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1.
Edumecentro ; 7(4): 125-145, oct.-dic. 2015. ilus
Article in Spanish | LILACS | ID: lil-760962

ABSTRACT

Fundamento: la finalidad de la estrategia curricular Dominio del Idioma Inglés, propuesta por la subcomisión de estrategias curriculares de la Universidad de Ciencias Médicas de la Habana desde el 2009, es la competitividad idiomática de los profesionales de la salud. Objetivo: diseñar acciones metodológicas para la implementación de la estrategia curricular Dominio del Idioma Inglés en la carrera de Medicina de la Filial Universitaria Municipal de Santo Domingo. Métodos: se realizó una investigación de desarrollo con enfoque mixto entre enero de 2011 y diciembre de 2013; se utilizaron métodos teóricos: análisis-síntesis e inducción-deducción y empíricos: análisis documental de la Resolución 210/2007, planes de trabajo metodológico y actas en los diferentes niveles organizativos, modelo del profesional y planes de clase; y la encuesta en forma de entrevista a directivos, y de cuestionario a docentes para identificar las principales insuficiencias en la preparación idiomática y metodológica. Resultados: se constató que las principales insuficiencias están relacionadas con la dirección y ejecución del trabajo metodológico interdisciplinar y con el pobre desarrollo de habilidades para la gestión de la información médica en idioma inglés, por lo que se diseñaron acciones metodológicas para lograr una mayor objetividad en la implementación interdisciplinar de esta estrategia que tribute al actual modelo del profesional de la salud. Conclusiones: las acciones fueron valoradas como pertinentes por criterios de especialistas, porque contribuyeron a transformar progresivamente la realización del trabajo metodológico para desarrollar una competencia idiomática interdisciplinar y profesional como garantía de un desempeño competente en contextos de habla inglesa.


Background: the purpose of the curricular strategy of the English Language command, proposed by the subcommittee of curricular strategies of Havana University of Medical Sciences since 2009 is the idiomatic competence of health professionals. Objective: to design methodological actions for the implementation of the curricular strategy of the English Language command in the Medicine career of Santo Domingo's Municipality Health University Site. Methods: it was carried out a development investigation with a combined approach from January 2011 to December 2013; theoretical methods were used: analysis-synthesis and induction-deduction and empiric ones: documental analysis of the 210/2007 Regulation from the Ministry of Higher Education , methodological plans and meeting records at different organizational levels, model of the professional and lesson plans; and the survey in interview form was applied to administrative leaders and a questionnaire was applied to the professors to identify the main inadequacies in the idiomatic and methodological preparation. Results: it was verified that the main inadequacies are related with the management and execution of the interdisciplinary methodological work and with the poor development of abilities for the medical information management in the English language, that's why methodological actions were designed to achieve a bigger objectivity in the interdisciplinary implementation of this strategy that contributes with the current model of health professionals. Conclusions: the actions were valued as pertinent by the specialists' criteria, because they contributed to transform the work with the methodological activity progressively to develop an interdisciplinary and professional idiomatic competence as guarantee of a competent performance in English-speaking contexts.


Subject(s)
English Abstract
2.
Rev. biol. trop ; 56(1): 27-54, mar. 2008. tab
Article in Spanish | LILACS | ID: lil-496391

ABSTRACT

Phytoplankton species collected from the limnetic to euryhaline sections of Tehuantepec River were identified, classified and compared with regional information from Mexico and South America. We collected 15 samples every three months from July 1997 through August 1998 with a 20 microm net and a Van Dorn bottle. Indicator values and a code checklist are included. A total of 58 families, 121 genera, 273 species, one subspecies, 75 varieties, 13 forms and one morphotype were identified in the taxa Bacillariophyta (42.0 %), Chlorophyta (29.0 %), Cyanoprocaryota (18.0 %), Euglenophyta (5.0 %), Dinophyta (3.0 %), Cryptophyta (2.0 %) and Chrysophyta (1.0 %). The predominant families were Scenedesmaceae (24 species), Oocystaceae (22), Bacillariophyceae (21), Chaetocerotaceae (15) and Euglenaceae (14). Five families, eight genera, 72 species, 45 varieties and eight forms are first records for Mexico. The species Chroococcus turgidus, Microcystis flosaquae and Pseudanabaena limnetica (which produce massive blooms or red tides) are important in this river of moderate water quality.


El fitoplancton recolectado en el río Tehuantepec con características limnéticas a eurihalinas se determinó, clasificó y comparó con información regional de México y Suramérica. Se incluyen valores indicadores y un código del listado florístico para facilitar el manejo de estas algas. Se determinó un total de 58 familias, 121 géneros, 273 especies, una subespecie, 75 variedades, 13 formas y un morfotipo, pertenecientes a las divisiones Bacillariophyta (42.0 %), Chlorophyta (29.0 %), Cyanoprocaryota (18.0 %), Euglenophyta (5.0 %), Dinophyta (3.0 %), Cryptophyta (2.0 %) y Chrysophyta (1.0 %). Las familias mejor representadas fueron Scenedesmaceae (24 especies), Oocystaceae (22), Bacillariophyceae (21), Chaetocerotaceae (15) y Euglenaceae (14). Se establecen nuevos registros para México: cinco familias, ocho géneros, 72 especies, 45 variedades y ocho formas. En este río, que presenta una moderada calidad del agua, sobresalieron las especies Chroococcus turgidus, Microcystis flosaquae y Pseudanabaena limnetica (como productoras de mareas rojas).


Subject(s)
Animals , Biodiversity , Ecosystem , Phytoplankton/classification , Environmental Monitoring , English Abstract , Journal Article , Seasons , Geography , Mexico , Rivers
3.
SJPH-Sudanese Journal of Public Health. 2006; 1 (4): 269-270
in English | IMEMR | ID: emr-81260
4.
EMHJ-Eastern Mediterranean Health Journal. 2005; 11 (1-2): 175-180
in Arabic | IMEMR | ID: emr-156745

ABSTRACT

This paper examines the importance of teaching in the mother tongue and looks at the political decisions taken in this respect. The preparations for Arabization in the Faculty of Medicine, Gezira University [in 1993] are reviewed and the experience of implementation from 1994 to 2002 is analysed by questioning the students and professors. The successes, failures, problems and obstacles are discussed in detail. The paper concludes with discussion and recommendations on how to boost success in Arabization based on previous experience


Subject(s)
Humans , Curriculum , English Abstract , Health Services Needs and Demand , Language , Organizational Innovation , Organizational Policy
5.
EMHJ-Eastern Mediterranean Health Journal. 2005; 11 (1-2): 199-208
in French | IMEMR | ID: emr-156748

ABSTRACT

The Eastern Mediterranean Region of the World Health Organization is confronted with formidable water problems due to: increased water dem and both for consumption and for irrigation in agriculture that is becoming more productive and more polluting; scarce water resources; drought, erosion and pollution; inappropriate management; inadequate policies; and institutional and legal considerations. Added to these problems are the risks of regional conflicts because of the lack of "shared" management of cross-border waters which are an object of contention between neighbouring countries. This report analyses the issues relating to water availability, health and development on the basis of the distribution of water resources, and their use by industry and the huge proportion for agricultural use. It raises the question whether countries in the Region are ready to review their strategies on water priorities, particularly in the areas of health, agriculture and food self-sufficiency


Subject(s)
Humans , Agriculture/organization & administration , Cause of Death , Cooperative Behavior , English Abstract , Environmental Health/organization & administration , Health Services Needs and Demand
6.
EMHJ-Eastern Mediterranean Health Journal. 2005; 11 (3): 435-441
in French | IMEMR | ID: emr-156772

ABSTRACT

We aimed to measure the extent of inappropriate hospital admissions and to identify factors associated with inappropriate hospital use. A descriptive study was carried out on a r and omized sample of 411 hospitalizations in 3 regional hospitals. The appropriateness of admissions was assessed using the Appropriateness Evaluation Protocol [AEP]. We found 21% [95% CI: 17%-25%] of the admissions were avoidable according to the AEP. Inappropriate admissions were associated with the hospital [P = 0.005], patient age [P = 0.003], length of stay and diagnosis [P < 0.001]. The most frequent reasons for appropriate admissions were parenteral therapy, an acute or progressive sensory motor circulatory or respiratory condition sufficient to incapacitate the patient and severe electrolyte or blood gas abnormality. Our study highlights the need to improve hospital management and to develop alternatives to hospitalization


Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Male , Age Factors , English Abstract , Health Care Surveys , Health Services Needs and Demand , Hospitalization/statistics & numerical data , Patient Selection
7.
EMHJ-Eastern Mediterranean Health Journal. 2005; 11 (5-6): 1018-1028
in Arabic | IMEMR | ID: emr-156835

ABSTRACT

Work injuries and accidents have a considerable impact on public and community health. This study targeted three work sectors: metal shaping, food production and building construction. Work injuries that occurred in these sectors were compared for the years 1999 and 2000 in Jericho District in the West Bank of Palestine. One hundred three injuries were examined and information recorded about the nature of the injury, site of injury in the body, direct cause of injury and some personal information about the injured worker. The most vulnerable group were young people in their twenties, and mostly those working in the metal shaping and building construction sectors. The kinds and sites of injuries varied. The data were compared with data from 1997, 1998 and 2001-2003, although only loosley as the available data about work injuries for these years were limited and inaccurate


Subject(s)
Humans , Adult , Age Distribution , Causality , Data Collection , English Abstract , Health Surveys
8.
EMHJ-Eastern Mediterranean Health Journal. 2005; 11 (5-6): 1053-1060
in French | IMEMR | ID: emr-156839

ABSTRACT

Prevalence of hepatitis G virus among Tunisian blood donors Hepatitis G virus [GBV-C/HGV] is a recently identified virus which occurs worldwide. The prevalence of GBV-C/HGV in Tunisia has not been previously studied. We aimed to assess the prevalence of GBV-C/HGV infection in Tunisian blood donors. A total of 912 blood donors were tested for anti-E2 antibodies of GBV-C/HGV by enzyme-linked immunosorbent assay and 600 were tested by reverse transcriptase polymerase chain reaction. GBV-C/HGV RNA was found in 5.3% of the sample and HGV antibodies occurred in 4.9%. A correlation was noticed between GBV-C/HGV infection and hepatitis C virus [P = 0.006]. The prevalence of GBV-C/HGV is similar to that reported worldwide


Subject(s)
Female , Humans , Middle Aged , Adolescent , Adult , Age Distribution , Comorbidity , DNA, Viral/analysis , English Abstract
9.
The Korean Journal of Gastroenterology ; : 321-332, 2005.
Article in Korean | WPRIM | ID: wpr-171745

ABSTRACT

Pancreatic inflammatory disease can be classified as acute pancreatitis (AP) and chronic pancreatitis (CP) primarily by clinical criteria, with an obvious difference by restoration of normal function in the former or by permanent residual damage in the latter. Gallstones and alcohol are the most common causes of AP. Recent investigations have established that AP from all cause may disrupt normal stimulus-secretion coupling function within the acinar cell. This disruption within the acinar cell leads to an event termed 'co-localization' in which the digestive and lysosomal enzymes merge resulting in a premature activation of proteases. The mechanisms of inflammatory cells which adhere to endothelial cell are determined by a variety of mediators of cytokines released at the site of tissue damage. Cytokines hold the key for both local and systemic inflammatory response in AP. Besides, CP is a debilitating disease characterized by progressive and irreversible destruction of pancreatic tissue leading to exocrine and endocrine insufficiencies. Alcohol intake is the most common cause of CP. Mutations in the cationic trypsinogen gene were identified as causative gene for hereditary pancreatitis. The recognition of frequent cystic fibrosis transmembrane conductance regulator (CFTR) mutations and serine protease inhibitor, Kazal type 1 (SPINK1) mutations in idiopathic CP has hightened the awareness of importance of genetic mutations in CP. Pancreatic stellate cells represent the main cellular source of extracellular matrix in CP and play a key role in pancreatic fibrosis.


Subject(s)
Humans , Acute Disease , English Abstract , Pancreatitis/etiology , Pancreatitis, Chronic/etiology
10.
The Korean Journal of Gastroenterology ; : 333-338, 2005.
Article in Korean | WPRIM | ID: wpr-171744

ABSTRACT

Acute pancreatitis is an inflammatory disease of pancreas which come from various etiologies. The pathologic spectrum of acute pancreatitis varies from mild edematous pancreatitis to severe necrotizing pancreatitis. To diagnose and to predict severity in acute pancreatitis, various biochemical marker, imaging modalities and clinical scoring sytstem are needed. Ideal parameters should be accurate, be performed easily and enable earlier assess. Unfortunately, no ideal parameter is available up to date. Serum amylase and lipase are still useful for the diagnosis but meaningless in predicting severity. C-reactive protein and inflammatory cytokines are promising single parameters to predict the severity. CT finding is also an useful determinant of severity, but is expensive and is delayed in assessment.


Subject(s)
Humans , Acute Disease , English Abstract , Pancreatitis/diagnosis , Severity of Illness Index
11.
The Korean Journal of Gastroenterology ; : 339-344, 2005.
Article in Korean | WPRIM | ID: wpr-171743

ABSTRACT

Medical management of acute pancreatitis relies on supportive care such as fluid resuscitation and pain control. Prophylactic antibiotics can reduce the opportunity of infection in severe pancreatitis. The effect of somatostatin or protease inhibitors still needs to be evaluated through further study. Early endoscopic retrograde cholangiopancreatography (ERCP) can ameliorate the course of severe biliary pancreatitis. Although sterile pancreatic necrosis, acute fluid collection, and pseudocyst usually resolve spontaneously, endoscopic or percutaneous drainages are needed when these complications are infected.


Subject(s)
Humans , Acute Disease , English Abstract , Pancreatitis/complications
12.
The Korean Journal of Gastroenterology ; : 345-351, 2005.
Article in Korean | WPRIM | ID: wpr-171742

ABSTRACT

Chronic pancreatitis is a progressive disease without curative treatment. Abdominal pain is the most predominant symptom of chronic pancreatitis that initially brings most of the patients to the physician's attention. Some studies have correlated the course of pain in chronic pancreatitis in comparison with the duration of the disease, progressing exocrine and endocrine pancreatic insufficiency, and morphological changes such as pancreatic calcification and duct abnormalities. Furthermore, the course of pain has been studied after alcohol abstinence or surgery in some groups. However, there are only few well-performed and valid studies, and some of them even have produced diversing results, in part. Further controlled studies harvoring a large number of patients in a multicenter setting should be considered. Therapeutic efforts on chronic pancreatitis have focused on palliative treatment of pain which is present in about 80% of cases. Endoscopic treatment of pain in chronic pancreatitis is useful and feasible in many patients. Selecting candidate for endotherapy is mandatory. Main indication of pancreatic stent insertion in chronic pancreatitis is the presence of an obvious ductal stricture. Complications of chronic pancreatitis are also indications of endoscopic intervention. Exocrine and endocrine insufficiencies should be meticulously managed to prevent complications and to maintain good quality of life.


Subject(s)
Humans , English Abstract , Pancreatitis, Chronic/diagnosis
13.
The Korean Journal of Gastroenterology ; : 352-357, 2005.
Article in Korean | WPRIM | ID: wpr-171741

ABSTRACT

The management of pancreatitis remained controversial over the past decades, varying from conservative medical treatment to surgical treatment. However, in recent years, treatment of severe acute pancreatitis is shifting from an early surgical debridement and necrosectomy to an aggressive intensive medical care. While the treatment is conservative in the earlier phase of the disease, surgery might be considered in the later phase. In chronic pancreatitis and in pancreatic pseudocyst, various surgical approaches are available these days. Apart from the conventional open surgery, laparoscopic procedure became popular since it is minimally invasive and effective. In addition, with the great improvements in interventional radiology and endoscopic techniques, multidisciplinary approaches including medical, interventional, and surgical management become much more important in the proper treatment of pancreatitis. In this review, pancreatitis is classified into three categories (acute pancreatitis, chronic pancreatitis, and pancreatic pseudocyst) for convenience, and the surgical treatment is described in each category.


Subject(s)
Humans , Acute Disease , English Abstract , Pancreatic Pseudocyst/surgery , Pancreatitis/surgery , Pancreatitis, Chronic/surgery
14.
The Korean Journal of Gastroenterology ; : 358-367, 2005.
Article in Korean | WPRIM | ID: wpr-171740

ABSTRACT

The first family of hereditary pancreatitis was described in 1952. The mode of inheritance is autosomal dominant trait with an 80% of penetrance rate. Although hereditary pancreatitis is rare, this disorder has provided valuable insights in understanding the pathophysiology of pancreatitis and pancreatic cancer. The causative gene of hereditary pancreatitis was identified in 1996 through mutational analysis of genes within chromosome 7q35. Most forms of hereditary pancreatitis are caused by one of two common mutations, R122H in the third exon or N29I in the second exon of the cationic trypsinogen gene (protease serine 1, PRSS1). R122H mutation is the most common PRSS1 mutation. Additional mutations of the cationic trypsinogen gene have been described. In Korea, first family of hereditary pancreatitis with cationic trypsinogen gene mutation revealed an arginine to histidine amino acid substitution at the residue 122. Patients with hereditary pancreatitis present with symptoms at an early age and have significant risk for the development of chronic pancreatitis and pancreatic cancer. The risk of pancreatic cancer is estimated to be 53-fold higher after the age of 50 years than the general population. The risk of pancreatic cancer is not related to the type of mutation. Since hereditary pancreatitis is a strong risk factor for pancreatic cancer, it is important to establish a diagnostic criteria for diagnosis and surveillance. However, there are potential benefits, risks and limitations in genetic testing for hereditary pancreatitis. It is difficult to provide the proper treatment, but recent developments in therapeutic approaches may be helpful in caring hereditary pancreatitis. This article includes the current status, pathogenesis, clinical features, and management of hereditary pancreatitis including the aspects of pancreatic cancer.


Subject(s)
Humans , Amino Acid Substitution , English Abstract , Mutation , Pancreatitis/diagnosis , Trypsin/genetics , Trypsinogen/genetics
15.
The Korean Journal of Gastroenterology ; : 368-372, 2005.
Article in Korean | WPRIM | ID: wpr-171739

ABSTRACT

BACKGROUND/AIMS: Quadruple therapy can be considered as a first-line therapy in areas where the resistance rate to clarithromycin is high. Comparison study of triple therapy and quadruple therapy for Helicobacter pylori (H. pylori) eradication is still lacking in Korea despite the increasing prevalence of antibiotic resistance. This study was conducted to compare the efficacy of triple and quadruple therapy as a first-line treatment in H. pylori infected patients with peptic ulcer. METHODS: Consecutive 149 cases of peptic ulcer disease associated with H. pylori infection were randomized either to proton pump inhibitor (PPI, bid), amoxicillin (1,000 mg, bid), and clarithromycin (500 mg, bid) (PAC group) or to PPI (bid), bismuth subcitrate (300 mg, qid), metronidazole (500 mg, tid), and tetracycline (500 mg, qid) (PBMT group) eradication treatments for 7 days. Outcome of eradication therapy was assessed by 13C-urea breath test performed 4-6 weeks after eradication. RESULTS: Eradication rates in PAC and PBMT group were 78.7% (59/75) and 71.6% (53/74) by intention to treat analysis, respectively (p=0.424). By per protocol analysis, eradication rates of PAC and PBMT group were 85.5% (59/69) and 85.5% (53/62), respectively (p=1.012). Adverse reactions occurred in 5 (6.6%) and 7 (9.5%) patients in PAC and PBMT group, respectively (p=0.346). CONCLUSIONS: One week-quadruple therapy as a first-line treatment for H. pylori infection does not offer any advantage over PPI-based triple therapy in Korean patients.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Antacids/administration & dosage , Anti-Infective Agents/administration & dosage , Drug Therapy, Combination , English Abstract , Helicobacter Infections/complications , Helicobacter pylori , Peptic Ulcer/microbiology , Proton Pumps/antagonists & inhibitors
16.
The Korean Journal of Hepatology ; : 227-242, 2005.
Article in Korean | WPRIM | ID: wpr-170400

ABSTRACT

BACKGROUND/AIMS: The therapeutic strategies of applying adefovir for treating lamivudine resistant HBV mutants are controversial. Thus, we observed the clinical outcomes after discontinuation of lamivudine to establish the timing to initiate adefovir therapy. METHODS: Fifty chronic hepatitis B (CHB) patients with lamivudine resistant HBV mutants who had received lamivudine for more than 12 months were included in the study. We investigated the clinical outcomes at 6 months after the end of treatment (EOT). We compared the serial clinical outcomes among respective groups based on serum ALT at the EOT and the clinical characteristics of patients with or without acute exacerbation (AE) and the HBeAg loss. We also investigated the predictive parameters of AE and HBeAg loss. RESULTS: Fifteen patients (30%) had experienced AE at 6 months after the EOT. Four patients received antiviral agents because of their hepatic decompensation. Patients with AE had higher serum ALT values and lower HBV DNA titers at EOT compared with those patients without AE. Serum ALT at the EOT was the predictive parameter of AE. Eight patients (21.6%) had newly developed HBeAg loss at 6 months after EOT. The total bilirubin at EOT was the predictive parameter of HBeAg loss. CONCLUSIONS: CHB patients with lamivudine resistant HBV mutants had favorable clinical outcomes at 6 months after EOT. Therefore, we can consider observing the clinical courses after discontinuation of lamivudine and it is not always required to overlap the adefovir for treating lamivudine resistant HBV mutants except for the treatment of patients with a high risk of developing decompensation.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Adenine/administration & dosage , Antiviral Agents/administration & dosage , Drug Resistance, Viral , English Abstract , Hepatitis B e Antigens/blood , Hepatitis B virus/drug effects , Hepatitis B, Chronic/drug therapy , Lamivudine/administration & dosage , Phosphorous Acids/administration & dosage , Reverse Transcriptase Inhibitors/therapeutic use , Treatment Outcome
17.
The Korean Journal of Hepatology ; : 243-249, 2005.
Article in Korean | WPRIM | ID: wpr-170399

ABSTRACT

BACKGROUND/AIMS: Spontaneous bacterial peritonitis (SBP) is one of the potentially life-threatening complications for patients with liver cirrhosis, and it has a mortality rate of over 20%. Early diagnosis of SBP and immediate use of an adequate antibiotic therapy are very important for achieving a better prognosis. The aim of our study was to assess the usefulness of reagent strips for making the rapid diagnosis of SBP. METHODS: A diagnostic paracentesis procedure was performed upon hospital admission in 257 cirrhotic patients (187 males, 70 females; mean age: 54 years) with ascites. Each fresh sample of ascitic fluid was tested using a reagent strip, and the result was scored as 0, 1+, 2+ or 3+. The leukocyte count, polymorphonuclear cell count, blood bottle culture, and chemistry of ascites were also done. RESULTS: We diagnosed 79 cases of SBP and 2 cases of secondary bacterial peritonitis by means of the polymorphonuclear cell count and the classical criteria. When a reagent strip result of 3+ was considered positive, the test's sensitivity was 86% (70 of 81), the specificity was 100% (176 of 176), and the positive predictive value was 94%. Furthermore, when a reagent strip result of 2+ or more was considered positive, the test sensitivity was 100% (81 of 81), the specificity was 99% (174 of 176), and negative predictive value was 99%. CONCLUSIONS: The use of reagent strips is a very sensitive and specific tool for the rapid diagnosis of SBP in cirrhotic patients. A positive result should be an indication for empirical antibiotic therapy, and a negative result may be useful as a screening test to exclude SBP.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Ascitic Fluid/chemistry , Bacterial Infections/diagnosis , English Abstract , Liver Cirrhosis/complications , Peritonitis/diagnosis , Predictive Value of Tests , Reagent Strips , Sensitivity and Specificity
18.
The Korean Journal of Gastroenterology ; : 463-470, 2005.
Article in Korean | WPRIM | ID: wpr-199897

ABSTRACT

BACKGROUND/AIMS: Bile duct injury is the most serious complication of cholecystectomy. The aim of this study was to evaluate the outcome of endoscopic treatment in bile duct injury after cholecystectomy. METHODS: We reviewed the results of endoscopic treatments in the patients diagnosed as bile duct injury after cholecystectomy on cholangiographic examinations, retrospectively. Endoscopic treatment included insertion of nasobiliary drainage catheter or plastic stent after endoscopic sphicterotomy. RESULTS: A total of twenty-two patients (9 male, 13 female; median age of 59 years) with bile duct injury were included. Endoscopic treatment was successfully performed in 12 of 13 patients with bile leak only. In patients with both bile leak and stricture, endoscopic treatment was successful in 2 of 3 patients. In 6 patients with complete obstruction of bile duct, endoscopic treatment failed and surgical approach was needed. In our series, transpapillary endoscopic treatment was not successful when proximal bile duct above the injured site was not visualized by endoscopic retrograde cholangiopancreatography (ERCP) and surgery was performed in all cases. Overall success rate of endoscopic treatment in 22 patients with bile duct injury was 64% (14/22). There was no complication associated with endoscopic treatment. CONCLUSIONS: ERCP is useful for the treatment of bile leakage after cholecystectomy and can be used for the treatment prior to surgery. Surgical intervention is needed in case of endoscopic treatment failure.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bile Ducts/injuries , Cholangiopancreatography, Endoscopic Retrograde , Cholecystectomy/adverse effects , Endoscopy, Digestive System , English Abstract , Treatment Outcome
19.
The Korean Journal of Gastroenterology ; : 471-474, 2005.
Article in Korean | WPRIM | ID: wpr-199896

ABSTRACT

Usual sources of subphrenic abscess with intestinal fistula are previous abdominal operation, inflammatory bowel disease and malignancy. Reported cases of intestinal fistula caused by adenocarcinoma were complicated by direct invasion. In this report, a 70-year-old male had a subphrenic abscess with intestinal fistula and the cause was a metastatic adenocarcinoma of unknown origin. As far as we know, this has not been reported previously in the literatures. The abscess went on chronic course for six months because intermittent administration of antibiotics modified its clinical presentation. The fistulous tract between the abscess and ileum was demonstrated by tubogram via the drainage catheter in abscess. The patient underwent surgical treatment because the cause of fistula was obscure. Invasion of the ileum by metastatic adenocarcinoma was diagnosed by the histologic examination of surgical specimen. Therefore, when a fistula develops without any apparent cause, there is a possibility of malignancy, and surgical approach must be considered. An early surgical approach will prevent the delay in treatment and reduce the mortality.


Subject(s)
Aged , Humans , Male , Adenocarcinoma/complications , English Abstract , Ileal Diseases/diagnosis , Ileal Neoplasms/complications , Intestinal Fistula/diagnosis , Neoplasms, Unknown Primary , Subphrenic Abscess/diagnosis
20.
The Korean Journal of Gastroenterology ; : 373-380, 2005.
Article in Korean | WPRIM | ID: wpr-165589

ABSTRACT

BACKGROUND/AIMS: We conducted this study to find the clinical characteristics of ulcer bleeding that occurred in patients who had been taking non-steroidal anti-inflammatory drugs (NSAIDs) and to evaluate the influences of NSAIDs on clinical outcomes. METHODS: Between January 2000 and December 2002, a total of 310 patients with ulcer bleeding were analyzed. Study group composed of 49 patients who had taken NSAIDs regularly for at least 4 weeks before the admission. Other 261 patients who had not taken NSAIDs were classified as control group. Relevant informations were obtained from the medical records. RESULTS: Of the NSAIDs group, aspirin was the most common medication. The mean age and the proportion of females in the NSAIDs group were significantly higher than those of the control group. Prevalence of co-morbid illness was significantly higher in the NSAIDs group than in the control group (85.7% vs 30.7%, p<0.001). The severity of bleeding which was assessed by hemoglobin level at presentation, amount of transfusion, and duration of admission, was not different between two groups. There were no significant differences in frequency of re-bleeding, urgent surgery, and mortality. CONCLUSIONS: Ulcer bleeding among patients taking NSAIDs occurred more frequently in older females with co- morbid illness. However, NSAIDs is not associated with higher morbidity and mortality.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , English Abstract , Peptic Ulcer Hemorrhage/chemically induced
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