Body Composition and Biochemical Parameters of Nutritional Status: Correlation with Health-Related Quality of Life in Patients with Colorectal Cancer.

Up to 60% of colorectal cancer (CRC) patients develop malnutrition, affecting treatment effectiveness, increasing toxicity, postoperative complications, hospital stay, and worsening health-related quality of life (HRQOL). This cross-sectional study analyzed data from 48 women and 65 men with CRC. We correlated scores of the scales from the questionnaires EORTC (European Organisation for Research and Treatment of Cancer) Quality of Life Questionnaire Core 30 (QLQ)-C30 and Colorectal Cancer module Colorectal 29 (QLQ-CR29) with patients' body composition and clinical and biochemical indicators of nutritional status. Results: Scores on quality of life were negatively associated with the lymphocyte count (rP = -0.386) and the fat trunk percentage (rP = -0.349) in the women's group. Scores on the physical and role functioning were inversely associated with the adiposity percentage (rP = -0.486 and rP = -0.411, respectively). In men, total skeletal muscle mass (SMM) was positively associated with emotional functioning (rP = 0.450); the trunk SMM was negatively related to fatigue (rP = -0.586), nausea and vomiting (rP = -0.469), pain (rP = -0.506), and financial difficulties (rP = -0.475); additionally, serum albumin was positively related to physical, emotional, and social functioning scales (rPs = 0.395, 0.453, and 0.363, respectively) and negatively to fatigue (rP = -0.362), nausea and vomiting (rP = -0.387), and appetite loss (rP = -0.347). Among the men, the reduced SMM and biochemical, nutritional parameters were related to low scores on the EORTC QLQ-C30 and QLQ-CR29 functioning scales. In conclusion, in patients with CRC, malnourishment could have a profound effect on the patients' functionality and QoL (quality of life).

Efficacy of metronidazole versus placebo in pain control after hemorrhoidectomy. Results of a controlled clinical trial.

INTRODUCTION: Hemorrhoidal disease occurs in 50% of people aged > 40 years and is the most common reason for anorectal surgery. Pain is the main complication. Multiple topical and systemic drugs have been investigated for pain control, but there is no ideal treatment. Metronidazole has been shown to decrease postoperative pain but is not used widely. OBJECTIVE: To evaluate the effect of oral metronidazole versus placebo and to assess postoperative pain following hemorrhoidectomy. MATERIAL AND METHODS: Controlled clinical trial in adult patients who underwent elective hemorrhoidectomy for grade III/IV hemorrhoids. Patients were assigned to receive metronidazole (500 mg q8 h orally; study group, SG) or placebo (control group, CG) for 7 days after surgery. Pain was assessed using a visual analog scale after surgery. Analgesic administration (time and use of analgesics) and resumption of daily life activities were also assessed. RESULTS: Forty-four patients were included, 22 in each group. Postoperative pain differed significantly between the SG and CG at 6 h (3.86 ± 0.56, 6.64 ± 1.49), 12 h (5.59 ± 1.33, 8.82 ± 0.79), 24 h (6.86 ± 1.49, 9.73 ± 0.45), day 4 (5.32 ± 2.10, 9.50 ± 0.59), day 7 (3.14 ± 1.03, 7.36 ± 1.39), and day 14 (2.14 ± 0.46, 5.45 ± 1.29). The first analgesia dose was required at 21.27 ± 5.47 h in the CG and 7.09 ± 2.36 h in the SG (p < 0.05), the time of analgesic use was 6.86 ± 1.61 days in the CG and 13.09 ± 2.48 days in the SG (p < 0.05), and resumption of daily activities occurred at 7.59 ± 1.56 days in the CG and 14.73 ± 3.76 days in the SG (p < 0.05). CONCLUSION: Oral administration of metronidazole is effective in pain management after hemorrhoidectomy.

Eficacia de metronidazol contra placebo en el control del dolor posterior a hemorroidectomía. Resultados de un ensayo clínico controlado / Efficacy of metronidazole versus placebo in pain control after hemorrhoidectomy. Results of a controlled clinical trial

INTRODUCCIÓN: la enfermedad hemorroidal se presenta en 50% de adultos mayores a 40 años, siendo la principal indicación de cirugía anorrectal y el dolor su principal complicación. Múltiples fármacos, tópicos y sistémicos, se han investigado para control del dolor, no obstante no existe un tratamiento ideal. El metronidazol ha demostrado disminuirlo, pero su uso no se ha generalizado. OBJETIVOS: evaluar el efecto de administración oral de metronidazol versus placebo en el control del dolor posthemorroidectomía. MATERIAL Y MÉTODOS: ensayo clínico controlado en pacientes adultos con hemorroides grado III/IV. Los del grupo de estudio (GE) recibieron metronidazol 500 mg oral cada 8 horas por 7 días y los del grupo control (GC) placebo. Se evaluó dolor postquirúrgico con escala visual análoga (EVA), consumo de analgésicos y reincorporación al trabajo. RESULTADOS: se incluyeron 44 pacientes, 22 en cada grupo, sin diferencias en la distribución demográfica. La evaluación del dolor postquirúrgico fue de 3,86 ± 0,56 y 6,64 ± 1,49 para GE y GC a las 6 h, de 5,59 ± 1,33 y 8,82 ± 0,79 a las 12 h, 6,86 ± 1,49 y 9,73 ± 0,45 a las 24 h, 5,32 ± 2,10 y 9,50 ± 0,59 al cuarto, 3,14 ± 1,03 y 7,36 ± 1,39 al séptimo, 2,14 ± 0,46 y 5,45 ± 1,29 al 14 día, significativo a favor del GE. La primera dosis analgésica se requirió a las 7,09 ± 2,36 h en el GE y 21,27 ± 5,47 horas en el GC (p < 0,05); tiempo del consumo de analgésicos 6,86 ± 1,61 y 13,09 ± 2,48 días (p < 0,05) y reincorporación al trabajo a los 7,59 ± 1,56 y 14,73 ± 3,76 días (p < 0,05). CONCLUSIONES: la administración oral de metronidazol es eficaz para el control del dolor post-hemorroidectomía

INTRODUCTION: Hemorrhoidal disease occurs in 50% of people aged > 40 years and is the most common reason for anorectal surgery. Pain is the main complication. Multiple topical and systemic drugs have been investigated for pain control, but there is no ideal treatment. Metronidazole has been shown to decrease postoperative pain but is not used widely. OBJECTIVE: To evaluate the effect of oral metronidazole versus placebo and to assess postoperative pain following hemorrhoidectomy. MATERIAL AND METHODS: Controlled clinical trial in adult patients who underwent elective hemorrhoidectomy for grade III/IV hemorrhoids. Patients were assigned to receive metronidazole (500 mg q8 h orally; study group, SG) or placebo (control group, CG) for 7 days after surgery. Pain was assessed using a visual analog scale after surgery. Analgesic administration (time and use of analgesics) and resumption of daily life activities were also assessed. RESULTS: Forty-four patients were included, 22 in each group. Postoperative pain differed significantly between the SG and CG at 6 h (3.86 ± 0.56, 6.64 ± 1.49), 12 h (5.59 ± 1.33, 8.82 ± 0.79), 24 h (6.86 ± 1.49, 9.73 ± 0.45), day 4 (5.32 ± 2.10, 9.50 ± 0.59), day 7 (3.14 ± 1.03, 7.36 ± 1.39), and day 14 (2.14 ± 0.46, 5.45 ± 1.29). The first analgesia dose was required at 21.27 ± 5.47 h in the CG and 7.09 ± 2.36 h in the SG (p < 0.05), the time of analgesic use was 6.86 ± 1.61 days in the CG and 13.09 ± 2.48 days in the SG (p < 0.05), and resumption of daily activities occurred at 7.59 ± 1.56 days in the CG and 14.73 ± 3.76 days in the SG (p < 0.05). CONCLUSION: Oral administration of metronidazole is effective in pain management after hemorrhoidectomy

[Restorative proctocolectomy with J-pouch reservoir. Experience in a national medical center]. / Proctocolectomía restaurativa con reservorio ileal en "J". 10 años de experiencia en un centro de especialidades.

OBJECTIVE: To present the experience for morbidity and mortality of surgical treatment of chronic ulcerative colitis (CUC) and familiar adenomatous polyposis (FAP) with restorative proctocolectomy with J-pouch. MATERIAL AND METHODS: We used a cases series of patients treated consecutively from January 1993 to December 2003. Selection criteria were patients with J-pouch restorative proctocolectomy with CUC and FAP who were treated and assessed prospectively. RESULTS: There were 16 cases treated with restorative proctocolectomy (nine males and seven females). Diagnosis of inflammatory bowel disease was established in 12 patients, and 4 with familiar adenomatous polyposis. Age average was 33 years. All cases had protective ileostomy. Seven patients developed at least one complication such as pelvic abscess, uretheral transection, pulmonary thromboembolism, hemoperitoneum, persistent transrectal bleeding, wound infection and sexual impotence. Only four patients required surgical reintervention. The median hospital stay was 11.9 days. Average bowel movements at 3 month-follow-up was 10.1, at 6 months 6.6. Medium average follow-up was 44.25 months. There was no mortality. CONCLUSIONS: Results of this study demonstrated adequate quality of life and appropriate functional results; rate of morbidity was acceptable with no mortality.independent of morbidity there was no mortality. Long-term follow up is necessary to identify long-term-late complications.