ABSTRACT
AIM: A four-arm multicentre randomized double-blind placebo-controlled trial was undertaken to assess the effect and safety of suppositories containing recombinant streptokinase (rSK) at two dose levels (100,000 IU and 200,000 IU) with sodium salicylate (SS) compared with placebo and SS for the treatment of acute haemorrhoidal disease. METHOD: Patients with acute symptoms of haemorrhoids were randomized to four treatment groups: (I) placebo, (II) SS, (III) SS + rSK 100,000 IU and (IV) SS + rSK 200,000 IU per suppository. Inpatient treatment was by four suppositories given every 6 h to discharge at 24 h. Evaluations were made at the time of discharge (24 h) and at 3, 5 and 20 days later. The main end-point was the degree of relief of pain, oedema and reduction in the size of the lesion by 90% on day 5. Adverse events and the occurrence of anti-SK antibodies were also determined. RESULTS: Eighty patients were included. Respective response rates in the four groups were 16%, 30%, 25% and 52%. In the last group there was a significant difference (36.8%) compared with control (95% CI 7.0-58.4%). The time to response was significantly shorter (median 5 days) in the 200,000 IU rSK group with respect to the others. There were no adverse events attributable to the treatment. No increase in anti-SK antibodies was detected 20 days after treatment. CONCLUSION: Suppositories with 200,000 IU rSK showed a significant improvement in symptoms of acute haemorrhoids, with an adequate safety profile.
Subject(s)
Fibrinolytic Agents/administration & dosage , Hemorrhoids/drug therapy , Streptokinase/administration & dosage , Acute Disease , Adult , Aged , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Double-Blind Method , Drug Therapy, Combination , Edema/etiology , Female , Fibrinolytic Agents/adverse effects , Hemorrhoids/complications , Humans , Male , Middle Aged , Pain/etiology , Pain Measurement , Recombinant Proteins/administration & dosage , Recombinant Proteins/adverse effects , Sodium Salicylate/administration & dosage , Streptokinase/adverse effects , Suppositories/therapeutic use , Young AdultABSTRACT
En este trabajo se presentan las características clínicas y la conducta seguida en un caso estudiado en el servicio de Geriatría y Gerontología del Hospital Provincial Universitario Camilo Cienfuegos de Sancti Spíritus, que por su escasa frecuencia y mostrarse exclusivamente en el anciano se consideró importante su conocimiento. Paciente geriátrico que ingresa por disfagia, dificultad para el habla y sepsis respiratoria, se estudiaron las afecciones que pudieron causar este cuadro, llegándose a la conclusión de que se trataba de un divertículo de Zenker. Luego de valorar con cirugía se procedió a la diverticulectomía con miotomía del músculo cricofaríngeo, siendo un éxito la operación y desapareciendo todos los síntomas que presentaba el paciente.
Subject(s)
Zenker Diverticulum , Case-Control StudiesABSTRACT
Es habitual en la práctica médica cuando se tratan pacientes con cuadro abdominal agudo encontrar enfermos que sufren de colecistitis aguda. El diagnóstico puede resultar fácil en ocasiones, aunque controversial cuando se decide el uso de antibióticos, mantener un tratamiento médico de inicio o realizar un proceder quirúrgico de urgencia a fin de lograr un máximo de beneficio para ellos.[AU]
Subject(s)
Cholecystectomy, Laparoscopic , Cholecystitis, AcuteABSTRACT
Con este trabajo se pretende hacer una reflexión sobre la Cirugía Video Laparoscópica y los aspectos bioéticos, que tienen implicación en la misma; realizando consideraciones sicológicas, socioeconómicas y éticas sobre los pacientes que reciben los beneficios de esta nueva tecnología, a fin de mejorar o curar sus dolencias con un mínimo de dolor, un bajo costo y una mejor estética[AU]
With this work it is sought to make a reflection on video laparoscopic surgery and the bioethical aspects implied in it; carrying out psychological, socioeconomic and ethical considerations on the patients that receive the benefits of this new technology, in order to improve or to cure their ailments with a minimum pain, a low cost and a better aesthetics(AU)
