patients with alcohol consumption habit, 63.6% of patients had tobacco consumption, 70.7% of patients with a recurrent history of smoked meat intake, and intake of diet rich in fat 75.8%. 75.8% of patients had H. pylori infection. The highest prevalence of location was the gastric antrum and the prevalent symptom in the group was epigastric pain. The incidence was 0.14 per 1,000 hospital patients, the prevalence was 1.22 per 1,000 patients. Mortality was 18 cases, 2.16 per 100,000 patients. Conclusions: The typical patient was male, aged> 65 years, without a history of gastric cancer, with H. pylori infection, consumption of a diet rich in fat, smoked meat, alcohol and tobacco. With gastric cancer located in the antrum and the most prevalent debut epigastralgia.

Clinical characteristics of gastrointestinal involvement in polyarteritis nodosa / 中华风湿病学杂志

Objective To investigate the clinical characteristics of gastrointestinal involvement in polyarteritis nodosa (PAN),and to improve the understanding of the disease.Methods PAN patients hospitalized in Peking Union Medical College Hospital from March 2002 to September 2016 were enrolled in this study,and were divided into gastrointestinal involvement group and non-gastrointestinal involvement group according to clinical manifestations and imaging findings.Data on clinical features,treatments and outcome were recorded.t test,chi-square test were used for statistical analysis.Results A total of 117 patients with PAN were hospitalized in the past 14 years.The prevalence of gastrointestinal involvement was 38％(44 cases).There was no significant difference in age and sex between the two groups (P＞0.05).Abdominal pain (29 cases,66％) was the most frequent manifestation,then gastrointestinal bleeding (10 cases,23％),splenic infarction (3 cases,7％),gastrointestinal ulcers (2 cases,5％),intestinal obstruction or diarrhea (each 2 cases,5％),and vomiting (1 case,2％).Patients with gastrointestinal involvement had more frequent fatigue (27％ vs 11％;x2=5.156,P=0.023),increased diastolic pressure (55％ vs 34％;x2=4.647,P=0.031),renal (34％ vs 18％;x2=3.998,P=0.046) and cardiac (25％ vs 8％;x2=6.225,P=0.013) involvements.ESR in the gastrointestinal involvement group was significantly higher (75％ vs 56％;x2=4.190,P=0.041).The average follow-up time was 315.8 (20.3,441.3) days,the relapse rate was higher in the gastrointestinal involvement group (23％ vs 8％;x2=4.895,P=0.027).The incidence of death or the irreversible organ injury was higher in the gastrointestinal involvement group (27％ vs 11％,x2=5.156,P=0.023).Conclusion Gastrointestinal invol-vement in poly-arteritis nodosa is common and its condition is severe.The incidence of relapse and death or irreversible organ injury is high.

Sarcoma de Kaposi gástrico como causa inusual de sangrado digestivo / Gastric Kaposi’s sarcoma as an unusual cause of digestive bleeding

Fundamento: el sarcoma de Kaposi es un tumor de origen vascular asociado a pacientes con infección por Virus de Inmunodeficiencia Humana. Objetivo: presentar el caso de un paciente con sarcoma de Kaposi gástrico que debuta con cuadro de hemorragia digestiva. Caso Clínico: paciente masculino de 29 años que presenta cuadro de sangrado digestivo alto a forma de melena asociado a dolor abdominal en epigastrio, astenia, anorexia y pérdida de peso. Se realiza estudios complementarios que concluyen sarcoma de Kaposi gástrico en paciente HIV positivo. Conclusiones: el Sarcoma de Kaposi gástrico es una causa inusual de sangrado digestivo por lo cual constituye un hallazgo endoscópico infrecuente en pacientes sin historia personal de infección por HIV.

Background: Kaposi’s sarcoma is a vascular tumor associated with HIV infection (Human Immunodeficiency Virus). Objective: to present the case of a patient with gastric Kaposi's sarcoma who debuted with digestive hemorrhage. Clinical case: a 29-year-old male patient with upper gastrointestinal bleeding associated with abdominal pain in the epigastrium, asthenia, anorexia, and weight loss. Complementary studies were conducted which concluded Gastric Kaposi ’s sarcoma in an HIV-positive patient. Conclusions: gastric Kaposi's sarcoma is an unusual cause of digestive bleeding, making it an uncommon endoscopic finding in patients with no history of HIV infection.

Estado nutricional e sintomas gastrointestinais de pacientes oncológicos em cuidados paliativos / Nutritional status and gastrointestinal symptoms of cancer patients in palliative care

Objetivo: Pesquisa retrospectiva, exploratória e descritiva, de caráter quantitativo, cujo objetivo foi identificar os sintomas gastrointestinais apresentados pelos pacientes oncológicos internados em Cuidados Paliativos e relacionar ao seu estado nutricional. Método: Para a análise do estado nutricional, foram utilizados parâmetros antropométricos e a Avaliação Subjetiva Global Produzida pelo Próprio Paciente, que identifica também os sintomas gastrointestinais. Resultados: Foram avaliados 47 prontuários de pacientes internados em tratamento paliativo, no período de maio a julho de 2015. Destes, 55,32% pertenciam ao sexo masculino e 44,68% ao feminino, com média de idade de 61,51 anos. Entre os tumores primários encontrados, o câncer de pulmão totalizou 21,28%. O estadiamento clínico IV foi o predominante, com 74,46%. O estado nutricional mostrou que 51,06% dos pacientes foram classificados com desnutrição suspeita/moderada e 42,55% com desnutrição grave. As maiores incidências de sintomas gastrointestinais foram anorexia, boca seca e constipação. Houve associação significativa entre anorexia (p=0,0374) e náuseas (p=0,0232) em relação ao estado nutricional dos pacientes classificados com algum grau de desnutrição. Conclusão: A presença de sintomas gastrointestinais é frequente nessa população e está associada à piora do estado nutricional.

Objective: Retrospective, exploratory and descriptive research, quantitative approach, whose goal was to identify the gastrointestinal symptoms presented by oncologic patients in palliative care and relate to their nutritional status. Methods: For the analysis of the nutritional status, anthropometric parameters and Patient-Generated Subjective Global Assessment also identifies the gastrointestinal symptoms were used. Results: Forty-seven medical records of patients admitted to palliative treatment in the period from May to July 2015 were assessed. Of these, 55.32% were male and 44.68% female, with an average age of 61.51 years. Among the primary tumors found, lung cancer amounted to 21.28%. The clinical stage IV was the predominant, with 74.46%. The nutritional status showed that 51.06% of the patients were classified with moderate or suspected malnutrition and 42.55% with severely malnourished. The highest incidences of gastrointestinal symptoms were anorexia, dry mouth, and constipation. There was a significant association between anorexia (p=0.0374) and nausea (p=0.0232) relative to the nutritional status of patients classified with some degree of malnutrition. Conclusion: The gastrointestinal symptoms presence is frequent in this population and is associated with worsening nutritional status.

Correlación entre los síntomas digestivos y los resultados de una prueba de hidrógeno en aliento en el diagnóstico de intolerancia a carbohidratos

Antecedentes: Las pruebas de hidrógeno en aliento (PHA) se utilizan para el diagnóstico de intolerancia a carbohidratos y sobrecrecimiento bacteriano intestinal. Objetivo: Determinar si existe una correlación entre la presencia e intensidad de los síntomas experimentados por el paciente tras la carga de carbohidrato y el resultado de la PHA. Materiales y métodos: Estudio observacional, retrospectivo y analítico en el cual se revisaron los expedientes con PHA realizadas en el Hospital San José TEC de Monterrey. Mediante una escala visual análoga se reportaron los síntomas y su intensidad presentados durante la PHA. Se realizó estadística descriptiva y para las pruebas de lactosa se calculó el coeficiente de correlación de Pearson entre la concentración máxima de hidrógeno y la intensidad de los síntomas (r). Resultados: 33 pacientes se sometieron a PHA: 23 de lactosa, 5 de fructosa y 5 de lactulosa. De estas, 10, 2 y 5 pruebas resultaron positivas, respectivamente. En las pruebas de lactosa, el síntoma más sensible fue la flatulencia (80%) con el coeficiente de probabilidad más alto (1,73). La diarrea tuvo la mayor especificidad (84,6%). Se observó una tendencia a positividad cuando los pacientes experimentaron síntomas. Se encontró una correlación moderadamente positiva entre las ppmh y la intensidad de los síntomas (r=0,472, p=0,023). Conclusiones: En los pacientes con intolerancia a la lactosa existe una correlación entre la intensidad de los síntomas y la positividad de la prueba de aliento. La presencia de flatulencia tras la carga de lactosa orienta a una prueba positiva.

Background: Hydrogen breath tests (HBT) are used to confirm the diagnosis of carbohydrate intolerance or small intestinal bacterial overgrowth (SIBO). Objective: Determine the existence of a correlation between the presence and intensity of symptoms experimented by the patient after the ingestion of a carbohydrate load and the test result. Materials and methods: This is an observational, retrospective and analytic study, in which all patients files from year 2008 to 2014 containing a report of a HBT performed at Hospital San José TEC de Monterrey were revised. Using a visual analogue scale (VAS), the patient reported the intensity of gastrointestinal symptoms during the test. Descriptive statistics were obtained, and exclusively for lactose HBTs, Pearsons correlation coefficient (r) between maximum hydrogen concentration in breath and symptom intensity was calculated. Results: A HBT was performed in 33 patients: 23 with lactose, 5 with fructose, and 5 with lactulose as substrate. Of these, 10, 2, and 5 tests were positive, respectively. For lactose HBTs, the symptom with most sensitivity was flatulence (80%), which also had the greatest likelihood ratio for a positive test (1.73). Diarrhea had the greatest specificity (84.6%). A tendency for positivity was observed when patients presented symptoms. A moderately positive correlation between hydrogen ppm and symptom intensity was found (r=0.427, p=0.023). Conclusions: A correlation between symptom intensity and test positivity was found in patients with lactose intolerance. The presence of flatulence after lactose loading may be indicative of a positive test.

The efficacy of SB knife in peroral endoscopic myotomy for achalasia / 中华消化内镜杂志

Objective To investigate the efficacy and safety of SB( stag beetle) knife in peroral en?doscopic myotomy( POEM) for achalasia( AC) . Methods A total of 58 cases of AC treated with POEM at department of gastroenterology of the People′s Hospital of Wuhan University from January 2013 to December 2014 were randomly divided into two groups,SB knife group and Dual knife group by using random number table, 29 patients in each group. The complications and therapeutic effects were analyzed. Results All 58 patients with achalasia successfully completed POEM. There were no significant complications in SB knife group such as subcutaneous emphysema, perforation or bleeding.But there were 4 cases of subcutaneous em?physema and 4 cases of bleeding occurred in Dual knife group.The overall incidence of complications was sig?nificantly lower in SB group than that in Dual knife group[0 VS 27?6%(8/29), P0?05). Conclusion SB knife is safe and effective for achalasia with POEM, which can effectively shorten the operation time and reduce the inci?dence of complications.

Prevalência de sinais e sintomas digestórios em trabalhadoras rurais e fatores associados / Prevalence of digestive signs and symptoms and associated factors among rural workers

Objetivo: Conhecer a prevalência de sinais e sintomas digestórios em trabalhadoras rurais e identificar fatores associados mais frequentes. Métodos Estudo transversal que incluiu 182 trabalhadoras rurais maiores de 18 anos e de agricultura de hortifrutigranjeiros. Para avaliar a consistência interna dos dados utilizou-se o coeficiente alfa de Cronbach. Para comparar médias entre os grupos, o teste t de Student foi aplicado para amostras independentes. Em caso de assimetria, foi utilizado o teste de Mann-Whitney. Resultados A prevalência de sinais e sintomas digestórios relatados foi 31,9%. Os sinais e sintomas digestórios relatados foram: dor epigástrica (27,4%), regurgitação (18,1%), inchaço (9,9%), náusea (9,9%) e vômitos (6,0%). Conclusão A prevalência de sinais e sintomas digestórios relatados por trabalhadoras rurais foi alto e esteve associado a idade maior de 60 anos, utilização de pesticidas agrícolas e ascendência italiana.

Objective: To determine the prevalence of digestive signs and symptoms in rural workers and identify frequently associated factors. Methods This cross-sectional study included 182 rural and horticultural farm workers aged 18 years or older. To assess internal data consistency, the Cronbach’s alpha coefficient was used. To compare means between groups, student’s t-test was used for independent samples. The Mann–Whitney test was used in cases of asymmetry. Results The prevalence of digestive signs and symptoms was 31.9%. The signs and symptoms included epigastric pain (27.4%), regurgitation (18.1%), bloating (9.9%), nausea (9.9%), and vomiting (6.0%). Conclusion The prevalence of digestive signs and symptoms reported by rural workers was high and was associated with being older than 60 years, using agricultural pesticides, and being of Italian descent.

Análise dos achados endoscópicos mais comuns em pacientes com sintomas dispépticos / Analysis of common endoscopic findings in patients with dyspeptic symptoms

Introdução: dispepsia representa queixa comum na prática clínica diária. É um conjunto variável de sintomas como dor ou queimação epigástrica, saciedade precoce ou plenitude pós-prandial, de acordo com os Critérios Diagnósticos Roma III. Associações entre esses sintomas, idade, sexo e achados endoscópicos sugerem diferentes prevalências. Faltam pesquisas com bases científicas para sistematizar quais pacientes devem ser submetidos à endoscopia. Objetivo: descrever a prevalência dos achados endoscópicos e relacioná-los às características dos pacientes com sintomas dispépticos submetidos à Endoscopia Digestiva Alta (EDA). Métodos: Estudo transversal, descritivo e analítico, realizado no HGCR (Hospital Governador Celso Ramos) em Florianópolis - SC. Foram analisados 450 laudos endoscópicos de pacientes que apresentaram como indicação dispepsia e/ou sintomas dispépticos para a realização de EDA. Coletou-se dados acerca da indicação, sexo, idade e achados à endoscopia, que foram analisados pelo teste Qui-quadrado e Fisher no software SPSS18.0. Este trabalho foi aprovado pelo Comitê de Ética da Unisul (Universidade do Sul de Santa Catarina). Resultados: a maioria dos laudos do estudo apresentou alterações à EDA, sendo o principal achado a gastrite enantematosa e/ou erosiva. Do total, a maioria pertencia a mulheres entre 30 e 49 anos. Associações de idade até 30 anos e EDA normal, assim como pacientes acima de 70 anos e câncer gástrico, foram estatisticamente significantes.

Introduction: dyspepsia is a common complaint in daily clinical practice. It is a variable set of symptoms, such as epigastric pain or burning, early satiety or postprandial fullness, according to Rome III. Associations between these symptoms, age, gender and endoscopic findings suggest different prevalences. There are insufficient researches with scientific bases to systematize which patients should undergo upper endoscopy. Objective: to describe the prevalence of endoscopic findings and relate to the characteristics of patients with dyspeptic symptoms undergoing upper endoscopy. Methods: crosssectional, descriptive and analytical study was carried out in a Hospital in Florianópolis-SC. We analyzed 450 endoscopic reports with dyspepsia as an indication and/ or dyspeptic symptoms for the realization of upper endoscopy. Data were collected on the indication, such as age, gender and endoscopic findings, which were analyzed by chi-square and Fisher tests in software SPSS 18.0. This study was approved by the Ethics Committee of Unisul. Results: most of the reports of the study presented findings in the endoscopy, the main findings were enanthematous and/or erosive gastritis. Of the total, the majority belonged to women between 30 and 49 years old. Associations between 30 years old or less and normal endoscopy, as well as, patients over 70 years and gastric cancer were statistically significant. Conclusion: the prevalence of upper endoscopy with some found in dyspeptic patients was high. Enanthematous and/or erosive gastritis was the most prevalent finding. Most patients were female, mean age of patients 45 years and the main dyspeptic symptom was epigastric pain. Associations between age and findings can be made.

Estudo randomizado para avaliação da dieta hipolipídica nos sintomas digestivos no pós-operatório imediato da colecistectomia por videolaparoscopia / Randomized study for assessment of hypolipidic diet in digestive symptoms immediately following laparoscopic cholecystectomy

OBJETIVO: Validar a necessidade da prescrição da dieta hipolipídica na prevenção ou redução dos sintomas dispépticos no período pós-operatório de pacientes submetidos à colecistectomia por videolaparoscopia. MÉTODOS: Foram selecionados 40 pacientes, distribuídos em dois grupos, isentos de doenças hepáticas, pancreáticas, litíase da via biliar, gastrite, úlcera, diabetes e dislipidemia. Foi realizado anamnese alimentar, identificação de dispepsias antes do aparecimento da colelitíase e orientações sobre a conduta alimentar no pós-operatório (normal ou hipolipídica). Foi utilizado o teste chi-square e a correlação de Pearson, considerando pd"0,05 como significância estatística. RESULTADOS: Comparando-se os dois grupos de pacientes sem dispepsias no pré-operatório, observou-se que no grupo I, sete pacientes (63,6%) permaneceram assintomáticos e no grupo II, quatro (66,7%). No grupo I, em quatro (36,4%) houve aparecimento de sintomas e no grupo II, em dois (33,3%), logo p=0,684. Correlacionando-se os dois grupos dispépticos no pré-operatório, observou-se que houve permanência, aparecimento ou desaparecimento dos sintomas no pós-operatório, sendo p=0,114. CONCLUSÃO: Não houve repercussão significativa da dieta hipolipídica na prevenção dos sintomas dispépticos, principalmente nos pacientes assintomáticos no pré-operatório. Sendo assim, não há necessidade em se orientar uma dieta hipolipídica. De modo que, cabe ao cirurgião avaliar cada paciente individualmente e ajustar a dieta às necessidades do paciente e às condições clínicas associadas.

OBJECTIVE: To validate the need for prescribing low-fat diet in the prevention or reduction of dyspeptic symptoms in the postoperative period in patients undergoing laparoscopic cholecystectomy. METHODS: We selected 40 patients, free of liver or pancreatic disease, biliary gallstones, gastritis, ulcer, diabetes and dyslipidemia, who were divided into two groups. We conducted dietary anamnesis, identification of dyspepsia before the onset of cholelithiasis and guidance on appropriate postoperatively feeding (normal or low-fat). We used the chi-square test and Pearson correlation for statistical assessment, considering p d" 0.05 as significant. RESULTS: When comparing the two groups of patients without preoperative dyspepsia, it was observed that in group I seven patients (63.6%) were asymptomatic and in group II, four (66.7%). In group I, four (36.4%) had onset of symptoms and in group II, two (33.3%), p = 0.684. When correlating the two groups with preoperative dyspeptic symptoms, it was observed that there was permanence, appearance or disappearance of symptoms postoperatively, p = 0.114. CONCLUSION: There was no significant effect of low-fat diet in the prevention of gastrointestinal symptoms, especially in preoperatively asymptomatic patients. Thus, there is no need of a low-fat diet. So, it is up to the surgeon to evaluate each patient individually and adjust the diet to his/her needs and clinical conditions.

The Prevalence of Gastrointestinal Symptoms in Patients with Non-Insulin Dependent Diabetes Mellitus

BACKGROUND/AIMS: Gastrointestinal (GI) symptoms are common among patients with non-insulin dependent diabetes mellitus (NIDDM). Our aim was to investigate the frequency of chronic GI symptoms in Korean patients with NIDDM. METHODS: A cross-sectional survey, using a reliable and valid questionnaire, was performed in diabetes clinics from seven hospitals of the Catholic University of Korea. RESULTS: A total of 608 patients (249 males and 359 females, mean age 53.7+/-10.9 years) were investigated. The frequencies of weekly heartburn and acid regurgitation (esophageal symptoms) were 7.1% (95% confidence interval [CI], 5.0 to 9.2) and 4.4% (95% CI, 2.8 to 6.1), respectively. The frequency of dyspepsia was 13.2% (95% CI, 10.5 to 15.8). The frequencies of constipation and diarrhea were 15.0% (95% CI, 12.2 to 18.0) and 5.3% (95% CI, 3.5 to 7.1), respectively. Nausea and the use of manual maneuvers to facilitate defecation were more prevalent in women than in men. Constipation and fecal incontinence were more common in diabetes patients with long duration (>10 years). Fecal incontinence and using laxatives were more frequent in the complicated diabetes group. Using laxatives was more frequent in the uncontrolled diabetes group. CONCLUSIONS: Two-thirds of diabetic patients experienced GI symptoms. The prevalence of GI symptoms was more common in patients who had diabetic complications and a long duration of diabetes.