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1.
Rev. esp. enferm. dig ; 112(4): 278-283, abr. 2020. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-187506

RESUMO

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) allows a diagnostic and therapeutic evaluation of pancreatobiliary diseases. However, the procedure in patients with surgically altered gastrointestinal anatomy represents a technical challenge. OBJECTIVE: to report the diagnostic and therapeutic outcome of device-assisted enteroscopy (DAE) ERCP in patients with a surgically altered gastrointestinal anatomy. METHODS: a prospective cohort of patients with a history of surgically altered gastrointestinal anatomy undergoing DAE-ERCP in a referral center was used. A double-balloon enteroscope was used to reach the papillary area or the bilio-enteric anastomosis. The clinical and endoscopic characteristics, and technical, diagnostic and therapeutic success were described. Clinical and endoscopic differences were evaluated according to diagnostic success, as well as the biochemical response in those patients with therapeutic success. RESULTS: ninety-six procedures were included in the study in 75 patients. Roux-en-Y hepaticojejunostomy (RYHJ) was the main surgical anatomy (82.3%) and cholangitis was the main indication for ERCP (49%). Diagnostic success was obtained in 69.8% of the participants. Of these, therapeutic success was obtained in 83.6% (overall success 58.3%). Cases with a diagnostic success had a higher frequency of cholangiography compared to those without diagnostic success (94% vs 0%, p < 0.001), as well as a lower probability of a failed cannulation (1.5% vs 100%, p < 0.001). A significant improvement was observed in patients with a therapeutic success in bilirubin, transaminases and alkaline phosphatase levels (p < 0.05). CONCLUSIONS: ERCP by means of double-balloon enteroscopy is a useful technique in patients with a surgically altered gastrointestinal anatomy, in whom access to the bile duct is required. However, these procedures are very challenging and diagnostic and therapeutic success where achieved in up to 60% of cases


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Colangite/diagnóstico por imagem , Colangite/cirurgia , Trato Gastrointestinal/anormalidades , Trato Gastrointestinal/cirurgia , Anastomose em-Y de Roux , Enteroscopia de Duplo Balão , Colangiopancreatografia Retrógrada Endoscópica , Estudos Prospectivos , Estudos de Coortes , Resultado do Tratamento
2.
Int. microbiol ; 22(4): 429-435, dic. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-185061

RESUMO

Studies of the digestive microbiota of ruminant animals most often focus on the bacterial diversity in the rumen or the feces of the animals, but little is known about the diversity and functions of their distal intestine. Here, the bacterial microbiota of the distal intestinal tract of two goats and two camels was investigated by metagenomics techniques. The bacterial taxonomic diversity and carbohydrate-active enzyme profile were estimated for samples taken from the small intestine, the large intestine, and the rectum of each animal. The bacterial diversity and abundance in the small intestine were lower than in the rectal and large intestinal samples. Analysis of the carbohydrate-active enzyme profiles at each site revealed a comparatively low abundance of enzymes targeting xylan and cellulose in all animals examined, similar to what has been reported earlier for sheep and therefore suggesting that plant cell wall digestion probably takes place elsewhere, such as in the rumen


No disponible


Assuntos
Animais , Camelus , Metagenômica/métodos , Microbioma Gastrointestinal , Ativação Enzimática/genética , Cabras , Trato Gastrointestinal/microbiologia , Intestino Delgado/microbiologia , Intestino Grosso/microbiologia , Estômago de Ruminante/enzimologia , Estômago de Ruminante/microbiologia , Ruminantes/microbiologia
4.
Eur. j. anat ; 23(6): 459-463, nov. 2019. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-185089

RESUMO

Situs inversus viscerum (SIV) is a rare congenital anomaly, which is still an intriguing phenomenon to anatomists and physicians alike. A complete SIV is characterized by a left-right transposition and mirror image of all thoraco-abdominal organs and their vasculature. The present report is based on one case with complete SIV, which was observed during the routine educational dissections of cadavers in the authors' Anatomy Department. A transposition of all truncal organs and their vasculature, and several variations of arteries and veins were present. The right branch of the proper hepatic artery was replaced by an artery that emanated from the superior mesenteric artery. The latter also released the inferior mesenteric artery. Additionally, a left accessory renal artery ran anterior to the inferior caval vein and posterior to the ureter to enter the hilum of the left kidney. There was also a variation in the anterior-posterior arrangement of the hilar structures of the left kidney. Additionally, a globally enlarged heart with coronary artery by-passes, a replaced aortic valve and an aortic arch aneurysm was observed. This case report is unique, as it presents a previously unreported co-incidence of SIV and hepatic, intestinal and renal vascular anomalies. It is important for the surgeon to be aware of such variations while planning an abdominal surgery in patients with SIV


No disponible


Assuntos
Humanos , Masculino , Idoso , Situs Inversus , Ductos Biliares Intra-Hepáticos/anormalidades , Trato Gastrointestinal/anormalidades , Rim/anormalidades , Anomalias dos Vasos Coronários , Ductos Biliares Intra-Hepáticos/anatomia & histologia , Trato Gastrointestinal/anatomia & histologia , Rim/anatomia & histologia , Dissecação/métodos , Artérias Mesentéricas/anormalidades , Artérias Mesentéricas/anatomia & histologia , Cadáver , Vasos Coronários/anatomia & histologia
7.
Rev. esp. enferm. dig ; 111(7): 500-506, jul. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190095

RESUMO

Background and aim: Helicobacter pylori (H. pylori) is closely associated with pre-neoplastic lesions such as atrophic gastritis (AG) and gastric intestinal metaplasia (GIM). The relationshionship between inflammation, hyperhomocysteinemia and arterial stiffness is of pathophysiological relevance for the development of cardiovascular disease. This study aimed to investigate the relationship between vitamin B12, folic acid, homocysteine (Hcy) and pulse wave velocity (PWV) levels in patients with GIM, AG and non-atrophic non-metaplastic chronic gastritis. Patients and methods: ninety-seven patients with GIM, 67 patients with AG and 69 patients with chronic gastritis were included in the study. Glucose, creatinine, total cholesterol, triglyceride, low-density lipoprotein, cholesterol, high-density lipoprotein cholesterol, vitamin B12, folic acid and Hcy levels were measured by biochemical methods. PWV and other vascular parameters were measured using the Phsyio-port AS device. Main results: PWV was higher in patients with GIM and AG than in controls (p < 0.05 and p < 0.05, respectively). Vitamin B12 levels were significantly lower in patients with GIM and AG than in controls (p < 0.01 and p < 0.01, respectively). Folic acid levels were significantly lower in patients with GIM than in controls (p < 0.05). Hcy levels were significantly higher in patients with GIM and AG than in controls (p < 0.001 and p < 0.05, respectively). A logistic regression analysis showed that GIM, AG and vitamin B12 deficiency were predictors for arterial stiffness. Conclusions: PWV values increased in patients with GIM and AG compared to non-atrophic non-metaplastic chronic gastritis, without different conventional cardiovascular risk factors


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Rigidez Vascular , Metaplasia/patologia , Gastrite Atrófica/patologia , Aterosclerose/complicações , Infecções por Helicobacter/complicações , Trato Gastrointestinal/patologia , Análise de Onda de Pulso/métodos , Fatores de Risco , Lesões Pré-Cancerosas/patologia , Helicobacter pylori/patogenicidade , Endoscopia Gastrointestinal/métodos , Estudos Prospectivos
10.
Rev. neurol. (Ed. impr.) ; 68(3): 111-117, 1 feb., 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-177242

RESUMO

Introducción. Se denomina microbiota al conjunto de millones de microorganismos que conviven de manera simbiótica en nuestro organismo. Este conjunto bacteriano, que se localiza principalmente en el tracto digestivo, se distribuye a lo largo de los diferentes órganos en función de las propiedades químicas. Los factores que influyen en su composición son múltiples (dieta, hábitos individuales, fármacos). La microbiota colabora en varias funciones, como pueden ser el metabolismo o la inmunidad. Desarrollo. En los últimos años se ha puesto de relieve el papel bidireccional de la microbiota del tracto digestivo y del sistema nervioso central, es el denominado eje intestino-cerebro. En lo que a este eje se refiere, se cree que la comunicación se produce a través de tres vías: el nervio vago, la vía sistémica (mediante la liberación de hormonas, metabolitos y neurotransmisores) y el sistema inmune (por la acción de las citocinas). Conclusiones. Aunque aún quedan muchas incógnitas por esclarecer, este eje se postula como una posible base patógena para numerosos trastornos neurológicos de gran impacto sanitario, como la enfermedad de Alzheimer, la enfermedad de Parkinson o la esclerosis múltiple. En el momento actual se están llevando a cabo estudios que intentan evaluar el impacto de los probióticos sobre algunas de estas enfermedades neurológicas


Introduction. The microbiota is the set of millions of microorganisms that coexist in a symbiotic way in our body. It is mainly located in the digestive tract, being distributed in function of the chemical properties and the functions of the different organs. The factors that influence its composition are multiple (diet, individual habits, diseases or drugs). It also participates in several functions of the organism such as metabolism, immunity or even the function of the central nervous system. Development. This last interrelationship is called: gut-brain axis. For years the relationship between the microbiota and the central nervous system has been known and how they influence one over the other. It is postulated that communication occurs through three systems: the vagus nerve, the systemic pathway (with the release of hormones, metabolites and neurotransmitters) and the immune system (by the action of cytokines). Conclusions. There are still many unknowns to be clarified in this field, but this microbiota-intestine-brain relationship is postulated as a possible pathogenic basis for neurological diseases of great health impact such as Alzheimer, Parkinson or multiple sclerosis. There are currently studies with probiotics with hopeful results in patients with Alzheimer's disease


Assuntos
Humanos , Microbioma Gastrointestinal , Encéfalo/fisiologia , Probióticos , Sistema Nervoso Central/fisiologia , Sistema Imunitário , Neurotransmissores , Microbiota , Trato Gastrointestinal/fisiologia
12.
Allergol. immunopatol ; 46(6): 607-611, nov.-dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-177902

RESUMO

Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergic disorder. Some diagnostic criteria have been published for acute FPIES. Of course, they are not all the same, so the clinician must choose which ones to adopt for his/her clinical practice. We present here a brief review of these criteria and, through two clinical cases, show how the choice of one or the other can change the diagnostic destiny of a child with suspect FPIES


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Alérgenos/imunologia , Proteínas Dietéticas do Ovo/imunologia , Proteínas de Peixes/imunologia , Hipersensibilidade Alimentar/diagnóstico , Trato Gastrointestinal/patologia , Doença Aguda , Dietoterapia , Enterocolite , Hipersensibilidade Alimentar/dietoterapia , Tolerância Imunológica , Síndrome
13.
Gastroenterol. hepatol. (Ed. impr.) ; 41(10): 672-678, dic. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-178247

RESUMO

OBJETIVO: Conocer el estado actual de la ultrasonografía endoscópica (USE) en España. MÉTODOS: Análisis descriptivo a partir de una encuesta nacional con 11 preguntas: 10 relativas a la técnica y una a la formación y experiencia de los ecoendoscopistas. RESULTADOS: Contestaron 60 endoscopistas correspondientes a 48 de los 97 (49,5%) hospitales que realizan USE en España. Se contabilizaron en un año 28.678 exploraciones (20.311 diagnósticas, 7.446 con punción y 921 terapéuticas). Un 64% de los hospitales realiza entre 300 y 999 pruebas por año. Todos los centros disponen de ecoendoscopio radial y sectorial, con una mediana de 2 por hospital (2-8). La aguja de citología que más se usa es la de 22 gauges (98%) y de histología la Procore (72%). El estudio del páncreas y la vía biliar es la indicación más frecuente de USE diagnóstica (60%), seguido de la estadificación de neoplasias del tubo digestivo (20%). El 72% de los hospitales dispone de un citopatólogo en la sala y la sedación es administrada a partes iguales por los endoscopistas y anestesistas. En cuanto a la experiencia, el 45% de los ecoendoscopistas realizan menos de 300 exploraciones anuales y la mediana de tiempo de formación es de 6meses (0,5-36). CONCLUSIONES: La USE está adecuadamente implementada en España y se dispone de buen equipamiento. Sin embargo, es necesario establecer un programa estandarizado de formación en USE, ya que la de muchos ecoendoscopistas podría ser insuficiente según los estándares establecidos por las Sociedades Científicas


AIM: To understand the current state of endoscopic ultrasonography (EUS) in Spain. METHODS: Descriptive analysis from a national survey with 11 questions: 10 related to technique and 1 to the training and experience of the endoscopists. RESULTS: Sixty endoscopists from 48 of the 97 (49.5%) hospitals that perform EUS in Spain responded to the survey. A total of 28,678 procedures (20,311 diagnostic, 7,446 with puncture and 921 therapeutic) were recorded over the course of one year. Approximately 64% of the hospitals perform between 300 and 999 tests per year. All have radial and sectorial echoendoscopes, with a median of 2 (2-8) scopes. For cytological diagnosis, the 22-gauge needle is the most commonly used (98%) and, for histological diagnosis, the Procore (72%). The study of the pancreas and bile duct is the most common indication for diagnostic EUS (60%), followed by the staging of digestive tract neoplasms (20%). Approximately 72% of the hospitals perform on-site cytopathology evaluations and sedation is administered in equal parts by both endoscopists and anaesthetists. In terms of experience, 45% of echoendoscopists perform fewer than 300 annual exams and the median training duration is 6months (0.5-36). CONCLUSIONS: EUS is adequately implemented in Spain and good equipment is available. However, it is necessary to establish a standardised EUS training program since the one undertaken by many echoendoscopists could prove insufficient according to the standards established by Scientific Societies


Assuntos
Humanos , Endossonografia , Educação Continuada , Trato Gastrointestinal/diagnóstico por imagem , Espanha , Inquéritos e Questionários , Epidemiologia Descritiva
14.
Cir. Esp. (Ed. impr.) ; 96(9): 537-545, nov. 2018. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-176544

RESUMO

La cirugía bariátrica y metabólica está desarrollando nuevos conceptos sobre la asimilación y absorción de alimentos en el intestino. Estudios recientes han destacado la función del tracto gastrointestinal en la génesis y evolución de la diabetes mellitus tipo 2. En esta revisión pretendemos dar respuesta a preguntas frecuentes sobre los mecanismos de acción y los resultados de la cirugía metabólica. Realizamos una búsqueda bibliográfica no sistemática en diferentes bases de datos, identificando artículos publicados en la última década y referidos a los mecanismos de acción de la cirugía metabólica. Entender dichos mecanismos ayudará a comprender por qué unas cirugías son más efectivas que otras y por qué los resultados pueden llegar a ser tan dispares entre pacientes sometidos a la misma técnica quirúrgica


Bariatric and metabolic surgery is creating new concepts about how the intestine assimilates food. Recent studies highlight the role of the gastrointestinal tract in the genesis and evolution of type 2 diabetes. This article has been written to answer frequent questions about metabolic surgery results and the mechanisms of action. For this purpose, a non-systematic search of different databases was carried out, identifying articles published in the last decade referring to the mechanisms of action of metabolic techniques. Understanding these mechanisms will help grasp why some surgeries are more effective than others and why the results can be so disparate among patients undergoing the same surgical approach


Assuntos
Humanos , Diabetes Mellitus Tipo 2 , Cirurgia Bariátrica , Trato Gastrointestinal/cirurgia , Microbiota , Gluconeogênese , Incretinas , Bile , Sódio
17.
Actas urol. esp ; 42(2): 77-85, mar. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172428

RESUMO

Introducción: Con el uso generalizado de técnicas mínimamente invasivas la cirugía urológica asistida por robot ha sido ampliamente adoptada. A pesar de su infrecuencia, las complicaciones viscerales y gastrointestinales podrían poner en peligro la vida. Objetivos: Identificar las principales lesiones gastrointestinales que ocurren en una cirugía urológica asistida por robot. Conocer la incidencia general y cómo es su manejo. Adquisición de la evidencia: Búsqueda en PubMed de artículos relacionados con complicaciones viscerales y gastrointestinales en cirugía urológica asistida por robot, escritos en inglés o español. Se revisaron publicaciones relevantes, así como revisiones de literatura y capítulos de libros. Síntesis de la evidencia: Junto con las lesiones vasculares, las lesiones viscerales y gastrointestinales se encuentran entre las complicaciones más peligrosas. Un estudio preoperatorio completo para individualizar las características de cada paciente y el uso correcto de la toma de imágenes podría ayudarnos a evitar complicaciones en primer lugar. Conocer todos los pasos arriesgados en los diferentes procedimientos urológicos robóticos nos permitirá anticipar los daños. El conocimiento de las lesiones principales y más peligrosas en los diferentes órganos abdominales y pélvicos es altamente recomendable. El diagnóstico precoz y la evaluación de las lesiones nos permitirán un manejo agudo durante la cirugía. El retraso en el reconocimiento podría convertir una lesión reparable a una situación potencialmente mortal. Conclusiones: A pesar de los beneficios innegables del enfoque robótico, hay lesiones gastrointestinales menores y mayores que todos los cirujanos urológicos deben saber. Los relacionados con la colocación de trocares son especialmente importantes. El diagnóstico y el manejo inmediatos son obligatorios


Introduction: with the widespread use of minimally invasive techniques, robot-assisted urologic surgery has become widely adopted. Despite their infrequency, visceral and gastrointestinal complications could be life-threatening. Objectives: To identify the main gastrointestinal injuries that occur in a robot-assisted urologic surgery. To know the overall incidence and how is their management. Acquisition of the evidence: Search in PubMed of articles related to visceral and gastrointestinal complications in robot-assisted urology surgery, written in English or Spanish. Relevant publications as well literature reviews and chapters from books were reviewed. Synthesis of the evidence: Along with vascular injuries, visceral and gastrointestinal lesions are among most dangerous complications. A complete preoperative study to individualize each patient characteristics and the correct use of imaging could help us to avoid complications in the first place. To know all the risky steps in the different robotic urologic procedures will let us anticipate the damage. Knowledge of main and most dangerous injuries in the different abdominal and pelvic organs is fully recommended. Early diagnosis and evaluation of lesions will let us an acute management during surgery. Recognition delay could change a repairable injury into a life-threatening situation. Conclusions: Despite the undeniable benefits of robotic approach, there are minor and major gastrointestinal injuries that all urologic surgeons must know. Those related with trocar placement are especially important. Immediate diagnosis and management is mandatory


Assuntos
Humanos , Procedimentos Cirúrgicos Urológicos/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Instrumentos Cirúrgicos , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Trato Gastrointestinal/lesões , Trato Gastrointestinal/cirurgia , Intestino Delgado/lesões , Intestino Delgado/cirurgia , Colo/lesões , Fígado/lesões , Baço/lesões
19.
Rev. esp. enferm. dig ; 110(1): 51-56, ene. 2018.
Artigo em Espanhol | IBECS | ID: ibc-170054

RESUMO

En el presente artículo, se repasa la historia de la microbiota; se definen los conceptos relacionados de microbiota, microbioma, metagenoma, patobionte, disbiosis, holobionte, filotipo y enterotipo; se presentan algunos de los conocimientos más precisos y actualizados sobre la misma y se repasan sus funciones: metabólicas, nutricionales e inmunomoduladoras. Se comentan, de forma sucinta, aquellas patologías digestivas en cuya patogenia se ha implicado a la microbiota intestinal, incluyendo la enfermedad inflamatoria intestinal, el síndrome del intestino irritable y la enfermedad celiaca, entre otras. Finalmente, se refieren algunos datos destacados y prometedores del trasplante de microbiota fecal en determinados procesos digestivos (AU)


In this article, the history of the microbiota is reviewed and the related concepts of the microbiota, microbiome, metagenome, pathobiont, dysbiosis, holobiont, phylotype and enterotype are defined. The most precise and current knowledge about the microbiota is presented and the metabolic, nutritional and immunomodulatory functions are reviewed. Some gastrointestinal diseases whose pathogenesis is associated with the intestinal microbiota, including inflammatory bowel disease, irritable bowel syndrome and celiac disease, among others, are briefly discussed. Finally, some prominent and promising data with regard to the fecal microbiota transplantation in certain digestive illness are discussed (AU)


Assuntos
Humanos , Microbioma Gastrointestinal/fisiologia , Metagenoma/fisiologia , Trato Gastrointestinal/microbiologia , Consórcios Microbianos/fisiologia , Filogenia , Transplante de Microbiota Fecal/tendências , Doenças Inflamatórias Intestinais/microbiologia
20.
Prog. obstet. ginecol. (Ed. impr.) ; 60(6): 576-578, nov.-dic. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-171145

RESUMO

Objetivo: descripción de hallazgos básicos para establecer sospecha de malformación cloacal. Material y métodos: estudio descriptivo de caso único de malformación cloacal, sospechado tras repetición de ecografía de primer trimestre por traslucencia nucal > p-99, con sacos linfáticos yugulares bilaterales y cribado combinado de 1/968. Resultados: presentamos el caso de una gestante cuya sospecha se estableció en la semana 15 de gestación mediante control ecográfico seriado y con diagnóstico anatomo-patológico definitivo tras estudio necrópsico al realizar interrupción legal del embarazo. Conclusiones: hemos sospechado esta rara y severa entidad precozmente mediante signos indirectos que induce a un examen exhaustivo. De esta manera, es posible llegar a su diagnóstico definitivo y clasificar su severidad, futuro pronóstico y posible tratamiento (AU)


Objective: Description of basic findings to be able to suspect cloacal malformation. Material and methods: Descriptive study of a unique case of cloacal malformation, suspected in a repeated ultrasound of the first trimester because of a nucal translucency of > p-99, with bilateral yugular saccules and combined risk 1/968. Results: We report the case of a pregnant woman, in which we suspected this malformation during de 15th week of gestation with repeated ultrasound, and with a definitive anatomy- pathological diagnosis as she performed a legal interruption of de gestation. Conclusion: We have suspected this strange and severe entity in a early time because of indirect signs that obligated us to an exhaustive exam. In this way, it is possible to establish a definitive diagnose and severity, future prognosis and treatment possibilities (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Cloaca/anormalidades , Anormalidades Urogenitais/diagnóstico por imagem , Trato Gastrointestinal/anormalidades , Ultrassonografia Pré-Natal , Aborto Legal , Medição da Translucência Nucal , Amniocentese , Diagnóstico Diferencial
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