RESUMO
La Salud Mental en el hospital general nos permite trazar lazos interdisciplinarios con otras disciplinas a la vez que se hace visible el padecimiento subjetivo, no solo de los pacientes internados por salud mental, sino también de aquellos que lo están por otras especialidades. Se hace visible un cuerpo no solo biológico sino además libidinal. Este equipo conformado fundamentalmente en contexto de Pandemia, cumple funciones vinculadas a un Segundo Nivel de complejidad, abordando situaciones de Crisis, Urgencia y Emergencia subjetiva desde las duplas Psicólogo y Psiquiatra. En el contexto de una Guardia General, en una franja horaria que va de 08 a 20hs. Luego de ese horario, los pacientes ingresan conforme a la Ley de Salud Mental 26.657 y permanecen para ser evaluados a través de guardia pasiva y/o bien de modo presencial, al día siguiente.
RESUMO
Introduction: Sphingosine-1-phosphate (S1P) is a membrane-derived lysophospholipid signaling molecule implicated in various physiological and pathological processes, such as regulation of the immune, cardiovascular, pulmonary, and nervous systems and theoretical cancer-related risks, through extracellular activation of S1P1-5 receptors.Areas covered: S1P receptor agonism is a novel strategy for the treatment of UC targeting lymphocyte recirculation, through blockade of lymphocyte egress from lymph nodes. We conducted an extensive literature review on PUBMED on currently available data on molecular aspects of S1P modulation, the mechanisms of action of S1PR agonists (fingolimod, ozanimod, etrasimod, and KRP-203), and their potential efficacy and safety for the treatment of patients with ulcerative colitis.Expert opinion: Selective S1P modulators have emerged to enlarge the efficacy and safety profile of this class of agents. Phase 3 programs should add the potential body of evidence to prove their benefit for the management of UC patients.
Assuntos
Colite Ulcerativa/tratamento farmacológico , Moduladores do Receptor de Esfingosina 1 Fosfato/uso terapêutico , Receptores de Esfingosina-1-Fosfato/agonistas , Acetatos/uso terapêutico , Ensaios Clínicos como Assunto , Colite Ulcerativa/patologia , Humanos , Indanos/uso terapêutico , Indóis/uso terapêutico , Lisofosfolipídeos/metabolismo , Oxidiazóis/uso terapêutico , Esfingosina/análogos & derivados , Esfingosina/metabolismo , Receptores de Esfingosina-1-Fosfato/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismoRESUMO
Inflammatory bowel disease (IBD) is a chronic systemic inflammatory condition. Previously, the focus has been on extraintestinal manifestations of IBD, including arthritis, psoriasis, and uveitis. Although comorbidities have long been the subject of intensive research in other chronic inflammatory diseases such as rheumatoid arthritis, the concept of comorbidities is only beginning to emerge in IBD. Several comorbid conditions have been proposed to be related to IBD, including cardiovascular disease, neuropsychological disorders, and metabolic syndrome. Recognition of these conditions and their treatment could lead to better management of IBD. This Review aims to explore current knowledge regarding classic and emerging comorbidities related to IBD.
Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/terapia , Síndrome Metabólica/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Comorbidade , Fadiga/epidemiologia , Humanos , Estilo de Vida , Adesão à Medicação , Osteoporose/epidemiologia , Prevalência , Saúde Reprodutiva , Saúde Sexual , Resultado do TratamentoRESUMO
Crohn's disease (CD) is an immune-mediated condition characterized by the transmural inflammation of the gut tissue, associated with progressive bowel damage often leading to surgical intervention. As operative resection of the damaged segment is not curative, a majority of patients undergoing intestinal resections for complicated CD present disease recurrence within 3 years after the intervention. Postoperative recurrence can be defined as endoscopic, clinical, radiological or surgical. Endoscopic recurrence rates within 1 year exceed 60% and the severity, according to the Rutgeerts' score, is associated with worse prognosis and can predict clinical recurrence (in up to 1/3 of the patients). Most importantly, about 50% of patients will undergo a reoperation after 10 years of their first intestinal resection. Therefore, the prevention of postoperative recurrence in CD remains a challenge in clinical practice and should be properly managed. We aim to summarize the most recent data on the definition, risk factors, assessment and treatment of postoperative CD recurrence.