Irritable bowel syndrome: a clinical review.

Irritable bowel syndrome (IBS) remains a clinical challenge in the 21(st) century. It's the most commonly diagnosed gastrointestinal condition and also the most common reason for referral to gastroenterology clinics. Its can affect up to one in five people at some point in their lives, and has a significantly impact of life quality and health care utilization. The prevalence varies according to country and criteria used to define IBS. Various mechanisms and theories have been proposed about its etiology, but the biopsychosocial model is the most currently accepted for IBS. The complex of symptoms would be the result of the interaction between psychological, behavioral, psychosocial and environmental factors. The diagnosis of IBS is not confirmed by a specific test or structural abnormality. It is made using criteria based on clinical symptoms such as Rome criteria, unless the symptoms are thought to be atypical. Today the Rome Criteria III is the current gold-standard for the diagnoses of IBS. Secure positive evidence of IBS by means of specific disease marker is currently not possible and cannot be currently recommended for routine diagnosis. There is still no clinical evidence to recommend the use of biomarkers in blood to diagnose IBS. However, a number of different changes in IBS patients were demonstrated in recent years, some of which can be used in the future as a diagnostic support. IBS has no definitive treatment but could be controlled by non-pharmacologic management eliminating of some exacerbating factors such certain drugs, stressor conditions and changes in dietary habits.The traditional pharmacologic management of IBS has been symptom based and several drugs have been used. However, the cornerstone of its therapy is a solid patient physician relationship. This review will provide a summary of pathophysiology, diagnostic criteria and current and emerging therapies for IBS.

The prevalence and clinical characteristics of primary headache in irritable bowel syndrome: a subgroup of the functional somatic syndromes.

CONTEXT: The irritable bowel syndrome and primary headache are two chronic diseases characterized by symptoms of recurring pain and affect approximately 10%-20% of the general population. OBJECTIVES: To study the prevalence of primary headache in volunteers with irritable bowel syndrome in a Brazilian urban community. METHODS: It was evaluated the prevalence of primary headache associated with irritable bowel syndrome in adult volunteers 330 no patients.The protocol included the Rome III criteria, international classification of Headaches, later divided into four groups: I- Irritable bowel syndrome (n = 52), II- Primary headache (n = 45), III-Irritable bowel syndrome (n = 26) and headache, and IV- Controls (207). RESULTS: We not found significant difference in the average age of the four groups and the diagnosis of irritable bowel syndrome, primary headache and their association was more frequent in females. The frequent use of analgesics was greater in groups II and III. CONCLUSION: Our results suggest that irritable bowel syndrome and primary headache are also common in third world countries. The frequency in use of analgesics in association between the two entities was relevant. The identification of irritable bowel syndrome patients with different clinical sub-types could improve the therapeutics options and the prevention strategies.

Pattern of tick spatial distribution of a fragment of forest in an urban area, through a survey by co2 trap

ABSTRACT The study of the ixodofauna in fragments of woods in an urban area is important to the knowledge of species of tick and the dynamic among wild and domestic hosts, allowing to subsidize proposals for the conservation of the fauna and the control of zoonoses such as Brazilian spotted fever. To accomplish the survey, CO2 traps were built up in six different sites of the forest, during a oneyear period, totalizing 12 collections. The ixodids were collected by monitoring the traps and the adjacent vegetation during two hours and put in ethanol 70° GL. At the laboratory they were identified under the stereoscopic optics. At the end of a one-year period of study 2.122 ixodids were colleted, being 793 larvae (37,3%) and 1.277 nymphs (57,8%) of the genus Amblyomma and 102 were adults (4,9%) of the Amblyomma species. The most constant species was Amblyomma cajennense, present in 83,33% of the collections (71 specimen) followed by Amblyomma dubitatum, present in 50% (30 specimen), and Amblyomma calcaratum, 8,33% (one specimen). The observations showed that in the observed environment the populations of Ixodidae have an aggregate distribution, possibly because of the aggregate distribution of the resource, in the case wild hosts.

RESUMO O estudo da ixodofauna de fragmentos de mata em área urbana é fundamental para o conhecimento das espécies de carrapatos e para a dinâmica de transmissão entre hospedeiros silvestres e domésticos, gerando subsídios para propostas de conservação da fauna e controle de zoonoses como a Febre Maculosa Brasileira. Para o levantamento, quatro armadilhas de CO2 foram montadas em seis localidades na mata do Morro do Imperador, Juiz de Fora, MG, durante um ano, totalizando 12 coletas. Os ixodídeos foram coletados por monitoramento das armadilhas e vegetação adjacente durante o período de duas horas e acondicionados em etanol 70° GL. No laboratório, os carrapatos foram identificados sob esterioscopia. Ao final de um ano de estudo, foram coletados 2.122 ixodídeos, sendo 793 larvas (37,3%) e 1.277 ninfas (57, 8%) do gênero Amblyomma, além de 102 adultos (4,9%) do gênero Amblyomma. A espécie mais constante foiAmblyomma cajennense, presente em 83,33% das coletas (71 espécimes), seguido de Amblyomma dubitatum presente em 50% (30 espécimes) e Amblyomma calcaratum em 8,33% (um espécime). As observações mostram que, no ambiente estudado, os ixodídeos têm um padrão de distribuição agregado, possivelmente em função da distribuição agregada do recurso, no caso hospedeiros silvestres.

Antidepressant-like and antinociceptive-like actions of 4-(4'-chlorophenyl)-6-(4''-methylphenyl)-2-hydrazinepyrimidine Mannich base in mice.

This study investigated the possible antidepressant and antinociceptive action of CPMPH Mannich base, as well as the involvement of serotonergic, dopaminergic, noradrenergic and opioid systems and the L-arginine-nitric oxide pathway in the antidepressant-like effect of CPMPH in the forced swimming test (FST) in mice. The immobility time in the FST was significantly reduced by CPMPH (0.1-10 mg/kg, i.p.), without accompanying changes in the ambulation in an open-field. CPMPH at high doses (i.p. or s.c. routes) produced a significant inhibition of acetic acid-induced writhing. The antidepressant-like effect of CPMPH (1 mg/kg, i.p.) in the FST was prevented by pre-treatment of mice with methysergide (2 mg/kg, i.p., a non-selective serotonin receptor antagonist), sulpiride (32 mg/kg, i.p., a D2 receptor antagonist) or yohimbine (1 mg/kg, i.p., an alpha2-adrenoceptor antagonist). In contrast, the antidepressant-like effect of CPMPH was not affected by pre-treatment (i.p.) with naloxone (1 mg/kg, a non-selective opioid receptor antagonist) or L-arginine (750 mg/kg, a nitric oxide precursor). The results demonstrate that CPMPH had an antidepressant-like action that appears to be mediated through its interaction with serotonergic, dopaminergic and noradrenergic systems.