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Ciapponi A, Virgilio SA, Berrueta M, Soto NC, Ciganda Á, Rojas Illanes MF, Rubio Martinez B, Gamba J, González Salazar CA, Rocha Rodríguez JN, Scarpellini B, Bravo Perdomo AM, Machnicki G, Aldunate L, De Paula J, Bardach A. Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study. PLoS One 2020; 15:e0228256. [PMID: 31986191 PMCID: PMC6984728 DOI: 10.1371/journal.pone.0228256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/12/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS Ulcerative Colitis (UC) and Crohn's Disease (CD) have a major impact on quality of life and medical costs. The aim of the study was to estimate the prevalence, incidence and clinical phenotypes of Inflammatory Bowel Disease (IBD) cases in Mexico and Colombia. METHODS We analyzed official administrative and health databases, used mathematical modelling to estimate the incidence and complete prevalence, and performed a case-series of IBD patients at a referral center both in Mexico and Colombia. RESULTS The age-adjusted complete prevalence of UC per 100,000 inhabitants for 2015/2016 ranged from 15.65 to 71.19 in Mexico and from 27.40 to 69.97 in Colombia depending on the model considered. The prevalence of CD per 100,000 inhabitants in Mexico ranged from 15.45 to 18.08 and from 16.75 to 18.43 in Colombia. In Mexico, the age-adjusted incidence of UC per 100,000 inhabitants per year ranged from 0.90 to 2.30, and from 0.55 to 2.33 in Colombia. The incidence for CD in Mexico ranged from 0.35 to 0.66 whereas in Colombia, the age-adjusted incidence of CD ranged from 0.30 to 0.57. The case-series included 200 IBD patients from Mexico and 204 patients from Colombia. The UC/CD prevalence ratio in Mexico and Colombia was 1.50:1 and 4.5:1 respectively. In Mexico, the female/male prevalence ratio for UC was 1.50:1 and 1.28:1 for CD, while in Colombia this ratio was 0.68:1 for UC and 0.8:1 for CD. In Mexico the relapse rate for UC was 63.3% and 72.5% for CD, while those rates in Colombia were 58.2% for UC and 58.3% for CD. CONCLUSIONS The estimated burden of disease of IBD in Mexico and Colombia is not negligible. Although these findings need to be confirmed by population-based studies, they are useful for decision-makers, practitioners and patients with this condition.
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Affiliation(s)
- Agustín Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | | | - Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Natalie Claire Soto
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Álvaro Ciganda
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | | | | | - Johana Gamba
- Fundación Universitaria Sánitas, Bogotá, Colombia
| | | | | | | | | | | | | | - Juan De Paula
- Hospital Italiano de Buenos Aires (HIBA), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
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Barcán L, Ducatenzeiler L, Bangher MDC, Barcelona L, Cornistein W, Daciuk L, De Paula J, Desse J, Dictar M, Fernández-Canigia L, Nacinovich F, Scapellato P, Martínez JV. [Intersociety guidelines for diagnosis, treatment and prevention of Clostridioides difficile infections]. Medicina (B Aires) 2020; 80 Suppl 1:1-32. [PMID: 31961792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
Clostridioides difficile infections (CDI) are among the leading causes of health care-associated infections. The epidemiology of CDI has undergone major changes in the last decade, showing an increase in incidence, severity, and rate of relapse. These guidelines were developed by specialists from four scientific societies: Sociedad Argentina de Infectología (SADI), Sociedad Argentina de Gastroenterología (SAGE), Sociedad Argentina de Bacteriología, Micología y Parasitología Clínicas (SADEBAC) and Asociación de Enfermeras en Control de Infecciones (ADECI). The objective of these intersociety guidelines is to provide national recommendations on CDI diagnosis, treatment and prevention. The methodology used involved the systematic review of the bibliography available up to December 2018, which was performed by six groups formed ad hoc: Epidemiology, Diagnosis, Treatment, Fecal Microbiota Transplantation, Special Populations, and Infection Control. The conclusions were presented and discussed in meetings held by each individual group and plenary meetings. In this document, updated diagnosis algorithms, therapeutic options (including fecal microbiota transplant) for immunocompetent and immunocompromised patients are presented, as well as strategies for the control of C. difficile infection.
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Affiliation(s)
- Laura Barcán
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. E-mail:
- Sociedad Argentina de Infectología (SADI)
| | - Laura Ducatenzeiler
- Hospital Italiano de San Justo Agustín Rocca, San Justo. Pcia. de Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - María Del Carmen Bangher
- Instituto de Cardiología de Corrientes, Corrientes, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Laura Barcelona
- Hospital Municipal Dr. Bernardo Houssay, Vicente López, Pcia. de Buenos Aires, Argentina
- Dr. Stamboulian, Servicio de Salud, Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Wanda Cornistein
- Hospital Universitario Austral, Pilar, Pcia. de Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Lucía Daciuk
- Hospital Nacional Alejandro Posadas, El Palomar, Pcia. de Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Juan De Paula
- Hospital Italiano de Buenos Aires, Argentina
- Sociedad Argentina de Gastroenterología (SAGE)
| | - Jaier Desse
- Hospital Zonal Dr. Enrique Erill, Pcia. de Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Miguel Dictar
- Instituto Alexander Fleming, Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Liliana Fernández-Canigia
- Hospital Alemán, Buenos Aires
- Subcomisión de Bacterias Anaerobias, Sociedad Argentina de Bacteriología, Micología y Parasitología Clínicas (SADEBAC), Asociación Argentina de Microbiología (AAM)
| | - Fancisco Nacinovich
- Instituto Cardiovascular Buenos Aires, Argentina
- Dr. Stamboulian, Servicio de Salud, Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Pablo Scapellato
- Hospital Donación Francisco Santojanni, Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
| | - Jorge Víctor Martínez
- Hospital Británico, Buenos Aires, Argentina
- Sociedad Argentina de Infectología (SADI)
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Cazorla SI, Maldonado-Galdeano C, Weill R, De Paula J, Perdigón GDV. Oral Administration of Probiotics Increases Paneth Cells and Intestinal Antimicrobial Activity. Front Microbiol 2018; 9:736. [PMID: 29713315 PMCID: PMC5911494 DOI: 10.3389/fmicb.2018.00736] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/28/2018] [Indexed: 12/12/2022] Open
Abstract
The huge amount of intestinal bacteria represents a continuing threat to the intestinal barrier. To meet this challenge, gut epithelial cells produce antimicrobial peptides (AMP) that act at the forefront of innate immunity. We explore whether this antimicrobial activity and Paneth cells, the main intestinal cell responsible of AMP production, are influenced by probiotics administration, to avoid the imbalance of intestinal microbiota and preserve intestinal barrier. Administration of Lactobacillus casei CRL 431 (Lc 431) and L. paracasei CNCM I-1518 (Lp 1518) to 42 days old mice, increases the number of Paneth cells on small intestine, and the antimicrobial activity against the pathogens Staphylococcus aureus and Salmonella Typhimurium in the intestinal fluids. Specifically, strong damage of the bacterial cell with leakage of cytoplasmic content, and cellular fragmentation were observed in S. Typhimurium and S. aureus. Even more important, probiotics increase the antimicrobial activity of the intestinal fluids at the different ages, from weaning (21 days old) to old age (180 days old). Intestinal antimicrobial activity stimulated by oral probiotics, do not influence significantly the composition of total anaerobic bacteria, lactobacilli and enterobacteria in the large intestine, at any age analyzed. This result, together with the antimicrobial activity observed against the same probiotic bacteria; endorse the regular consumption of probiotics without adverse effect on the intestinal homeostasis in healthy individuals. We demonstrate that oral probiotics increase intestinal antimicrobial activity and Paneth cells in order to strengthen epithelial barrier against pathogens. This effect would be another important mechanism by which probiotics protect the host mainly against infectious diseases.
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Affiliation(s)
- Silvia I Cazorla
- Laboratorio de Inmunología, Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Argentina.,Cátedra de Inmunología, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina
| | - Carolina Maldonado-Galdeano
- Laboratorio de Inmunología, Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Argentina.,Cátedra de Inmunología, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina
| | - Ricardo Weill
- Departamento de Investigación y Desarrollo, DANONE, Buenos Aires, Argentina
| | - Juan De Paula
- Servicio de Gastroenterología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Gabriela D V Perdigón
- Laboratorio de Inmunología, Centro de Referencia para Lactobacilos (CERELA-CONICET), San Miguel de Tucumán, Argentina.,Cátedra de Inmunología, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Argentina
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Pizzala J, Pogorelsky V, González M, Abecia-Soria V, De los Ríos A, Rivera J, Seehaus A, De Paula J, Macías-Gómez C. [Pneumatosis cystoides intestinalis: a case report and review of the literature]. Acta Gastroenterol Latinoam 2014; 44:48-51. [PMID: 24847630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pneumatosis cystoides intestinalis features the presence of subserum or submucous cysts with gas in the intestinal wall. Its prevalence is 0.03%, although it has increased in the past decades due to a greater use of colonoscopy in everyday medical practice. Though there are several theories about its origin and many associated diseases were reported, its pathogenesis still remains uncertain. It is generally diagnosed as a finding in an imaging test. The treatment depends on the severity of the associated disease and symptoms. We report the case of a 59-year-old woman, heavy smoker, with no other clinical conditions who took a medical consultation due to abdominal bloating. She underwent a screening colonoscopy which detected the existence of cysts on the colonic wall. Afterwards, a computed tomography was performed and showed apical lung bullae, gas in a colonic wall segment, and ascitis associated to a big anexial tumor. She underwent a cytoreductive surgery, confirming the presence of advanced ovary neoplasm. The endoscopic biopsy confirmed the diagnosis of penumatosis cystoides intestinalis. We report these case because it is a rare entity which requires uncommon management and treatment guidelines.
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Van Domselaar F, Matoso MD, Piccioni HL, Varela E, Marcolongo MM, Bonadeo F, Quintana GO, Cavadas D, Mullen EG, De Paula J. [Gastrointestinal bleeding and intestinal perforation due to polyarteritis nodosa in a patient with celiac disease. A case report]. Acta Gastroenterol Latinoam 2011; 41:312-316. [PMID: 22292228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Complications of celiac disease could present with intestinal perforation and rarely, gastrointestinal bleeding, which are usually secondary to nongranulomatous ulcerative jejunoileitis or T-cell lymphoma. We describe the case of a 66-year-old male patient with an 8-year history of celiac disease (CD) who presented with recurrent abdominal pain and gastrointestinal bleeding. Several tests were performed to find out possible complications associated to CD. Due to an overt gastrointestinal bleeding, an arteriography was performed and signs of polyarteritis nodosa were found. Vascular disease was aggressive, and despite multiple medical and surgical treatments the patient died. As arteriography is not usually performed for the study of the complications of CD, it is possible that the association between CD and PAN has been underdiagnosed.
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Affiliation(s)
- Fernando Van Domselaar
- Servicio de Gastroenterología, Hospital Italiano, Ciudad Autónoma de Buenos Aires, Argentina.
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