Jejunal varix with a high transfusion requirement: therapy with cyanoacrylate with radiological control by double-balloon enteroscopy.

A jejunal varix with high transfusion requirement is treated by double-balloon enteroscopy with cyanoacrylate/ lipiodol with radiological control. The patient had not gastrointestinal hemorrhage or transfusion requeriment after 8 months follow up. Our recent previous article in Rev Esp Enferm Dig on advanced therapeutics by enteroscopy is referenced, providing this new therapeutic possibility.

Utilidad de una unidad de diagnóstico rápido en mayores de 69 años / Usefulness of a quick diagnosis unit in older than 69 years

Introduction: Quick Diagnosis Units (QDU) have demonstrated their importance as an alternative to conventional hospitalization in the study of potentially serious pathologies. The aim of the present study is to demonstrate itsusefulness also in the elderly population.Methods: A retrospective observational study of the patients admitted to theQDU of the Palencia University Health Complex (PUHC) from 2008 to 2020.Different variables were compared between the group ≥70 years and thegroup <70 using Student's t-test, Mann-Whitney U test or Chi-square tests.Results: The study included 9.090 patients (41.6% ≥70 years), with delayuntil the first visit of 1±2 days, and until diagnosis of 14±21 days, withoutdifferences between the two groups. Significant differences were found between the group ≥70 and the group <70 in the origin of the request (fromprimary care 58,1% and 50%), reasons for consultation (deterioration ofgeneral condition 28,5% and 16,1%, anemia 15,6% and 6,5%, lymphadenopathy 3,8% and 9,8% and abdominal pain 6,8% and 8,8%), percentage ofneoplasms (25% and 13,7%) and final destination (hospitalization 6,4% and2,9%, return to primary care 38% and 45,9% and palliative care 3,3% and 0%)Conclusions: QDU of PUHC prevents the admission of 93,6% of elderly patients, with a diagnostic delay similar to that of young people, reduces discontinuity with the socio-family environment and the loss of autonomy of thepatient, and contributes to contain health spending. QDUs are useful in thestudy of potentially serious pathologies regardless of age. (AU)

Introduction: Las Unidades de Diagnóstico Rápido (UDR) han demostradosu importancia como alternativa a la hospitalización convencional en el estudio de patologías potencialmente graves. El objetivo del presente estudio esdemostrar su utilidad también en la población anciana.Métodos: Estudio observacional retrospectivo de los pacientes atendidosen la UDR del Complejo Asistencial Universitario de Palencia (CAUPA), entre2008 y 2020. Se compararon distintas variables entre el grupo de ≥70 años yel de <70 mediante t de Student, U de Mann-Whitney o Chi-cuadrado.Resultados: Fueron estudiados 9.090 pacientes (41,6% de ≥70 años), condemora hasta la primera consulta de 1±2 días, y hasta el diagnóstico de14±21 días, sin diferencias entre ambos grupos. Se encontraron diferenciasentre el grupo de ≥70 y el de <70 en el origen de la solicitud (desde atenciónprimaria 58,1% y 50%), motivos de consulta (alteración del estado general28,5% y 16,1%, anemia 15,6% y 6,5%, adenopatías 3,8% y 9,8% y abdominalgia 6,8% y 8,8%), porcentaje de neoplasias (25% y 13,7%) y destino final(ingresaron 6,4% y 2,9%, regresaron a atención primaria 38% y 45,9% y acuidados paliativos 3,3% y 0%).Conclusiones: La UDR del CAUPA evita el ingreso del 93,6% de los pacientesancianos, con una demora diagnóstica similar a la de los jóvenes. Reduce ladiscontinuidad con el entorno socio-familiar y la pérdida de autonomía delpaciente, y contribuye a la contención del gasto sanitario. Las UDR son útilesen el estudio de patologías potencialmente graves independientemente dela edad. (AU)

Prospective comparative study of the treatment of Helicobacter pylori with antibiotic susceptibility testing-guided triple therapy compared to quadruple therapy with bismuth-metronidazole-tetracycline subcitrate.

INTRODUCTION: the current indicated first-line treatment for Helicobacter pylori (H. pylori) infection is the quadruple therapy with bismuth (Pylera®), or the quadruple concomitant therapy without bismuth. The triple therapy was abandoned due to its low eradication rates, partly derived from an increase in antibiotic resistance. The aim of this study was to compare the H. pylori eradication rates guided by antibiotic susceptibility testing (AST) versus Pylera®. METHODS: a specimen was taken prospectively for culture and antibiotic susceptibility testing (AST) from all patients diagnosed with H. pylori infection using gastroscopy, and they were randomized to receive triple therapy depending on the results of the AST, or quadruple therapy with Pylera®. The eradication rates of both groups were analyzed using fecal antigen. The adherence and side effects of the treatment were also analyzed. RESULTS: of the 108 patients with H. pylori infection, 55 received Pylera® and 53 AST-guided triple therapy. The eradication rates were 92.7 % with Pylera® and 90.6 % in the AST-guided group, and the difference was statistically significant. There were also no differences found in adherence or side effects. CONCLUSIONS: the treatment of H. pylori with AST-guided triple therapy is effective, especially in regions with high rates of antibiotic resistance.

Sweet syndrome in severe ulcerative flare.

Sweet Syndrome or Acute Febrile Neutrophilic Dermatosis is an uncommon extraintestinal manifestation of inflammatory bowel disease, also related with other pathologies. Its diagnosis is anatomopathological and presents a good evolution with the treatment of the underlying disease.

Síndrome de Mondor / Mondor's syndrome

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