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Schmulson M, Gudiño-Zayas M, Hani A. The Impact of COVID-19 Pandemic on Neurogastroenterologists in Latin America: Results of an Online Survey. J Clin Gastroenterol 2021; 55:684-690. [PMID: 33471492 PMCID: PMC8356844 DOI: 10.1097/mcg.0000000000001413] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/26/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic has affected medical practice in fields not related to the infection. Neurogastroenterology is a subspecialty of gastroenterology focused on motility and functional gastrointestinal disorders, including consultations, and conducting procedures (eg, endoscopies, manometries/pH-monitoring). AIM The aim of this study was to determine the impact of COVID-19 on Neurogastroenterology in Latin America. METHODS Members of the Latin American Society of Neurogastroenterology were invited by e-mail and social networks to participate in an online anonymous survey. It included 24 questions on demographics, clinical practice and procedure characteristics, impact of the pandemic, Telemedicine, and involvement in COVID-19 patient care. RESULTS Sixty-one members mainly from Colombia, Mexico, and Brazil answered the survey. All reported a negative impact on their practice (88.6%: a 61% to 100% decrease), mainly in office consultations and elective endoscopies. Interestingly, emergency endoscopies decreased by 33.3%, while only 4% stopped performing manometries/pH-monitoring. The main reasons were patients' fear for consulting, country's lockdown, and physician's decision to prevent infection spread. Telemedicine was implemented by 83% but only 64.7% were being remunerated. Almost 46% had to reduce salaries and working hours of their personnel. Fifty-nine percent had colleagues diagnosed with COVID-19, 24.6% were involved in these patients' care, and 11.5% were mobilized to COVID-19 wards. There were country differences: Colombia, lockdown (P=0.001); Mexico, COVID-19 patient-care (P=0.053); Mexico/Colombia, working in COVID-19 wards, (P=0.012); Brazil, less common elective procedures' ban (P=0.012) and Telemedicine/reimbursement (P=0.034). CONCLUSIONS The COVID-19 pandemic has negatively impacted the practice and wellness of Neurogastroenterologists in Latin America. Guidelines to resume activities and policies for Telemedicine practice and reimbursement are warranted.
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Affiliation(s)
- Max Schmulson
- Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM), Gastroenterología y Endoscopía, Centro Médico ABC, Gastroenterología y Motilidad Gastrointestinal, Clínica Lomas Altas SC
| | - Marco Gudiño-Zayas
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Albis Hani
- Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontifica Universidad Javeriana, Santa Fé de Bogotá, Colombia
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Pochard C, Coquenlorge S, Freyssinet M, Naveilhan P, Bourreille A, Neunlist M, Rolli-Derkinderen M. The multiple faces of inflammatory enteric glial cells: is Crohn's disease a gliopathy? Am J Physiol Gastrointest Liver Physiol 2018. [PMID: 29517926 DOI: 10.1152/ajpgi.00016.2018] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gone are the days when enteric glial cells (EGC) were considered merely satellites of enteric neurons. Like their brain counterpart astrocytes, EGC express an impressive number of receptors for neurotransmitters and intercellular messengers, thereby contributing to neuroprotection and to the regulation of neuronal activity. EGC also produce different soluble factors that regulate neighboring cells, among which are intestinal epithelial cells. A better understanding of EGC response to an inflammatory environment, often referred to as enteric glial reactivity, could help define the physiological role of EGC and the importance of this reactivity in maintaining gut functions. In chronic inflammatory disorders of the gut such as Crohn's disease (CD) and ulcerative colitis, EGC exhibit abnormal phenotypes, and their neighboring cells are dysfunctional; however, it remains unclear whether EGC are only passive bystanders or active players in the pathophysiology of both disorders. The aim of the present study is to review the physiological roles and properties of EGC, their response to inflammation, and their role in the regulation of the intestinal epithelial barrier and to discuss the emerging concept of CD as an enteric gliopathy.
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Affiliation(s)
- Camille Pochard
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
| | - Sabrina Coquenlorge
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
| | - Marie Freyssinet
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
| | - Philippe Naveilhan
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
| | - Arnaud Bourreille
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
| | - Michel Neunlist
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
| | - Malvyne Rolli-Derkinderen
- Inserm, UMR1235 TENS, Nantes , France.,Nantes University , Nantes , France.,Institut des Maladies de l'Appareil Digestif, IMAD, Centre Hospitalier Universitaire de Nantes, Hôpital Hôtel-Dieu, Nantes , France
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Udit S, Gautron L. Molecular anatomy of the gut-brain axis revealed with transgenic technologies: implications in metabolic research. Front Neurosci 2013; 7:134. [PMID: 23914153 PMCID: PMC3728986 DOI: 10.3389/fnins.2013.00134] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/12/2013] [Indexed: 01/05/2023] Open
Abstract
Neurons residing in the gut-brain axis remain understudied despite their important role in coordinating metabolic functions. This lack of knowledge is observed, in part, because labeling gut-brain axis neurons and their connections using conventional neuroanatomical methods is inherently challenging. This article summarizes genetic approaches that enable the labeling of distinct populations of gut-brain axis neurons in living laboratory rodents. In particular, we review the respective strengths and limitations of currently available genetic and viral approaches that permit the marking of gut-brain axis neurons without the need for antibodies or conventional neurotropic tracers. Finally, we discuss how these methodological advances are progressively transforming the study of the healthy and diseased gut-brain axis in the context of its role in chronic metabolic diseases, including diabetes and obesity.
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Affiliation(s)
- Swalpa Udit
- Division of Hypothalamic Research, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas Dallas, TX, USA
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