RESUMO
INTRODUCTION: Malignant gastric outlet obstruction is a condition that alters patient quality of life, conditioning progressive malnutrition. However, self-expanding metal stents (SEMSs) and surgical gastrojejunostomy (SGJ) are palliative options in patients with unresectable disease. AIM: To characterize patients diagnosed with malignant gastric outlet obstruction requiring SEMS placement or SGJ. MATERIALS AND METHODS: Sequential non-probability convenience sampling was conducted and included 68 patients, 40 of whom had SEMS placement and 28 of whom underwent SGJ. RESULTS: Patients sought medical consultations for the symptoms of vomiting, abdominal pain, weight loss, and upper gastrointestinal bleeding. Ninety-five percent of the patients in the SEMS group and 64.3% in the SGJ group presented with metastasis. Technical and clinical success, patency duration, and number of patients with no complications were greater in the SGJ group. Mean survival in days was 88 (SD⯱â¯21) in the SEMS group versus 501 (SD⯱â¯122) in the SGJ group. The log-rank test detected a statistically significant difference between subgroups (pâ¯=â¯0.00). CONCLUSION: SGJ has greater technical and clinical success rates but SEMS placement continues to be utilized in distal gastric cancer, especially in cases in which surgery is not an option.
Assuntos
Obstrução da Saída Gástrica , Neoplasias Gástricas , Colômbia , Obstrução da Saída Gástrica/etiologia , Obstrução da Saída Gástrica/cirurgia , Hospitais , Humanos , Qualidade de Vida , Estudos Retrospectivos , Neoplasias Gástricas/complicações , Resultado do TratamentoRESUMO
INTRODUCTION: Malignant gastric outlet obstruction is a condition that alters patient quality of life, conditioning progressive malnutrition. However, self-expanding metal stents (SEMSs) and surgical gastrojejunostomy (SGJ) are palliative options in patients with unresectable disease. AIMS: To characterize patients diagnosed with malignant gastric outlet obstruction requiring SEMS placement or SGJ. MATERIALS AND METHODS: Sequential non-probability convenience sampling was conducted and included 68 patients, 40 of whom had SEMS placement and 28 of whom underwent SGJ. RESULTS: Patients sought medical consultations for the symptoms of vomiting, abdominal pain, weight loss, and upper gastrointestinal bleeding. Ninety-five percent of the patients in the SEMS group and 64.3% in the SGJ group presented with metastasis. Technical and clinical success, patency duration, and number of patients with no complications were greater in the SGJ group. Mean survival in days was 88 (SD ± 21) in the SEMS group versus 501 (SD ± 122) in the SGJ group. The log-rank test detected a statistically significant difference between subgroups (p = 0.00). CONCLUSION: SGJ has greater technical and clinical success rates but SEMS placement continues to be utilized in distal gastric cancer, especially in cases in which surgery is not an option.
RESUMO
Ranchers in Venezuela historically have controlled the cattle-fever tick, Boophilus microplus (Canestrini), with acaricide treatments of cattle but no technical planning. We developed a simulation model to evaluate cattle-tick population dynamics in systematic pasture rotation systems and Integrated Pest Management (IPM) approaches to managing ticks in the tropical dry-forest ecological zone of Venezuela. Model output showed five generations of cattle-ticks produced each year throughout the dry and rainy seasons that occur in this zone. Sensitivity analyses showed disproportionately large changes in on-host B. microplus populations in response to small changes in larval mortality rates, such as those resulting from differences in the innate resistance of cattle to tick parasitism. Simulation results with 1-6 pasture systems suggest that adjusting the graze:rest sequence with systematic rotation among 4-6 pastures could suppress, but not eradicate, tick populations.
Assuntos
Doenças dos Bovinos/parasitologia , Simulação por Computador , Controle de Insetos/métodos , Modelos Biológicos , Infestações por Carrapato/veterinária , Carrapatos/crescimento & desenvolvimento , Criação de Animais Domésticos , Animais , Bovinos , Doenças dos Bovinos/prevenção & controle , Feminino , Estações do Ano , Infestações por Carrapato/prevenção & controle , VenezuelaRESUMO
El tratamiento adecuado del aneurisma de la aorta abdominal, está encaminado a la reseccion y colocacion de protesis, cirugia que actualmente se encuentra reglada y estandarizada; es sencilla y directa y arroja tasas de morbimortalidad minimas en la mayoria de los centros hospitalarios. Lo que mas ha progresado en esta entidad es el diagnostico, la fisiopatologia y el manejo hemodinámico durante el pre, trans y postoperatorio de la misma. En este trabajo se presenta la experiencia con el tipo de cirugia mencionado, practicado en el E.S.E. Hospital Universitario de Cartagena, durante el periodo comprendido entre marzo de 1988 y febrero de 7998. Se operaron 39 pacientes, 31(76.6 por ciento) hombres y 8(23.4 por ciento) mujeres; las edades oscilaron entre 52 y 79 años, con un promedio de 65.3 años y una desviacion estándar de 7.8. El motivo de consulta mas frecuente fue el dolor abdominal, seguido por sensacion de masa abdominal. El metodo diagnostico definitivo mas frecuente fue la ecografia abdominal en 55.3 por ciento, seguido por la tomografia axial computarizada (TAC) del abdomen, en 44.7 por ciento. Se utilizo cateter de Swan-Ganz. en 32 pacientes (84.2 por ciento); las patologias asociadas en su orden fueron, la cardiopatia en 15 casos (38.5 por ciento) y la hipertension arterial en 11 pacientes (28.2 por ciento). Se uso el injerto en pantalon en 31 pacientes (66 por ciento), y en 8 (17 por ciento) como injerto tubular. La mortalidad en esta serie fue de 1 paciente (2.1 por ciento). Se realiza una extensa revision de la patologia y se hace enfasis en los aspectos etiologicos, diagnosticos, fisiopatologicos, manejo hemodinámico y control durante el pre, trans y postoperatorio, con base en la experiencia acumulada en este tipo de cirugia en nuestro Hospital.