RESUMO
The migration of Kirschner wires (K-wires) is a rare complication. We herein present a case of an inflammatory polyp in the colon caused by the migration of a K-wire following fixation of a pelvic fracture. Surgery was carried out to remove the K-wire through an incision at the level of the left iliac bone. Simultaneous endoscopic clipping of the colonic wound was also performed. The patient's postoperative course was uneventful. Although very rare, migration of devices should be considered in patients with a previous history of orthopedic surgery.
Assuntos
Fios Ortopédicos/efeitos adversos , Colo/lesões , Pólipos do Colo/etiologia , Migração de Corpo Estranho/complicações , Fixação Interna de Fraturas/efeitos adversos , Fraturas Ósseas/cirurgia , Ossos Pélvicos/lesões , Colo/cirurgia , Pólipos do Colo/diagnóstico , Pólipos do Colo/cirurgia , Colonoscopia , Remoção de Dispositivo/métodos , Migração de Corpo Estranho/diagnóstico , Fixação Interna de Fraturas/instrumentação , Fraturas Ósseas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/diagnóstico por imagem , Tomografia Computadorizada por Raios XAssuntos
Carcinoma Ductal Pancreático/complicações , Neoplasias Pancreáticas/complicações , Infarto do Baço/diagnóstico , Infarto do Baço/etiologia , Idoso , Carcinoma Ductal Pancreático/patologia , Progressão da Doença , Evolução Fatal , Hemorragia Gastrointestinal/etiologia , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/secundário , Masculino , Neoplasias Pancreáticas/patologiaRESUMO
AIM: To investigate the different impact of genotypes B and C on the development of liver cirrhosis (LC) among different age groups of patients with chronic hepatitis B (CH-B). METHODS: We examined the outcome of 121 patients with CH-B, divided by age and genotype. Univariate analyses were used to compare different groups. The Cox proportional hazard model was employed to evaluate factors affecting the development of LC. RESULTS: In patients < 30 years old, there were no significant predictors for development of LC. However, in patients > or = 30 years old, genotype C was the only significant predictor. In the genotype C group, 8 of 12 patients who progressed to LC were 30-49 years old at initial diagnosis of chronic hepatitis (7 patients were positive for HBeAg). In the genotype B group, 4 of 8 patients who developed LC were > or = 50 years old at initial diagnosis and were HBeAg-negative. CONCLUSION: The rate of development of LC was comparable in patients infected with genotypes B and C when CH-B occurred at < 30 years old. However, CH-B patients infected with genotype C showed poor prognosis if they were 30-49 years old and were positive for HBeAg. Age-specific natural course of CH-B should be considered when patients with CH-B are treated with antiviral drugs.
Assuntos
Envelhecimento , DNA Viral , Vírus da Hepatite B/genética , Hepatite B Crônica/complicações , Cirrose Hepática/virologia , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Progressão da Doença , Genótipo , Antígenos E da Hepatite B/sangue , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/genética , Hepatite B Crônica/imunologia , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
AIM: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated with the degree of histological liver fibrosis in patients with chronic liver disease. However, data are few on the usefulness of markers in NAFLD patients. The aim of this study was to identify better noninvasive predictors of hepatic fibrosis, with special focus on markers of liver fibrosis, type VI collagen 7S domain and hyaluronic acid. METHODS: One hundred and twelve patients with histologically proven NAFLD were studied. RESULTS: The histological stage of NAFLD correlated with several clinical and biochemical variables, the extent of hepatic fibrosis and the markers of liver fibrosis were relatively strong associated. The best cutoff values to detect NASH were assessed by using receiver operating characteristic analysis: type VI collagen 7S domain > or =5.0 ng/mL, hyaluronic acid > or =43 ng/mL. Both markers had a high positive predictive value: type VI collagen 7S domain, 86% and hyaluronic acid, 92%. Diagnostic accuracies of these markers were evaluated to detect severe fibrosis. Both markers showed high negative predictive values: type VI collagen 7S domain (> or =5.0 ng/mL), 84% and hyaluronic acid (> or =50 ng/mL), 78%, and were significantly and independently associated with the presence of NASH or severe fibrosis by logistic regression analysis. CONCLUSION: Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.