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Rev Enferm [keywords]
- Gastric and duodenal pseudomelanosis: A propos of two cases. [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):346-347.
- Innate lymphoid cells and natural killer T cells in the gastrointestinal tract immune system. [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):334-345.
The gastrointestinal tract is equipped with a highly specialized intrinsic immune system. However, the intestine is exposed to a high antigenic burden that requires a fast, nonspecific response -so-called innate immunity- to maintain homeostasis and protect the body from incoming pathogens. In the last decade multiple studies helped to unravel the particular developmental requirements and specific functions of the cells that play a role in innate immunity. In this review we shall focus on innate lymphoid cells, a newly discovered, heterogeneous set of cells that derive from an Id2-dependent lymphoid progenitor cell population. These cells have been categorized on the basis of the pattern of cytokines that they secrete, and the transcription factors that regulate their development and functions. Innate lymphoid cells play a role in the early response to pathogens, the anatomical contention of the commensal flora, and the maintenance of epithelial integrity.Amongst the various innate lymphoid cells we shall lay emphasis on a subpopulation with several peculiarities, namely that of natural killer T cells, a subset of T lymphocytes that express both T-cell and NK-cell receptors. The most numerous fraction of the NKT population are the so-called invariant NKT or iNKT cells. These iNKT cells have an invariant TCR and recognize the glycolipidic structures presented by the CD1d molecule, a homolog of class-I MHC molecules. Following activation they rapidly acquire cytotoxic activity and secrete both Th1 and Th2 cytokines, including IL-17. While their specific role is not yet established, iNKT cells take part in a great variety of intestinal immune responses ranging from oral tolerance to involvement in a number of gastrointestinal conditions.
- MicroRNAs: An epigenetic tool to study celiac disease. [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):325-333.
This article summarizes recent findings on the role of microRNAs (miRNAs) in biological processes associated with the regulation of chronic inflammation and autoimmunity. miRNAs are small non-coding RNA molecules that have been recently emerged as a new class of modulators of gene expression at the post-transcriptional level. MiRNAs bind to complementary sequences of specific targets of messengers RNA, which can interfere with protein synthesis. We reviewed studies that evaluated the expression patterns of miRNAs in different autoimmune diseases, especially in celiac disease (CD). CD is a chronic enteropathy triggered by gluten proteins, characterized by altered immune responses in genetically susceptible individuals that results in damage to the bowel mucosa. CD has a high prevalence and an effective treatment by a specific diet ("gluten free diet"). Genetic factors confer susceptibility but do not explain the whole disease, suggesting that environmental factors do playa relevant role in the development of the condition.The evaluation of the potential role of miRNA is of particular interest in CD given that these epigenetic mechanisms in the pathogenesis of autoimmune and inflammatory diseases have been recently described. Improving our understanding of miRNAs in CD will contribute to clarify the role of altered epigenetic regulation in the development and course of this disease.
- Prevalence and persistence of nausea and vomiting along the pregnancy. [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):318-324.
Background/aims: Nausea and vomiting of pregnancy (NVP) impact in the pregnant woman´s quality of life, especially when are persistent or severe. The objective is to estimate the prevalence and factors associated with the persistence of NVP in each trimester of pregnancy.Methods: We studied a cohort of 263 pregnant women with gestational age < 12 weeks. Data were collected using the Gastro- Esophageal Reflux Questionnaire validated for use in the Spanish population. Data were collected through telephone interviews at the end of each trimester of pregnancy. The main variable was the presence of NVP in each trimester and their persistence along the pregnancy.Results: The prevalence of nausea in the each trimester was 63.5 %, 33.8 %, 26.2 %, and vomiting was 29.3 %, 22.1 %, 14.1 %, respectively. Factors associated with nausea in the first trimester were Latin-American origin (OR: 3.60, 95 %IC 1.61- 80.5) and primary education (OR: 0.31; 0.13-0.73); vomiting was associated with Latin-American origin (OR: 13.80, 1.82-104.4) and was inversely associated with weight gain (OR: 0.58, 0.35-0.97). Persistence of NVP were only associated with suffering the symptom in the previous trimester (p < 0.01), and did not find other predictor factors.Conclusions: NVP´s prevalence declines along pregnancy, is associated with race and inversely with weight gain, and its persistence over time cannot be predicted.
- Preparations for colon capsule endoscopy. Prospective and randomized comparative study between two preparations for colon capsule endoscopy: PEG 2 liters + ascorbic acid versus PEG 4 liters. [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):312-317.
Introduction: PillCam© colon capsule endoscopy (CCE) enables the study of colonic diseases in a safe and non-invasive way, although there are aspects that need to be improved. Current methods of bowel preparation lead to discordant rates of adequate cleansing and CCE excretion.Aims: To compare the efficacy of colon cleansing using two different regimes (2L PEG plus ascorbic acid versus 4L PEG alone) for PillCam Colon (C2) capsule endoscopy.Methods: Fifty eight patients included in this prospective study and randomized to: Group A, PEG plus ascorbic acid regimen (n = 28, 12 F/16 M) or group B, PEG alone regimen (n = 30, 14 F/16 M). The degree of cleansing was categorized into "excellent-good" or "fair-poor", according to Leighton´s recently published preparation scale. CCE excretion rate and colon cleansing were assessed. Patients underwent to PillCam colon of second generation (C2).Results: Cleansing was considered to be excellent-good in 78 % of cases in group A and in 64 % of cases in group B, with no significant difference between the groups (p = 0.252). Nevertheless, when the grade of cleansing was analyzed in segments, a significant difference was found in the cecum and transverse colon. No differences were observed in the bubble effect between preparations. The excretion rate was 93 % in group A versus 70 % in group B (p = 0.043).Conclusions: These results suggest that a 2L PEG plus ascorbic acid regimen is at least as effective as a 4L PEG regimen. This regimen may be considered an effective alternative which would improve compliance because a smaller volume is required.
- Effectiveness of entecavir treatment and predictive factors for virologic response. [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):305-311.
Introduction: Entecavir (ETV) is a potent inhibitor of hepatitis B virus (HBV) replication. In patients adherent to treatment, virologic remission rates of > 95 % can be maintained with entecavir at 3-5 years.Aim and methods: A cohort study was performed, including all subjects who received ETV for chronic hepatitis B, in the South- Eastern Romania. We assessed viral response, HBeAg loss and seroconversion, HBsAg loss and seroconversion, biochemical response. Comparison of categorical data was performed by Chi2-test or Fisher´s exact where applicable.Results: Data from 533 patients were available: predominantly males (64 %), 82.6 % nucleotide naive, 23.1 % HBe-Ag positive, 78.2 % with elevated ALT, 8 % with cirrhosis. The median follow up was 24 months (range 12-48 months). Rate of undetectable HBV DNA increased constantly from year 1 to 3, reaching 91.2 %. Positive predictive factors for virologic response were low score of fibrosis (p-0.006), low level of HBV DNA (p-0.003), while negative predictive factors were: HBe antigen positive status (p-value < 0.001), prior IFN therapy (p 0.015). Virologic rebound was found in 7.8 % (breakthrough in 0.8 %). Rate of HBe Ag loss increases with the therapy duration, reaching 47.83 % in year 3,with two positive predictive factors: Male sex (p = 0.007), and undetectable HBV DNA at 24 weeks (p = 0.002). The percentage of HBs Ag loss was 1.31 %.Conclusions: ETV maintained and even increased the high initial response rate (from 78 % to 91.2 %). Low score of fibrosis, low level of HBV DNA, HBe antigen negative status, absence of prior interferon therapy predict a good virologic response. Virologic rebound was found in a higher rate in our population, due probably to a poor drug compliance. Lamivudine-resistant patients usually respond well to ETV, but 15.62 % are non-responders, suspect of Entecavir resistance.
- Low-volume cleansing regimens for colon capsule endoscopy: The answer to the million-dollar question? [JOURNAL ARTICLE]
- Rev Esp Enferm Dig 2014 May; 106(5):301-304.
- [In Process Citation]. [Journal Article]
- Rev Bras Enferm 2014 Jul; 67(4):646-8.
- [Incorporation of controlling dengue by community health agent]. [English Abstract, Journal Article]
- Rev Bras Enferm 2014 Jul; 67(4):637-45.
The purpose of this study was to identify self-perceived differences in the work processes of community health agents (CHA) in two counties of Mato Grosso do Sul, regarding dengue control and Family Health Strategy (FHS) activities. Structured interviews were applied to 57 CHA. The subjects had similar sociodemographic characteristics. Agents in Rio Verde de Mato Grosso county, who performed only FHS tasks, failed to complete essential data of the Form A. In São Gabriel do Oeste county, CHA currently perform tasks pertaining to dengue fever control, previously conducted by Endemic Disease Control Agents (now abolished), while in Rio Verde de Mato Grosso county, dengue control remained assigned to the latter group. In São Gabriel do Oeste county, CHA did not view the double workload of two programs as affecting their professional productivity. The pooling of tasks from the two programs proved to be feasible, with no detrimental effects on performance.
- [Use of musical experiences as therapy for symptoms of nausea and vomiting in chemotherapy]. [English Abstract, Journal Article]
- Rev Bras Enferm 2014 Jul; 67(4):630-6.
The study aimed to evaluate the therapeutic effects of musical experiments in nausea and vomiting associated with antineoplastic chemotherapy, and to identify changes in vital parameters of the patients who participated in the experience. This is a descriptive, transversal study, level II, which used a quantitative approach, conducted with thirteen patients from an outpatient chemotherapy unit, of a private hospital in São Paulo City. Two instruments were used, one of them proposed by MASCC (Multinational Association on Supportive Care in Cancer). The participants were predominantly females, aged 40 to 60 years, married and with breast cancer. Heart rate has decreased in 77% of the sample, and the reduction of nausea occurred in 100% of patients after the first musical experience, and in 85% after the second one. Patients reported disbelief in music in relieving nausea and vomiting before the sessions, and relief of nausea after them. It was concluded that there was a statistically significant reduction of the symptoms nausea and vomiting after the musical experiences.