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Introduction: Primary Health Care (PHC) has acquired different meanings for different people, at specific times and places, which poses important challenges for its understanding. Objective: To analyze the meaning(s) and sense(s) of Primary/Basic Health Care in the academic views on Nursing/Health in the context of undergraduate Nursing courses offered at two public Higher Education Institutions. Materials and methods: Qualitative study with an exploratory approach. Semi-structured interviews and documentary analysis were used as data collection techniques. Results: The senses/meanings of Primary Health Care converge with the population's gateway to the health system at the first care level and with the first contact of a person with the health service. However, it is still considered as a less important service within the care network. Conclusion: Primary Health Care means a relevant possibility for Nursing/Health care through health promotion and disease prevention actions, with a commitment to respond to most of the population's health needs.
Introducción: La Atención Primaria de Salud ha adquirido diferentes significados para diversas personas, en momentos y lugares específicos, lo cual plantea importantes retos para su entendimiento. Objetivo: Analizar los significados y sentidos de la Atención Primaria de Salud desde una visión académica en Enfermería y en el contexto de cursos de pregrado en Enfermería ofrecidos en dos Instituciones Públicas de Educación Superior. Materiales y métodos: Estudio cualitativo con un enfoque exploratorio, para la recolección de datos se emplearon entrevistas semiestructuradas y análisis documental de contenidos. Resultados: Los sentidos/significados de la Atención Primaria de la Salud convergen con el ingreso de la población al sistema de salud en el primer nivel de atención y la primera experiencia de la persona con el servicio de salud. Sin embargo, dicha Atención Primaria todavía se considera un servicio de baja importancia dentro de la red asistencial. Conclusión: La Atención Primaria de Salud representa una posibilidad relevante para el cuidado de Enfermería a través de acciones de promoción de la salud y prevención de enfermedades, que debe fortalecerse para responder la mayoría de las necesidades de salud de la población.
Introdução: A Atenção Primária à Saúde tem adquirido diferentes significados para diferentes pessoas, em momentos e locais específicos, o que coloca desafios importantes para a sua compreensão. Objetivo: Analisar os sentidos e significados da Atenção Primária à Saúde na perspectiva acadêmica em Enfermagem e no contexto dos cursos de graduação em Enfermagem oferecidos em duas Instituições de Ensino Superior Públicas. Materiais e métodos: Estudo qualitativo com abordagem exploratória, utilizou-se entrevistas semiestruturadas para coleta de dados e análise de conteúdo documental. Resultados: Os sentidos/significados da Atenção Primária à Saúde convergem com a entrada da população no sistema de saúde no primeiro nível de atenção e a primeira experiência da pessoa com o serviço de saúde. Contudo, a referida Atenção Básica ainda é considerada um serviço de baixa importância dentro da rede de saúde. Conclusão: A Atenção Primária à Saúde representa uma possibilidade relevante para o cuidado de Enfermagem por meio de ações de promoção da saúde e prevenção de doenças, que devem ser fortalecidas para responder à maioria das necessidades de saúde da população.
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Humanos , Masculino , Femenino , Atención Primaria de Salud , Prevención Primaria , Promoción de la Salud , Sistemas de Costos en Instituciones de SaludRESUMEN
Our objective is to determine the effectiveness of a therapeutic regimen for helicobacter pylori that includes a proton pump inhibitor, doxycycline, furazolidone and bismuth in our location. We carried out a retrospective study, non-randomized, in a private hospital in Lima, Peru. Patients with biopsy and/or rapid urease test proven helicobacter pylori infection after an endoscopy, from January 2017 to October 2022 were included. They received the therapeutic regimen of the study or an alternative triple regimen with a proton pump inhibitor, amoxicillin and levofloxacin and were followed with a urea breath test within 1 to 6 months upon completion of therapy. The quadruple therapy with furazolidone obtained success in 117/122 cases (95.9%) while the triple therapy with levofloxacin only in 5/16 (31.2%) when used for 7 days and 22/38 (57.9%) when used for 10 days, a statistically significant difference with p<0.001. Conclusion: Quadruple therapy with furazolidone reached high effectiveness in our location, while triple therapy with levofloxacin was not an acceptable alternative.
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Infecciones por Helicobacter , Helicobacter pylori , Humanos , Bismuto/uso terapéutico , Doxiciclina/uso terapéutico , Inhibidores de la Bomba de Protones/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Furazolidona/uso terapéutico , Furazolidona/farmacología , Antibacterianos/uso terapéutico , Levofloxacino/uso terapéutico , Levofloxacino/farmacología , Estudios Retrospectivos , Quimioterapia Combinada , Amoxicilina/uso terapéutico , Resultado del TratamientoRESUMEN
Nuestro objetivo es determinar si el tratamiento para Helicobacter pylori (HP) con doxiciclina, furazolidona, bismuto y un inhibidor de bomba de protones mantiene su efectividad en nuestra población. Se realizó un estudio retrospectivo, no aleatorio, realizado en una clínica privada de Lima, Perú. Se obtuvo la información de la historia clínica digital. Se incluyó a pacientes con el diagnóstico de infección por HP por biopsia y/o test rápido de la ureasa, obtenidos al realizar una endoscopía entre enero 2017 a octubre 2022. Debían haber recibido el tratamiento cuádruple en estudio o un esquema triple alternativo con amoxicilina, levofloxacino e inhibidor de bomba de protones y tener una prueba de aliento para HP en el lapso de 1 a 6 meses después del tratamiento. El esquema cuádruple con furazolidona logró la erradicación en 117/122 casos (95,9%) mientras que el triple con levofloxacino en 5/16 (31,2%) cuando se usó por 7 dias y en 22/38 (57,9%) cuando se usó por 10 días, siendo las diferencias altamente significativas (p>0,001). En conclusión, el tratamiento cuádruple con furazolidona mostró alta efectividad, mientras que el triple con levofloxacino no alcanzó niveles aceptables.
Our objective is to determine the effectiveness of a therapeutic regimen for helicobacter pylori that includes a proton pump inhibitor, doxycycline, furazolidone and bismuth in our location. We carried out a retrospective study, non-randomized, in a private hospital in Lima, Peru. Patients with biopsy and/or rapid urease test proven helicobacter pylori infection after an endoscopy, from January 2017 to October 2022 were included. They received the therapeutic regimen of the study or an alternative triple regimen with a proton pump inhibitor, amoxicillin and levofloxacin and were followed with a urea breath test within 1 to 6 months upon completion of therapy. The quadruple therapy with furazolidone obtained success in 117/122 cases (95.9%) while the triple therapy with levofloxacin only in 5/16 (31.2%) when used for 7 days and 22/38 (57.9%) when used for 10 days, a statistically significant difference with p<0.001. Conclusion: Quadruple therapy with furazolidone reached high effectiveness in our location, while triple therapy with levofloxacin was not an acceptable alternative.
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Few reports on clinical factors, treatment, and survival in children and adolescents with Central nervous system tumors in low-income and middle-income countries in Latin America exist. We retrospectively reviewed such data in all cases of patients younger than 18 years with brain tumors diagnosed in a single tertiary care center in Peru from 2007 through 2017. Variables were analyzed for association with overall survival and event-free survival by using the Kaplan-Meier method and the Cox hazards ratio regression. Seventy-five patients' data were analyzed (40 boys, 35 girls; mean age=7.7 y). The main clinical symptoms were headache, vomiting, difficulty walking, and visual disturbances. The most frequent clinical signs were hydrocephalus, cerebellar signs, visual abnormalities, and focal motor signs. The median time to diagnosis was 12 weeks. Tumor resection was performed in 68 patients, and 37 patients received postoperative radiotherapy. The most frequent histologic subtypes were low-grade gliomas and medulloblastomas. Overall survival rates at 1 and 5 years of disease were 78% (CI 95%, 0.67 to 0.86) and 74% (CI 95%, 0.62 to 0.82), respectively, and the 5-year event-free survival rate was 62% (CI 95%, 0.47 to 0.73). Although diagnosis occurred late in our cohort, the survival rate was higher than that in other Latin American countries.
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Neoplasias del Sistema Nervioso Central , Neoplasias Cerebelosas , Meduloblastoma , Niño , Masculino , Adolescente , Femenino , Humanos , Estudios Retrospectivos , Perú/epidemiología , Meduloblastoma/terapia , Neoplasias del Sistema Nervioso Central/epidemiología , Neoplasias del Sistema Nervioso Central/terapia , Neoplasias Cerebelosas/terapiaRESUMEN
OBJECTIVE: characterize the behavior of attempted suicide in adolescents in Colombia, and its associated epidemiological factors from 2016 to 2019. METHOD: quantitative, observational, descriptive, and ecological study. The sample was extracted from the database of the Integrated Social Protection Information System, by identifying cases of attempted suicide for ages in the range from 12 to 17 years old, calculated for a prevalence estimate based on a total population of 32,076. Univariate and bivariate analysis of the variables of interest was performed. RESULTS: suicide attempts occurred more frequently in females (n: 24,619; 76.7%), of subsidized regime (n: 17,960; 56%); and being in psychiatric centers is the most frequent vulnerability condition (n: 676; 2.11%). Living in the capital city is a risk factor for attempted suicide (OR: 1.423; 95% CI: 1.385 to 1.462), while being male is a protective factor (OR: 0.290; 95% CI: 0.283 a 0.298). CONCLUSION: suicide attempts are a subject of interest in Public Health due to their prevalence and impact on the family and social environment. The Nursing professional is competent in the identification, treatment, and prevention of this phenomenon. HIGHLIGHTS: (1) Know the epidemiological behavior of suicide attempt in adolescents.(2) Reflect on nursing care in the approach to suicide attempts.(3) Identify the conditions of vulnerability related to suicide attempts.(4) The methodological design allows reviewing the problem at national level.
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Investigación , Intento de Suicidio , Femenino , Adolescente , Masculino , Humanos , Niño , Colombia/epidemiología , Salud Pública , Factores de RiesgoRESUMEN
Antecedentes: La detección y resección de lesiones colónicas elevadas (pólipos) sésiles o planas, con polipectomía clásica o compleja detiene la secuencia adenoma-cáncer. La mucosectomía endoscópica (EMR) fue introducida en los setentas y perfeccionada en los ochentas como un procedimiento avanzado para el tratamiento de pólipos grandes o complejos. Una adecuada realización de la técnica puede evitar procedimientos quirúrgicos mayores. Objetivos: Evaluar los resultados y complicaciones de la técnica de mucosectomía (EMR) realizada por gastroenterólogos-endoscopistas en un centro de referencia del Perú. Revisión de indicaciones, éxito, complicaciones y seguimiento. Material y método: Se realizó un análisis descriptivo, retrospectivo y observacional de pacientes tratados con técnica de mucosectomía endoscópica en un centro de endoscopia de referencia nacional en Lima, Perú, desde enero de 2004 a diciembre de 2018. Se aplicó la técnica de elevación y corte controlado en lesiones polipoideas mayores a 1 cm. Se realizó la resección en bloque en lesiones hasta 3 cms y técnica de "piecemeal" o sacabocado en mayores de 3 cms. Se evaluaron resultados, eventos adversos y recurrencia. Resultados: Se analizaron 756 lesiones en el mismo número de pacientes. Hombres 46.8 % (298) y mujeres 53.2 % (338). La edad promedio fue de 61.9 (rangos 37-91). El tamaño promedio de las lesiones fue de 20,3 mm (10 - 50 mm). El tiempo promedio por procedimiento fue de 46 minutos (rango 20-123 minutos). Se logró resección en bloque en 78.04 % de pólipos (590 lesiones). Se realizó técnica sacabocado en 166 (21.96 %) lesiones. La tasa de complicaciones en nuestra serie fue del 6.74 %, todos manejados endoscópicamente más tratamiento conservador médico sin cirugía. El seguimiento promedio fue de 18 meses (3 - 24 meses) y la tasa global de recidiva local fue de 2.49 %. El tratamiento quirúrgico post procedimiento y con pieza analizada se indicó en 15 casos por adenomas avanzados con adenocarcinoma intramucoso bien diferenciado (ADCA-IM). A los 12 meses, 13 de 15 recidivas fueron tratadas endoscópicamente y 2 casos refractarios fueron operados. Conclusiones: La mucosectomía (RME ó EMR) es un procedimiento que, realizado por endoscopistas-gastroenterólogos bien entrenados muestra baja tasa de recurrencia y complicaciones aisladas permitiendo la obtención de adecuado material para el estudio anátomo-patológico y reduciendo necesidad de cirugía abierta o laparoscópica.
Background: Detection and resection of colonic polypoid sessile and flat lesions, prevents the development of colon cancer. Endoscopic mucosal resection (EMR) has emerged in the 70´s and improved in the 80´s, as an alternative treatment of this lesions and is considered the procedure of choice nowadays, being able to avoid major surgical procedures. Objectives: Evaluation of the results and complications of the technique by endoscopists of a reference center. Review of indications and limitations of the technique. Material and methods: Descriptive, retrospective and observational analysis of patients treated with endoscopic mucosal resection technique at a referral center in Lima, Peru, between January 2004 and December 2018. EMR Technique was used in polypoid lesions greater than 1 cm. The bloc resection and the piecemeal resection technique was used for those lesions up to 3 cm and more. We evaluated complications and results according to the technique as recurrence rate, performing tracking in all cases with endoscopic follow up. Results: 756 lesions and patients (338 women and 298 men) The average age was 61.9 years (37-91 years) and the average lesion size of 20.3 mm (10-50 mm). En bloc or one-piece resection was performed in 78.04 %(590) and piece meal in 21.96%(166) achieving endoscopic and pathological resection. The complication rate in our series was 6.74% and managed endoscopically and with conservative measures and no surgery. Mean follow-up was 18 months (3-24 months) and overall local recurrence rate was 2.49%. After-procedure, additional surgical treatment was performed in 15 cases with pathologic piece report and intramucous adenocarcinoma (IM-ADCA). 13 of 15 local recurrences at 12 months follow up were treated endoscopically and 2 had surgical treatment. Conclusions: Endoscopic mucosal resection (EMR) or Mucosectomy is a technique performed by experts endoscopists and shows low rates of recurrence and complications with suitable material for pathologic examination. It reduces open and laparoscopic surgery.
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Coronavirus disease 2019 (COVID-19) has quickly become a global pandemic. Reports from different parts of the world indicate that a significant proportion of people who have recovered from COVID-19 are suffering from various health problems collectively referred to as "long COVID-19". Common symptoms include fatigue, shortness of breath, cough, joint pain, chest pain, muscle aches, headaches, and so on. Vitamin D is an immunomodulatory hormone with proven efficacy against various upper respiratory tract infections. Vitamin D can inhibit hyperinflammatory reactions and accelerate the healing process in the affected areas, especially in lung tissue. Moreover, vitamin D deficiency has been associated with the severity and mortality of COVID-19 cases, with a high prevalence of hypovitaminosis D found in patients with COVID-19 and acute respiratory failure. Thus, there are promising reasons to promote research into the effects of vitamin D supplementation in COVID-19 patients. However, no studies to date have found that vitamin D affects post-COVID-19 symptoms or biomarkers. Based on this scenario, this review aims to provide an up-to-date overview of the potential role of vitamin D in long COVID-19 and of the current literature on this topic.
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COVID-19 , Deficiencia de Vitamina D , COVID-19/complicaciones , Humanos , SARS-CoV-2 , Vitamina D/farmacología , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Vitaminas/uso terapéutico , Síndrome Post Agudo de COVID-19RESUMEN
Abstract Objective: characterize the behavior of attempted suicide in adolescents in Colombia, and its associated epidemiological factors from 2016 to 2019. Method: quantitative, observational, descriptive, and ecological study. The sample was extracted from the database of the Integrated Social Protection Information System, by identifying cases of attempted suicide for ages in the range from 12 to 17 years old, calculated for a prevalence estimate based on a total population of 32,076. Univariate and bivariate analysis of the variables of interest was performed. Results: suicide attempts occurred more frequently in females (n: 24,619; 76.7%), of subsidized regime (n: 17,960; 56%); and being in psychiatric centers is the most frequent vulnerability condition (n: 676; 2.11%). Living in the capital city is a risk factor for attempted suicide (OR: 1.423; 95% CI: 1.385 to 1.462), while being male is a protective factor (OR: 0.290; 95% CI: 0.283 a 0.298). Conclusion: suicide attempts are a subject of interest in Public Health due to their prevalence and impact on the family and social environment. The Nursing professional is competent in the identification, treatment, and prevention of this phenomenon.
Resumo Objetivo: caracterizar o comportamento da tentativa de suicídio em adolescentes na Colômbia e seus fatores epidemiológicos relacionados no período entre 2016 e 2019. Método: estudo quantitativo, observacional, descritivo e ecológico. A amostra foi obtida a partir do banco de dados do Sistema Integrado de Informação de Proteção Social, por meio da identificação de casos de tentativa de suicídio entre 12 e 17 anos, calculado para uma estimativa de prevalência de uma população total de 32.076. Foram realizadas análises univariadas e bivariadas das variáveis de interesse. Resultados: a tentativa de suicídio ocorre com maior frequência em mulheres (n: 24.619; 76,7%), de regime subsidiado (n: 17.960; 56%); e a condição de vulnerabilidade mais frequente é estar em centros psiquiátricos (n: 676; 2,11%). Morar na sede municipal é fator de risco para tentativas de suicídio (OR: 1,423; IC95%: 1,385 a 1,462) e ser do sexo masculino é fator de proteção (OR: 0,290; IC95%: 0,283 a 0,298). Conclusão: a tentativa de suicídio é um tema de interesse da Saúde Pública devido à sua prevalência e impacto no meio familiar e social, e o profissional de Enfermagem tem competência para identificar, tratar e prevenir esse fenômeno.
Resumen Objetivo: caracterizar el comportamiento del intento de suicidio en adolescentes en Colombia y sus factores epidemiológicos asociados en el período entre 2016 y 2019. Método: estudio cuantitativo, de tipo observacional, descriptivo y ecológico. La muestra se obtuvo en la base de datos del Sistema Integrado de Información de la Protección Social, mediante la identificación de casos de intento de suicidio para edades entre los 12 y 17 años, calculado para una estimación de prevalencia a partir de una población total de 32.076. Se realizó análisis univariado y bivariado de las variables de interés. Resultados: el intento de suicidio se presenta con mayor frecuencia en mujeres (n: 24.619; 76,7%), de régimen subsidiado (n: 17.960; 56%); y la condición de vulnerabilidad más frecuente es estar en centros psiquiátricos (n: 676; 2,11%). El vivir en la cabecera municipal es un factor de riesgo para el intento de suicidio (OR: 1,423; IC95%: 1,385 a 1,462) y ser hombre es factor protector (OR: 0,290; IC 95%: 0,283 a 0,298). Conclusión: el intento suicida significa un tema de interés en Salud Pública por su prevalencia e impacto en el ámbito familiar y social, y el profesional de Enfermería posee competencia para la identificación, tratamiento y prevención de este fenómeno.
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Humanos , Masculino , Femenino , Niño , Adolescente , Intento de Suicidio , Salud Pública , Factores de Riesgo , Colombia/epidemiologíaRESUMEN
INTRODUCTION: Bile duct stones constitutes 20% of symptomatic gallbladder disease and difficult stones are one third of this. Endoscopic papillary large balloon dilation (EPLBD) with or without prior endoscopic sphincterotomy (EST) produces excellent outcomes for the treatment of complex or difficult common bile duct (CBD) stones, alone or combined with previous therapeutic options as mechanical lithotripsy (ML) and temporary or definitive stenting. OBJECTIVES: Show success rate, complications and adverse events. Show that higher success rates are obtained combining ERCP techniques with no increase in complications. MATERIALS AND METHODS: We evaluated the safety and therapeutic outcomes of EPLBD with vs. without EST and other combinations for the removal of difficult bile duct stones. We described our procedures for a decade and compare them with the previous decade without balloon dilation. Of 865 patients and procedures, 223 (25.78%) had difficult stones. Treatments where EPLBD with EST (n=183), EPLBD alone group (n=40). Additional modalities where required in 15.25% (n=34). These two groups were compared with respect to overall procedure-related adverse events, overall stone removal success rate, number of sessions required for complete stone removal, need for mechanical lithotripsy, temporal or definite stenting and total procedure time. Results Safety removal of stones was achieved in one session on 84.75% of cases with EPLBD. The incidence of adverse events was not significantly different between the groups (EPLBD alone vs. EPLBD with EST: overall adverse events 12.5% vs. 10.38% (including pain); pancreatitis 2.7% vs. 2.5%, p=0.62). Overall success similar, initial success similar, and the need for additional techniques were also similar between groups. Median total procedure time tended to be greater in the EPLBD alone group (20.5 minutes) than in the EPLBD with EST group. Conclusion DPBGD in ERCP allows bile duct stone extraction rates close to 99.65% (90% in previous decade) according to other reports of literature. Adverse events of EPLBD alone or with EST are similar between them and with classic ERCP without statistical difference and similar to other world series.
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Coledocolitiasis , Cálculos Biliares , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitiasis/cirugía , Dilatación , Cálculos Biliares/diagnóstico por imagen , Cálculos Biliares/terapia , Humanos , Derivación y Consulta , Esfinterotomía Endoscópica , Resultado del TratamientoRESUMEN
Introducción : La coledocolitiasis sigue estando presente hasta en 20% de la enfermedad vesicular calculosa sintomática y los cálculos complejos o difíciles son un tercio de estos. La dilatación papilar con balones de gran diámetro (DPBGD) con o sin esfinterotomía endoscópica (EE) previa proporciona excelentes resultados en el tratamiento de dichos cálculos y además complementada con variantes como litotricia mecánica (LM) y prótesis temporales y/o definitivas metálicas. Objetivos : mostrar tasas de éxito, complicaciones y eventos adversos. Demostrar que se obtiene mayor tasa de éxito con técnicas combinadas o variantes. Materiales y métodos : Evaluamos la seguridad y éxito de la DPBGD con o sin EE y otras combinaciones para el manejo de cálculos complejos. Describimos nuestros casos de una década y los comparamos con la anterior donde no realizábamos dilataciones. De 865 CPRE's por coledocolitiasis, 223 (25,78%) fueron cálculos complejos. Los tratamientos EE+DPBGD (n=183) y DPBGD solamente (n=40). Se requirieron modalidades adicionales en 15,25% (n=34). Estos dos grupos se compararon con respecto a eventos adversos, éxito de extracción, número de sesiones, duración de procedimientos y necesidad de LM y colocación de prótesis plásticas. Resultados: Se logró tratamiento completo y extracción en primera sesión en 84,74% sin diferencia significativa entre EE o sin/EE (p=0,2). Los eventos adversos no fueron significativamente diferentes en los grupos (DPBGD sóla vs. DPBGD c/EE p=0,1): eventos adversos 12,5% vs. 10,38% (incluyendo dolor sin pancreatitis); pancreatitis 2,7% vs. 2,5%). Éxito inicial y con métodos adicionales similares. El tiempo promedio de procedimiento fue mayor en el grupo de DPBGD sin/EE (20,5 minutos) contra el de DPBGD c/EE. Conclusiones : La DPBGD en CPRE permite extraer cálculos hasta en 99,65% de casos (90% en series previas sin dilatación) cifras similares a lo descrito en la literatura. Los eventos adversos de la DPBGD con/sin EE son similares entre sí y con los de CPRE clásica y no hay diferencia estadística, guardando similitud con otras series nacionales y mundiales.
Introduction : Bile duct stones constitutes 20% of symptomatic gallbladder disease and difficult stones are one third of this. Endoscopic papillary large balloon dilation (EPLBD) with or without prior endoscopic sphincterotomy (EST) produces excellent outcomes for the treatment of complex or difficult common bile duct (CBD) stones, alone or combined with previous therapeutic options as mechanical lithotripsy (ML) and temporary or definitive stenting. Objectives : Show success rate, complications and adverse events. Show that higher success rates are obtained combining ERCP techniques with no increase in complications. Materials and methods: We evaluated the safety and therapeutic outcomes of EPLBD with vs. without EST and other combinations for the removal of difficult bile duct stones. We described our procedures for a decade and compare them with the previous decade without balloon dilation. Of 865 patients and procedures, 223 (25.78%) had difficult stones. Treatments where EPLBD with EST (n=183), EPLBD alone group (n=40). Additional modalities where required in 15.25% (n=34). These two groups were compared with respect to overall procedure-related adverse events, overall stone removal success rate, number of sessions required for complete stone removal, need for mechanical lithotripsy, temporal or definite stenting and total procedure time. Results Safety removal of stones was achieved in one session on 84.75% of cases with EPLBD. The incidence of adverse events was not significantly different between the groups (EPLBD alone vs. EPLBD with EST: overall adverse events 12.5% vs. 10.38% (including pain); pancreatitis 2.7% vs. 2.5%, p=0.62). Overall success similar, initial success similar, and the need for additional techniques were also similar between groups. Median total procedure time tended to be greater in the EPLBD alone group (20.5 minutes) than in the EPLBD with EST group. Conclusion DPBGD in ERCP allows bile duct stone extraction rates close to 99.65% (90% in previous decade) according to other reports of literature. Adverse events of EPLBD alone or with EST are similar between them and with classic ERCP without statistical difference and similar to other world series.
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OBJECTIVE: The objective of this study was to identify the genetic cause for progressive peripheral nerve disease in a Venezuelan family. Despite the growing list of genes associated with Charcot-Marie-Tooth disease, many patients with axonal forms lack a genetic diagnosis. METHODS: A pedigree was constructed, based on family clinical data. Next-generation sequencing of mitochondrial DNA (mtDNA) was performed for 6 affected family members. Muscle biopsies from 4 family members were used for analysis of muscle histology and ultrastructure, mtDNA sequencing, and RNA quantification. Ultrastructural studies were performed on sensory nerve biopsies from 2 affected family members. RESULTS: Electrodiagnostic testing showed a motor and sensory axonal polyneuropathy. Pedigree analysis revealed inheritance only through the maternal line, consistent with mitochondrial transmission. Sequencing of mtDNA identified a mutation in the mitochondrial tRNAVal (mt-tRNAVal ) gene, m.1661A>G, present at nearly 100% heteroplasmy, which disrupts a Watson-Crick base pair in the T-stem-loop. Muscle biopsies showed chronic denervation/reinnervation changes, whereas biochemical analysis of electron transport chain (ETC) enzyme activities showed reduction in multiple ETC complexes. Northern blots from skeletal muscle total RNA showed severe reduction in abundance of mt-tRNAVal , and mildly increased mt-tRNAPhe , in subjects compared with unrelated age- and sex-matched controls. Nerve biopsies from 2 affected family members demonstrated ultrastructural mitochondrial abnormalities (hyperplasia, hypertrophy, and crystalline arrays) consistent with a mitochondrial neuropathy. CONCLUSION: We identify a previously unreported cause of Charcot-Marie-Tooth (CMT) disease, a mutation in the mt-tRNAVal , in a Venezuelan family. This work expands the list of CMT-associated genes from protein-coding genes to a mitochondrial tRNA gene. ANN NEUROL 2020;88:830-842.
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Enfermedad de Charcot-Marie-Tooth/genética , ARN Mitocondrial/genética , ARN de Transferencia/genética , Adolescente , Adulto , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mutación , Linaje , Venezuela , Adulto JovenRESUMEN
Resumen Introducción: El empleo de asfaltos modificados con polímeros en la construcción de obras viales es una práctica frecuente a nivel internacional pero limitada aún en Ecuador. Sin embargo, ante la poca durabilidad de nuestros pavimentos asfálticos, mayormente causada por agrietamientos prematuros de fatiga o bloques, el potencial de estos productos debe ser considerado. Objetivo: Evaluar el comportamiento del asfalto procedente de la Refinería de Esmeraldas al mezclarse con tres tipos de polímeros, mediante las pruebas exigidas para la clasificación por viscosidad y por grados de desempeño Superpave, incluyendo un análisis reológico empleando diagramas de Black. Materiales y métodos: Los polímeros empleados fueron: SBS, Elvaloy y caucho de llantas, dosificados para cumplir ciertas exigencias de calidad determinadas por métodos experimentales, según las normativas ASTM. Resultados: Como principales resultados se obtuvo que al modificar el asfalto PG 64-28 con los distintos polímeros todos incrementaron el grado alto de temperatura a 76, manteniéndose el grado bajo en los modificados con Elvaloy y caucho en -28, mientras que para el SBS aumentó a -22. En relación a las temperaturas intermedias, la temperatura crítica a la fatiga no tuvo mayor variación al emplear los diferentes modificadores. Esta situación fue corroborada con los diagramas de Black. Conclusiones: Tratar de solucionar el mal comportamiento del asfalto ecuatoriano ante el agrietamiento mediante su mezcla con los polímeros estudiados no sería la solución más efectiva, aunque es notoria la mejora del comportamiento ante las deformaciones plásticas.
Abstract Introduction: The use of modified asphalts with polymers in the construction of roads is a frequent practice at an international level but still limited in Ecuador. However, due to the short durability of our asphalt pavements, mainly caused by premature fatigue cracks or blocks, the potential of these products should be considered. Objective: Evaluate the behavior of the asphalt coming from the Esmeraldas Refinery when it is mixed with three commercial polymers, by means of the tests required for the classification of viscosity and by Superpave performance grades, including a rheological analysis using master curves and Black diagrams. Materials and methods: The polymers used were: SBS, Elvaloy and rubber tires, dosed to meet certain quality requirements determined by experimental methods, according to ASTM regulations. Results: As main results the high degree of temperature increased to 76 by modifying the PG 6428 asphalt with the different polymers, maintaining the low degree on those modified with Elvaloy and rubber in -28, while for the SBS it increased to -22. Regarding to intermediate temperatures, the critical temperature to fatigue didn't have much variation when the different modifiers were applied. This situation was corroborated with Black diagrams. Conclusions: Trying to solve the poor cracking performance of the Ecuadorian asphalt by mixing it with the polymers studied would not be the most effective solution, although the improvement of the performance to plastic deformations is notorious.
Resumo Introdução: O uso de asfalto modificado com polímeros na construção de obras viárias é uma prática frequente em nível internacional, mas ainda limitada no Equador. No entanto, dada a curta durabilidade de nossos pavimentos asfálticos, causada principalmente por rachaduras prematura de fadiga ou blocos, o potencial desses produtos deve ser considerado. Objetivo: Avaliar o comportamento do asfalto da refinaria de Esmeraldas quando misturado com três tipos de polímeros, por meio dos testes exigidos para a classificação por viscosidade e pelos graus de desempenho Superpave, incluindo uma análise reológica usando diagramas pretos. Materiais e métodos: Os polímeros utilizados foram: SBS, Elvaloy e pneus de borracha, dosados para atender a determinados requisitos de qualidade determinados por métodos experimentais, de acordo com as normas da ASTM. Resultados. Como principais resultados, foi obtido que, ao modificar o asfalto PG 64-28 com os diferentes polímeros, todos aumentaram o alto grau de temperatura para 76, mantendo o baixo grau naqueles modificados com Elvaloy e borracha em -28, enquanto para o SBS aumentou para -22. Em relação às temperaturas intermediárias, a temperatura crítica à fadiga não apresentou muita variação ao utilizar os diferentes modificadores. Esta situação foi corroborada com os diagramas de Black. Conclusões: Tentar resolver o mau comportamento do asfalto produzido na Refinaria de Esmeraldas antes de partir pela fadiga, misturando-o com os polímeros estudados, não é a solução mais eficaz, embora seja notório a melhora do comportamento diante das deformações plásticas.
RESUMEN
El consumo de cocaína representa un problema de salud, por constituir un psicotrópico ilícito de elevado consumo, lo que ocasiona motivo de atención en los servicios de emergencia, adicción que genera riesgos relativos a los componentes asociados a la misma. Se realizó un estudio cuantitativo, de tipo descriptivo, cuyo objetivo fue caracterizar muestras inorgánicas de cocaína en el Laboratorio de Química Forense de una provincia del contexto ecuatoriano durante el período julio y diciembre de 2016. Se trabajó con la totalidad de la población, la que estuvo compuesta por 90 muestras. La cuantificación de los elementos químicos presen-tes en los ejemplares se realizó a través de una cromatografía de gases utilizando un detector de masas acoplado al equipo. Se determinó que de forma mayoritaria la mitad de las muestras contenían impurezas como cinamoilcocaína, metilecgonina, tropococaína, benzoilecgonina, kientras que solo el 11,1% de estas no tenía contaminaciones alcaloidales. En cuanto a la presencia de adulterantes en el material analizado, el almidón resultó ser el más utilizado por los comercializadores de la cocaína en el entorno estudiado; aunque también se pudo obser-var el uso de fenacetina, levamisol y aminopirina.
Consumption of cocaine represents an emerging health problem because it is an illicit psychotropic drug consumed among patients treated in emergency rooms, and it also genera-tes other risks related to the components that may be present in it. The study was carried out with a quantitative, descriptive approach. The research aimed to characterize the inorganic samples of cocaine in the Forensic Chemistry Laboratory of a province in the Ecuadorian context during the period July-December 2016. The whole population of 90 samples was taken into account. The quantification of the chemical elements presented in the specimens was carried out through gas chromatography using a mass detector coupled to the equipment. It was determined that half of the samples contained impurities sucah as cinnamoylcocaine, methylecgonine and tropococaine, benzoylecgonine and only 11.1% of the samples did not have alkaloidal impurities as results of the research. Regarding the presence of adulterants in the material analyzed, starch was the most used by cocaine drug dealers in the studied envi-ronment; the use of phenacetin, levamisole and aminopyrine could also be observed.
Asunto(s)
Humanos , Cocaína , Trastornos Relacionados con Cocaína , NarcóticosRESUMEN
OBJECTIVE: To determine the effectiveness of two new therapeutic regimes for Helicobacter pylori versus triple therapy that includes a proton pump inhibitor, amoxicillin and clarithromycin. MATERIALS AND METHODS: prospective study, non-randomized, in a private Hospital in Lima, Peru. Patients with biopsy and/or rapid ureasa test proven Helicobacter pylori infection received one of the three therapeutic regimens and were followed with a urea breath test 1 to 6 months upon completion of therapy. RESULTS: Triple therapy achieved eradication in 49/68 of cases (71.2%); quadruple therapy (doxycycline + metronidazole + bismuth + esomeprazole) in 52/62 (83.9%), and the simplified regimen with doxycycline + furazolidone + bismuth, obtained success in 79/83 of cases (95.2%). Statistically significant difference with p<0.005 and p<0.05 respectively. CONCLUSION: Triple therapy against Hp does not achieve acceptable effectiveness in our institution. This highlights the need to look for new therapeutic options, being the simplified regime (doxycycline, furazolidone and bismuth) used in the current study a good option, requiring further studies for validation.
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Antiácidos/uso terapéutico , Antibacterianos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Inhibidores de la Bomba de Protones/uso terapéutico , Adolescente , Adulto , Anciano , Amoxicilina/uso terapéutico , Bismuto/uso terapéutico , Pruebas Respiratorias , Claritromicina/uso terapéutico , Doxiciclina/uso terapéutico , Quimioterapia Combinada , Femenino , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Metronidazol/uso terapéutico , Persona de Mediana Edad , Perú , Estudios Prospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
RESUMEN Objetivo: Determinar la efectividad de dos nuevos esquemas para el tratamiento de Helicobacter pylori frente al esquema triple convencional de amoxilina, claritromicina y un inhibidor de bomba de protones. Materiales y métodos: Estudio prospectivo, no aleatorio, realizado en una clínica privada de Lima, Perú. Los pacientes con infección por Helicobacter demostrada por endoscopia con biopsia y/o test de la ureasa, recibieron uno de tres tratamientos en estudio y fueron examinados mediante el test del aliento con urea C14, entre 1 y 6 meses después. Resultados: El tratamiento triple convencional solo logró la erradicación en 49/68 casos (71,2%) y el cuádruple con doxiciclina, metronidazol, bismuto y esomeprazol lo hizo en 52/62 casos (83,9%) siendo esta diferencia no significativa (p>0,1). El esquema simplificado de doxiciclina, furazolidona y bismuto logró curar a 79/83 pacientes (95,2%) superando a los dos anteriores con valor significativo (p<0,005 y p<0,05 respectivamente). Conclusiones: El tratamiento triple convencional para Helicobacter no está alcanzando niveles aceptables de efectividad en nuestra institución. Esto enfatiza la necesidad de buscar nuevas alternativas; por lo que sería útil validar con nuevos estudios los buenos resultados logrados por el régimen Simplificado de doxiciclina, furazolidona y bismuto que aquí presentamos
ABSTRACT Objective: To determine the effectiveness of two new therapeutic regimes for Helicobacter pylori versus triple therapy that includes a proton pump inhibitor, amoxicillin and clarithromycin. Materials and methods: prospective study, non-randomized, in a private Hospital in Lima, Peru. Patients with biopsy and/or rapid ureasa test proven Helicobacter pylori infection received one of the three therapeutic regimens and were followed with a urea breath test 1 to 6 months upon completion of therapy. Results: Triple therapy achieved eradication in 49/68 of cases (71.2%); quadruple therapy (doxycycline + metronidazole + bismuth + esomeprazole) in 52/62 (83.9%), and the simplified regimen with doxycycline + furazolidone + bismuth, obtained success in 79/83 of cases (95.2%). Statistically significant difference with p<0.005 and p<0.05 respectively. Conclusion: Triple therapy against Hp does not achieve acceptable effectiveness in our institution. This highlights the need to look for new therapeutic options, being the simplified regime (doxycycline, furazolidone and bismuth) used in the current study a good option, requiring further studies for validation.
Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Helicobacter pylori , Infecciones por Helicobacter/tratamiento farmacológico , Inhibidores de la Bomba de Protones/uso terapéutico , Antiácidos/uso terapéutico , Antibacterianos/uso terapéutico , Perú , Bismuto/uso terapéutico , Pruebas Respiratorias , Estudios Prospectivos , Helicobacter pylori/aislamiento & purificación , Infecciones por Helicobacter/diagnóstico , Resultado del Tratamiento , Claritromicina/uso terapéutico , Doxiciclina/uso terapéutico , Quimioterapia Combinada , Amoxicilina/uso terapéutico , Metronidazol/uso terapéuticoRESUMEN
El enfoque de marco lógico es una metodología para el desarrollo de proyectos con impacto social con amplio uso en el mundo; que, además se utiliza en la educación universitaria como herramienta de planificación, ejecución y evaluación de iniciativas de vinculación con la sociedad. Entre sus ventajas se pueden mencionar: formato sencillo, alto grado de detalle en cada procedimiento, estimula la participación de los beneficiarios, consenso y empodera-miento de la colectividad y asegura la viabilidad de los componentes y acciones previstas. En el campo de la Enfermería, permite proporcionar cuidados culturalmente congruentes con énfasis en la promoción de la salud a grupos sociales; así como desarrolla experiencias de valor en esos profesionales. En este artículo de revisión se detalla cómo esta metodología y sus técnicas de interacción con la comunidad, permiten la elaboración, ejecución y monitoreo de proyectos en el contexto ecuatoriano
The logical framework approach is a methodology to develop projects with social impact with wide use in the world. It is also used in university education as a tool for planning, executing and assessing initiatives linked to society. Some of its advantages must be mentio-ned such as: simple format, high degree of detail in each procedure, stimulates the participa-tion of the beneficiaries, consensus and empowerment of the community and ensures the viability of the components and planned actions. It allows providing culturally congruent care with emphasis on the promotion of health to social groups in the field of Nursing, as well as developing valuable experiences in these professionals. This review article details how this methodology and its interaction techniques with the community allow the preparation, execution and monitoring of projects in the Ecuadorian context.
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Humanos , Relaciones Comunidad-Institución , Participación de la Comunidad , Promoción de la SaludRESUMEN
OBJECTIVES: To investigate the prevalence of helicobacter pylori infection and the histological type of gastritis in patients with erosive esophagitis and compare these findings with a control group without esophagitis. MATERIALS AND METHODS: Prospective study in the settings of a private clinic in Lima, Peru. Each esophagitis and control patient had two biopsies taken from the antrum, two from the corpus as well as two additional samples for the ureasa (CLO) test. If any of the samples was positive for helicobacter, the patient was considered infected. The histological type of gastritis was assessed in the biopsies. RESULTS: 140 adult patients (69% males, mean age 48 years) with endoscopically proven esophagitis and 140 control cases, matched by age and sex, were included. A lower prevalence of helicobacter infection was found in the esophagitis group (27 vs. 44% p= 0.004).The risk for esophagitis was also lower in the patients with helicobacter OR: 0.48 IC95% (0.28 - 0.82. A higher percentage of normal gastric histology was found in the patients with esophagitis (44 vs. 31% p= 0.036). In 16 patients the erosive esophagitis was developed "de novo", after the eradication of helicobacter. CONCLUSIONS: A lower prevalence of helicobacter infection and a higher percentage of normal gastric mucosa were found in patients with endoscopic proven erosive esophagitis.
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Esofagitis/microbiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Adolescente , Adulto , Anciano , Femenino , Gastritis/microbiología , Gastritis/patología , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica , Prevalencia , Estudios Prospectivos , Adulto JovenRESUMEN
Objetivos: Investigar la prevalencia de infección por Helicobacter pylori y el tipo histológico de gastritis que presentan los pacientes con esofagitis erosiva confirmada por endoscopía. Contrastar estos resultados con los de un grupo control sin esofagitis. Materiales y métodos: Estudio realizado con recolección prospectiva de datos en una clínica privada de Lima, Perú. En cada paciente y control se tomaron 2 biopsias del antro gástrico, 2 del cuerpo y 2 muestras para el test de la ureasa. Si alguna de estas pruebas era positiva para helicobacter se consideraba al paciente infectado. Se determinó el tipo de gastritis en las biopsias. Resultados: Ingresaron al estudio 140 pacientes adultos con esofagitis, edad promedio 48 años, 69% varones y 140 controles pareados por edad y sexo. La prevalencia de infección por helicobacter fue menor en los pacientes con esofagitis (27 vs 44% p=0,004). Los pacientes infectados mostraron menor riesgo de presentar esofagitis: OR: 0,48 IC95% (0,28 - 0,82) No se demostró diferencias en el tipo histológico de gastritis, pero si hubo una mayor proporción de pacientes con histología gástrica normal en el grupo con esofagitis (44 vs 31% p= 0,036). En 16 pacientes la esofagitis erosiva se desarrolló de novo luego de la erradicación del helicobacter. Conclusiones: Se demostró una menor prevalencia de infección por helicobacter y una mayor proporción de biopsias gástricas normales en los pacientes con esofagitis erosiva.
Objectives: To investigate the prevalence of helicobacter pylori infection and the histological type of gastritis in patients with erosive esophagitis and compare these findings with a control group without esophagitis. Materials and methods: Prospective study in the settings of a private clinic in Lima, Peru. Each esophagitis and control patient had two biopsies taken from the antrum, two from the corpus as well as two additional samples for the ureasa (CLO) test. If any of the samples was positive for helicobacter, the patient was considered infected. The histological type of gastritis was assessed in the biopsies. Results: 140 adult patients (69% males, mean age 48 years) with endoscopically proven esophagitis and 140 control cases, matched by age and sex, were included. A lower prevalence of helicobacter infection was found in the esophagitis group (27 vs. 44% p= 0.004). The risk for esophagitis was also lower in the patients with helicobacter OR: 0.48 IC95% (0.28 - 0.82. A higher percentage of normal gastric histology was found in the patients with esophagitis (44 vs. 31% p= 0.036). In 16 patients the erosive esophagitis was developed de novo, after the eradication of helicobacter. Conclusions: A lower prevalence of helicobacter infection and a higher percentage of normal gastric mucosa were found in patients with endoscopic proven erosive esophagitis.
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Esofagitis/microbiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Gastritis/microbiología , Gastritis/patología , Úlcera Péptica , Prevalencia , Estudios ProspectivosRESUMEN
INTRODUCTION: It is important to detect and remove adenomas in order to prevent colon cancer. Angiogenesis is an early change in the pre malignant transformation sequence and narrow band imaging (NBI) allows for better visualization of the capillary pattern of the mucosa. OBJECTIVE: We present our data regarding the assessment of superficial lesions of the colon on colonoscopies using NBI as well as the Sano-Emura classification. MATERIALS & METHODS: Prospective study done in Lima Peru. Three endoscopists evaluate the capillary pattern of colonic lesions in real time using NBI and electronic magnification. These findings are then compared to the pathology report. RESULTS: 380 patients were evaluated with a total of 739 lesions; 473 adenomas, 241 non neoplastic lesions, and 25 serrated lesions. These were grouped depending on their NBI capillary pattern into two groups: Neoplastic (Sano-Emura types II, IIIa, and IIIb), and Non-Neoplastic (Sano-Emura type I). Sensitivity for adenomas 84%, diagnostic accuracy 77%, PPV 82%, NPV 67%, specificity 63%. Sensitivity and diagnostic accuracy improved to 94% and 84%, respectively when evaluating lesions of 5 mm to 9 mm. For diminutive rectosigmoid polyps, the NPV for adenomas was 81%. The serrated lesions showed both types of capillary pattern with equal frequency. CONCLUSIONS: Our results using NBI with electronic magnification showed that this method is useful for the differentiation of lesions 5 mm or bigger, as reported previously. Accuracy was diminished when evaluating lesions less than 5 mm. NBI was not capable of aiding in the differential diagnosis of serrated lesions.
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Adenoma/diagnóstico , Capilares/patología , Colon/irrigación sanguínea , Neoplasias del Colon/diagnóstico , Colonoscopía/métodos , Mucosa Intestinal/irrigación sanguínea , Imagen de Banda Estrecha/métodos , Colon/patología , Femenino , Humanos , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Perú , Sector Privado , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
INTRODUCCION: La detección y resección de los adenomas es importante para prevenir el cáncer colorrectal. La angiogénesis es un factor primordial en el crecimiento tumoral y la endoscopía con imagen de banda estrecha (NBI) permite una mejor evaluación del patrón capilar de la mucosa. OBJETIVO: Presentar nuestra experiencia en la diferenciación de las lesiones superficiales del colon, utilizando colonoscopía con NBI y la clasificación de Sano û Emura. MATERIAL & MÉTODOS: Estudio prospectivo realizado en Lima, Perú. Tres endoscopistas evalúan en tiempo real el patrón capilar de las lesiones, usando NBI con magnificación electrónica, y sus diagnósticos se correlacionan con el resultado histopatológico. RESULTADOS: se incluyen 380 pacientes con 739 lesiones; 473 adenomas, 241 pólipos no neoplásicos y 25 lesiones aserradas. Son divididas, por su patrón capilar al NBI, en dos grupos: Neoplásicas (Sano -Emura tipo II, IIIa y IIIb) y No Neoplásicas (Sano-Emura tipo I). Sensibilidad para adenomas: 84%, precisión diagnóstica: 77%, VPP: 82%, VPN: 67% y especificidad: 63%. La sensibilidad y la precisión diagnóstica aumentan a 94% y 84% en lesiones de 5 a 9 mm. En lesiones diminutas del recto-sigmoides, el VPN para adenomas mejora a 81%. Para las lesiones aserradas estos índices solo alcanzan el 50%. CONCLUSIONES: El NBI con magnificación electrónica resultó útil en la diferenciación de las lesiones de 5 mm o mayores, con resultados similares a estudios publicados. En lesiones menores de 5mm disminuyó la exactitud. Las lesiones aserradas no pudieron ser diferenciadas con NBI.
INTRODUCTION: It is important to detect and remove adenomas in order to prevent colon cancer. Angiogenesis is an early change in the pre malignant transformation sequence and narrow band imaging (NBI) allows for better visualization of the capillary pattern of the mucosa. OBJECTIVE: We present our data regarding the assessment of superficial lesions of the colon on colonoscopies using NBI as well as the Sano-Emura classification. MATERIALS & METHODS: Prospective study done in Lima Peru. Three endoscopists evaluate the capillary pattern of colonic lesions in real time using NBI and electronic magnification. These findings are then compared to the pathology report. RESULTS: 380 patients were evaluated with a total of 739 lesions; 473 adenomas, 241 non neoplastic lesions, and 25 serrated lesions. These were grouped depending on their NBI capillary pattern into two groups: Neoplastic (Sano-Emura types II, IIIa, and IIIb), and Non-Neoplastic (Sano-Emura type I). Sensitivity for adenomas 84%, diagnostic accuracy 77%, PPV 82%, NPV 67%, specificity 63%. Sensitivity and diagnostic accuracy improved to 94% and 84%, respectively when evaluating lesions of 5mm to 9mm. For diminutive rectosigmoid polyps, the NPV for adenomas was 81%. The serrated lesions showed both types of capillary pattern with equal frequency. CONCLUSIONS: Our results using NBI with electronic magnification showed that this method is useful for the differentiation of lesions 5 mm or bigger, as reported previously. Accuracy was diminished when evaluating lesions less than 5mm. NBI was not capable of aiding in the differential diagnosis of serrated lesions.