ABSTRACT
No disponible
Subject(s)
Humans , Female , Young Adult , Salicylates/poisoning , Renal Dialysis , /therapy , Suicide, AttemptedABSTRACT
AIM: To establish the most common vacA alleles in Helicobacter pylori (H pylori) strains isolated from Chilean patients and its relationship with gastritis and gastroduodenal ulcers. METHODS: Two hundred and forty five H pylori clinical isolates were obtained from 79 biopsies from Chilean infected patients suffering from gastrointestinal diseases. An average of 2-3 strains per patient was isolated and the vacA genotype was analyzed by PCR and 3% agarose electrophoresis. Some genotypes were checked by DNA sequencing. RESULTS: The most prevalent vacA genotype in Chilean patients was s1b m1 (76%), followed by s1a m1 (21%). In contrast, the s2 m2 genotype was scarcely represented (3%). The s1b m1 genotype was found most frequently linked to gastropathies (P<0.05) rather than ulcers. Ulcers were found more commonly in male and older patients. Curiously, patients living in cities located North and far South of Santiago, the capital and largest Chilean city, carried almost exclusively strains with the s1b m1 genotype. In contrast, patients from Santiago and cities located South of Santiago carried strains with either one or both s1a m1 and s1b m1 genotypes. Regarding the s2 m2 genotype, comparison with GenBank sequences revealed that Chilean s2 sequence was identical to those of Australian, American, and Colombian strains but quite different from those of Alaska and India. CONCLUSION: Differences in geographic distribution of the s and m vacA alleles in Chile and a relationship of s1b m1 genotype with gastritis were found. Sequence data in part support a hispanic origin for the vacA genotype. Asymmetric distribution of genotypes s1b m1 and s2 m2 recedes H Pylori strain distribution in Spain and Portugal.
Subject(s)
Alleles , Bacterial Proteins/genetics , Gastrointestinal Diseases/microbiology , Helicobacter pylori/genetics , Adolescent , Adult , Aged , Amino Acid Sequence , Bacterial Proteins/metabolism , Child , Child, Preschool , Chile , Female , Helicobacter Infections , Humans , Male , Middle Aged , Molecular Sequence Data , Sequence AlignmentABSTRACT
PURPOSE: We report two cases of percutaneous endoscopic sigmoidopexy in patients with sigmoid volvulus. METHODS: Two patients with recurrent sigmoid volvulus were considered unfit for resective surgery or general anesthesia (American Society of Anesthesiologists physical status III-IV). Fixation of the sigmoid colon to the abdominal wall was performed percutaneously under sedation in the endoscopy suite. Fixation was obtained using three T-fasteners in a triangular disposition in the bowel. The T-fasteners were cut at the skin after 28 days. RESULTS: Both procedures were successfully performed in approximately 20 minutes and were well tolerated. Feeding commenced the same day. One patient died after seven months of follow-up, without recurrence, of causes not related to volvulus. The other patient had no recurrence after 18 months of follow-up. CONCLUSION: The authors purpose was to show a new technique for colonic fixation performed in patients with recurrent sigmoid volvulus who otherwise had contraindication for elective surgery. Future studies will be required to verify the effectiveness and safety of this novel technique.
Subject(s)
Intestinal Obstruction/surgery , Sigmoid Diseases/surgery , Sigmoidoscopy/methods , Aged , Aged, 80 and over , Female , Humans , Intestinal Obstruction/etiology , Male , Sigmoid Diseases/complications , Suture TechniquesSubject(s)
Intestinal Obstruction/surgery , Sigmoid Diseases/surgery , Sigmoidoscopy/methods , Aged , Aged, 80 and over , Female , HumansABSTRACT
BACKGROUND: The prevalence of chronic pancreatitis in Chile is not known and there is no local information about the surgical treatment of this disease. AIM: To review retrospectively the results of surgical treatment of chronic pancreatitis. MATERIAL AND METHODS: The charts of 17 patients (12 male), aged 7 to 65 years old, with chronic pancreatitis that were operated in three different Chilean regions, were reviewed. RESULTS: Seven patients had previous endoscopic therapeutic procedures (papillotomy in 4 and stent placing in 3). Seven patients had been subjected to previous biliary surgical procedures. Indications for surgery were severe pain in 14 patients, the suspicion of a pancreatic carcinoma in 4 patients, an infected pseudocyst in one and massive bleeding of multiple pseudo-aneurysms in a pseudocyst in one patient. Twelve patients were subjected to decompressions and 5 to pancreatic resections. There was no operative mortality and one transient pancreatic fistula. After an average follow up of 22 months, pain improved in 94% of cases, pancreatic cancer was diagnosed in one patient and 79% of subjects gained weight. One patient became insulin dependent, one increased his insulin requirements and one had transient steatorrhea, since she could not afford pancreatic enzyme replacement therapy. CONCLUSIONS: The multidisciplinary approach of patients with chronic pancreatitis, with selective use of surgery, may greatly improve their quality of life.
Subject(s)
Pancreatitis/surgery , Adolescent , Adult , Aged , Child , Chronic Disease , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain/classification , Retrospective Studies , Treatment OutcomeABSTRACT
Las prótesis biliares han sido de gran utilidad desde su primera colocación en 1978, en entidades benignas como estenosis o colangitis y en carcinomas de ampolla y vía biliar, así como el cierre de fístulas biliares y el síndrome de Mirizzi. En este trabajo se revisan los diferentes tipos de prótesis, sus indicaciones y complicaciones
Subject(s)
Humans , Biliary Tract Diseases , Prostheses and Implants , Endoscopy, Digestive SystemABSTRACT
Hemos efectuado GPE en 70 pacientes empleando 3 procedimientos diferentes. La gran mayoría se realizó con el método de Ponsky. El procedimiento se logró exitosamente en todos los casos. No hubo mortalidad ni complicaciones mayores. En 26 casos tuvimos complicaciones menores que respondieron al tratamiento. consideramos que la GPE es un método simple, seguro y de gran utilidad para alimentación enteral por tiempo prolongado. el método de Ponsky (pull) por su simplicidad y bajo costo nos parece el más conveniente
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adolescent , Adult , Middle Aged , Endoscopy, Gastrointestinal , GastrostomyABSTRACT
In a five year period 75 colonoscopies were carried out in 66 children with rectal bleeding. Five patients presented with severe anemia. Their age ranged from 2 to 16 years (mean 6.6). Most of the procedures were performed on an outpatient basis (87%) and under oral sedative premedication (78%). At least the splenic flexure was reached in each case. We found 59 polyps in 47 children (71%). All polyps were snared and removed during the same procedure. There were no serious complications. Colonoscopy is a most usefull diagnostic and therapeutic procedure in children with rectal bleeding, where there is a high probability that a juvenile polyp can be found which can be safely treated during the same session.
Subject(s)
Colonic Polyps/diagnosis , Adolescent , Anemia/etiology , Child , Child, Preschool , Colonic Polyps/complications , Colonic Polyps/surgery , Colonoscopy , Female , Gastrointestinal Hemorrhage/etiology , Humans , Male , Outpatients , RectumABSTRACT
Forty-seven endoscopic small intestinal biopsies were performed in children with chronic diarrhea and malabsorption and suspected celiac disease. The purpose of this study was to reach the distal duodenum or proximal jejunum with large channel panendoscopes in order to get adequate samples for histopathological diagnosis. Patients younger than 8 years of age were anesthetized with ketamine. Time required for the full procedure was less than 10 min in most cases. There were no failures or complications. In all 47 endoscopic examinations, histologically adequate specimens of small bowel mucosa were obtained. These results suggest that this is a safe, quick, and easy method to obtain high-quality samples for histopathological diagnosis of enteropathies.
