Results of a survey about specific inflammatory bowel disease units in Andalusia.

BACKGROUND: Inflammatory bowel disease (IBD) has become one of the most prevalent pathologies in Gastroenterology Units, which added to its clinical outcome, treatment, the complexity of affected patients and the need to be continuously updated for the correct management of the disease, have made essential the presence of specific IBD units in each hospital. OBJECTIVES: The primary aims of this study were: a) to reveal the existence of these units in our area and how they work; and b) to draw conclusions regarding the necessary resources in these units and their aims. MATERIAL AND METHODS: In order to analyse the presence of these specialized units and the available resources in Andalusian hospitals, a 24-question survey was designed, being answered by 11 hospitals. The evaluated questions included the number of days patients are attended and the number of physicians attending the unit, the number of available healthcare assistants, if emergencies are attended or not, if there is an activated telephone number for patient consultation, if a day care unit is available and if new treatments are easily accessible. RESULTS: A specific IBD unit is present in all studied hospitals attending more than 11 patients each, although in the 63.4% of the cases patients are not attended more than 3 days per week. On the other hand, the 81.8% of the included hospitals attend emergencies although only the 54.5% of them had a specific telephone number for patient attendance. CONCLUSIONS: A specific IBD unit is present in many Andalusian hospitals, although some deficiencies can be observed. The general opinion of this Group is that these units are necessary in order to properly attend, monitorize and treat patients affected by IBD.

[Influence of climatic factors on the incidence of upper gastrointestinal bleeding]. / Influencia de los factores climáticos en la incidencia de hemorragia digestiva alta.

OBJECTIVES: Several studies have suggested the existence of seasonal variation in the incidence of upper gastrointestinal bleeding (UGB). However, the role of climatic factors has not been elucidated. The aim of the present study was to investigate the role of these factors in the incidence of UGB secondary to esophageal varices (EV), gastric ulcer (GU), and duodenal ulcer (DU). MATERIAL AND METHODS: Based on the use of the Minimum Data Set and the International Classification of Diseases, cases of endoscopically-confirmed UGB secondary to EV, GU and DU were retrospectively included (1998-2001). The incidence of UGB was correlated with daily climatic factors (temperature, atmospheric pressure, humidity, direction and speed of wind) in Jerez de la Frontera (Spain) during the study period. RESULTS: A total of 499 patients were included (GU = 192, DU = 199, EV = 108). No significant differences were found in the monthly or seasonal incidence of UGB. Episodes of UGB were grouped according to the climatic conditions present on the day of admission. No significant relationship was found between UGB and any of the daily climatic factors studied. DISCUSSION: The results of our study do not support the existence of a seasonal pattern in the incidence of UGB secondary to GU, DU or EV and allow us to conclude that, in our geographical area, these factors are not involved in episodes of bleeding.

Anxiety during the performance of colonoscopies: modification using music therapy.

BACKGROUND AND STUDY AIMS: Colonoscopies are usually performed using pharmacological sedation. This process entails certain risks. In the search for alternative methods, some studies have analysed the effect music can have on patients during the procedure when used as a complement to sedation. We present a prospective, randomized study in which we assess the anxiolytic action music has when it is administered during a single colonoscopy. PATIENTS AND METHODS: We included 118 patients who were scheduled for ambulatory colonoscopies. They were randomly assigned to the control group (n = 55) and the experimental group (n = 63). We determined their levels of anxiety using the State-Trait Anxiety Inventory Test (STAI) form, which they filled in before and after the examination. Patients listened to music through personal headphones. RESULTS: The score on the STAI form before the examination was 25.25 +/- 10.49 and 28.16 +/- 11.43 in the control and experimental groups, respectively (P > 0.05). The decrease of the score on the STAI scale after the colonoscopy in the control and experimental groups was 6.27 (95% confidence interval, 3.26-9.28) and 11.35 (95% confidence interval, 8.64-14.05), respectively (P < 0.01). CONCLUSIONS: Listening to music during ambulatory colonoscopies decreases the level of anxiety that is inherent to the process without other anxiolytic methods.

[Familial colonic varices: report of two cases]. / Varices colónicas familiares: presentación de dos casos.

Idiopathic or familial colonic varices are an infrequent cause of gastrointestinal hemorrhage. It seems that congenital vascular abnormalities are involved in its etiopathogenesis. We present two cases in the same family. The disease first presented as intermittent episodes of rectorrhagia. In one case varices of the small intestine were detected by radiology. Both cases were given conservative treatment and we believe that surgery should be limited to selected cases and always after a careful observation period.

[Acute recurrent pancreatitis and ampullary tumor: a case report]. / Pancreatitis aguda recidivante y tumor ampular: presentación de un caso.

A case of ampullary cancer, the first clinical manifestation of which was two episodes of acute pancreatitis is presented with review of the literature on the possible role of this type of cancer as a causal agent of episodes of acute pancreatitis. We support the use of ERCP in all patients with acute idiopathic pancreatitis with the aim of discarding the possibility of a tributary ampullary tumor of curative removal.