Navegando por Palavras-chave "Inflammatory bowel diseases"
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- ItemAcesso aberto (Open Access)Anemia in inflammatory bowel disease: prevalence, differential diagnosis and association with clinical and laboratory variables(Associação Paulista de Medicina - APM, 2014-04-14) Alves, Rodrigo Andrade; Miszputen, Sender Jankiel; Figueiredo, Maria Stella [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVES:Anemia is the most frequent extraintestinal complication of inflammatory bowel disease. This study aimed to: 1) determine the prevalence of anemia among patients with inflammatory bowel disease; 2) investigate whether routine laboratory markers are useful for diagnosing anemia; and 3) evaluate whether any association exists between anemia and clinical/laboratory variables.DESIGN AND SETTING:Cross-sectional at a federal university.METHODS:44 outpatients with Crohn's disease and 55 with ulcerative colitis were evaluated. Clinical variables (disease activity index, location of disease and pharmacological treatment) and laboratory variables (blood count, iron laboratory, vitamin B12 and folic acid) were investigated.RESULTS:Anemia and/or iron laboratory disorders were present in 75% of the patients with Crohn's disease and in 78.2% with ulcerative colitis. Anemia was observed in 20.5% of the patients with Crohn's disease and in 23.6% with ulcerative colitis. Iron-deficiency anemia was highly prevalent in patients with Crohn's disease (69.6%) and ulcerative colitis (76.7%). Anemia of chronic disease in combination with iron deficiency anemia was present in 3% of the patients with Crohn's disease and in 7% of the patients with ulcerative colitis. There was no association between anemia and disease location. In ulcerative colitis, anemia was associated with the disease activity index.CONCLUSIONS:Most patients present iron laboratory disorders, with or without anemia, mainly due to iron deficiency. The differential diagnosis between the two most prevalent types of anemia was made based on clinical data and routine laboratory tests. In ulcerative colitis, anemia was associated with the disease activity index.
- ItemAcesso aberto (Open Access)Avaliação das alterações do sono em pacientes com doença inflamatória intestinal e a relação com períodos de remissão e atividade da doença(Universidade Federal de São Paulo (UNIFESP), 2017-06-14) Paixão, Deise Luna [UNIFESP]; Paiotti, Ana Paula Ribeiro [UNIFESP]; Chagas, Jair Ribeiro [UNIFESP]; http://lattes.cnpq.br/2482076525999383 ; http://lattes.cnpq.br/9404512862732685 ; http://lattes.cnpq.br/7045332401797527; Universidade Federal de São Paulo (UNIFESP)Introdução: A patogênese da DII não está definida, entretanto, fatores genéticos, imunológicos e ambientais são reportados como possíveis desencadeadores. Distúrbios do sono com alteração no ciclo circadiano, que afetam o sistema imune, têm sido descritos como potencial gatilho e/ou fator predisponente para ativação da doença, contribuindo para a piora do quadro clínico. Dessa forma, se faz necessário caracterizar esses distúrbios nesse grupo de pacientes. Objetivo: Avaliar a qualidade do sono nos pacientes com DII e relacioná-los aos períodos de atividade ou remissão da doença. Casuística e Método: Uma amostra de conveniência com 20 participantes foi incluída, sendo 11 com RCUI e nove participantes com DC (sete com doença ativa e 13 em remissão). Foram realizados exames de polissonografia e aplicados dois questionários: índice de qualidade do sono de Pittsburgh (PSQI) e escala modificada de impacto de fadiga (MIFS). As interleucinas IL-6, IL-10 e TNF-α foram mensuradas por ELISA no soro dos participantes. Os dados foram analisados por estatística descritiva, teste de normalidade, teste Exato de Fisher, teste t/Mann Whitney e teste de correlação de Spearman. Resultados: A latência do sono nos participantes com a doença ativa foi de, em média, 133,07 minutos e em remissão, foi de 106,79 minutos. A eficiência do sono foi de 80,90% na doença ativa e 84,20% em remissão. O escore total do PSQI foi igual ou maior que cinco para todos os voluntários incluídos no estudo, o que denota uma má qualidade do sono. No MIFS, observamos diferença significativa entre doença ativa e remissão (p=0,032), onde a maioria dos participantes com a doença em remissão relataram ausência de fadiga. Na análise da dosagem das interleucinas observamos valores aumentados em ambos os grupos. Conclusão: Não houve alterações significativas na qualidade do sono dos participantes por meio do exame de polissonografia, independentemente da fase da doença. Entretanto, houve um aumento na queixa dos participantes em relação a qualidade do sono e sintomas de fadiga por meio dos questionários aplicados. Os valores séricos das citocinas IL-6 e TNF-α estão aumentados nesses pacientes, independente da fase da doença, no entanto não foi possível estabelecer correlação entre os parâmetros. Sugerimos o acompanhamento da qualidade do sono nesse grupo de pacientes e um estudo mais amplo para elucidar essas alterações.
- ItemAcesso aberto (Open Access)Case for diagnosis(Sociedade Brasileira de Dermatologia, 2012-12-01) Mesquita, Kleyton De Carvalho; Costa, Izelda Maria Carvalho [UNIFESP]; University of Brasilia; Federal District Department of Health; Universidade Federal de São Paulo (UNIFESP)Pyodermatitis-pyostomatitis vegetans is a rare mucocutaneous dermatosis characterized by pustular and vegetating lesions of the skin and oral mucosa. It is considered a highly specific marker for inflammatory bowel diseases. The authors describe a case of pyodermatitis-pyostomatitis vegetans in a pediatric patient who presented marked clinical improvement after beginning treatment with oral corticosteroids, azathioprine, and dapsone. Bowel surveillance is mandatory, since the dermatosis is associated with inflammatory bowel diseases in more than 70% of patients, especially ulcerative colitis.
- ItemSomente MetadadadosInfliximab to treat severe ulcerative colitis(Baishideng Publ Grp Co Ltd, 2009-04-14) Cury, Didia Bisamra [UNIFESP]; Cury, Marcelo de Souza [UNIFESP]; Elias, Geraldo Vinicius Hemerly [UNIFESP]; Mizsputen, Sender Lankiel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A 48-year-old female with severe ulcerative colitis refractory to conventional therapy was referred to our facility for management. the patient showed extensive ulcerative colitis since the age of 20 years and had failed therapy with 5-aminosalicylic acid agents and azathioprine. the disease remained active despite treatment with steroids and cyclosporine. the clinical and endoscopic parameters were consistent with severe disease. Infectious precipitants were ruled out. Given the severity of the disease and in order to avoid a colectomy, we started the patient on infliximab therapy. A dramatic clinical and endoscopic response was observed and she remained in remission at the end of a 1-year follow-up period. We discuss findings in the literature regarding the use of infliximab therapy in patients with ulcerative colitis who have failed steroids and cyclosporine. (C) 2009 the WJG Press and Baishideng. All rights reserved.
- ItemAcesso aberto (Open Access)Qualidade de vida em pacientes portadores de doença inflamatória intestinal: tradução para o português e validação do questionário Inflammatory Bowel Disease Questionnaire (IBDQ)(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2004-06-01) Pontes, Rose Meire Albuquerque; Miszputen, Sender Jankiel [UNIFESP]; Ferreira-filho, Olavo Franco; Miranda, Cláudio [UNIFESP]; Ferraz, Marcos Bosi [UNIFESP]; Universidade Estadual de Londrina; Universidade Federal de São Paulo (UNIFESP); UEL Departamento de Clínica MédicaBACKGROUND: Crohn's disease comprises, together with ulcerative colitis, the inflammatory bowel diseases, which because their morbidity and chronic evolution have a considerable impact on the patient's quality of life. The measurement of quality of life requires the determination of the degree of subjective well-being attributed to the lack of symptoms, to psychological state and daily activity, and is useful as an instrument of evaluation, both in clinical trials and health programs. Inflammatory Bowel Disease Questionnaire is an instrument developed by North-American investigators of McMaster University which reproducibility and validity has been determined in several countries studies, and has shown its use in the measurement of the quality of life of patients with inflammatory bowel diseases. AIMS: Our purpose was to translate that instrument into Portuguese language, its adaptation to Brazilian culture and verify its psychometric properties (validity and reproducibility). METHODS: It was applied to a population of 50 inflammatory bowel diseases patients (24 with Crohn's disease, 26 with ulcerative colitis). To test the criteria and construction validity of the instrument's, it was compared with SF-36, a general questionnaire for establishing quality of life, and the Crohn's Disease Activity Index and Lichtiger's Index. RESULTS: The correlations obtained were mostly moderate. About the intestinal diseases activity index, Lichtiger's index showed better correlations than Crohn's Disease Activity Index. To evaluate its reproducibility, the instrument was applied on three occasions, twice by the same observer (12 days average between applications) and once by a second observer, resulting in a high degree of intra- and interobserver correlation. CONCLUSIONS: Portuguese version of Inflammatory Bowel Disease Questionnaire is a valid and reproducible instrument which can be used to evaluate the quality of life of Brazilian inflammatory bowel diseases patients.