ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Choledocholithiasis/physiopathology , CA-19-9 Antigen/analysis , Biomarkers, Tumor/analysis , Smoking , Alcohol Drinking , Diagnosis, DifferentialSubject(s)
CA-19-9 Antigen/analysis , Choledocholithiasis/blood , Aged , Biomarkers , Cholecystectomy , Choledocholithiasis/complications , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery , Diagnosis, Differential , Female , Humans , Jaundice, Obstructive/etiology , Neoplasms/diagnosis , Sphincterotomy, Endoscopic , Tomography, X-Ray ComputedABSTRACT
In this article we present the case and images of an infrequent submucosal gastric tumor: an inflammatory fibroid polyp or Vanek´s tumor. When the tumor size exceeds the centimeter, it may be difficult to differentiate from malignant lesions. Endoscopic removal may be feasible and curative.
Subject(s)
Gastrointestinal Stromal Tumors/pathology , Stomach Neoplasms/pathology , Stomach Ulcer/pathology , Aged , Female , Gastric Mucosa/pathology , Gastrointestinal Stromal Tumors/diagnostic imaging , Gastrointestinal Stromal Tumors/surgery , Humans , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/surgery , Stomach Ulcer/diagnostic imaging , Stomach Ulcer/surgery , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Intestinal Polyps/surgery , Intestinal Polyps , Gastrointestinal Neoplasms , Endoscopy/methods , Leiomyoma/surgery , Leiomyoma , Prognosis , Immunohistochemistry/methods , Appendix/physiopathology , Appendix , Granuloma/pathology , Granuloma/surgery , GranulomaABSTRACT
No disponible
Subject(s)
Female , Humans , Young Adult , Glutens/adverse effects , Diet, Gluten-Free , Ataxia/diet therapy , Celiac Disease/diet therapy , Feeding and Eating Disorders/diet therapy , Conduct Disorder/etiology , Celiac Disease/complicationsABSTRACT
INTRODUCCIÓN: El tratamiento de la hepatitis crónica B antígeno e negativa (HCB HBeAg negativa) con antivíricos orales (AO) suele prolongarse de forma indefinida debido a que la pérdida del antígeno de superficie como objetivo para su suspensión es un hecho infrecuente. Recientemente han aparecido las primeras evidencias que sugieren finalizar la terapia con AO en casos seleccionados. OBJETIVOS: Analizar la tasa de rebote virológico en pacientes con HCB Age negativa que suspendieron el tratamiento con AO. MATERIAL Y MÉTODOS: Estudio retrospectivo observacional que incluyó 140 casos de HCB HBeAg negativa. Veintidós pacientes, que recibieron exclusivamente AO, los suspendieron por diversos motivos realizándose un seguimiento posterior. Todos presentaban transaminasas normales, ADN indetectable y ausencia de cirrosis o comorbilidades importantes al finalizar el tratamiento. RESULTADOS: Doce pacientes presentaron rebote virológico (54,54%), transcurriendo una media de 6,38 meses (± 1,9) desde la suspensión hasta el rebote (el 75% dentro de los 12 primeros meses tras la suspensión). Cinco recibieron adefovir, uno lamivudina más adefovir, uno tenofovir y 5 lamivudina. La duración media del tratamiento, desde el inicio hasta la suspensión, fue de 38,5 meses (± 4,5). El grupo con respuesta sostenida presentaba una edad media y duración del tratamiento superior a los sujetos con rebote, si bien estas diferencias no resultaron estadísticamente significativas. CONCLUSIONES: Los resultados sugieren que es posible suspender la terapia con AO en casos seleccionados de HCB Age negativa, siempre que no exista cirrosis, se cumpla un tiempo mínimo de tratamiento, las transaminasas sean normales y el ADN indetectable de forma mantenida. En estos casos, se debe realizar un seguimiento estrecho durante el primer año y posteriormente de forma indefinida
BACKGROUND: Treatment of HBeAg-negative chronic hepatitis B (CHB) with nucleos(t)ide analogues (NA) is usually indefinite, since the loss of HBsAg, as a criterion for its discontinuation, is a rare event. Recent evidence suggests that discontinuing NA therapy may be feasible in selected patients. OBJECTIVES: To analyze the rate of virological relapse in patients with HBeAg-negative CHB who discontinued treatment with NAs. METHODS: We performed a single-center observational study that included 140 patients with HBsAg-negative CHB. Twenty-two patients, who received only NAs, discontinued treatment for different reasons and were subsequently monitored. All had normal ALT and AST, undetectable DNA and absence of cirrhosis or significant comorbidities before stopping treatment. RESULTS: Twelve patients showed virologic relapse (54.54%). The mean interval between discontinuation and relapse was 6.38 months (± 1.9) (75% relapsed during the first 12 months after discontinuation). Five received adefovir, 1 lamivudine and adefovir, 1 tenofovir and 5 lamivudine alone. The mean treatment duration in this group was 38.5 months (± 4.5). The sustained response group had a higher mean age and longer treatment duration than patients with virologic relapse but these differences were not statistically significant. CONCLUSIONS: The results suggest that NA treatment can be stopped in selected patients with CHB as long as they are not cirrhotic, have completed a minimum period of treatment, have normal ALT and sustained undetectable DNA. These patients should be closely monitored during the first year and then indefinitely
Subject(s)
Humans , Antiviral Agents/therapeutic use , Hepatitis B, Chronic/drug therapy , Withholding Treatment , Hepatitis B virus/pathogenicity , Rebound Effect , Hepatitis B Antigens , Viral Load , Retrospective StudiesABSTRACT
BACKGROUND: Treatment of HBeAg-negative chronic hepatitis B (CHB) with nucleos(t)ide analogues (NA) is usually indefinite, since the loss of HBsAg, as a criterion for its discontinuation, is a rare event. Recent evidence suggests that discontinuing NA therapy may be feasible in selected patients. OBJECTIVES: To analyze the rate of virological relapse in patients with HBeAg-negative CHB who discontinued treatment with NAs. METHODS: We performed a single-center observational study that included 140 patients with HBsAg-negative CHB. Twenty-two patients, who received only NAs, discontinued treatment for different reasons and were subsequently monitored. All had normal ALT and AST, undetectable DNA and absence of cirrhosis or significant comorbidities before stopping treatment. RESULTS: Twelve patients showed virologic relapse (54.54%). The mean interval between discontinuation and relapse was 6.38 months (± 1.9) (75% relapsed during the first 12 months after discontinuation). Five received adefovir, 1 lamivudine and adefovir, 1 tenofovir and 5 lamivudine alone. The mean treatment duration in this group was 38.5 months (± 4.5). The sustained response group had a higher mean age and longer treatment duration than patients with virologic relapse but these differences were not statistically significant. CONCLUSIONS: The results suggest that NA treatment can be stopped in selected patients with CHB as long as they are not cirrhotic, have completed a minimum period of treatment, have normal ALT and sustained undetectable DNA. These patients should be closely monitored during the first year and then indefinitely.
Subject(s)
Alanine Transaminase/blood , Antiviral Agents/therapeutic use , Hepatitis B e Antigens/immunology , Hepatitis B, Chronic/drug therapy , Nucleotides/therapeutic use , Adult , Aged , Aspartate Aminotransferases/blood , DNA, Viral/isolation & purification , Drug Therapy, Combination , Female , Hepatitis B virus/genetics , Hepatitis B virus/immunology , Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/immunology , Humans , Liver Cirrhosis/drug therapy , Male , Middle Aged , Recurrence , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Pancreatic Diseases/enzymology , Drug Hypersensitivity/diagnosis , Eosinophilia/etiology , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Pancreatic Function Tests , Edema/etiologySubject(s)
Ataxia/etiology , Celiac Disease/complications , Diet, Gluten-Free , Leukoencephalopathies/etiology , Mental Disorders/etiology , Biopsy , Celiac Disease/diagnosis , Celiac Disease/diet therapy , Celiac Disease/psychology , Cross Reactions , Duodenum/pathology , Female , Folic Acid Deficiency/complications , Folic Acid Deficiency/drug therapy , Frontal Lobe/physiopathology , Humans , IgA Deficiency/complications , Iron/therapeutic use , Iron Deficiencies , Leukoencephalopathies/diagnostic imaging , Leukoencephalopathies/physiopathology , Leukoencephalopathies/psychology , Magnetic Resonance Imaging , Mental Disorders/physiopathology , Purkinje Cells/immunology , Tremor/etiology , Young AdultSubject(s)
Amylases/blood , Atorvastatin/adverse effects , Drug Hypersensitivity Syndrome/diagnosis , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Lipase/blood , Adrenal Cortex Hormones/therapeutic use , Atorvastatin/therapeutic use , Drug Eruptions/blood , Drug Eruptions/diagnosis , Drug Eruptions/drug therapy , Drug Eruptions/etiology , Drug Hypersensitivity Syndrome/blood , Drug Hypersensitivity Syndrome/drug therapy , Drug Hypersensitivity Syndrome/etiology , Edema/chemically induced , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Middle AgedABSTRACT
La pancreatitis aguda por hipertrigliceridemia es la tercera causa de pancreatitis aguda en la población occidental. Normalmente hay una alteración subyacente del metabolismo lipidémico, sobre la que actúa un factor secundario. La presentación clínica es similar a la de las pancreatitis agudas de otras etiologías, aunque su curso parece ser más tórpido y recurrente. Para su diagnóstico hay que saber que algunos parámetros de la analítica pueden estar artefactados, lo que puede conducir a un fallo en el diagnóstico. Tal es el caso de la amilasa, que puede estar falsamente descendida. El tratamiento se basa en sueroterapia intensa y analgesia. Cuando no responde al tratamiento conservador, deben utilizarse otros métodos para disminuir el nivel de triglicéridos. Para ello disponemos de la plasmaféresis, la insulina y la heparina. Este artículo pretende mostrar una revisión de la literatura actual sobre esta patología (AU)
Acute hypertriglyceridemic pancreatitis is the third cause of acute pancreatitis in the Western population. There is usually an underlying alteration in lipid metabolism and a secondary factor. Clinical presentation is similar to that of pancreatitis of other etiologies, but the course of acute hypertriglyceridemic pancreatitis seems to be worse and more recurrent. Some laboratory data can be artefacts, leading to diagnostic errors. This is the case of amylase, which can show false low levels. Treatment is based on intense fluidotherapy and analgesia. When there is no response to conservative management, other methods to lower triglyceride levels should be used. Several options are available, such as plasmapheresis, insulin, and heparin. The present article provides a review of the current literature on this entity (AU)
Subject(s)
Humans , Pancreatitis/etiology , Hypertriglyceridemia/complications , Cholesterol, VLDL/analysis , Hyperlipidemias/complications , Plasmapheresis/methods , Biomarkers/analysis , Risk FactorsABSTRACT
Acute hypertriglyceridemic pancreatitis is the third cause of acute pancreatitis in the Western population. There is usually an underlying alteration in lipid metabolism and a secondary factor. Clinical presentation is similar to that of pancreatitis of other etiologies, but the course of acute hypertriglyceridemic pancreatitis seems to be worse and more recurrent. Some laboratory data can be artefacts, leading to diagnostic errors. This is the case of amylase, which can show false low levels. Treatment is based on intense fluidotherapy and analgesia. When there is no response to conservative management, other methods to lower triglyceride levels should be used. Several options are available, such as plasmapheresis, insulin, and heparin. The present article provides a review of the current literature on this entity.