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2.
Nefrología (Madrid) ; 39(1): 50-57, ene.-feb. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181909

RESUMO

Introducción: A pesar de la frecuencia con que la anemia está presente en los pacientes con enfermedad renal crónica (ERC), su relación con lesiones gastrointestinales no ha sido estudiada. Método: Estudio observacional analítico transversal de un año de reclutamiento para determinar la prevalencia de lesiones gastrointestinales endoscópicas y los factores de riesgo asociados en pacientes asintomáticos con ERC estadios 1-5 y anemia que presentaban un test inmunoquímico cualitativo de sangre oculta en heces positivo. Resultados: Se analizaron 9.658 pacientes con ERC, de los que 286 (2,9%) presentaban anemia; 198 tuvieron un test de sangre oculta en heces positivo (47% varones, 71,1 ± 11,8 años). El estudio endoscópico reveló 255 lesiones, con al menos una lesión en el 68,2%, siendo las más prevalentes: pólipos colorrectales adenomatosos (39,6%), lesiones agudas de la mucosa gástrica (22,6%), lesiones neoplásicas (15,1%), angiodisplasias (14,4%), esofagitis (8,4%), enfermedad inflamatoria intestinal (4,8%) y colitis isquémica (3,1%). La uremia y el ácido acetilsalicílico fueron identificados como factores de riesgo de lesiones agudas de la mucosa gástrica. Las angiodisplasias se relacionaron con el enolismo, el mayor estadio de ERC, la anemia y la ausencia de respuesta a agentes estimulantes de la eritropoyesis. La edad y la anemia refractaria constituyeron factores de riesgo de pólipos adenomatosos y cáncer colorrectal. Conclusión: Los pacientes renales con anemia podrían beneficiarse de un estudio endoscópico debido a la alta prevalencia de lesiones gastrointestinales que presentan, particularmente pólipos adenomatosos y cáncer colorrectal, más frecuentes en los mayores de 50 años con ERC estadios 3-5


Introduction: Despite the frequency with which anaemia is present in patients with chronic kidney disease (CKD), its relationship with gastrointestinal lesions has not been studied. Method: A cross-sectional, analytical, observational study involving one year of recruitment was carried out to determine the prevalence of endoscopic gastrointestinal lesions and associated risk factors in asymptomatic patients with chronic kidney disease stages 1-5 and anaemia who had a positive qualitative immunochemical faecal occult blood test. Results: A total of 9,658 patients with CKD were analysed, of which 286 (2.9%) had anaemia; 198 had a positive faecal occult blood test (47% male, 71.1 ± 11.8 years). The endoscopic study revealed 255 lesions, with at least one lesion in 68.2% of patients, with the most prevalent being: adenomatous colorectal polyps (39.6%), acute lesions of the gastric mucosa (22.6%), neoplastic lesions 15.1%), angiodysplasia (14.4%), oesophagitis (8.4%), inflammatory bowel disease (4.8%) and ischaemic colitis (3.1%). Uraemia and acetylsalicylic acid were identified as risk factors for acute gastric mucosal lesions. Angiodysplasia was associated with alcoholism, a more advanced stage of chronic kidney disease, anaemia, and lack of response to erythropoiesis-stimulating agents. Age and refractory anaemia were risk factors for adenomatous polyps and colorectal cancer. Conclusion: Renal patients with anaemia could benefit from an endoscopic study due to their high prevalence of gastrointestinal lesions, particularly adenomatous polyps and colorectal cancer, which are more common in those over 50 years of age with CKD stages 3-5


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Insuficiência Renal Crônica/complicações , Gastropatias/diagnóstico , Gastropatias/etiologia , Anemia/complicações , Anemia/diagnóstico , Insuficiência Renal Crônica/sangue , Estudos Transversais , Fatores de Risco , Prevalência , Índice de Gravidade de Doença , Endoscopia
3.
Gastroenterol. hepatol. (Ed. impr.) ; 42(2): 127-132, feb. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-182108

RESUMO

Aim: This research was conducted to obtain accurate information on the protective effects of Portulaca oleracea L. against hepatogastric diseases. Results: P. oleracea L. (Purslane) has traditionally been used for the treatment of hepatogastric diseases. However, the low number of research studies has shown that P. oleracea L. possesses protective effects against hepatotoxic agents. The safety of P. oleracea L. has been demonstrated in several clinical trials. Conclusion: Modern pharmacological studies have indicated the gastroprotective and hepatoprotective effects of P. oleracea L. by using in vivo and in vitro models. However, due to lack of information of its effects in humans, more studies should be conducted to confirm the efficacy of P. oleracea L. in humans


Objetivo: Se realizó esta investigación para disponer de información precisa sobre los efectos protectores de Portulaca oleracea L. frente a enfermedades hepatogástricas. Resultados: Portulaca oleracea L. (Purslane) se ha utilizado tradicionalmente para el tratamiento de enfermedades hepatogástricas. Sin embargo, las investigaciones limitadas han demostrado que Portulaca oleracea L. posee efectos protectores frente a sustancias hepatotóxicas. Varios ensayos clínicos han demostrado la seguridad de Portulaca oleracea L. Conclusión: Estudios farmacológicos modernos han revelado los efectos gastroprotectores y hepatoprotectores de Portulaca oleracea L. mediante el uso de modelos in vivo e in vitro. Sin embargo, debido a la falta de información sobre sus efectos en el ser humano, se deben realizar más estudios para confirmar la eficacia de Portulaca oleracea L. en el ser humano


Assuntos
Humanos , Animais , Hepatopatias/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Portulaca , Gastropatias/tratamento farmacológico
8.
An. pediatr. (2003, Ed. impr.) ; 78(1): 51-53, ene. 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-108156

RESUMO

Introducción: El ibuprofeno, antiinflamatorio no esteroideo bastante utilizado en pediatría como analgésico y antitérmico, se ha considerado un fármaco muy seguro que no se asocia a gastrolesividad en niños cuando se usa a dosis bajas durante periodos cortos. Pacientes y métodos: El objetivo de nuestro estudio fue revisar los casos de hemorragia digestiva y valorar si existen casos de gastropatía hemorrágica tras dosis habituales de ibuprofeno. Resultados: Se encontraron 9 casos de sangrado digestivo secundario a gastropatía en niños sanos, sin factores de riesgo, que habían ingerido varias dosis de ibuprofeno para el tratamiento de la fiebre(AU)


Introduction: Ibuprofen is a non-steroidal anti-inflammatory drug frequently used in children for fever and pain. It is usually considered to be safe and of low risk at low doses and short-term use. Patients and methods: The aim of our study was to review the cases of gastrointestinal bleeding and assessment of gastrointestinal bleeding after recommended doses of ibuprofen. Results: We describe 9 previously healthy patients with upper gastrointestinal bleeding after receiving weight-related doses of ibuprofen for fever(AU)


Assuntos
Humanos , Criança , Gastropatias/induzido quimicamente , Ibuprofeno/efeitos adversos , Febre/tratamento farmacológico , Hemorragia Gastrointestinal/induzido quimicamente , Ibuprofeno/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Febre/complicações
9.
Farm. hosp ; 36(6): 498-505, nov.-dic. 2012. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-135943

RESUMO

Background: Medicine review with follow up quantitative studies conducted on heart failure (HF) outpatients detected health problems that were frequently treated insufficiently: hyperuricemia, gastric injury prevention, anemia, and diabetes mellitus. Objective: The aim of this qualitative study was to explore experiences in the pharmacological management of these health problems, and to contribute with strategies to overcome the identified obstacles. Methods: The internal medicine specialists and cardiologists of a tertiary hospital HF clinic underwent in-depth semi-structured interviews and a constant comparative approach was used. Results: Interviewees highlighted there is a lack of guidelines concerning the treatment of asymptomatic hyperuricemia in HF, thus in routine practice it is often not treated. Interviewees said that preventive strategies to avoid gastric injury in at-risk patients taking prophylactic low-dose aspirin are needed, but the most appropriate strategy is not well defined. Interviewees thought that structural support is needed for the management of HF patients with anemia, and proper clinic pathways should be created to identify which service patients should be referred to. The same lack of communication with other services appeared with diabetes mellitus. Conclusion: HF specialists demand a closer interaction with other specialists for a comprehensive approach to these polymedicated patients with multiple co-morbidities. And suggest that specific recommendations in HF guidelines to manage these co-morbidities specifically in HF would be helpful to shed light upon the existing confusing evidence (AU)


Antecedentes: Estudios de seguimiento farmacoterapéutico realizados en insuficiencia cardiaca (IC) detectaron problemas de salud insuficientemente tratados de manera frecuente: hiperuricemia, gastroprotección, anemia y diabetes mellitus. Objetivo: El objetivo de este estudio cualitativo fue explorar las experiencias de los médicos en el manejo farmacológico de estos problemas de salud, y contribuir con estrategias para solventar los obstáculos identificados. Métodos: Los especialistas en medicina interna y cardiología de la unidad de IC de un hospital terciario fueron entrevistados en profundidad con entrevistas semi-estructuradas utilizándose para su análisis el método de comparación constante. Resultados: Los entrevistados destacaron que hay una falta de guías sobre el tratamiento de la hiperuricemia asintomática en IC, por lo que en la práctica clínica generalmente no se trata. Los otros servicios apareció al hablar de la diabetes. Conclusión: Los especialistas en IC piden una interacción más cercana con otros especialistas para un abordaje más completo de estos pacientes polimedicados con múltiples comorbilidades. Y sugieren que sería de ayuda para aportar algo de luz en la confusa evidencia que existe el tener recomendaciones especí- ficas en las guías de IC para manejar estas comorbilidades en pacientes con IC en concreto (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Anemia/tratamento farmacológico , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/terapia , Aspirina/uso terapêutico , Diabetes Mellitus/terapia , Hiperuricemia/complicações , Atitude do Pessoal de Saúde , Administração de Caso , Interpretação Estatística de Dados , Médicos , Inibidores da Agregação de Plaquetas/uso terapêutico , Gastropatias/prevenção & controle
13.
Rev. esp. enferm. dig ; 102(2): 80-85, feb. 2010. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-78882

RESUMO

Objective: to evaluate the type, frequency, and severity of macroscopicsmall bowel mucosal injury after chronic NSAID intake asassessed by capsule endoscopy (CE), as well as to correlate the severityof gastroduodenal and intestinal damage in these patients.Material and methods: a prospective, endoscopist-blind,controlled trial. Sixteen patients (14F/2M; age: 57.06 ± 10.16yrs) with osteoarthritis (OA) on chronic therapy with NSAIDs underwentCE and upper gastrointestinal endoscopy (UGE). Seventeenpatients with OA (9F/2M; age: 57.47 ± 9.82 yrs) who didnot take NSAIDs were included as a control group. A scale rangingfrom 0 to 2 (0 = no lesions, 1-minor = red spots or petechiae,denuded areas and/or 1-5 mucosal breaks; 2-major = > 5mucosal breaks and/or strictures, or hemorrhage) was designed toassess the severity of small bowel mucosal injuries.Results: CE found intestinal lesions in 75% (12/16) of patientsin the study group and in 11.76% (2/17) of controls (p <0.01). Seven out of 16 NSAID consumers (43.75%) and none inthe control group (0%) had a major small bowel mucosal injury (p< 0.01). The percentages of patients with grade 1 and 2 gastroduodenopathyin the study group, as assessed by UGE, were37.14 and 23.81%, respectively. There was no significant differencein the rate of major enteropathy between patients withnone or minor gastroduodenal injury, and those with major gastroduodenopathy(43.75 vs. 40%; p = N.S.).Conclusions: chronic NSAID intake is associated with a highrate of small bowel mucosal injuries. Our data have failed to demonstratea relationship between the severity of gastroduodenaland intestinal injury(AU)


Assuntos
Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Anti-Inflamatórios não Esteroides/efeitos adversos , Endoscopia por Cápsula , Diclofenaco/efeitos adversos , Duodenopatias/induzido quimicamente , Ibuprofeno/efeitos adversos , Gastropatias/induzido quimicamente , Gastropatias/diagnóstico , Mucosa Intestinal , Osteoartrite/tratamento farmacológico , Estudos Prospectivos , Índice de Gravidade de Doença
14.
Gastroenterol. hepatol. (Ed. impr.) ; 33(10): 700-703, Dic. 2010. ilus
Artigo em Espanhol | IBECS | ID: ibc-95445

RESUMO

La gastropatía isquémica es un cuadro que se presenta de forma muy poco frecuente en la práctica médica diaria habiéndose observado en los últimos años un aumento de los casos reportados. Aunque el síntoma guía suele ser el dolor abdominal, el espectro clínico de la enfermedad es muy variable, siendo el diagnóstico y tratamiento precoz fundamentales para cambiar la historia natural de la enfermedad. Presentamos el caso de un varón de 75 años con dolor abdominal crónico que desarrolló una forma fulminante de isquemia gástrica necrotizante falleciendo en menos de veinticuatro horas (AU)


Ischemic gastropathy is highly infrequent in daily medical practice. In the last few years, the number of reported cases has increased. Although the guiding symptom is usually abdominal pain, the clinical spectrum of the disease is highly variable. Early diagnosis and treatment are essential to change the natural history of the disease. We present the case of a 75-year-old man with chronic abdominal pain who developed a fulminant form of necrotizing gastric ischemia and died within less than 24h (AU)


Assuntos
Humanos , Masculino , Idoso , Isquemia/complicações , Necrose/complicações , Gastropatias/complicações , Gastroparesia/complicações , Úlcera Gástrica/complicações , Circulação Esplâncnica
16.
Gastroenterol. hepatol. (Ed. impr.) ; 32(2): 88-91, feb. 2009. ilus
Artigo em Espanhol | IBECS | ID: ibc-59281

RESUMO

Los pólipos de glándulas fúndicas pueden aparecer en formas esporádicas o asociados a síndrome de poliposis adenomatosa familiar. Se ha descrito su asociación al tratamiento continuado con inhibidores de la bomba de protones (IBP), así como una regresión tras su retirada. No suelen asociar componente displásico.Se describen 4 casos de pacientes en tratamiento crónico con IBP, con endoscopia previa normal, en los que se detectó la presencia de múltiples pólipos de glándulas fúndicas, y se constató su desaparición a los 6 meses tras la supresión del tratamiento(AU)


Fundic gland polyps can appear sporadically or in association with familial adenomatous polyposis syndrome. An association between fundic gland polyps and prolonged treatment with proton pump inhibitors has been described, as has their regression after withdrawal of these inhibitors. Dysplastic components are not usually associated.We describe four patients who were receiving chronic treatment with proton pump inhibitors. The results of prior endoscopic analysis were normal. The presence of multiple fundic gland polyps was detected as was their disappearance 6 months after treatment cessation(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Gastropatias/induzido quimicamente , Bombas de Próton/efeitos adversos , Pólipos/induzido quimicamente , Fundo Gástrico , Gastroscopia
19.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. impr.) ; 34(10): 502-506, dic. 2008. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-74106

RESUMO

La gastropatía por antiinflamatorios no esteroideos (AINE)es una patología frecuente que debemos tener en cuentaante todo paciente que nos consulte por problemas de dispepsiao astenia de larga evolución. Actualmente se cifran en16.500 las muertes anuales por complicaciones por el consumode estos fármacos y en más de cien mil, los ingresoshospitalarios anuales, datos que pueden darnos una idea dela verdadera importancia del problema. Los factores de riesgoimplicados más frecuentemente y que siempre debemostener en cuenta son la edad (mayor de 65 años), la toma conjuntade más de un AINE, la toma de anticoagulantes o corticoides,ISRS o ISRNS, ulcus o gastropatía previos y la existenciade alguna enfermedad concomitante grave. Otroaspecto a tener en cuenta es la erradicación del Helicobacter(H.) pylori, lo que parece que es coste efectivo y reduce elriesgo de complicaciones gastrointestinales (GI). Ante un pacientecon factores de riesgo en el que vayamos a iniciar untratamiento con AINE o ya lo siguiera por cualquier causa,que tuviera un evento GI, debemos, siempre que se pueda,suspender el AINE y testar el H. pylori para erradicarlo sisale positivo y posteriormente reiniciar el tratamiento conAINE más conveniente (si se puede, siempre el menos gastrolesivo)teniendo en cuenta los factores de riesgo GI y cardiovascularesy asociando un protector gástrico. El papel actualde los COX-2, como AINE y con un riesgo de lesión GImenor que los AINE clásicos, debe tenerse también en cuenta,si bien debe barajarse el riesgo cardiovascular del pacienteen la decisión de dicha alternativa terapéutica (AU)


NSAIDs gastropathy is a frequent disease that we shouldtake into account whenever there is a patient who consultsdue to long term dyspepsia or asthenia. Currently there areabout 16,500 deaths a years due to complicatons from consumptionof these drugs and there are more than one hundredthousand hospitalizations per year. This could give usan idea of the true importance of the problem. The most frequentlyinvolved risk factors and those which should also betaken into account are age (older than 65 years), combineduse of an NSAID, anticoagulants or corticosteroids, SSRI orSNRIS, ulcer or previous gastropathy and the existence ofany serious concomitant disease. Another aspect to consideris the eradication of Helicobacter (H.) pylori, where it seemsthat it is cost effective and reduces gastrointestinal complications.When a patient has risk factors and we are going toinitiate NSAID treatment or continue it for any reason, or ifwhen the patient is taking it for any reason, he or she has aGI event, we should always, when possible, suspend theNSAID and test for H. Pylori to see if it is positive and to eradicateit and then reinitiate the best possible NSAID treatment(if possible, always with the least gastrointestinalharm) considering the GI and cardiovascular risk factors andassociating a gastrointestinal protector. The current role ofCOX-2, as NSAID and with a risk of less GI injury than theclassical NSAIDs should also be taken into account althoughthe cardiovascular risk of the patient should be consideredin the decision of the therapeutic alternative (AU)


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Gastropatias/induzido quimicamente , Anti-Inflamatórios não Esteroides/efeitos adversos , Inibidores da Bomba de Prótons/efeitos adversos , Misoprostol/efeitos adversos , Helicobacter pylori , Helicobacter pylori/patogenicidade , Infecções por Helicobacter/complicações , Gastropatias/diagnóstico , Anti-Inflamatórios não Esteroides/farmacologia , Diagnóstico Clínico , Fatores de Risco
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