Asunto(s)
Infecciones Bacterianas/transmisión , Endoscopios/microbiología , Endoscopios/virología , Endoscopía Gastrointestinal/efectos adversos , Evaluación de la Tecnología Biomédica , Virosis/transmisión , Infecciones Bacterianas/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Desinfección/métodos , Endoscopios/efectos adversos , Endoscopía Gastrointestinal/métodos , Contaminación de Equipos/prevención & control , Estudios de Evaluación como Asunto , Humanos , Medición de Riesgo , Estados Unidos , Virosis/prevención & controlAsunto(s)
Endoscopios , Endoscopía Gastrointestinal/métodos , Técnicas Hemostáticas/instrumentación , Endoscopios/efectos adversos , Endoscopía Gastrointestinal/efectos adversos , Diseño de Equipo , Seguridad de Equipos , Costos de la Atención en Salud , Técnicas Hemostáticas/economía , Humanos , Sensibilidad y Especificidad , Evaluación de la Tecnología Biomédica , Estados UnidosAsunto(s)
Anestésicos Intravenosos/administración & dosificación , Endoscopía Gastrointestinal/métodos , Premedicación/normas , Propofol/administración & dosificación , Evaluación de la Tecnología Biomédica , Anestésicos Intravenosos/efectos adversos , Anestésicos Intravenosos/economía , Femenino , Humanos , Masculino , Dimensión del Dolor , Satisfacción del Paciente , Propofol/efectos adversos , Propofol/economía , Ensayos Clínicos Controlados Aleatorios como Asunto , Sensibilidad y EspecificidadRESUMEN
Although chlorpropamide and tolbutamide are well recognized as causes of hepatotoxicity, there are only 3 reported cases of hepatic injury caused by a third oral hypoglycemic agent, tolazamide. In 2 of these cases, the liver-function tests returned to normal when the drug was discontinued. In the third case, the patient had cholestasis from chlorpropamide before administration of tolazamide and developed chronic liver disease. We are reporting the second instance of chronic liver disease induced by tolazamide. Our patient had been taking chlorpropamide, but she had no evidence of liver disease before administration of tolazamide. Tolazamide should be considered as a drug capable of producing hepatotoxicity that on occasion may be chronic.
Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Tolazamida/efectos adversos , Anciano , Clorpropamida/uso terapéutico , Diabetes Mellitus/tratamiento farmacológico , Femenino , Humanos , Ictericia/inducido químicamente , Tolazamida/uso terapéuticoRESUMEN
In 2 cases of ampullary tumor, the diagnosis was made by intraampullary biopsy after an abnormality was discovered via the fluoroscope during endoscopic retrograde cholangiopancreatography. One case was a villotubular adenoma with dysplasia and carcinoma in situ, and the other, a polypoid adenocarcinoma of the ampulla of Vater. These tumors were not visualized on upper gastrointestinal barium studies and conventional duodenoscopy nor by direct vision during endoscopic retrograde cholangiopancreatography. In the past the diagnosis of ampullary neoplasm has been most often made of surgery and on autopsy. Only in 11 of 538 patients reviewed was the diagnosis made by biopsy of a tumor visible at endoscopy. As demonstrated by the two cases we report, intraampullary biopsy of lesions visualized on fluoroscopy during endoscopic retrograde cholangiopancreatography may facilitate early diagnosis.