RESUMO
INTRODUCTION AND AIM: Functional gastrointestinal disorders (FGIDs) are complex illnesses characterized by gastrointestinal symptoms, with no underlying organic pathology. They are common, chronic, recurrent, and disabling disorders that significantly impair quality of life (QoL). The aim of the present cross-sectional analytical study was to assess QoL and its correlates in adult patients with FGIDs. MATERIALS AND METHODS: A cross-sectional, observational, hospital-based study was conducted at the gastroenterology outpatient department of a tertiary care teaching hospital. The ROME IV diagnostic criteria were used to identify the FGIDs. Anxiety, depression, coping strategies, social support, and QoL were assessed by the hospital anxiety and depression scale, the coping strategies inventory, the multidimensional scale of perceived social support, and the functional digestive disorders quality-of-life questionnaire, respectively. RESULTS: Of the 52 consecutive patients diagnosed with FGIDs, functional dyspepsia (51.92%) and irritable bowel syndrome (40.38%) were the most common. There were no significant associations between sociodemographic variables (age, sex, marital status, socioeconomic status, educational level, employment, occupation, dietary pattern) and QoL scores (all p values >0.05). Duration and social support were not significantly associated with QoL (all p values >0.05). In contrast, psychological variables, such as disengagement coping (r=-0.344, p=0.012), depression (r=-0.600, p=0.000), and anxiety (r=-0.590, p=0.000), were significantly correlated with QoL. CONCLUSIONS: Despite advances in neurogastroenterology, patients continue to be disabled by FGIDs. Psychological factors, especially depression, significantly contribute to poor QoL in those patients and should be addressed in a holistic, multidisciplinary way. The biopsychosocial framework, as it applies to FGIDs, should lead to the inclusion of psychosocial assessments in the clinical management and research of those disorders.
RESUMO
A total of 45 strains of Vibrio cholerae O1 isolated from 10 different places in India where they were associated with cases of cholera between the years 2007 and 2008 were examined by molecular methods. With the help of phenotypic and genotypic tests the strains were confirmed to be O1 El Tor biotype strains with classical ctxB gene. Polymerase chain reaction (PCR) analysis by double - mismatch amplification mutation assay PCR showed 16 of these strains carried the ctxB-7 allele reported in Haitian strains. Sequencing of the ctxB gene in all the 45 strains revealed that in 16 strains the histidine at the 20th amino acid position had been replaced by asparagine and this single nucleotide polymorphism did not affect cholera toxin production as revealed by beads enzyme-linked immunosorbent assay. This study shows that the new ctxB gene sequence was circulating in different places in India. Seven representatives of these 45 strains analysed by pulsed - field gel electrophoresis showed four distinct Not I digested profiles showing that multiple clones were causing cholera in 2007 and 2008.
Assuntos
Toxina da Cólera/genética , Vibrio cholerae O1/classificação , Vibrio cholerae O1/genética , Técnicas de Tipagem Bacteriana , Eletroforese em Gel de Campo Pulsado , Ensaio de Imunoadsorção Enzimática , Genótipo , Haiti , Índia , Análise de Sequência de DNARESUMO
Plasmid RP4, which normally confers resistance to ampicillin (Apr), tetracycline (Tcr), and kanamycin (Kmr) to its hosts, failed to express enhanced Apr when transferred from Escherichia coli to Azospirillum brasilense which has its own intrinsic beta-lactamase. Even in a beta-lactamase-deficient mutant, A. brasilense RG-D16, no increase in beta-lactamase or significant Apr appeared following transfer of RP4. However, A. brasilense RG (RP4) and A. brasilense RG-D16 (RP4) did exhibit Tcr Kmr. When RP4 was transferred back from A. brasilense to E. coli all three drug resistances and beta-lactamase activity were fully expressed.