[Epidemiological study of colorectal cancer in Zamora (Spain): a comparison between the years 1996 and 2003]. / Estudio epidemiológico del cáncer colorrectal en la provincia de Zamora: comparación entre los años 1996 y 2003.

INTRODUCTION: Colorectal cancer (CRC) is one of the most frequent tumors in Western countries. In Spain, widely different rates have been reported for distinct regions. AIM: To determine the epidemiological characteristics of CRC in the province of Zamora in 1996 and 2003 and to identify possible variations in these characteristics in each of these two years. MATERIAL AND METHODS: We performed a descriptive, retrospective study of all cases of CRC diagnosed in the Complejo Asistencial de Zamora in 1996 and 2003. RESULTS: In 1996, 146 patients were diagnosed with CRC, representing an unadjusted and adjusted incidence of 70.85 and 49.40 cases per 10(5) inhabitants. In 2003, 173 patients were diagnosed, representing an unadjusted and adjusted incidence of 86.89 and 58.12 cases per 105 inhabitants. The mean age at diagnosis was 72.08 years in 1996 and 71.15 years in 2003. The mean time to diagnosis was 3.37 months in 1996 and 4.11 in 2003. The mean time to diagnosis in 1996 was 4.35 months in rectal tumors and 2.87 months in colon tumors (p = 0.013). In 2003, the mean time to diagnosis was 4.70 months in rectal tumors and 3.84 months in colon tumors (p = 0.0749). The mean time to diagnosis was 3.56 and 3.83 months in patients living in urban areas and was 3.24 and 4.35 months in those living in rural areas in 1996 and 2003, respectively. More than 65% of the neoplasms were located in the rectum and sigmoid colon, with no differences between the two years. In 1996, 46.1% of the tumors were stage III or IV at diagnosis while in 2003, this percentage increased to 50.9%. In both years, the four basic health areas with the highest rates within the province were Aliste, Carbajales, Carballeda and Corrales. CONCLUSION: CRC is a highly frequent disease in the province of Zamora, especially in some of the western regions. The incidence of CRC was higher in 2003 than in 1996. Most of the tumors were located in the rectum and sigmoid colon. The time from symptom onset to diagnosis was prolonged. A high percentage of tumors were diagnosed in advanced stages.

Estudio epidemiológico del cáncer colorrectal en la provincia de Zamora: comparación entre los años 1996 y 2003 / Epidemiological study of colorectal cancer in Zamora (Spain): a comparison between the years 1996 and 2003

Introducción: El cáncer colorrectal (CCR) es uno de los tumores más frecuentes en los países occidentales. En España se han comunicado tasas muy diferentes en distintas regiones. El objetivo del presente estudio ha sido conocer las características del CCR en la provincia de Zamora en los años 1996 y 2003, evaluando si existen variaciones en las características epidemiológicas en estos 2 años. Material y métodos: Se ha realizado un estudio descriptivo, retrospectivo, de todos los casos diagnosticados en el Complejo Asistencial de Zamora en los años 1996 y 2003. Resultados: En el año 1996, se diagnosticó de CCR a 146 pacientes, con una tasa bruta de 70,85 casos/105 habitantes. En el año 2003, se diagnosticó a 173 enfermos, con una tasa bruta de 86,89 casos/105 habitantes. Las tasas ajustadas fueron de 49,40 casos/105 habitantes en 1996 y de 58,12 casos/105 habitantes en 2003. La edad media en el momento del diagnóstico fue de 72,08 años en 1996 y de 71,15 en 2003. En el año 1996, el tiempo medio de diagnóstico fue de 3,37 meses, que ascendió hasta 4,11 meses en 2003. El tiempo medio de diagnóstico de los tumores rectales en el año 1996 fue de 4,35 meses, y el de los tumores de colon, de 2,87 meses (p = 0,013). En 2003, las neoplasias rectales se diagnostican en 4,70 meses de media y las de colon, en 3,84 meses (p = 0,0749). En el año 1996, el tiempo medio de diagnóstico fue de 3,56 meses en pacientes que vivían en medio urbano y de 3,24 meses en los del medio rural, mientras que en 2003 fue de 3,83 meses en el primer caso y de 4,35 en el segundo. Más del 65% de las neoplasias se asentó en el recto y el sigma, situación que ocurrió por igual en ambos años estudiados. El 46,1% de los tumores se diagnosticó en estadios III y IV en el año 1996, porcentaje que amumentó en el año 2003 hasta el 50,9%. Aliste, Carbajales, Carballeda y Corrales son las 4 zonas básicas de salud con tasas más altas dentro de la provincia en ambos años. Conclusión: El CCR es muy frecuente en nuestra provincia, fundamentalmente en algunas comarcas de la franja oeste. Su incidencia aumentó en el año 2003 en comparación con 1996. La mayoría de las neoplasias se asientan en el recto y elsigma. El tiempo que transcurre desde el comienzo de los síntomas hasta su diagnóstico es muy prolongado. En un gran porcentaje de tumores, el diagnóstico se realiza en estadios avanzados

Introduction: Colorectal cancer (CRC) is one of the most frequent tumors in Western countries. In Spain, widely different rates have been reported for distinct regions. Aim: To determine the epidemiological characteristics of CRC in the province of Zamora in 1996 and 2003 and to identify possible variations in these characteristics in each of these two years. Material and methods: We performed a descriptive, retrospective study of all cases of CRC diagnosed in the Complejo Asistencial de Zamora in 1996 and 2003. Results: In 1996, 146 patients were diagnosed with CRC, representing an unadjusted and adjusted incidence of 70.85 and 49.40 cases per 105 inhabitants. In 2003, 173 patients were diagnosed, representing an unadjusted and adjusted incidence of 86.89 and 58.12 cases per 105 inhabitants. The mean age at diagnosis was 72.08 years in 1996 and 71.15 years in 2003. The mean time to diagnosis was 3.37 months in 1996 and 4.11 in 2003. The mean time to diagnosis in 1996 was 4.35 months in rectal tumors and 2.87 months in colon tumors (p = 0.013). In 2003, the mean time to diagnosis was 4.70 months in rectal tumors and 3.84 months in colon tumors (p = 0.0749). The mean time to diagnosis was 3.56 and 3.83 months in patients living in urban areas and was 3.24 and 4.35 months in those living in rural areas in 1996 and 2003, respectively. More than 65% of the neoplasms were located in the rectum and sigmoid colon, with no differences between the two years. In 1996, 46.1% of the tumors were stage III or IV at diagnosis while in 2003, this percentage increased to 50.9%. In both years, the four basic health areas with the highest rates within the province were Aliste, Carbajales, Carballeda and Corrales. Conclusion: CRC is a highly frequent disease in the province of Zamora, especially in some of the western regions. The incidence of CRC was higher in 2003 than in 1996. Most of the tumors were located in the rectum and sigmoid colon. The time from symptom onset to diagnosis was prolonged. A high percentage of tumors were diagnosed in advanced stages

Preparación colónica con polietilenglicol, hipofosfatemia y síndrome confusional agudo / Colonic preparation with polyethylene glycol, hypophosphatemia and acute confusional síndrome

No disponible

[Acute necrotizing injuries of the upper gastrointestinal tract]. / Lesiones necrosantes agudas del tracto digestivo superior.

Because of the rich vascular supply and the density of the intramural vascular network in the upper gastrointestinal tract, acute necrotizing injuries at this site are exceptional. However, low-flow states secondary to certain severe systemic diseases can cause ischemic mucosal damage that finally leads to acute local necrosis. Two cases of acute necrotizing lesions in the esophagus and stomach are presented, together with their endoscopic and pathologic characteristics. The pathogenic, clinical and follow-up features of these injuries are also discussed.

[Eosinophilic gastroenteritis: clinical spectrum of the same disease]. / Gastroenteritis eosinofílica: espectro clínico de una misma entidad.

Eosinophilic gastroenteritis is a condition of unknown etiopathogenesis and unusual description. Clinical symptoms are widely diverse ranging from mild episodes of abdominal discomfort to acute intestinal obstruction which leads occasionally to urgent surgical approach. This wide range of clinical possibilities seems to be secondary to the rate of eosinophilic infiltration of the bowel wall and the number of layers involved. We report two cases showing that anatomo-clinical variety and their therapeutic outcomes.

Gastroenteritis eosinofílica: espectro clínico de una misma entidad / Eosinophilic gastroenteritis: clinical spectrum of the same disease

La gastroenteritis eosinofílica es una entidad de etiopatogenia no aclarada y presentación excepcional. Sus síntomas clínicos son muy diversos, abarcando desde cuadros leves y de dolor abdominal inespecífico hasta episodios agudos de obstrucción intestinal que hacen preciso en ocasiones un tratamiento quirúrgico urgente. Este amplio abanico sintomático parece estar condicionado por el grado de infiltración eosinófila de la pared intestinal y el número de capas afectadas. Presentamos dos casos que ilustran la diversidad anatomo-clínica del cuadro y sus implicaciones terapéuticas (AU)

[Acute cholestatic hepatitis induced by dextromethorphan]. / Hepatitis aguda colestásica inducida por dextrometorfano.

A case of a 68-years-old female who was symptomatically treated with the codeine analog dextromethorphan because of a flu-like syndrome is herein reported. Five days later, she developed a cholestatic syndrome without fever or abdominal pain. Dextrometorphan was withdrawn and a rapid clinical improvement was observed, associated with decreasing levels of biochemical markers of cholestasis. Normal values were reached two months later. This type of adverse drug reaction, its potential pathogenic mechanisms and the therapeutic consequences are discussed.

[Ischemic colitis associated with antithrombin deficiency]. / Colitis isquémica asociada a déficit de antitrombina III.

Colonic ischemia is one of the more common disorders of the colon in elderly people; the ischemic colitis can affect young people too. The splenic flexure, the descending colon and the sigmoid are the parts most commonly involved. Only in some cases it is possible to identify the specific cause of colonic ischemia. We report a case of ischemic colitis associated with antithrombin III deficiency.

Colitis isquémica asociada a déficit de antitrombina III / Ischemic colitis associated with antithrombin deficiency

La isquemia colónica es una de las patologías que más frecuentemente afectan al colon en ancianos, aunque puede también aparecer en personas jóvenes. El sigma y el colon izquierdo son las zonas que con más frecuencia se afectan. Aunque en la mayoría de los casos no se identifica una causa específica de isquemia, en otras ocasiones existe una causa desencadenante. Presentamos el caso de una enferma que desarrolló una colitis isquémica asociada a déficit congénito de antitrombina III (AU)