RESUMO
Background: The pull-through method to install endoscopic gastrostomies is not devoid of complications. Aim: To describe and show the results of a trans-abdominal method to perform endoscopic gastrostomies using the accessories available in any endoscopic facility. material and methods: The technique consists in installing an exchange tube using the pull kit, which acts as a tube installer. We attempted the procedure in 14 patients whose ages ranged from 15 days to 83 years in a regional hospital. results: In 13 patients, the tube was correctly installed using the trans-abdominal pathway and they could be fed two hours later. Three months later, 11 patients were alive and did not experience complications associated with the gastrostomy. Conclusions: This preliminary experience supports the use of the described technique to install gastrostomies.
Objetivo: Para evitar las complicaciones de la gastrostomía endoscópica (GE) hemos desarrollado un método transabdominal empleando accesorios disponibles en cualquier unidad de endoscopia y una técnica con la cual los endoscopistas están familiarizados. Describimos el método y mostramos sus resultados. material y método: Esta técnica consiste en instalar una sonda de recambio con la ayuda del kit Pull que actúa como instalador de la sonda. Hemos intentado este procedimiento en 14 pacientes con edades entre 15 días y ochenta y tres años. Esta experiencia se realizó en el Hospital de Iquique. resultados: En 13 pacientes se logró instalar la sonda por vía transabdominal y alimentar dos horas después. A los 3 meses, once permanecían vivos y no habían tenido complicaciones mayores relacionadas a su gastrostomía. Conclusión: Aunque se trata de una experiencia inicial, creemos que esta técnica de gastrostomía combinada presenta una alternativa a otras técnicas endoscópicas de acceso transabdominal.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Gastrostomia/efeitos adversos , Gastroscopia/efeitos adversos , Nutrição Enteral/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Gastrostomia/instrumentação , Seguimentos , Gastroscopia/instrumentação , Falha de EquipamentoRESUMO
Helicobacter pylori infection is highly prevalent in Chile (73%). Usually a minority of infected patients develops complications such as ulcers and gastric cancer that have been associated with the presence of virulence factors (cagA, vacA) and host T helper response (Th1/Th2). Our aim was to evaluate the relationship between strain virulence and host immune response, using a multiple regression approach for the development of a model based on data collected from H. pylori infected patients in Chile. We analyzed levels of selected cytokines determined by ELISA (interleukin (IL)-12, IL-10, interferon (IFN)-gamma and IL-4) and the presence of cagA and vacA alleles polymorphisms determined by PCR in antral biopsies of 41 patients referred to endoscopy. By multiple regression analysis we established a correlation between bacterial and host factors using clinical outcome (gastritis and duodenal ulcer) as dependent variables. The selected model was described by: clinical outcome=0.867491 (cagA)+0.0131847 (IL-12/IL-10)+0.0103503 (IFN-gamma/IL-4) and it was able to explain over 90% of clinical outcomes observations (R(2)=96.4). This model considers that clinical outcomes are better explained by the interaction of host immune factors and strain virulence as a complex and interdependent mechanism.
Assuntos
Citocinas/imunologia , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/virologia , Helicobacter pylori/imunologia , Helicobacter pylori/patogenicidade , Fatores de Virulência/genética , Adolescente , Adulto , Alelos , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Criança , Pré-Escolar , Úlcera Duodenal/imunologia , Úlcera Duodenal/virologia , Feminino , Gastrite/imunologia , Gastrite/virologia , Helicobacter pylori/genética , Humanos , Masculino , Pessoa de Meia-Idade , Células Th1/imunologia , Células Th2/imunologiaAssuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Gastrostomia/métodos , Nutrição Enteral , Intubação Gastrointestinal/instrumentação , ChileRESUMO
En 14 niños con síndrome de malabsorción o sospecha de Enfermedad Celíaca se tornaron una o más muestras endoscópicas para biopsias del yeyuno en el hospital de Iquique. Los exámenes fueron hechos bajo anestesia disociativa, empleando panendoscopios entándar de canal amplio y pinzas de biopsia. Se obtuvieron 113 muestras que fueron estudiadas en el Departamento de Anatomía Patológica del Hospital Dr. Luis Calvo Mackenna, comprobándose que eran adecuadas para el examen histopatológico