Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas/enzimología , Gastroenterología/educación , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Hepatopatías/enzimología , Anciano , Autoanticuerpos/análisis , Desmineralización Ósea Patológica/etiología , Enfermedad Hepática Inducida por Sustancias y Drogas/epidemiología , Femenino , Ferritinas/análisis , Ferritinas/metabolismo , Hemocromatosis/diagnóstico , Hemocromatosis/metabolismo , Hemocromatosis/patología , Hepatitis B/diagnóstico , Hepatitis B/tratamiento farmacológico , Hepatitis B/inmunología , Hepatitis C Crónica/diagnóstico , Hepatitis C Crónica/genética , Enfermedad de Hodgkin/diagnóstico , Enfermedad de Hodgkin/tratamiento farmacológico , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Cirrosis Hepática Biliar/complicaciones , Hepatopatías/diagnóstico por imagen , Hepatopatías/inmunología , Hepatopatías/patología , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/enzimología , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Adulto JovenRESUMEN
Hepatic encephalopathy exists along a continuum from abnormal neuropsychiatric testing in the absence of clinical findings to varying degrees of detectable clinical findings. The International Society for Hepatic Encephalopathy and Nitrogen Metabolism has endorsed the term "covert" to encompass minimal hepatic encephalopathy and grade I overt hepatic encephalopathy. Covert hepatic encephalopathy has been associated with poor quality of life, decreased employment, increased falls, and increased traffic accidents that significantly impact quality of life and health care expenditures. Probiotics, nonabsorbable dissacharides, rifaximin, and l-ornithine-l-aspartate have been evaluated with varying levels of success. Because of the lack of universally accepted diagnostic tools, optimal timing of testing and treatment remains controversial.
Asunto(s)
Fármacos Gastrointestinales/uso terapéutico , Encefalopatía Hepática/tratamiento farmacológico , Probióticos/uso terapéutico , Dipéptidos/uso terapéutico , Humanos , Lactulosa/uso terapéutico , Selección de Paciente , Rifamicinas/uso terapéutico , Rifaximina , Índice de Severidad de la Enfermedad , Perfil de Impacto de EnfermedadRESUMEN
Anorectal conditions are frequently encountered clinical entities but are often misunderstood and misdiagnosed. Although the most common anorectal disorders are not considered life threatening, they can negatively impact patients' activities of daily living and quality of life. Comprehensive anorectal examination, including the use of anoscopy, has become a "lost art," and graduate medical education programs should utilize more formal training in this area. This review discusses the comprehensive anorectal exam and the diagnosis and management of three common anorectal disorders: hemorrhoids, anal fissure, and pruritus ani.
Asunto(s)
Fisura Anal , Hemorroides , Examen Físico/métodos , Proctoscopía , Prurito Anal , Fisura Anal/diagnóstico , Fisura Anal/terapia , Hemorroides/diagnóstico , Hemorroides/terapia , Humanos , Prurito Anal/diagnóstico , Prurito Anal/terapiaRESUMEN
Rather than being a diagnosis of exclusion, irritable bowel syndrome (IBS) is a diagnosis that can be identified by symptom-based criteria. The collection of these criteria by a meticulous history can be enhanced by using various tools. Once a positive diagnosis is made, using clinical criteria for diagnosis, one should look for alarm or warning symptoms or signs, and should characterize the type of bowel habit. Determining whether the condition is a diarrhea-predominant or a constipation-predominant IBS will direct further diagnostic evaluation and management.
