Aspectos psicopatológicos en la enfermedad de Crohn y en la colitis ulcerosa

Las enfermedades inflamatorias del intestino (EII) son trastornos crónicos que inflaman y destruyen el tejido intestinal de forma periódica y recurrente. Las EII se clasifican en dos tipos: enfermedad de Crohn (EC) y colitis ulcerosa (CU). La etiología tanto de la EC como de la CU es poco conocida y el curso está influido por múltiples factores de tipo biopsicosocial. Al respecto, diversas investigaciones están aportando evidencia de la implicación de factores psicológicos en el curso de las EII, tales como el estrés psicosocial, las estrategias de afrontamiento, las características de personalidad, los síntomas psicopatológicos y el apoyo social.

Quality of life and Chronic Obstructive Pulmonary Disease

The Chronic Obstructive Pulmonary Disease (COPD) has a progressive and irreversible character and it’s associated to the triad of dyspnea, exercise limitation and the evident deterioration of quality of life. In the United States the prevalence of COPD in adult population is approximately of 6% in men, and 1 to 3% in women and it’s the fourth cause of mortality by no transmissible chronic diseases. In 1993, the National Health Interview Surgery considered that 12 millions of Americans suffer from chronic bronchitis and 2 million had emphysema. These two affections are responsible for more than 13% of the hospitalizations. As this affection progresses, patients experience a diminution in quality of life related to health (CVRS), their capacity to work get worse and their participation in physical and social activities reduces. Nevertheless, it has been confirmed that the isolated evaluation of COPD seriousness, defined by the reduction of the Forced Expiratory Volume in the First Second (FEV1), does not provide enough information to know the health state perceived by the patients. The fact that the CVRS is the result of the interaction of multiple physical, psychological and social factors, unique for each individual, can explain this finding. This paper is a general and updated approach to the integral handling of patients with COPD, and it discusses the concept of quality of life, related to health improvement.

Avaliação do risco de ocorrência de lesões de reabsorção dentária em animais com gengivo-estomatite crónica felina

A gengivo-estomatite crónica felina é uma inflamação complexa crónica, com severidade e intensidade variáveis. Apesar de não estar definida a sua etiopatogenia, parece haver uma relação entre a inflamação e a ocorrência de lesões de reabsorção dentária, enquanto causa ou enquanto consequência da doença. O tratamento para as duas doenças é inespecífico, mas baseia-se na extração dentária, contornada ou não com tratamentos médicos. Este estudo teve como objetivo determinar a ocorrência de lesões de reabsorção dentária em gatos com gengivo-estomatite crónica e avaliar a existência de uma possível associação entre um padrão de estomatite crónica e a presença de lesões de reabsorção dentária. O objetivo secundário consistiu na determinação da percentagem de sucesso e o grau de satisfação dos proprietários, após a intervenção cirúrgica. Foram incluídos no estudo 27 gatos. Os critérios de inclusão consistiram no diagnóstico de genvivo-estomatite crónica, realização de um exame radiográfico intraoral completo de todos os dentes, seguido de tratamento cirúrgico, com extrações dentárias e, finalmente, a resposta, por parte dos proprietários, a um questionário. A ocorrência de lesões de reabsorção dentária neste estudo foi de 66,67%. Não foi possível estabelecer nenhuma associação entre a gengivo-estomatite crónica felina e o desenvolvimento de lesões de reabsorção dentária. Os padrões ulcerativos, proliferativos e o de estomatite caudal na gengivo-estomatite crónica felina mostraram risco acrescido para lesões de reabsorção dentária, mas sem significado estatístico. 70,37% dos animais atingiu a cura clínica e 29,63% obteve melhoria global, num período médio de 2 meses. O grau de satisfação dos proprietários obteve uma média de 4,52 valores, numa escala de 1 a 5. Apesar da prevalência elevada de lesões de reabsorção dentária, não foi possível identificar a gengivo-estomatite crónica felina, enquanto fator de risco para a sua ocorrência. À semelhança de estudos anteriores, a gengivo-estomatite crónica felina responde a tratamento cirúrgico com extrações dentárias.

Chronic pesticide poisoning from persistent low-dose exposures in Ecuadorean floriculture workers: toward validating a low-cost test battery

Chronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador’s floriculture industry. First we had to develop a case definition; as with all occupational diseases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis, we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis suggested three distinct manifestations of pesticide poisoning. We then determined sensitivity and specificity of various combinations of symptoms and simple neurotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone – the current screening standard. While sensitivity and specificity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings.

The role of animal nutrition in improving the nutritive value of animal-derived foods in relation to chronic disease

Foods derived from animals are an important source of nutrients in the diet; for example, milk and meat together provide about 60 and 55% of the dietary intake of Ca and protein respectively in the UK. However, certain aspects of some animal-derived foods, particularly their fat and saturated fatty acid (SFA) contents, have led to concerns that these foods substantially contribute to the risk of CVD, the metabolic syndrome and other chronic diseases. In most parts of Europe dairy products are the greatest single dietary source of SFA. The fatty acid composition of various animal-derived foods is, however, not constant and can, in many cases, be enhanced by animal nutrition. In particular, milk fat with reduced concentrations of the C12-16 SFA and an increased concentration of 18:1 MUFA is achievable, although enrichment with very-long-chain n-3 PUFA is much less efficient. However, there is now evidence that some animal-derived foods (notably milk products) contain compounds that may actively promote long-term health, and research is urgently required to fully characterise the benefits associated with the consumption of these compounds and to understand how the levels in natural foods can be enhanced. It is also vital that the beneficial effects are not inadvertently destroyed in the process of reducing the concentrations of SFA. In the future the role of animal nutrition in creating foods closer to the optimum composition for long-term human health is likely to become increasingly important, but production of such foods on a scale that will substantially affect national diets will require political and financial incentives and great changes in the animal production industry.