RESUMO
BACKGROUND: Variations in healthcare provision around the world may impact how patients with functional gastrointestinal disorder (FGIDs) are investigated, diagnosed, and treated. However, these differences have not been reviewed. PURPOSES: The Multinational Working Team of the Rome Foundation, established to make recommendations on the conduct of multinational, cross-cultural research in FGIDs, identified seven key issues that are analyzed herein: (i) coverage afforded by different healthcare systems/providers; (ii) level of the healthcare system where patients with FGIDs are treated; (iii) extent/types of diagnostic procedures typically undertaken to diagnose FGIDs; (iv) physicians' familiarity with and implementation of the Rome diagnostic criteria in clinical practice; (v) range of medications approved for FGIDs and approval process for new agents; (vi) costs involved in treating FGIDs; and (vii) prevalence and role of complementary/alternative medicine (CAM) for FGIDs. Because it was not feasible to survey all countries around the world, we compared a selected number of countries based on their geographical and ethno-cultural diversity. Thus, we included Italy and South Korea as representative of nations with broad-based coverage of healthcare in the population and India and Mexico as newly industrialized countries where there may be limited provision of healthcare for substantial segments of the population. In light of the paucity of formal publications on these issues, we included additional sources from the medical literature as well as perspectives provided by local experts and the media. Finally, we provide future directions on healthcare issues that should be taken into account and implemented when conducting cross-cultural and multinational research in FGIDs.
Assuntos
Atenção à Saúde , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Atenção à Saúde/etnologia , Gastroenteropatias/economia , Gastroenteropatias/etnologia , Humanos , Índia , Itália , México , República da CoreiaRESUMO
Chile is a country with high incidence of gastrointestinal diseases, but there are Chilean populations without access to an expeditious endoscopic diagnosis. Easter Island (3.791 inhabitants) and Chile Chico (3.042 inhabitants). Objective: To describe and compare the endoscopic findings in two subgroups of Chilean population of Easter Island (Isla de Pascua) and Chile Chico. Methods: Endoscopic procedures were performed on selected subgroups from Isla de Pascua and Chile Chico during October 2008 and March 2009, in the context of health operations conducted by our hospital. Results: Seventy two patients were evaluated in Isla de Pascua and 52 in Chile Chico. The most frequent endoscopic indications in Isla de Pascua were epigastric pain (22%), heartburn (18.2%), and gastroesophageal reflux (16.2%) and in Chile Chico: gastroesophageal reflux and pirosis (36,5%), epigastric pain (19,3%), and previous gastric ulcer (5.7%). Endoscopic findings in Isla de Pascua and Chile Chico were: gastritis, 26 patients (36.1%) and 5 (9.6%); peptic ulcer 2 (2.7%) and 9 (17.2%); esophagitis 10 (13.8%) and 6 (11.5%); hiatal hernia, 9 (12.5%) and 11 (21%); and endoscopy without lesions 20 (27%) and 13 (25%), respectively. Comparing the findings in both groups the occurrence of two advanced cancers stands out (gastric and esophageal) in the population of Chile Chico; no neoplastic diseases were found in Isla de Pascua. Conclusion: The endoscopic findings in a subgroup of Chileans belonging to isolated populations are described. Differences in the type of digestive diseases suggest that these are different populations despite sharing the same nationality. Future operations will provide a better understanding of these conditions.
Introducción: Chile es un país con alta incidencia de patología digestiva, sin embargo, existen poblaciones chilenas que por situación geográfica no cuentan con acceso expedito a un diagnóstico endoscópico. Objetivo: Describir los hallazgos endoscópicos en dos subgrupos de población chilena de Isla de Pascua y Chile Chico y compararlos entre sí. Métodos: Se realizaron procedimientos endoscópicos a subgrupos seleccionados en Isla de Pascua y Chile Chico en los meses de octubre de 2008 y marzo de 2009, en el marco de los operativos de salud realizados por nuestro Hospital. Resultados: Se evaluaron 72 pacientes en Isla de Pascua y 52 en Chile Chico. Las indicaciones endoscópicas más frecuentes en Isla de Pascua son epigastralgia (22%), pirosis (18,2%) y control de reflujo gastroesofágico (16,2%) y en Chile Chico: reflujo gastroesofágico y pirosis (36,5%), epigastralgia (19,3%) y antecedente de úlcera gástrica (5,7%). Los hallazgos endoscópicos en Isla de Pascua y Chile Chico respectivamente son: gastritis 26 pacientes (36,1%) y 5 (9,6%), úlcera péptica 2 (2,7%) y 9 (17,2%), esofagitis 10 (13,8%) y 6 (11,5%), hernia hiatal 9 (12,5%) y 11 (21%), sin lesiones 20 (27%) y 13 (25%). Al comparar los hallazgos en ambos grupos destaca la presencia de dos cánceres avanzados (gástrico y esofágico) en la población de Chile Chico, sin encontrarse patología neoplásica en Isla de Pascua. Conclusión: Se describen los hallazgos endoscópicos en un subgrupo de chilenos pertenecientes a poblaciones más aisladas. Las diferencias en el tipo de patologías pesquisadas sugiere que se trata de poblaciones diferentes pese a compartir una misma nacionalidad. La realización de futuros operativos permitirá obtener un mayor conocimiento de las patologías más prevalentes en dichas poblaciones y evaluar la influencia de las...
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Endoscopia Gastrointestinal , Gastroenteropatias/etnologia , Chile/epidemiologia , Gastroenteropatias/diagnóstico , Gastroenteropatias/epidemiologia , Doenças do Esôfago/etnologia , Helicobacter pylori/isolamento & purificação , Hemorragia Gastrointestinal/etnologia , Azia/etnologia , Refluxo Gastroesofágico/etnologia , Urease , Úlcera Gástrica/etnologiaRESUMO
El objetivo del presente estudio fue conocer la frecuencia de talla baja en niños del medio rural y estudiar los factores que se encuentran asociados a ella. Se incluyeron todos los niños (n=137) entre 13 y 84 meses de edad, de una población rural del Valle de Oaxaca. Se les midió, y se aplicó un cuestionario a los padres o tutores de los niños. Los datos se analizaron en tablas de contingencias por análisis de varianza. Se encontró que las enfermedades gastrointestinales y respiratorias, los hábitos alimentarios y la escolaridad materna, tienen una asociación inversa y significativa con la talla baja (p< 0.05)
Assuntos
Lactente , Pré-Escolar , Criança , Humanos , Peso-Estatura , Escolaridade , Gastroenteropatias/etnologia , Comportamento Alimentar/etnologia , Comportamento Alimentar/fisiologia , Inquéritos e QuestionáriosRESUMO
The study of folk illnesses provides insight into client health beliefs and behaviors. This paper describes the expression of empacho in children living in a mainland Puerto Rican community. Etiology, symptom presentation, and treatment options in various health care sectors, as well as an investigation of overlapping folk/biomedical symptom domains are described. Implications regarding health and health care in the multicultural setting are discussed.
Assuntos
Gastroenteropatias/etnologia , Medicina Tradicional , Connecticut , Ingestão de Alimentos , Alimentos , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Porto Rico/etnologia , Saliva , Inquéritos e QuestionáriosRESUMO
This paper discusses research designed to investigate the patterns and consequences of the use of lead based folk remedies in the treatment of some gastrointestinal problems in Mexico. Use of lead is seen in 35% of the population sampled in Guadalajara who treated the folk illness empacho, and 5% of a similar population in Oaxaca. Lead use seems to be associated with mestizo ethnic background, and with lower levels of parental education and income.