Quistes hepáticos en el adulto / No disponible

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Effect of Helicobacter pylori eradication therapy in rosacea patients.

OBJECTIVE: The causal relation between rosacea and Helicobacter pylori infection is discussed. We evaluated the clinical evolution of rosacea after infection eradication. PATIENTS AND METHODS: We have prospectively studied 44 patients diagnosed with rosacea. Helicobacter pylori infection was determined, and infected patients were treated with eradication therapy. The evolution of dermatological symptoms in a subgroup of 29 infected patients in whom eradication had been achieved was followed during 16.8 (+/- 17.8) months. Median age was 50.6 (+/- 14.1) years for 22 women (75.9%) and 7 men (24.1%). Clinical response according to gender and clinical subtype of rosacea was evaluated. RESULTS: Complete improvement was observed in 10 patients (34.5%; 95% CI: 18.6-54.3%), relevant improvement in 9 (31.1%; 95% CI: 16-51%), poor improvement in 5 (17.2%; 95% CI: 6.5-36.4%), and absence of improvement in 5 cases (17.2%; 95% CI: 6.5-36.4%). No significant differences in dermatological evolution according to sex were observed. Regarding subtype of rosacea there was a relevant improvement in 83.3% (95% CI: 64.1-93.8%) of cases with papulopustular type as opposed to 36.5% (95% CI: 20-56.1%) of cases with erythematous predominance, p = 0.02. CONCLUSIONS: Based on these results, the relation between Helicobacter pylori and rosacea is supported, and infection should be investigated in these patients because an appreciable percentage of patients diagnosed with rosacea and Helicobacter pylori infection can benefit from eradication therapy, mainly in the papulopustular subtype.

Gastrectomía laparoscópica por adenocarcinoma gástrico. Resultados a largo plazo / Effect of Helicobacter pylori eradication therapy in rosacea patients

Objetivo: la relación causal entre la rosácea y la infección porHelicobacter pylori es discutida. Se propuso valorar la evoluciónde los síntomas cutáneos de la rosácea tras la erradicación de lainfección.Pacientes y métodos: se estudió prospectivamente a 44 pacientesdiagnosticados de rosácea. Se determinó la infección porHelicobacter pylori y se administró terapia erradicadora a los pacientesinfectados. Se siguió durante 16,8 (±17,8) meses la evoluciónde los síntomas dermatológicos del subgrupo de 29 pacientesinfectados en los que se había conseguido la erradicación. La edadmedia fue 50,6 (±14,1) años, siendo 22 mujeres (75,9%) y 7 varones(24,1%). Se valoró la respuesta clínica en función del sexo ydel subtipo clínico de rosácea.Resultados: se observó mejoría completa en 10 pacientes(34,5%; IC95%: 18,6-54,3%), mejoría importante en 9 (31,1%;IC95%: 16,5-51%), mejoría escasa en 5 (17,2%; IC95%: 6,5-36,4%) y ausencia de mejoría en 5 casos (17,2%; IC95%: 6,5-36,4%). No se observaron diferencias significativas en función delsexo. Con respecto al subtipo de rosácea experimentaron buenarespuesta el 83,3% (IC95%: 64,1-93,8%) de las rosáceas pápulopustulosasfrente al 36,5% (IC95%: 20-56,1%) de las rosáceas depredominio eritematoso, p = 0,02.Conclusiones: con estos datos se sigue apoyando la relaciónHelicobacter pylori-rosácea y se debería investigar la infección enlos pacientes con esta enfermedad, ya que un porcentaje apreciablede pacientes diagnosticados de rosácea e infectados con Helicobacterpylori pueden beneficiarse de la terapia erradicadora dela infección, sobre todo en el subtipo pápulo-pustuloso

Objective: the causal relation between rosacea and Helicobacterpylori infection is discussed. We evaluated the clinicalevolution of rosacea after infection eradication.Patients and methods: we have prospectively studied 44patients diagnosed with rosacea. Helicobacter pylori infectionwas determined, and infected patients were treated with eradicationtherapy. The evolution of dermatological symptoms in a subgroupof 29 infected patients in whom eradication had beenachieved was followed during 16.8 (± 17.8) months. Median agewas 50.6 (± 14.1) years for 22 women (75.9%) and 7 men(24.1%). Clinical response according to gender and clinical subtypeof rosacea was evaluated.Results: complete improvement was observed in 10 patients(34.5%; 95% CI: 18.6-54.3%), relevant improvement in 9(31.1%; 95% CI: 16-51%), poor improvement in 5 (17.2%; 95%CI: 6.5-36.4%), and absence of improvement in 5 cases (17.2%;95% CI: 6.5-36.4%). No significant differences in dermatologicalevolution according to sex were observed. Regarding subtype ofrosacea there was a relevant improvement in 83.3% (95% CI:64.1-93.8%) of cases with papulopustular type as opposed to36.5% (95% CI: 20-56.1%) of cases with erythematous predominance,p = 0.02.Conclusions: based on these results, the relation betweenHelicobacter pylori and rosacea is supported, and infectionshould be investigated in these patients because an appreciablepercentage of patients diagnosed with rosacea and Helicobacterpylori infection can benefit from eradication therapy, mainly inthe papulopustular subtype

Penetrancia familiar del gen HFE: los cuatro hermanos de una familia afectados por hemocromatosis hereditaria / Familiar penetrancy of HFE gene: four brothers of the same family affected by hereditary haemochromatosis

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Toxicidad hepática por flutamida / Liver toxicity associated with flutamide

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Intestinal metaplasia: evolution after Helicobacter pylori eradication and influence in the success of eradicating therapy.

INTRODUCTION: intestinal metaplasia associated with Helicobacter pylori infection is a stage of the temporal sequence of histological lesions gradually induced by this microorganism. It is considered a preneoplastic lesion and its regression after eradication is controversial. AIM: to assess the evolution of intestinal metaplasia after eradication and to investigate whether metaplasia is a factor that contributes to successful treatment. MATERIAL AND METHODS: four hundred Helicobacter pylori positive patients were studied. Eradicating therapy was administered and endoscopic biopsies of gastric antrum and body were taken before and after eradication. Among other histological data, the presence of intestinal metaplasia was assessed. RESULTS: of all patients successfully treated, biopsies were taken before and after eradication in 268 of them: 71 (26,5%) had metaplasia before and 50 (18,7%) after eradication. A significant difference was observed in the outcome (p = 0,036) of the first eradicating treatment between the group without initial metaplasia (72,7%) and the group with initial metaplasia (61.2%). DISCUSSION: Helicobacter pylori eradication can revert intestinal metaplasia in some patients. On the other hand, the first treatment could be less successful in patients with intestinal metaplasia.

Prevention of de novo hepatitis B infection in liver allograft recipients with previous hepatitis B infection or hepatitis B vaccination.

OBJECTIVES: To assess de novo hepatitis B virus (HBV) transmission from liver donors with HBV serum markers (HBM) to their recipients and the need for HBV vaccination before liver transplantation. METHODS: A total of 108 orthotopic liver transplantations for nonviral disease and the risk of developing de novo hepatitis B based on HBMs before transplantation have been studied. Of the 108 patients, 94 met the study criteria and were divided into two groups: 27 who had HBMs before transplantation (from past infection or by previous vaccination) and 67 who had no HBM. Development of de novo hepatitis B was determined by analytical, serological, and histological parameters. RESULTS: No case (0%) of de novo hepatitis B was detected in the pretransplantation HBM group, whereas there were 10 cases (14.5%) in the other group (p < 0.005). CONCLUSIONS: The presence of pretransplantation HBM in liver transplant recipients protects these patients against the development of de novo hepatitis B. This is especially important considering that there is a high prevalence of donors with positive hepatitis B core antibody (especially in some countries), and that these donors transmit HBV infection to recipients without HBM in a significant number of cases. Thus, vaccination against HBV in patients who are candidates for liver transplantation is fundamental to avoid cases of de novo hepatitis B.

Compresión gástrica extrínseca simulando un tumor submucoso: diagnóstico por ecoendoscopia / Submucosal impression of the stomach like a submucosal tumour: diagnosis by endoscopic ultrasound

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[Presentation of Crohn's disease with esophageal involvement]. / Inicio de la enfermedad de Crohn con afección esofágica.

Inflammatory bowel disease basically consists of two entities: ulcerative colitis (UC) and Crohn's disease (CD). Both processes are characterized by chronic inflammation of the intestine, which in the case of CD may affect the entire digestive tract. We present the case of a young man who was diagnosed with esophageal CD after presenting dysphagia and odynophagia. Intestinal involvement was subsequently found. Esophageal involvement is infrequent and as the first manifestation of CD it is extremely rare. It should, however, be borne in mind in patients with esophageal ulcerations without symptoms or endoscopic signs compatible with peptic etiology, even though other indications of inflammatory disease are absent.