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1.
Rev. méd. hered ; 23(1): 11-15, ene.-mar. 2012. tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-620768

RESUMO

Objetivo: Comparar la sensibilidad de la biopsia gástrica en la detección de Helicobacter pylori (Hp) en pacientes que recibieron inhibidores de la bomba de protones (IBP) entre 7 y 14 días previos a la endoscopía digestiva alta y los que recibieron medicación diferente a IBP o no usaron medicación. Material y métodos: Estudio tipo serie de casos comparativo. Se incluyeron pacientes con dispepsia sometidos a endoscopía digestiva alta y biopsia gástrica en el Servicio de Gastroenterología del Hospital Nacional Cayetano Heredia entre noviembre 2008 y enero 2009, que habían recibido IBP entre 7 y 14 días. Se excluyeron pacientes con cáncer gástrico, cirugía previa, que se encontraban en terapia antibiótica o con salicilato de bismuto en las 4 semanas previas. Se tomaron dos biopsias en cuerpo y dos en antro. Se utilizó el programa STATA 10 para el análisis. Resultados: Se estudiaron 80 pacientes; 38 (47,5%) recibieron IBP. El 64,29% (27/42) de los que no tomaron IBP fueron Hp (+) y el 65,79% (23/38) de los que tomaron IBP (p=0,90). Conclusiones: La proporción de resultados positivos para Hp fue similar en los pacientes que tomaron IBP entre 7 y 14 días y los que no recibieron IBP.


Objective: To evaluate the sensitivity of gastric biopsy in detecting Helycobacter pylori (Hp) infection among patients who received proton pump inhibitors (PPI) 7-14 days before endoscopy compared to those who did not received PPI or who received a different medication. Methods: Case series. Patients with dyspepsia who undergo upper endoscopy and biopsy from November 2008 to January 2009 were included if they had received PPI 7-14 days before the procedure. Patients with gastric cancer, prior surgery and those who had received antibiotics or bismuth subsalicylate were excluded. Two biopsies of the main gastric body and atrum were taken. The STATA software was used for the analysis. Results: 80 patients were studied; 38 (47.5%) received PPI. 64.29% (27/42) of those who did not received PPI were Hp positive vs. 65.79% (23/38) in patients who received PPIs (p=0.90). Conclusions: Hp rate was similar irrespective of PPI use.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Biópsia , Dispepsia , Endoscopia Gastrointestinal , Helicobacter pylori , Inibidores da Bomba de Prótons/uso terapêutico , Relatos de Casos
2.
Rev Gastroenterol Peru ; 31(2): 169-72, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-21836657

RESUMO

Gastrointestinal stromal cell tumors (GIST) are rare neoplasms of the gastrointestinal tract, although they are the most common mesenchymal neoplasms. The stomach and small intestine are the most frequent site of involvement accounting for approximately 85% of cases. However, esophagus involvement is exceptional (<5%); indeed some large series fail to report it. Surgery resection is the cornerstone of treatment; currently imatinib has demonstrated its utility to reduce local recurrences and tumor mass. We report a 75 years-old male with a medical history of dysphagia who presented upper gastrointestinal bleeding caused by an esophageal GIST. The patient did not undergo surgery because of severe chronic heart failure.


Assuntos
Neoplasias Esofágicas/patologia , Tumores do Estroma Gastrointestinal/patologia , Idoso , Antineoplásicos/uso terapêutico , Sulfato de Bário , Benzamidas , Contraindicações , Transtornos de Deglutição/etiologia , Emergências , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/tratamento farmacológico , Esofagectomia , Esofagoscopia , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Insuficiência Cardíaca/complicações , Humanos , Mesilato de Imatinib , Masculino , Melena/etiologia , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico
3.
Case Rep Med ; 2011: 960638, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21837244

RESUMO

Histoplasma capsulatum and Paracoccidioides brasiliensis are dimorphic fungi that cause systemic mycosis mostly in tropical South America and some areas of North America. Gastrointestinal involvement is not uncommon among these fungal diseases, but coinfection has not previously been reported. We report a patient with chronic diarrhea and pancolitis caused by paracoccidioidomycosis and histoplasmosis.

4.
Rev. gastroenterol. Perú ; 31(2): 169-172, abr.-jun. 2011. ilus
Artigo em Espanhol | LILACS, LIPECS | ID: lil-597278

RESUMO

Los tumores del estroma gastrointestinales (GIST) son neoplasias poco frecuentes del tracto digestivo, sin embargo, son los tumores mesenquimales más frecuentes. El estómago y el intestino delgado son los lugares de presentación más comunes representando aproximadamente el 85 por ciento de los casos. Por otro lado la ubicación esofágica es excepcional (<5 por ciento), inclusive existen grandes series donde su frecuencia no se reporta. El manejo quirúrgico es el tratamiento definitivo, sin embargo actualmente con el uso de imatinib se ha podido disminuir la frecuencia de recurrencias y la masa tumoral. Presentamos un paciente varón de 75 años con antecedente de disfagia que presentó hemorragia digestiva alta debido a un GIST de esófago. El paciente no fue sometido a manejo quirúrgico, debido a una severa insuficiencia cardiaca.


Gastrointestinal stromal cell tumors (GIST) are rare neoplasms of the gastrointestinal tract, although they are the most common mesenchymal neoplasms. The stomach and small intestine are the most frequent site of involvement accounting for approximately 85 percent of cases. However, esophagus involvement is exceptional (<5 percent); indeed some large series fail to report it. Surgery resection is the cornerstone of treatment; currently imatinib has demonstrated its utility to reduce local recurrences and tumor mass. We report a 75 years-old male with a medical history of dysphagia who presented upper gastrointestinal bleeding caused by an esophageal GIST. The patient did not undergo surgery because of severe chronic heart failure.


Assuntos
Humanos , Masculino , Idoso , Hemorragia Gastrointestinal , Neoplasias Esofágicas , Transtornos de Deglutição , Tumores do Estroma Gastrointestinal
5.
Case Rep Med ; 2010: 140505, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20671977

RESUMO

South American blastomycosis is a systemic micosis caused by infection with Paracoccidioides brasiliensis. The most frequently affected sites are the lower lip buccal mucous membrane, palate, tongue, sublingual region, lymph glands, and lungs. However, colonic involvement is not a common expression of Paracoccidioidomycosis. We report a case of chronic diarrhea and pancolitis caused by Paracoccidioidomycosis with fatal outcome.

6.
Rev Gastroenterol Peru ; 30(1): 78-81, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-20445730

RESUMO

Duodenal ulcer due to cytomegalovirus (CMV) is quite infrequent in the inmunocompetent patient. We present an elderly patient with a history of upper urinary infections who was admitted at the hospital because of tarry black stool and coffee ground vomits. Endoscopy revealed duodenal ulcer and the histopathology confirm CMV infection. The workout was negative for human immunodeficient virus (HIV), HTLV-1 and occult cancer. The patient developed a serious infection and died due to urinary septic shock. Key words : Duodenal ulcer, cytomegalovirus, upper gastrointestinal bleeding, immunocompetent.


Assuntos
Infecções por Citomegalovirus/complicações , Úlcera Duodenal/complicações , Úlcera Duodenal/virologia , Hemorragia Gastrointestinal/etiologia , Idoso , Humanos , Imunocompetência , Masculino
7.
Rev. gastroenterol. Perú ; 30(1): 78-81, ene.-mar. 2010. ilus
Artigo em Espanhol | LILACS, LIPECS | ID: lil-559001

RESUMO

La úlcera duodenal por citomegalovirus (CMV) es muy poco frecuente en el paciente inmunocompetente. El presente caso es un adulto mayor con antecedente de infecciones urinarias a repetición que ingresa al hospital por historia de melena y vómitos tipo borra de café con hallazgos endoscópicos de úlcera duodenal y confirmación histopatológica de infección por citomegalovirus (CMV). Los estudios VIH, HTLV-1 y neoplasia oculta fueron negativos. El paciente presentó una evolución desfavorable falleciendo de shock séptico de origen urinario.


Duodenal ulcer due to cytomegalovirus (CMV) is quite infrequent in the inmunocompetent patient. We present an elderly patient with a history of upper urinary infections who wasadmitted at the hospital because of tarry black stool and coffee ground vomits. Endoscopy revealed duodenal ulcer and the histopathology confirm CMV infection. The workout was negative for human immunodeficient virus (HIV), HTLV-1 and occult cancer. The patient developed a serious infection and died due to urinary septic shock.


Assuntos
Humanos , Masculino , Idoso , Citomegalovirus , Hemorragia Gastrointestinal , Imunocompetência , Úlcera Duodenal
8.
Rev. gastroenterol. Perú ; 29(4): 321-325, oct.-dic. 2009. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-559292

RESUMO

INTRODUCCIÓN: En 2002, la US Multi-Society Task Force on Colorectal Cancer publicó los criterios de calidad para estandarizar la técnica colonoscópica en la prevención del cáncer colorrectal, recomendando tomar un tiempo mínimo entre 6 y 10 minutos en el retiro del colonoscopio. Estudios posteriores demostraron un aumento significativode la tasa de detección de cáncer colonrectal al tomar un tiempo de retiro mayor. Sin embargo, estos resultados fueron obtenidos a partir de poblaciones con alta incidencia de cáncer colorrectal. El objetivo de este trabajo es evaluar el impacto que ha tenido el adoptar como norma retirar el colonoscopio en más de 6 minutos, en una población conbaja incidencia de cáncer colorrectal. MATERIAL Y MÉTODOS: Estudio descriptivo retrospectivo, donde se revisó informes de colonoscopias entre enero 2006 y julio 2009. Desde enero del 2008 se incorporó en elservicio de Gastroenterología, la norma de tomar un tiempo de retiro del colonoscopio ≥ 6 minutos. Se comparó las tasas de detección de pólipos obtenidas durante este periodo detiempo, con las obtenidas en los años 2006 y 2007, cuando rutinariamente no se tomaba en cuenta el tiempo de retiro luego de la intubación al ciego.RESULTADOS: Se revisó 2004 informes de colonoscopías entre enero del 2006 hasta julio del 2009; de los cuales 1042 correspondieron al periodo de enero del 2008 hasta julio del 2009 y 962 a los años 2006 y 2007. Se encontró un total de 162 pacientes que presentaron pólipos durante el periodo de incorporación de la norma, mientras que en el 2006 y 2007 se encontraron pólipos en 144 pacientes. La tasa de detección de pólipos durante elperiodo de evaluación del tiempo de retiro del colonoscopio ≥ 6 minutos fue de 15.55 por ciento frente a 16.17 por ciento y 15.84 por ciento correspondientes al año 2006 y 2007 respectivamente. No se encontró diferencia significativa entre la tasa de detección de pólipos en los periodos analizados (p= 0.955)...


INTRODUCTION: In 2002, the US Multi-Society Task Force on Colorectal Cancerrecommended that the withdrawal phase during colonoscopy should average at least 6-10 min to improve the detecting ratio of polyps. However, these recommendations werebased on previous studies with a high colorectal cancer-risk population. The aim of our study is to determine if the implementation of a policy of colonoscopy withdrawal time ≥6minutes would be statistically associated with an increase in the colon polyp detection rate. MATERIALS AND METHODS: We retrospectively evaluated the procedural data from alltotal colonoscopies performed at our general hospital from January 2006 through July 2009. Since January 2008 we implemented the policy of withdrawal time ≥6 minutes. Wecalculated the detection rate and compared data from these period with our baseline consisted of the two years previous period in which withdrawal time was not aware. RESULTS: We reviewed procedural data from 2004 colonoscopies performed from January2006 through July 2009; 1042 from the ≥6 minutes-withdrawal time implementation period and 962 from the two years previous period. We found 162 patients with at least one polypdetected during the ≥6 minutes-withdrawal time implementation period whereas 144 patients were detected from our baseline. The polyp detection rate was 15.55 percent from the period with a withdrawal time of ≥6 minutes versus 16.17 and 15.84 percent from each year of our baseline. No significant increase (p = 0.955) in the polyp detection rate was detected between the two comparative groups. CONCLUSION: The implementation of a policy of colonoscopy withdrawal time ≥6 minutes had no effect on colon polyp detection.


Assuntos
Colonoscopia , Pólipos , Tempo de Permanência , Epidemiologia Descritiva , Estudos Retrospectivos
9.
Rev Gastroenterol Peru ; 29(3): 272-5, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19898601

RESUMO

The case of a 23-year old woman with a history of epigastric pain, a palpable tumor that covered the epigastrium and the left hypochondrium, and an episode of acute pancreatitis was reported. The computerized tomography revealed a pancreatic cyst. The CA-125 increased significantly. An exploratory laparotomy was performed, finding an endometrioma. The pathological anatomy showed necrotic tissue, mucus and blood, with a presence of macrophages with hemosiderin phagocytosis. The symptoms and signs, pathogenesis and treatment of the endometriosis of the pancreas are discussed.


Assuntos
Ascite/etiologia , Enterite/complicações , Eosinofilia/complicações , Adulto , Feminino , Humanos
10.
Rev. gastroenterol. Perú ; 29(3): 272-275, jul.-sept. 2009. ilus
Artigo em Espanhol | LILACS, LIPECS | ID: lil-559678

RESUMO

Reportamos el caso de una mujer de 23 años de edad con historia de dolor epigástrico, tumoración palpable que abarca el epigastrio y el hipocondrio izquierdo y un episodio de pancreatitis aguda. La tomografía computarizada reveló un quiste pancreático. ElCA-125 se elevó notablemente. Se efectuó una laparotomía exploratoria encontrándose un endometrioma. La anatomía patológica mostró tejido necrótico, moco y sangre, conpresencia de macrófagos con fagocitosis de hemosiderina. Se discute el cuadro clínico, la patogénesis y el tratamiento de la endometriosis pancreática.


The case of a 23-year old woman with a history of epigastric pain, a palpable tumor that covered the epigastrium and the left hypochondrium, and an episode of acute pancreatitis was reported. The computerized tomography revealed a pancreatic cyst. The CA-125 increased significantly. An exploratory laparotomy was performed, finding an endometrioma. The pathological anatomy showed necrotic tissue, mucus and blood, with a presence of macrophages with hemosiderin phagocytosis. The symptoms and signs, pathogenesis and treatment of the endometriosis of the pancreas are discussed.


Assuntos
Humanos , Adulto , Feminino , Endometriose , Pancreatopatias , Pancreatite Necrosante Aguda
11.
Rev Gastroenterol Peru ; 29(1): 33-9, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19424406

RESUMO

INTRODUCTION: The anal fissure is a linear tear in the anal canal mucosa. If healing fails, it evolves into a chronic anal fissure (CAF). This is one of the most frequent proctologic problems affecting younger patients, altering their social and work life. As it is disabling disease, it causes a socioeconomic problem and, hence, it is important to make a proper diagnosis and apply a rapid and efficient treatment.At present, there are different therapeutic options, both medical and surgical. Among the first, there are several options that relax the anal sphincter. One of the options which are most used is the 0.2% Glycerol Trinitrate (GTN) ointment, there being some randomized and controlled studies reporting 48% and 69% healing rates and other studies with comparable results against surgery.The objective was to know the results of the GTN ointment, so as to avoid surgery, and the probable permanent section of the internal anal sphincter. MATERIAL AND METHODS: Topical Glycerol Trinitrate ointment 0.2% was used twice a day during two weeks. All patients diagnosed with CAF who met the inclusion criteria participated in this study for a one-year period, from February 2007 to January 2008. Two controls were carried out, one at the end of the treatment to verify healing and absence of symptoms, and the other after two months to check recidivism. RESULTS: There were 19 female patients (63.3%) and 11 male patients (36.7%). The average age was 34.87 years, with higher prevalence between 21 and 40 years (50%) and minor prevalence between 41 and 50 years (13.3%). The most frequent symptoms found were the association of anal pain with rectal bleeding in 66.6% of the patients, followed by isolated rectal bleeding and anal pain in 23.3% and 10% of cases, respectively. The most common localization of the CAF was the posterior midline in 63.3% of patients, followed by the anterior midline in 16.7% of patients, and by both midlines in 16.7% of cases. Four of the 30 patients included were lost. All the symptoms vanished in 73% (19)of the 26 remaining patients and symptoms persisted to a lower degree in 27% (7).Headache was an adverse effect in three patients. The control performed after 2 weeks of treatment evidenced partial and complete cicatrization of the fissure in 22 patients (84.6%) and persistence in 4 patients (15.4%). The final control performed after 2 months on the 18 patients who attended evidenced healing of the fissure in 16 (69.6%) and recidivism in 2 (8.7%). CONCLUSIONS: The following conclusion was drawn topical Glycerol Trinitrate 0.2% ointment, applied twice a day during two weeks, is effective in the treatment of chronic anal fissure, with a 69.9% success rate after two months of follow-up. Consequently, it must be considered as an alternate therapy in the treatment of CAF.


Assuntos
Fissura Anal/tratamento farmacológico , Nitroglicerina/uso terapêutico , Administração Tópica , Adolescente , Adulto , Doença Crônica , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pomadas , Estudos Prospectivos , Adulto Jovem
12.
Rev. gastroenterol. Perú ; 29(1): 33-39, ene.-mar. 2009. ilus
Artigo em Espanhol | LILACS, LIPECS | ID: lil-525863

RESUMO

INTRODUCCIÓN: La fisura anal es un desgarro lineal de la mucosa del canal anal. Cuando la curación falla progresa a fisura anal crónica (FAC). La FAC es un problema proctológico frecuente, afecta mayormente a pacientes jóvenes, es incapacitante, por lo que es importante un diagnóstico adecuado y un tratamiento rápido y eficaz. Actualmente existen diferentes opciones terapéuticas, médicas y quirúrgicas. Dentro de las primeras existen varias opciones que producen relajación del esfínter anal. Una de las opciones más usadas es el ungüento de Trinitrato de Glicerol (TNG) al 0.2 por ciento, conalgunos estudios randomizados y controlados que reportan tasas de curación entre 48 y 69 por ciento y otros con resultados equiparables comparados con la cirugía. Nuestro objetivo fue conocer los resultados del ungüento de TNG evitando la cirugía yla probable sección permanente del esfínter anal interno. MATERIAL Y MÉTODOS: se utilizó Trinitrato de Glicerol al 0.2 por ciento en ungüento tópico, 2 veces al día durante 2 semanas. En todos los pacientes con diagnóstico de FAC, que cumplían los criterios de inclusión, en el periodo, de febrero de 2007 a Enero de 2008.Se realizaron dos controles, uno al término del tratamiento para verificar cicatrización y desaparición de sintomatología y el otro a los 2 meses para constatar recidiva. RESULTADOS: Ingresaron al estudio 30 pacientes, 19 mujeres (63.3 por ciento) y 11 varones (36.7 por ciento). La edad promedio fue de 34.87 años, con mayor prevalencia entre 21 y 40 años (50 por ciento) ycon menor entre 41 y 50 (13.3 por ciento). La sintomatología más frecuentemente encontrada fue la asociación de dolor anal y rectorragia en 66.6 por ciento, seguida de rectorragia y dolor anal aislados en 23.3 por ciento y 10 por ciento respectivamente. La localización más frecuente de la FAC fue la línea media posterior en 63.3 por ciento, seguida de la línea media anterior en 16.7 por ciento y ambas en16.7 por ciento...


INTRODUCTION: The anal fissure is a linear tear in the anal canal mucosa. If healing fails, it evolves into a chronic anal fissure (CAF). This is one of the most frequent proctologic problems affecting younger patients, altering their social and work life. As it is disabling disease, it causes a socioeconomic problem and, hence, it is important to make a proper diagnosis and apply a rapid and efficient treatment. At present, there are different therapeutic options, both medical and surgical. Among the first, there are several options that relax the anal sphincter. One of the options which are most used is the 0.2 per cent Glycerol Trinitrate (GTN) ointment, there being some randomized and controlled studies reporting 48 per cent and 69 per cent healing rates and other studies with comparable results against surgery. The objective was to know the results of the GTN ointment, so as to avoid surgery, and the probable permanent section of the internal anal sphincter. MATERIAL AND METHODS: Topical Glycerol Trinitrate ointment 0.2 per cent was used twice a day during two weeks. All patients diagnosed with CAF who met the inclusion criteriaparticipated in this study for a one-year period, from February 2007 to January 2008. Two controls were carried out, one at the end of the treatment to verify healing and absence of symptoms, and the other after two months to check recidivism. RESULTS: There were 19 female patients (63.3 per cent) and 11 male patients (36.7 per cent). Theaverage age was 34.87 years, with higher prevalence between 21 and 40 years (50 per cent) and minor prevalence between 41 and 50 years (13.3 per cent). The most frequent symptoms found were the association of anal pain with rectal bleeding in 66.6 per cent of the patients, followedby isolated rectal bleeding and anal pain in 23.3 per cent and 10 per cent of cases, respectively. The most common localization of the CAF was the posterior midline in 63.3 per cent of patients, ...


Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Fissura Anal/terapia , Nitroglicerina/uso terapêutico , Estudos Prospectivos
13.
Rev Gastroenterol Peru ; 29(4): 321-5, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-20066016

RESUMO

INTRODUCTION: In 2002, the US Multi-Society Task Force on Colorectal Cancer recommended that the withdrawal phase during colonoscopy should average at least 6-10 min to improve the detecting ratio of polyps. However, these recommendations were based on previous studies with a high colorectal cancer-risk population. The aim of our study is to determine if the implementation of a policy of colonoscopy withdrawal time > or = 6 minutes would be statistically associated with an increase in the colon polyp detection rate. MATERIALS AND METHODS: We retrospectively evaluated the procedural data from all total colonoscopies performed at our general hospital from January 2006 through July 2009. Since January 2008 we implemented the policy of withdrawal time > or = 6 minutes. We calculated the detection rate and compared data from these period with our baseline consisted of the two years previous period in which withdrawal time was not aware. RESULTS: We reviewed procedural data from 2004 colonoscopies performed from January 2006 through July 2009; 1042 from the > or = 6 minutes-withdrawal time implementation period and 962 from the two years previous period. We found 162 patients with at least one polyp detected during the > or = 6 minutes-withdrawal time implementation period whereas 144 patients were detected from our baseline. The polyp detection rate was 15.55% from the period with a withdrawal time of e6 minutes versus 16.17 and 15.84% from each year of our baseline. No significant increase (p = 0.955) in the polyp detection rate was detected between the two comparative groups. CONCLUSION: The implementation of a policy of colonoscopy withdrawal time e6 minutes had no effect on colon polyp detection.


Assuntos
Neoplasias do Colo/patologia , Colonoscopia/métodos , Colonoscopia/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
14.
Rev Gastroenterol Peru ; 27(1): 72-8, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17431438

RESUMO

A case of a patient is reported who was admitted with massive intestinal haemorrhaging after 10 days of medical discomfort, characterized by persistent fever, headache and abdominal pain. The patient did not respond to medical treatment: antibiotics, blood transfusions and fluid replacement and required emergency surgical intervention. Intestinal resection with primary anastomosis was performed, controlling the bleeding. Following the testing of blood cultures and histopathological study infection by the S. tiphy bacteria was recorded by testing. In Latin America this strain of typhoid fever was common until the beginning of the 90's, before the cholera epidemic and has rarely been seen in the past 15 years.


Assuntos
Hemorragia Gastrointestinal/etiologia , Febre Tifoide/complicações , Adulto , Humanos , Masculino , Recidiva , Índice de Gravidade de Doença
15.
Rev. gastroenterol. Perú ; 27(1): 72-78, ener.-mar. 2007. ilus, tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-533806

RESUMO

Reportamos el caso de un paciente que fue admitido por presentar un cuadro de enterorragia masiva luego de 10 días de evolución, caracterizado por fiebre persistente, cefalea global y dolor abdominal, el cual no respondió al tratamiento médico con antibióticos, transfusiones y resucitación con fluidos, requiriendo intervención quirúrgica de emergencia. Se realizó una resección intestinal con anastomosis primaria, controlando así el sangrado. Se documentó la infección con S. tiphy en los hemocultivos y en la histopatología. En América Latina esta complicación de fiebre tifoidea fue común hasta inicios de la década del 90, antes de la epidemia del cólera. Este tipo de complicación ha sido raramente vista en los últimos 15 años.


A case of a patient is reported who was admitted with massive intestinal haemorrhaging after 10 days of medical discomfort, characterized by persistent fever, headache and abdominal pain. The patient did not respond to medical treatment: antibiotics, blood transfusions and fluid replacement and required emergency surgical intervention. Intestinal resection with primary anastomosis was performed, controlling the bleeding. Following the testing of blood cultures and histopathological study infection by theS.tiphy bacteria was recorded by testing. In Latin America this strain of typhoid fever was common until the beginning of the 90´s, before the cholera epidemic and has rarely been seen in the past 15 years.


Assuntos
Humanos , Masculino , Adulto , Anastomose Cirúrgica , Febre Tifoide/complicações , Hemorragia Gastrointestinal/cirurgia , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/patologia
16.
Rev Gastroenterol Peru ; 26(3): 265-70, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-17053822

RESUMO

UNLABELLED: The prevalence of hepatitis C varies according to geographical areas and risk groups. Patients with terminal chronic renal failure (TCRF) under dialysis are an important risk group. In Peru, hepatitis C virus (HCV) infection rates in patients under hemo-dialysis reach 90%, and are associated with transfusions and time under dialysis as risk factors. Little is known about the prevalence of HCV in patients with TCRF receiving non dialysis therapy. The purpose of this study is to know the prevalence of HCV infection in these patients and to determine the risk factors. METHODOLOGY: Prospective study, anti-hepatitis C (anti HCV) antibodies were assessed in patients with TCRF in non-dialysis conservative therapy at the Department of Nephrology of the Arzobispo Loayza Hospital. RESULTS: Ninety nine (99) patients were studied, 54.1% male and 45.8% female, with an average age of 56.6 + 17.9 years, with an average time of CRF diagnosis of 9.28 + 14.35 months. The most frequent cause of CRF was the unknown cause, followed by diabetes. A rate of anti HCV of 1.01% (1/99) was found. CONCLUSION: A low prevalence of antiHCV was found in the population studied. It was similar to the rates found in populations without CTRF.


Assuntos
Hepatite C/epidemiologia , Falência Renal Crônica/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hepacivirus/imunologia , Hepatite C/sangue , Hepatite C/complicações , Anticorpos Anti-Hepatite C/sangue , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Estudos Prospectivos , Diálise Renal/estatística & dados numéricos
17.
Rev. gastroenterol. Perú ; 26(3): 265-270, jul.-sept. 2006. tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-533750

RESUMO

Introducción: La prevalencia de hepatitis C varía según el área geográfica y los grupos de riesgo. Los pacientes con insuficiencia renal crónica terminal (IRCT) en diálisis constituyen un grupo importante de riesgo. En el Perú las tasas de infección por el virus de la hepatitis C (HCB) en pacientes en hemodiálisis llegan hasta 90 por ciento, asociándose a las transfusiones y al tiempo en diálisis como factores de riesgo. Poco se sabe sobre la prevalencia de la infección por el HCV en pacientes con IRCT en terapia no dialítica. El objetivo de este estudio es conocer la prevalencia de la infección por HCV en estos pacientes y determinar los factores de riesgo. Metodología: Estudio prospectivo, se evaluaron los anticuerpos anti-hepatitis C (antiHCV), en los pacientes con IRCT en terapia conservadora, no dialítica, del Servicio de Nefrología del Hospital Arzobispo Loayza. Resultados: Se estudiaron 99 pacientes, 54.1 por ciento varones y 45.8 por ciento de mujeres, con una edad promedio de 56.60 más menos 17.9 años, con un tiempo de diagnóstico de IRC promedio de 9.28 más menos 14.35 meses. La causa más frecuente de IRC fue la no identificada seguida de la diabetes. Se halló una tasa de antiHCV de 1.01 por ciento (1/99). Conclusión: Se halló una prevalencia baja de antiHCV en la población estudiada, comparable con las tasas de la población general sin IRCT.


The prevalence of hepatitis C varies according to geographical areas and risk groups. Patients with terminal chronic renal failure (TCRF) under dialysis are an important risk group. In Peru, hepatitis C virus (HCV) infection rates in patients under hemodialysis reach 90 per cent, and are associated with transfusions and time under dialysis asrisk factors. Little is known about the prevalence of HCV in patients with TCRF receiving non dialysis therapy. The purpose of this study is to know the prevalence of HCV infection in these patients and to determine the risk factors. METHODOLOGY: Prospective study, anti-hepatitis C (anti HCV) antibodies were assessed in patients with TCRF in non-dialysis conservative therapy at the Department of Nephrology of the Arzobispo Loayza Hospital. RESULTS: Ninety nine (99) patients were studied, 54.1 per cent male and 45.8 per cent female, withan average age of 56.6 more 17.9 years, with an average time of CRF diagnosis of 9.28 more 14.35 months. The most frequent cause of CRF was the unknown cause, followed by diabetes. A rate of anti HCV of 1.01 per cent (1/99) was found. CONCLUSION: A low prevalence of antiHCV was found in the population studied. It was similar to the rates found in populations without CTRF.


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Feminino , Hepatite C , Insuficiência Renal Crônica , Prevalência , Estudos Prospectivos
18.
Rev Gastroenterol Peru ; 23(4): 265-8, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-14716421

RESUMO

UNLABELLED: Hepatitis C is the second major endemic viral infection in the world after HIV. In the USA it is the first liver transplant indication. Currently, the main risk factors to develop this disease are history of blood transfusions and IV drug usage. Sexual transmission remains controversial and accounts probably for less than 5% of case transmissions. PURPOSE: Determine the prevalence of hepatitis C virus infection in female sexual workers from Northern Lima and identify other risk factors. MATERIAL AND METHODS: A prospective study was performed in female sexual workers from Northern Lima. Risk factors were assessed in a survey; at the time of the assessment they were HIV negative. The COBAS CORE Anti-HCV EIA II Test was used. RESULTS: HCV serology was negative in all 98 sexual workers. 90% used protection with condoms, none used IV drugs and only one had a previous history of blood transfusion. CONCLUSIONS: HCV prevalence in female sexual workers evaluated was zero. They have few risk factors, sexual transmission of this virus is very low and even lower in a population where over 90% of the people uses condoms.


Assuntos
Hepatite C/epidemiologia , Trabalho Sexual , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Feminino , Hepacivirus/imunologia , Anticorpos Anti-Hepatite B/sangue , Hepatite C/sangue , Hepatite C/transmissão , Humanos , Peru/epidemiologia , Prevalência , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Doenças Virais Sexualmente Transmissíveis/sangue , Doenças Virais Sexualmente Transmissíveis/transmissão
19.
Rev Gastroenterol Peru ; 23(4): 297-301, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-14716425

RESUMO

A case of Chylous Ascites was reported in a 64-year-old male patient who underwent a diagnostic laparoscopy, through which its etiology was determined. It is a retroperitoneal lymphoma with liver infiltration, an unusual presentation of this disease, where diagnosis could be determined.


Assuntos
Ascite Quilosa/diagnóstico , Neoplasias Hepáticas/diagnóstico , Fígado/patologia , Linfoma/diagnóstico , Biópsia/métodos , Ascite Quilosa/terapia , Humanos , Laparoscopia , Neoplasias Hepáticas/terapia , Linfa , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Espaço Retroperitoneal/patologia , Espaço Retroperitoneal/cirurgia , Tomografia Computadorizada por Raios X
20.
Rev. méd. hered ; 8(2): 67-71, jun. 1997. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-224923

RESUMO

Determinar la prevalencia de anticuerpos antihepatitis C (Ac HCV) en pacientes en hemodiálisis crónica su correlación con marcadores de enfermedad hepática y los factores de riesgo asociados a la infección. Material y métodos: Se realizó un estudio transversal y multicéntrico. La población estuvo compuesta por pacientes con insuficiencia renal crónica (IRC), en programa de hemodiálisis (HD) crónica intermitente, que acudieron a las sesiones de HD durante los meses de marzo y abril de 1996, en 3 centros de diálisis de Lima. Para determinar Ac HCV se utilizó la prueba de ELISA de segunda generación, asimismo se determinó alanino aminotransferasa (ALT) y foosfatasa alcalina (FA) en sangre. Resultados: la población estuvo compuesta por 124 pacientes, 72 (58.1 por ciento) fueron varones y 53 (41.9 por ciento), mujeres. La edad promedio fue de 54.98 ñ 14.3 años. La prevalencia de Ac HCV fue 83.9 ñ 6.5 (IC 95 por ciento), no encontrándose diferencias entre los 3 centros de diálisis. El único factor de riesgo asociado a la presencia de Ac HCV (más) fue el tiempo de permanencia en programas de hemodiálisis (p = 0.00001). No se encontró asociación entre los valores de ALT y FA ni de la causa de la IRC, con la presencia de Ac HCV. Conclusión: La prevalencia de Ac HCV es alta en pacientes en hemodiálisis crónica y el factor de riesgo asociado a la infección, es el tiempo en programa de hemodiálisis crónica.


Assuntos
Humanos , Masculino , Feminino , Fatores de Risco , Hepatite C , Hepatite Viral Humana , Diálise Renal , Insuficiência Renal Crônica , Sangue , Alanina Transaminase , Fosfatase Alcalina
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