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1.
Más Vita ; 3(4): 33-40, dic. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1355015

ABSTRACT

La gastritis es una enfermedad con una alta morbilidad a nivel mundial, el principal factor de riesgo es la infección por Helicobacter pylori. Objetivo: Describir las características clínicas, histopatológica y endoscópicas en una población con gastritis crónica. Material y métodos: Se realizó un estudio observacional de tipo descriptivo, retrospectivo, se incluyeron 49 pacientes que acudieron a la consulta externa del área de gastroenterología, de 18 a 65 años, a quienes se realizó el estudio histopatológico y endoscópico en el Servicio de Gastroenterología en el Hospital General Quevedo, de Los Ríos-Ecuador, durante septiembre 2017 ­ septiembre 2018. Resultados: Se observó predominio del género masculino (65%); en mayores de 40 años (55%), la epigastralgía y la sensación de acidez estomacal, 39% y 35% respectivamente, fueron los síntomas más frecuentes, La positividad para Helicobacter pylori, alcanzó el 86%, y la lesión no erosiva un 73%, existió mayor presencia de la forma no atrófica (84%) sobre la atrófica. Conclusiones: La gastritis crónica predominó en el grupo etario mayor a 40 años y de género masculino, siendo los factores de riesgo de mayor prevalencia la infección por Helicobacter pylori y los asociados al consumo de antiinflamatorios no esteroideos, mala alimentación, alcohol y tabaco, los síntomas como epigastralgía y la sensación de acidez estomacal fueron los más frecuentes. El hallazgo endoscópico fue mayor para las formas no erosivas, y de acuerdo a la histopatología la gastritis no atrófica antral moderada fue la más frecuente(AU)


Gastritis is a disease with high morbidity worldwide, the main risk factor is Helicobacter pylori infection. Objective: To describe the clinical, histopathological and endoscopic characteristics in a population with chronic gastritis. Material and methods: An observational, descriptive, retrospective study was carried out, including 49 patients who attended the outpatient consultation of the gastroenterology area, aged 18 to 65 years, who underwent a histopathological and endoscopic study in the Gastroenterology Service at the Quevedo General Hospital, Los Ríos-Ecuador, during September 2017 - September 2018. Results: A predominance of the male gender was observed (65%); In people over 40 years of age (55%), epigastralgia and the sensation of heartburn, 39% and 35% spectively, were the most frequent symptoms, the positivity for Helicobacter pylori, reached 86%, and the non-erosive lesion 73 %, there was a greater presence of the non-atrophic form (84%) over the atrophic one. Conclusions: Chronic gastritis predominated in the age group over 40 years of age and male, the most prevalent risk factors being Helicobacter pylori infection and those associated with the consumption of non-steroidal anti-inflammatory drugs, poor diet, alcohol and tobacco. symptoms such as epigastric pain and the sensation of heartburn were the most frequent. The endoscopic finding was greater for non-erosive forms, and according to histopathology, moderate antral non-atrophic gastritis was the most frequent(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal , Helicobacter pylori/drug effects , Dyspepsia/etiology , Gastric Mucosa/pathology , Gastritis/physiopathology , Peptic Ulcer , Signs and Symptoms , Biopsy , Pharmaceutical Preparations , Endoscopy, Gastrointestinal , Acidity , Gastroenterology
2.
Arq. gastroenterol ; 58(2): 164-167, Apr.-June 2021. graf
Article in English | LILACS | ID: biblio-1285334

ABSTRACT

ABSTRACT BACKGROUND: Celiac disease (CD) is an immune-mediated systemic disorder elicited by the ingestion of gluten. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines published in 2012 suggested a no-biopsy pathway (NBP) for symptomatic children with IgA tissue transglutaminase (TGA-IgA) ≥10x upper limit of normal (ULN). Biopsy confirmation remained mandatory for other cases. OBJECTIVE: This retrospective case note study was aimed at evaluating the adherence to the ESPGHAN 2012 guidelines for diagnosing CD in our unit. METHODS: Forty-three cases with positive TGA-IgA were identified by a laboratory database search from January 2013 to December 2019. 6 of 43 patients were not referred for a confirmation of CD diagnosis. Data was collected on the diagnostic pathways followed, and appropriateness of adherence was compared with the existing ESPGHAN guidelines. RESULTS: A total of 37 cases were included with 35 children diagnosed with CD. 29/35 (83%) were diagnosed via the NBP;15/29 (52%) children did not meet all the criteria required for NBP, but were diagnosed and managed as having CD. 20/35 (57%) children were diagnosed with CD in adherence to the 2012 guidelines. CONCLUSION: The recommended diagnostic guidelines were frequently not implemented; adherence to the guidelines may improve following regular educational sessions. The revised 2020 ESPGHAN guidelines which exclude HLA-DQ2/DQ8 testing would address the issue of diagnosis for the 10/15 NBP cases (with TGA-IgA >10xULN) in our study who did not have HLA testing and were therefore non-adherent to the 2012 diagnostic guidelines. NBP, with the reduced need for endoscopy may be beneficial in resource limited settings.


RESUMO CONTEXTO: A doença celíaca (DC) é uma doença sistêmica imuno-mediada provocada pela ingestão de glúten. As diretrizes da Sociedade Europeia de Gastroenterologia Pediátrica, Hepatologia e Nutrição (ESPGHAN) publicadas em 2012 sugeriram uma via sem biópsia (VSB) para crianças sintomáticas com transglutaminase de tecido IgA (TGA-IgA) ≥10x limite superior do normal (LSN). A confirmação da biópsia permaneceu obrigatória para outros casos. OBJETIVO: Este estudo retrospectivo de dados de caso teve como objetivo avaliar a adesão às diretrizes da ESPGHAN 2012 para o diagnóstico de DC em nossa unidade. MÉTODOS: Quarenta e três casos com TGA-IgA positivo foram identificados por uma pesquisa laboratorial de banco de dados de janeiro de 2013 a dezembro de 2019. Seis de 43 pacientes não foram encaminhados para confirmação do diagnóstico de DC. Os dados foram coletados nas vias diagnósticas seguidas, e a adequação da adesão foi comparada com as diretrizes ESPGHAN existentes. RESULTADOS: Foram incluídos 37 casos com 35 crianças diagnosticadas com DC. Foram diagnosticados 29 (83%) de 35 VSB; 15 (52%) de 29 crianças não atenderam a todos os critérios exigidos para a VSB, mas foram diagnosticadas e gerenciadas como tendo DC. Vinte (57%) em 35 foram diagnosticadas com DC em adesão às diretrizes de 2012. CONCLUSÃO: As diretrizes diagnósticas recomendadas não foram frequentemente implementadas; a adesão às diretrizes pode melhorar após sessões educativas regulares. As diretrizes revisadas ESPGHAN de 2020 que excluem os testes HLA-DQ2/DQ8 abordariam a questão do diagnóstico para 10 em 15 casos VSB (com TGA-IgA >10x LSN) em nosso estudo os quais não fizeram testes de HLA e, portanto, não aderiram às diretrizes de diagnóstico de 2012. A VSB, com a necessidade reduzida de endoscopia, pode ser benéfica em configurações limitadas de recursos.


Subject(s)
Humans , Child , Celiac Disease/diagnosis , Gastroenterology , Autoantibodies , Biopsy , Transglutaminases , Retrospective Studies , Glutens
3.
Medisan ; 25(3)2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1287306

ABSTRACT

Introducción: En el proceso de formación del residente en Gastroenterología se perciben limitaciones en la atención a pacientes con neoplasias digestivas, las cuales tienen su base en una insuficiente dinámica, en tanto se revela una visible polarización médico-instrumental de la práctica asistencial, orientada más hacia la endoscopia digestiva diagnóstica y terapéutica, en detrimento de lo preventivo, como parte indisoluble de esa formación. Objetivo: Proponer una estrategia para la formación del residente en gastroenterología en la atención holística endoscópica a pacientes con neoplasias del sistema digestivo. Desarrollo: Se propone una estrategia pedagógica para sistematizar la atención holística preventivo-diagnóstico-terapéutica en la formación del residente en gastroenterología, que deviene un instrumento práctico y flexible, contentivo de etapas, subetapas, orientaciones metodológicas y un sistema de evaluación que permite articular los contenidos clínico-endoscópicos, en un movimiento integrador, a través del diagnóstico, elaboración, implementación y evaluación de acciones para la formación del futuro especialista. Conclusiones: Este instrumento práctico se encamina a sistematizar la formación praxiológico-endoscópico-asistencial de este especialista en la atención holística preventivo-diagnóstico-terapéutica a pacientes con neoplasias digestivas, para el desarrollo de la excelencia en la profesión.


Introduction: In the process of the Gastroenterology resident training there are limitations in the care to patients with digestive neoplasms, which have their base in an scarce dynamics, while a visible polarization doctor-tools in the healthcare practice is observed, which is addressed towards the diagnostic and therapeutical digestive endoscopy more than to the preventive digestive endoscopy, as an indispensable part of the training process. Objective: To propose a pedagogical strategy, for the training of the Gastroenterology resident in the holistic and endoscopic care to patients with neoplasms of the digestive system. Development: A pedagogical strategy is proposed to systematize the preventive-diagnostic-therapeutical and holistic care in the training of the gastroenterology resident, which becomes a practical and flexible instrument, that includes stages and substages, methodological orientations and an evaluation system which allows to articulate the clinical and endoscopic contents, in an comprehensive movement, through the diagnosis, elaboration, implementation and evaluation of actions for the training of the future specialist. Conclusions: This practical instrument proposed is aimed at systematizing the praxiological-endoscopic training of these specialists in the holistic, preventive-diagnostic-therapeutic treatment to patients with digestive neoplasms, so as to reach professional excellence in the profession.


Subject(s)
Education, Continuing/methods , Professional Training , Gastroenterology , Digestive System , Digestive System Neoplasms/diagnosis
4.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022105, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1367441

ABSTRACT

RESUMO Introdução: Constipação funcional (CF) é um distúrbio gastrointestinal muito comum, é de fácil diagnóstico e manejo. Este estudo objetiva avaliar a prevalência de CF em crianças atendidas em serviço especializado, o perfil clínico, os tratamentos instituídos e seus desfechos. Método: estudo transversal de pacientes com CF atendidos de outubro/2012 a abril/2018 em ambulatório de gastroenterologia pediátrica. Coletados dados clínico-epidemiológicos, do manejo prévio, número de consultas até o diagnóstico pela equipe, resposta ao tratamento, e desfecho. Resultados: Observou-se prevalência de 15,7%, sendo 50,6% na idade escolar, 60,7% em meninos. Fezes endurecidas ou dor/esforço evacuatório (86,5%) e fezes volumosas (48,3%) foram as manifestações mais observadas; em 77,8% dos pacientes o tempo de sintomas até a primeira consulta foi superior a um ano; 74,2% dos pacientes já haviam recebido algum tipo de tratamento, principalmente laxativos osmóticos (53,9%); mas 25,8% dos pacientes não receberam qualquer tratamento até a consulta especializada. Em 62% foi necessária uma consulta para o diagnóstico de CF. Apenas 7% responderam exclusivamente à mudança dietética, mas 87% necessitaram laxativos osmóticos. A alta ambulatorial foi possível na grande maioria dos pacientes. Conclusões: CF é altamente prevalente no ambulatório estudado. Muitos pacientes com longo tempo de evolução e tratamentos ineficazes, e quase metade referenciados de outros municípios. No entanto, a maioria foi diagnosticada e manejada em até duas consultas pela equipe especializada, e responderam prontamente ao laxante osmótico. Isto demonstra deficiência na abordagem da CF pelos profissionais da atenção primária da nossa região, gerando encaminhamentos desnecessários, apesar do diagnóstico e manejo simples. PALAVRAS-CHAVE: Constipação intestinal, criança, prevalência, gastroenterologia, terapêutica


ABSTRACT Introduction: Functional constipation (FC) is a very common gastrointestinal disorder that is easy to diagnose and manage. This study aims to assess the prevalence of FC in children seen at a specialized service, the clinical profile, the treatments instituted and their outcomes. Method: A cross-sectional study of patients with FC treated from October, 2012 to April, 2018 in a pediatric gastroenterology clinic. Clinical and epidemiological, previous management, number of consultations until diagnosis by the team, response to treatment, and outcome data were collected. Results: There was a prevalence of 15.7%, with 50.6% in school age, 60.7% in boys. Hard stools or pain/defecation effort (86.5%) and bulky stools (48.3%) were the most observed manifestations; in 77.8% of patients, the duration of symptoms until the first consultation was greater than one year; 74.2% of patients had already received some type of treatment, mainly osmotic laxatives (53.9%); but 25.8% of patients did not receive any treatment until the specialist consultation. In 62%, an appointment was necessary for the diagnosis of CF. Only 7% responded exclusively to dietary change, but 87% required osmotic laxatives. Outpatient discharge was possible for the vast majority of patients. Conclusions: FC is highly prevalent in the studied clinic. Many patients with long evolution time and ineffective treatments, and almost half referred from other cities. However, most were diagnosed and managed in up to two consultations by the specialized team, and responded promptly to the osmotic laxative. This demonstrates a deficiency in the approach to FC by primary care professionals in our region, generating unnecessary referrals, despite the simple diagnosis and management. KEYWORDS: Constipation, child, prevalence, gastroenterology, therapeutics


Subject(s)
Humans , Child , Therapeutics , Prevalence , Constipation , Gastroenterology
5.
Rev. medica electron ; 43(2): 3249-3256, mar.-abr. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251942

ABSTRACT

RESUMEN El Blastocystis sp. es un parásito frecuente en el humano, identificado por el laboratorio en muestras de heces fecales. Se presentó el caso de un paciente de 5 años atendido en consulta de Gastroenterología en el Hospital Pediátrico Docente Provincial Eliseo Noel Caamaño, de Matanzas, por presentar dolor abdominal, heces pastosas, náuseas y vómitos desde hacía un año. Llevó tratamiento con ranitidina, omeprazol y domperidona, sin mejoría clínica. Se realizó estudio coproparasitológico en muestras de heces fecales seriadas, con la presencia del Blastocystis hominis. Se indicó tratamiento con metronidazol, sin mejoría clínica, y posteriormente se indicó como alternativa la nitazoxanida. Se evaluó a los 15 días, sin sintomatología y con negativización de las heces fecales seriadas. Resulta frecuente el desconocimiento y la poca importancia que los profesionales sanitarios muestran ante esta infestación, aunque cada vez más se confirma la participación del parásito en manifestaciones clínicas (AU).


ABSTRACT Blastocystis sp. is a frequent parasite in humans, identified in the laboratory in samples of fecal feces. The case of a 5-year-old patient is presented; he assisted the consultation of Gastroenterology in the Provincial Teaching Pediatric Hospital Eliseo Noel Caamaño in Matanzas, suffering abdominal pain, mash feces, nauseas and vomits for one year, and was treated with ranitidine, omeprazole and domperidone without clinical improvement. A coproparasitological study was carried out in serial fecal feces samples with the presence of Blastocystis hominis. Treatment with metronidazole was indicated without clinical improvement and them, as an alternative, nitazoxanide was indicated. He was evaluated at 15 days without symptoms and with negative serial fecal feces. The ignorance and the little importance that health professionals show towards this infestation are frequent, although more and more frequently it is confirmed the participation of the parasite in clinical manifestations (AU).


Subject(s)
Humans , Male , Child , Abdominal Pain/diagnosis , Child , Blastocystis hominis/pathogenicity , Signs and Symptoms , Specimen Handling/methods , Clinical Diagnosis , Feces/parasitology , Gastroenterology , Intestinal Diseases, Parasitic/complications
6.
Rev. moçamb. ciênc. saúde ; 7(1): 36-39, Out. 2021. mapas, tab, Fig.
Article in Portuguese | AIM, RSDM, AIM | ID: biblio-1344133

ABSTRACT

Ao longo dos últimos dez anos, muitos passos foram dados para a evolução e progressão da especialidade de Gastroenterologia no nosso país, quer em termos de formação de novos especialistas, bem como no aumento de novos procedimentos endoscópicos, que vieram beneficiar muito aos utentes que frequentam o Sistema Nacional de Saúde (SNS). Moçambique é um país vasto, com uma área de 801.590 km² e uma população estimada em 28.861.863 habitantes, sendo cerca de 15 milhões do sexo feminino e cerca de 13 milhões do sexo masculino, com maior concentração populacional nas províncias de Nampula e Zambézia.3 Aproximadamente, 55% está na faixa etária dos 15 aos 64 anos de idade, com o rácio de um médico para 11.904 habitantes,4 facto que mostra que o país ainda tem muita carência de especialistas em gastroenterologia, para responder à demanda que, a cada dia, vem crescendo...


Subject(s)
Humans , Male , Female , Specialization , Gastroenterology , Investments , Quality of Health Care , Endoscopy/trends , Medical Chaperones , Mozambique/epidemiology
7.
Chinese Journal of Hepatology ; (12): 216-226, 2021.
Article in Chinese | WPRIM | ID: wpr-879636

ABSTRACT

In order to standardize the effective prevention, early screening and diagnosis of the population at risk of primary liver cancer, the Chinese Society of Hepatology and Chinese Medical Association organized the relevant domestic experts to formulate the "Consensus on Secondary Prevention of Primary Liver Cancer (2021 version)," based on the basic, clinical and preventive research progress, combined with the actual situation at home and abroad, so as to provide an important basis for the prevention, screening and early diagnosis of primary liver cancer in the population of chronic liver disease.


Subject(s)
Carcinoma, Hepatocellular/prevention & control , Consensus , Gastroenterology , Humans , Liver Cirrhosis , Liver Neoplasms/prevention & control , Mass Screening , Secondary Prevention
10.
Medisan ; 24(6) tab
Article in Spanish | LILACS, CUMED | ID: biblio-1143261

ABSTRACT

Introducción: Las varices esofágicas son canales vasculares que unen la circulación venosa portal y la sistémica. Se forman como consecuencia de la hipertensión portal, predominantemente en la submucosa del tercio inferior del esófago. Objetivo: Caracterizar a pacientes con rotura de varices esofágicas según principales variables clinicoepidemiológicas y terapéutico-endoscópicas. Métodos: Se realizó un estudio observacional, descriptivo y longitudinal de 20 pacientes con hemorragia digestiva alta por rotura de varices esofágicas, los cuales recibieron tratamiento endoscópico con bandas elásticas en el Servicio de Gastroenterología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, de noviembre de 2016 a febrero de 2018. En el análisis estadístico se utilizó el porcentaje como medida de resumen y se aplicó la prueba de independencia de la Χ2 para identificar alguna asociación significativa entre variables. Resultados: Existió un predominio del sexo masculino (80,0 %) y del grupo etario de 51 a 60 años (40,0 %). La mayoría de los afectados presentó cirrosis hepática (60,0 %) como causa de la hipertensión portal y hematemesis (50,0 %) como forma de hemorragia digestiva alta; asimismo, el gran tamaño de las varices fue el principal factor de riesgo asociado a la rotura (70,0 %) y, luego de practicado el tratamiento endoscópico, no se produjo resangrado en la casi totalidad de los pacientes (95,0 %). Conclusiones: La aplicación de este procedimiento terapéutico resultó ser satisfactoria y no provocó complicación alguna.


Introduction: The esophageal varicose veins are vascular channels that unite the portal venous and systemic circulation. They are formed as consequence of the portal hypertension, predominantly in the submucosa of the inferior section of the esophagus. Objective: To characterize patients with break of esophageal varicose veins according to main clinical epidemiological and therapeutic-endoscopic variables. Methods: An observational, descriptive and longitudinal study of 20 patients with upper digestive bleeding due to break of esophageal varicose veins was carried out, they received endoscopic treatment with banding in the Gastroenterology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from November, 2016 to February, 2018. In the statistical analysis the percentage was used as summary measure and the chi-square test was applied to identify the existence of some significant association among variables. Results: There was a prevalence of the male sex (80.0 %) and the 51 to 60 age group (40.0 %). Most of the patients presented liver cirrhosis (60.0 %) as cause of the portal hypertension and hematemesis (50.0 %) as form of upper digestive bleeding; also, the great size of the esophageal varicose veins was the main risk factor associated with the break (70.0 %) and, after the implementation of the endoscopic treatment, there was no second bleeding in almost all the patients (95.0 %). Conclusions: The application of this therapeutic procedure was satisfactory and it didn't cause any complication.


Subject(s)
Esophageal and Gastric Varices , Ligation , Hematemesis , Gastroenterology , Hypertension, Portal , Liver Cirrhosis
11.
Arq. gastroenterol ; 57(4): 381-398, Oct.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142348

ABSTRACT

ABSTRACT Over the last years, there is growing evidence that microorganisms are involved in the maintenance of our health and are related to various diseases, both intestinal and extraintestinal. Changes in the gut microbiota appears to be a key element in the pathogenesis of hepatic and gastrointestinal disorders, including non-alcoholic fatty liver disease, alcoholic liver disease, liver cirrhosis, inflammatory bowel disease, irritable bowel syndrome, and Clostridium difficile - associated diarrhea. In 2019, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Nucleus for the Study of Helicobacter Pylori and Microbiota (NBEHPM), and Brazilian Federation of Gastroenterology (FBG) sponsored a joint meeting on gut microbiota and the use of prebiotics, probiotics, and synbiotics in gastrointestinal and liver diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to provide practical information about this topic, addressing the latest discoveries and indicating areas for future studies.


RESUMO Nos últimos anos, um volume crescente de evidências indica que os microrganismos estão envolvidos na manutenção da saúde humana e também estão relacionados a várias doenças, tanto intestinais quanto extraintestinais. Alterações na microbiota intestinal parecem ser um elemento chave na patogênese de doenças hepáticas e gastrointestinais, incluindo doença hepática gordurosa não-alcoólica, doença hepática alcoólica, cirrose hepática, doenças inflamatórias intestinais, síndrome do intestino irritável e diarreia associada ao Clostridium difficile. Em 2019, a Sociedade Brasileira de Hepatologia (SBH) em colaboração com o Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM) e a Federação Brasileira de Gastroenterologia (FBG) realizaram um encontro exclusivamente voltado para a discussão sobre microbiota e uso de prebióticos, probióticos e simbióticos em doenças hepáticas e gastrointestinais. Este texto resume os principais pontos discutidos durante o evento, e tem a intenção de fornecer informações práticas sobre o assunto, abordando as descobertas mais recentes e indicando áreas para estudos futuros.


Subject(s)
Helicobacter pylori , Probiotics , Digestive System Diseases , Synbiotics , Gastrointestinal Microbiome , Gastroenterology , Brazil , Congresses as Topic , Prebiotics
12.
Rev. medica electron ; 42(5): 2301-2313, sept.-oct. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144735

ABSTRACT

RESUMEN Introducción: la infección por Helicobacter pylori es una de las más prevalentes en el planeta. Supone una carga significativa para los sistemas sanitarios, debido a la elevada resistencia a antibióticos que presenta para su erradicación. Objetivo: determinar las características clínico epidemiológicas de infección por Helicobacter pylori de pacientes atendidos en Consulta Provincial de Gastroenterología. Materiales y métodos: se realizó un estudio observacional descriptivo. El universo estuvo conformado por los 167 pacientes con determinación de Helicobacter pylori positivo, por test de ureasa. Las variables a considerar fueron: la edad, el sexo, diagnóstico histológico, síntomas clínicos y la evolución clínica posterior al tratamiento específico para Helicobacter pylori. Se utilizó la técnica estadística de análisis de distribución de frecuencias. Resultados: un 59,6 % de los pacientes resultó con Helicobacter pylori positivo con predominio del sexo masculino. Fue la gastritis crónica la alteración gástrica que más se asoció a la infección. La epigastralgia y distensión abdominal resultaron los síntomas más frecuentes. Evolucionaron de forma satisfactoria el 49 % de los casos y solo un 17 % presentaron una mala respuesta al tratamiento. Conclusiones: se obtuvo un alto porcentaje de infección por Helicobacter pylori y una buena respuesta al tratamiento utilizado (AU).


ABSTRACT Introduction: the infection for Helicobacter pylori is one of the more prevalent in the world; it supposes a significant burden for the sanitary systems, due to the high resistance to antibiotics that it presents for its eradication. Objective: to determine the clinical epidemiological characteristics of the infection due to Helicobacter pylori in patients treated in the provincial consultation of Gastroenterología. Materials and methods: an observational, descriptive study was carried out in a universe formed by 167 patients with positive Helicobacter pylori determined by urease test. The variables to consider were age, sex, histologic diagnosis, clinical symptoms and clinical evolution after the specific treatment for Helicobacter pylori. The statistical technique of analysis of frequencies distribution was used. Results: 59, 6% of the patients was Helicobacter pylori positive with prevalence of the male sex; chronic gastritis was the gastric alteration more associated to the infection. Epigastralgia and abdominal distension were the most frequent symptoms. 49% of the cases evolved in a satisfactory way and only 17% answered bad to the treatment. Conclusions: a high percent of infection by Helicobacter pylori was found and also a good answer to the used treatment (AU).


Subject(s)
Humans , Male , Female , Helicobacter pylori/pathogenicity , Gastroenterology/methods , Patients , Pathological Conditions, Signs and Symptoms , Gastritis/complications , Infections/complications , Infections/parasitology , Anti-Bacterial Agents
13.
Rev. medica electron ; 42(4): 2121-2129,
Article in Spanish | LILACS, CUMED | ID: biblio-1139302

ABSTRACT

RESUMEN La enteritis eosinofílica consiste en la presencia de infiltrados eosinofílicos en el tracto digestivo. Constituye en la actualidad una entidad rara que puede localizarse en cualquier región del tubo digestivo. Su etiopatogenia se desconoce y en muchas ocasiones se relaciona con antecedentes de atopia. Las manifestaciones clínicas varían en función de las capas afectadas. Se presentó el caso de un paciente de 26 años de edad, con antecedentes de haber sido operado de apendicitis aguda, en el año 2011. Llegó al Cuerpo de Guardia refiriendo dolor intenso, fijo; en fosa iliaca derecha, acompañado de fiebre de 39°C, con escalofríos y síntomas dispéptico. Se orientó ingreso y se le realizó una videoendoscopia, se observó gastritis antral eritematosa exudativa con test para Helicobacter pylori positivo. Además, una videolaparoscopia arrojando presencia de asas delgadas apelotonadas y adherencias no recientes en fosa iliaca derecha. A pesar del tratamiento empleado el paciente continuó con dolor y fiebre, por lo que se decidió indicarle una enteroscopia de doble balón con biopsia de íleon. Se informó que a nivel del colon presentaba una colitis crónica inespecífica y en el íleon una hiperplasia linfoide. El estudio histopatológico confirmó la colitis inespecífica y una eosinofilia moderada en íleon. Se indicó tratamiento con prednisona y mesalazina con mejoría notable del cuadro clínico, fue dado de alta con el diagnóstico de una enteritis eosinofílica, con seguimiento por consulta externa de gastroenterología. En la actualidad se mantiene asintomático (AU).


ABSTRACT Eosinophilic enteritis is the presence of eosinophilic infiltrates in the digestive tract. Currently it is a rare entity than could be located in any region of the digestive tract. Its etiopathogenesis is unknown and is related, in many cases, to antecedents of atopy, Clinical manifestations may vary according to the affected layer. The authors present the case of a patient aged 26 years, with antecedents of having undergone an acute appendicitis surgery in 2011. He arrived to Emergency referring intense, steady pain in the right iliac fossa, accompanied by a 39o C fever, chills and dyspeptic symptoms. He was admitted and a video endoscopy was carried out. An exudative erythematous antral gastritis was observed with a positive test for Helicobacter pylori. In addition, video laparoscopy also showed the presence of thin, lumped loops and no-recent adherences in the right iliac fossa. In spite of the applied treatment, the patient continued with pain and fever, so the doctors indicated a double-balloon enteroscopy with ileum biopsy. It was informed an unspecific chronic colitis at the colon level and a lymphoid hyperplasia in the ileum. The histopathologic study confirmed the unspecific colitis and a moderate eosinophilia in the ileum. A prednisone and mesalazine treatment was indicated with a notable improvement of the clinical characteristics. The patient was discharged diagnosed with a eosinophilic enteritis and follow-up in out-patient consultation of Gastroenterology. Currently he keeps on asymptomatic (AU).


Subject(s)
Humans , Female , Young Adult , Enteritis/diagnosis , Eosinophilia/diagnosis , Signs and Symptoms , Therapeutics , Case Reports , Colitis/classification , Colitis/diagnosis , Gastroenterology
14.
Rev. medica electron ; 42(3): 1815-1825, mayo.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1127043

ABSTRACT

RESUMEN Introducción: el embarazo supone cambios en la fisiología de la mujer. Estos cambios pueden llevar a la aparición de enfermedades que afectan el hígado como: síndrome de HELLP, colestasis gravídica intrahepática, esteatosis hepática aguda del embarazo, entre otras, que pueden repercutir en el curso de la gestación. Material y métodos: se realizó un estudio observacional, descriptivo, retrospectivo de corte transversal en 52 gestantes que fueron valoradas en gastroenterología por sospecha de hepatopatías durante el embarazo en el año 2018, que constituyeron el universo de estudio, con el objetivo de determinar el comportamiento de las hepatopatías durante la gestación en las embarazadas valoradas por el servicio de Gastroenterología del Hospital Universitario "Comandante Faustino Pérez Hernández" de Matanzas. Se estudiaron las variables: trimestre gestacional, síntomas y signos, resultados analíticos, entidad nosológica, tipo de parto y complicación neonatal. Se elaboró una planilla para la recolección de los datos. Los resultados se analizaron en frecuencias absolutas y porcientos y se expusieron en tablas. Resultados: predominaron las gestantes del tercer trimestre con 61.6 %. El síntoma más frecuente fue el prurito en 33 gestantes (63.6%). La hipertransaminasemia se manifestó en el 100% de las gestantes. La entidad más frecuente fue la hepatitis crónica por virus B en 19 gestantes (36.5%) seguida de la colestasis intrahepática del embarazo con un 25 %. La mayoría de los partos fueron realizados por cesárea (94.2 %). La principal complicación neonatal fue el bajo peso al nacer en 26 (39.4 %). Conclusiones: las hepatopatías propias de la gestación se comportaron con igual frecuencia descrita en la literatura de acuerdo al trimestre que predominó, aunque fue significativa la incidencia de gestantes valoradas con infección por virus de la hepatitis b cuyo diagnóstico se hizo durante el embarazo siendo la principal causa de las complicaciones neonatales observadas (AU).


SUMMARY Introduction: Pregnancy supposes changes in the woman's physiology. These changes can lead to the appearance of illnesses affecting the liver, such as Hellp syndrome, intrahepatic cholestasis gravidarum, acute hepatic steatosis of pregnancy, among others, that can rebound in the course of the gestation. Materials and methods: a cross-sectional retrospective, descriptive, observational study was carried out in 52 pregnant women that were valued in Gastroenterology due to the suspicion of liver diseases during pregnancy in 2018; they were the universe of the study and the aim was determining the behavior of liver diseases during pregnancy in pregnant women valued in the service of Gastroenterology of the university hospital "Comandante Faustino Pérez Hernández" of the province of Matanzas: The studied variables were: gestational trimester, symptoms and signs, analytical results; nosological entity, type of delivery and neonatal complications. A form was draw up to collect data. The results were analyzed in absolute frequencies and percentages and showed in tables. Results: The third semester pregnant women predominated with 61.7 %. Pruritus was the most frequent symptom in 33 pregnant women (63.6 %). High levels of serum transaminases were present in 100 % of the studied women. The most frequent disease was chronic hepatitis caused by virus B in 19 pregnant women (36.5 %), followed by intrahepatic cholestasis of pregnancy with 25 %. Most of deliveries were performed by cesarean (94.2 %). The main neonatal complication was low weight at birth in 26 (39.4 %). Conclusions: liver diseases that are proper of gestation behaved in the same frequency as they are described in literature in relation to the predominating semester, although it was significant the incidence of assessed pregnant women with infection caused by the virus of hepatitis B diagnosed during pregnancy; it was the main cause of the observed neonatal complications (AU).


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Gastroenterology , Liver Diseases/epidemiology , Maternal Mortality , Epidemiology, Descriptive , Retrospective Studies , Morbidity , Fetal Mortality , Observational Study , Liver Diseases/complications , Liver Diseases/diagnosis , Liver Diseases/etiology
15.
Rev. medica electron ; 42(3): 1920-1927, mayo.-jun. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1127052

ABSTRACT

RESUMEN La colitis ulcerativa es una enfermedad crónica recidivante del tracto gastrointestinal, que evoluciona por recaídas formando parte de las enfermedades inflamatorias intestinales (EII). Afecta la mucosa y submucosa del colon, caracterizada por un proceso ulcerativo y supurado de la mucosa. La diarrea crónica con sangre es el síntoma más importante. En su curso alternan periodos de remisión y de crisis. No existe un criterio patognomónico para su definición, su diagnóstico se basa en una serie de criterios clínicos, endoscópicos e histológicos. Esta entidad infrecuente en su forma extensa severa. Aparece en un paciente, que llega a la institución de salud refiriendo que hace aproximadamente dos años, presenta cuadros de diarreas intermitentes con sangre, tratadas en el área de salud. Se le realizó Rx y colonoscopia constatando presencia de eritema, granularidad mucosa, friabilidad, pérdida de la vascularización submucosa, erosiones y ulceraciones extensas, profundas, signos de edema, pseudopólipos, pérdida de haustras, rigidez, sangrado, tractos fibrosos y presencia de exudado luminal. Se diagnosticó colitis extensa ulcerativa severa y se orientó tratamiento médico endovenoso y se continuó por via oral, obteniendo la remisión del cuadro clínico desde el punto de vista clínico y endoscópico (AU).


ABSTRACT Ulcerative colitis is a chronic recidivist disease of the gastrointestinal tract, evolving by relapses and is one of the intestinal inflammatory diseases. It affects the colon mucosa and sub-mucosa, characterized for an ulcerative process and mucosa exudation. Chronic diarrhea with blood is the most important symptom. Periods of crisis and remission alternated in its course; there is not a pathognomonic criteria for its definition and its diagnosis is based in a series of clinical, endoscopic and histological criteria. This entity, infrequent in extensive severe form, appears in a patient arriving to the hospital referring having intermittent diarrheas with blood for two years, treated in the health area. He undergone a radiography and colonoscopy, showing the presence of an erythema, mucosa granularity, friability, lost of submucosa vascularization, deep extensive erosions and ulcerations, edema signs, pseudo polyps, haustras lost, stiffness, bleeding, fibrous tracts and presence of luminal exudates. Severe ulcerative extensive colitis was diagnosed and was prescribed an endovenous medical treatment, continued orally, achieving the disease remission from the clinical and endoscopic point of view (AU).


Subject(s)
Humans , Female , Aged , Colitis, Ulcerative/etiology , Chronic Disease , Colonoscopy , Gastrointestinal Tract/pathology , Urology , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/epidemiology , Colitis, Ulcerative/diagnostic imaging , Gastrointestinal Tract/diagnostic imaging , Diarrhea/diagnosis , Gastroenterology
17.
Rev. cuba. med. mil ; 49(2): e469, abr.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1139002

ABSTRACT

La revolución científico técnica desempeñó un papel fundamental en la introducción de nuevas tecnologías en las ciencias médicas y en específico en la gastroenterología. Dicho progreso en las tecnologías no debe dejar de lado la parte ética de la relación médico paciente y el principio de no hacer daño. A esta disyuntiva se enfrenta el gastroenterólogo cuando debe decidir, tratar a un paciente con una técnica endoscópica, que es menos invasiva, o remitirlo para el médico cirujano. Con el objetivo de determinar el impacto de las nuevas tecnologías endoscópicas en las ciencias después de la revolución científico técnica, así como establecer los factores que atentan contra las buenas prácticas de la cirugía endoscópica endoluminal y su repercusión en los pacientes en el panorama nacional; se realizó un análisis de los beneficios de los adelantos tecnológicos en la endoscopía terapéutica, la manometría esofágica y la cirugía de mínimo acceso en Cuba y su repercusión en las cualidades éticas que deben caracterizar al médico, contenidas en el juramento hipocrático. Se concluye que la cirugía endoscópica endoluminal ha creado una nueva dimensión en el tratamiento de las lesiones del tubo digestivo y en sus años de existencia se tiene la experiencia suficiente para afrontar los retos del futuro con profesionalidad y humanismo(AU)


The scientific-technical revolution played a fundamental role in the introduction of new technologies in medical sciences and specifically in Gastroenterology. Such progress in technologies should not leave aside the ethical part of the doctor-patient relationship and the principle of not doing harm. The gastroenterologist faces this dilemma when he must decide to treat a patient with an endoscopic technique, which is less invasive, or refer it to the surgeon. With the objective of determining the impact of new endoscopic technologies in the sciences after the scientific and technical revolution; as well as establishing the factors that undermine the good practices of endoluminal endoscopic surgery and its impact on patients in the national scenario. An analysis was made of the benefits of technological advances in therapeutic endoscopy, esophageal manometry and minimum access surgery in Cuba and its impact on the ethical qualities that should characterize the physician, making a critical analysis at the beginning of the oath Hippocratic. It is concluded that endoluminal endoscopic surgery has created a new dimension in the treatment of digestive tract injuries and in its years of existence has sufficient experience to face the challenges of the future with professionalism and humanism(AU)


Subject(s)
Humans , Technology , Gastrointestinal Tract , Gastroenterologists , Gastroenterology
18.
Arq. gastroenterol ; 57(2): 216-220, Apr.-June 2020. graf
Article in English | LILACS | ID: biblio-1131661

ABSTRACT

ABSTRACT Fat infiltration in the pancreas is called pancreatic steatosis and it has several synonyms such as pancreatic lipomatosis, non-alcoholic fatty pancreatic disease, lipomatous pseudohypertrophy, fatty replacement, fatty pancreas and fatty infiltration. Pancreatic steatosis describes a disease ranging from infiltration of fat in the pancreas to pancreatic inflammation, and development of pancreatic fibrosis. There are multiple aetiologies of this condition, such as metabolic syndrome, alcohol intake, viral infections, toxins, congenital syndromes, etc. Pancreatic steatosis is usually diagnosed by trans-abdominal ultrasound, computed tomography scan and magnetic resonance imaging. Fatty infiltration in pancreas may lead to pancreatitis, diabetes mellitus and may be a predisposing cause of pancreatic cancer. Now a day, pancreatic steatosis is a common incidental finding during abdominal ultrasonography for other reasons and is a new challenge in Gastroenterology. But there is no guideline for pancreatic steatosis till now. In this review article, we are trying to give an overall idea (aetiologies, diagnosis, management, clinical significances) on pancreatic steatosis.


RESUMO A infiltração de gordura no pâncreas é chamada de esteatose pancreática ou lipomatose pancreática e tem vários sinônimos tais como: doença pancreática gordurosa não alcoólica, pseudo hipertrofia lipomatosa, reposição gordurosa, pâncreas gorduroso e infiltração gordurosa. A esteatose pancreática descreve uma doença que vai desde a infiltração de gordura no pâncreas até a inflamação pancreática com o desenvolvimento de fibrose pancreática. Existem múltiplas causas dessa condição, como síndrome metabólica, ingestão de álcool, infecções virais, toxinas, síndromes congênitas, etc. A esteatose pancreática é geralmente diagnosticada por ultrassom trans-abdominal, tomografia computadorizada ou ressonância magnética. A infiltração gordurosa no pâncreas pode levar à pancreatite e pode ser uma causa predisponente ao câncer de pâncreas. Hoje em dia, a fibrose pancreática é um achado incidental comum durante a ultrassonografia abdominal realizada por outras razões e é um novo desafio na Gastroenterologia. Mas não há diretriz para esteatose pancreática até agora. Neste artigo de revisão, objetivamos dar uma ideia geral sobre esteatose pancreática.


Subject(s)
Humans , Pancreatic Diseases , Gastroenterology , Pancreas , Metabolic Syndrome , Fatty Liver
19.
Medisan ; 24(2)mar.-abr. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1098398

ABSTRACT

Introducción: En la formación del residente de Gastroenterología todavía se perciben limitaciones en cuanto al tratamiento, la prevención y la pesquisa de neoplasias del sistema digestivo, lo que indica la necesidad de un proceso pedagógico que tipifique y eleve la importancia de una praxis asistencial más coherente y comprometida con las necesidades de salud de la población. Desarrollo: Los referentes epistemológicos sobre este tema revelan una limitada sistematización de la dimensión asistencial respecto a la atención a pacientes con tumores digestivos, pues no se ha logrado integrar el diagnóstico, la prevención y la terapéutica en la intervención holística endoscópica de los especialistas de esta rama de la medicina. Conclusiones: La dinámica praxiológica, endoscópica y asistencial que se propone en esta investigación deviene lógica de sistematización formativa que favorece el perfeccionamiento de la práctica clinicoendoscópico-asistencial de este especialista en la atención holística a pacientes con neoplasias del tracto gastrointestinal.


Introduction: In the training of the Gastroenterology resident are still limitations perceived as for the treatment, prevention and investigation of the digestive system neoplasms, what indicates the necessity of a pedagogic process that typifies and elevate the importance of a more coherent and committed assistance practice with the population's health needs. Development: The epistemological referents on this topic reveal a limited systematization of the assistance dimension regarding care to patients with digestive tumors, because it has not been possible to integrate the diagnosis, prevention and therapy in the holistic endoscopic intervention of the specialists of this branch of medicine. Conclusions: The praxiologic, endoscopic and assistance dynamic that is suggested in this investigation becomes logic of training systematizing that favors the improvement of this specialist's clinicoendoscopic-assistance practice in the holistic care to patients with gastrointestinal tract neoplasms.


Subject(s)
Professional Training , Gastroenterology/education , Digestive System Neoplasms , Medical Staff, Hospital
20.
Rev. chil. pediatr ; 91(1): 46-50, feb. 2020. tab
Article in Spanish | LILACS | ID: biblio-1092786

ABSTRACT

Resumen: Introducción: La migraña abdominal (MA) es infrecuente y poco estudiada. Nuestro objetivo fue investigar el diagnóstico y tratamiento de niños y adolescentes con MA y compararlos entre gastroen terólogos y neurólogos pediatras. Pacientes y Método: Todos los cuadros de MA (1-18 años) de un hospital de EE. UU, con diagnóstico de MA o sus variantes (ICD-9 346.2 o IC-10 G43.D, G43.D0, G43.D1) entre 2011-2017 fueron revisados. La información sobre diagnóstico, intervalo desde inicio de síntomas, criterios diagnósticos, pruebas diagnósticas, tratamiento y resultado se analizaron. Re sultados: Sesenta y nueve historias médicas fueron identificadas. La edad media al diagnóstico fue 9,7 años. El 48% de los pacientes fueron del sexo femenino. Cincuenta (72,4%) pacientes fueron tratados solo por gastroenterólogos pediatras, y 10/69 (14,5%) por neurológos pediatras exclusivamente. 6/69 (8,7%) fueron inicialmente evaluados por gastroenterología y posteriormente referidos a neurología, y 2/69 (2,9%) fueron inicialmente evaluados por neurología y luego referidos a gastroenterología. 3/10 (30%) de las MA diagnosticadas por neurólogos no mencionaban que el paciente tuviera dolor abdominal, sin embargo, todos los diagnósticos realizados por gastroenterólogos presentaron dicho síntoma (p=0,0035). 5/50 (10%) de las historias médicas de gastroenterología y ninguna de las histo rias de neurología mencionaban los criterios de Roma. Conclusiones: La mayoría de los niños fueron diagnosticados por pediatras gastroenterólogos. Los gastroenterólogos rara vez utilizaron los criterios de Roma. Pacientes evaluados por neurología son frecuentemente diagnosticados con MA, incluso sin presentar dolor abdominal (criterio necesario para el diagnóstico). Se recomienda educación para el correcto y oportuno diagnóstico de la migraña abdominal.


Abstract: Introduction: Abdominal migraine (AM) is uncommon and understudied. Our objective was to investigate the diagnosis and treatment of children and adolescents with AM and compare with that of pediatric gastroenterologists and neurologists. Patients and Method: All AM cases (1-18 years) from a USA hospital with diagnosis of abdominal migraine or its variants (ICD-9 346.2 or IC-10 G43.D, G43.D0, G43.D1) between 2011 and 2017 were reviewed. Information on diagnosis, interval from onset of symptoms, diagnostic criteria, diagnostic tests, treatment, and outcome were analyzed. Results: 69 medical records were identified. The mean age at diagnosis was 9.7 years, and 48% of patients were female. 50/69 (72.4%) patients were exclusively treated by a pediatric gastroenterologist and 10/69 (14.5%) exclusively by a pediatric neurologist. 6/69 (8.7%) were initially evaluated by gas troenterology and referred to neurology, and 2/69 (2.9%) were initially evaluated by neurology and then referred to gastroenterology. 3/10 (30%) of the AM diagnosed by neurologists did no report ab dominal pain (AP), however, all diagnoses made by gastroenterologists did (p = 0.0035). 5/50 (10%) of the gastroenterology medical records and no neurology medical records mentioned Rome criteria. Conclusions: Most of the children were diagnosed by pediatric gastroenterologists. Gastroenterolo gists rarely use the Rome criteria. Patients evaluated by neurologists are frequently diagnosed with AM even without AP (a criterion that is required for its diagnosis). Education is recommended for the correct and timely diagnosis of AM.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Pediatrics , Practice Patterns, Physicians'/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Gastroenterology , Migraine Disorders/diagnosis , Migraine Disorders/therapy , Neurology , Referral and Consultation , United States , Abdominal Pain/etiology , Follow-Up Studies , Practice Guidelines as Topic , Guideline Adherence/statistics & numerical data , Diagnosis, Differential , Diagnostic Errors , Migraine Disorders/complications
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