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1.
BMC Gastroenterol ; 24(1): 166, 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38755577

RESUMEN

INTRODUCTION: The diagnosis of intestinal tuberculosis is challenging even nowadays. This study aims to report the positivity rates of new diagnostic methods such as immunohistochemistry and Real-Time Polymerase Chain Reaction in patients with intestinal tuberculosis, as well as describe the pathological and endoscopic features of intestinal tuberculosis in our population. METHODS: This was a retrospective observational study conducted in patients diagnosed with intestinal tuberculosis, between 2010 to 2023 from the Hospital Nacional Daniel Alcides Carrion and a Private Pathology Center, both located in Peru. Clinical data was obtained, histologic features were independently re-evaluated by three pathologists; and immunohistochemistry and real-time Polymerase Chain Reaction evaluation were performed. The 33 patients with intestinal tuberculosis who fulfilled the inclusion criteria were recruited. RESULTS: Immunohistochemistry was positive in 90.9% of cases, while real-time Polymerase Chain Reaction was positive in 38.7%. The ileocecal region was the most affected area (33.3%), and the most frequent endoscopic appearance was an ulcer (63.6%). Most of the granulomas were composed solely of epithelioid histiocytes (75.8%). Crypt architectural disarray was the second most frequent histologic finding (78.8%) after granulomas, but most of them were mild. CONCLUSION: Since immunohistochemistry does not require an intact cell wall, it demonstrates higher sensitivity compared to Ziehl-Neelsen staining. Therefore, it could be helpful for the diagnosis of paucibacillary tuberculosis.


Asunto(s)
Inmunohistoquímica , Reacción en Cadena en Tiempo Real de la Polimerasa , Tuberculosis Gastrointestinal , Humanos , Tuberculosis Gastrointestinal/diagnóstico , Tuberculosis Gastrointestinal/microbiología , Perú , Masculino , Femenino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Granuloma/diagnóstico , Granuloma/microbiología , Granuloma/patología , Mycobacterium tuberculosis/aislamiento & purificación , Mycobacterium tuberculosis/genética , Adolescente , Sensibilidad y Especificidad
2.
BMC Gastroenterol ; 22(1): 171, 2022 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-35395750

RESUMEN

INTRODUCTION: Since 2003, a progressive increase in sexually transmitted infections (STI), presented as proctitis, has been described in homosexual men. In 2013 Arnold et al. described microscopic features that enable pathologists to formulate a histological diagnosis of STI related proctitis. The aim of this study is to identify the presence of Chlamydia trachomatis by immunohistochemistry in a group of patients with male to male sexual activity and pathology compatible with STI proctitis. METHODS: Cross-sectional study. The study included 54 patients with risky sexual activity and histopathology compatible with STI-proctitis according to Arnold´s recommendations. The Chlamydia trachomatis identification was carried out retrospectively on paraffin blocks using mouse monoclonal antibodies from Santa Cruz biotechnology. RESULTS: all patients were young men with male to male sexual activity, 69% were positive for HIV. The most common endoscopic presentation was rectal ulcer (61%). Basal lymphoplasmacytic inflammation and mild crypt distortion were the most common histological findings. The immunohistochemical study identified positivity for Chlamydia trachomatis in 40% (18 of 45 tested) of STI proctitis cases. DISCUSSION: The epidemiological and endoscopic characteristics of the patients studied are similar to those previously reported. In accordance with Arnold et al., the most common histological findings were (a) mild distortion of the crypts; (b) dense and basal lymphoplasmacytic infiltrate and (c) scarcity of eosinophils. The positivity of chlamydia trachomatis in immunohistochemistry was lower than others studies that used PCR for this purpose. We did not find similar published studies to compare our results. CONCLUSIONS: In summary, 54 cases of patients with STI related proctitis are presented, all of them with distinctive histological characteristics and third of the cases tested positive by IHC for Chlamydia trachomatis.


Asunto(s)
Proctitis , Enfermedades de Transmisión Sexual , Animales , Chlamydia trachomatis , Estudios Transversales , Humanos , Masculino , Ratones , Proctitis/diagnóstico , Proctitis/patología , Estudios Retrospectivos , Conducta Sexual , Enfermedades de Transmisión Sexual/diagnóstico
3.
Dig Dis Sci ; 67(8): 4131-4139, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-34635979

RESUMEN

BACKGROUND: Fluid therapy plays a critical role in the management of acute pancreatitis. Normal saline (NS) is commonly used in these patients. However, Lactate Ringer's (LR) has also been shown to be useful for this condition. AIM: To assess the effect of LR compared to NS in patients with acute pancreatitis. METHODS: We searched in three electronic databases from inception to December 2020 for randomized controlled trials (RCTs). Outcomes were mortality, intensive care unit (ICU) admission, hospital stay, and Systemic Inflammatory Response Syndrome (SIRS) at 24, 48, and 72 h. The risk of bias was assessed using the Risk of Bias 2.0 tool. All meta-analyses were performed using a random-effects model. RESULTS: Four RCTs comprising 248 patients were included. The mean age ranged from 42.3 to 63.8 years and 49% of patients were men. Patients treated with LR had similar risk of mortality (risk ratio [RR], 0.53; 95% confidence interval [CI], 0.09-3.00) and SIRS at 24 h (RR, 0.69; 95% CI, 0.32-1.51), 48 h (RR, 0.80; 95% CI, 0.46-1.41), and 72 h (RR, 0.68; 95% CI, 0.37-1.25) compared to NS. LR had significantly lower hospital stay (mean difference, - 1.10; 95% CI, - 1.92 to - 0.28) and lower risk of ICU admission (RR, 0.42; 95% CI, 0.20-0.89) compared to NS. The risk of bias was low in nearly all RCTs. CONCLUSION: No differences were found in the mortality and SIRS at 24, 48, and 72 h in patients treated with LR and NS. In contrast, patients who received LR had a lower risk of ICU admission and lower hospital stay than NS.


Asunto(s)
Pancreatitis , Solución Salina , Adulto , Femenino , Humanos , Lactatos , Masculino , Persona de Mediana Edad , Pancreatitis/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Lactato de Ringer , Solución Salina/uso terapéutico , Síndrome de Respuesta Inflamatoria Sistémica/terapia
4.
Wilderness Environ Med ; 33(2): 148-153, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35361528

RESUMEN

INTRODUCTION: Acute altitude exposure is a common event in Latin America that can result in mild to severe altitude illness. Medical students from some Latin American countries receive little information on this topic. Our aim was to determine the knowledge and incidence of acute mountain sickness (AMS), as well as the methods used to prevent AMS among medical students attending the Pan-American Student Meeting in Cusco, Peru, a city at high altitude (3400 m). METHODS: We conducted a cross-sectional study on medical students attending a conference. Participants completed a questionnaire on the day of registration that collected demographic data and investigated students' knowledge of AMS, its prophylaxis, and their personal experience of symptoms. RESULTS: A total of 840 students attended the meeting. Two hundred eighty-eight returned surveys, 51 from high altitude locations. Respondent age was 23±3 y (mean±SD), and 72% were female. Thirty-two percent had basic knowledge about symptoms of AMS. Headache was recognized as a symptom by 79%. Knowledge of AMS prophylaxis was reported by 70%. Coca leaf products and dimenhydrinate were mentioned by 30 and 16%, respectively, whereas acetazolamide was recognized by only 10% of participants. AMS incidence was 42%. Prophylactic measures were adopted by 47% of the participants in our study. Thirty-six percent used dimenhydrinate and 27% used coca tea. Less than 1% used acetazolamide as recommended. CONCLUSIONS: We found poor knowledge of AMS and effective prophylaxis among medical students from several South American countries traveling to 3400 m.


Asunto(s)
Mal de Altura , Dimenhidrinato , Estudiantes de Medicina , Acetazolamida/uso terapéutico , Enfermedad Aguda , Mal de Altura/diagnóstico , Mal de Altura/epidemiología , Mal de Altura/prevención & control , Estudios Transversales , Dimenhidrinato/uso terapéutico , Femenino , Humanos , América Latina/epidemiología , Masculino
5.
Rev Gastroenterol Peru ; 38(4): 345-348, 2018.
Artículo en Español | MEDLINE | ID: mdl-30860505

RESUMEN

INTRODUCTION: Some authors have found increase of neuroendocrine cells in microscopic colitis and ulcerative colitis. OBJECTIVE: The aim of this study is to evaluate the presence of neuroendocrine cells in ulcerative colitis and lymphocytic colitis and collagenous colitis. MATERIALS AND METHODS: Immunohistochemistry was performed to identify neuroendocrine cells through marker chromogranin A (CgA). The study included 10 cases of each diagnosis of Lymphocytic colitis, collagenous colitis and ulcerative colitis. RESULTS: There was statistically significant difference in the count of neuroendocrine cells, between lymphocytic colitis and control (p=0.019104), and between ulcerative colitis and controls (p=0.0077). In collagenous colitis there was an increase in neuroendocrine cells but we failed to find statistical differences. CONCLUSION: We could observe neuroendocrine cell hyperplasia in lymphocytic colitis and ulcerative colitis compared with controls, which confirm previous studies.


Asunto(s)
Colitis Colagenosa/patología , Colitis Linfocítica/patología , Colitis Ulcerosa/patología , Células Neuroendocrinas/patología , Humanos , Hiperplasia
6.
Rev Gastroenterol Peru ; 38(3): 248-252, 2018.
Artículo en Español | MEDLINE | ID: mdl-30540728

RESUMEN

OBJECTIVE: The purpose of this study was to determine the prevalence of the different types of gastric polyps in the Daniel Alcides Carrión Hospital between the years of 2014 and 2016, and also define the endoscopic and histopathological characteristics of the lesions. MATERIALS AND METHODS: 7559 endoscopic reports were reviewed, in which 148 gastric polyps were found. The patients age and sex as well as the localization, number, size and macroscopic and microscopic aspects of the polyps were recorded. RESULTS: The prevalence of gastric polyps was 1.9%; 74.3% of these were found in women with an average age of 61.5 years. 59.4% of the gastric polyps found were singular, and the majority were located on the body and antrum of the stomach. 74.29% of the polyps were less than 1 cm in diameter and 83.64% of these were sessile when seen macroscopically. According to the histological type, it was found that the majority of gastric polyps were hyperplasic (76.4%), followed by fundic gland polyps (17.5%) and gastric adenomas (6.1%). It was also found that multiple gastric polyps were associated with fundic gland polyps while singular polyps were most likely hyperplastic or adenomas. CONCLUSION: The prevalence of fundic gland polyps has increased, while the other types of polyps have maintained their estimated prevalence.


Asunto(s)
Pólipos Adenomatosos/epidemiología , Neoplasias Gástricas/epidemiología , Adenoma/epidemiología , Adenoma/patología , Adenoma/cirugía , Pólipos Adenomatosos/patología , Pólipos Adenomatosos/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Fundus Gástrico/patología , Gastroscopía , Humanos , Hiperplasia , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Adulto Joven
7.
Rev Gastroenterol Peru ; 37(4): 301-304, 2017.
Artículo en Español | MEDLINE | ID: mdl-29459798

RESUMEN

OBJECTIVE: To determine whether localization and size are related to the presence of high-grade dysplasia of colon adenomas in patients of a Peruvian hospital. MATERIALS AND METHODS: This is a descriptive transversal study. We checked colonoscopyreports of 2014-2015 years of Hospital Daniel Alcides Carrion, we included the polyps found in patients older than 18 years old, and excluded reports from patients with colorectal cancer, an antecedent of oncological surgery, inflammatory bowel disease and polyposis (6 or more). We used data based on localization (proximal and distal colon, based on the splenic angle), size (less than 10 mm and 10 mm or more), shape (pediculate and sessile) and grade of dysplasia (low and high-grade). We calculated the strength of association by OR, and we determined whether there was association by Chi-square test with a significance value less than 0.05. RESULTS: We reviewed a total of 1710 of colonoscopy reports, 378 patients had polyps, so the adenoma detection rate was 22.1%. There were 458 polyps, from which 254 were adenomas. From these adenomas, we found an association between distal colon localization and high-grade dysplasia (OR 2.68 IC 1.12-6.42, p < 0.05); likewise, there was an association between the size of the adenomas and high-grade dysplasia (OR 7.75 IC 3.05-19.69, p<0.05). We did not find any association between the shape and grade of dysplasia. CONCLUSION: This study concludes that there is an association between the size of 10 mm or more and localization in the distal colon with high-grade dysplasia of adenomas.


Asunto(s)
Adenoma/patología , Neoplasias del Colon/patología , Pólipos del Colon/patología , Adulto , Anciano , Anciano de 80 o más Años , Colonoscopía , Estudios Transversales , Femenino , Humanos , Hiperplasia/patología , Inflamación , Poliposis Intestinal/patología , Masculino , Persona de Mediana Edad , Especificidad de Órganos , Carga Tumoral , Adulto Joven
8.
Rev Gastroenterol Peru ; 37(4): 340-345, 2017.
Artículo en Español | MEDLINE | ID: mdl-29459804

RESUMEN

INTRODUCTION: Lymphocytic colitis and microscopic enteritis are relatively common causes of chronic diarrhea and it is characterized by an intraepithelial lymphocytic infiltrate. There have been no previous reports of coexistence between these 2 pathologies. OBJECTIVE: To describe histological and clinical characteristic in patients with coexistence of lymphocytic colitis and microscopic enteritis. MATERIAL AND METHODS: All cases with simultaneous diagnosis of lymphocytic duodenosis and lymphocytic colitis were reevaluated during lapse time 2010-2016 in hospital Daniel Carrion. The slides were reviewed by 3 pathologists and clinical information was obtained from clinical records. Expression of CD3 and CD8 was detected in 6 cases by immunohistochemical assays. RESULTS: A total of 35 patients with coexistence of lymphocytic duodenitis and lymphocytic colitis were selected of the pathology archives, 80% were females, Anemia was identified in 28.5% of patients. Blastocysitis hominis infestation was identified in 31.8%. The mean intraepithelial lymphocyte CD8 and CD3 positive was 40% in microscopic enteritis, while the mean intraepithelial lymphocyte CD3 positive was 37.2% and CD8 positive was 29.2% Additionally, lymphocytic ileitis was diagnosed in 11 of our cases. Eosinophilic colitis was diagnosed in 9 cases of lymphocytic colitis Conclusion: We found that lymphocytic colitis, microscopic enteritis and even lymphocytic ileitis can coexist in a group of patients with chronic diarrhea. These findings bring the question if this concurrence of both pathologies constituted a more generalized gastrointestinal disorder, involving both the large and the small intestines.


Asunto(s)
Colitis Linfocítica/complicaciones , Colitis Microscópica/complicaciones , Diarrea/etiología , Adulto , Anciano , Biopsia , Infecciones por Blastocystis/complicaciones , Infecciones por Blastocystis/patología , Enfermedad Crónica , Colitis Linfocítica/patología , Colitis Microscópica/patología , Colon/patología , Estudios Transversales , Duodeno/patología , Femenino , Humanos , Ileítis/complicaciones , Ileítis/patología , Íleon/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
9.
Rev Gastroenterol Peru ; 37(3): 231-234, 2017.
Artículo en Español | MEDLINE | ID: mdl-29093586

RESUMEN

OBJECTIVE: The aim of this study was characterized sin duodenum the heterotopic gastric mucosa. MATERIALS AND METHODS: The slides with the diagnosis of heterotopic gastric mucosa during 2014-2015, were reviewed, and clinical, histological and endoscopic data was to collected for every case. RESULTS: 45 cases of heterotopic gastric mucosa in duodenum were found, 91.1% were located in duodenum bulb and 73.2%, presenting as polyps in 73.2% of cases. In all cases, parietal cell was identified as main criteria for the diagnosis. Neither Helicobacter pylori nor dysplasia were identified. CONCLUSIONS: Our data confirm its non neoplastic nature. Heterotopic gastric mucosa should be taken into account in diagnosis of duodenal polyps. Parietal cells identification in duodenal mucosa is essential in differential diagnosis with peptic duodenitis.


Asunto(s)
Coristoma/diagnóstico por imagen , Coristoma/patología , Enfermedades Duodenales/diagnóstico por imagen , Enfermedades Duodenales/patología , Duodenoscopía , Mucosa Gástrica , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
10.
Rev Gastroenterol Peru ; 37(4): 346-349, 2017.
Artículo en Español | MEDLINE | ID: mdl-29459805

RESUMEN

OBJECTIVE: The aim of the present study was to determine the prevalence of sero positivity for HBsAg, Anti-HBcAg and AntiHVC in the blood bank of Hospital Daniel Carrion during the period 2010 - 2012. MATERIALS AND METHODS: Retrospective cross-sectional study. Potential donors who met the inclusion criteria were included. Sociodemographic factors, risk behaviors were gathered. A descriptive analysis was performed with STATA 14. RESULTS: 13,887 potential blood donors of the HNDAC between January 2010 and December 2012 were identified. The population's mean was 37 years, 32% were women. 897 potential positive blood donors were identified. The prevalence of HBsAg was 0.55%; Anti-HBcAg, 5.15%; and Anti-HVC, 1.25%. CONCLUSION: The prevalence of positive serology for HBsAg was similar to the previous reports and Anti-HVC was higher than the prevalence reported in our country.


Asunto(s)
Bancos de Sangre/estadística & datos numéricos , Donantes de Sangre/estadística & datos numéricos , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Adulto , Estudios Transversales , Femenino , Hepatitis B/sangre , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis C/sangre , Anticuerpos contra la Hepatitis C/sangre , Hospitales Generales/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Estudios Retrospectivos , Estudios Seroepidemiológicos
11.
Rev Gastroenterol Peru ; 36(2): 123-8, 2016.
Artículo en Español | MEDLINE | ID: mdl-27409088

RESUMEN

UNLABELLED: There is a group of enteropathies recently known as seronegative villous atrophy (SNVA), which can simulate celiac disease. OBJECTIVE: The aim of this study was to describe histological and immunohistochemical differences between a group of Celiac disease and SNVA patients. MATERIAL AND METHODS: Microscopy reexamination and Immunohistochemistry study were performed for a group of 15 celiac patients and 19 SNVA patients. Histological features as severe atrophy, crypt hyperplasia, plasma cells number, eosinophils number, neutrophils presence were studied; CD4, CD8, CD3, and CD56 markers were studied through immunohistochemistry. RESULTS: There was a significant difference between the frequency of observation of crypt hyperplasia (p=0.0348) and plasma cells (p=0.0348) in celiac disease patients than SNVA patients. In celiac disease was bigger. The number and distribution of CD 8, CD4 and CD56 lymphocytes was similar in both groups. The percentage of CD3 positive intraepithelial lymphocytes (p=0.0144) was higher in SNVA. CONCLUSION: Histological and immunohistochemical evaluation shows more similarities than differences. The differences found in this study suggest more humoral immune response in celiac disease than in SNVA.


Asunto(s)
Antígenos CD/metabolismo , Enfermedad Celíaca/metabolismo , Enfermedad Celíaca/patología , Duodeno/patología , Mucosa Intestinal/patología , Linfocitos/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Atrofia , Biomarcadores/metabolismo , Biopsia , Enfermedad Celíaca/diagnóstico , Estudios Transversales , Diagnóstico Diferencial , Duodeno/metabolismo , Femenino , Humanos , Inmunohistoquímica , Mucosa Intestinal/metabolismo , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
12.
Rev Gastroenterol Peru ; 33(1): 39-42, 2013.
Artículo en Español | MEDLINE | ID: mdl-23539055

RESUMEN

OBJECTIVES: 1) To determine the prevalence of increased number of eosinophils in colonic mucosa of patients with lymphocytic colitis (LC). 2) To determine the coexistence of eosinophilic colitis (EC) in patients with lymphocytic colitis. MATERIALS AND METHODS: slides of adult patients with cronic diarrhea with diagnosis of LC were reviewed between October 2009 and March 2012. The number of eosinophils was quantified. RESULTS: Sixty eight patients with LC were included. Elevated eosinophils were found in 76.5 and in 51.4% a diagnosis of EC was established. CONCLUSION: 3 out of 4 patients with LC had elevated eosinophils and 1 of 2 patients with LC had criteria for EC.


Asunto(s)
Colitis Linfocítica/complicaciones , Diarrea/complicaciones , Eosinofilia/complicaciones , Eosinofilia/patología , Enfermedad Crónica , Colitis/complicaciones , Colitis/patología , Colitis Linfocítica/patología , Eosinófilos , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad
13.
Rev Gastroenterol Peru ; 31(1): 11-6, 2011.
Artículo en Español | MEDLINE | ID: mdl-21544150

RESUMEN

AIM: To evaluate the platelet count/spleen diameter (PC/SD) ratio as a non invasive diagnostic test to predict esophageal varices (VE) in patients with cirrhosis. METHODS: Diagnostic test study, retrospective analysis. Data was collected from patients with diagnosis of liver cirrhosis at gastrointestinal unit of Hospital Nacional Daniel Alcides Carrión between September 2010 and January 2011. Using a PC/SD ratio with a cut off value of 909, sensitivity, specificity, Positive and negative predictive values, positive and negative likelihood ratios were calculate. RESULTS: There were 47 patients; mean age of 60,74; etiology: alcoholic (25,5%); undeterminated (48,9%). Twenty-five percent patients had varices and 74,5% had no varices. The PC/SD ratio had a sensitivity of 40%, specificity of 75%, PPV of 82%, NPV 30%, LR (+) of 1,6 and LR (-) of 0,8. CONCLUSIONS: The PC/SD ratio was not an effective diagnostic test for esophageal varices.


Asunto(s)
Várices Esofágicas y Gástricas/diagnóstico , Várices Esofágicas y Gástricas/etiología , Cirrosis Hepática/complicaciones , Recuento de Plaquetas , Bazo/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Adulto Joven
14.
Dig Endosc ; 22(2): 156-7, 2010 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-20447214

RESUMEN

Ascariasis is the most common helminthic infection in developing countries. It may cause chronic abdominal pain, tenderness and bloating. Our aim is to report a case of acute episodic abdominal pain and pancreatitis associated with ascariasis. We report a 59-year-old female patient who was admitted for acute abdominal pain, having had several previous similar events before one of them was diagnosed as acute idiopathic pancreatitis. On admission, her physical exam was normal. Laboratory results showed hemoglobin 12.2 g/dL, white blood cell count 11 900 cells/mm(3), eosinophils 420 cells/mm(3), serum amylase 84 IU/mL, lipase 22 IU/mL and normal liver function tests. Abdominal ultrasound and a plain abdominal X-ray were also normal. An upper endoscopy showed round white worms in the duodenum and the stomach, some of them with bile in their intestines. The intestinal parasites were diagnosed as Ascaris lumbricoides, and the patient was started on albendazole, with full recovery within a week. We believe that ascariasis should be considered in patients with recurrent abdominal pain and idiopathic pancreatitis.


Asunto(s)
Dolor Abdominal/patología , Dolor Abdominal/parasitología , Ascariasis/patología , Ascaris lumbricoides , Animales , Ascariasis/complicaciones , Ascariasis/terapia , Endoscopía del Sistema Digestivo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia
18.
Rev Peru Med Exp Salud Publica ; 33(4): 670-679, 2016.
Artículo en Español | MEDLINE | ID: mdl-28327835

RESUMEN

OBJECTIVES: . To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. MATERIALS AND METHODS: . A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month. Variables related to the doctor, assailant, and health service were measured. Raw and adjusted prevalence ratios (PR) were calculated by means of a Poisson-family generalized linear model with non-parametric bootstrapping. RESULTS: . A total of 406 doctors participated; 31.5% were victims of EWV at least once during their professional practice, with 19.9% over the past 12 months and 7.6% during the last month. The chances of being threatened in the last 12 months increased if the doctor was male (adjusted PR [aPR]: 1.7; 95% confidence interval [CI] = 1.1- 2.8), had graduated from a Peruvian university outside of the metropolitan area of Lima (aPR: 1.5; 95% CI = 1.1-2.4), worked at MINSA (aPR: 7.9; 95% CI = 2.24-50.73) or EsSalud (RR: 8.68; 95% CI = 2.26-56.17), and worked in the emergency (aPR: 1.9; 95% CI = 1.2-3.6) or operating room (aPR: 1.6; 95% CI = 1.1-2.3). Age, years of professional practice, or being a medical resident were not associated with EWV. CONCLUSION: . In the hospitals studied, a large number of doctors have been victims of EWV. Working in public services increases the possibility of violence. Implementation of support, identification, and primary prevention strategies in hospitals is recommended.


Asunto(s)
Médicos , Violencia Laboral , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Perú , Prevalencia , Lugar de Trabajo
19.
Rev. colomb. gastroenterol ; 35(4): 414-420, dic. 2020. tab, graf
Artículo en Español | LILACS | ID: biblio-1156323

RESUMEN

Resumen Introducción: los pólipos de vesícula biliar, benignos y malignos, en la mayoría de pacientes tienen un diagnóstico generalmente incidental; a través de estudios de imágenes, que no se pueden distinguir con precisión según su grado de malignidad. Objetivo: determinar los factores de riesgo para la malignidad de los pólipos vesiculares en dos hospitales públicos peruanos. Metodología: estudio de cohorte retrospectiva, de datos secundarios, en colecistectomizados del 2004 al 2012 en un hospital de Lima y otro de Callao. Se definió como pólipo maligno según el tipo histopatológico de adenocarcinoma. Se obtuvieron los riesgos relativos y sus intervalos de confianza del 95 % (IC 95 %). Además, mediante curvas ROC (característica operativa del receptor), se obtuvieron la sensibilidad y especificidad según el tamaño de pólipo. Resultados: de las 368 biopsias, 26 (7 %) fueron adenocarcinomas. La mediana del tamaño de los pólipos fue de 4 mm (rango: 1-65 mm), 176 (51 %) tuvieron múltiples pólipos y 85 (23 %) tuvieron litiasis biliar asociada. En el análisis multivariado, se incrementó el riesgo de malignidad por cada milímetro del tamaño del pólipo en 26 % (IC 95 %:14 %-40 %, valor p < 0,001) y del tamaño de la pared vesicular en 182 % (IC 95 %:46 %-445 %, valor p: 0,002), ajustados por la edad del paciente, la litiasis y el tamaño vesicular. Para un tamaño de 6 mm se tuvo una sensibilidad de 81 % y especificidad del 85 %. Conclusión: se concluye que el tamaño del pólipo y el grosor de la pared vesicular estuvieron asociados con la malignidad de pólipos vesiculares.


Abstract Introduction: In most patients, gallbladder polyps, both benign and malignant, are usually an incidental finding. However, imaging studies cannot accurately establish their degree of malignancy. Objective: To determine the risk factors for gallbladder polyp malignancy in two Peruvian public hospitals. Methodology: Retrospective cohort study conducted on secondary data from patients who underwent cholecystectomy between 2004 and 2012 in Lima and another in Callao, Peru. The malignancy of the polyp was established according to the histopathological type of adenocarcinoma. Relative risks and their 95% confidence intervals (95%CI) were obtained. Moreover, ROC curves were used to determine sensitivity and specificity according to the size of the polyp. Results: Of 368 biopsies, 26 (7%) were adenocarcinomas. The median size of the polyps was 4mm (range: 1-65mm). 176 patients (51%) had multiple polyps, and 85 (23%) had associated gallstones. Multivariate analysis showed that the risk of malignancy increased by 26% (95%CI:14-40%, p-value:<0.001) per millimeter of polyp size and by 182% (95%CI:46-445%, p-value=0.002) based on vesicular wall size, adjusted for patient age, lithiasis and vesicular size. For a size of 6mm, sensitivity was 81%, and specificity was 85%. Conclusion: The size of the polyp and the thickness of the vesicular wall are associated with the malignancy of vesicular polyps.


Asunto(s)
Humanos , Masculino , Femenino , Pólipos , Adenocarcinoma , Factores de Riesgo , Vesícula Biliar , Hospitales Públicos , Neoplasias
20.
Rev. gastroenterol. Perú ; 38(4): 345-348, oct.-dic. 2018. ilus, tab
Artículo en Español | LILACS | ID: biblio-1014107

RESUMEN

Introducción: Algunos autores han demostrado incremento de células neuroendócrinas en colitis microscópica y colitis ulcerativa. Objetivo: El objetivo del presente estudio fue evaluar la presencia de células neuroendócrinas en colitis linfocítica, colitis colagenosa y colitis ulcerativa en comparación a controles. Materiales y métodos: Se usó inmunohistoquímica para identificar a las células neuroendócrinas a través del marcador cromogranina A. El estudio incluyó 10 casos de cada diagnóstico de colitis linfocítica, colitis colagenosa y colitis ulcerativa. Resultados: Se encontró diferencia estadísticamente significativa en el conteo de células neuroendocrinas en colitis linfocítica (p=0,019104) y colitis ulcerativa en comparación con los controles (p=0,0077). En colitis colagenosa, se encontró un incremento de células neuroendocrinas pero no pudimos demostrar diferencias estadísticamente significativa. Conclusión: Se demostró hiperplasia de células neuroendocrinas en colitis linfocítica y colitis ulcerativa, lo que confirma lo reportado por los pocos estudios anteriores realizados sobre el tema.


Introduction: Some authors have found increase of neuroendocrine cells in microscopic colitis and ulcerative colitis. Objective: The aim of this study is to evaluate the presence of neuroendocrine cells in ulcerative colitis and lymphocytic colitis and collagenous colitis. Materials and methods: Immunohistochemistry was performed to identify neuroendocrine cells through marker chromogranin A (CgA). The study included 10 cases of each diagnosis of Lymphocytic colitis, collagenous colitis and ulcerative colitis. Results: There was statistically significant difference in the count of neuroendocrine cells, between lymphocytic colitis and control (p=0.019104), and between ulcerative colitis and controls (p=0.0077). In collagenous colitis there was an increase in neuroendocrine cells but we failed to find statistical differences. Conclusion: We could observe neuroendocrine cell hyperplasia in lymphocytic colitis and ulcerative colitis compared with controls, which confirm previous studies.


Asunto(s)
Humanos , Colitis Ulcerosa/patología , Colitis Colagenosa/patología , Colitis Linfocítica/patología , Células Neuroendocrinas/patología , Hiperplasia
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