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Ayala I, Cabot A, Garcia-Martinez JD, Escobar MT, Alberca F. Endoscopic Endocautery Polypectomy for the Treatment of Duodenal and Gastric Polyps in a Cat. Top Companion Anim Med 2021; 44:100537. [PMID: 33957307 DOI: 10.1016/j.tcam.2021.100537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/23/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
Endoscopic polypectomy is commonly performed in human medicine, with large-scale studies reported. However, few reports have described its use in veterinary medicine and, specifically, the procedure in the case of duodenal polyps in cats has not been reported. A 7 kg 14-year-old cat presented with recurrent vomiting for several months. Gastroduodenoscopy revealed a pedunculated polyp at the pyloric antrum and another in the duodenum, with its head protruding into the pylorus. Endoscopic polypectomy was performed using an electrosurgical snare with no recurrence of clinical signs after six months. Duodenal polypectomy in cats may be difficult because of space limitation but it can be safe, minimally invasive, and successful, thus avoiding more invasive surgical techniques. Endoscopic polypectomy may be a viable alternative to surgery in cats with gastric and duodenal polyps.
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Affiliation(s)
- Ignacio Ayala
- University of Murcia: Universidad de Murcia, Espinardo, Murcia, Spain.
| | - Antonio Cabot
- University of Murcia: Universidad de Murcia, Espinardo, Murcia, Spain
| | | | | | - Fernando Alberca
- University of Murcia: Universidad de Murcia, Espinardo, Murcia, Spain
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Ruiz de Angulo D, Ortiz MÁ, Munitiz V, Martínez de Haro LF, Alberca F, Serrano A, Egea J, Parrilla P. Role of self-expanding stents in the treatment of intrathoracic dehiscence after Ivor Lewis esophagectomy. Cir Esp 2018; 96:555-559. [PMID: 29934256 DOI: 10.1016/j.ciresp.2018.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/13/2018] [Accepted: 05/06/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The role that self-expanding stents play in the treatment of dehiscence after transthoracic esophagectomy is not well defined and controversial. Our aim is to describe the experience in a tertiary care hospital using these devices for treating dehiscence after Ivor Lewis esophagectomy. METHODS Descriptive observational study of patients who suffered anastomotic dehiscence after a transthoracic esophagectomy, and especially those treated with stents, in the period between 2011-2016 at our hospital. RESULTS Ten patients (11.8%) presented anastomotic dehiscence. Eight patients received stents, one of them died due to causes unrelated to the device. Stent migration was observed in one case, and the devices were maintained an average of 47.3 days. The stent was not effective only in one patient who suffered early dehiscence due to acute ischemia of the stomach. The two patients who did not receive stents died after reoperation. CONCLUSIONS Stents are safe and effective devices that did not associate mortality in our series. They are especially indicated in intermediate or late-onset dehiscence and in fragile patients. The use of stents, together with mediastinal and pleural drainage, avoid reoperations with morbidity and mortality. Therefore, stents should be part of the usual therapeutic arsenal for the resolution of most suture dehiscences after Ivor Lewis esophagectomy. Randomized prospective studies would help to more precisely determine the role played by these devices in the treatment of dehiscence after transthoracic esophagectomy.
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Affiliation(s)
- David Ruiz de Angulo
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España.
| | - María Ángeles Ortiz
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Vicente Munitiz
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Luisa Fernanda Martínez de Haro
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Fernando Alberca
- Unidad de Endoscopias, Servicio de Medicina Interna del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Andrés Serrano
- Unidad de Endoscopias, Servicio de Medicina Interna del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Juan Egea
- Unidad de Endoscopias, Servicio de Medicina Interna del Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Pascual Parrilla
- Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
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Vivas D, Roldán I, Ferrandis R, Marín F, Roldán V, Tello-Montoliu A, Ruiz-Nodar JM, Gómez-Doblas JJ, Martín A, Llau JV, Ramos-Gallo MJ, Muñoz R, Arcelus JI, Leyva F, Alberca F, Oliva R, Gómez AM, Montero C, Arikan F, Ley L, Santos-Bueso E, Figuero E, Bujaldón A, Urbano J, Otero R, Hermida JF, Egocheaga I, Llisterri JL, Lobos JM, Serrano A, Madridano O, Ferreiro JL. Perioperative and Periprocedural Management of Antithrombotic Therapy: Consensus Document of SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT and AEU. ACTA ACUST UNITED AC 2018; 71:553-564. [PMID: 29887180 DOI: 10.1016/j.rec.2018.01.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/05/2018] [Indexed: 01/17/2023]
Abstract
During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice.
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Affiliation(s)
- David Vivas
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain; Unidad de Cardiología, Clínica MD Anderson, Madrid, Spain.
| | - Inmaculada Roldán
- Servicio de Cardiología, Hospital Universitario La Paz, CIBER-CV, Madrid, Spain
| | - Raquel Ferrandis
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Universitat de València, Valencia, Spain
| | - Francisco Marín
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, CIBER-CV, Murcia, Spain
| | - Vanessa Roldán
- Servicio de Hematología, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Antonio Tello-Montoliu
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, CIBER-CV, Murcia, Spain
| | - Juan Miguel Ruiz-Nodar
- Servicio de Cardiología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante ISABIAL, CIBER-CV, Alicante, Spain
| | - Juan José Gómez-Doblas
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, CIBER-CV, Málaga, Spain
| | - Alfonso Martín
- Servicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Juan Vicente Llau
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic Universitari, València, Universitat de València, Valencia, Spain
| | | | - Rafael Muñoz
- Servicio de Cirugía Cardiaca, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Juan Ignacio Arcelus
- Servicio de Cirugía General y Digestiva, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Francisco Leyva
- Servicio de Cirugía Plástica, Estética y Reparadora, Hospital Clínico San Carlos, Madrid, Spain
| | - Fernando Alberca
- Servicio de Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Raquel Oliva
- Servicio de Ginecología y Obstetricia, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Ana María Gómez
- Servicio de Cirugía Torácica, Hospital Clínico San Carlos, Madrid, Spain
| | - Carmen Montero
- Servicio de Neumología, Hospital Universitario A Coruña, A Coruña, Spain
| | - Fuat Arikan
- Servicio de Neurocirugía, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Luis Ley
- Servicio de Neurocirugía, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Elena Figuero
- Departamento de Especialidades Clínicas Odontológicas (DECO), Facultad de Odontología, Universidad Complutense de Madrid UCM, Madrid, Spain
| | - Antonio Bujaldón
- Facultad de Odontología, Universidad Complutense de Madrid UCM, Madrid, Spain
| | - José Urbano
- Servicio de Radiología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Rafael Otero
- Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - José Luis Llisterri
- Medicina de Familia, Centro de Salud Ingeniero Joaquín Benlloch, Valencia, Spain
| | | | - Ainhoa Serrano
- Servicio de Medicina Intensiva, Hospital Clínico Universitario, Valencia, Spain
| | - Olga Madridano
- Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - José Luis Ferreiro
- Área de Enfermedades del Corazón, Hospital Universitario de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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Argüelles-Arias F, Donat E, Fernández-Urien I, Alberca F, Argüelles-Martín F, Martínez MJ, Molina M, Varea V, Herrerías-Gutiérrez JM, Ribes-Koninckx C. Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases). Rev Esp Enferm Dig 2017; 107:714-31. [PMID: 26671584 DOI: 10.17235/reed.2015.3921/2015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Capsule Endoscopy (CE) in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. MATERIAL AND METHODS Some experts from the Spanish Society of Gastroenterology (SEPD) and Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) were invited to answer different issues about CE in children. These sections were: a) Indications, contraindications and limitations; b) efficacy of CE in different clinical scenarios; c) CE performance; d) CE-related complications; e) Patency Capsule; and f) colon capsule endoscopy. They reviewed relevant questions on each topic. RESULTS The main indication is Crohn's disease (CD). There is no contraindication for the age and in the event that the patient not to swallow it, it should be administered under deep sedation with endoscopy and specific device. The CE is useful in CD, for the management of OGIB in children and in Peutz-Jeghers syndrome (in this indication has the most effectiveness). The main complication is retention, which should be specially taken into account in cases of CD already diagnosed with malnutrition. A preparation regimen based on a low volume of polyethylene glycol (PEG) the day before plus simethicone on the same day is the best one in terms of cleanliness although does not improve the results of the CE procedure. CONCLUSIONS CE is safe and useful in children. Indications are similar to those of adults, the main one is CD to establish both a diagnosis and disease extension. Moreover, only few limitations are detected in children.
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Affiliation(s)
| | | | | | - Fernando Alberca
- DIGESTIVO/ENDOSCOPIAS, Hospital Universitario Virgen de la Arrixaca. Murcia, España
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Vazquez-Sequeiros E, Baron TH, Pérez-Miranda M, Sánchez-Yagüe A, Gornals J, Gonzalez-Huix F, de la Serna C, Gonzalez Martin JA, Gimeno-Garcia AZ, Marra-Lopez C, Castellot A, Alberca F, Fernandez-Urien I, Aparicio JR, Legaz ML, Sendino O, Loras C, Subtil JC, Nerin J, Perez-Carreras M, Diaz-Tasende J, Perez G, Repiso A, Vilella A, Dolz C, Alvarez A, Rodriguez S, Esteban JM, Juzgado D, Albillos A. Evaluation of the short- and long-term effectiveness and safety of fully covered self-expandable metal stents for drainage of pancreatic fluid collections: results of a Spanish nationwide registry. Gastrointest Endosc 2016; 84:450-457.e2. [PMID: 26970012 DOI: 10.1016/j.gie.2016.02.044] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/17/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Initial reports suggest that fully covered self-expandable metal stents (FCSEMSs) may be better suited for drainage of dense pancreatic fluid collections (PFCs), such as walled-off pancreatic necrosis. The primary aim was to analyze the effectiveness and safety of FCSEMSs for drainage of different types of PFCs in a large cohort. The secondary aim was to investigate which type of FCSEMS is superior. METHODS This was a retrospective, noncomparative review of a nationwide database involving all hospitals in Spain performing EUS-guided PFC drainage. From April 2008 to August 2013, all patients undergoing PFC drainage with an FCSEMS were included in a database. The main outcome measurements were technical success, short-term (2 weeks) and long-term (6 months) effectiveness, adverse events, and need for surgery. RESULTS The study included 211 patients (pseudocyst/walled-off pancreatic necrosis, 53%/47%). The FCSEMSs used were straight biliary (66%) or lumen-apposing (34%). Technical success was achieved in 97% of patients (95% confidence interval [CI], 93%-99%). Short-term- and long-term clinical success was obtained in 94% (95% CI, 89%-97%) and 85% (95% CI, 79%-89%) of patients, respectively. Adverse events occurred in 21% of patients (95% CI, 16%-27%): infection (11%), bleeding (7%), and stent migration and/or perforation (3%). By multivariate analysis, patient age (>58 years) and previous failed drainage were the most important factors associated with negative outcome. CONCLUSIONS An FCSEMS is effective and safe for PFC drainage. Older patients with a history of unsuccessful drainage are more likely to fail EUS-guided drainage. The type of FCSEMS does not seem to influence patient outcome.
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Affiliation(s)
- Enrique Vazquez-Sequeiros
- Endoscopy Unit, Gastroenterology Division, University Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Gastroenterology Division, University Hospital Quirón, Madrid, Spain
| | - Todd H Baron
- Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Manuel Pérez-Miranda
- Department of Gastroenterology and Hepatology, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Andres Sánchez-Yagüe
- Gastroenterology Department, Hospital Costa del Sol, Marbella, Spain; Gastroenterology Department, Vithas Xanit Internacional Hospital, Benalmadena, Spain
| | - Joan Gornals
- Endoscopy Unit, Digestive Disease Department, Hospital Universitari de Bellvitge-Institut d'Investigació Biomèdica de Bellvitge, Barcelona, Spain
| | | | - Carlos de la Serna
- Department of Gastroenterology and Hepatology, Hospital Universitario Rio Hortega, Valladolid, Spain
| | - Juan Angel Gonzalez Martin
- Endoscopy Unit, Gastroenterology Division, University Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Antonio Z Gimeno-Garcia
- Gastroenterology Department, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain
| | - Carlos Marra-Lopez
- Gastroenterology Department, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Ana Castellot
- Complejo Hospitalario Universitario Insular Materno Infantil, Gran Canaria, Spain
| | - Fernando Alberca
- Gastroenterology Department, Unidad de Gestión Clínica Digestivo, Hospital Clinico Universitario de la Arrixava, Murcia, Spain
| | | | | | - Maria Luisa Legaz
- Gastroenterology Department, Hospital General La Mancha Centro, Alcázar de San Juan, Spain
| | - Oriol Sendino
- Endoscopy Unit, Gastroenterology Department, Institute of Digestive and Metabolic Diseases, Hospital Clínic, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, University of Barcelona, Barcelona, Spain
| | - Carmen Loras
- Gastroenterology Department, Servei Aparell Digestiu-Unitat d'Endoscòpia, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Jose Carlos Subtil
- Gastroenterology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan Nerin
- Gastroenterology Department, Hospital Clínico Universitario "Lozano Blesa," Zaragoza, Spain
| | - Mercedes Perez-Carreras
- Endoscopy Unit, Gastroenterology Department, Servicio de Medicina de Aparato Digestivo, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Jose Diaz-Tasende
- Endoscopy Unit, Gastroenterology Department, Servicio de Medicina de Aparato Digestivo, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gustavo Perez
- Endoscopy Unit, Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Alejandro Repiso
- Endoscopy Unit, Gastroenterology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Angels Vilella
- Endoscopy Unit, Gastroenterology Department. Hospital Son Llatzer, Palma de Mallorca, Spain
| | - Carlos Dolz
- Endoscopy Unit, Gastroenterology Department. Hospital Son Llatzer, Palma de Mallorca, Spain
| | - Alberto Alvarez
- Gastroenterology Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Santiago Rodriguez
- Gastroenterology Department, Complejo Asistencial Universitario de Zamora, Zamora, Spain
| | | | - Diego Juzgado
- Gastroenterology Division, University Hospital Quirón, Madrid, Spain
| | - Agustin Albillos
- Endoscopy Unit, Gastroenterology Division, University Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
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Piñera MJG, Morote JMS, Bermejo JPH, Vallejo OG, Alberca F, Ruiz SC, Serradilla JLR, Carmona GAZ, Cantó MAG. [Total tubular colonic duplication in a neonate with rectal bleeding: value of the endoscopy in the diagnose and treatment]. Cir Pediatr 2007; 20:59-62. [PMID: 17489497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Gastrointestinal duplication is an infrequent congenital abnormality. Colonic and tubular duplications are the least common. In neonates there are few described cases. It's difficult to identify the duplication preoperatively and a standard surgical approach has not been developped. We report a neonate with bleeding of the digestive tube who presented a colonic duplication who required multiple diagnostic test before the diagnosis was made for colonoscopy. Laparotomy showed a total tubular duplication of the right, transverse and left colon with proximal and distal communication. Exclusion of the duplicated segment was performed, but three months after the operation, subocclusion due to stenosis of the colonic distal loop was developed. This finding was confirmed by a second colonoscopy and septum was partially removed. The study implies that CD, though uncommon, should be included in the differential diagnosis of rectal bleeding and the importance of the colonoscopy in the diagnosis and treatment of this malformation.
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Affiliation(s)
- M J Guirao Piñera
- Servicio de Cirugía Pediátrica, Hospital Universitario Virgen de la Arrixaca, Murcia.
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Baños R, Serrano A, Alberca F, Alajarín M, Albaladejo A, Vargas A, Molina J. [Esophageal tuberculosis]. Rev Gastroenterol Peru 2006; 26:200-2. [PMID: 16865167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Primary esophageal tuberculosis is virtually non-existent and there are few cases described of secondary esophageal tuberculosis. Esophageal tuberculosis should be suspected in patients with dysphagia, positive test results for tuberculin, active pulmonary disease or mediastinal adenopathies. Endoscopic or x-ray images could be indistinguishable from esophageal carcinomas, hence a diagnosis can prevent wrong treatments. Confirming the diagnosis requires isolation of tuberculosis bacillus. Treatment for a patient with esophageal tuberculosis is standard therapy. Key words: Tuberculosis, esophagus.
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Affiliation(s)
- Ramón Baños
- Unidad de Endoscopia Digestiva, Hospital Universitario "Virgen de la Arrixacz", Murcia, Espana
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Pons JA, Ramirez P, Miras M, Robles R, Bueno FS, Marin C, Alberca F, Torrella E, Parrilla P. Hepatitis C in liver transplant patients. Transpl Int 2001; 7 Suppl 1:S213-5. [PMID: 11271205 DOI: 10.1111/j.1432-2277.1994.tb01349.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to determine whether infection by the hepatitis C virus (HCV) recurs after orthotopic liver transplantation (OLT) and to define the natural history of post-transplantation chronic hepatitis due to HCV. Of 70 patients, 10 (14.3%) were found to have antibodies to HCV before transplantation. After OLT 14 of the 70 patients (20%) had positive anti-HCV antibodies: 8 of 10 positive pre-OLT (80%) and 6 of 60 negative pre-OLT (10%). Of 14 patients anti-HCV+ post-OLT (57%), developed 8 chronic hepatitis: chronic persistent hepatitis in three patients, chronic lobular hepatitis in three patients and chronic, active hepatitis in two patients. We treated four patients with interferon obtaining normalization of transaminases in three of them after 6 months, but with a severe relapse in two. These results suggest that hepatitis C recurs in a majority, of liver transplant recipients and that morbidity is an important consideration. Interferon treatment of these patients requires further study to obtain conclusive results.
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Affiliation(s)
- J A Pons
- Liver Transplant Unit, Hospital Universitario V. Arrixaca, Muricia, Spain
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Miras M, Ramírez P, Pons JA, Marín C, Sánchez F, Robles R, Alberca F, Torrella E, Megías D, Parrilla P. [Quality of life of cirrhotic patients before and after liver transplantation]. Rev Esp Enferm Dig 1994; 86:809-12. [PMID: 7848691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In this study we assessed the quality of life of a group of cirrhotic patients who underwent liver transplant using a psychological test to evaluate family relations, work activity, emotional state and social relations. The quantification of hospital dependence and degree of fitness for work, before and after the transplant were also analyzed. 32 patients were included in the study with the diagnosis of hepatic cirrhosis and minimum post-transplant follow-up of 6 months. The average age of the study population was 44.8 +/- 10.5 years; there were 23 males and 9 females, with an average follow-up of 15 months. The psychological test used was the Quality of Life Scale (QLS), which consists of 21 items, each scoring from 1 to 6 points. The questionnaire was completed before the transplant by all the patients, and after the transplant by 32 patients at 6 months, 20 at 12 months and 12 at 24 months. Hospital dependence was evaluated by number of admissions and number of days per admission. Lastly, we compare the rate of unfitness for work before the transplant and at one and two years after the transplant. The QLS test showed a post-transplant improvement in the 4 aspects assessed, specially in the personal aspects (emotions and family) (p < 0.001). Hospital dependence following pre-transplant situation (p < 0.01). Finally, the post-transplant percentage of unfitness for work decreased with time, reaching significant differences 2 years after the liver transplant (p < 0.05).
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Affiliation(s)
- M Miras
- Unidad de Trasplante Hepático, Hospital Universitario Virgen de la Arrixaca, Murcia
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