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2.
Gastroenterol. latinoam ; 22(2): 91-97, abr.-jun. 2011. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-661801

RESUMO

Celiac disease diagnosis (CD) is based on clinical, serological and histological studies. Endoscopy is of great help in clinically suspicious celiac disease patients showing digestive symptoms related to this exam. Objective: To describe endosopic lesions in 70 videos of celiac disease patients, to analyze concordance among endoscopists and correlate with histology. Materials and methods: Seventy videos are edited, corresponding to 20 Marsh III A patients; 25 Marsh III B; and 25 Marsh III C. Five endoscopists reviewed the duodenal bulb and the second portion, checking for markers such as reduction in the number of duodenal folds; scalloping of folds; mucosal fissures or cracks; Mosaic pattern to the mucosa; Nodes and Vascular Augmentation. The presence of a lesion was assigned 1 point; 0 points in case of no lesion. Results: Videos correspond to 57 women (81.4 percent) and 13 men; 90 percent between 21-60 years old. Lesions were observed in the bulb in 55 (78.5 percent) cases (78.2 percent nodes; 9 percent vascular augmentation and 12.7 percent nodes and vascular augmentation). In the second portion, 100 percent presented a lesion: scalloping of folds (60 percent); reduction in the number of folds (58.5 percent); mucosal fissures or cracks (45.7 percent); Nodes (31.4 percent); Mosaic pattern (12.8 percent) and vascular augmentation (11.4 percent). Two or more lesions were detected en 53 cases (75 percent). Concordance among endoscopists was 72.1 percent. Average score assigned by the endoscopists to Marsh III A was 9.05; 11.2 to Marsh III B, and 13.6 to Marsh III C; p < 0,001 between III A and III C; non-significant between III A and B, and III B and III C. Conclusions: All patients present a type of lesion of the second portion and 78 percent also in the bulb. The most frequently occurring are scalloping of folds and reduction in the number of folds; most of the cases present two or more markers...


El diagnóstico de la enfermedad celíaca (EC) se basa en la clínica, la serología e histología. Se considera a la endoscopia de gran ayuda en la sospecha de EC, en pacientes con sintomatología digestiva derivados para este examen. Objetivo: Describir las lesiones endoscópicas en 70 videos de pacientes celíacos, analizar la concordancia entre endoscopistas, y correlacionar con la histología. Material y Método: Se editan 70 videos correspondiente a 20 pacientes Marsh III A; 25 casos Marsh III B; y 25 casos Marsh III C. Cinco endoscopistas revisaron el bulbo duodenal y la segunda porción, evaluando la presencia de marcadores como disminución de pliegues (DP); Festoneado (F); Surcos (S); Mosaico (M); Nódulos (N) y Aumento de vasculatura (AV). A la presencia de una lesión se le asignó 1 punto y la ausencia 0 puntos. Resultados: Los videos corresponden a 57 mujeres (81,4 por ciento) y 13 hombres; el 90 por ciento tiene 21 a 60 años. En el bulbo se observaron lesiones en 55 (78,5 por ciento) casos (78,2 por ciento nódulos; 9 por ciento AV y 12,7 por ciento N+AV). En la segunda porción, el 100 por ciento presentaba alguna lesión: F en 60 por ciento; DP (58,5 por ciento), S (45,7 por ciento); N (31,4 por ciento); M (12,8 por ciento) y AV (11,4 por ciento). Se detectaron dos o más lesiones en 53 casos (75 por ciento). La concordancia entre endoscopistas fue de 72,1 por ciento. El puntaje promedio asignado por los endoscopistas a los Marsh III A fue de 9,05; 11,2 a los III B y 13,6 a los Marsh III C; p < 0,001 entre III A y III C, no significativo entre III A y B, y III B y III C. Conclusiones: Todos los pacientes presentan algún tipo de lesión de la segunda porción y 78 por ciento además en el bulbo. Las más frecuentes son el festoneado y la disminución de pliegues, y la mayoría de los casos presentan más de dos marcadores. Mientras más daño histológico de la mucosa, se observó un mayor número de lesiones...


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Endoscopia Gastrointestinal , Doença Celíaca/diagnóstico , Doença Celíaca/patologia , Biópsia , Distribuição por Idade , Duodeno/patologia , Doença Celíaca/classificação , Gravação em Vídeo , Mucosa Intestinal/patologia , Sensibilidade e Especificidade , Variações Dependentes do Observador , Índice de Gravidade de Doença
4.
Rev. méd. Chile ; 119(2): 158-63, feb. 1991. tab
Artigo em Espanhol | LILACS | ID: lil-98199

RESUMO

Fine needloe aspiration cytology (FNAC) has been shown to be second only to surgical biopsy for demonstration of malignancy in thyroid nodules. A prospective study of FNAC for euthyroid uninodular goiter (EUG) was conducted between January 1987 and June 1990, totalizing 87 patients of which 61 were submitted to surgical biopsy. FNAC in the latter were interpreted as benign in 41 cases, suspected malignancy in 8, and definitely malignant in 7. The remaining 5 smears were considered technically inadecuate for diagnosis. In 39 of the 41 patients with a benign (negative- cytology result, the histopathological diagnosis confirmed the absenece of a neoplastic process (2 false negatives). In 12 of the 15 patients with a suspected amloignant (positive) cytology result, a subsequent histopathological report confirmed a neoplastic process (3 false positives). Thus FNAC had a sensitivity of 86% and a specificity of 93%. We conclude that FNAC is a valuable tool for the diagnosis of enthyroid goiter and could help reduce significantly the number of patients who need to be surgically intervened


Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Biópsia por Agulha , Bócio Nodular/patologia , Diagnóstico Diferencial
5.
Cuad. cir ; 5(1): 35-9, 1991. tab
Artigo em Espanhol | LILACS | ID: lil-131653

RESUMO

En 10 pacientes con quemaduras de tercer grado de 19ñ4,5 por ciento de superficie corporal comprometida, se tomaron biopsias de la herida el día 5§, 12§ y 18§ para comparar prospectivamente el rendimiento individual de la biopsia contemporánea por congelación, biopsia diferida por inclusión y el recuento de colonias por gramo de tejido, de los pacientes con infección invasora y potencial desarrollo de sepsis secundaria. En 6 casos se produjo infección invasora clínica. De ellos, 2 pacientes presentaron sépsis. En 4 pacientes no se identificó infección invasora. No hubo mortalidad. En los pacientes con infección invasora, 15/18 muestras evidenciaron gérmenes en tejido vital en la biopsia contemporánea. En la biopsia diferida, 16/18 y 14/18 muestras mostraron gérmenes e inflamación, lo que es comparable para ambos métodos. En el grupo sin infección invasora, 2/12 muestras señalaron gérmenes con ambas técnicas. El recuento de coloniaspor gramo fue 10 5 en 14/18 muestras en el grupo con infección invasora y 10 3 en 8/12 muestras en el segundo grupo, diferencia estadísticamente significativa. Se concluye que en una experiencia inicial, los métodos biópticos y microbiológicos cuantitativos han sido efectivos para diagnosticar precozmente la infección invasora de la herida con una predicción de 78 y 83 por ciento respectivamente, lo que permitirá ajustar oportunamente el tratamiento local y sistémico en futuros casos de alto riesgo y evitar la sepsis. Se destaca la ventaja en la rapidez de información que ofrece la biopsia contemporánea por congelación


Assuntos
Humanos , Masculino , Feminino , Infecções Bacterianas/diagnóstico , Queimaduras/complicações , Infecção dos Ferimentos/diagnóstico , Biópsia , Queimaduras/patologia , Cicatriz/microbiologia
6.
Rev. méd. Chile ; 118(10): 1111-5, oct. 1990. tab
Artigo em Espanhol | LILACS | ID: lil-96805

RESUMO

We report our experience with 19 patients with early gastric cancer in Valdivia, a southern province of Chile. All patients had symptoms and 15 had a preoperative biopsy. A mean of 39 days elapsed between biopsy and surgery. An emergency operation was performed in 3 patients. The mean lesion size was 10 cm2. An intramucous location was prsent in 9 patients and a submucous one in 10. Infiltration of the first lymph node barrier was observed in only 1 patient. A type F.1 ressection was performed in 68% of patients, a type 2 resection in 11% and a type 3 in 5%. Recurrences were observed in 3 patients and 2 of them died. 5 year survival rate was 100% and 7 year survival rate was 100% and 7 years survival was 68%


Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/cirurgia , Biópsia , Endoscopia
10.
Clin Cardiol ; 11(5): 329-33, 1988 May.
Artigo em Inglês | MEDLINE | ID: mdl-3383471

RESUMO

Left ventricular (LV) morphological and functional characteristics in 9 women suffering from pregnancy-induced hypertension (PIH) were studied by means of echocardiograms. In order to distinguish which changes depended on the pressure values and which were the result of pregnancy, 10 nonpregnant control women with no heart disease and 10 normal pregnant women (NP) were studied and the results of each of the groups compared. To evaluate the structure, left ventricular systodiastolic diameters and wall thickness were measured. The only statistically significant difference was in the diastolic diameters between the PIH (4.7 +/- 0.3 cm) and the control group (4.4 +/- 0.2 cm) p less than 0.01. Left ventricular mass was significantly increased (p less than 0.01) in the PIH patients (185 +/- 53.1 g) compared to the NP patients (161 +/- 29.6 g) and the control group (125 +/- 17.4 g). No statistically significant differences were found in the radius thickness ratio in the three groups. The systolic function assessed by the shortening percentage was significantly lower (p less than 0.05) in the control group (32.8 +/- 4.4%) and in the NP patients (37.8 +/- 5.2%) than in the PIH group (39 +/- 6.5%). Afterload assessed by isovolumic period stress was significantly greater (p less than 0.01) in the PIH patients (157 +/- 10.6 dyne/cm2) compared with the NP group (118.9 +/- 7.01 dyne/cm2). There were no significant differences between the first group and the control group (134.09 +/- 8.7 dyne/cm2). As evidence of the diastolic function, analysis was made, on the one hand, of diastolic isovolumic period length (DIP).(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Coração/fisiopatologia , Hipertensão/fisiopatologia , Complicações Cardiovasculares na Gravidez/fisiopatologia , Adolescente , Adulto , Pressão Sanguínea , Ecocardiografia , Feminino , Frequência Cardíaca , Ventrículos do Coração/patologia , Humanos , Hipertensão/patologia , Gravidez , Complicações Cardiovasculares na Gravidez/patologia , Sístole
11.
Rev. chil. obstet. ginecol ; 51(1): 42-55, 1986. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-44556

RESUMO

Con el objeto de estudiar la morfología del tejido mamario en nuestro medio, se examinaron 152 muestras obtenidas de autopsias médico-legales, separando el material por grupos de edad, con amplitud de 14 a 96 años. Se encontró fibrosis lobulillar en el 70% de los casos, con una presencia ligeramente superior al 50% en la tercera y cuartas décadas. Los microquistes estaban presentes en el 50%; los macroquistes en el 9%; la metaplasia apocrina en el 28%, y la hiperplasia epitelial en el 9%. Estos hallazgos concuerdan con la observación de otros autores, que han informado una alta presencia de rasgos morfológicos de la enfermedad fibroquística en tejido mamario aparentemente sano. El examen de nuestro material estaría indicando que la fibrosis, los microquistes y la metaplasia apocrina son muy frecuentes, y su presencia aislada no permite formular el diagnóstico de enfermedad fibroquística de la mama


Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Mama/patologia , Doença da Mama Fibrocística/patologia , Tecido Adiposo/patologia , Fatores Etários , Autopsia , Hiperplasia , Metaplasia
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