RESUMO
INTRODUCTION AND AIMS: Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders. Prevalence worldwide is estimated at 11%. There is little information on the prevalence of the other functional bowel disorders (FBDs). Our aim was to establish the prevalence of IBS and other FBDs according to the Rome IV criteria, in Uruguay. MATERIALS AND METHODS: An observational, population-based prevalence study was conducted. Data were collected through an online questionnaire, utilizing the Rome IV criteria. RESULTS: Of the 1,052 participants (79% women, mean patient age 44 years), 47.2% met the Rome IV diagnostic criteria for at least one of the FBDs analyzed. Functional constipation (FC) was the most frequent, at 18.7% (16.4-21.1), followed by IBS at 17.1% (14.9-19.4) and functional diarrhea (FD) at 15.4% (13.3-17.6). IBS with constipation (IBS-C) was the most frequent IBS subtype (35%) and the IBS with diarrhea (IBS-D) subtype predominated in men. All FBDs were more prevalent in women and youths. Of the survey participants with a FBD, 59% stated that they perceived no worsening of their symptoms related to the COVID-19 pandemic. CONCLUSIONS: Ours is the first prevalence study on FBDs conducted on the Uruguayan general population. Half of the participants surveyed presented with a FBD analyzed in the study. FC was the most frequent, followed by IBS and FD. The prevalence rate of IBS was the highest, based on the Rome IV diagnostic criteria, and constipation was the most frequent subtype.
Assuntos
Síndrome do Intestino Irritável , Humanos , Uruguai/epidemiologia , Feminino , Masculino , Síndrome do Intestino Irritável/epidemiologia , Adulto , Prevalência , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Gastroenteropatias/epidemiologia , Idoso , Constipação Intestinal/epidemiologia , Inquéritos e Questionários , Estudos TransversaisRESUMO
The COVID-19 situation is a worldwide health emergency with strong implications in clinical oncology. In this viewpoint, we address two crucial dilemmas from the ethical dimension: (1) Is it ethical to postpone or suspend cancer treatments which offer a statistically significant benefit in quality of life and survival in cancer patients during this time of pandemic?; (2) Should we vaccinate cancer patients against COVID-19 if scientific studies have not included this subgroup of patients? Regarding the first question, the best available evidence applied to the ethical principles of Beauchamp and Childress shows that treatments (such as chemotherapy) with clinical benefit are fair and beneficial. Indeed, the suspension or delay of such treatments should be considered malefic. Regarding the second question, applying the doctrine of double-effect, we show that the potential beneficial effect of vaccines in the population with cancer (or those one that has had cancer) is much higher than the potential adverse effects of these vaccines. In addition, there is no better and less harmful known solution.
Assuntos
COVID-19/prevenção & controle , Tomada de Decisão Clínica/ética , Neoplasias/tratamento farmacológico , Seleção de Pacientes/ética , Tempo para o Tratamento/ética , Antineoplásicos/administração & dosagem , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/virologia , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Humanos , Oncologia/ética , Neoplasias/imunologia , Neoplasias/mortalidade , Neoplasias/psicologia , Pandemias/prevenção & controle , Qualidade de Vida , Fatores de Risco , SARS-CoV-2/imunologia , Fatores de Tempo , Vacinação/efeitos adversos , Vacinação/éticaRESUMO
The high microsatellite instability (MSI-H) is frequently observed in localized colorectal adenocarcinoma. MSI-H is a good prognostic factor in nonmetastatic colon adenocarcinoma. However, MSI-H is not a predictive factor because it is not related with better survival in patients with colon cancer with adjuvant chemotherapy. MSI-H should be a predictive factor because it is associated with a higher expression of enzymes, which are inhibited by cytotoxic agents. Here, we analyze this controversy. We conclude MSI-H is not a predictive factor because the adjuvant therapy based on traditional cytotoxic agents does not act on either immune signaling pathways or BRAF mutation.
Assuntos
Neoplasias do Colo/tratamento farmacológico , Instabilidade de Microssatélites , Proteínas Proto-Oncogênicas B-raf/genética , Idoso , Quimioterapia Adjuvante , Neoplasias do Colo/genética , Neoplasias do Colo/patologia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , PrognósticoRESUMO
Bacteria isolated from Mimosa nodules in Taiwan, Papua New Guinea, Mexico and Puerto Rico were identified as belonging to either the alpha- or beta-proteobacteria. The beta-proteobacterial Burkholderia and Cupriavidus strains formed effective symbioses with the common invasive species Mimosa diplotricha, M. pigra and M. pudica, but the alpha-proteobacterial Rhizobium etli and R. tropici strains produced a range of symbiotic phenotypes from no nodulation through ineffective to effective nodulation, depending on Mimosa species. Competition studies were performed between three of the alpha-proteobacteria (R. etli TJ167, R. tropici NGR181 and UPRM8021) and two of the beta-rhizobial symbionts (Burkholderia mimosarum PAS44 and Cupriavidus taiwanensis LMG19424) for nodulation of these invasive Mimosa species. Under flooded conditions, B. mimosarum PAS44 out-competed LMG19424 and all three alpha-proteobacteria to the point of exclusion. This advantage was not explained by initial inoculum levels, rates of bacterial growth, rhizobia-rhizobia growth inhibition or individual nodulation rate. However, the competitive domination of PAS44 over LMG19424 was reduced in the presence of nitrate for all three plant hosts. The largest significant effect was for M. pudica, in which LMG19424 formed 57% of the nodules in the presence of 0.5 mM potassium nitrate. In this host, ammonium also had a similar, but lesser, effect. Comparable results were also found using an N-containing soil mixture, and environmental N levels are therefore suggested as a factor in the competitive success of the bacterial symbiont in vivo.
Assuntos
Alphaproteobacteria/isolamento & purificação , Alphaproteobacteria/fisiologia , Betaproteobacteria/isolamento & purificação , Betaproteobacteria/fisiologia , Mimosa/microbiologia , Nitrogênio/metabolismo , Simbiose , Alphaproteobacteria/classificação , Alphaproteobacteria/crescimento & desenvolvimento , Betaproteobacteria/classificação , Betaproteobacteria/crescimento & desenvolvimento , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Genes de RNAr , México , Papua Nova Guiné , Filogenia , Porto Rico , RNA Bacteriano/genética , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Homologia de Sequência do Ácido Nucleico , TaiwanRESUMO
La agricultura de estos últimos años requiere del uso de muchos insumos para mejorar la producción de los cultivos, por esta razón a esta actividad en la actualidad se le considera como una de las que ocasionan el mayor impacto por el uso de fertilizantes químicos, nematicidas, insecticidas, fungicidas, herbicidas entre otros, siendo la localidad de Curahuasi, uno de los valles interandinos con mayor actividad agrícola del Departamento de Apurímac, donde se logra dos cosechas al año, ha merecido la atención mediante el presente proyecto.