RESUMEN
Enteral nutrition in intensive care has been a great advance in medicine, due to its benefit, cost-effectiveness and few complications. Bronchoaspiration, diarrhea, regurgitation or mechanical problems are the main adverse effects. Esophageal obstruction by bezoar is a very infrequent complication, and there are only a few cases described in the literature.
Asunto(s)
Bezoares , Nutrición Enteral , Bezoares/diagnóstico por imagen , Bezoares/etiología , Bezoares/terapia , Cuidados Críticos , Diarrea/etiología , Nutrición Enteral/efectos adversos , Esófago , HumanosRESUMEN
In relation to the article published in this journal by Guzmán describing a case of ampulla of Vater carcinosarcoma, we present a case of extrahepatic bile duct carcinosarcoma. A neoplasm described in different anatomical locations with an exceptional origin in the bile duct.
Asunto(s)
Ampolla Hepatopancreática , Neoplasias de los Conductos Biliares , Conductos Biliares Extrahepáticos , Carcinosarcoma , Neoplasias del Conducto Colédoco , Ictericia Obstructiva , Neoplasias de los Conductos Biliares/complicaciones , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Extrahepáticos/diagnóstico por imagen , Conductos Biliares Extrahepáticos/cirugía , Carcinosarcoma/complicaciones , Carcinosarcoma/diagnóstico por imagen , Carcinosarcoma/cirugía , Neoplasias del Conducto Colédoco/complicaciones , Neoplasias del Conducto Colédoco/diagnóstico por imagen , Neoplasias del Conducto Colédoco/cirugía , Humanos , Ictericia Obstructiva/etiologíaRESUMEN
INTRODUCTION: immigrants from areas of high endemicity for hepatitis C represent a relevant risk group. The goal of this study was to analyze the characteristics of these patients in a high-immigration health care area, and to analyze the impact of promoting diagnosis and referral by means of training sessions in the primary care setting. MATERIALS AND METHODS: a retrospective study in immigrant patients with HCV monoinfection treated with direct-acting antiviral agents in Almería between 2015 and 2020. Epidemiological and clinical variables were collected, as well as the impact of a micro-elimination approach. RESULTS: a total of 175 immigrant patients were enrolled, most of them from eastern Europe (52.5 %), followed by sub-Saharan Africa (21.1 %) and the Maghreb (14.8 %). Patients from sub-Saharan Africa and eastern Europe were younger (p = 0.002) and sub-Saharan subjects predominantly exhibited genotypes 2 and 3, whereas genotype 1 predominated in the rest of patients (p < 0.001). Of all the patients, 156 attained SVR (ITT-SVR, 89.1 %). The modified ITT rate was 96.9 %. Patients with SVR had spent more time in Spain (12.7 vs 6.1 years; p = 0.006). CONCLUSIONS: the immigrant population with HCV infection in our health care area exhibits homogeneous clinical and epidemiological characteristics. The efficacy of antiviral therapy is similar to that reported in the non-immigrant population, with higher rates of losses to follow-up and dosage errors, particularly in those who have been in the country for less time.