712 resultados para Diarrhea incidenc


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P rosea syn. Indica belong to the family of plumbaginaceae, is an important medicinal plant, cultivated widely in India. The roots of these plant are generally used for medicinal purposes mainly as diuretic, germicidal, vessicant, and abortifacient. It is also used for anaemia, diarrhea, leprosy and common wart. The bark of the root contains orange yellow pigment named plumbagin, a crystalline substance, belongs to the class of naphthoquinone. Its chemical structure is 5-hydroxy 2-methyl 1,4naphthoquinone. Apart from P rosea, P zeylanica, P europea, Drosera and Drosophyllum also contains plumbagin. The most exploited source of plumbagin is, of course, P. rosea roots. The roots contain O.9mg/ g D.Wt. of plumbagin in the roots. These plants grow very slowly and the roots suitable for plumbagin extraction can be obtained only after several years of growth. The productivity of the plant is also rather poor. The focus of the present study was to develop alternative strategies to obtain plumbagin. The tissue culture of P rosea for micropropagation has been studied

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The regional population growth in West Africa, and especially its urban centers, will bring about new and critical challenges for urban development policy, especially in terms of ensuring food security and providing employment for the growing population. (Peri-) urban livestock and vegetable production systems, which can contribute significantly to these endeavours, are limited by various constraints, amongst them limited access to expensive production factors and their (in)efficient use. To achieve sustainable production systems with low consumer health risks, that can meet the urban increased demand, this doctoral thesis determined nutrient use efficiencies in representative (peri-) urban livestock production systems in three West African cities, and investigated potential health risks for consumers ensuing from there. The field study, which was conducted during July 2007 to December 2009, undertook a comparative analysis of (peri-) urban livestock production strategies across 210 livestock keeping households (HH) in the three West African cities of Kano/Nigeria (84 HH), Bobo Dioulasso/Burkina Faso (63 HH) and Sikasso/Mali (63 HH). These livestock enterprises were belonging to the following three farm types: commercial gardening plus field crops and livestock (cGCL; 88 HH), commercial livestock plus subsistence field cropping (cLsC; 109 HH) and commercial gardening plus semi-commercial livestock (cGscL; 13 HH) which had been classified in a preceding study; they represented the diversity of (peri-) urban livestock production systems in West Africa. In the study on the efficiency of ruminant livestock production, lactating cowsand sheep herd units were differentiated based on whether feed supplements were offered to the animals at the homestead (Go: grazing only; Gsf: mainly grazing plus some supplement feeding). Inflows and outflows of nutrients were quantified in these herds during 18 months, and the effects of seasonal variations in nutrient availability on animals’ productivity and reproductive performance was determined in Sikasso. To assess the safety of animal products and vegetables, contamination sources of irrigated lettuce and milk with microbiological contaminants, and of tomato and cabbage with pesticide residues in (peri-) urban agriculture systems of Bobo Dioulasso and Sikasso were characterized at three occasions in 2009. Samples of irrigation water, organic fertilizer and ix lettuce were collected in 6 gardens, and samples of cabbage and tomato in 12 gardens; raw and curdled milk were sampled in 6 dairy herds. Information on health risks for consumers of such foodstuffs was obtained from 11 health centers in Sikasso. In (peri-) urban livestock production systems, sheep and goats dominated (P<0.001) in Kano compared to Bobo Dioulasso and Sikasso, while cattle and poultry were more frequent (P<0.001) in Bobo Dioulasso and Sikasso than in Kano. Across cities, ruminant feeding relied on grazing and homestead supplementation with fresh grasses, crop residues, cereal brans and cotton seed cake; cereal grains and brans were the major ingredients of poultry feeds. There was little association of gardens and livestock; likewise field cropping and livestock were rarely integrated. No relation existed between the education of the HH head and the adoption of improved management practices (P>0.05), but the proportion of HH heads with a long-term experience in (peri-) urban agriculture was higher in Kano and in Bobo Dioulasso than in Sikasso (P<0.001). Cattle and sheep fetched highest market prices in Kano; unit prices for goats and chicken were highest in Sikasso. Animal inflow, outflow and dairy herd growth rates were significantly higher (P<0.05) in the Gsf than in the Go cattle herds. Maize bran and cottonseed expeller were the main feeds offered to Gsf cows as dry-season supplement, while Gsf sheep received maize bran, fresh grasses and cowpea pods. The short periodic transhumance of Go dairy cows help them maintaining their live weight, whereas Gsf cows lost weight during the dry season despite supplement feeding at a rate of 1506 g dry matter per cow and day, resulting in low productivity and reproductive performance. The daily live weight gains of calves and lambs, respectively, were low and not significantly different between the Go and the Gsf system. However, the average live weight gains of lambs were significantly higher in the dry season (P<0.05) than in the rainy season because of the high pressure of gastrointestinal parasites and of Trypanosoma sp. In consequence, 47% of the sheep leaving the Go and Gsf herds died due to diseases during the study period. Thermo-tolerant coliforms and Escherichia coli contamination levels of irrigation water significantly exceeded WHO recommendations for the unrestricted irrigation of vegetables consumed raw. Microbial contamination levels of lettuce at the farm gate and the market place in Bobo Dioulasso and at the farm gate in Sikasso were higher than at the market place in Sikasso (P<0.05). Pesticide residues were detected in only one cabbage and one tomato sample and were below the maximum residue limit for consumption. Counts of thermo-tolerant coliforms and Escherichia coli were higher in curdled than in raw milk (P<0.05). From 2006 to x 2009, cases of diarrhea/vomiting and typhoid fever had increased by 11% and 48%, respectively, in Sikasso. For ensuring economically successful and ecologically viable (peri-) urban livestock husbandry and food safety of (peri-) urban foodstuffs of animal and plant origin, the dissemination and adoption of improved feeding practices, livestock healthcare and dung management are key. In addition, measures fostering the safety of animal products and vegetables including the appropriate use of wastewater in (peri-) urban agriculture, restriction to approve vegetable pesticides and the respect of their latency periods, and passing and enforcement of safety laws is required. Finally, the incorporation of environmentally sound (peri-) urban agriculture in urban planning by policy makers, public and private extension agencies and the urban farmers themselves is of utmost importance. To enable an efficient (peri-) urban livestock production in the future, research should concentrate on cost-effective feeding systems that allow meeting the animals’ requirement for production and reproduction. Thereby focus should be laid on the use of crop-residues and leguminous forages. The improvement of the milk production potential through crossbreeding of local cattle breeds with exotic breeds known for their high milk yield might be an accompanying option, but it needs careful supervision to prevent the loss of the local trypanotolerant purebreds.

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Introducción: La enfermedad diarreica aguda (EDA) es la segunda causa de muerte a nivel mundial en menores de cinco años. El rotavirus es el principal entero-patógeno asociado a EDA severa por lo cual se ha iniciado la vacunación contra este virus en Colombia. Este trabajo evaluó la efectividad de la vacunación contra la hospitalización por diarrea en niños menores de dos años en cinco ciudades de Colombia. Metodología: Análisis de sobrevida para estimar la efectividad de la vacuna contra el rotavirus en la prevención de hospitalización por EDA, basado en los datos de una encuesta poblacional realizada en niños menores de dos años de Bogotá, Barranquilla, Cali, Cartagena y Riohacha, en la que se recolectó información socio-demográfica, de vacunación, factores de riesgo para EDA y antecedentes de EDA. Resultados: Incidencia acumulada de hospitalización por diarrea de 5,3%. Cobertura de vacunación fue de 88,5% y 78% para primera y segunda dosis respectivamente. La vacunación con dos dosis presentó una efectividad de 52,4% IC 95% (13,2% a 73,9%) en la prevención de hospitalizaciones por EDA y la vacunación adecuada una efectividad de 59,5% IC 95% (23,9% a78,4%). El sexo masculino y la ciudad de residencia (Riohacha) se asociaron al riesgo de hospitalización. Conclusiones: La vacunación contra rotavirus mostro ser efectiva en la prevención de la hospitalización por EDA. Las coberturas de vacunación y la adherencia al esquema presentan deficiencias que requieren medidas para asegurar la vacunación de todos los niños antes de los seis meses..

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La desnutrición infantil y la pobreza se encuentran asociadas y estas a su vez con el progreso de los países. Conocer las determinantes sociales y económicas de la niñez que padece de bajo peso es necesario para crear escenarios propicios para el adecuado desarrollo de la primera infancia y de esta manera contribuir con la superación de la pobreza en el marco de sistemas sanitarios equitativos. Se realiza una descripción de las características socio-económicas y un análisis de posibles asociaciones entre estas y el bajo peso infantil de una muestra de infantes de uno de los sectores de mayor vulnerabilidad y pobreza de Bogotá (Colombia). La tasa del bajo peso infantil en la muestra del estudio en más alta a la presentada en Bogotá y Colombia (8.5%, 2.9% y 3.4% respectivamente). Al realizar el análisis de las posibles asociaciones entre el bajo peso y las variables de estudio, se evidencia que las relaciones son débiles entre la primera y las segundas, siendo la condición de desplazamiento la que mayor asociación positiva presenta con la deficiencia nutricional seguido del rango de edad entre los 25 y 36 meses. La situación que presenta mayor independencia con respecto al bajo peso infantil es contar con vivienda propia seguida del sexo. La desnutrición infantil se presenta en niveles importantes en sectores de mayor vulnerabilidad con implicaciones para el adecuado desarrollo de los infantes y para las intenciones de reducción de los índices de pobreza en el país. El fortalecimiento de las políticas públicas que favorezca el desarrollo infantil, la superación de la pobreza y las inequidades en los sistemas de salud deben contemplar acciones integrales dirigidas a los más vulnerables, con la participación de la sociedad civil y los sectores públicos y privados, el compromiso político y económico de los gobiernos y reglas claras que contribuyan a la solución estructural de la pobreza y que promueva el adecuado desarrollo infantil.

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Introducción La infección por Clostridium difficile, es una de las causas más frecuentes de diarrea nosocomial con una alta morbimortalidad, con un aumento exponencial en su incidencia, en Estados Unidos se duplicó, de 261 casos x 100.000 en 1993 pasó a 546 x 100.000 en 2003 2, y en Canadá se encontraron datos similares con un aumento de 4.5 veces, en 1991 de 35.6 casos x 100.000 a 156.3 casos por 100.000 en 2004 3 . Se han descrito varios factores asociados Materiales y Métodos Se trata de un estudio descriptivo de tipo serie de casos en el que se evaluaron pacientes con diagnóstico de infección por C. Difficile y los factores asociados en un Hospital Universitario entre febrero de 2010 hasta septiembre de 2011 Resultados Se recolectaron 31 pacientes la edad promedio fue de 58 años con un rango entre 18 y 93 años, de los cuales 19 (61%) fueron mujeres y 12 (39%) hombres. El factor asociado a la infección por C. Difficile más frecuentemente encontrado fue el uso de inhibidores de bomba de protones con 54.84% (n=17) .No se encontraron pacientes VIH positivos o con diagnóstico de enfermedad inflamatoria intestinal. Ningún paciente presentó complicaciones asociadas a la infección ni mortalidad alguna. Conclusión El factor asociado que más se presentó fue el uso de antimicrobianos en los quince dias previos al inicio del cuadro en el 74% de los pacientes lo que coincide con lo presentado en la literatura mundial.

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Introducción: La enfermedad celiaca (EC) es una enfermedad autoinmune (EA) intestinal desencadenada por la ingesta de gluten. Por la falta de información de la presencia de EC en Latinoamérica (LA), nosotros investigamos la prevalencia de la enfermedad en esta región utilizando una revisión sistemática de la literatura y un meta-análisis. Métodos y resultados: Este trabajo fue realizado en dos fases: La primera, fue un estudio de corte transversal de 300 individuos Colombianos. La segunda, fue una revisión sistemática y una meta-regresión siguiendo las guías PRSIMA. Nuestros resultados ponen de manifiesto una falta de anti-transglutaminasa tisular (tTG) e IgA anti-endomisio (EMA) en la población Colombiana. En la revisión sistemática, 72 artículos cumplían con los criterios de selección, la prevalencia estimada de EC en LA fue de 0,46% a 0,64%, mientras que la prevalencia en familiares de primer grado fue de 5,5 a 5,6%, y en los pacientes con diabetes mellitus tipo 1 fue de 4,6% a 8,7% Conclusión: Nuestro estudio muestra que la prevalencia de EC en pacientes sanos de LA es similar a la notificada en la población europea.

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INTRODUCCIÓN: El éxito de erradicación del H. pylori con las terapias convencionales ha disminuido a niveles inaceptables. Se buscan óptimos esquemas terapéuticos con excelentes tasas de erradicación. OBJETIVO: Cuantificar los desenlaces clínicos evaluados como efectividad, adherencia y seguridad, de una terapia secuencial de primera línea con Esomeprazol, Moxifloxacina, Amoxicilina y Tinidazol para la erradicación individual del H. pylori. METODOLOGÍA: Estudio prospectivo no controlado, piloto, abierto, único centro. Consecutivamente se incluirán adultos con prueba microbiológica positiva para H. pylori y síntomas dispépticos. Los pacientes recibirán un régimen de tratamiento de 10 días que consistirá los 5 primeros días de (Esomeprazol 40 mg, bd; Amoxicilina 1 g, bd). Del día 6 a 10 (Esomeprazol 40 mg, bd ; Tinidazol 500 mg, bd y Moxifloxacina 500 mg, bd). Se realizará una prueba de antígeno en materia fecal, para evaluar la efectividad terapéutica al menos a las 4 semanas de finalizar el tratamiento. RESULTADOS: 38 de 42 pacientes completaron el estudio. La tasa de erradicación fue de 87% (Intervalo de Confianza (IC) 95% (75,5 – 98,5%) en análisis por protocolo (PP), y 79% (IC) 95% (65 – 93%) en análisis por intención de tratar (ITT). La adherencia al tratamiento fue del 95% (40 pacientes), de los pacientes que ingresaron al estudio 48% presentaron al menos un efecto secundario menor principalmente diarrea y nauseas. CONCLUSIONES: Diez días de terapia secuencial basada en moxifloxacina proporciona tasas de erradicación óptimas, con una buena adherencia y efectos secundarios leves y transitorios.

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Se realizó un estudio descriptivo de corte transversal a partir de la base de datos de ausentismo por incapacidad médica del área administrativa de una empresa de salud con sede en Bogotá durante el primer semestre de 2014 Objetivo: Caracterizar las principales causas de ausentismo laboral en los funcionarios administrativos de una empresa de salud desde la revisión de una base de datos para plantear recomendaciones de prevención. Métodos: Mediante un estudio descriptivo de corte transversal se analizó a un grupo de 284 trabajadores administrativos de una empresa de salud que reportaron ausentismo por incapacidad médica en el primer semestre de 2014. Resultados: Las principales causas de ausentismo laboral en el personal administrativo para el primer periodo de 2014 fueron por enfermedad general la diarrea y gastroenteritis (22,2%) y la rinofaringitis aguda (4,4%), y por enfermedad laboral los trastornos osteomusculares (1,04%). El 72% (207) de las incapacidades se generaron en trabajadores administrativos del género femenino y el 46.3% (133) en el grupo etáreo comprendido entre los 31-40 años; según la antigüedad laboral las personas que tienen entre 1 y 10 años generaron el 59.2% de los eventos. Conclusión: Las incapacidades en la población de estudio están dadas en mayor porcentaje por incapacidad general, por enfermedades infectocontagiosas y osteomusculares. Teniendo en cuenta que el presente estudio es netamente descriptivo, puede servir como punto de partida para futuros estudios en los que pueda medirse relación causal entre tipo de incapacidad, duración, género, cargo y grupo etáreo.

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Antecedentes: Cada año hay 2,5 billones de casos de diarrea en menores de 5 años y 1,3 millones de estos niños mueren; lo que constituye a la EDA como segunda causa de muerte en este grupo de edad Metodología: Análisis transversal transnacional multinivel de la Encuesta DHS y el Banco Mundial en 348.706 niños de 40 países Resultados: Prevalencia de EDA 14%. Inequidad (OR=1.335; IC 95% 1.117-1.663) y bajos ingresos en las naciones (OR=1.488; IC 95% 1.024-2.163) presentaron asociación con EDA. Vivir en un país pobre aumenta la asociación entre el índice de riqueza del hogar y EDA (OR=1.0961; IC 95% 1.003-1.207) y la asociación entre no educación de la madre y EDA (OR=1.310; IC 95% 1.035-1.601). Otros factores asociados con EDA fueron sexo femenino, (OR=0.922; IC 95% 1.900-0.944), edad de niño (OR=0.978; IC 95% 0.978-0.979), vacunación (OR=0.821; IC 95% 0.799-0.843), peso normal al nacer (OR=0.879; IC 95% 0.834-0.926), edad de la madre (OR=0.987; IC 95% 0.985-0.989), no educación de la madre (OR=1.416; IC 95% 1.283-1.564), madre trabajadora (OR=1.136; IC 95% 1.106-1.167), embarazo deseado (OR=0.774; IC 95% 0.753-0.795), familia nuclear (OR=0.949; IC 95% 0.923-0.975) e índice de riqueza del hogar (OR=0.948; IC 95% 0.921-0.977) Conclusiones: La desigualdad y los bajos ingresos de los países desarrollados se asocian con EDA, independientemente de las características del niño, la mamá o el hogar. El gasto en salud no presenta asociaciones con EDA. Esto se debe considerar en las campañas de salud pública orientadas al manejo de la EDA.

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A “Border Disease” é uma doença infecciosa causada por um pestivírus que afecta maioritariamente pequenos ruminantes, causando problemas reprodutivos, alterações congénitas e animais persistentemente infectados. Não existem registos da seroprevalência desta patologia em Portugal. O objectivo deste trabalho foi estudar a seroprevalência de “Border Disease” em explorações de pequenos ruminantes na região do Baixo Alentejo e relacioná-la com a raça dos animais, dimensão do efectivo, coabitação com bovinos e localização da exploração. Em 197 animais, observaram-se 10 seropositivos que correspondem a uma seroprevalência de 5%. Em 29 explorações observaram-se 6 positivas nas quais, havia pelo menos um animal seropositivo, que corresponde a 20,6 % das explorações. Não foi observada relação significativa da prevalência nas explorações com as raças dos animais, a dimensão do efectivo e a sua localização geográfica. Existe maior probabilidade de casos seropositivos de “Border Disease” em pequenos ruminantes que coabitem com bovinos. A seroprevalência de “Border Disease” é baixa na região do Baixo Alentejo. Mais estudos devem ser efectuados de forma a identificar a estirpe do vírus “Border Disease” (BDV) presente nesta região, a verificar se a seroconversão poderá ter origem no contacto com o vírus da diarreia viral bovina (BVDV) e estudar o impacto desta doença na produção de pequenos ruminantes no Baixo Alentejo.

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A pancreatite, apesar de relativamente comum na medicina canina, continua a constituir um desafio devido à sua elevada complexidade patogénica, sinais clínicos não patognomónicos, diagnóstico por vezes difícil e tratamento inespecífico. De forma a realizar um estudo retrospectivo foram avaliados registos médicos de 41 canídeos diagnosticados com pancreatite, apresentados à consulta entre 2007 e 2013, de forma a caracterizar o doente pancreático. As características do animal, história clinica, sinais clínicos apresentados, métodos de diagnóstico e tratamento instituído foram analisados. Como critérios de inclusão neste estudo encontram-se a medição de cPLI com resultados acima do valor de referência e a realização de ecografia abdominal. A ecografia demonstrou evidências de pancreatite em 81% dos casos, sendo este valor superior aos 68% encontrados na literatura. Os sinais clínicos apresentados mais comuns foram vómito (39), prostração (38), dor abdominal (36), perda de peso e anorexia (26), desidratação (25), diarreia (21) e febre (5). Todos os animais foram submetidos a tratamento médico, tendo sido apenas 4 deles sujeitos também a cirurgia. A taxa de sobrevivência nos animais com tratamento médico foi de 95% e de 50 % nos animais com tratamento médico e cirúrgico.

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Oral supplements of arginine and citrulline increase local nitric oxide (NO production in the small intestine and this may be harmful under certain circumstances. Gastrointestinal toxicity was therefore reviewed with respect to the intestinal physiology of arginine, citrulline, ornithine, and cystine (which shares the same transporter) and the many clinical trials of supplements of the dibasic amino acids or N-acetylcysteine (NAC. The human intestinal dibasic amino acid transport system has high affinity and low capacity. L-Arginine (but not lysine, ornithine, or D-arginine) induces water and electrolyte secretion that is mediated by NO, which acts as an absorbagogue at low levels and as a secretagogue at high levels. The action of many laxatives is NO mediated and there are reports of diarrhea following oral administration of arginine or ornithine ihine. The clinical data cover a wide span of arginine intakes f rom 3 g/d to > 100 g/d, but the standard of reporting adverse effects (e.g. nausea, vomiting, and diarrhea) was variable. Single doses of 3-6 g rarely provoked side effects and healthy athletes appeared to be more susceptible than diabetic patients to gastrointestinal symptoms at individual doses >9 g. This may relate to an effect of disease on gastrointestinal motility and pharmacokinetics. Most side effects of arginine and NAC occurred at single doses of >9 g in adults >140 mg/kg) often when part of a daily regime of similar to>30 g/d (>174 mmol/d). In the case of arginine, this compares with the laxative threshold of the nonabsorbed disaccharide alcohol, lactitol (74 g or 194 mmol). Adverse effects seemed dependent on the dosage regime and disappeared if divided doses were ingested (unlike lactitol). Large single doses of poorly absorbed amino acids seem to provoke diarrhea. More research is needed to refine dosage strategies that reduce this phenomenon. It is suggested that dipeptide forms of arginine may meet this criterion.

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Objectives: Does artichoke leaf extract (ALE) ameliorate symptoms of Irritable bowel syndrome (IBS) in otherwise healthy volunteers suffering concomitant dyspepsia? Methods: A subset analysis of a previous dose-ranging, open, postal study, in adults suffering dyspepsia. Two hundred and eight (208) adults were identified post hoc as suffering with IBS. IBS incidence, self-reported usual bowel pattern, and the Nepean Dyspepsia Index (NDI) were compared before and after a 2-month intervention period. Results: There was a significant fall in IBS incidence of 26.4% (p<0.001) after treatment. A significant shift in self-reported usual bowel pattern away from "alternating constipation/diarrhea" toward "normal" (p<0.001) was observed. NDI total symptom score significantly decreased by 41% (p<0.001) after treatment. Similarly, there was a significant 20% improvement in the NDI total quality-of-life (QOL) score in the subset after treatment. Conclusion: This report supports previous findings that ALE ameliorates symptoms of IBS, plus improves health-related QOL.

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Objectives: Certain milk factors may help to promote the growth of a host-friendly colonic microflora (e.g. bifidobacteria, lactobacilli) and explain why breast-fed infants experience fewer and milder intestinal infections than those who are formula-fed. The effects of supplementation of formula with two such milk factors was investigated in this study. Materials and Methods: Infant rhesus macaques were breastfed, fed control formula, or formula supplemented with glycomacropeptide (GMP) or alpha-lactalburnin (alpha-LA) from birth to 5 months of age. Blood was drawn monthly and rectal swabs were collected weekly. At 4.5 months of age, 10(8) colonyforming units of enteropathogenic E.coli O127, strain 2349/68 (EPEC) was given orally and the response to infection assessed. The bacteriology of rectal swabs pre- and post-infection was determined by culture independent fluorescence in situ hybridization. Results: Post-challenge, breast-fed infants and infants fed alpha-LA-supplemented formula had no diarrhea, whilst those infants fed GMP-supplemented formula had intermittent diarrhea. In infants fed control formula the diarrhea was acute. Conclusions: Supplementation of infant formula with appropriate milk proteins may be useful for improving the infant's ability to resist acute infection caused by E.coli.

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First defined in the mid-1990s, prebiotics, which alter the composition and activity of gastrointestinal (GI) microbiota to improve health and well-being, have generated scientific and consumer interest and regulatory debate. The Life Sciences Research Organization, Inc. (LSRO) held a workshop, Prebiotics and the Health Benefits of Fiber: Future Research and Goals, in February 2011 to assess the current state of the science and the international regulatory environment for prebiotics, identify research gaps, and create a strategy for future research. A developing body of evidence supports a role for prebiotics in reducing the risk and severity of GI infection and inflammation, including diarrhea, inflammatory bowel disease, and ulcerative colitis as well as bowel function disorders, including irritable bowel syndrome. Prebiotics also increase the bioavailability and uptake of minerals and data suggest that they reduce the risk of obesity by promoting satiety and weight loss. Additional research is needed to define the relationship between the consumption of different prebiotics and improvement of human health. New information derived from the characterization of the composition and function of different prebiotics as well as the interactions among and between gut microbiota and the human host would improve our understanding of the effects of prebiotics on health and disease and could assist in surmounting regulatory issues related to prebiotic use.