RESUMO
RESUMEN Las duplicaciones del tracto gastrointestinal son malformaciones congénitas poco frecuentes que pueden afectar cualquier segmento del tubo digestivo. Suelen presentarse en los primeros dos años de vida con síntomas de pobre ganancia de peso y masa abdominal palpable o pueden ser asintomáticos hasta la adultez. Reportamos el caso de un paciente masculino de 37 años que fue evaluado por epigastralgia y antecedente de hemorragia digestiva superior. La endoscopia alta reveló lesión subepitelial en fundus gástrico ulcerada con sospecha diagnóstica de tumor del estroma gastrointestinal (GIST). El ultrasonido endoscópico confirmó masa gástrica con focos de necrosis y calcificación, compatible con tumor estromal tipo GIST. Se realizó resección gástrica distal en cuña sin complicaciones. El informe de patología señaló duplicación gástrica.
ABSTRACT Gastrointestinal tract duplications are rare congenital malformations that can affect any segment of the digestive tract. They usually occur in the first two years of life with symptoms of poor weight gain and palpable abdominal mass or may be asymptomatic until adulthood. We report the case of a 37-year-old male patient who was evaluated for epigastralgia and a history of upper gastrointestinal bleeding. High endoscopy revealed ulcerated subepithelial lesion in gastric fundus with diagnostic suspicion of gastrointestinal stromal tumor (GIST). Endoscopic ultrasound confirmed gastric mass with foci of necrosis and calcification, compatible with stromal tumor type GIST. Distal gastric resection was performed in wedge without complications. The pathology report noted gastric duplication.
Assuntos
Adulto , Humanos , Masculino , Neoplasias Gástricas , Cistos , Tumores do Estroma Gastrointestinal , Anormalidades do Sistema Digestório , Hemorragia GastrointestinalRESUMO
Gastrointestinal tract duplications are rare congenital malformations that can affect any segment of the digestive tract. They usually occur in the first two years of life with symptoms of poor weight gain and palpable abdominal mass or may be asymptomatic until adulthood. We report the case of a 37-year-old male patient who was evaluated for epigastralgia and a history of upper gastrointestinal bleeding. High endoscopy revealed ulcerated subepithelial lesion in gastric fundus with diagnostic suspicion of gastrointestinal stromal tumor (GIST). Endoscopic ultrasound confirmed gastric mass with foci of necrosis and calcification, compatible with stromal tumor type GIST. Distal gastric resection was performed in wedge without complications. The pathology report noted gastric duplication.
Assuntos
Cistos , Anormalidades do Sistema Digestório , Tumores do Estroma Gastrointestinal , Neoplasias Gástricas , Adulto , Hemorragia Gastrointestinal , Humanos , MasculinoRESUMO
Introducción: Las políticas públicas son asuntos clave de la gestión gubernamental y su estudio es importante cuando se analiza el impacto que tienen frente a problemas relevantes que se reflejan en el perfil epidemiológico. Objetivo: Analizar la importancia que las enfermedades cardio-cerebro-vasculares tuvieron en la formulación de las políticas públicas en salud en Medellín entre 2000-2013. Materiales y métodos: Enfoque cualitativo con estrategia metodológica de análisis documental de corte hermenéutico. Se tomaron como base los acuerdos aprobados por el Concejo de Medellín y se seleccionaron aquellos, que tienen relación directa o indirecta con estas enfermedades, asimismo se revisaron planes de desarrollo contextualizados en lineamientos de políticas nacionales e internacionales. Resultados: Se encuentra un acuerdo que se refiere explícitamente a estas enfermedades. La mayoría son políticas orientadas, a grupos específicos o problemáticas relacionadas con promoción de la salud y prevención de las enfermedades cardio-cerebro-vasculares. El seguimiento y evaluación son fases menos tenidas en cuenta en el ciclo de las políticas públicas. Conclusiones: Los resultados sugieren la necesidad de una concepción amplia de la salud que oriente la formulación de las políticas locales e impacte un problema tan complejo e importante para el municipio, como lo son estas enfermedades.
Introduction: Public policy is a key element to government administration and its study is important when analyzing the impact it has on relevant issues evidenced in the epidemiological profile. Objective: To analyze the importance of cardio-cerebrovascular diseases in the development of public policy in health in Medellin between 2000 and 2013. Materials and methods: A qualitative approach with hermeneutic documentary analysis was done. The agreements approved by the Medellin council were taken as a base, from which those directly or indirectly related with these diseases were selected. Plans of action based on national and international policy guidelines were also reviewed. Results: An agreement that explicitly referred to these diseases was found. Most policy is oriented toward specific groups or issues related to health promotion and the prevention of cardio-cerebrovascular diseases. Follow-up and evaluation are the most overlooked stages of the public policy cycle. Conclusions: These results suggest the need for a broader definition of health that foments local policy development and impacts such a complex and important issue for the city by taking into account these diseases.
Assuntos
Formulação de Políticas , Fatores de Risco , Promoção da SaúdeRESUMO
INTRODUCTION: Among different kinds of cerebrovascular diseases, few of them are caused by genetic disturbances, such as CADASIL (caused by Notch3 mutations), CARASIL, mitochondrial encephalopathy, MELAS and dementia typed Binswanger. However, to describe these type of cerebrovascular diseases related with genetic mutations could permit to determinate the causes of both hereditary and sporadic cerebrovascular diseases and then lead solutions. OBJECTIVE: To describe the genetic, environmental and cohort factors that determinate the presence of many affected people by a several cerebrovascular diseases in the pedigree of a large family from Antioquia (Colombia). PATIENTS AND METHODS: We performed one pedigree (268 individuals), through singular recruit and then complex segregation analysis with POINTER program. RESULTS: The model that more close to data is autosomal dominant mayor locus without influence of environmental factors. Frequency of allele of susceptibility to develop stroke or subcortical vascular dementia was 0.0006. Mayor gene is over epistatic effects or interactions with other gene. CONCLUSIONS: Described an autosomal dominant hereditary model through complex segregation analysis in a pedigree of patients with hereditary cerebral vascular diseases characterized by recurrent strokes, early onset subcortical dementia, hearing loss, antecedent of migraine and MRI signal abnormalities, subcortical infarcts and leukoencephalopathy. In this family the parameter calculated, autosomal dominant model, and clinical feature strongly support the diagnostic of CADASIL, linkage analysis and sequentiation will be performed to determinate if mutant gene is Notch3.