[Study of gastronitestinal transit times with capsule endoscopy]. / Estudio de los tiempos de tránsito gastrointestinal con cápsula endoscópica.

INTRODUCTION: Until the introduction of capsule endoscopy (CE), studies of gastrointestinal transit times were based on indirect data or data obtained with radiographic techniques. We analyzed gastric and intestinal transit times through the images obtained with EC and evaluated the influence of age, sex, body mass index (BMI) and abdominal perimeter on these times. PATIENTS AND METHOD: Of the total number of procedures performed over one year, we reviewed 89 in which CE reached the blind gut. Transit times through the pylorus and the ileocecal valve, as well as a series of clinical and epidemiological characteristics of the patients, were recorded. RESULTS: The mean age of the patients was 59.2 years with a mean BMI of 25.5. Gastric transit times ranged from 0.7 to 171 min (mean 22.6) while small intestine transit times ranged from 91 to 416 min (mean 283.3). No significant associations were found between gastric and intestinal transit times with age, sex, BMI, or abdominal perimeter. A significant negative correlation (p < 0.05) was found between transit time of CE through the stomach with respect to the time taken between the pylorus and the cecal pole. CONCLUSION: CE is a good method to study gastrointestinal transit times directly and could lead to greater knowledge of the pathogenesis of various gastrointestinal entities. Age, sex and nutritional status do not seem to influence intestinal kinetics. In contrast, longer or shorter gastric emptying times have an inverse effect on the transit of CE through the small intestine.

Estudio de los tiempos de tránsito gastrointestinal con cápsula endoscópica / Study of gastronitestinal transit times with capsule endoscopy

Introducción: Hasta la llegada de la cápsula endoscópica (CE), los estudios sobre tiempos de tránsito gastrointestinal se basaban en datos indirectos u obtenidos con técnicas irradiantes. Hemos analizado la duración de los tránsitos gástricos e intestinales a través de las imágenes obtenidas con la CE y valorado la influencia que sobre ellos tienen la edad, el sexo, el índice de masa corporal (IMC) y el perímetro abdominal. Pacientes y método: Revisamos las 89 exploraciones en las que la CE llegó al ciego del total de pruebas realizadas durante un año. Se recogieron los tiempos de paso por el píloro y la válvula ileocecal, así como una serie de características clinicoepidemiológicas de los pacientes. Resultados: La edad media de los pacientes fue de 59,2 años, con un IMC medio de 25,5. Los períodos de vaciamiento gástrico variaron de 0,7 a 171 min (media de 22,6), situándose los del intestino delgado entre 91 y 416 min (media de 283,3). No había relación significativa entre ninguno de ambos tiempos con la edad, el sexo, el IMC ni la cintura. Se evidenció interrelación negativa significativa (p < 0,05) entre la duración del tránsito de la CE por el estómago respecto a lo que tardó en recorrer la distancia entre el píloro y polo cecal. Conclusión: La CE puede constituir un buen método para el estudio de los tiempos de tránsito gastrointestinal de una manera directa. Su conocimiento podría suponer avances en el campo de la etiopatogenia de diversas entidades digestivas. La edad, el sexo o el estado nutricional no parecen influir en la cinética intestinal. Por otra parte, la mayor o menor duración del vaciamiento gástrico sí determina de forma inversa el recorrido de la CE por el intestino delgado

Introduction: Until the introduction of capsule endoscopy (CE), studies of gastrointestinal transit times were based on indirect data or data obtained with radiographic techniques. We analyzed gastric and intestinal transit times through the images obtained with EC and evaluated the influence of age, sex, body mass index (BMI) and abdominal perimeter on these times. Patients and method: Of the total number of procedures performed over one year, we reviewed 89 in which CE reached the blind gut. Transit times through the pylorus and the ileocecal valve, as well as a series of clinical and epidemiological characteristics of the patients, were recorded. Results: The mean age of the patients was 59.2 years with a mean BMI of 25.5. Gastric transit times ranged from 0.7 to 171 min (mean 22.6) while small intestine transit times ranged from 91 to 416 min (mean 283.3). No significant associations were found between gastric and intestinal transit times with age, sex, BMI, or abdominal perimeter. A significant negative correlation (p < 0.05) was found between transit time of CE through the stomach with respect to the time taken between the pylorus and the cecal pole. Conclusion: CE is a good method to study gastrointestinal transit times directly and could lead to greater knowledge of the pathogenesis of various gastrointestinal entities. Age, sex and nutritional status do not seem to influence intestinal kinetics. In contrast, longer or shorter gastric emptying times have an inverse effect on the transit of CE through the small intestine

Sobrecarga de hierro y genotipo 3 se asocian a la presencia de esteatosis en la hepatitis C / No disponible

Objetivo: determinar los factores epidemiológicos, analíticos, virológicos e histológicos a los que se asocia la esteatosis en la hepatitis C. Pacientes: se revisaron de forma retrospectiva 53 historias clínicas de pacientes biopsiados consecutivamente desde junio de 2000 a diciembre de 2002. Se excluyeron pacientes con otros virus. Se revisaron las biopsias hepáticas de forma protocolizada. Se obtuvieron los datos epidemiológicos, analíticos y virológicos. La talla y el peso de los pacientes se recogieron en el momento de la biopsia hepática. Se estudió la asociación estadística de las variables cualitativas y cuantitativas con la presencia de esteatosis y se realizó un análisis multivariante. Resultados: se identificó esteatosis en el 52% de las biopsias. No hubo asociación estadísticamente significativa con edad, sexo, vía de contagio, tiempo de evolución, ingesta de alcohol, presencia de enfermedades asociadas, índice de masa corporal, glucosa, triglicéridos, colesterol, AST, ALT, GGT, FA, bilirrubina, carga viral. Se asoció a mayor sideremia, IST y ferritina. Se demostró asociación con el genotipo 3. La esteatosis se asoció a necrosis piecemeal, degeneración hepatocelular, hiperplasia de células de Kupffer, hierro hepático y fibrosis portal. El hierro hepático, la hiperplasia de las células de Kupffer y el genotipo 3 se asociaron de manera independiente a la esteatosis hepática. Conclusiones: la esteatosis en la hepatitis C se asocia a la infección por genotipo 3, a la hiperplasia de las células de Kupffer y a sobrecarga de hierro. También se asocia a mayor inflamación y fibrosis por lo que debe ser considerada factor agravante (AU)

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[Colonic polyps: dysplasia predictive factors]. / Pólipos de colon: factores predictivos de displasia.

OBJECTIVE: Analyze the presence of dysplasia in colonoscopy visualized colonic polyps, and the predictive factors for high grade dysplasia. MATERIAL AND METHODS: We studied the polyps observed in the colonoscopies carried out during the year 2001. Colonoscopies carried out in 2,144 patients were analyzed, with demonstration of polyps in 326 patients (average age: 67 12,6 years, 63,5% males). 732 polyps were analyzed, with average of 2.27 2 polyps by patient. RESULTS: 72% polyps were located distally to splenic flexure, and sigmoid colon was the most frequent location (34.7%). Most of the polyps (86%) were sessile. Only 3% were > 2 cm, and the majority (88%) was < 1 cm. The most prevalent histological type was tubular adenoma (36%). Dysplasia was observed in 42.2% (low grade in 40% and high grade in 2.2%) Size > 1 cm and location proximal to splenic flexure were the only variables with indendent significant association to high grade dysplasia. CONCLUSIONS: The presence of high grade dysplasia in the colonic polyps was related in our cohort both to the location of the polyps in the colon and to its size, so that greater risk was for proximal polyps and for polyps > 1 cm.

Iron overload and genotype 3 are associated with liver steatosis in chronic hepatitis C.

OBJECTIVE: To determine epidemiological, biochemical, virological, and histological factors associated with liver steatosis in chronic hepatitis C. SUBJECTS: The medical histories of 53 patients biopsied for chronic hepatitis C diagnosis between June 2000 and December 2002 were retrospectively studied. Epidemiological, biochemical, and virological data were collected. Patients with hepatitis B virus or human immunodeficiency virus coinfection were excluded. Liver biopsy specimens were reviewed and scored by one pathologist. Weight and height were measured at liver biopsy time. The statistic association between qualitative and quantitative variables and the presence of liver steatosis was studied. RESULTS: Steatosis was identified in 52% of biopsies. There was no statistic association with age, sex, method of transmission, duration of infection, alcohol consumption, other diseases, body mass index, glucose, triglycerides, cholesterol, AST, ALT, GGT, alkaline phosphatase, bilirubin, or viral load. Liver steatosis was associated with serum iron, transferrin saturation, and ferritin. Genotype 3 was also associated with steatosis. Piecemeal necrosis, hepatocellular injury, Kupffer cell hyperplasia, liver iron, and portal fibrosis were also associated with steatosis. A multivariate analysis showed that genotype 3, Kupffer cell hyperplasia, and liver iron were associated with the presence of steatosis. CONCLUSIONS: Liver steatosis in chronic hepatitis C associates with genotype 3, Kupffer cell hyperplasia, and iron overload. Hepatic steatosis also associates with greater inflammation and fibrosis, and must be considered to contribute to disease progression.

Triple píloro o doble fístula antroduodenal / Triple pylorus or double antroduodenal fistula

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[Colonic balantidiasis]. / Balantidiasis cólica.

Balantidium coli is a Protozoa that is not usually pathogenic in man, although epidemics have been described in tropical areas. It mainly affects the colon and clinical presentation varies from asymptomatic forms to severe dysenteric syndromes. We present a case of endoscopically diagnosed colonic balantidiasis and review the most important characteristics of this parasite-induced disease.