[Complications of the intragastric balloon prosthesis]. / Complicaciones de la prótesis balón intragástrica.

The intragastric balloon prosthesis (PBIG) is being used as a mechanical treatment for obesity; an evaluation of its physiopathological implications, efficiency, and complications is still incomplete. In order to investigate in our area the incidence of complications of this endoscopic treatment, we have used the Danish model "Danish Obesity Treatment" (DOT) (Ballobes) inflated with air, in a prospective study in which forty obese patients were treated during three months. We draw the attention upon a gastric ulcer, a spontaneous anal extrusion-migration, and a duodenal ulcer. We establish the safety of the method, the literature is reviewed, we discuss the cause and treatment of these lesions, and we conclude indicating the low morbidity and the absence of major complications such as oesophageal perforation or intestinal obstruction occurring with other prosthesis models.

[Variability and lengthening of reaction time in the early diagnosis of subclinical hepatic encephalopathy]. / Variabilidad y alargamiento del tiempo de reacción en el diagnóstico precoz de la encefalopatía hepática subclínica.

A prospective study was made of the psychophysiological technique reaction time as regards the parameters of duration and variability, by evaluating the average of 10 consecutive sequences in two groups of patients. The first group was formed by cirrhotics (diagnosed by histology) of different Child stages (N: 31) (A: 18, B: 6, C: 7) who had different clinical neurological manifestations that varied from asymptomatic to hepatic encephalopathy (EH) that permitted the degree of necessary collaboration. The second group -controls- included normal subjects (N: 31) with normal liver function and absence of gastrointestinal pathology. In both groups other CNS pathology and/or anterior or concomitant psychotropic drug use were excluded. The difference in the duration of reaction time between the control group and cirrhotics was statistically significant (more prolonged in cirrhotics), as was the difference between the control group and Child A cirrhotics. During the evolution of the cirrhotic group (follow-up of 6 months), it was found that individual variations in reaction time for each case greater larger as liver function deteriorated (higher Child grade), and that there were progressively larger deviations from Child A to Child C. In conclusion, reaction time is useful in discriminating subclinical hepatic encephalopathy in cirrhotics (longer duration), although its major application may be the prognosis of established hepatic encephalopathy, as determined by the increasing variability observed with greater deterioration of liver function.