ABSTRACT
INTRODUCTION: Irritable Bowel Syndrome (IBS) is a frequent functional digestive disorder. Several studies have established the relationship between IBS and anxiety. Also it has been described a negative impact on quality of life in patients who suffer it, but in our country none of these studies have used ROME III criteria for evaluation. OBJECTIVE: To know the frequency of anxiety in the different subgroups of IBS and its impact on quality of life. METHODS: The study was conducted in patients who attended for first time to the outpatient clinic of our hospital for ten months. Adult patients who met the criteria of IBS were included. We applied the SF-36 quality of life questionnaire and the Hamilton anxiety scale. RESULTS: One hundred and two patients who met for IBS criteria were included, of which 85% had anxiety. The IBS-C was the most frequent subgroup. Divided by subgroups, found that 52%, 85.1%, 90% and 80.9% had anxiety for IBS-C, IBS-D, IBS-M and IBS-NC respectively, without significant difference between groups. Patients with anxiety had lower quality of life scores in the categories of physical health, mental health and change in the state of health, (54.2 ± 18 vs. 72 ± 16, 52.8 ± 20 vs. 74 ± 14, 48 ± 28 vs. 59 ± 32) with respect to those who have no anxiety (p <0.0001, p <0.0001 and p<0.15 respectively). CONCLUSIONS: The anxiety was not associated to any subgroup in particular of IBS, the presence of this influenced adversely and significantly on the quality of life of patients who suffer it.
Subject(s)
Anxiety/etiology , Irritable Bowel Syndrome/complications , Irritable Bowel Syndrome/psychology , Quality of Life , Adult , Female , Humans , MaleABSTRACT
We present two years of our surgical experience in the Gastroenterologic department of General Hospital of Mexico city; we studied prospectively 23 patients with choledocholithiasis diagnosed preoperatively and postoperatively, 18 females (78%) and 5 males (22%). Diagnosis were performed preoperatively by sonogram, intravenous cholangiography and/or endoscopic retrograde pancreatocholangiography in 19 cases, and postoperatively in four cases. In 22 cases we performed colecistectomy with choledocotomy, extraction of calculi and placement of a "T" biliary catheter. In only one case was necessary a choledoco-duodenal anastomosis. We observed morbility in 3 cases (13%), and a patient died postoperatively (4%). The postoperative follow up was satisfactory in 83% of these cases.
Subject(s)
Gallstones/surgery , Adult , Aged , Aged, 80 and over , Clinical Protocols , Female , Gallstones/therapy , Hospitals, General , Humans , Male , Mexico , Middle AgedABSTRACT
The authors review the cases with smooth muscle tumors of the stomach (SMTS), excluding the leiomyomas, at the Mexico's General Hospital in a period of 5 years. They found 8 cases in women and 3 in men, with 51.3 years average. The average of evolution of symptoms was 5 months, prevailing: anaemia, digestive bleeding and abdominal pain. Barium radiology and endoscopy guided to the diagnosis. The tumors were located 7 at the fundus, 3 at the body and one at the gastric antrum. The size oscillated between 1.5-28 cm., average 8 cm. Endoscopic specimens were positive in 2/7 cases and cytologic samples were negative in all cases. Eight tumors were leiomyosarcomas (LMS) and 3 were leiomyoblastomas (LMB); the histologic criteria in order to differentiate them was based on the number of mitosis for 50 fields (50 csf), the size and their hypercellularity. A patient died before being operated. Two cases were subjected to emergency surgery, and died after that. In the cases treated with elective surgery the authors performed subtotal gastrectomy with major omentectomy in 4 and surgical resection of the tumor in the remaining 4 patients. The mortality rate for surgery was 27.2%.
Subject(s)
Leiomyoma, Epithelioid , Leiomyosarcoma , Stomach Neoplasms , Adult , Aged , Aged, 80 and over , Endoscopy , Female , Gastrectomy , Humans , Leiomyoma, Epithelioid/diagnosis , Leiomyoma, Epithelioid/surgery , Leiomyosarcoma/diagnosis , Leiomyosarcoma/surgery , Male , Middle Aged , Stomach Neoplasms/diagnosis , Stomach Neoplasms/surgeryABSTRACT
Primary achalasia is a motor dysfunction of the esophagus with unknown aetiology. We present our results obtained in 39 patients treated by Heller's Cardiomyotomy. The procedure was successful in 92.3% of the cases and when it is performed in conjunction with an antirreflux technique, it offers excellent results with a very low frequency of gastroesophageal reflux symptoms and complications.
Subject(s)
Esophageal Achalasia/surgery , Adult , Aged , Cardia/surgery , Esophageal Achalasia/etiology , Esophageal Motility Disorders/complications , Gastroesophageal Reflux , Humans , Middle AgedABSTRACT
Crohn's disease is rare in Mexico. The regarding of this pathology at Gastrointestinal Unit of the General Hospital of Mexico city, between january 1980 and december 1989, is presented. There were six cases of Crohn's disease, two women (33%) and four men (66%). The definitive diagnosis was done preoperatively only in one case, the other were diagnosed postoperatively. In all, intestinal obstruction was the surgical indication. A patient died (16.6%), three cases were followed for 12 months, only two patients are still under surveillance after 15 months.
Subject(s)
Crohn Disease , Crohn Disease/diagnosis , Crohn Disease/epidemiology , Crohn Disease/surgery , Female , Humans , Male , Mexico/epidemiology , Retrospective StudiesABSTRACT
A 20 years old female patient with a history of 15 years with intermittent abdominal pain, who was diagnoses as type I choledochal cyst at the Division of Gastroenterology at the Hospital General de Mexico SS is presented. The clinical studies, treatment and evolution of this case are discussed and a literature review is presented with special attention to the new diagnostic and therapeutical approaches.