978 resultados para Incontinència fecal
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da a conocer el estado de la contaminación marina en el periodo comprendido entre 1994 a 1995 en diferentes áreas del litoral peruano. En el trabajo se consideraron las principales fuentes terrestres de contaminación provenientes de los desechos domésticos e industriales, plaguicidas organoclorados, hidrocarburos de petróleo y metales pesados. Así mismo se evaluaron los efectos de ellos sobre el macrobentos en las áreas estudiadas, contrastando con ensayos de corta duración de toxicidad letal y utilizando zoeas de Emerita analoga con hidrocarburos y metales pesados. Las bahías de Callao y Chimbote mostraron mayor contaminación por desechos domésticos e industriales, con deterioro de la calidad microbiológica determinándose altos niveles de contaminación fecal. En ninguna de las áreas marinas hubo presencia de Vibrio cholerae toxigénico. En lo que se refiere a los plaguicidas se detectaron 3 tipos de DDT 's en la zona del Callao. En la evaluación de los efectos de la contaminación sobre las comunidades marinas del macrozoobentos tanto de sustrato blando como rocoso de las áreas de Chimbote, Huacho, Pisco e Ilo se ha determinado que la comunidad béntica de sustrato rocoso situada al norte de bahía Ferrol, Chimbote muestra una moderada perturbación al igual que las comunidades de sustratos blandos de las bahías de Paracas e Ite.
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A água é um recurso natural essencial à vida fortemente suscetível de degradação, pelo que é fundamental a sua gestão e o controlo da sua qualidade. Os usos da água dependem das suas propriedades e composição. Estas, por sua vez, resultam de processos de interação água-rocha e da introdução antrópica de substâncias que podem afetar a sua qualidade e, assim, condicionar os usos. A presente investigação tem como objetivo a avaliação do estado de qualidade da água e potencialidades de uso no concelho de S. Domingos, Ilha de Santiago, Cabo Verde. Foram colhidas 22 amostras de água, sujeitas as medições in situ de parâmetros expeditos: pH, condutividade elétrica (CE), sólidos dissolvidos totais (TDS) e temperatura. A caracterização foi completada com a análise da componente aniónica (cloreto, brometo, fluoreto, nitrato, nitrito, fosfato e sulfato), de alcalinidade, oxidabilidade, sólidos suspensos totais e metais. Os resultados obtidos mostram, de uma maneira geral, o carácter mineralizado destas águas, com valor médio de condutividade de 1361µS/cm. A classificação hidroquímica, de acordo com diagrama de Piper, conduziu à discriminação dos seguintes tipos: águas mistas bicarbonatadas, equivalendo a 50% das amostras, mistas cloretadas (22,7%) e mistas sódicas (cloretadas e bicarbonatadas), correspondendo a 27% das amostras. Considerando o que está estabelecido no Decreto-Lei n.º 236/98, de 1 de agosto de Portugal e no Decreto-Lei nº8/2004 de Cabo Verde, que definem os valores paramétricos de qualidade da água, verificou-se que apenas 36% das amostras têm qualidade suficiente para consumo humano, cumprindo na íntegra os padrões de potabilidade estabelecidos. No que respeita à utilização da água para rega, segundo o Diagrama U. S. Salinity Laboratory, 68% das amostras mostram evidências de perigo salinização alto a muito alto e 32% apresentam risco médio. Quanto à alcalinização apenas 9% das amostras apresentam perigo médio, enquanto as restantes não indicam qualquer restrição de uso na agricultura. A análise estatística dos resultados pôs em evidência processos naturais de evolução hidroquímica, particularmente a salinização de amostras situadas em aluviões e praias fósseis. De maneira similar, o estudo efetuado revelou a existência de processos de degradação desencadeados por contaminação fecal. Visando a proteção da saúde da população do concelho, recomenda-se a implementação de medidas que proporcionem o aproveitamento sustentado e seguro dos recursos hídricos que passam, desde logo, pela elaboração de um plano de monitorização da qualidade de água para todo o concelho.
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BACKGROUND: There is increasing evidence for the clinical relevance of mucosal healing (MH) as therapeutic treatment goal in inflammatory bowel disease (IBD). We aimed to investigate by which method gastroenterologists monitor IBD activity in daily practice. METHODS: A questionnaire was sent to all board-certified gastroenterologists in Switzerland to specifically address their strategy to monitor IBD between May 2009 and April 2010. RESULTS: The response rate was 57% (153/270). Fifty-two percent of gastroenterologists worked in private practice and 48% worked in hospitals. Seventy-eight percent judged clinical activity to be the most relevant criterion for monitoring IBD activity, 15% chose endoscopic severity, and 7% chose biomarkers. Seventy percent of gastroenterologists based their therapeutic decisions on clinical activity, 24% on endoscopic severity, and 6% on biomarkers. The following biomarkers were used for IBD activity monitoring: CRP, 94%; differential blood count, 78%; fecal calprotectin (FC), 74%; iron status, 63%; blood sedimentation rate, 3%; protein electrophoresis, 0.7%; fecal neutrophils, 0.7%; and vitamin B12, 0.7%. Gastroenterologists in hospitals and those with ≤ 10 years of professional experience used FC more frequently compared with colleagues in private practice (P=0.035) and those with > 10 years of experience (P<0.001). CONCLUSIONS: Clinical activity is judged to be more relevant for monitoring IBD activity and guiding therapeutic decisions than endoscopic severity and biomarkers. As such, the accumulating scientific evidence on the clinical impact of mucosal healing does not yet seem to influence the management of IBD in daily gastroenterologic practice.
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Even though anal incontinence affects a significant proportion of the population, causing a major burden to both patient and society, it still remains "the last closet issue". Less than a third of patients will share this problem with their physician. Consequently, the incidence of anal incontinence is difficult to determine, varying from 2-50%. Since this disabling condition is often associated with urinary incontinence and/or pelvic organ prolapse, a multidisciplinary team approach is required. A wide range of therapeutic options are available. When dietary, medical and rehabilitative treatments have failed, sacral neuromodulation should be considered in selected cases. More invasive surgery is usually undertaken in the presence of major structural defects. The aim of this article is to suggest a comprehensive way of identifying and treating anal incontinence.
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Background a nd A ims: D iscriminating irritable bowelsyndrome (IBS) from inflammatory bowel disease (IBD) can bea clinical c hallenge as s ymptoms c an overlap. We a nd othershave recently shown that fecal c alprotectin ( FC) is moreaccurate for d iscriminating IBS f rom IBD compared to C -reactive p rotein ( CRP) and b lood leukocytes. We a imed toassess which b iomarkers are used by g astroenterologists intheir daily practice for discriminating IBS from IBD.Methods: A q uestionnaire was sent to all board certifiedgastroenterologists in Switzerland in July 2010.Results: Response rate was 57% (153/270). Mean physician'sage was 50±9years, mean duration o f gastroenterologicpractice 1 4±8years, 52% of them were working in p rivatepractice a nd 48% in h ospitals. T he following biomarkers weredetermined for discriminating IBS from IBD: CRP 100%, FC79%, hematogram (red blood cells and leukocytes) 70%, ironstatus ( ferritin, t ransferrin s aturation) 59%, e rythrocytesedimentation rate 2.7%, protein electrophoresis 0.7%, andalpha-1 antitrypsin clearance 0.7%. There was a trend for usingFC more often in p rivate practice t han in h ospital ( P = 0.08).Eighty-nine percent of gastroenterologists considered FC to besuperior to CRP for discriminating IBS from IBD, 8 7% thoughtthat patient's compliance for fecal sampling is high, and 51%judged the fee of USD 60 for a FC test as appropriate.Conclusions: F C is widely used in c linical practice t odiscriminate IBS from IBD. In accordance with the scientificevidence, the majority of gastroenterologists consider FC to bemore accurate than CRP for discriminating IBS from IBD.
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Antibiotic resistance is an increasing global problem resulting from the pressure of antibiotic usage, greater mobility of the population, and industrialization. Many antibiotic resistance genes are believed to have originated in microorganisms in the environment, and to have been transferred to other bacteria through mobile genetic elements. Among others, ß-lactam antibiotics show clinical efficacy and low toxicity, and they are thus widely used as antimicrobials. Resistance to ß-lactam antibiotics is conferred by ß-lactamase genes and penicillin-binding proteins, which are chromosomal- or plasmid-encoded, although there is little information available on the contribution of other mobile genetic elements, such as phages. This study is focused on three genes that confer resistance to ß-lactam antibiotics, namely two ß-lactamase genes (blaTEM and blaCTX-M9) and one encoding a penicillin-binding protein (mecA) in bacteriophage DNA isolated from environmental water samples. The three genes were quantified in the DNA isolated from bacteriophages collected from 30 urban sewage and river water samples, using quantitative PCR amplification. All three genes were detected in the DNA of phages from all the samples tested, in some cases reaching 104 gene copies (GC) of blaTEM or 102 GC of blaCTX-M and mecA. These values are consistent with the amount of fecal pollution in the sample, except for mecA, which showed a higher number of copies in river water samples than in urban sewage. The bla genes from phage DNA were transferred by electroporation to sensitive host bacteria, which became resistant to ampicillin. blaTEM and blaCTX were detected in the DNA of the resistant clones after transfection. This study indicates that phages are reservoirs of resistance genes in the environment.
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La diarrhée congénitale de sodium est une maladie génétique très rare. Les enfants touchés par cette maladie présentent une diarrhée aqueuse sévère accompagnée d'une perte fécale de sodium et bicarbonates causant une déshydratation hyponatrémique et une acidose métabolique. Des analyses génétiques ont identifié des mutations du gène Spint2 comme cause de cette maladie. Le gène Spint2 code pour un inhibiteur de sérine protéase transmembranaire exprimé dans divers épithéliums tels que ceux du tube digestif ou des tubules rénaux. Le rôle physiologique de Spint2 n'est pas connu. De plus, aucun partenaire physiologique de Spint2 n'a été identifié et le mécanisme d'inhibition par Spint2 nous est peu connu. Le but de ce projet est donc d'obtenir de plus amples informations concernant la fonction et le rôle de Spint2 dans le contexte de la diarrhée congénitale de sodium, cela afin de mieux comprendre la physiopathologie des diarrhées et peut-être d'identifier de nouvelles cibles thérapeutiques. Un test fonctionnel dans les ovocytes de Xenopus a identifié les sérine protéases transmembranaires CAPI et Tmprssl3 comme potentielles cibles de Spint2 dans la mesure où ces deux protéases n'étaient plus bloquées par le mutant de Spint2 Y163C qui est associé avec la diarrhée congénitale de sodium. Des expériences fonctionnelles et biochimiques plus poussées suggèrent que l'inhibition de Tmprssl3 par Spint2 est le résultat d'une interaction complexe entre ces deux protéines. Les effets des sérine protéases transmembranaires sur l'échangeur Na+-H+ NHE3, qui pourrait être impliqué dans la pathogenèse de la diarrhée congénitale de sodium ont aussi été testés. Un clivage spécifique de NHE3 par la sérine protéase transmembranaire Tmprss3 a été observé lors d'expériences biochimiques. Malheureusement, la pertinence physiologique de ces résultats n'a pas pu être évaluée in vivo, étant donné que le modèle de souris knockout conditionnel de Spint2 que nous avons créé ne montrait une réduction de l'expression de Spint2 que de 50% et aucun phénotype. En résumé, ce travail met en évidence deux nouveaux partenaires possibles de Spint2, ainsi qu'une potentielle régulation de NHE3 par des sérine protéases transmembranaires. Des expériences supplémentaires faites dans des modèles animaux et lignées cellulaires sont requises pour évaluer la pertinence physiologique de ces données et pour obtenir de plus amples informations au sujet de Spint2 et de la diarrhée congénitale de sodium. - The congenital sodium diarrhea is a very rare genetic disease. Children affected by this condition suffer from a severe diarrhea characterized by watery stools with a high fecal loss of sodium and bicarbonates, resulting in hyponatremic dehydration and metabolic acidosis. Genetic analyses have identified mutations in the Spint2 gene as a cause of this disease. The spint2 gene encodes a transmembrane serine protease inhibitor expressed in various epithelial tissues including the gastro-intestinal tract and renal tubules. The physiological role of Spint2 is completely unknown. In addition, physiological partners of Spint2 are still to be identified and the mechanism of inhibition by Spint2 remains elusive. Therefore, the aim of this project was to get insights about the function and the role of Spint2 in the context of the congenital sodium diarrhea in order to better understand the pathophysiology of diarrheas and maybe identify new therapeutic targets. A functional assay in Xenopus oocytes identified the membrane-bound serine proteases CAPI and Tmprssl3 as potential targets of Spint2 because both proteases were no longer inhibited by the mutant Spint2 Y163C that has been associated with the congenital diarrhea. Further functional and biochemical experiments suggested that the inhibition of Tmprssl3 by Spint2 occurs though a complex interaction between both proteins. The effects of membrane-bound serine proteases on the Na+-H+ exchanger NHE3, which has been proposed to be involved in the pathogenesis of the congenital sodium diarrhea, were also tested. A specific cleavage of NHE3 by the membrane-bound serine protease Tmprss3 was observed in biochemical experiments. Unfortunately, the physiological relevance of these results could not be assessed in vivo since the conditional Spint2 knockout mouse model that we generated showed a reduction in Spint2 expression of only 50% and displayed no phenotype. Briefly, this work provides two new potential partners of Spint2 and emphasizes a putative regulation of NHE3 by membrane-bound serine proteases. Further work done in animal models and cell lines is required to assess the physiological relevance of these results and to obtain additional data about Spint2 and the congenital diarrhea.
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Ano-rectal incontinence is known to affect about 2% of the population. Main risk factors are traumatic delivery and previous anal surgery. All patients should have a trial of conservative treatment. Patients with major external anal sphincter defect have a 70 to 80% improvement of their symptoms after an overlap sphincter repair Unfortunately, these results deteriorate over time. Sacral nerve modulation improves continence and quality of life in 75 to 100% of patients with various aetiologies. In case of idiopathic internal sphincter degeneration, sphincter augmentation with bulking agents seems to be the least expensive option.
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M. myotis and M. blythii are two sibling species of bats that live sympatrically over wide areas of the Western Palearctic region, and which often coexist intimately in their nursery roosts. According to the principle of <<limiting similarity>> this cohabitation should imply an interspecific ecological differentiation. The hypothesis of a niche separation at the trophic level is tested here. The fecal analysis of 300 droppings collected from a zone of sympatry shows a clear interspecific differentiation in diets : M. myotis eats mostly Carabidae (Coleoptera), whereas M. blythii captures essentially Tettigoniidae, Gryllidae and Acrididae (Orthoptera). Because they consume exclusively terrestrial arthropods, M. myotis and M. blythii are typical ground and/or grass gleaning bats. However, despite their narrow niches they are probably not specialized in the predation of only some definite categories of prey. The narrow diets probably reflect the high specialization of their modes of resource exploitation: M. myotis and M. blythii prey upon ground arthropods and they are likely to select for different foraging;g habitats. M. myotis probably prefers wooded feeding grounds (Carabidae) whereas M. blythii exploits herbaceous habitats (Orthoptera). The strong trophic segregation observed in sympatry between M. myotis and M. blythii shows that the interspecific competition is distinctly much weaker than the intraspecific one. This would explain the stable, intimate co-existence of these two virtual competitors.
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Objetivou-se neste estudo, determinar a disponibilidade biológica do P de diferentes fontes, para eqüinos em fase de crescimento. Utilizaram-se dezesseis eqüinos machos em fase de crescimento, submetidos à aplicação de quatro fontes fosfatadas -- fosfato de rocha de Tapira (TAP), fosfato de rocha de Patos de Minas (PAT), fosfato bicálcico (BIC) e farinha de osso (FOS) --, adicionadas à dieta basal em quantidades suficientes para fornecer 22 g de P/animal/dia. No 16º dia, foram-lhes injetados 30 MBq de 32P/animal, e coletaram-se amostras de sangue, fezes e urina, durante sete dias. Foram determinadas as atividades específicas no plasma, fezes e urina e calculou-se a perda endógena fecal e a absorção real de P. Os valores obtidos quanto ao P consumido, P excretado, P no plasma e P retido não apresentaram diferenças estatísticas (P>0,05). Os valores de absorção real do P do TAP, PAT, BIC e da FOS foram, respectivamente, 25,23%, 33,97%, 31,71% e 29,36%. Não houve diferenças estatísticas (P>0,05) entre as fontes estudadas. Em relação ao BIC, as rochas fosfáticas apresentaram altos valores de disponibilidade biológica.
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O trabalho teve por objetivo avaliar os efeitos de diferentes níveis de P na dieta de eqüinos em crescimento sobre sua perda endógena fecal, e verificar qual seja a exigência mínima diária desse elemento na sua alimentação. Foram utilizados 16 eqüinos machos em crescimento, recebendo dieta basal sem suplementação de P, e dieta basal suplementada com fosfato bicálcico, para fornecer 15, 20 e 25 g P/animal/dia. No 16º dia experimental, foram injetados 30 MBq de 32P/animal e coletaram-se amostras de sangue, fezes e urina, durante sete dias. Foram determinadas as atividades específicas do P no plasma, nas fezes e na urina, e calculou-se a perda endógena fecal e a absorção real de P. A perda endógena fecal e a absorção real de P não foram afetadas (P>0,05) pelos tratamentos, e foram estimados, em média, 10,34 mg P/kg PV/dia e 47,07%, respectivamente, o que indica que, nas condições experimentais, animais com idade média de 19 meses necessitam de 21,96 mg de P/kg PV/dia para manter o balanço da perda metabólica fecal, e a quantidade diária de P de 14,75 g.
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A determinação da absorção real de fósforo (P) em bovinos deve levar em consideração a fração endógena mínina do mineral, que se perde nas fezes. De modo geral esses cálculos são feitos utilizando-se tabelas cujos valores foram obtidos em outros países, com outras raças de animais e em condições bem diferentes das condições brasileiras. O trabalho teve como objetivo determinar a perda endógena de P nas fezes e estimar a exigência mínima de P em novilhos da raça Nelore (Bos indicus). Foram utilizados 18 novilhos castrados, com peso médio de 190,82±27,53 kg e idade aproximada de 12 meses, divididos em três grupos de seis animais, e mantidos em gaiolas metabólicas individuais. Os animais receberam dieta básica constituída de feno de Brachiaria decumbens e uma mistura de concentrados durante os 30 dias de período experimental. Os tratamentos consistiram de diferentes quantidades de fosfato bicálcico em níveis de 0,12, 0,24 e 0,36% de P, com base na dieta total. Foram aplicadas injeções de 32P nos animais para a determinação da perda endógena fecal de P. A perda endógena mínima fecal de P para uma ingestão zero do mineral, calculada por interpolação, foi de 5,72 mg/kg de peso vivo e para um balanço zero, o requerimento mínimo foi de 8,84 mg/kg de peso vivo por dia.
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Traveler's diarrhea is generally a benign condition which resolves spontaneously in 48 h. Information on dietary hygiene, severity of symptoms and dehydration, as well as their management, is essential. Chemoprophylaxis and antibiotic treatment are not recommended, except in very specific situations. The incidence of chronic diarrhea in HIV-positive patients has dramatically decreased since the introduction of HAART. In the absence of any correlation with the initiation of HAART, a stepwise diagnostic workup is indicated (bacteriological cultures and microscopic examination of fecal samples followed by ileocolonoscopy and gastroduodenoscopy). Specific treatment of any pathogens identified, and HAART in the case of microsporidiasis or cryptosporidiosis, constitute the mainstay of therapeutic management of chronic diarrhea in these patients.
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The goal of this trial was to estimate the total dry matter (TDMI) and daily pasture dry matter intakes (PDMI) by lactating crossbred Holstein - Zebu cows grazing elephant grass (Pennisetum purpureum Schum.) paddocks submitted to different rest periods. Three groups of 24 cows were used during two years. The paddocks were grazed during three days at the stocking rate of 4.5 cows/ha. Treatments consisted of resting periods of 30 days without concentrate and resting periods of 30, 37.5 and 45 days with 2 kg/cow/day of 20.6% crude protein concentrate. From July to October, pasture was supplemented with chopped sugarcane plus 1% urea. Total daily dry matter intake was estimated using the extrusa in vitro dry matter digestibility and the fecal output with chromium oxide. Regardless of the treatment the estimated average TDMI was 2.7, 2.9 and 2.9±0.03% and the mean PDMI was 1.9, 2.1 and 2.1±0.03% of body weight in the first, second and third grazing day, respectively (P<0.05). Only during the summer pasture quality was the same whichever the grazing day. Sugarcane effectively replaced grazing pasture, mainly in the first day when pasture dry matter intake was lowest.