Non-invasive diagnosis and grading of postsurgical endoscopic recurrence in Crohn's disease
Abstract Non-invasive techniques aim to be an alternative to endoscopy in the assessment of postsurgical recurrence of Crohn's disease (CD). The object of this study was to evaluate the accuracy of abdominal ultrasonography (AUS) and 99m Tc-hexamethylpropylene amineoxime ( 99m Tc-HMPAO)-labelled leucocyte scintigraphy (LLS) compared with endoscopy in the diagnosis and grading of postsurgical recurrence of CD. Between January 2006 and May 2007, all patients with CD and resection with ileocolic anastomosis were included prospectively. Within three days they underwent an ileocolonoscopy, AUS with evaluation of bowel wall thickness and the presence of Doppler flow, and LLS. Forty patients who m…
Ultrasonography and Transmural Healing in Crohn’s Disease
Úlcera solitaria de recto, ¿inflamación, infección, isquemia o trastorno motor?
Contrast-enhanced ultrasonography: usefulness in the assessment of postoperative recurrence of Crohn's disease.
Abstract Aim The aim of this study was to assess whether the contrast-enhanced ultrasonography (CEUS) can increase the value of the ultrasonography in the study of postoperative recurrence of Crohn's disease (CD). Materials and methods 60 patients with CD who had previously undergone ileocolic resection underwent prospectively both CEUS and colonoscopy within a 3-day period. The sonographic examination included evaluation of bowel wall thickness, transmural complications, colour Doppler grade and contrast-enhanced US. In addition a sonographic score was established. The capacity of CEUS to diagnose endoscopic recurrence, as well as its severity, was assessed by calculating the sensitivity, …
Reactivación de hepatitis B en paciente con hepatitis crónica C tratado con antivirales de acción directa
Role of the gastroenterologist in the management of the obese patient.
Obesity is a highly prevalent disease worldwide, and one in which gastroenterologists can play an important role. Some digestive diseases are more common in obese patients, and preoperative evaluation may be required in some cases. Additionally, bariatric surgery can lead to digestive complications in the short and long term that require intervention, and endoscopic treatment can be an important factor in weight loss. The aim of this review is to highlight the role of the gastroenterologist in the management of obese patients who are either scheduled for or have undergone surgical or endoscopic treatment for obesity.
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…
Síndrome del intestino irritable
Hemocromatosis: etiopatogenia, diagnóstico y estrategia terapéutica
Resumen La hemocromatosis hereditaria (HH) engloba varios trastornos hereditarios caracterizados por un aumento de la absorcion intestinal de hierro, y una acumulacion posterior en los tejidos. La mayoria de los pacientes (aproximadamente el 90%) con HH tienen mutaciones en el gen HFE . Aproximadamente el 95% de las personas con HH con mutacion HFE son homocigotos para la mutacion C282Y. Estudios poblacionales indican que la mutacion C282Y tiene una penetrancia incompleta. Las mutaciones en los genes relacionados con el hierro que codifican la hemojuvelina, hepcidina, ferroportina, receptor de transferrina 2 y la ferritina constituyen las HH no relacionadas con el gen HFE . En HH-HFE el exc…
Usefulness of abdominal ultrasonography in the analysis of endoscopic activity in patients with Crohn's disease: changes following treatment with immunomodulators and/or anti-TNF antibodies.
The objective of this study was to analyze the accuracy of abdominal ultrasonography (AUS) in the assessment of mucosal healing in patients with Crohn's disease (CD) receiving immunomodulators and/or biological treatment, with ileocolonoscopy as the reference standard.Thirty patients were included in a prospective longitudinal study. All patients underwent ileocolonoscopy and AUS before and after a minimum of one year of treatment. The Crohn's Disease Endoscopic Inflammatory Index of Severity (CDEIS) was used for endoscopic assessment whereas AUS was analyzed by means of bowel wall thickness, color Doppler grade and percentage of increase of parietal enhancement after contrast injection.In …
Mo2023 Virtual Chromoendoscopy With I-Scan As Alternative to Dye-Spray Chromoendoscopy for Dysplasia Detection in Long-Standing Colonic Inflammatory Bowel Disease
Hepatitis tóxica por escitalopram
Valor de la proteína C reactiva en la detección de la necrosis en la pancreatitis aguda
Objetivos Valorar la utilidad de la proteina C reactiva (PCR) en la deteccion de la necrosis en la pancreatitis aguda y precisar el mejor nivel de corte de la PCR para esta finalidad. Material y metodos Se incluyeron, de forma retrospectiva, 157 pacientes con pancreatitis aguda a los que se habia efectuado una tomografia computarizada (TC) con contraste intravenoso, entre las 72 h y el octavo dia del inicio de la sintomatologia, y determinado el valor de la PCR en el suero por nefelometria a partir de las 24 h del comienzo del dolor. Resultados En total, fueron incluidos 94 varones y 63 mujeres, con una media de edad de 61 anos (limites, 15-96 anos). La etiologia de la pancreatitis fue: lit…
Esteatosis hepática en la hepatitis crónica por virus C: estudio de los factores de riesgo y relación con el estadio de fibrosis
Fundamento y objetivo La esteatosis hepatica (EH) es un hallazgo histologico frecuente en la infeccion cronica por el virus de la hepatitis C (VHC) que puede influir en el pronostico de la enfermedad. El objetivo del presente estudio prospectivo es valorar los factores asociados a su presencia y su relacion con el estadio de fibrosis en pacientes con infeccion cronica por VHC. Material y metodo Se incluyo a 84 pacientes consecutivos con ARN-VHC positivo, no tratados previamente y a los que se practico una biopsia hepatica. En todos los pacientes se recogieron en el momento de la biopsia variables demograficas, clinicas, analiticas, virales e histologicas. Se practicaron analisis bivariante …
EXPERIENCE WITH CYTOLYT SOLUTION IN ENDOSCOPIC ULTRASOUND-GUIDED TISSUE SAMPLING FOR SPECIMEN PRESERVATION AND EVALUATION
Pancreas and Cystic Fibrosis: The Implications of Increased Survival in Cystic Fibrosis
Background: In acute pancreatitis (AP), pancreatic necrosis (PN) is an important local complication that can be identified by means of contrast-enhanced computed tomography (CECT).
Ser y no ser del síndrome del instestino irritable
El esfuerzo para desarrollar un sistema de definicion del sindrome del intestino irritable (SII) se justifica por la necesidad de disponer de una base que permita el logro de dos objetivos relevantes: efectuar un diagnostico positivo del sindrome y optimar su investigacion clinica. La importancia del primer objetivo es obvia si se considera que el SII es un trastorno de elevada prevalencia que, como muchos otros trastornos funcionales digestivos, carece de marcadores objetivos que lo caractericen; el no disponer de una prueba diagnostica definitiva determina, tanto en el medico como en el paciente, un elevado grado de incertidumbre y frustracion que frecuentemente lleva al clinico a solicit…
99mTc-Hexamethylpropylene Amineoxime Leukocyte Scintigraphy in Acute Pancreatitis: An Alternative to Contrast-Enhanced Computed Tomography?
Contrast-enhanced computed tomography (CECT) is the most efficient imaging technique for the diagnosis and staging of acute pancreatitis (AP); its use, however, may be unfeasible in some patients as a consequence of the drawbacks of intravenous (IV) contrast material. The aim of this study was to test the utility of labeled leukocyte scintigraphy (LLS) as an alternative imaging technique to CECT for the staging of AP.Sixty-six patients with AP were prospectively studied. All patients underwent CECT and pancreatic LLS using (99m)Tc-hexamethylpropylene amineoxime as leukocyte label within a time interval of 2 days, in the early phase of AP. In addition, all patients had their serum C-reactive…
Association ofStreptococcus gallolyticussubspeciesgallolyticuswith colorectal cancer: Serological evidence
The colonic opportunist Streptococcus gallolyticus subspecies gallolyticus (SGG) is potentially associated with colorectal cancer (CRC). Large-scale seroepidemiological data for SGG antibodies and their possible association with CRC is currently missing. Associations between CRC and antibody responses to SGG were examined in 576 CRC cases and 576 controls matched by sex, age and province from a population-based multicase-control project (MCC-Spain). MCC-Spain was conducted between 2008 and 2013 in 12 Spanish provinces. Antibody responses to recombinant affinity-purified SGG pilus proteins Gallo1569, 2039, 2178 and 2179 were analysed by multiplex serology. Polyomavirus (PyV) JC VP1 and PyV 6…
Patología articular en la enfermedad inflamatoria intestinal
The joint disorders taxonomically included in the group of seronegative spondyloarthropathies under the generic name of enteropathic arthropathy represent the most frequent extra-intestinal manifestation of inflammatory bowel disease (IBD), affecting 33% of patients. Their frequency is similar to that of ulcerative colitis and Crohn's disease. Enteropathic arthropathy consists of two main joint alterations, peripheral and axial arthritis, as well as a variable group of other peri-articular disorders. Type 1, or pauciarticular, peripheral arthritis generally coincides with IBD exacerbations, while type 2, or polyarticular, peripheral arthritis follows an independent course from IBD. Axial in…
Papel del digestólogo en el manejo del paciente obeso
Resumen La obesidad es una enfermedad con una elevada prevalencia a nivel mundial en la que el digestologo puede tener una labor importante. Por una parte, algunas enfermedades digestivas son mas frecuentes en este grupo de pacientes y es posible que sea necesario evaluarlos antes de la cirugia. Por otra, la cirugia bariatrica puede presentar complicaciones digestivas a corto y largo plazo en las que sea imprescindible nuestra actuacion. Ademas, no podemos olvidar el papel que el tratamiento endoscopico puede tener en la perdida de peso. El objetivo de la presente revision es destacar el papel del digestologo en el manejo del paciente obeso candidato y/o sometido a tratamiento quirurgico o …
Endoscopic treatment of recurrent sigmoid volvulus with colopexy assisted by T-fasteners and colostomy.
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…
Protocolo diagnóstico de sospecha de alteración del metabolismo férrico en el adulto
Resumen El hierro es un metal esencial para la vida, pero en cantidades elevadas resulta toxico. Las alteraciones del metabolismo del hierro pueden consistir tanto en sindromes que cursan con sobrecarga ferrica, destacando entre ellos la hemocromatosis hereditaria, como en estados deficitarios, representando la anemia ferropenica un problema de salud publica mundial. La anemia ferropenica se puede deber a perdidas excesivas, a un aumento de las necesidades de hierro o a cuadros de malabsorcion intestinal. Ademas del examen fisico se llega al diagnostico mediante datos de laboratorio, siendo el descenso de la ferritina y del indice de saturacion de transferrina los marcadores especificos de …