ABSTRACT
BACKGROUND: In recent years, several studies have shown that the age of the donor may be related to an increase in the occurrence of biliary complications (BCs), which remain the main cause of morbidity after liver transplantation. This study analyzed the type and management of these BCs, the impact of BCs on graft and patient survival rates, and the influence of some characteristics of donors and recipients on BC appearance in patients transplanted with donors 75 years of age or older. PATIENTS AND METHODS: From 2003 to 2016, 100 liver transplantations with donors 75 years of age or older (15.6%) were performed in our hospital. The data were compared with a control group of 400 patients with younger donors (case-control 1:4 per chronology). RESULTS: The BC rate in the group of patients transplanted with organs from elderly donors was 18%, compared to 21.5% in the control group. Specifically, in the immediate post-transplantation period, 14% of the elderly donor group and 13.8% of the control group presented some BCs, with no statistically significant differences in the incidence, type, and treatment of BCs between the two groups. The occurrence of BCs was not a factor associated with graft and patient survival rates. In the global population, donor death by cerebral vascular accident and male donors have influenced the occurrence of BCs. CONCLUSIONS: The advanced age of the donor has not influenced BC rates after transplantation.
Subject(s)
Liver Transplantation/methods , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Tissue Donors , Age Factors , Aged , Case-Control Studies , Female , Graft Survival , Humans , Liver Transplantation/mortality , Male , Middle Aged , Retrospective StudiesABSTRACT
Budd-Chiari syndrome can be defined as an interruption or diminution of the normal blood flow out of the liver. Patients with Budd-Chiari syndrome present with varying degrees of symptomatology that can be divided into the following categories: fulminant, acute, subacute and chronic. The subacute form is the most common presentation. A majority of patients with Budd-Chiari syndrome have an underlying hypercoagulability state. We present the case of a young woman with Crohn s disease on oral contraceptives who developed bilateral pulmonary thromboembolism and Budd-Chiari syndrome.
Subject(s)
Budd-Chiari Syndrome/complications , Contraceptives, Oral/adverse effects , Crohn Disease/complications , Ethinyl Estradiol/adverse effects , Pulmonary Embolism/chemically induced , Adult , Budd-Chiari Syndrome/diagnostic imaging , Colonoscopy , Crohn Disease/diagnosis , Crohn Disease/diagnostic imaging , Female , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/drug therapy , Radiography, Abdominal , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
OBJECTIVE: To analyze the clinical characteristics, treatment, and follow-up of a cohort of 29 patients with Wilson's disease (WD) within the region of Murcia. PATIENTS AND METHOD: We reviewed the medical records of 29 cases of WD (mean age, 20.3 +/- 13.4 years) diagnosed during the last 16 years. RESULTS: The most frequent reason for consultation was upon discovering a high transaminase level in almost half the patients, followed by tremors or dystonia in 17% of patients, respectively. A Kayser-Fleischer ring was observed in 17/29 (58.6%) of patients (100% of patients with pure neurological involvement and 35% of patients with pure clinical hepatic disease; p < 0.001). Blood copper levels not associated with ceruloplasmin as well as cupruria were notably superior in patients with neurological symptoms and in those with liver cirrhosis at the time of diagnosis. Patient clinical symptoms remained stable with D-penicillamine or trientine, or improved during the observation period, for 18 out of 29 patients (62%), while 11 out of 29 patients (38%) got worse. CONCLUSIONS: In our region patients with WD are diagnosed at a younger age, and in most cases for hepatic disease. Patients with neurological disease or liver cirrhosis had a high level of free copper not associated to ceruloplasmin and cupruria. The disease had a favorable evolution in all patients but those diagnosed with hepatic disease or advanced neurological disease.
Subject(s)
Hepatolenticular Degeneration/diagnosis , Hepatolenticular Degeneration/therapy , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , Time Factors , Young AdultSubject(s)
Cellulitis/etiology , Liver Cirrhosis, Alcoholic/complications , Fatal Outcome , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Cellulite/etiology , Liver Cirrhosis, Alcoholic/complications , Fatal OutcomeABSTRACT
BACKGROUND: fibre is effective in some types of constipation. Our objective was to determine if the administration of an enriched dairy preparation with a supplement of soluble fibre (Naturfibra) [inulin and digestion resistant maltodextrin (Fibersol 2)], improves primary chronic constipation. METHODS: Prospective, randomized, double blind clinical trial randomized with dietary intervention in 32 subjects with constipation according to the Rome II criteria. Thirty two subjects (men 4; women 28) with an average age of 47 +/- 15 years were randomly divided in two homogeneous groups. A type of milk (A or B) was assigned to each group. Group A received fibre enriched semi-skimmed milk; Group B received semi skimmed milk. The subjects drank half a litre of milk per day during 20 days, meaning that those who drank the enriched milk ingested 20 grams of fibre a day. RESULTS: The subjects that presented straining at defecation (p < 0.001), sensation of incomplete evacuation (p < 0.001), sensation of obstruction in the evacuation (p < 0.001) and days between bowel movements, diminished significantly after the intake of milk supplemented with fibre. CONCLUSION: The intake of a dairy preparation with a supplement of fibre containing 20 grams of soluble fibre (inulin and digestion resistant maltodextrin), improves the situation of idiopathic primary chronic constipation based on the Rome II criteria.
Subject(s)
Constipation/diet therapy , Dietary Fiber/therapeutic use , Food, Fortified , Milk , Adult , Analysis of Variance , Animals , Chronic Disease , Constipation/diagnosis , Dietary Fiber/administration & dosage , Double-Blind Method , Energy Intake , Female , Humans , Male , Middle Aged , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
Objetivo: Determinar si la administración de un preparado lácteo enriquecido con un suplemento de fibra soluble (Naturfibra)®[inulina y maltodextrina resistente a la digestión (Fibersol 2®)], afecta a la sintomatología en el estreñimiento crónico primario idiopático. Ámbito: Sujetos de ambos sexos con estreñimiento según los criterios de Roma II. Sujetos: Se trata de un ensayo clínico doble ciego aleatorizado de intervención dietética realizado en 32 individuos con estreñimiento de ambos sexos (hombres 4; mujeres 28) y con una edad media de 47 ± 15 años. Los 32 individuos que formaban la muestra, se dividieron al azar en dos grupos homogéneos. Intervenciones: A cada grupo se le asignó un tipo de leche (A o B), una de ellas era leche semidesnatada enriquecida con fibra (A) y la otra leche semidesnatada (B). Los sujetos tomaron medio litro de leche diario durante 20 días, lo que supone que aquellos que tomaron la leche enriquecida ingirieron 20 gramos de fibra al día. Resultados: Los individuos que presentaban esfuerzo deposicional (p < 0,001), sensación de evacuación incompleta (p < 0,001), sensación de obstrucción en la evacuación (p < 0,001) y número de días entre deposiciones, disminuyeron significativamente tras la ingesta de leche con fibra. Conclusiones: La ingesta de un preparado lácteo con un suplemento de fibra que contiene 20 gramos de fibra soluble (inulina y maltodextrina resistente a la digestión), mejora la situación de estreñimiento crónico primario idiopático en base a los criterios de Roma II (AU)
Background: fibre is effective in some types of constipation. Our objective was to determine if the administration of an enriched dairy preparation with a supplement of soluble fibre (Naturfibra)® [inulin and digestion resistant maltodextrin (Fibersol 2®)], improves primary chronic constipation. Methods: Prospective, randomized, double blind clinical trial randomized with dietary intervention in 32 subjects with constipation according to the Rome II criteria. Thirty two subjects (men 4; women 28) with an average age of 47 ± 15 years were randomly divided in two homogeneous groups. A type of milk (A or B) was assigned to each group. Group A received fibre enriched semi-skimmed milk; Group B received semi skimmed milk. The subjects drank half a litre of milk per day during 20 days, meaning that those who drank the enriched milk ingested 20 grams of fibre a day. Result: The subjects that presented straining at defecation (p < 0,001), sensation of incomplete evacuation (p < 0,001), sensation of obstruction in the evacuation (p < 0,001) and days between bowel movements, diminished significantly after the intake of milk supplemented with fibre. Conclusion: The intake of a dairy preparation with a supplement of fibre containing 20 grams of soluble fibre (inulin and digestion resistant maltodextrin), improves the situation of idiopathic primary chronic constipation based on the Rome II criteria (AU)
Subject(s)
Humans , Male , Female , Constipation/diet therapy , Dietary Fiber/administration & dosage , Inulin/administration & dosage , Probiotics/administration & dosage , Polymers/therapeutic use , Milk , Nutrition SurveysABSTRACT
The small bowel leiomyosarcoma is a infrequent tumour in the clinical practice. We report the case of a 50 year old male admitted to the hospital on two occasions for gastrointestinal bleeding. On the second occasion a push enteroscopy located in jejunum a tumour. The pathologic diagnosis was a low grade jejunal leiomyosarcoma. The patient required a surgical intervention with resection of the affected portion of the jejunum.
Subject(s)
Gastrointestinal Hemorrhage/etiology , Jejunal Neoplasms/complications , Leiomyosarcoma/complications , Humans , Male , Middle AgedABSTRACT
El leiomiosarcoma de intestino delgado es un tumor infrecuente en la práctica clínica. Presentamos el caso de un hombre de 50 años que ingresó en el hospital en dos ocasiones por hemorragia digestiva. En el segundo ingreso una enteroscopia permitió localizar en yeyuno un tumor. El diagnóstico anatomopatológico fue de un leiomiosarcoma de yeyuno de bajo grado. El paciente precisó cirugía con resección de la porción de yeyuno afectada
The small bowel leiomiosarcoma is a infrequent tumour in the clinical practice.We report the case of a 50 year old male admitted to the hospital on two occasions for gastrointestinal bleeding. On the second ocassion a push enteroscopy located in jejunum a tumour. The pathologic diagnosis was a low grade jejunal leiomyosarcoma. The patient required a surgical intervention with resection of the affected portion of the jejunum
Subject(s)
Male , Middle Aged , Humans , Gastrointestinal Hemorrhage/etiology , Intestinal Neoplasms/pathology , Intestine, Small/pathology , Leiomyosarcoma/pathology , Endoscopy, GastrointestinalSubject(s)
Common Bile Duct Neoplasms/complications , Jaundice, Obstructive/etiology , Aged , Humans , MaleABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Jaundice, Obstructive/etiology , Common Bile Duct Neoplasms/complicationsABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Polyps , Deglutition Disorders , Deglutition Disorders , Esophageal NeoplasmsABSTRACT
Thromboembolic episode is a well known extraintestinal manifestation of inflammatory bowel disease, but it is a clinical rare complication. Histological and hematological studies suggest that a hypercoagulable state is involved in the pathogenesis of inflammatory bowel disease. However, the exact mechanism of hypercoagulability is still unknown. During the acute recurrences there is an increase of factor VIII, fibrinogen, platelet, factor V and decrease of antithrombin III. Hematologic disorders seem markedly correlated with the activity of the disease. We report on two patients with Inflammatory bowel disease and hypercoagulable state. We review the literature and discuss about the pathogenic mechanisms of such complication.
Subject(s)
Arteriosclerosis/complications , Brain Ischemia/etiology , Colitis, Ulcerative/complications , Crohn Disease/complications , Thrombophilia/etiology , Thrombosis/etiology , Adult , Colitis, Ulcerative/blood , Crohn Disease/blood , Female , HumansABSTRACT
Los fenómenos tromboembólicos son una manifestación extraintestinal bien conocida de la enfermedad inflamatoria intestinal, pero rara en la practica clínica. Estudios histológicos y hematológicos sugieren que el síndrome de hipercoagulabilidad presente en esta enfermedad está involucrado en la patogénesis de la enfermedad inflamatoria intestinal. De todas maneras el mecanismo exacto de hipercoagulabilidad aún no es bien conocido. Durante la fase de actividad de la enfermedad hay un aumento de los niveles de factor VIII, fibrinógeno, plaquetas, Factor V y un descenso en los niveles de antitrombina III. Hay una correlación clara entre estas alteraciones hematológicas y la actividad de la enfermedad. Presentamos dos pacientes con enfermedad inflamatoria intestinal y síndrome de hipercoagulabilidad. Se revisa la literatura y se comentan los mecanismos patogénicos (AU)
