RESUMO
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.
Assuntos
Bezoares , Nutrição Enteral , Bezoares/diagnóstico por imagem , Bezoares/etiologia , Bezoares/terapia , Cuidados Críticos , Diarreia/etiologia , Nutrição Enteral/efeitos adversos , Esôfago , HumanosRESUMO
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.
Assuntos
Ampola Hepatopancreática , Neoplasias dos Ductos Biliares , Ductos Biliares Extra-Hepáticos , Carcinossarcoma , Neoplasias do Ducto Colédoco , Icterícia Obstrutiva , Neoplasias dos Ductos Biliares/complicações , Neoplasias dos Ductos Biliares/diagnóstico por imagem , Neoplasias dos Ductos Biliares/cirurgia , Ductos Biliares Extra-Hepáticos/diagnóstico por imagem , Ductos Biliares Extra-Hepáticos/cirurgia , Carcinossarcoma/complicações , Carcinossarcoma/diagnóstico por imagem , Carcinossarcoma/cirurgia , Neoplasias do Ducto Colédoco/complicações , Neoplasias do Ducto Colédoco/diagnóstico por imagem , Neoplasias do Ducto Colédoco/cirurgia , Humanos , Icterícia Obstrutiva/etiologiaRESUMO
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.
Assuntos
Hepatite C Crônica , Hepatite C , Antivirais/uso terapêutico , Emigração e Imigração , Hepacivirus , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Hepatite C Crônica/tratamento farmacológico , Humanos , Estudos RetrospectivosAssuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Colite/induzido quimicamente , Neoplasias Ósseas/secundário , Colite/diagnóstico por imagem , Colite/tratamento farmacológico , Colite Ulcerativa/diagnóstico por imagem , Colonoscopia , Humanos , Neoplasias Pulmonares/secundário , Masculino , Melanoma/tratamento farmacológico , Melanoma/secundário , Pessoa de Meia-Idade , Neoplasias Cutâneas/tratamento farmacológicoAssuntos
Neoplasias Colorretais/genética , Genes BRCA1 , Doenças Inflamatórias Intestinais/genética , Síndromes Neoplásicas Hereditárias/genética , Adenocarcinoma/genética , Adenocarcinoma/cirurgia , Adulto , Idade de Início , Anti-Inflamatórios/uso terapêutico , Azatioprina/uso terapêutico , Neoplasias da Mama/genética , Colite Ulcerativa/genética , Neoplasias do Colo/genética , Neoplasias do Colo/cirurgia , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Mesalamina/uso terapêutico , Proctocolectomia RestauradoraRESUMO
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