Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump.

In the cases where a primary anastomosis is unable after a duodenal resection, special care must be taken to avoid any complication in the duodenal stump such as suture dehiscence. Wall inflammation is an important factor in the development of this complication. We report a case of a 35-year-old woman who had previously undergone to pyloric exclusion due to a wall defect occurred after a bilio-digestive anastomosis, which complicated with a posterior duodenal stump dehiscence. The acute edema of the stump walls that resulted after it because exposure to bile conducted to heroic measures for its closure: first, the use of a polytetrafluoroethylene tube as duodenostomy and posteriorly a patch of the same material for its final closure. Both gave successful results in the repair of a refractory duodenal stump dehiscence.

Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump.

In the cases where a primary anastomosis is unable after a duodenal resection, special care must be taken to avoid any complication in the duodenal stump such as suture dehiscence. Wall inflammation is an important factor in the development of this complication. We report a case of a 35-year-old woman who had previously undergone to pyloric exclusion due to a wall defect occurred after a bilio-digestive anastomosis, which complicated with a posterior duodenal stump dehiscence. The acute edema of the stump walls that resulted after it because exposure to bile conducted to heroic measures for its closure: first, the use of a polytetrafluoroethylene tube as duodenostomy and posteriorly a patch of the same material for its final closure. Both gave successful results in the repair of a refractory duodenal stump dehiscence.

[The factors that determine participation in cervical cancer screening in the state of Morelos]. / Factores que determinan la participación en el tamizaje de cáncer cervical en el estado de Morelos.

OBJECTIVE: To determine the main factors associated to participation in an early detection program of cancer (DPC), in a population with a high cervical cancer (CC) mortality rate. MATERIAL AND METHODS: A population-based, cross-sectional study was performed in the state of Morelos, which included 3,197 women aged between 15 and 49 years, randomly selected from a household sample frame of the 33 municipalities of the state. RESULTS: Awareness of the utility of the Papanicolaou (Pap) test (OR 29.6, 95% CI 23.6-37) and a former history of gynecological symptoms (OR 1.7, 95% CI 1.2-2.4) predisposed to greater use of the DPC. Factors associated to the use of the Pap test were precedents of using one contraceptive (OR 1.4, 95% CI 1.1-1.8) or two or more contraceptives (OR 2.1, 95% CI 1.6-2.8). CONCLUSIONS: In the state of Morelos, Mexico, screening for cervical cancer is offered opportunistically in the context of health care use. Therefore, the precedent of using health care services is the main determining factor for use of the DPC program. These results reveal the need to design alternative strategies to promote participation among women who have no access to health services, since they constitute the population group at highest risk of developing CC.

Uso del agente espamolitico otilonio bromuro (spamonen) en endoscopia digestiva: estudio prospectivo en 63 pacientes / Use of spasmolytic agent otilonium bromide in digestive endoscopy: a prospective study in 63 patients

El otilonio bromuro es un antagonista del calcio con un efecto miolítico directo, el cual está indicado en estados espásticos y disguinesias funcionales del aparato gastroentérico (sindrome del intestino irritable) y como premedicación para procedimientos endoscópicos gastrointestinales. El presente estudio evaluó el otilonio bromuro 40 mg PO la noche anterior y 40 mg PO la mañana de 49 fibroscopías bajas en 63 pacientes, para determinar la presencia o ausencia de peristalsis y relajación del píloro. No se observaron efectos colaterales debido a la medicación. En 46 (93.8 por ciento) endoscopías altas se observó marcada relajación del tracto gastrointestinal y del píloro. En 13 (92.8 por ciento) endoscopías bajas también se observó marcada relajación del tracto colónico. Todos los pacientes toleraron bien las endoscopías. El otilonio bromuro fue útil como premedicación para facilitar las exploraciones endoscópicas altas y bajas, debido a su efecto espasmolítico.

Uso del agente espamolitico otilonio bromuro (spamonen) en endoscopia digestiva: estudio prospectivo en 63 pacientes / Use of spasmolytic agent otilonium bromide in digestive endoscopy: a prospective study in 63 patients

El otilonio bromuro es un antagonista del calcio con un efecto miolítico directo, el cual está indicado en estados espásticos y disguinesias funcionales del aparato gastroentérico (sindrome del intestino irritable) y como premedicación para procedimientos endoscópicos gastrointestinales. El presente estudio evaluó el otilonio bromuro 40 mg PO la noche anterior y 40 mg PO la mañana de 49 fibroscopías bajas en 63 pacientes, para determinar la presencia o ausencia de peristalsis y relajación del píloro. No se observaron efectos colaterales debido a la medicación. En 46 (93.8 por ciento) endoscopías altas se observó marcada relajación del tracto gastrointestinal y del píloro. En 13 (92.8 por ciento) endoscopías bajas también se observó marcada relajación del tracto colónico. Todos los pacientes toleraron bien las endoscopías. El otilonio bromuro fue útil como premedicación para facilitar las exploraciones endoscópicas altas y bajas, debido a su efecto espasmolítico. (AU)

Syphilitic rectal ulcer associated with perforation of the hard palate: case report.

We report a case of a patient that presented with a perforated hard palate as a late complication due to an unsuspected syphilis. This disease first presented as a rectal ulcer which was misdiagnosed as an amebic proctitis. The patient received antiamebic treatment with a satisfactory outcome. He did not return for late control of the latter treatment and returned seeking medical advice six years later with the former complication. He tested positive for syphilis and appropriate treatment was performed. In addition, the ORL department recommended a palate prosthesis.

[Use of spasmolytic agent otilonium bromide (spasmomen) in digestive endoscopy: a prospective study in 63 patients]. / Uso del agente espasmolítico otilonio bromuro (spasmomen) en endoscopía digestiva: estudio prospectivo en 63 pacientes.

Otilonium bromide is a calcium antagonist with a direct myolytic effect, that is indicated in spastic conditions and functional dyskinesias of the gastroenteric apparatus (irritable bowel syndrome) and as a premedication for gastrointestinal endoscopic procedures. The present study assessed otilonium bromide 40 mg PO the night before and 40 mg PO the morning in 49 upper and 14 lower flexible endoscopies in 63 patients, to determine the presence or absence of peristalsis and relaxation of the pylorus. No side effects were observed due to the medication. In 46 (93.8%) upper endoscopies marked relaxation of the gastrointestinal tract and also pylorus relaxation were observed. In 13 (92.8%) lower endoscopies, marked relaxation of the colonic tract was also seen. All patients tolerated well the endoscopies. Otilonium bromide was useful as premedication in order to enable upper and lower endoscopic explorations, because of its spasmolytic effect.

Syphilitic rectal ulcer associated with perforation of the hard palate: case report

We report a case of a patient that presented with a perforated hard palate as a late complication due to an unsuspected syphilis. This disease first presented as a rectal ulcer which was misdiagnosed as an amebic proctitis. The patient received antiamebic treatment with a satisfactory outcome. He did not return for late control of the latter treatment and returned seeking medical advise six years later with the former complication. He tested positive for syphilis and appropiate treatment was performed. In addition, the ORL department recommended a palate prosthesis. (AU)

Syphilitic rectal ulcer associated with perforation of the hard palate: case report

We report a case of a patient that presented with a perforated hard palate as a late complication due to an unsuspected syphilis. This disease first presented as a rectal ulcer which was misdiagnosed as an amebic proctitis. The patient received antiamebic treatment with a satisfactory outcome. He did not return for late control of the latter treatment and returned seeking medical advise six years later with the former complication. He tested positive for syphilis and appropiate treatment was performed. In addition, the ORL department recommended a palate prosthesis.

Acute acalculous cholecystitis due to Vibrio cholerae.

The case of a 57-year-old woman admitted with symptoms and signs suggesting an intestinal infection caused by Vibrio cholerae, and who also developed a clinical picture compatible with acute cholecystitis, is presented. Cholera was diagnosed by examining a fresh sample of stools and cultures. An abdominal sonogram disclosed signs of acute acalculous cholecystitis. She underwent cholecystectomy, and cultures of a clear fluid and a "milky" sediment found within the gallbladder were also positive for V. cholerae. This microorganism was seen at the gallbladder mucosa microscopically. The strain was serotyped V. cholerae 01 (El Tor) Ogawa and was the etiology of the acute acalculous cholecystitis in this patient.

[Helicobacter pylori in patients with gastritis and gastric ulcer]. / Helicobacter pylori en pacientes con gastritis y úlcera gástrica.

Seventy patients symptoms and signs compatible with gastritis and/or peptic ulcer were included in the study; they were 41 women and 29 men, with an age range of 9-84 years, and they underwent upper endoscopy. Brushing of the antrum was performed and 4 biopsies were taken from it. With the gastric mucus, a smear was prepared for Gram staining; one sample of tissue was placed directly in urea medium and another tissue sample in Skirrow medium; and two samples of tissue were stained with Hematoxylin-eosin and examined under the light microscope. Those patients who were taking antibiotics capable of inhibiting growth of Helicobacter pylori (Hp), the last four weeks prior endoscopy, were excluded from the study. Twenty-six patients (37.1%) were positive (+) for Hp the culture in urea medium. Of these 26 patients, 15 (21.4%) were also positive by the Skirrow method, and 11 (15.7%) by Gram stain. Epigastric pain was the most predominant symptom in (+) patients (80.7%) and (-) patients (68.1%) for Hp. Superficial acute gastritis within the antrum was the most frequent endoscopic finding in (+) (84.6%) and (-) (68.1%) patients. Chronic superficial gastritis was the predominant microscopic finding in (+) (42.3%) and (-) (38.6%) patients as well. Microscopic examination was positive for Hp in 6 (23%) patients by H-E stain. According to these results, there was no statistically significant difference in symptoms, endoscopic and microscopic findings between positive and negative patients for Hp.

Helicobacter pylori en pacientes con gastritis y ulcera gástrica / Helicobacter pylori in patients with gastritis and gastric ulcer

Seventy patients symptoms and signs compatible with gastritis and/or peptic ulcer were included in the study; they were 41 women and 29 men, with an age range of 9-84 years, and they underwent upper endoscopy. Brushing of the antrum was performed and 4 biopsies were taken from it. With the gastric mucus, a smear was prepared for Gram staining; one sample of tissue was placed directly in urea medium and another tissue sample in Skirrow medium; and two samples of tissue were stained with Hematoxylin-eosin and examined under the light microscope. Those patients who were taking antibiotics capable of inhibiting growth of Helicobacter pylori (Hp), the last four weeks prior endoscopy, were excluded from the study. Twenty-six patients (37.1 percent) were positive (+) for Hp the culture in urea medium. Of these 26 patients, 15 (21.4 percent) were also positive by the Skirrow method, and 11 (15.7 percent) by Gram stain. Epigastric pain was the most predominant sympton in (+) patients (80.7 percent) and (-) patients (68.1 percent) for Hp. Superficial acute gastritis within the antrum was the most frequent endoscopic finding in (+) (84.6 percent) and (-) (68.1 percent) patients. Chronic superficial gastritis was the predominant microscopic finding in (+) (42.3 percent) and (-) (38.6 percent) patients as well. Microscopic examination was positive for Hp in 6 (23 percent) patients by H-E stain. According to these results, there was no statistically significant difference in symptoms, endoscopic and microscopic findings between positive and negative patients for Hp

Helicobacter pylori en pacientes con gastritis y ulcera gástrica / Helicobacter pylori in patients with gastritis and gastric ulcer

Seventy patients symptoms and signs compatible with gastritis and/or peptic ulcer were included in the study; they were 41 women and 29 men, with an age range of 9-84 years, and they underwent upper endoscopy. Brushing of the antrum was performed and 4 biopsies were taken from it. With the gastric mucus, a smear was prepared for Gram staining; one sample of tissue was placed directly in urea medium and another tissue sample in Skirrow medium; and two samples of tissue were stained with Hematoxylin-eosin and examined under the light microscope. Those patients who were taking antibiotics capable of inhibiting growth of Helicobacter pylori (Hp), the last four weeks prior endoscopy, were excluded from the study. Twenty-six patients (37.1 percent) were positive (+) for Hp the culture in urea medium. Of these 26 patients, 15 (21.4 percent) were also positive by the Skirrow method, and 11 (15.7 percent) by Gram stain. Epigastric pain was the most predominant sympton in (+) patients (80.7 percent) and (-) patients (68.1 percent) for Hp. Superficial acute gastritis within the antrum was the most frequent endoscopic finding in (+) (84.6 percent) and (-) (68.1 percent) patients. Chronic superficial gastritis was the predominant microscopic finding in (+) (42.3 percent) and (-) (38.6 percent) patients as well. Microscopic examination was positive for Hp in 6 (23 percent) patients by H-E stain. According to these results, there was no statistically significant difference in symptoms, endoscopic and microscopic findings between positive and negative patients for Hp (AU)

Helicobacter pylori en pacientes con gastritis y úlcera gástrica. / [Helicobacter pylori in patients with gastritis and gastric ulcer]

Seventy patients symptoms and signs compatible with gastritis and/or peptic ulcer were included in the study; they were 41 women and 29 men, with an age range of 9-84 years, and they underwent upper endoscopy. Brushing of the antrum was performed and 4 biopsies were taken from it. With the gastric mucus, a smear was prepared for Gram staining; one sample of tissue was placed directly in urea medium and another tissue sample in Skirrow medium; and two samples of tissue were stained with Hematoxylin-eosin and examined under the light microscope. Those patients who were taking antibiotics capable of inhibiting growth of Helicobacter pylori (Hp), the last four weeks prior endoscopy, were excluded from the study. Twenty-six patients (37.1

) were positive (+) for Hp the culture in urea medium. Of these 26 patients, 15 (21.4

) were also positive by the Skirrow method, and 11 (15.7

) by Gram stain. Epigastric pain was the most predominant symptom in (+) patients (80.7

) and (-) patients (68.1

) for Hp. Superficial acute gastritis within the antrum was the most frequent endoscopic finding in (+) (84.6

) and (-) (68.1

) patients. Chronic superficial gastritis was the predominant microscopic finding in (+) (42.3

) and (-) (38.6

) patients as well. Microscopic examination was positive for Hp in 6 (23

) patients by H-E stain. According to these results, there was no statistically significant difference in symptoms, endoscopic and microscopic findings between positive and negative patients for Hp.