RESUMO
Purpose: Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBDs) with multifactorial causes. They are becoming more prevalent in developing countries such as Brazil; however, relevant studies in poorer regions of the country are limited. Here, we report the clinical-epidemiological profile of patients with IBD treated at reference centers in three states of Northeast Brazil. Patients and Methods: This was a prospective cohort study involving patients at referral outpatient clinics for IBD from January 2020 through December 2021. Results: Of 571 patients with IBD, 355 (62%) had UC, and 216 (38%) had CD. The patients were predominantly women (355, 62%) for both UC and CD. Extensive colitis was the pattern present in 39% of the UC cases. For CD, ileocolonic disease was the predominant manifestation (38%), with 67% of cases showing penetrating and/or stenosing behavior. The majority of patients were diagnosed between the ages of 17 and 40, corresponding to 60.2% in CD and 52.7% in UC. The median time between symptom onset and diagnosis was 12 months for CD and 8 months for UC (p=0.042). Joint involvement was the most frequent extraintestinal manifestation, with arthralgia and arthritis present in 41.9% and 18.6% of the patients, respectively. Biological therapy was prescribed to 73% of CD patients and 26% of UC patients. A progressive increase in new cases was observed in every 5-year interval over the last five decades, with 58.6% being diagnosed in the last 10 years. Conclusion: More extensive disease behavior patterns predominated in UC, while forms associated with complications were prevalent in CD. A prolonged time to diagnosis may have contributed to these findings. A progressive increase in IBD incidence was observed and may be related to greater urbanization and better access to specialized outpatient clinics, resulting in improvements in diagnosis.
RESUMO
This study assessed the efficacy of chitosan (CHI) and Mentha piperita L. essential oil (MPEO) alone or in combination to control the mycelial growth of five different Colletotrichum species, C. asianum, C. dianesei, C. fructicola, C. tropicale and C. karstii, identified as potential anthracnose-causing agents in mango (Mangifera indica L.). The efficacy of coatings of CHI and MPEO mixtures in controlling the development of anthracnose in mango cultivar Tommy Atkins was evaluated. CHI (2.5, 5, 7.5 and 10 mg/mL) and MPEO (0.3, 0.6, 1.25, 2.5 and 5 µL/mL) alone effectively inhibited mycelial growth of all tested Colletotrichum strains in synthetic media. Mixtures of CHI (5 or 7.5 mg/mL) and MPEO (0.3, 0.6 or 1.25 µL/mL) strongly inhibited mycelial growth and showed additive or synergistic inhibitory effects on the tested Colletotrichum strains based on the Abbott index. The application of coatings of CHI (5 or 7.5 mg/mL) and MPEO (0.6 or 1.25 µL/mL) mixtures that presented synergistic interactions decreased anthracnose lesion severity in mango artificially contaminated with either of the tested Colletotrichum strains over 15 days of storage at 25 °C. The anthracnose lesion severity in mango coated with the mixtures of CHI and MPEO was similar or lower than those observed in mango treated with the synthetic fungicides thiophanate-methyl (10 µg a.i./mL) and difenoconazole (0.5 µg a.i./mL). The application of coatings containing low doses of CHI and MPEO may be an effective alternative for controlling the postharvest development of anthracnose in mango cultivar Tommy Atkins.
