Assuntos
Doenças Retais/etiologia , Úlcera/etiologia , Adulto , Algoritmos , Constipação Intestinal/complicações , Constipação Intestinal/terapia , Defecação , Feminino , Motilidade Gastrointestinal , Humanos , Isquemia/complicações , Masculino , Proctite/complicações , Proctite/microbiologia , Doenças Retais/diagnóstico , Doenças Retais/fisiopatologia , Doenças Retais/terapia , Prolapso Retal/complicações , Prolapso Retal/cirurgia , Reto/irrigação sanguínea , Úlcera/diagnóstico , Úlcera/fisiopatologia , Úlcera/terapiaRESUMO
Hepatocellular carcinoma develops in more of 90% of patients in the setting of cirrhosis. The increasing prevalence seems related with the wide-spread distribution of hepatitis C virus infection, as 80% of cases arise on chronic infection caused by this agent. Either conventional resection or orthotopic liver transplantation are often curative but suitable for few patients, If the surgical approach is not adequate, percutaneous ablation using ethanol injection or radiofrequency current may be considered. However, only 15-20% of patients can benefit from these therapies. Chemoembolization is considered when the previous options are contra-indicated but benefits on survival are still a matter of debate. The impact of new agents as tamoxifen, interferon o diverse chemotherapies on both survival and symptoms also remains to be stablished.
Assuntos
Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Carcinoma Hepatocelular/patologia , Ensaios Clínicos como Assunto , Humanos , Neoplasias Hepáticas/patologiaAssuntos
Colite/tratamento farmacológico , Colite/etiologia , Fármacos Gastrointestinais/uso terapêutico , Lesões por Radiação/tratamento farmacológico , Sucralfato/uso terapêutico , Enema , Feminino , Fármacos Gastrointestinais/administração & dosagem , Neoplasias dos Genitais Femininos/complicações , Neoplasias dos Genitais Femininos/radioterapia , Humanos , Pessoa de Meia-Idade , Radioterapia/efeitos adversos , Sucralfato/administração & dosagemRESUMO
UNLABELLED: To establish the influence of nonsteroidal anti-inflammatory drugs (NSAIDs) on the clinical course of upper gastrointestinal bleeding (UGIB), we designed a longitudinal cohort study to assess the effect of prior use of these drugs on several outcome variables in patients with UGIB. RESULTS: 164 (46.6%) of 352 patients with UGIB consumed NSAIDs in the week previous to the onset of bleeding. This group had significantly fewer previous episodes of peptic ulcer and UGIB (p < 0.01), more associated comorbidity, and increased use of steroids (p < 0.05). On endoscopic examination, gastric ulcer was the most frequent lesion in patients with NSAIDs as compared to duodenal ulcer in patients without NSAID use (p < 0.0001). There were no differences in the multivariate analysis between groups regarding lowest hemoglobin level, need for transfusion, stability of bleeding, surgical or endoscopic management, depth of lesions and hospital stay. CONCLUSIONS: a relevant proportion of patients admitted for UGIB had used NSAIDs during the previous week. The most frequent lesion in this group was gastric ulcer. In our study the clinical course of NSAID-associated UGIB was similar to that in other nonvariceal types of bleeding.
