[Prevention of thromboembolism in bariatric surgery]. / Prevencíon del tromboembolismo en cirugía bariátrica.

Disease thromboembolic (ETEV) is one of the major complications that can occur after surgery, and is the leading cause of death in the postoperative period of Bariatric Surgery. Among other factors, should be aware that these patients are at additional risk of ETEV due to own obesity (IMC > 30). After Bariatric Surgery the risk of thromboembolic events varies according to the surveyed series. In general, it is estimated that danger EP (pulmonary embolism) is 0.8% and DVT (deep vein thrombosis) of 1.7%. ETEV global mortality estimates of 0.1 to 2%.

Prevención del tromboembolismo en cirugía bariátrica / Prevention of thromboembolism in bariatric surgery

La enfermedad tromboembólica (ETEV) es una de las complicaciones más importantes que pueden aparecer tras cualquier cirugía, y constituye la primera causa de muerte en el postoperatorio de cirugía bariátrica. Entre otros factores, se debe tener en cuenta que estos pacientes presentan un riesgo adicional de ETEV debido a la propia obesidad (IMC>30). Tras la cirugía bariátrica el riesgo de padecer eventos tromboembólicos varía según las series consultadas. En líneas generales, se estima que el peligro de EP (embolia pulmonar) es del 0,8% y el de TVP (trombosis venosa profunda) de 1,7%. La mortalidad global por ETEV se estima del 0,1 al 2%(AU)

Disease thromboembolic (ETEV) is one of the major complications that can occur after surgery, and is the leading cause of death in the postoperative period of Bariatric Surgery. Among other factors, should be aware that these patients are at additional risk of ETEV due to own obesity (IMC>30). After Bariatric Surgery the risk of thromboembolic events varies according to the surveyed series. In general, it is estimated that danger EP (pulmonary embolism) is 0.8% and DVT (deep vein thrombosis) of 1.7%. ETEV global mortality estimates of 0.1 to 2%(AU)

Rendimiento neuropsicológico en niños pretérmino con muy bajo peso en el nacimiento / Neuropsychologycal (performance, efficiency, production) in preterm infants with very low birth weight

Introducción: El objetivo principal de este trabajo es conocerlas características neuropsicológicas de un grupo de niños prematuros y con bajo peso al nacimiento, teniendo en cuenta su heterogeneidad y sus rasgos comunes, la gravedad de los síntomas y la necesidad de recibir cuidados específicos. Pacientes y métodos: El grupo estaba formado por 73 sujetos en total, 33 niños y 40 niñas. El número de sujetos en el grupo de bajo peso (GBP) fue de 23 y el del grupo control (GC) de 50. La media de edad en el momento de la recogida de datos fue de 32,65 meses en el GBP y de 31,9 meses para el GC. El estatus socioeconómico de ambos grupos era de tipo medio. Los estadísticos descriptivos de ambos grupos son: «semanas de gestación» con grupo pretérmino (<32 semanas) y grupo control (>37 semanas) y, «peso al nacimiento» con grupo de bajo peso (<1.500 g) y grupo control (>2.500 g). Se evaluó a los participantes mediante una batería de pruebas neuropsicológicas creada específicamente para este estudio. Resultados: El GC obtuvo mejores resultados en casi todas las funciones, pero no todas resultaron estadísticamente significativas, sólo «articulación, lenguaje expresivo y reconocimiento de figuras». Por el contrario, el GBP obtuvo resultados estadísticamente significativos en «reconocimiento de colores». Conclusiones: Se postula la necesidad de realizar un diagnóstico neuropsicológico precoz en los niños de bajo peso al nacer por pertenecer a una población de alto riesgo(AU)

Introduction: The primary target of this work is to know the neuropsychological characteristics of one premature children and with low weight in the birth group, considering it's heterogeneity, common characteristics, the gravity of the symptoms and the necessity to receive specific cares. Patients and methods: The total group is formed by 73 subjects, 33 males and 40 females. The number of subjects of low weight group (LWG) are 23 and the subjects of control group (CG) 50. The average ages at the time of the sample were of 32.65 months, GBP and of 31.9 months GC. The socioeconomic status of both groups were average type. Statistical descriptive of both groups are "weeks of gestation" with the group preterm (<32 weeks) and the control group (>37 weeks) and "weight in the birth", the group of very low weight (<1,500 g) and the control group (>2,500 g). The subjects are evaluated through a neuropsychological battery of tests created for this study. Results: The LWG obtains better results in almost functions but not all are statistically significant, only "articulation, expressive language and recognition of figures". In the other way, the CG obtains statistically significant results in "recognition of colors". Conclusions: We postulate the necessity to realise a precocious neuropsychologycal diagnostic in the children with low weight birth because they belong to a high-risk group(AU)

Estudio comparativo del tratamientode la estenosis de uretra con dos tiposde dilatadores uretrales diferentes / No disponible

Teniendo en cuenta que la dilatación de la uretra es una de las técnicas utilizadas para resolver su estenosis , queríamos comprobarsu repercusión en pacientes con esta patología, y, además , valorar si había o no diferencias de resultados con el uso de dos diferentesmodelos de dilatadores, utilizando siempre unas técnicas cuidadosas. Llegamos a la conclusión de una tendencia ascendente enmedidas de calibración y flujos y decreciente en los residuos (AU)

Taking into account that the dilatation of the urethra is one of the techniques used to solve its stenosis, we wanted to check its repercussionon patients with this pathology, and, besides, to value if there was or not differences of results with the use of two differentmodels of expanders, always using some careful techniques. We arrive to the conclusion of an increasing trend in measurements ofcalibration and flows and decreasing in the waste (AU)

AM3, a natural glycoconjugate, induces the functional maturation of human dendritic cells.

BACKGROUND AND PURPOSE: Dendritic cells (DCs) are dedicated antigen-presenting cells able to initiate specific immune responses and their maturation is critical for the induction of antigen-specific T-lymphocyte responses. Here, we have investigated the effects of Inmunoferon-active principle (AM3), the active agent of a commercial immunomodulatory drug, on human monocyte-derived DCs (MDDCs). EXPERIMENTAL APPROACH: MDDCs derived from healthy and hepatitis C virus (HCV)-infected patients were stimulated with AM3. We analysed the expression of cell surface proteins by flow cytometry, that of cytokine production by ELISA, and the expression of chemokines and chemokine receptors by RNase protection assays. T-lymphocyte proliferation was assessed in mixed lymphocyte reactions, protein expression by western blot and luciferase-based reporter methods, and Toll-like receptor (TLR)-blocking antibodies were employed to analyse TLR activity. KEY RESULTS: In MDDCs, AM3 induced or enhanced expression of CD54, CD83, CD86, HLA-DR, chemokines and chemokine receptors, interleukin (IL)-12p70 and IL-10. Furthermore, AM3 stimulated MDDCs to increase proliferation of allogenic T cells. AM3 triggered nuclear translocation of NF-kappaB and phosphorylation of p38 mitogen-activated protein kinase. AM3 promoted NF-kappaB activation in a TLR-4-dependent manner, and blocking TLR-4 activity attenuated the enhanced expression of CD80, CD83 and CD86 induced by AM3. AM3 enhanced the expression of maturation-associated markers in MDDCs from HCV-infected patients and increased the proliferation of T lymphocytes induced by these MDDCs. CONCLUSIONS AND IMPLICATIONS: These results underline the effects of AM3 in promoting maturation of MDDCs and suggest that AM3 might be useful in regulating immune responses in pathophysiological situations requiring DC maturation.

Transient elastography to assess hepatic fibrosis in primary biliary cirrhosis.

BACKGROUND: Liver stiffness measurements may have potential for detecting and monitoring hepatic fibrosis in chronic liver disease. AIM: To study the detection, quantification and progression of hepatic fibrosis in primary biliary cirrhosis by liver stiffness measurements. METHODS: Liver stiffness measurements were generated in 80 patients with primary biliary cirrhosis by applying transient elastography; however, as there were 55 with liver biopsy, histological stage (METAVIR) and liver stiffness measurements were compared only in these 55 patients. The efficiency of liver stiffness measurements in predicting stage of fibrosis was determined from the area under receiver operating characteristics curve analysis. RESULTS: Of the 80 patients included, 91, 4% were women and their mean age was 56 +/- 12 (s.d.) years. A significant correlation was found (P < 0.05) between histological fibrosis stage (METAVIR) and liver stiffness measurements. The values obtained from area under receiver operating characteristic curve analysis of liver stiffness measurement data were 0.89 for F > 2 and 0.96 for F = 4. Liver stiffness measurements were 9.0 +/- 5.3 and 7.9 +/- 6.0 kPa for patients followed up more than 5 years and less than 5 years, respectively (P > 0.05). CONCLUSIONS: In patients with primary biliary cirrhosis, median values of liver stiffness measurements correlated with histological severity of hepatic fibrosis. Liver stiffness measurements appear to be promising for liver fibrosis detection and quantification, as well as monitoring its progression, in patients with primary biliary cirrhosis. The progression rate of hepatic fibrosis in our primary biliary cirrhosis patients appears to be slow.

Nuevas perspectivas terapéuticas de la fibrosis hepática / No disponible

No disponible

[Evoked potentials in a population of children below 1,500 grams at birth: a description and probabilities]. / Potenciales evocados en una población de niños menores de 1.500 gramos: descripción y probabilidades.

INTRODUCTION: Bioelectrical behaviour was studied in a group of low birth weight children. AIM: To evaluate whether the characteristics of the waves of the brain potentials in these children, who weighed less than 1500 g at birth and experienced anomalous circumstances and events during their perinatal period, would help reach an early diagnosis of the possible developmental disorders they might suffer later on in life. SUBJECTS AND METHODS: Both visual and auditory cerebral evoked potentials were recorded in a group of children born underweight and the results were compared with the findings from another group of healthy children who were born in normal physiological conditions and were apparently free of any kind of pathology. RESULTS: In the waves and locations that were examined, the problem group displayed latencies that were longer than those of the control group; in contrast, no statistically significant differences were found in the amplitude, regardless of the location. Low gestational age and lower weight made latencies longer, but no relationship was found between latencies and the other perinatal features that were studied. CONCLUSIONS: Children with low weight at birth have slower wave latencies than normal children. This slowing, which is inversely proportional to the weight and weeks of gestation, is considered to be an anomalous sign that could be related to brain immaturity, delayed development or to disorders affecting myelination. Moreover, the amplitude, which has received far less attention from researchers, is usually shorter in these processes, although in our study we found no differences with the group of healthy children--only very slightly in the P300, in the weeks and the weight, and the N100 only in one location with respect to weight. Since these children usually have developmental disorders, the use of evoked potentials could be a very useful tool in their detection and ensuing therapy.

Potenciales evocados en una población de niños menores de 1.500 gramos: descripción y probabilidades / Evoked potentials in a population of children below 1500 grams at birth: a description and probabilities

Introducción. Se estudió el comportamiento bioeléctrico en un grupo de niños con bajo peso al nacer. Objetivo. Valorar si las características de las ondas de los potenciales cerebrales en estos niños con pesos menores de 1.500 g en el momento del nacimiento, que sufrieron circunstancias y accidentes anómalos durante su etapa perinatal, ayudarían en el diagnóstico precoz de las posibles alteraciones del desarrollo que eventualmente pudieran presentar. Sujetos y métodos. Se realizaron los potenciales evocados cerebrales tanto visuales como auditivos en un grupo de niños de bajo peso en el momento del nacimiento y los resultados se compararon con los hallados en otro grupo de niños sanos, que nacieron en condiciones fisiológicas y en los que no se ha detectado patología alguna. Resultados. En las ondas y las localizaciones examinadas, el grupo problema presentó unas latencias más alargadas que el grupo control; en cambio, no se encontró una diferencia estadísticamente significativa en la amplitud, con independencia de la localización. La corta edad gestacional y el menor peso alargan las latencias, pero no hemos encontrado relación alguna entre las latencias y el resto de las características perinatales estudiadas. Conclusiones. Los niños de muy bajo peso en el momento del nacimiento tienen lentificada la latencia de las ondas con respecto a los niños normales. Esta lentitud, que es inversamente proporcional al peso y a las semanas de gestación, es considerada como un signo anómalo que pudiera estar en relación con la inmadurez cerebral, con el retardo del desarrollo o con la alteración de la mielinización. Por otro lado, la amplitud, mucho menos estudiada, suele estar acortada en esos procesos, aunque en nuestro estudio no encontramos diferencias con el grupo de niños sanos; sólo escasamente en la P300, en las semanas y en el peso, y la N100 únicamente en una localización en relación con el peso. Como esta colectividad de niños suele presentar trastornos del desarrollo, la utilización de potenciales evocados podría constituir una herramienta de gran utilidad para su detección y posterior terapia (AU)

Introduction. Bioelectrical behaviour was studied in a group of low birth weight children. Aim. To evaluate whether the characteristics of the waves of the brain potentials in these children, who weighed less than 1500 g at birth and experienced anomalous circumstances and events during their perinatal period, would help reach an early diagnosis of the possible developmental disorders they might suffer later on in life. Subjects and methods. Both visual and auditory cerebral evoked potentials were recorded in a group of children born underweight and the results were compared with the findings from another group of healthy children who were born in normal physiological conditions and were apparently free of any kind of pathology. Results. In the waves and locations that were examined, the problem group displayed latencies that were longer than those of the control group; in contrast, no statistically significant differences were found in the amplitude, regardless of the location. Low gestational age and lower weight made latencies longer, but no relationship was found between latencies and the other perinatal features that were studied. Conclusions. Children with low weight at birth have slower wave latencies than normal children. This slowing, which is inversely proportional to the weight and weeks of gestation, is considered to be an anomalo ussign that could be related to brain immaturity, delayed development or to disorders affecting myelination. Moreover, the amplitude, which has received far less attention from researchers, is usually shorter in these processes, although in our study we found no differences with the group of healthy children –only very slightly in the P300, in the weeks and the weight, and theN100 only in one location with respect to weight. Since these children usually have developmental disorders, the use of evoked potentials could (AU)

Evaluation of 3 different tests for the detection of stool antigens to confirm Helicobacter pylori eradication after treatment. A pilot study.

INTRODUCTION: Recently, several new diagnostic methods aimed to detect Helicobacter pylori stool antigens have been developed. Our aim was to evaluate the accuracy of 3 different stool tests to confirm H. pylori eradication. PATIENTS AND METHODS: Twenty-six patients received H. pylori eradication treatment. Eradication was confirmed with 13C-urea breath test 6-8 weeks later, when stool samples were analyzed by polyclonal (Premier-Platinum-HpSATM), monoclonal (Amplified-IDEIATM-HpStARTM), and rapid test (ImmunoCard-STAT-HpSATM). RESULTS: H. pylori was eradicated in 85% of the cases. Sensitivity, specificity, positive predictive value and negative predictive value with the polyclonal test were: 25%, 91%, 33% and 87%. Corresponding results with the monoclonal test, using the cut-off point recommended by the manufacturer, were 100%, 46%, 25% and 100%. However, the best cut-off point in our study had 100% sensitivity and 91% specificity. The area under ROC curve for the polyclonal and the monoclonal tests was 0.65 and 0.95. Diagnostic accuracy with the rapid test was 75%, 90%, 60% and 95%. CONCLUSION: Neither the polyclonal stool antigen test nor the rapid stool antigen test can be recommended to confirm H. pylori eradication after treatment. The monoclonal test has better diagnostic accuracy, although more studies are necessary to definitively recommend its use for the confirmation of H. pylori eradication success.

Evaluation of 3 different tests for the detection of stool antigens to confirm Helicobacter pylori eradication after treatment. A pilot study

Introducción: Recientemente se han desarrollado varios métodos diagnósticos nuevos dirigidos a la detección de antígenos de Helicobacter pylori en las heces. El objetivo de nuestro estudio ha sido la evaluación de la precisión de 3 pruebas distintas de detección de antígenos en heces para confirmar la erradicación de H. pylori. Pacientes y métodos: Se administró tratamiento de erradicación de H. pylori a 26 pacientes. La erradicación se confirmó 6-8 semanas después mediante la prueba de urea marcada con 13C en el aire espirado, con análisis de muestras de heces mediante una prueba policlonal (Premier-Platinum-HpSATM), una prueba monoclonal (Amplified-IDEIA®-HpStARTM) y una prueba rápida (ImmunoCard-STAT-HpSATM). Resultados: La erradicación de H. pylori se confirmó en el 85% de los casos. Los porcentajes correspondientes a la sensibilidad, la especificidad, el valor predictivo positivo y el valor predictivo negativo de la prueba policlonal fueron del 25, el 91, el 33 y el 87%. Los resultados correspondientes a la prueba monoclonal utilizando el umbral recomendado por el fabricante fueron del 100, el 46, el 25 y el 100%. No obstante, el mejor umbral considerado en nuestro estudio dio lugar a una sensibilidad del 100% y una especificidad del 95%. El área bajo la curva de rendimiento diagnóstico (receiver operating characteristics) respecto a las pruebas policlonal y monoclonal fue de 0,65 y 0,95, respectivamente. Los resultados correspondientes a la sensibilidad, la especificidad, el valor predictivo positivo y el valor predictivo negativo de la prueba rápida fueron del 75, el 90, el 60 y el 95%. Conclusión: Para la confirmación de la erradicación de H. pylori tras el tratamiento no se pueden recomendar la prueba policlonal ni la prueba rápida de detección de antígenos en heces. La prueba monoclonal muestra una precisión diagnóstica mayor, aunque son necesarios nuevos estudios para poder recomendar definitivamente su aplicación de cara a la confirmación de la erradicación de H. pylori

Introduction: Recently, several new diagnostic methods aimed to detect Helicobacter pylori stool antigens have been developed. Our aim was to evaluate the accuracy of 3 different stool tests to confirm H. pylori eradication. Patients and methods: Twenty-six patients received H. pylori eradication treatment. Eradication was confirmed with 13C-urea breath test 6-8 weeks later, when stool samples were analyzed by polyclonal (Premier-Platinum-HpSATM), monoclonal (Amplified-IDEIATM-HpStARTM), and rapid test (ImmunoCard-STAT-HpSATM). Results: H. pylori was eradicated in 85% of the cases. Sensitivity, specificity, positive predictive value and negative predictive value with the polyclonal test were: 25%, 91%, 33% and 87%. Corresponding results with the monoclonal test, using the cut-off point recommended by the manufacturer, were 100%, 46%, 25% and 100%. However, the best cut-off point in our study had 100% sensitivity and 91% specificity. The area under ROC curve for the polyclonal and the monoclonal tests was 0.65 and 0.95. Diagnostic accuracy with the rapid test was 75%, 90%, 60% and 95%. Conclusion: Neither the polyclonal stool antigen test nor the rapid stool antigen test can be recommended to confirm H. pylori eradication after treatment. The monoclonal test has better diagnostic accuracy, although more studies are necessary to definitively recommend its use for the confirmation of H. pylori eradication success

Maintenance of T1 response as induced during PEG-IFNalpha plus ribavirin therapy controls viral replication in genotype-1 patients with chronic hepatitis C.

OBJECTIVES: To analyze the T1/T2 cytokine profile in CD8 T cells from peripheral blood mononuclear cells from patients with genotype-1 CHC during treatment with pegylated interferon (Peg-IFN) alpha2a plus ribavirin (RBV). To correlate Th1/Th2 balance with virological response. PATIENTS AND METHODS: In this prospective longitudinal study, a total of 28 naïve genotype-1 CHC patients received Peg-IFNalpha2a (180 microg/week) plus RBV (1-1.2 g/day) for 48 weeks. All patients (mean age 45 +/- 8 years) completed treatment and follow-up: 12 (43%) achieved a sustained virological response (SVR), 13 relapsed after end of treatment (47%), and only 3 (10%) were non-responders. Sixteen healthy controls were also analyzed (mean age 39 +/- 17 years). The production of IL-4, IFNgamma, and TNFalpha by CD8 T cells was measured by intracytoplasmic detection using flow cytometry in both resting and stimulated cells with a phorbol ester. STATISTICS: Student's t test for independent values, chi2 test, and ANOVA test were used; relapsers and non-responders were joined to achieve a higher statistical power. RESULTS: At third month during treatment, phorbol ester-stimulated-IL-4 levels tend to be lower in patients who presented with SVR versus those who did not (0.97 vs 2.58; p = 0.1). No statistically significant differences were found in IFNgamma and TNFalpha levels at month 3. At EOT, the stimulated-IFNgamma production was significantly higher in patients with SVR (20 vs. 8; p < 0.05). Conversely, IL-4 production was higher in NR patients although these data did not reach statistical significance (p < 0.1). No significant differences were found in TNFalpha (14 vs. 7; p < 0.2). CONCLUSIONS: Cytokine T1 induced-response maintenance during combination treatment, measured as IFNgamma production by CD8+ T lymphocytes, is associated with SVR and suggests the replication control and later clearance of patients infected by genotype-1 HCV.

La respuesta inmune T1 inducida durante el tratamiento con PEG-IFNα m¨¢s ribavirina controla la replicaci¨®n viral en pacientes con hepatitis cr¨®nica C / Maintenance of T1 response as induced during PEG-IFNα plus ribavirin therapy controls viral replication in genotype-1 patients with chronic hepatitis C

Objetivos: analizar el perfil de citocinas T1/T2 producidaspor los linfocitos T CD8+ de sangre perif¨¦rica en pacientes conhepatitis cr¨®nica C (HCC) y genotipo 1 durante el tratamiento coninterfer¨®n pegilado (Peg-IFN) α2a y ribavirina (RBV) y compararloscon controles sanos. Correlacionar el balance T1/T2 con larespuesta virol¨®gica al tratamiento combinado.Pacientes y m¨¦todos: en este estudio prospectivo longitudinalse incluyeron 28 pacientes naïve con HCC genotipo 1 tratadoscon Peg-IFNα2a (180 µg/semana) m¨¢s RBV (1-1,2 g/d¨ªa) durante48 semanas. Los 28 pacientes (edad media 45 ¡À 8 años)finalizaron el tratamiento y seguimiento: 12 (43%) presentaronrespuesta viral sostenida (RVS), 13 recidivaron (47%) y s¨®lo 3 fueronno respondedores (10%). Se estudiaron 16 controles sanos(edad media de 39 ¡À 17 años). Se analiz¨® mediante citometr¨ªa deflujo la producci¨®n intracitopl¨¢smica de IL-4, IFNγ y TNFα por loslinfocitos T CD8+ en reposo y tras ser estimulados con un ¨¦sterde forbol. An¨¢lisis estad¨ªstico: t de Student, test de χ2 y ANOVA;se agrupan los pacientes recidivantes y no respondedores paraobtener mayor potencia estad¨ªstica.Resultados: no se encontraron diferencias significativas entrelos niveles de citocinas de controles sanos y pacientes conHCC. Al tercer mes de tratamiento, los niveles de IL-4 inducidostend¨ªan a ser menores en los pacientes que obtuvieron una RVSque en el resto de pacientes (0,97 vs. 2,58; p = 0,1); tampocose encontr¨® significaci¨®n estad¨ªstica en relaci¨®n a los niveles deIFNγ y de TNFα. Al final del tratamiento, la producci¨®n de IFNγestimulado fue significativamente mayor en los pacientes queobtuvieron una RVS (20 vs. 8; p < 0,05). Por el contrario, laproducci¨®n de IL-4 fue mayor en los pacientes no respondedores,aunque estos datos no alcanzaron significaci¨®n estad¨ªstica(p < 0,1). No se encontraron diferencias en relaci¨®n con los nivelesde TNFα (14 vs. 7; p < 0,2).Conclusiones: el mantenimiento de la respuesta inmune tipoT1 durante el tratamiento combinado, medida en funci¨®n de las¨ªntesis de IFNγ por los linfocitos T CD8, se asocia con RVS y sugiereel control de la replicaci¨®n y el aclaramiento posterior de lospacientes infectados con el genotipo 1 del VHC

Objectives: to analyze the T1/T2 cytokine profile in CD8 Tcells from peripheral blood mononuclear cells from patients withgenotype-1 CHC during treatment with pegylated interferon (Peg-IFN) α2a plus ribavirin (RBV). To correlate Th1/Th2 balance withvirological response.Patients and methods: in this prospective longitudinalstudy, a total of 28 naïve genotype-1 CHC patients received Peg-IFNα2a (180 µg/week) plus RBV (1-1.2 g/day) for 48 weeks. Allpatients (mean age 45 ¡À 8 years) completed treatment and followup:12 (43%) achieved a sustained virological response (SVR), 13relapsed after end of treatment (47%), and only 3 (10%) werenon-responders. Sixteen healthy controls were also analyzed(mean age 39 ¡À 17 years). The production of IL-4, IFNγ, andTNFα by CD8 T cells was measured by intracytoplasmic detectionusing flow cytometry in both resting and stimulated cells with aphorbol ester. Statistics: Student¡¯s t test for independent values, χ2test, and ANOVA test were used; relapsers and non-responderswere joined to achieve a higher statistical power.Results: at third month during treatment, phorbol ester-stimulated-IL-4 levels tend to be lower in patients who presented withSVR versus those who did not (0.97 vs 2.58; p = 0.1). No statisticallysignificant differences were found in IFNγ and TNFα levelsat month 3. At EOT, the stimulated-IFNγ production was significantlyhigher in patients with SVR (20 vs. 8; p < 0.05). Conversely,IL-4 production was higher in NR patients although these datadid not reach statistical significance (p < 0.1). No significant differenceswere found in TNFα (14 vs. 7; p < 0.2).Conclusions: Cytokine T1 induced-response maintenanceduring combination treatment, measured as IFNγ production byCD8+ T lymphocytes, is associated with SVR and suggests thereplication control and later clearance of patients infected bygenotype-1 HCV

A pilot study on the endoscopic surveillance of colorectal dysplasia and cancer in long-standing ulcerative colitis.

INTRODUCTION: Patients with ulcerative colitis (UC) have a greater risk of developing colorectal cancer (CRC) when compared to the general population. Epithelial dysplasia comes before this neoplasm, and thus endoscopic surveillance is recommended to these patients. This pilot study aims at establishing the incidence of dysplasia and CRC in patients with long-standing UC in our hospital. MATERIAL AND METHODS: This is a prospective observational study performed in patients with a definite diagnosis of UC for more than 8 years. These patients were encouraged to enroll in an endoscopic surveillance program for CRC. All patients underwent colonoscopy and multiple biopsies every 18 to 24 months in order to detect epithelial dysplasia. RESULTS: Thirty-nine patients were included from January 1994 to December 2003. Half of them were males. Mean age was 52 +/- 13 years. Mean duration of UC was 15 +/- 8 years. Thirteen (35%) patients had left colitis, and 26 (65%) had pancolitis or extensive colitis. The presence of mild dysplasia was detected in four patients, on two occasions in one of them (13%; 95% CI: 6.1-33.5); the incidence of mild dysplasia was 1.3% patients per surveillance year. No severe dysplasia or CRCs were identified. CONCLUSION: The incidence of dysplasia in our area is lower than expected, and does not support surveillance programs for these patients. However, no definite conclusions may be drawn from such a small number of patients.

Estudio piloto sobre la vigilancia endoscópica de la displasia y del cáncer colorrectal en la colitis ulcerosa de larga evolución / A pilot study on the endoscopic surveillance of colorectal dysplasia and cancer in long-standing ulcerative colitis

Introducción: los pacientes con colitis ulcerosa (CU) tienen un mayor riesgo de desarrollar cáncer colorrectal (CCR) que la población general. La displasia epitelial precede a esta neoplasia por lo que se recomienda la vigilancia endoscópica de estos pacientes Este estudio piloto pretende determinar la incidencia de la displasia y del CCR en pacientes con CU de larga evolución en nuestro hospital. Material y métodos: estudio prospectivo y observacional en pacientes con el diagnóstico firme de CU de más de 8 años de evolución a los que se propuso entrar en un programa de vigilancia endoscópica del CCR. A todos los enfermos se les sometió cada 18/24 meses a una colonoscopia con múltiples biopsias para detectar displasias epiteliales. Resultados: se incluyeron 39 pacientes desde enero de 1994 hasta diciembre de 2003. La mitad de ellos eran varones. La edad media fue de 52 años (±13 años). La duración media de la CU fue de 15 ± 8 años. Trece (35%) enfermos sufrían una colitis izquierda y 26 (65%) una pancolitis o colitis extensa. Se detectó la presencia de displasia leve en 4 pacientes, en uno de ellos en dos ocasiones (13%, IC 95%: 6,1-33,5), la incidencia de displasia leve fue de 1,3% pacientes por año de vigilancia. No se detectaron displasiasgraves ni CCRs. Conclusión: la incidencia de displasia en nuestra área es menor que la esperada y no sustenta los programas de vigilancia en estos enfermos. Aunque por el pequeño número de pacientes no se pueden sacar conclusiones firmes

Introduction: patients with ulcerative colitis (UC) have a greater risk of developing colorectal cancer (CRC) when comparedto the general population. Epithelial dysplasia comes before this neoplasm, and thus endoscopic surveillance is recommendedto these patients. This pilot study aims at establishing the incidence of dysplasia and CRC in patients with long-standing UC inour hospital. Material and methods: this is a prospective observational study performed in patients with a definite diagnosis of UC for more than 8 years. These patients were encouraged to enroll in an endoscopic surveillance program for CRC. All patients underwent colonoscopy and multiple biopsies every 18 to 24 months in order to detect epithelial dysplasia. Results: thirty-nine patients were included from January 1994 to December 2003. Half of them were males. Mean age was 52 ± 13 years. Mean duration of UC was 15 ± 8 years. Thirteen (35%) patients had left colitis, and 26 (65%) had pancolitis or extensive colitis. The presence of mild dysplasia was detected in four patients, on two occasions in one of them (13%; 95% CI: 6.1-33.5); the incidence of mild dysplasia was 1.3% patients per surveillance year. No severe dysplasia or CRCs were identified. Conclusion: the incidence of dysplasia in our area is lower than expected, and does not support surveillance programs for these patients. However, no definite conclusions may be drawn from such a small number of patients

[A study of evoked potentials in the brains of very low birth weight infants]. / Estudio de potenciales evocados cerebrales en niños de muy bajo peso al nacimiento.

INTRODUCTION: This work studies the behaviour of the N200 and P300 waves of the brain evoked potentials (BEP) in a group of very low birth weight infants and results are compared with a second group of children whose weight was normal at birth. AIMS: The objective of this study was to determine whether the N200 and, more especially, the P300 waves in children under the age of 3 could be used to assess the development and prognosis of their disorders. PATIENTS AND METHODS: BEP were performed in very low birth weight infants (taken as the test group) and in others whose weight at birth was normal (control group); the difference in ages when the potentials were recorded was not statistically significant. RESULTS: The EEG index was evaluated for both the test and the control group, and a difference was found with a significance of p < 0.001. Latency, in milliseconds, of the N200 wave and the P300 wave was recorded at the same sites for the test and control groups and showed differences with a significance of p < 0.001. CONCLUSIONS: The findings from the EEG and the latencies of the N200 and P300 waves in the BEP of very low birth weight infants are pathological and are linked to immaturity of the brain, which is characteristic of this population. This tool could help to detect developmental disorders and to facilitate a better approach to attending these children.

Estudio de potenciales evocados cerebrales en niños de muy bajo peso al nacimiento / A study of evoked potentials in the brains of very low birth weight infants

Introducción. Se estudia el comportamiento de las ondas N200 y P300 de los potenciales evocados cerebrales (PEC) de un grupo de niños nacidos con muy bajo peso y se compara con otro de nacidos normales. Objetivos. Comprobar si la latencia de las ondas N200 y, sobre todo, de la P300, en niños mayores de 3 años, que nacieron con pesos muy bajos, podrían servir para valorar el desarrollo y el pronóstico de sus alteraciones. Pacientes y métodos. Se realizaron PEC en niños nacidos con muy bajo peso como grupo probando y en otros cuyo peso al nacer fue normal, cuya diferencia de edad en el momento de realizar los potenciales no era estadísticamente significativa. Resultados. Se evaluó el índice electroencefalográfico, tanto para el grupo probando como para el testigo, y se obtuvo una diferencia con una significación de p < 0,001. La latencia, en milisegundos de la onda N200 y de la onda P300 tomadas en las mismas localizaciones para el grupo testigo y para el grupo probando, demuestran diferencias con una significación de p < 0,001. Conclusiones. Los hallazgos encontrados en el electroencefalograma y las latencias de las ondas N200 y P300 de los PEC de los niños de muy bajo peso al nacimiento son patológicos y se relacionan con la inmadurez cerebral, propia de esta población. Esta herramienta podría ayudar para detectar trastornos del desarrollo, y facilitar un mejor tratamiento a la atención de estos niños (AU)

Introduction. This work studies the behaviour of the N200 and P300 waves of the brain evoked potentials (BEP) in a group of very low birth weight infants and results are compared with a second group of children whose weight was normal at birth. Aims. The objective of this study was to determine whether the N200 and, more especially, the P300 waves in children under the age of 3 could be used to assess the development and prognosis of their disorders. Patients and methods. BEP were performed in very low birth weight infants (taken as the test group) and in others whose weight at birth was normal (control group); the difference in ages when the potentials were recorded was not statistically significant. Results. The EEG index was evaluated for both the test and the control group, and a difference was found with a significance of p < 0.001. Latency, in milliseconds, of the N200 wave and the P300 wave was recorded at the same sites for the test and control groups and showed differences with a significance of p < 0.001. Conclusions. The findings from the EEG and the latencies of the N200 and P300 waves in the BEP of very low birth weight infants are pathological and are linked to immaturity of the brain, which is characteristic of this population. This tool could help to detect developmental disorders and to facilitate a better approach to attending these children (AU)

Evaluation of three different tests for the detection of stool antigens to diagnose Helicobacter pylori infection in patients with upper gastrointestinal bleeding.

AIM: To evaluate the accuracy of several methods aimed to detect Helicobacter pylori stool antigens in patients with upper gastrointestinal bleeding. METHODS: Thirty-four patients with upper gastrointestinal bleeding because of peptic ulcer were included. The first stool sample during hospitalization was collected, and stool antigens were determined with: polyclonal enzyme-linked immunosorbent assay (Premier-Platinum-HpSA); monoclonal enzyme-linked immunosorbent assay (Amplified-IDEIA-HpStAR); and rapid monoclonal immunochromatographic test (ImmunoCard-STAT HpSA). A patient was considered infected when H. pylori was diagnosed with invasive tests (rapid urease test or histology) or with (13)C-urea breath test. When all tests were negative, a new breath test was repeated after stopping proton pump inhibitors. RESULTS: All patients were infected and, therefore, only sensitivity of the tests could be calculated: polyclonal enzyme-linked immunosorbent assay (74%), monoclonal enzyme-linked immunosorbent assay (94%), and rapid monoclonal immunochromatographic test (60%; concordance between the two observers was high, kappa = 0.9). Neither the presence of maelena nor the delay in obtaining stool samples explained false negatives. CONCLUSIONS: Neither the polyclonal enzyme-linked immunosorbent assay stool antigen test nor the rapid immunochromatographic stool antigen test can be recommended to diagnose H. pylori infection in patients with upper gastrointestinal bleeding. However, the monoclonal enzyme-linked immunosorbent assay stool antigen test is highly sensitive for detecting the infection in patients with this complication, although more studies are necessary to evaluate the specificity of the method.

Prolapsed hyperplastic gastric polyp causing pancreatitis: case report.

A huge hyperplastic gastric polyp prolapsed into the duodenum. The compression and obstruction of the ampulla of Vater by this polyp caused acute pancreatitis. An overview of imaging findings, general considerations about hyperplastic gastric polyps, and a review of the literature are provided.