Melanosis coli: diagnóstico endoscópico. Reporte de caso / Melanosis coli: endoscopic diagnosis. Case report

La melanosis coli consiste en una pigmentación negruzca de la mucosa del intestino grueso, producida por absorción de productos aromáticos, por uso excesivo de laxantes derivados del antraceno. Se presentó el primer caso de melanosis coli diagnosticado en los últimos 30 años de trabajo, en el departamento de Gastroenterología del Hospital Faustino Pérez, de Matanzas. Se trata de un paciente con antecedentes de estreñimiento crónico, al cual se le diagnóstica esta entidad por estudio videoendoscópico del colon, corroborándose por estudio histológico, concluyéndose que esta entidad constituye una condición inocua que no traduce manifestaciones clínicas. Casi siempre, aparece de forma accidental en pacientes a los que se les realiza estudios endoscópicos del tracto digestivo inferior y con historia de abuso de laxantes. Para evitarla se recomienda régimen higiénico dietético adecuado, consumo de alimentos ricos en fibras, ejercicios físicos sistemáticos y proscribiendo el uso de laxantes derivados de las antroquinonas. Por tanto, es de gran importancia para Gastroenterólogos estar conscientes de su existencia. A pesar, de que no esté dilucidada todavía la importancia clínica de esta entidad.

The Melanosis coli consist in a blackish pigmentation of the large intestine mucosa, produced for the absorption of aromatic products due to the excessive usage of anthracene-derived laxatives. We present the first case of Melanosis coli diagnosed in the Gastroenterology Department of the Hospital “Faustino Perez”, of Matanzas in the last 30 years. It is the case of a patient with antecedents of chronic constipation, to whom the disease is diagnosed as a result of a colon videoendoscopic study, corroborated by histological study, concluding that this disease is an innocuous condition without clinical manifestations. It almost always appears in an accidental way, in patients to whom endoscopic studies of the low digestive tract are carried out, and having a history of laxatives abuse. To avoid it, an adequate hygiene-epidemiologic regime, rich-in-fibers food consumption, systemic physical training and the proscription of anthraquinone-derived laxatives are need. It is very importance for the gastroenterologists to be conscious of the existence of this entity, although its clinical importance is not elucidated yet.

Melanosis coli, diagnóstico endoscópico: reporte de caso / Melanosis coli, endoscopic diagnosis: case report

La melanosis coli consiste en una pigmentación negruzca de la mucosa del intestino grueso, producida por absorción de productos aromáticos, por uso excesivo de laxantes derivados del antraceno. Se presentó el primer caso de melanosis coli diagnosticado en los últimos 30 años de trabajo, en el departamento de Gastroenterología del Hospital Faustino Pérez, de Matanzas. Se trata de un paciente con antecedentes de estreñimiento crónico, al cual se le diagnóstica esta entidad por estudio videoendoscópico del colon, corroborándose por estudio histológico, concluyéndose que esta entidad constituye una condición inocua que no traduce manifestaciones clínicas. Casi siempre, aparece de forma accidental en pacientes a los que se les realiza estudios endoscópicos del tracto digestivo inferior y con historia de abuso de laxantes. Para evitarla se recomienda régimen higiénico dietético adecuado, consumo de alimentos ricos en fibras, ejercicios físicos sistemáticos y proscribiendo el uso de laxantes derivados de las antroquinonas. Por tanto, es de gran importancia para Gastroenterólogos estar conscientes de su existencia. A pesar, de que no esté dilucidada todavía la importancia clínica de esta entidad(AU)

The Melanosis coli consist in a blackish pigmentation of the large intestine mucosa, produced for the absorption of aromatic products due to the excessive usage of anthracene-derived laxatives. We present the first case of Melanosis coli diagnosed in the Gastroenterology Department of the Hospital Faustino Perez, of Matanzas in the last 30 years. It is the case of a patient with antecedents of chronic constipation, to whom the disease is diagnosed as a result of a colon videoendoscopic study, corroborated by histological study, concluding that this disease is an innocuous condition without clinical manifestations. It almost always appears in an accidental way, in patients to whom endoscopic studies of the low digestive tract are carried out, and having a history of laxatives abuse. To avoid it, an adequate hygiene-epidemiologic regime, rich-in-fibers food consumption, systemic physical training and the proscription of anthraquinone-derived laxatives are need. It is very importance for the gastroenterologists to be conscious of the existence of this entity, although its clinical importance is not elucidated yet(AU)

Intestinal parasites in children from a day care centre in Matanzas City, Cuba.

BACKGROUND: Intestinal parasitic infections are widely distributed throughout the world and children are the most affected population. Day care centres are environments where children have proven to be more susceptible to acquiring IP. METHODS AND PRINCIPAL FINDINGS: A cross-sectional study was carried to determine the prevalence of intestinal parasites in stool samples among children who attend to a day care centre in an urban area of Matanzas city, Cuba, from March to June 2012. 104 children under five years old were included on the study after informed consent form was signed by parents or legal guardians. Three fresh faecal samples were collected from each child in different days and were examined by direct wet mount, formalin-ether, and Kato- Katz techniques. Data relating to demography, socioeconomic status, source of drinking water, and personal hygiene habits were also collected using a standardized questionnaire. In total, 71.1% of children harbored at least one type of intestinal parasite and 47 (45.2%) were infected by more than one species. Giardia duodenalis and Blastocystis sp. were the most common parasites found, with prevalence rates of 54.8% and 38.5% respectively. CONCLUSIONS: Despite public health campaigns, improvement in the level of education, and the availability of and access to medical services in Cuba infections by intestinal protozoan is high in this centre. Almost nothing is published regarding intestinal parasites in Matanzas province during the last 40 years so this work could also be the initial point to carry out other studies to clarify the IP status in this region.

Intestinal Parasites in Children from a Day Care Centre in Matanzas City, Cuba

Background: Intestinal parasitic infections are widely distributed throughout the world and children are the most affected population. Day care centres are environments where children have proven to be more susceptible to acquiring IP. Methods and Principal Findings: A cross-sectional study was carried to determine the prevalence of intestinal parasites in stool samples among children who attend to a day care centre in an urban area of Matanzas city, Cuba, from March to June 2012. 104 children under five years old were included on the study after informed consent form was signed by parents or legal guardians. Three fresh faecal samples were collected from each child in different days and were examined by direct wet mount, formalin-ether, and Kato- Katz techniques. Data relating to demography, socioeconomic status, source of drinking water, and personal hygiene habits were also collected using a standardized questionnaire. In total, 71,1 percent of children harbored at least one type of intestinal parasite and 47 (45,2 percent) were infected by more than one species. Giardia duodenalis and Blastocystis sp. were the most common parasites found, with prevalence rates of 54,8 percent and 38,5 percent respectively. Conclusions: Despite public health campaigns, improvement in the level of education, and the availability of and access to medical services in Cuba infections by intestinal protozoan is high in this centre. Almost nothing is published regarding intestinal parasites in Matanzas province during the last 40 years so this work could also be the initial point to carry out other studies to clarify the IP status in this region(AU)

Low prevalence of Helicobacter pylori among symptomatic children from a hospital in Havana, Cuba.

The aims of this study were to assess the prevalence of Helicobacter pylori infection and to introduce a new algorithm to improve its diagnosis in Cuban symptomatic children. One hundred and thirty-three consecutive children with upper gastrointestinal symptoms were studied. Patients were endoscoped and antral biopsies were obtained for rapid urease test (RUT), culture and histology. Prevalence of H. pylori infection was 30.8%. No statistical differences were found concerning demographic, socio-economic factors or chief clinical complaints, between H. pylori-positive and negative children, except for haematemesis, which was significantly higher in infected children (p = 0.003). Histologically, there was statistical association between moderate chronic gastritis in infected children (p = 0.04). Culture and RUT had the highest specificity and sensitivity, respectively. The prevalence of H. pylori infection in Cuban symptomatic children is similar to the one observed in developed countries. Culture and RUT is a useful combination to diagnose H. pylori infection in paediatric patients.

Estudio clínico Piroxicam I.M. y oral en el tratamiento de pacientes con trastornos musculoesqueléticos agudos / Clinic studied Piroxicam I.M. and oral in the treatment of patient with acute musculoskeletal disorders

Se presentan los resultados encontrados en 23 pacientes con desórdenes musculoesqueléticos agudos, de diferente localización, tratados con Piroxicam I.M. durante los primeros tres días y seguidos con Piroxicam oral por cuatro días más. La evaluación por parte de los investigadores considerará los parámetros de dolor, tumefacción y limitación del movimiento y autoevaluación del dolor por escala suministrada al paciente. Veintiuno de los 23 casos (91.3 por ciento) mostraron una evaluación muy buena y excelente a los siete días del tratamiento. Como efectos secundarios que justificaron la descontinuidad del tratamiento, se presentó solo en un paciente por reacción de urticaria. Dos casos que presentaron gastritis inicial, pudieron finalizar el estudio sin mayores efectos, continuando la terapia. Los autores concluyeron que el uso inicial de Piroxicam I.M. seguido por vía oral es efectivo y bien tolerado en el tratamiento de trastornos musculoesqueléticos agudos.