Subject(s)
Betacoronavirus , Pneumonia, Viral/epidemiology , COVID-19 , Coronavirus Infections , Humans , Pandemics , SARS-CoV-2ABSTRACT
BACKGROUND: Endoscopic ligation is the treatment of choice for bleeding esophageal varices. The usefulness of additional sclerotherapy is not clear. AIM: To assess the effectiveness of ligation followed by sclerotherapy in the treatment of variceal bleeding. PATIENTS AND METHODS: Forty eight patients with variceal bleeding admitted for emergency treatment and 73 patients admitted for elective treatment were studied. Varices were ligated until a significant reduction in size was achieved. Eradication was completed with the injection of 1% polidocanol. RESULTS: In 34 of 48 patients admitted for emergency treatment, the site of variceal rupture was identified. In all these subjects, and in 13 of 14 patients in whom the rupture site was not identified, hemorrhage was stopped with the procedure. Varices were eradicated in 108 of the 121 patients. Hemorrhage recidivated in 12.5% of patients admitted for emergency treatment, in a period of 14 months of follow up and in 9.6% of those admitted for elective treatment, in a period of 16 months follow up. Mortality was 14, 18 and 57% among patients classified as Child Pugh A, B or C, respectively. CONCLUSIONS: Endoscopic ligation is effective in the treatment of variceal bleeding. Adding sclerotherapy, variceal eradication is achieved in a high percentage of patients. Survival depends on hepatic function.
Subject(s)
Esophageal and Gastric Varices/therapy , Gastrointestinal Hemorrhage/therapy , Sclerotherapy/methods , Adolescent , Adult , Aged , Aged, 80 and over , Combined Modality Therapy , Elective Surgical Procedures , Emergency Treatment , Esophageal and Gastric Varices/complications , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Humans , Ligation/methods , Male , Middle Aged , Secondary Prevention , Treatment OutcomeABSTRACT
To assess prospectively the effects of a controlled program of inspiratory muscle program and nutritional support in patients with chronic obstructive lung disease (COPD). 23 patients with COPD were randomly assigned into 4 groups. Group I received a 1000 kcal/day nutritional supplement, given as a casein based enteral nutritional formula; group III was subjected to inspiratory muscle training, using an inexpensive pressure threshold load valve constructed according to appropriate technology principles of the WHO, adjusted at 30 percent of Maximal Inspiratory Mouth Pressure and received also the nutritional supplement; group IV was trained but did not receive the nutritional supplement and group II was not trained nor supplemented. Patients were studied during 3 months and monthly, inspiratory muscle function, exercise capacity and antropometry were measured. A significant improvement in exercise capacity, maximal inspiratory pressure and inspiratory muscle endurance was observed in the 4 groups throughout the study. Trained subjects had greater improvement in their inspiratory muscle endurance, compared to untrained subjects. Nutritional support had no effect in inspiratory muscle function or exercise capacity. No changes in antropometric measures were observed. The pressure threshold load valve used in this study, improved inspiratory muscle endurance and nutritional support had no effect in patients with COPD
Subject(s)
Humans , Male , Female , Middle Aged , Nutritional Support , Pulmonary Ventilation/physiology , Respiratory Muscles/physiopathology , Airway Obstruction/therapy , Inspiratory Capacity/physiology , Nutritional Status/physiology , Exercise Therapy/instrumentation , Clinical Protocols , Respiratory Function Tests/methodsABSTRACT
In a five year period 75 colonoscopies were carried out in 66 children with rectal bleeding. Five patients presented with severe anemia. Their age ranged from 2 to 16 years (mean 6.6). Most of the procedures were performed on an outpatient basis (87%) and under oral sedative premedication (78%). At least the splenic flexure was reached in each case. We found 59 polyps in 47 children (71%). All polyps were snared and removed during the same procedure. There were no serious complications. Colonoscopy is a most usefull diagnostic and therapeutic procedure in children with rectal bleeding, where there is a high probability that a juvenile polyp can be found which can be safely treated during the same session.
Subject(s)
Colonic Polyps/diagnosis , Adolescent , Anemia/etiology , Child , Child, Preschool , Colonic Polyps/complications , Colonic Polyps/surgery , Colonoscopy , Female , Gastrointestinal Hemorrhage/etiology , Humans , Male , Outpatients , RectumABSTRACT
La identificacion del embarazo de alto riesgo es de gran importancia cuando se quiere disminuir las tasas de morbimortalidad maternas y perinatal. Se han estudiado dos test de screening, llamados de Hobel y de Goodwin por sus autores. La aplicacion de los test se ha hecho en el periodo prenatal e intraparto y su evaluacion se ha hecho con los resultados obtenidos con el recien nacido. Se ha visto que el test de Hobel separa un grupo de pacientes cuyos recien nacidos tienen una morbilidad y un Apgar al minuto cuya diferencia es muy significativa (P< ou = 0.002 y P< ou = 0.01 respectivamente) con respeto a los otros grupos. No se ha logrado demostrar la misma diferencia al aplicar el test de Goodwin. Se sugiere entonces la utilidad que se puede obtener de la aplicacion de este test (el de Hobel) especialmente en medios que no cuentan con otro tipo de recursos para una identificacion mas avanzada del embarazo de Alto Riesgo