A nested case-control study on dietary fat consumption and the risk for gallstone disease.

BACKGROUND: Gallstone disease (GD) incidence and prevalence rates differ between populations. Diet and lifestyle may be involved in GD development. To our knowledge, no study to date has evaluated quantitative data on diet when studying the relationship between fat consumption levels and GD in an Argentinean population. The present study aimed to assess the association between dietary fat intake and GD. METHODS: A nested case-control study design was applied. Data were taken from subjects who participated in a previous cross-sectional study carried out in a random sample of asymptomatic people in Rosario, Argentina. Participants underwent a personal interview, and current weight and height, ancestor's ethnicity, and socio-economic status were recorded. Applying a food-frequency questionnaire and a food photography atlas, quantitative dietary data were estimated by combining the intake frequency, portion size and food composition. Logistic regression analysis was used to compute odds ratios and 95% confidence intervals adjusted by age, sex, ancestor's ethnicity, body mass index and daily total energy intake as potential confounders. RESULTS: In total, 114 patients were studied (49 cases and 65 controls), without any statistically significant differences for age, sex, socio-economic status, body mass index and ancestry. The mean energy intake was higher in cases than in controls, and significant differences were found for dietary fat consumption. Obese or overweight people have a higher GD risk than subjects with normal weight. Increased GD risks were associated with high intakes of energy, total fat, and saturated and monounsaturated fatty acids. CONCLUSIONS: According to our results, total fat, saturated and monounsaturated fatty acids high intakes are associated with increased GD risk.

Ovarian recovery after total body irradiation and allogeneic bone marrow transplantation: long-term follow up of 79 females.

Seventy-nine females undergoing allogeneic BMT following conditioning with total body irradiation (TBI), were prospectively followed between March 1983 and March 1992 with regular gynaecological examinations, including plasma levels of luteinising hormone (LH), follicle stimulating hormone (FSH), 17-beta oestradiol (E2) and pelvic ultrasonography. The end-points of this study were the following: (1) early and late effects of TBI on ovarian function, (2) compliance and results of hormonal replacement therapy (HRT), and (3) predictive events for ovarian recovery. During the first year post-BMT most adult women complained of vasomotor and/or genitourinary tract symptoms. These were associated with decreased E2 and increased LH-FSH plasma levels and a deterioration in their sexual life (94% of sexually active women). Forty-nine adult females were selected to receive systemic hormonal replacement therapy (HRT), consisting of cyclic transdermal oestrogens plus medroxyprogesterone acetate (MPA) or cyclic oral therapy with low doses of conjugated oestrogens and MPA: these patients were selected on the basis of age (< 45 years), absence of medical contraindications or subjective refusal. Compliance and tolerability were overall good: most women (65%) never stopped HRT; this was discontinued in 14 patients for medical reasons and in 3 because of refusal. Forty-three females completed 6 months of HRT: vasomotor symptoms disappeared in 91% of 58 women who previously referred these symptoms. Improvement of genitourinary symptoms was seen both with local and systemic hormonal therapy. However sexual symptoms were reduced in 21 of 26 women (81%) given HRT compared with 8 of 19 (42%) women given local treatment (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Morphological and demographic associations of biliary symptoms in subjects with gallstones: findings from a population-based survey in Rosario, Argentina.

BACKGROUND: Gallstone disease is a frequently encountered disorder in subjects living in Rosario. The reasons for the presence or absence of symptoms are unknown. AIMS: To determine associations between biliary symptoms and ultrasonographic features of gallbladder and gallstones. SUBJECTS: A random study was conducted on 1,173 subjects, inhabitants of 20 years and older, in the city of Rosario, Argentina. METHODS: High-resolution abdominal ultrasound examinations were performed. Biliary pain was defined based on previously published definitions. RESULTS: Gallstones were found in 149 subjects (101 female, 48 male) of whom 51% of females and 35% of males with cholelithiasis were symptomatic. Mean age was 53 years in symptomatic and 55 in asymptomatic subjects. Gallbladder size was normal in 97% of symptomatic and in 96% of the asymptomatic participants. There were no significant differences between the groups as far as concerns size and gallstone number. Impacted stones were observed in 10% of symptomatic and in none of the asymptomatic subjects (p<0.01). CONCLUSIONS: Subjects' age and gender, gallstones size and number, as well as ultrasonographic features of gallbladder and biliary tract did not differ significantly between symptomatic and asymptomatic subjects. Only impacted stones were significantly more frequent in symptomatic subjects.

[Blind biliary pouch syndrome (sump syndrome). Diagnostic and therapeutic considerations]. / Síndrome del saco ciego biliar (sump syndrome). Consideraciones diagnósticas y terapéuticas.

One of the remote complications of choledochoduodenostomy is the formation of a biliary sack in the retroduodenal portion of the choledocho between anastomosis and the obstructed papilla. These results in the accumulation of gallstones and debris in the sack giving rise to pain, colics, infection, cholangitis and pancreatitis. Three cases are presented here: their main symptoms were pain and fever, without jaundice. The accurate diagnosis is carried out with E.R.C.P. which combines endoscopic visualization of anastomosis and papilla with probing and contrast injection in both of them. The definitive treatment was performed in two patients. One was treated surgically; the other using endoscopic papillotomy. The latter is recommended as the treatment of choice in the sump syndrome.

[An awareness campaign on the diagnosis and prevention of colon and rectal cancer. Planning and evaluation of its results]. / Campaña de difusión del diagnóstico y prevención del cáncer de colon y recto. Planificación y evaluación de sus resultados.

Colorectal cancer is very frequent in Argentina. It is the third most frequent cancer, after skin and breast tumor in the city of Rosario. Our population usually ignores the symptoms of colonic cancer and early diagnosis are infrequent. The Societies of Gastroenterology, Oncology and Colonoproctology organizes a public awareness campaign during july, august and september 1985 in Rosario and its surrounding (population 1,300,000) by means of newspaper, radio and specially by television, describing the symptoms were present, as well as insisting of the possibility of prevention by endoscopy diagnosis and removal of polyps. Literature and pamphlets were distributed, and information letters were send to all the physicians in Rosario. An International update meeting on colon and rectal took place. The results of this campaign were evaluated through the Tumor Registry of Rosario. Since september 1984 still february 1986, the monthly incidence of polyps and cancer of the colon and rectum was recorded. The monthly average incidence of polyps was 18.9. Previous to the campaign, the monthly average of diagnosed polyps was 17.5; during the campaign, 27.5; and after it, 13.8. The monthly average of colorectal cancer was 39, before the campaign, 41; during the campaign, 49, and 26 afterwards. These results were statistically studies by the parametric test of Mann and Whitney. During the campaign a significant (p = 0.05) increase of diagnosed polyps and cancers, was found. Our conclusion is that the awareness was successful, but we think that it is necessary to insist with periodic and longer campaigns.

[Intrahemorrhagic esophagogastroduodenofibroscopy. Survey in the city of Rosario]. / Esofagogastroduodenofibroscopias intrahemorrágicas. Encuesta en la ciudad de Rosario.

1.897 patients with upper gastrointestinal bleeding (UGIB) were studied and the cause was diagnosed in 1.756 (92.6%). The most frequently found pathology was the acute bleeding gastropathy (24.5%). Considering the gastric duodenal and anastomotic ulcer as a whole, in 47.5% of the cases the ulcer was observed. Both pathologies together make out that 72 out of 100 patients with UGIB have bleeding due to an ulcer or gastritis. It comes out that the low incidence of neoplasy as a consequence of UGIB and that the 31% of the diagnosed pathology could not have been diagnosed by X-ray.

Transabdominal and transvaginal ultrasonographic diagnosis of ectopic pregnancy: clinical implications.

Thirty-five patients attending an emergency room with a positive pregnancy test and suspected ectopic pregnancy underwent an ultrasonographic examination with both the transabdominal and the transvaginal techniques. Twenty-four out of 26 ectopic pregnancies were correctly diagnosed on admission, combining results of the two techniques, the sensitivity of the two techniques used separately being 88.4% (transvaginal) and 76.9% (transabdominal). In our unselected symptomatic patients, the transvaginal technique showed to be advantageous but not essential in the management of ectopic pregnancy. The surgical outcome of these patients suggested that a prompt diagnosis of ectopic pregnancy did not warrant a conservative treatment.

Epidemiology of gallstone disease in Argentina: prevalences in the general population and European descendants.

To assess gallstone disease prevalence in Argentina, a random sample of the Rosario City population was studied, considering already known associated factors, and analyzing ethnic groups living in the city. A total of 1,173 participants (69% response), both sexes, 20 years and older were studied. Each subject underwent an abdominal ultrasound examination, a blood test, and a standardized questionnaire. It was seen that gallstone disease prevalence (gallstones or cholecystectomy), overall was 20.5% (23.8% in women and 15.5% in men; (P = 0.0005), and was associated with age and body mass index in both sexes, and with pregnancy number and hypertriglyceridemia in women. As regards ancestors' nationalities, Italian and Spanish descendants presented higher prevalence rates for all age groups than those described in Italy and Spain. Thus far, in a subsample of 78% of nonparticipants submitted to a new home visit, presence of cholecystectomy or symptoms did not differ from participants, supporting the validity of our results.

Sindrome del saco ciego biliar (Sump syndrome). Consideraciones diagnosticas y terapeuticas. / Biliary blind sack syndrome (Sump syndrome). Diagnostic and therapeutic considerations

Una de las complicaciones alejadas de las coledocoduodenoanastomosis es la formacion de un saco biliar, en la porcion retroduodenal del coledoco entre la anastomosis y la papila obstruida. Esta da lugar a la acumulacion de calculos y restos alimenticios en dicho saco provocando dolores, colicos, infeccion, colangitis y pancreatitis. Se presentan tres casos: dolor y fiebre fueron sus sintomas predominantes. No tuvieron ictericia. El diagnostico de certeza se realiza con la E.R.C.P. que combina la visualizacion endoscopica de la anastomosis y papila con canulacion e inyeccion de contraste en ambas. El tratamiento definitivo se realizo en dos casos, uno quirurgico, el restante por papilotomia endoscopica, terapeutica esta ultima que los autores consideran de primera eleccion

Sindrome del saco ciego biliar (Sump syndrome). Consideraciones diagnosticas y terapeuticas. / Biliary blind sack syndrome (Sump syndrome). Diagnostic and therapeutic considerations

Una de las complicaciones alejadas de las coledocoduodenoanastomosis es la formacion de un saco biliar, en la porcion retroduodenal del coledoco entre la anastomosis y la papila obstruida. Esta da lugar a la acumulacion de calculos y restos alimenticios en dicho saco provocando dolores, colicos, infeccion, colangitis y pancreatitis. Se presentan tres casos: dolor y fiebre fueron sus sintomas predominantes. No tuvieron ictericia. El diagnostico de certeza se realiza con la E.R.C.P. que combina la visualizacion endoscopica de la anastomosis y papila con canulacion e inyeccion de contraste en ambas. El tratamiento definitivo se realizo en dos casos, uno quirurgico, el restante por papilotomia endoscopica, terapeutica esta ultima que los autores consideran de primera eleccion

Síndrome del saco ciego biliar (sump syndrome). Consideraciones diagnósticas y terapéuticas. / [Blind biliary pouch syndrome (sump syndrome). Diagnostic and therapeutic considerations]

One of the remote complications of choledochoduodenostomy is the formation of a biliary sack in the retroduodenal portion of the choledocho between anastomosis and the obstructed papilla. These results in the accumulation of gallstones and debris in the sack giving rise to pain, colics, infection, cholangitis and pancreatitis. Three cases are presented here: their main symptoms were pain and fever, without jaundice. The accurate diagnosis is carried out with E.R.C.P. which combines endoscopic visualization of anastomosis and papilla with probing and contrast injection in both of them. The definitive treatment was performed in two patients. One was treated surgically; the other using endoscopic papillotomy. The latter is recommended as the treatment of choice in the sump syndrome.

Campaña de difusión del diagnóstico y prevención del cancer de colon y recto: planificación y evaluación de sus resultados / Campaign of diffusion of the diagnosis and prevention of colon and rectal cancer: planning and evaluation of its results

El cáncer colo-rectal es muy frecuente en Argentina. Es el tercer cáncer más frecuente luego del de piel y mama en la ciudad de Rosario. Nuestra población usualmente ignora los síntomas del cáncer colónico y el diagnóstico precoz es infrecuente. Las Sociedades de Gastroenterología, Cancerología y Colonoproctología de Rosario organizaron una camapña de disfusión durante julio, agosto y setiembre de 1985 en Rosario en Rosario y sus alrededores (población: 1.300.000) por medio de afiches, mensajes en los diarios, radios y especialmente por televisión, describiendo en la posibilidad de prevención por diagnóstico y extirpación de pólipos. Afiches y panfletos fueron distribuidos en lugares públicos y cartas información fueron enviadas a todos los médicos de Rosario. Se realizó un Curso Internacional de Actualización sobre cáncer de colon y recto. Los resultados de la campaña fueron evaluados a través del Registro de Tumores de Rosario e instituciones privadas. Desde setiembre de 1984 hasta febrero de 1985 la incidencia mensual de pólipos y cáncer fue revisada. El promedio mensual de cáncer de colon y recto fue de 39; antes de la campaña 41, durante la misma 49 y después de ella 26. El promedio de incidencia mensual de pólipos fue de 18,9. Antes de la campaña 17,5, durante la misma 27,5 y después de ella 13,8. Estos resultados fueron estudiados estadísticamente por el test paramétrico de Mann y Whitney. Durante la campaña se observó un incremento levemente significativo (p=0,05) de cáncer y pólipos diagnosticados. Se concluye que la campaña logró sus objetivos de difusión pública pero se considera que es necesario insistir con campañas más extensas y periódicas