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Crohn's disease environmental factors in the developing world: A case-control study in a statewide catchment area in Brazil

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World Journal of Gastroenterology 2017年第30期23卷 5549-5556页

作者： Valéria cristina Loureiro Salgado Ronir Raggio Luiz Neio Boechat bianca C Schorr Isabella S Leao Tiago Nunes Cyrla Zaltman Division of Gastroenterology Department of Internal MedicineClementino Fraga Filho HospitalFederal University of Rio de Janeiro Institute for Studies in Public Health Federal University of Rio de Janeiro Multidisciplinary Research Laboratory Clementino Fraga Filho University HospitalInstitute of Thoracic DiseasesFaculty of MedicineFederal University of Rio de Janeiro Gastrointestinal Physiology Institute of Nutritional ScienceNestle Research Center

To identify environmental risk factors associated with the development of Crohn’s disease (CD) in order to re-assess the hygiene hypothesis. METHODSA hospital-based, case-control study was carried out with CD patients (n = 145) and controls (n = 163) representing a socioeconomically diverse statewide catchment area in Brazil. Controls were recruited from caregivers of patients seen in different outpatient clinics at the same hospital. A multi-item survey with 94 questions regarding family history of CD, perinatal and childhood circumstances, living conditions, tobacco use and familial socioeconomic status was carried out by interviewers. RESULTSOn the univariate analysis, predictive variables for CD included being male, under age of 40, a high education level, urban dweller, smaller family size, exposure to enteric pathogens and user of treated water (P < 0.005). On the multivariate analysis, variables significantly associated with CD were male gender (OR = 2.09), under age 40 (OR = 3.10), white (OR = 2.32), from a small family in childhood (OR = 2.34) and adulthood (OR = 3.02), absence of viral infections in childhood (OR = 2.23), exposure to enteric pathogens (OR = 2.41), having had an appendectomy (OR = 2.47) and prior or current smoker (OR = 2.83/1.12). CONCLUSIONMost variables supporting the “hygiene hypothesis” are associated with the development of CD but are not independent predictors of the diagnosis.

关键词： Crohn’s disease Environment Hygiene hypothesis Risk factors

Age,blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

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World Journal of Clinical Cases 2023年第19期11卷 4513-4530页

作者： bianca Codrina Morarasu Victorita Sorodoc Anca Haisan Stefan Morarasu cristina Bologa Raluca Ecaterina Haliga Catalina Lionte Emilia Adriana Marciuc Mohammed Elsiddig Diana Cimpoesu Gabriel Mihail Dimofte Laurentiu Sorodoc Department of Internal Medicine and Toxicology Saint Spiridon University Regional Emergency HospitalFaculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700111Romania Department of Emergency Medicine Saint Spiridon University Regional Emergency HospitalFaculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700111Romania Second Department of Surgical Oncology Regional Institute of OncologyFaculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700111Romania Department of Radiology Emergency Hospital“Prof.Dr.N.Oblu”Faculty of Medicine“Grigore T.Popa”University of Medicine and PharmacyIasi 700309Romania Department of Gatroenterology Beaumont HospitalDublin D09V2N0Ireland

BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality *** To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January *** calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding *** subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score *** All scores had discriminative ability in predicting in-hospital mortality irrespective of study ***65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding ***,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both *** score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical *** of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of *** ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding *** and GBS should be used to determine need for endoscopic and surgical intervention,respective

关键词： Glasgow-Blatchford Pre-endoscopic Rockall Age older than 65 Age,blood tests and comorbidities Risk score Gastrointestinal bleeding

Vestibular Function Evaluation in Endemic Diseases Combat Agents

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Health 2021年第2期13卷 144-156页

作者： Patrícia Arruda de Souza Alcarás bianca Simone Zeigelboim Maria cristina Alves Corazza Débora Lüders Jair Mendes Marques Adriana Bender Moreira de Lacerda University of Western Sã o Paulo UNOESTE Presidente Prudente S&#227 o Paulo Brazil Tuiuti University of Paraná UTP Curitiba Paraná Brazil Université de Montréal UdeM Quebec Canada

Introduction: Simultaneous exposure to certain chemical agents and noise may cause synergistic, additive or potentiating effects on the auditory and vestibular system. However, there is still a lack of studies investigating simultaneous exposure to pesticides and noise in the vestibular system. Purpose: To analyze the findings of the vestibular evaluation of endemic diseases combat agents when simultaneously exposed to pesticides and noise. Method: Thirty-three male pesticide-exposed and noise-fighting endemic diseases combat agents participated in the study. The age range was 48 to 67 years (mean = 56 years). All participants underwent vestibular examinations, such as positional nystagmus research, spontaneous nystagmus with open and closed eyes, semi-spontaneous nystagmus, optokinetic nystagmus, pendular screening, per rotatory, caloric tests and tonal audiometry. Data were analyzed by descriptive statistics. Results: Altered exams were presented in 36.4% of the cases. There was no statistically significant relationship between pesticide handling time and test results (p = 0.2825). The results of pure tone audiometry correlated significantly (p = 0.0494) with the vestibular exams, as participants who presented with worse hearing thresholds at the frequency of 4000 Hz in the right ear also presented altered results in the vestibular exam. Conclusion: The present study concluded that more than 1/3 of the studied population presented with vestibular dysfunction, which was related to anterior and posterior labyrinth alteration (Cochlear-Vestibular Syndrome). No central vestibular alteration was noted in this population.

关键词： Community Health Workers Pesticides Noise Hearing Vestibular System

The Evaluation of Bioremediation Potential of a Yeast Collection Isolated from Composting

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Advances in Microbiology 2014年第12期4卷 796-807页

作者： bianca Trama Joao Daniel Santos Fernandes Geórgia Labuto Júlio Cézar Franco de Oliveira cristina Viana-Niero Renata C. Pascon Marcelo A. Vallim Departamento de Ciencias Biologicas—Universidade Federal de Sao Paulo Diadema Sao Paulo Brasil

The influence of xenobiotic compounds on environment and on living organisms has been reported as an imminent public health problem. Among them we can list the contamination by Alkanes present in petroleum, hydrocarbons and organic contaminant substances from industrial effluents. Also, heavy metals are of particular interest because of their persistence in the environment contaminating the food webs. Among the innovative solutions for treatment of contaminated water and soil is the use of biological materials like living or dead microorganisms. Yeasts exhibit the ability to adapt to extreme condition such as temperature, pH and levels of organic and inorganic contaminants that make them a potential material to be used to remediate contaminated environment application. The goal of this work was to search for yeast isolates capable to use n-hexadecane (alkane hydrocarbon) as a primary carbon source and for those able to tolerate high concentration of lead (Pb) within a collection of 90 isolates obtained from the Sao Paulo Zoo composting system. The isolated yeast strains were identified by mass spectrometry (MALDI-TOF-MS) and by sequencing of the ribosomal DNA (18S and D1/D2) conserved regions. We found that the collection bares 23 isolates capable of utilizing n-hexadecane and one which is able to tolerate high concentration of lead (Pb) with a high biosorption index compared to the reference yeast strains (BY4742, PE-2, CAT-1 and BG-1). These results confirm the initial hypothesis that the Sao Paulo Zoo composting is the source for diverse yeasts species with biotechnological application potential.

关键词： Biosorption Lead Yeast Trichosporon montevideense Saccharomyces cerevisiae

Risk factors associated with inflammatory bowel disease: A multicenter case-control study in Brazil

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World Journal of Gastroenterology 2020年第25期26卷 3611-3624页

作者： Valéria cristina Loureiro Salgado Ronir Raggio Luiz Neio Lucio Fernandes Boéchat Isabella Sued Leao bianca do Carmo Schorr JoséMiguel Luz Parente Daniela Calado Lima Eduardo Santos Silveira Júnior Genoile Oliveira Santana Silva Neogélia Pereira Almeida Andrea Vieira Maria Luiza Queiroz de Bueno Júlio Maria Chebli érika Ruback Bertges Luísa Martins da Costa Brugnara Columbano Junqueira Neto Stefania Burjack Gabriel Campbell Luana Letiza Discacciati Joao Paulo Silva Cézar Tiago Nunes Gilaad G Kaplan Cyrla Zaltman Division of Gastroenterology Department of Internal MedicineClementino Fraga Filho HospitalFederal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Institute for Studies in Public Health Federal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Multidisciplinary Research Laboratory Clementino Fraga Filho HospitalInstitute of Thoracic DiseasesFaculty of MedicineFederal University of Rio de JaneiroRio de Janeiro 21940-230Brazil Division of Gastroenterology Department of Internal MedicineHospital UniversityFaculty of MedicineFederal University of PiauíPiauí64049-550Brazil Almeida Division of GastroenterologyInflammatory Bowel Disease Outpatient ClinicRoberto Santos General Hospital(HGRS)of the Bahia State Department of HealthBahia 40110-060Brazil Division of Gastroenterology Inflammatory Bowel Disease Outpatient ClinicIrmandade Santa Casa da Misericórdia of São PauloSão Paulo 01221020Brazil Division of Gastroenterology Department of Internal MedicineHospital UniversityFaculty of MedicineFederal University of Juiz de ForaMinas Gerais 36036-247Brazil Division of Gastroenterology Inflammatory Bowel Disease Outpatient ClinicFederal District Base HospitalBrasília 70330-150Brazil Gastrointestinal Physiology Institute of Nutritional ScienceNestle Research CenterLausanne 1000Switzerland Departments of Medicine and Community Health Sciences University of CalgaryCalgary T2N4Z6Canada

BACKGROUND The etiology of inflammatory bowel disease(IBD)is unknown,but it is believed to be *** hygiene hypothesis proposes that better hygiene conditions would lead to less infectious disease during childhood and favor the development of immune-mediated *** To test the hygiene hypothesis in IBD by assessing the environmental risk factors associated with IBD development in different regions of Brazil with diverse socioeconomic development *** A multicenter case-control study was carried out with 548 Crohn’s disease(CD)and 492 ulcerative colitis(UC)outpatients and 416 healthy controls,from six IBD centers within different Brazilian states at diverse socioeconomic development stages.A semi-structured questionnaire with 87 socioeconomic and environmental questions was *** regression model was created to assess the odds ratio(OR)with P value and 95%confidence intervals(CI).RESULTS Predictive variables for both diseases(CD and UC)were women[odd ratios(OR)=1.31;OR=1.69],low monthly family income(OR=1.78;OR=1.57),lower number of cohabitants(OR=1.70;OR=1.60),absence of vaccination(OR=3.11;OR=2.51),previous history of bowel infections(OR=1.78;OR=1.49),and family history of IBD(OR=5.26;OR=3.33).Associated risk factors for CD were age(18-39 years)(OR=1.73),higher educational level(OR=2.22),absence of infectious childhood diseases(OR=1.99).The UC predictive variables were living in an urban area(OR=1.62),inadequate living conditions(OR=1.48)and former smokers(OR=3.36).Appendectomy was a risk factor for CD(OR=1.58)with inverse association with UC(OR=4.79).Consumption of treated and untreated water was associated with risk of CD(OR=1.38)and UC(OR=1.53),*** This is the first examining environmental exposures as risk factors for inflammatory bowel disease in *** of the variables associated with disease risk support the role of the hygiene hypothesis in IBD development.

关键词： Crohn’s disease Ulcerative colitis Risk factors Environmental factors Hygiene hypothesis