[Abdominal and gastrointestinal symptoms of Dengue fever. Analysis of a cohort of 8559 patients]. / Síntomas abdominales y gastrointestinales del dengue. Análisis de una cohorte de 8.559 pacientes.

INTRODUCTION/AIM: Dengue fever is a common disease in tropical and subtropical regions and is characterized by fever, headache, and joint and muscle pain. Occasionally, patients develop abdominal and gastrointestinal symptoms but information about the real frequency of these manifestations is lacking. The aim of this study was to determine the frequency of abdominal and gastrointestinal symptoms in a cohort of patients with Dengue fever. PATIENTS AND METHODS: We performed a retrospective review of 8559 patients with a diagnosis of Dengue fever during the 2006 epidemic to determine the frequency of abdominal and gastrointestinal symptoms. RESULTS: Abdominal and gastrointestinal symptoms were present in 67% of patients. The most frequent symptom was nausea (n=4453, 52%), followed by abdominal pain (n=3058, 36%), vomiting (n=2477, 29%), diarrhea (n=1471, 17%), hepatomegaly, (n=144, 2%), gastrointestinal bleeding (n=34, 0.3%) and ascites (n=8, 0.1%). Hospitalization was required in 1640 patients (19%), of which 1210 (74%, p=0.0001) had some abdominal and gastrointestinal symptoms. In this group, the most frequent symptoms were nausea (n=972, 59%), abdominal pain (n=692, 42%), vomiting (n=668, 41%) and diarrhea (n=393, 24%). Among patients admitted to our hospital for Dengue, 70% showed alterations in liver function tests. CONCLUSIONS: Our findings suggest that close to 67% of patients with Dengue fever have abdominal and gastrointestinal symptoms or abnormalities in liver function tests. Abdominal and gastrointestinal symptoms were significantly more frequent in patients who were hospitalized. The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinal symptoms in patients living in endemic areas or who have recently travelled to certain regions should include Dengue fever.

Síntomas abdominales y gastrointestinales del dengue. Análisis de una cohorte de 8.559 pacientes / Abdominal and gastrointestinal symptoms of Dengue fever. Analysis of a cohort

Introducción/objetivo: El dengue es una enfermedad común en áreas tropicales y subtropicalesque se caracteriza por fiebre, cefalea, artralgia y mialgia. Ocasionalmente, los pacientesdesarrollan síntomas abdominales y gastrointestinales (SAGI), sin embargo, existe poca informaciónrespecto a la frecuencia real de estas manifestaciones. El objetivo de este estudio fuedeterminar la frecuencia de SAGI en una cohorte de pacientes con dengue.Pacientes y métodos: Se realizó una revisión retrospectiva de 8.559 pacientes con diagnósticode dengue durante la epidemia del a˜no 2006 para determinar la frecuencia de los SAGI.Resultados: El 67% de los pacientes presentaron SAGI. La náusea fue el síntoma más frecuente(n = 4.453, 52%) seguida del dolor abdominal (n = 3.058, 36%), vómito (n = 2.477, 29%), diarrea(n = 1.471, 17%), hepatomegalia (n = 144, 2%), esplenomegalia (n = 43, 0,5%), sangrado digestivo(n = 34, 0,3%) y ascitis (n = 8, 0,1%). Se hospitalizaron a 1.640 pacientes (19%) de los cuales1.210 (74%, p = 0,0001) presentaban algún SAGI. En este grupo los síntomas más frecuentesfueron náusea (n = 972, 59%), dolor abdominal (n = 692, 42%), vómito (n = 668, 41%) y diarrea(n = 393, 24%). En el grupo de los pacientes hospitalizados con dengue en el HRAEV el 70%presentó alteraciones en las pruebas de función hepática.Conclusión: Nuestros hallazgos indican que cerca del 67% de los pacientes con dengue presentanSAGI o alteraciones de pruebas de función hepática. La frecuencia de SAGI fue significativamentemayor en pacientes hospitalizados. El diagnóstico diferencial de un síndrome febrilagudo con síntomas gastrointestinales en pacientes en áreas endémicas o con historia de viajea ciertas regiones con antecedentes epidémicos debe incluir al dengue (AU)

Introduction/aim: Dengue fever is a common disease in tropical and subtropical regions andis characterized by fever, headache, and joint and muscle pain. Occasionally, patients developabdominal and gastrointestinal symptoms but information about the real frequency of thesemanifestations is lacking. The aim of this study was to determine the frequency of abdominaland gastrointestinal symptoms in a cohort of patients with Dengue fever.Patients and methods: We performed a retrospective review of 8559 patients with a diagnosisof Dengue fever during the 2006 epidemic to determine the frequency of abdominal andgastrointestinal symptoms.Results: Abdominal and gastrointestinal symptoms were present in 67% of patients. The mostfrequent symptom was nausea (n = 4453, 52%), followed by abdominal pain (n = 3058, 36%),vomiting (n = 2477, 29%), diarrhea (n = 1471, 17%), hepatomegaly, (n = 144, 2%), gastrointestinalbleeding (n = 34, 0.3%) and ascites (n = 8, 0.1%). Hospitalization was required in 1640 patients(19%), of which 1210 (74%, p = 0.0001) had some abdominal and gastrointestinal symptoms. Inthis group, the most frequent symptoms were nausea (n = 972, 59%), abdominal pain (n = 692,42%), vomiting (n = 668, 41%) and diarrhea (n = 393, 24%). Among patients admitted to ourhospital for Dengue, 70% showed alterations in liver function tests.Conclusions: Our findings suggest that close to 67% of patients with Dengue fever have abdominaland gastrointestinal symptoms or abnormalities in liver function tests. Abdominal andgastrointestinal symptoms were significantly more frequent in patients who were hospitalized.The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinalsymptoms in patients living in endemic areas or who have recently travelled to certain regionsshould include Dengue fever (AU)

[Urological complications following kidney transplantation using Lich-Gregoir technique: A 4-year experience in Mexico]. / Complicaciones urológicas postrasplante renal con técnica de Lich-Gregoir. Experiencia de cuatro años.

OBJECTIVE: We present a retrospective review of urological complications following kidney transplantation in two medical centers in the Mexican state of Veracruz using Lich-Gregoir extravesical ureteroneocystostomy during a 4-year period. METHODS: Records from 242 patients from January 2003 to November 2007 were reviewed. Standard technique for organ procurement, open nephrectomy and kidney transplant was performed. EVU was used in all patients. Urological complications and management are reported. RESULTS: There were 19 complications recorded in 18 patients (7.8%). Sixteen kidneys were obtained from living donors. Urinary leak was the most common complication (4.5%) followed by ureteral stenosis (1.6%), vesicoureteral reflux (1.2%) and ureteral necrosis (0.4%) Most patients were treated with Foley catheter (42%), Boary flap (26%) and nephrostomy (15%); 1.23% grafts were lost associated with urological complications. CONCLUSIONS: Renal transplantation should incur few urological complications. Attention to technical details should be paid to avoid major complications. Early evaluation to correct complications reduces sepsis, morbidity and the risk of losing graft function.

Complicaciones urológicas postrasplante renal con técnica de Lich-Gregoir: experiencia de cuatro años / Urological complications following kidney transplantation using Lich-Gregoir technique: a 4-year experience in Mexico

Objetivo: Revisión de las complicaciones urológicas posteriores al trasplante renal en dos centros hospitalarios utilizando la técnica de ureteroneocistostomía extravesical de Lich-Gregoir en un periodo de cuatro años. Material y métodos: Se revisaron los expedientes de 242 pacientes en quienes se llevó a cabo trasplante renal de enero de 2003 a noviembre de 2007. En todos los pacientes se realizó ureteroneocistostomía extravesical. Se informaron todas las complicaciones urológicas y su manejo. Resultados: Se registraron 19 complicaciones en 18 pacientes, con una incidencia de 7.8 %; 16 riñones se obtuvieron de donadores vivos. Las complicaciones más comunes fueron fuga de orina (4.5 %), estenosis urinaria (1.6 %), reflujo vesicoureteral (1.2 %) y necrosis ureteral (0.4 %). La mayoría de los pacientes fueron tratados con sonda de Foley (42 %), colgajo de Boary (26 %) y nefrostomía (15 %). La pérdida del injerto renal se asoció a complicaciones urológicas en 1.23 % Conclusiones: El trasplante renal debe incurrir en pocas complicaciones urológicas, por lo que debe cuidarse los detalles técnicos. La evaluación temprana para corregir las complicaciones reduce la sepsis, morbilidad y el riesgo de pérdida del injerto.

OBJECTIVE: We present a retrospective review of urological complications following kidney transplantation in two medical centers in the Mexican state of Veracruz using Lich-Gregoir extravesical ureteroneocystostomy during a 4-year period. METHODS: Records from 242 patients from January 2003 to November 2007 were reviewed. Standard technique for organ procurement, open nephrectomy and kidney transplant was performed. EVU was used in all patients. Urological complications and management are reported. RESULTS: There were 19 complications recorded in 18 patients (7.8%). Sixteen kidneys were obtained from living donors. Urinary leak was the most common complication (4.5%) followed by ureteral stenosis (1.6%), vesicoureteral reflux (1.2%) and ureteral necrosis (0.4%) Most patients were treated with Foley catheter (42%), Boary flap (26%) and nephrostomy (15%); 1.23% grafts were lost associated with urological complications. CONCLUSIONS: Renal transplantation should incur few urological complications. Attention to technical details should be paid to avoid major complications. Early evaluation to correct complications reduces sepsis, morbidity and the risk of losing graft function.