Optimisation in the multidisciplinary approach to patients with hepatitis C in the era of direct-acting antivirals. / Optimización en el abordaje multidisciplinar del paciente con hepatitis C en la era de los antivirales de acción directa.

The advents of current direct-acting antiviral treatments has revolutionised the therapeutic approach to hepatitis C, increasing cure rates to above 90% and substantially simplifying treatment, which translates into benefits for patients, clinicians and the health system. These new drugs allow cure to be achieved, irrespective of the patient's characteristics, with tolerability similar to that of placebo and few drug reactions with concomitant medication. This in turn improves patients' quality of life and wellbeing. Moreover, these drugs allow multidisciplinary optimisation of the approach to patients with hepatitis C, thus reducing both short- and long-term costs. All these factors facilitate treatment universality, with treatments that are less influenced by specific factors and that allow better results to be obtained in a larger number of patients. Elimination of hepatitis C is now a real possibility. Supplement information: This article is part of a supplement entitled "The value of simplicity in hepatitis C treatment", which is sponsored by Gilead. © 2019 Elsevier España, S.L.U. All rights reserved.

[Transrectal ultrasonography in the preoperative staging of rectal adenocarcinoma. Cross-sectional study 1991-1994]. / Ultrasonido transrectal en la estadificación preoperatoria del adenocarcinoma de recto. Estudio transversal 1991-1994.

Preoperative evaluation of the depth of invasion in the rectal wall as well as the presence of regional metastatic nodes are considered important factors in order to decide surgical treatment as well as prognosis in cases of cancer of the rectum. This investigation was carried out in order to establish how usefull transrectal ultrasound was for the pre-operative evaluation of cancer of the rectum. We studied 78 patients with different ano rectal pathology, among them 40 patients with confirmed ADC of the rectum that were completely studied and had ultra sonographic as well as surgical and pathological staging using TNM classification. Confiability indicators of transrectal ultrasound when compared with pathology findings, showed a sensibility of 100% in T1-T2 and T4; in T3 lesions sensibility was 76%. Specificity was between 94% and 100% in all stages. We believe that trans-rectal ultrasound is a usefull, precise and reliable diagnostic tool, for staging purposes of rectal carcinoma.