Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 11 de 11
Filtrar
1.
Rev Esp Enferm Dig ; 2023 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-37170545

RESUMO

A 71-year-old male was diagnosed with gastric leiomyosarcoma in 2020 after biopsies of an ulcerated gastric lesion. Despite oncological treatment, he presented bone, liver and lung progression. Fourth line treatment with Pazopanib was started in 2022 with no evidence of intestinal or peritoneal metastases. He was attended in the Emergency Department in February 2023 due to symptoms of gastrointestinal bleeding with clinical and analytical repercussion with hemoglobin 5.8g/dl. Initially he presented hematemesis and subsequently hematochezia. An upper and lower endoscopic study was performed, revealing multiple sessile polypoid lesions with an irregular mucosal pattern of between 5-30 mm distributed throughout all explored sections at the gastric, duodenal and colic mucosal; some of them ulcerated with fibrin deposits on the surface and signs of recent hemostasis. The histological study demonstrated infiltration by spindle-shaped mesenchymal cells with atypical nuclei, a Ki-67 proliferation index >80%, and an immunohistochemical profile consistent with digestive metastases of primary gastric leiomyosarcoma. CT scan was performed confirming tumor progression with pulmonary, digestive, hepatic, bone, muscle and peritoneal dissemination of gastric leiomyosarcoma.

2.
Gastroenterol Hepatol ; 45(6): 440-449, 2022.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34400187

RESUMO

BACKGROUND AND STUDY AIMS: Data from Japanese series show that surface morphology of laterally spreading tumors (LST) in the colon identifies lesions with different incidence and pattern of submucosal invasion. Such data from western countries are scarce. We compared clinical and histological features of LST in a western country and an eastern country, with special interest on mucosal invasiveness of LST, and investigated the effect of clinical factors on invasiveness in both countries. PATIENTS AND METHODS: Patients with LST lesions ≥20mm were included from a multicenter prospective registry in Spain and from a retrospective registry from the National Cancer Center Hospital East, Japan. The primary outcome was the presence of submucosal invasion in LST. The secondary outcome was the presence of high-risk histology, defined as high-grade dysplasia or submucosal invasion. RESULTS: We evaluated 1102 patients in Spain and 663 in Japan. Morphological and histological characteristics differed. The prevalence of submucosal invasion in Japan was six-fold the prevalence in Spain (Prevalence Ratio PR=5.66; 95%CI: 3.96, 8.08), and the prevalence of high-risk histology was 1.5 higher (PR=1.44; 95%CI: 1.31, 1.58). Compared to the granular homogeneous type and adjusted by clinical features, granular mixed, flat elevated, and pseudo-depressed types were associated with higher odds of submucosal invasion in Japan, whereas only the pseudo-depressed type showed higher risk in Spain. Regarding high-risk histology, both granular mixed and pseudo-depressed were associated with higher odds in Japan, compared with only the granular mixed type in Spain. CONCLUSION: This study reveals differences in location, morphology and invasiveness of LST in an eastern and a western cohort.


Assuntos
Colonoscopia , Neoplasias Colorretais , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Humanos , Mucosa Intestinal/patologia , Invasividade Neoplásica/patologia , Estudos Retrospectivos
3.
Rev Esp Enferm Dig ; 109(4): 286-287, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28372449

RESUMO

Postoperative fistula results in increased morbidity and a longer hospital stay. While surgery is the most common treatment, the endoscopic approach is an increasingly used alternative. A 57-year-old woman underwent surgery for colonic adenocarcinoma, which relapsed as peritoneal carcinomatosis and was managed with chemotherapy and surgery, a biological Permacol™ mesh was used for abdominal wall closure.


Assuntos
Stents , Telas Cirúrgicas/efeitos adversos , Fístula Urinária/etiologia , Fístula Urinária/cirurgia , Adenocarcinoma/complicações , Adenocarcinoma/cirurgia , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Feminino , Herniorrafia , Humanos , Pessoa de Meia-Idade , Fístula Urinária/diagnóstico por imagem
6.
Gastroenterol Hepatol ; 36(2): 63-8, 2013 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-23140757

RESUMO

INTRODUCTION: Capsule endoscopy (CE) is the technique of choice to detect small bowel lesions. Flexible spectral imaging color enhancement (FICE) software has recently been incorporated into the new RAPID 6.0 workstation, which allows three distinct patterns to be visualized in the mucosal structure according to different wavelengths. The aim of this study was to evaluate whether CE-FICE is more effective in detecting lesions than standard visualization. PATIENTS AND METHODS: Fifty lesions were detected by CE in 41 consecutive patients in 2010. These patients were administered PillCamTM SB2 in our center and were classified into three groups: 1) vascular lesions and angiodysplasias (18 lesions), 2) erosions and ulcers (18 lesions) and 3) polyps and tumors (14 lesions). Subsequently, these lesions were independently analyzed with the available FICE patterns by three endoscopists, who assigned them a score according to the changes in the visualization of each FICE mode: +2, strong improvement; +1, slight improvement; 0, no relevant changes; -1, slight worsening; -2, clear worsening. When the sum of the scores of the three observers was 3 or more, visualization was considered to have improved; a score of 2 to -2 indicated no change; and a score of from -3 to -6 indicated poorer visualization. RESULTS: The FICE 1 mode improved visualization of angiodysplastic and vascular lesions in 16/18 patients (88.9%) and that of erosions/ulcers in 14/18 patients (77.8%). The FICE 2 mode improved these lesions in 88.9% and 55.5%, respectively. The FICE 3 mode only improved visualization of these lesions in 5/18 (27.7%) and 1/18 patients (5.5%), respectively. Likewise, the distinct FICE modes improved visualization of polyps/tumors in 2/14 (14.2%), 3/13 (21.4%) and 4/14 (28.5%) for FICE 1, 2 and 3, respectively. CONCLUSIONS: The application of CE-FICE modes 1 and 2 could improve the characterization of angiodysplastic/vascular lesions and erosions or ulcers in small bowel lesions. However, FICE 3 seems to provide no significant advantages. None of the CE-FICE modes seems to improve the characterization of polyps and tumors.


Assuntos
Endoscopia por Cápsula , Aumento da Imagem , Enteropatias/patologia , Intestino Delgado/patologia , Cor , Humanos
10.
Nutr Hosp ; 33(4): 387, 2016 Jul 19.
Artigo em Espanhol | MEDLINE | ID: mdl-27571662

RESUMO

Introducción: la esofagitis eosinofílica (EEo) es una enfermedad inmunoalérgica crónica emergente en adultos. Surge como respuesta disfuncional frente a los antígenos de los alimentos y se caracteriza por síntomas recurrentes de disfunción esofágica e inflamación. El tratamiento farmacológico y dietético se basa en su patogénesis y debe ser individualizado. Uno de los posibles abordajes dietéticos se basa en la eliminación empírica de alimentos que con mayor frecuencia causan EEo.Objetivo: evaluar la ingesta dietética de los pacientes con EEo que siguen la dieta de exclusión de los seis grupos de alimentos (DESGA) y conocer sus posibles carencias nutricionales.Métodos: estudio transversal descriptivo en un grupo de pacientes con EEo que inició tratamiento con DESGA durante el periodo de marzo de 2013 hasta marzo de 2015. Se evaluó la ingesta mediante registro de 72 horas. Se compararon los resultados con las referencias para población adulta sana española (23). Para el análisis estadístico se usaron los test de Mann-Whitney, Krhuskall-Wallis y Chi-cuadrado. Significación p < 0,05.Resultados: se incluyeron en el estudio 14 pacientes. En algunos de ellos, la ingesta dietética siguiendo DESGA fue deficitaria en energía, proteínas y fibra. Tampoco consiguieron cubrir las ingestas de micronutrientes de calcio, zinc, magnesio, ácido fólico, niacina y vitaminas B2 y D, teniendo en cuenta edad y sexo, el 60% de la muestra.Conclusiones: el abordaje terapéutico mediante DESGA, teniendo en cuenta las características de la dieta, debe acompañarse de una evaluación periódica del estado nutricional, que incluya micronutrientes y una pauta de suplementación específica.


Assuntos
Esofagite Eosinofílica/dietoterapia , Adulto , Estudos Transversais , Dieta , Ingestão de Alimentos , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Referência
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA