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‣ Cytomegalovirus in colorectal cancer and idiopathic ulcerative colitis; Citomegalovírus em câncer coloretal e colite idiopática ulcerativa

MARIGUELA, Viviane Casagrande; CHACHA, Silvana Gama Florêncio; CUNHA, Aldo de Albuquerque; TRONCON, Luiz Ernesto de Almeida; ZUCOLOTO, Sérgio; FIGUEIREDO, Luiz Tadeu Moraes
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica
Português
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Cytomegalovirus (CMV) is a genus in the family Herpesviridae that has been associated with gastrointestinal syndromes. In this work we looked for a possible association of CMV infection with colorectal cancer and ulcerative colitis (UC). Blood and enteric tissue samples of 14 patients with colorectal cancer and of 21 with UC were subjected to a nested-PCR that amplifies part of the gB gene of CMV and also to immunohistochemistry using a specific monoclonal antibody to IE 76kDa protein of CMV. CMV was detected by nested-PCR in the blood and/or the enteric tissue of nine (64.3%) colorectal cancer and 16 (76.2%) ulcerative colitis patients. In the immunohistochemistry it was observed that 12 (12/21, 57.1%) positive enteric tissue samples of patients with UC and none from patients with colorectal cancer (0/14) were positive to CMV. The positivity of CMV infections in the UC patient group (12/21, 57.1%) showed by both techniques, was significantly higher (p = 0.015) than that observed for colorectal cancer patients (2/14, 14.3%). These results suggest an association of ulcerative colitis with CMV infection of the enteric tissue.; Os Cytomegalovírus (CMV) são um gênero da família Herpesviridae, que pode estar associado a síndromes gastrointestinais. No presente trabalho buscamos uma possível associação da infecção por CMV com câncer coloretal e retocolite ulcerativa (RCU). Amostras de sangue e tecido entérico de 14 pacientes com câncer coloretal e 21 com RCU foram submetidas a uma nested-PCR que amplifica parte do gene gB do CMV e a uma imunohistoquímica utilizando um anticorpo monoclonal específico para proteína IE 76Kda de CMV. CMV foi detectado pela nested-PCR em sangue e/ou tecido entérico de 9 (64...

‣ Intestinal mucosa-associated microflora in ulcerative colitis patients before and after restorative proctocolectomy with an ileoanal pouch

ALMEIDA, Maristela G.; KISS, Desiderio R.; ZILBERSTEIN, Bruno; QUINTANILHA, Alina G.; TEIXEIRA, Magaly G.; HABR-GAMA, Angelita
Fonte: LIPPINCOTT WILLIAMS & WILKINS Publicador: LIPPINCOTT WILLIAMS & WILKINS
Tipo: Artigo de Revista Científica
Português
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PURPOSE: This study was designed to identify the mucosa-associated microflora in patients with severe ulcerative colitis before and after restorative proctocolectomy with ileoanal pouch construction in comparison with historic controls. METHODS: Ten patients with a diagnosis of ulcerative colitis were evaluated. Mucus was collected during colonoscopy from all segments of the colon and terminal ileum before surgery, and from the ileal pouch two and eight months after ileostomy closure. The prevalence and mean concentration of the mucosa-associated microflora were compared over time and with historic controls. RESULTS: Veillonella sp was the most prevalent bacterium in patients and controls. Klebsiella sp was significantly more prevalent in the ileum of controls, was not found in patients with ulcerative colitis, and after proctocolectomy returned to values found in controls. Some bacteria such as Enterobacter sp, Staphylococcus sp (coag-), Bacteroides sp (npg), Lactobacillus sp, and Veillonella sp had higher mean concentrations in the ileal pouch of patients after surgery than in controls. CONCLUSION: No bacterium was identified that could be exclusively responsible for the maintenance of the inflammatory process. The mucosa-associated microflora of patients with ulcerative colitis underwent significant changes after proctocolectomy with ileal pouch construction and returned to almost normal values for some bacteria.

‣ Efeito da colite ulcerativa experimental sobre o receptor P2X7 no sistema nervoso entérico de ratos wistar.; Effect of experimental ulcerative colitis on the P2X7 receptor in the Wistar rats enteric nervous system.

Silva, Marcos Vinicius da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 02/12/2011 Português
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No trato digestório a colite ulcerativa apresenta necrose no intestino como processos patofisiológicos. Este projeto visou estudar neurônios com códigos químicos do sistema nervoso entérico (SNE) e a morfologia estrutural do intestino grosso de animais com colite ulcerativa. Grupos: a) Colite: injetados com TNBS, b) PBS: injetados com PBS e c) controle. Os tecidos foram preparados por métodos imunohistoquímicos de duplas marcações do receptor P2X7 com NOS, ChAT, Calb, Calr, anti-HuC/D (pan-neuronal) e S100 (células glias). No grupo Colite, no plexo mioentérico, o receptor P2X7 estava diminuído. No tecido lesado apresentou aumento de neutrófilos e da lâmina própria, alteração de colágeno e destruição do epitélio e células caliciformes. Reduziram colocalizações de neurônios com receptor no plexo mioentérico e aumento no plexo submucoso. Houve reduções nas densidades e áreas dos neurônios no SNE. Conclui-se que a colite afetou os neurônios entéricos e células gliais, causou alterações morfológicas, sendo assim, pode afetar motilidade intestinal.; In the digestive tract ulcerative colitis have a bowel necrosis as pathophysiological processes. This project aimed to study neurons with their respective chemicals codes the enteric nervous system (ENS) as well as structural morphology of the distal colon of animals with ulcerative colitis. Groups: a) colitis: TNBS injected...

‣ Estudo do perfil da microbiota intestinal em modelo experimental de colite ulcerativa induzida em camundongo da linhagem C57BL/6; Profile study of intestinal microbiota in experimental ulcerative colitis model induced in mice of the C57BL/6 lineage

Milanezi, Ana Carolina Medeiros
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Trabalho de Conclusão de Curso Formato: application/pdf
Português
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(Estudo do perfil da microbiota intestinal em modelo experimental de colite ulcerativa induzida em camundongos da linhagem C57BL/6). O trato gastrointestinal dos vertebrados é extensamente colonizado por micro-organismos que estabelecem uma relação mutuamente benéfica. Esta situação é consequência de um longo processo de coevolução, que permitiu o desenvolvimento de tolerância imune a esta microbiota por parte do hospedeiro. Alterações que resultam na quebra desta homeostasia podem comprometer esta relação e, possivelmente, estão envolvidas no desenvolvimento de doenças inflamatórias intestinais, como a colite ulcerativa. O objetivo deste trabalho foi analisar a resposta da microbiota ao longo da indução de colite ulcerativa em um camundongo C57BL/6 pela administração de dextran sulfato de sódio 2%. Amostras da região anal do camundongo foram obtidas em quatro momentos ao longo do estudo: um dia antes do início do tratamento (dia 0), no segundo dia de tratamento (dia 2), no quinto dia de tratamento (dia 5) e no último dia de tratamento (dia 8). As amostras eram semeadas em meio de cultura ágar padrão para contagem e meios seletivos e não seletivos. As colônias consideradas morfologicamente distintas eram subsequentemente isoladas e submetidas à identificação bioquímica. Foram observadas oscilações no número de bactérias heterotróficas entre os dias analisados e identificadas três espécies de bactérias Gram-negativas: Citrobacter rodentium...

‣ Comparison of omega-3 fatty acids and sulfasalazine in ulcerative colitis

Dichi, I; Frenhane, P.; Dichi, J. B.; Correa, C. R.; Angeleli, AYO; Bicudo, M. H.; Rodrigues, MAM; Victoria, C. R.; Burini, R. C.
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 87-90
Português
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Fish oil omega-3 fatty acids exert antiinflammatory effects on patients with ulcerative colitis. However, a comparative study in patients with mild to moderate ulcerative colitis receiving only sulfasalazine or omega-3 fatty acids has not been performed. We sought to detect changes in the inflammatory disease activity with the use of either fish oil omega-3 fatty acids or sulfasalazine in patients with ulcerative colitis. Ten patients (five male, five female; mean age = 48 +/- 12 y) with mild to moderate active ulcerative colitis were investigated in a randomized cross-over design. They received either sulfasalazine (2 g/d) or omega-3 fatty acids (5.4 g/d) for 2 mo. Disease activity was assessed by clinical and laboratory indicators, sigmoidoscopy, histology, and whole-body protein turnover (with N-15-glycine). Treatment with w-3 fatty acids resulted in greater disease activity as detected by a significant increase in platelet count, erythrocyte sedimentation rate, C-reactive protein, and total fecal nitrogen excretion. No major changes in protein synthesis and breakdown were observed during either treatment. In conclusion, treatment with sulfasalazine is superior to treatment with omega-3 fatty acids in patients with mild to moderate active ulcerative colitis. Nutrition 2000;16:87-901 (C) Elsevier B.V. 2000.

‣ Nutritional intake according to injury extent in ulcerative colitis patients

Urbano, A. P S; Sassaki, L. Y.; Dorna, M. S.; de Barros Leite Carvalhaes, M. A.; Martini, L. A.; Ferreira, A. L A
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 445-451
Português
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Background: Ulcerative colitis (UC) is often associated with nutritional deficiency, which appears to contribute to the progression of UC severity. The present study aimed to evaluate nutritional status and dietary intake in UC remission patients. Methods: The present study comprised a cross-sectional study in which variables such as extent of disease (distal colitis, left-sided colitis, pancolitis), remission period, sex and age were recorded. Extent of disease was assessed by the results of a colonoscopy and dietary intake was evaluated by using 3-day, 24-h recalls. A Kruskall-Wallis test was used to compare the intake of macro- and micronutrients among the three study groups. The analysis was complemented by the Mann-Whitney test. A logistic regression analysis was performed to identify predictive factors of extent of disease (pancolitis versus left-sided colitis versus distal colitis). Results: The median (range) age of the 59 patients was 49.0 (37.0-63.0) years and 53.3% were female. Twenty-six (44.1%) patients had distal colitis, 11 (18.6%) patients had left-sided colitis and 22 (37.3%) patients had pancolitis. A high probability of an inadequate intake of fibre (100%), fat soluble vitamins (>40% for vitamin A and >95% for vitamin E)...

‣ FOCAL ENHANCED GASTRITIS AND MACROPHAGE MICROAGGREGATES IN THE GASTRIC MUCOSA: potential role in the differential diagnosis between Crohn’s disease and ulcerative colitis

MAGALHÃES-COSTA,Marcia Henriques de; REIS,Beatriz Ribeiro dos; CHAGAS,Vera Lúcia Antunes; NUNES,Tiago; SOUZA,Heitor Siffert Pereira de; ZALTMAN,Cyrla
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2014 Português
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Context and Objectives Focally enhanced gastritis and macrophage microaggregates are found in the upper gastrointestinal involvement of Crohn’s disease, and may reflect an underlying defective innate immunity. These features, however, are also described in patients with Helicobacter pylori infection. The role of these gastric abnormalities in the diagnosis of Crohn’s disease was assessed in a population with high prevalence of H. pylori infection. Methods Thirty-seven Crohn’s disease, 26 ulcerative colitis, and 30 control patients were included. The H. pylori status was evaluated by the rapid urease test and histology. The presence of focally enhanced gastritis and macrophage microaggregates was recorded. Results Focally enhanced gastritis was present in 24% of Crohn’s disease patients, 4% of ulcerative colitis patients and 11.5% of controls, presenting an overall sensitivity and specificity for Crohn’s disease of 24% and 88%, respectively. Macrophage microaggregates were found in all groups, but were only detected in ulcerative colitis and controls in association with H. pylori infection, with an overall sensitivity and specificity for Crohn’s disease of 61% and 69%, respectively. In the absence of H. pylori infection...

‣ Cytomegalovirus in colorectal cancer and idiopathic ulcerative colitis

Mariguela,Viviane Casagrande; Chacha,Silvana Gama Florêncio; Cunha,Aldo de Albuquerque; Troncon,Luiz Ernesto de Almeida; Zucoloto,Sérgio; Figueiredo,Luiz Tadeu Moraes
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2008 Português
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Cytomegalovirus (CMV) is a genus in the family Herpesviridae that has been associated with gastrointestinal syndromes. In this work we looked for a possible association of CMV infection with colorectal cancer and ulcerative colitis (UC). Blood and enteric tissue samples of 14 patients with colorectal cancer and of 21 with UC were subjected to a nested-PCR that amplifies part of the gB gene of CMV and also to immunohistochemistry using a specific monoclonal antibody to IE 76kDa protein of CMV. CMV was detected by nested-PCR in the blood and/or the enteric tissue of nine (64.3%) colorectal cancer and 16 (76.2%) ulcerative colitis patients. In the immunohistochemistry it was observed that 12 (12/21, 57.1%) positive enteric tissue samples of patients with UC and none from patients with colorectal cancer (0/14) were positive to CMV. The positivity of CMV infections in the UC patient group (12/21, 57.1%) showed by both techniques, was significantly higher (p = 0.015) than that observed for colorectal cancer patients (2/14, 14.3%). These results suggest an association of ulcerative colitis with CMV infection of the enteric tissue.

‣ Pouchitis: extracolonic manifestation of ulcerative colitis?

Teixeira,William Gemio Jacobsen; Silva,José Hyppólito da; Teixeira,Magaly Gemio; Almeida,Maristela; Calache,João Elias; Habr-Gama,Angelita
Fonte: Faculdade de Medicina / Universidade de São Paulo - FM/USP Publicador: Faculdade de Medicina / Universidade de São Paulo - FM/USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/1999 Português
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Pouchitis is the most frequent complication of ileal pouch-anal anastomosis for treatment of ulcerative colitis. There are several possible explanations. Among them, we focus on the one that considers pouchitis as an extracolonic manifestation of ulcerative colitis. The aim of this study was to investigate the association between pouchitis and extra-intestinal manifestations (EIM), which are frequent in these patients. Sixty patients underwent restorative proctocolectomy with an ileal J pouch (IPAA) from September 1984 to December 1998. Pouchitis was defined by clinical, endoscopic, and histologic criteria. The following extra-intestinal manifestations were studied: articular, cutaneous, hepatobiliary, ocular, genitourinary, and growth failure. Thirteen patients, of which 10 were female (76.9%), developed one or more episodes of pouchitis. Twelve patients of this group (92.3%) presented some kind of extra-intestinal manifestation, 4 pre-operatively (exclusively), 2 post-operatively (exclusively), and 6 both pre- and post-operatively (1.7 per patient). Twenty patients (42.7%) of the 47 without pouchitis did not present extra-intestinal manifestations; 10/35 (28.5%) of females had pouchitis, compared to 3/35 (12.0%) of men. Pouchitis was more frequent among females...

‣ Infrequent p53 gene alterations in ulcerative colitis

Mattar,R.; Alexandrino,A.M.; Laudanna,A.A.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/1999 Português
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The purpose of this study was to determine whether point mutations and loss of the p53 gene take place in ulcerative colitis which is histologically negative for dysplasia. DNA was extracted from 13 frozen rectal or colon biopsies and blood samples. Ulcerative colitis was classified histologically as active (10 cases) and inactive (3 cases). Exons 5-8 were amplified by PCR, treated with exonuclease and shrimp alkaline phosphatase and sequenced by the dideoxy chain termination method with the Sequenase Version 2.0 DNA sequencing kit. PCR products of intron 6 and exon 4 were digested with MspI and AccII, respectively, for RFLP analysis. No p53 gene mutation was detected in these cases. The number of informative patients for loss of heterozygosity (LOH) at the p53 intron 6 was high, 11 out of 12 (92%), whereas no LOH was observed. LOH affecting p53 exon 4 was not detected in lesions from 5 of 12 patients (42%). In ulcerative colitis, tumor progression is similar to that in sporadic colon cancer, and other oncogenes and tumor suppressor genes are likely to be mutated before the p53 gene.

‣ Altered lectin-binding sites in normal colon and ulcerative colitis

Melo-Júnior,Mario R.; Telles,Adriana M. S.; Albuquerque,Francisco E. B.; Pontes-Filho,Nicodemos T.; Carvalho Jr.,Luiz B.; Beltrão,Eduardo I. C.
Fonte: Sociedade Brasileira de Patologia Clínica; Sociedade Brasileira de Patologia; Sociedade Brasileira de Citopatologia Publicador: Sociedade Brasileira de Patologia Clínica; Sociedade Brasileira de Patologia; Sociedade Brasileira de Citopatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2004 Português
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The aim of this study was to evaluate the expression of carbohydrates via lectin histochemistry and computer image analysis in normal colon and ulcerative colitis. Sections of human intestinal tissues (4mm) were incubated with lectins (Con A, WGA, LTA and PNA) and evaluated through optical microscopy. Staining results were analysed using an image analysis programme. The results showed a positive intense staining pattern to the inflammatory cells, mainly neutrophils of sigmoid and rectum portion of colon as well as epithelial gland cells. WGA and LTA lectins showed distinct patterns between normal gland epithelium and ulcerative colitis. PNA and Con A failed to recognize carbohydrate moieties in studied cases. The results were also confirmed by the image analysis. The observations reported here suggest that WGA and LTA lectins are promising histologic markers to differentiate normal gland epithelium from inflammatory ulcerative colitis regarding the differences observed in the expression of N-acetylglucosamine and L-fucose.

‣ The Role of Mesalamine in the Treatment of Ulcerative Colitis

Karagozian, Raffi; Burakoff, Robert
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Português
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Ulcerative colitis (UC) is a chronic inflammatory condition of unclear etiology affecting the large bowel, most commonly the rectum and extending proximally in a continuous fashion. The overall principle in the pathophysiolgy of ulcerative colitis is the dysregulation of the normal immune system against an antigenic trigger leading to a prolonged mucosal inflammatory response. The diagnosing of UC is made by combining the clinical picture, tissue biopsy with the endoscopic appearance of mucosal ulceration, friable, edematous, erythematous granular appearing mucus. The approach to therapy of UC has been dependent on severity of symptoms with frontline therapy being salicylate based sulfasalazine. Newer formulations of salicylates based drugs with fewer side-effects have been developed. These are free of the sulphur component and are composed of 5-ASA, without the sulfapyridine carrier molecule. Mesalamine is one of these 5-ASA based agents that are currently available and indicated for treatment of UC. In mild/moderate active disease mesalamine has response rates between 40%–70% and remission rates of 15%–20%. Considering that the efficacy of 5-ASA is dose dependent, 4.8 g/day and 2.4 g/day have been shown to be the optimal dosages for mild-moderate distal active disease and for maintenance therapy...

‣ CRP Correlates with clinical score in ulcerative colitis but not in Crohn's disease

Rodgers, A.; Cummins, A.
Fonte: Kluwer Academic/Plenum Publ Publicador: Kluwer Academic/Plenum Publ
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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The aim of this study was to prospectively evaluate the correlation between clinical scoring systems and C-reactive protein (CRP) in inflammatory bowel disease. The modified Harvey-Bradshaw index was used in 40 patients (58 assessments) with Crohn’s disease, and the Lichtiger score in 29 patients (36 assessments) with ulcerative colitis. In ulcerative colitis, CRP was elevated in 14%, 42%, 64%, and 83%, respectively, of subjects with quiescent, mild, moderate, and severe disease. There was a linear correlation of log(CRP) with clinical score except for proctitis. In Crohn’s disease, CRP was elevated in 54%, 70%, 75%, and 100%, respectively, of subjects with quiescent, mild, moderate, and severe disease. We conclude that the clinical score has a good correlation with CRP in ulcerative colitis except for proctitis, whereas clinical score has a poor correlation with CRP in Crohn’s disease, particularly in those with clinically quiescent, fibrostenotic, and ileal disease.; http://www.springer.com/medicine/internal/journal/10620; Alexander D. Rodgers and Adrian G. Cummins; The original publication can be found at www.springerlink.com

‣ Avaliação do consumo da casca de Passiflora edulis na prevenção e tratamento da colite ulcerativa induzida por TNBS; Evaluation of Passiflora edulis peel intake in prevention and treatment of TNBS induced ulcerative colitis

Cínthia Baú Betim Cazarin
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 24/02/2014 Português
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A doença inflamatória intestinal (DII) édoença crônica recidivante que atinge milhões de pessoas no mundo, englobando a Doença de Crohn (DC) e a Retocolite Ulcerativa (RCU). A diferença entre as duas éa sua localização, sendo a RCU específica da região do cólon e reto. O tratamento atual para estas patologias é realizado a base de corticosteróides, imunomoduladores ou anti -TNF-a, conhecido como terapia biol ógica, os quais apresentam diversos efeitos colaterais ao paciente. A patogênese desta doença está relacionada com fatores gen éticos, imunol ógicos e ambientais. Acredita-se que o desequilíbrio da microbiota, assim como a ruptura na barreira natural exercida pela mucosa intestinal seja o primeiro passo para o desencadeamento da resposta inflamatória. As fibras alimentares apresentam função sobre a modulação da microbiota, sendo utilizada como substrato para a formação de ácidos graxos de cadeia curta (AGCC), gerados por meio do processo de fermentação. Em adição, os compostos fenólicos presentes nos alimentos apresentam atividade antioxidante e anti -inflamatória que podem atuar na modulação do processo inflamatório. Sendo assim, o objetivo deste trabalho foi avaliar a utilização de um subproduto da indústria de alimentos...

‣ Efeitos de antocianinas monoméricas de Sambucus nigra L. sobre modelo de colite ulcerativa induzida por TNBS; Effects of Sambucus nigra L. monomeric anthocyanins on TNBS induced ulcerative colitis

Eduardo Augusto Rabelo Socca
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 13/01/2011 Português
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Retocolite ulcerativa idiopática e doença de Crohn são doenças inflamatórias intestinais caracterizadas por inflamação crônica da mucosa, resultando em diarréia, fezes sanguinolentas, dores abdominais, anemia, febre, fadiga e perda de peso, tanto em homens quanto em mulheres. Acredita-se que essas manifestações sejam resultado de uma interação multifatorial envolvendo indivíduos geneticamente susceptíveis, condições ambientais específicas, desbalanço na microflora intestinal e desajuste da resposta imune. Drogas derivadas do acido 5-aminossalicilico (sulfassalazina, mesalamina), corticosteroides e agentes imunomoduladores são utilizadas, em conjunto no tratamento dessas patologias. No entanto tais drogas apresentam efeitos adversos importantes, o que acaba por motivar pesquisas envolvendo produtos naturais como alternativas de tratamento. Neste contexto, este trabalho avaliou os efeitos de antocianinas presentes nos frutos de Sambucus nigra L. (sabugueiro), espécie arbustiva pertencente a família Adoxaceae, em modelo de colite ulcerativa induzida pelo acido 2,4,6-trinitrobenzeno sulfônico (TNBS). Os frutos do sabugueiro apresentam grandes concentrações de metabolitos secundários como antocianinas, alem de outros compostos fenólicos...

‣ DECISION TREE CONSTRUCTION AND COST-EFFECTIVENESS ANALYSIS OF TREATMENT OF ULCERATIVE COLITIS WITH PENTASA®MESALAZINE 2 G SACHET

NISHIKAWA,Alvaro Mitsunori; PALADINI,Luciano; DELFINI,Régis; KOTZE,Paulo Gustavo; CLARK,Otavio
Fonte: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED Publicador: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE ; Colégio Brasileiro de Cirurgia Digestiva - CBCD ; Sociedade Brasileira de Motilidade Digestiva - SBMD ; Federação Brasileira de Gastroenterologia - FBG; Sociedade Brasileira de Hepatologia - SBH; Sociedade Brasileira de Endoscopia Digestiva - SOBED
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 Português
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ContextUnspecified Ulcerative Rectocolitis is a chronic disease that affects between 0.5 and 24.5/105 inhabitants in the world. National and international clinical guidelines recommend the use of aminosalicylates (including mesalazine) as first-line therapy for induction of remission of unspecified ulcerative rectocolitis, and recommend the maintenance of these agents after remission is achieved. However, multiple daily doses required for the maintenance of disease remission compromise compliance with treatment, which is very low (between 45% and 65%). Use of mesalazina in granules (2 g sachet) once daily - Pentasa® sachets 2 g - can enhance treatment adherence, reflecting in an improvement in patients' outcomes.ObjectiveTo evaluate the evidence on the use of mesalazine for the maintenance of remission in patients with unspecified ulcerative rectocolitis and its effectiveness when taken once versus more than once a day. From an economic standpoint, to analyze the impact of the adoption of this dosage in Brazil's public health system, considering patients' adherence to treatment.MethodsA decision tree was developed based on the Clinical Protocol and Therapeutic Guidelines for Ulcerative Colitis, published by the Ministry of Health in the lobby SAS/MS n° 861 of November 4 th...

‣ New Keys to Maintenance Treatment in Ulcerative Colitis

Higgins, Peter D.R.
Fonte: S. Karger AG Publicador: S. Karger AG
Tipo: Artigo de Revista Científica
Publicado em /10/2010 Português
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Maintenance treatment in ulcerative colitis often fails to prevent flares and long term complications. The first key to maintenance is to use effective therapy, even when patients become asymptomatic. The second key is to communicate the importance of adherence to patients, and to help them achieve long term adherence. Simplified dosing schedules are of some benefit, but the bond between patient and doctor, and the patient's belief in the efficacy of the therapy are essential. Decreased co-pays (a fixed amount paid by patients seeking care that is not reimbursed my medical insurance) have been associated with increased adherence, and incentives for patients may be a cost-effective approach to improving adherence. While the most substantial data on the association between adherence and clinical outcomes is in 5-ASAs, non-adherence can also limit the efficacy of thiopurines and biologics. The third key to maintenance treatment is monitoring and maintaining control of inflammation. Decreased histologic and endoscopic damage to the colon has been associated with decreased risk of colon cancer. The most cost-effective way to monitor smoldering inflammation is not known, but endoscopy, structured symptom indices, and biomarkers may be valuable approaches. The fourth key to maintenance treatment is optimizing immunomodulator therapy with thiopurines...

‣ Citomegalovírus em câncer coloretal e colite idiopática ulcerativa; Cytomegalovirus in colorectal cancer and idiopathic ulcerative colitis

Mariguela, Viviane Casagrande; Chacha, Silvana Gama Florêncio; Cunha, Aldo de Albuquerque; Troncon, Luiz Ernesto de Almeida; Zucoloto, Sérgio; Figueiredo, Luiz Tadeu Moraes
Fonte: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo Publicador: Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; Formato: application/pdf
Publicado em 01/04/2008 Português
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Os Cytomegalovírus (CMV) são um gênero da família Herpesviridae, que pode estar associado a síndromes gastrointestinais. No presente trabalho buscamos uma possível associação da infecção por CMV com câncer coloretal e retocolite ulcerativa (RCU). Amostras de sangue e tecido entérico de 14 pacientes com câncer coloretal e 21 com RCU foram submetidas a uma nested-PCR que amplifica parte do gene gB do CMV e a uma imunohistoquímica utilizando um anticorpo monoclonal específico para proteína IE 76Kda de CMV. CMV foi detectado pela nested-PCR em sangue e/ou tecido entérico de 9 (64,3%) dos pacientes com câncer coloretal e 16 (76,2%) dos pacientes com RCU. Na imunohistoquímica foram observadas 12 (57,1%) amostras positivas para CMV nos pacientes com RCU e nos pacientes com câncer coloretal o CMV não foi detectado em nenhuma amostra. A positividade das infecções no grupo de pacientes com RCU (12/21, 57.1%) foi significantemente mais alta (p = 0,015) que aquela observada nos pacientes com câncer coloretal (2/14, 14.3%). Estes resultados sugerem uma associação da presença de CMV no tecido entérico com RCU.; Cytomegalovirus (CMV) is a genus in the family Herpesviridae that has been associated with gastrointestinal syndromes. In this work we looked for a possible association of CMV infection with colorectal cancer and ulcerative colitis (UC). Blood and enteric tissue samples of 14 patients with colorectal cancer and of 21 with UC were subjected to a nested-PCR that amplifies part of the gB gene of CMV and also to immunohistochemistry using a specific monoclonal antibody to IE 76kDa protein of CMV. CMV was detected by nested-PCR in the blood and/or the enteric tissue of nine (64.3%) colorectal cancer and 16 (76.2%) ulcerative colitis patients. In the immunohistochemistry it was observed that 12 (12/21...

‣ Infliximab induces clinical, endoscopic and histological responses in refractory ulcerative colitis

Bermejo,F.; López-Sanromán,A.; Hinojosa,J.; Castro,L.; Jurado,C.; Gómez-Belda,A. B.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/02/2004 Português
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Background: infliximab is a monoclonal antiTNF-α antibody that has repeatedly shown to be effective in the management of Crohn's disease. However, data are scarce about its efficacy in ulcerative colitis. Aim: to describe the joint experience of three Spanish hospitals in the use of infliximab in patients with active refractory ulcerative colitis. Patients and methods: we present seven cases of ulcerative colitis (6 with chronic active disease despite immunosuppressive therapy, and one with acute steroid-refractory ulcerative colitis) treated with infliximab 5 mg/kg of body weight. Clinical response was evaluated by means of the Clinical Activity Index at 2, 4 and 8 weeks after initial infusion. Biochemical (erythrocyte sedimentation rate and C-reactive protein), endoscopic, and histological changes were also assessed. Results: mean age of patients was 45.8 ± 17 years (range 23-77); 4 were female. No adverse effects were recorded. Inflammatory activity diminished significantly in 6 of 7 patients (85.7%; CI 95%: 42-99%) both from a clinical (p = 0.01) and biochemical (p <0.05) point of view. Five out of six patients (83.3%; 36-99%) with corticosteroid-dependent disease could be successfully weaned off these drugs. Five patients were endoscopicly controlled both before and after therapy...

‣ Autoimmune pancreatitis and ulcerative colitis: A clinical challenge of a true association

Barreiro,Pedro; Marques,Pedro Pinto; Couto,Gilberto; Serra,David; Chagas,Cristina; Matos,Leopoldo
Fonte: Sociedade Portuguesa de Gastrenterologia Publicador: Sociedade Portuguesa de Gastrenterologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2013 Português
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Autoimmune pancreatitis is emerging as a well-defined clinical entity, yet its diagnosis and therapeutic approach still constitute a clinical challenge. Its association to other autoimmune diseases, namely ulcerative colitis, is known although the exact relationship between the two entities is not completely clarified. We present the case of a patient who developed obstructive jaundice with later onset of blood-stained diarrhea, leading to a final diagnosis of autoimmune pancreatitis and ulcerative colitis. We make a brief revision of autoimmune pancreatitis, its relationship with ulcerative colitis and therapeutic approaches of the same, namely the eventual necessity of immunosuppressive therapy.