Prevalencia de los diferentes trastornos motores primarios del esófago: Estudio prospectivo de 5.440 casos / Primary esophageal motor disturbances among patients with esophageal symptoms

Background: The esophagus can suffer several motor disturbances of striated or smooth muscle. Aim: To determine the presence of primary motor disturbances of the esophagus among a group of patients with esophageal symptoms. Material and methods: Prospective study of 5,440 patients consulting for heartburn, chest pain or dysphagia, with primary esophageal motor disturbances, studied between 1994 and 2004. AH were subjected to an esophageal manometry with eight perfused catheters connected to pressure transducers. Results: Nineteen percent of subjects had a normal esophageal manometry, 60 percent had unspecific motor disturbances usually associated to gastroesophageal reflux, 13 percent had a nutcracker esophagus, 5 percent had diffuse esophageal spasm, 2 percent had achalasia and 0,3 percent had an hypertensive sphincter. Conclusions: Primaryesophageal motor disturbances are common among patients with esophageal symptoms. A manometry should be performed to these patients.

Patología digestiva en niños infectados con el virus de inmunodeficiencia humana VIH en Santiago de Chile / Gastrointestinal diseases in children infected with the human immunodeficiency virus

Background: Human immunodeficiency virus (HIV) epidemiology has changed, affecting an increasing number of children. As in adults, the disease predominantly affects the digestive and respiratory systems. Aim: To report the gastrointestinal problems in HIV infected pediatric patients. Patients and methods : Twenty four HIV infected children (nine male, aged 1 to 12 years old, followed for 1 to 170 months), are reported. This group has been under care by a multiprofessional team. Results: Oral candidiasis was present in 21 (88 percent), esophagic candidiasis in 3 (13 percent), oral ulcers in 4 (17 percent). Diarrhea was observed in 18 children (75 percent) and in eight, it had a chronic evolution. Cryptosporidium parvum was the most frequent agent found in six cases (1 with acute and 5 with chronic diarrhea). Schlerosing cholangiopathy was observed in one case, with a fatal outcome, in association to microsporidiosis. Upper endoscopy was done in 11 patients, demonstrating microscopic inflammatory changes in esophagic, gastric and duodenal epithelia in all. Conclusions: Digestive problems are common in HIV infected pediatric patients. They must be always sought actively. Endoscopy is a valuable tool for the early diagnosis of these problems