VALORACIÓN DEL TIEMPO DE TRÁNSITO COLÓNICO (TTC) EN EL DIAGNÓSTICO DEL ESTREÑIMIENTO CRÓNICO FUNCIONAL (ECF) Y SU RELACIÓN CON LOS DATOS DE UN DIARIO CLÍNICO (30 DÍAS)

Introduccion El estrenimiento es un sintoma relatado por el paciente y el medico verifica que cumple los criterios consensuados para sentar el diagnostico de ECF. Para algunos autores el TTC seria el metodo objetivo para la definicion de estrenimiento. Objetivos Relacionar los datos clinicos recogidos mediante diario de 30 dias con el TTC determinado por marcadores radioopacos en pacientes con ECF. Material y metodos Grupo de estudio constituido por 220 pacientes diagnosticados de ECF (Roma II) de edad media 38,3±15 anos (IC95% 36,3–40,3, mediana 37 anos), integrado por 204 mujeres (38,4±15,2, IC95% 36,3–40,5, mediana 37) y 16 hombres (36,1±12,9, IC95% 29,2–43, mediana 31,5 anos). Se han re…

Treatment of infected pancreatic necrosis: Outcome in a 9-year, single-center, consecutive series (2006-2014)

RELACIÓN DE COMPLICACIONES LOCALES EN PANCREATITIS AGUDA CON LA PERSISTENCIA DE LAS COMPLICACIONES SISTÉMICAS

Antecedentes De acuerdo con la clasificacion de Atlanta, la pancreatitis aguda grave se define por la presencia de complicaciones locales (CL) y/o sistemicas (CS). Recientemente se ha sugerido que aquellos pacientes con complicaciones sistemicas de inicio (CSI) que aparecen en la primera semana, pero duran menos de 48 horas, no deberian considerarse como indicadores de gravedad. Objetivo Analizar la evolucion y aparicion de complicaciones locales en pacientes con Pancreatitis Aguda (PA) en funcion de la presencia o no de CSI transitorias o permanentes. Metodos Se han recogido prospectiva y consecutivamente todos los pacientes con un primer episodio de PA entre enero de 2000 y diciembre de 2…

Recurrence of Acute Gallstone Pancreatitis and Relationship with Cholecystectomy or Endoscopic Sphincterotomy

To determine the prevalence of recurrence of gallstone pancreatitis, its clinical features, and the presence of prognostic factors of recurrence.From January 1, 2000 to August 31, 2003, 233 patients admitted with acute gallstone pancreatitis (AGP) were prospectively studied. Patients were divided into two groups: recurrent and nonrecurrent group. Clinical, analytical, radiological, prognostic parameters, and severity (Atlanta criteria) were assessed, along with the performance of cholecystectomy or endoscopic sphincterotomy (ES). Clinical features of recurrence were analyzed. Univariate (chi(2), Student's t-test) and multivariate tests were performed. Statistical significance was assumed if…

Evidence-based Guidelines for the Management of Exocrine Pancreatic Insufficiency After Pancreatic Surgery

Objective: To provide evidence-based recommendations for the management of exocrine pancreatic insufficiency (EPI) after pancreatic surgery. Background: EPI is a common complication after pancreatic surgery but there is certain confusion about its frequency, optimal methods of diagnosis, and when and how to treat these patients. Methods: Eighteen multidisciplinary reviewers performed a systematic review on 10 predefined questions following the GRADE methodology. Six external expert referees reviewed the retrieved information. Members from Spanish Association of Pancreatology were invited to suggest modifications and voted for the quantification of agreement. Results: These guidelines analyz…

Diagnosis, treatment and long-term outcomes of autoimmune pancreatitis in Spain based on the International Consensus Diagnostic Criteria: A multi-centre study.

Abstract Objectives Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis that has been reported worldwide for the last two decades. The aim of this study is to analyse the clinical profile of patients from Spain with AIP, as well as treatments, relapses and long-term outcomes. Methods Data from 59 patients with suspected AIP that had been diagnosed in 15 institutions are retrospectively analysed. Subjects are classified according to the International Consensus Diagnostic Criteria (ICDC). Patients with type 1 AIP (AIP1) and type 2 AIP (AIP2) are compared. Kaplan–Meier methodology is used to estimate the overall survival without relapses. Results Fifty-two patients met ICDC, 45 pat…

Caustic ingestion: development and validation of a prognostic score

Abstract Background Caustic ingestion is a potentially severe condition and early identification of poor outcome is essential to improve management; however, prediction based on endoscopy alone can overestimate severity. This study aimed to develop and validate a prognostic score. Methods A prospective cohort study was designed to include all consecutive patients aged > 15 years who presented with caustic ingestion between 1995 and 2017. Adverse outcome was defined by intensive care unit admission, urgent surgery, or death. The predictive value of clinical, analytical, and endoscopic variables was assessed in the first cohort (derivation cohort) and a prognostic score based on the result…

Neoadjuvant treatment for locally advanced unresectable and borderline resectable pancreatic cancer: oncological outcomes at a single academic centre.

INTRODUCTION: Pancreatic cancer (PC), even in the absence of metastatic disease, has a dismal prognosis. One-third of them are borderline resectable (BRPC) or locally advanced unresectable PC (LAUPC) at diagnosis. There are limited prospective data supporting the best approach on these tumours. Neoadjuvant chemotherapy (ChT) is being increasingly used in this setting. METHODS: This is a retrospective series of consecutive patients staged as BRPC or LAUPC after discussion in the multidisciplinary board (MDB) at an academic centre. All received neoadjuvant ChT, followed by chemoradiation (ChRT) in some cases, and those achieving enough downstaging had a curative-intent surgery. Descriptive da…

Association of elevated serum triglyceride levels with a more severe course of acute pancreatitis: Cohort analysis of 1457 patients.

Previous publications have reported an association between hypertriglyceridemia (HTG) and severity of acute pancreatitis, but this relationship remains somewhat controversial.To evaluate the outcome of acute pancreatitis according to serum triglyceride levels on admission.Retrospective analysis of prospectively collected data, which included all consecutive cases of acute pancreatitis admitted to a tertiary hospital (January 2002-December 2014). Acute pancreatitis patients were classified into 3 groups based on serum triglyceride levels (mg/dl) measured within 48 h from admission: normal triglycerides-mild HTG (200); moderate HTG (200-749); severe HTG (≥750). Primary outcomes were the diffe…

Elevated serum eotaxin levels in patients with inflammatory bowel disease.

OBJECTIVE: Eotaxin is a recently characterized chemokine with potent and selective chemotactic activity for eosinophils. Previous studies indicating that eosinophils accumulate and become activated in inflammatory bowel disease (IBD) led us to hypothesize that eotaxin is potentially involved in the pathophysiology of IBD and, therefore, that eotaxin would be increased in the serum of patients with IBD. The objective of this study was to test those assumptions. METHODS: We investigated 72 patients with IBD, 35 with ulcerative colitis, and 37 with Crohn’s disease. A total of 27 patients had active and 45 inactive disease; 26 were receiving corticosteroids. Eotaxin serum levels were determined…

A risk score system for identification of patients with upper-GI bleeding suitable for outpatient management.

Abstract Background The aim of this study was to develop a risk score system for identification of patients with upper-GI hemorrhage who are suitable for outpatient management. Methods From a prospective cohort of 983 consecutive patients with upper-GI hemorrhage not associated with portal hypertension, 581 cases that did not meet pre-established criteria for admission were selected, and a logistic regression analysis was performed to identify factors associated with two adverse outcomes: recurrent bleeding and/or the need for emergency surgery. The risk score system was developed by using the beta coefficients of the logistic model, and its performance was evaluated. The results of this mo…

Malondialdehyde in early phase of acute pancreatitis

Aims: to assess oxidative stress in acute pancreatitis, its evolution over time and its relationship with the severity of the disease. Methods: during a two-year period, patients with acute pancreatitis with less than 24 hours of pain were evaluated. Serum was obtained the first, second and fourth day from admittance, if complications were detected, and after recovery. Malondialdehyde was determined by high performance liquid chromatography. Twenty healthy volunteers constituted the control group. Malondialdehyde between groups was compared with Mann-Whitney and Kruskal-Wallis tests; malondialdehyde evolution was studied with Wilcoxon test. Results: one hundred and sixty-nine patients were …

Dental and periodontal lesions in patients with gastro-oesophageal reflux disease.

Dental erosion has been considered an extraesophageal manifestation of gastro-oesophageal reflux disease, but few reports have studied the relationship between this disease and other periodontal or dental lesions. The aim of this study was to investigate the prevalence of dental and periodontal lesions in patients with gastro-oesophageal reflux disease.A total of 253 subjects were prospectively studied between April 1998 and May 2000. Two study groups were established: 181 patients with gastro-oesophageal reflux disease and 72 healthy volunteers. Clinical assessment, including body mass index and consumption of tobacco and alcohol, was performed in all subjects, as well as a dental and peri…

Diagnosis and treatment of autoimmune pancreatitis in Spain

Aims: The analysis of laparoscopic operations in treatment of chronic pancreatitis. Patients & methods: In our clinic there were performed 32 laparoscopic interventions for chronic pancreatitis and its complications. Results: Laparoscopic interventions were performed in 32 cases: cystogastrostomy10, cystoduodenostomy2, cystojejunostomy3, cystectomy1, longitudinal laparoscopic pancreaticojejunostomy 2, the Beger procedure without proximal pancreatoenterostomy 2 and the Berne modification 10. In all the cases of laparoscopic procedures the communication of a cystwith the main pancreatic duct were confirmed by preoperative biochemical and cytologic analysis of cystic fluid taken under the ultr…