Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 276
Filtrar
3.
J Int Neuropsychol Soc ; 30(2): 172-182, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37465902

RESUMO

OBJECTIVE: Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores. METHOD: A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05). RESULTS: Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures. CONCLUSIONS: The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.


Assuntos
Disfunção Cognitiva , Pessoa de Meia-Idade , Humanos , Idoso , Adulto , Idoso de 80 Anos ou mais , Escolaridade , Modelos Lineares , Linguística , Testes Neuropsicológicos
4.
Front Cell Dev Biol ; 11: 1114769, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37397257

RESUMO

Blood-testis barrier (BTB) creates a particular compartment in the seminiferous epithelium. Contacting Sertoli cell-Sertoli cell plasma membranes possess specialized junction proteins which present a complex dynamic of formation and dismantling. Thus, these specialized structures facilitate germ cell movement across the BTB. Junctions are constantly rearranged during spermatogenesis while the BTB preserves its barrier function. Imaging methods are essential to studying the dynamic of this sophisticated structure in order to understand its functional morphology. Isolated Sertoli cell cultures cannot represent the multiple interactions of the seminiferous epithelium and in situ studies became a fundamental approach to analyze BTB dynamics. In this review, we discuss the contributions of high-resolution microscopy studies to enlarge the body of morphofunctional data to understand the biology of the BTB as a dynamic structure. The first morphological evidence of the BTB was based on a fine structure of the junctions, which was resolved with Transmission Electron Microscopy. The use of conventional Fluorescent Light Microscopy to examine labelled molecules emerged as a fundamental technique for elucidating the precise protein localization at the BTB. Then laser-scanning confocal microscopy allowed the study of three-dimensional structures and complexes at the seminiferous epithelium. Several junction proteins, like the transmembrane, scaffold and signaling proteins, were identified in the testis using traditional animal models. BTB morphology was analyzed in different physiological conditions as the spermatocyte movement during meiosis, testis development, and seasonal spermatogenesis, but also structural elements, proteins, and BTB permeability were studied. Under pathological, pharmacological, or pollutant/toxic conditions, there are significant studies that provide high-resolution images which help to understand the dynamic of the BTB. Notwithstanding the advances, further research using new technologies is required to gain information on the BTB. Super-resolution light microscopy is needed to provide new research with high-quality images of targeted molecules at a nanometer-scale resolution. Finally, we highlight research areas that warrant future studies, pinpointing new microscopy approaches and helping to improve our ability to understand this barrier complexity.

5.
Rev. cir. (Impr.) ; 75(2)abr. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1441461

RESUMO

Introducción: La pancreatoduodenectomía de urgencia (PDDU) es una cirugía reservada para lesiones graves pancreatoduodenales secundarias a trauma, lesiones inflamatorias o posterior a procedimientos endoscópicos. Objetivo: Describir dos casos clínicos en los que se realizó PDDU. Casos Clínicos: Se reportan 2 casos clínicos en los cuales se requirió una PDD. En el primer caso secundario a úlcera duodenal perforada que comprometía más del 50% del lumen asociado a biliperitoneo y fistula duodenal sin control; y en el segundo, a consecuencia de un trauma por herida de bala con perforación duodenal, íleon distal y desgarro de 1,5 cm en cabeza de páncreas. Discusión: En la actualidad no existe un consenso sobre las indicaciones de PPDU, sin embargo esta compleja cirugía representa una opción de tratamiento en pacientes bien seleccionados, cuando la cirugía de control de daños y los intentos de controlar la necrosis y fistulas duodenales han fracasado. Conclusión: El tratamiento de una lesión pancreática y duodenal compleja puede requerir PDDU. Sin embargo, en pacientes inestables se debe considerar una cirugía en dos tiempos por un equipo de cirujanos experimentados.


Introduction: Emergency pancreaticoduodenectomy (UPDD) is a surgery reserved for severe pancreaticoduodenal injuries secondary to trauma, inflammatory injuries or after endoscopic procedures. Aim: To describe two clinical cases in which PDDU was performed. Clinical Cases: 2 clinical cases are reported in which a PDDU was required. The first case was secondary to a perforated duodenal ulcer that compromised more than 50% of the lumen associated with biliperitoneum uncontrolled duodenal fistula; in the second one, as a consequence of a gunshot wound trauma with duodenal perforation, distal ileum and a 1.5 cm tear in the head of pancreas. Discussion: Currently there is no consensus on the indications for UPDD, however this complex surgery represents a treatment option in well-selected patients, when damage control surgery and attempts to control necrosis and duodenal fistulas have failed. Conclusión: Treatment of a complex pancreatic and duodenal injury may require pancreatoduodenectomy. However, in unstable patients, a two-stage surgery should be considered by an experienced surgical team.

8.
J Cancer Policy ; 34: 100370, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36375808

RESUMO

BACKGROUND: The invasion of Ukraine by Russia in February 2022 has resulted in destruction of healthcare infrastructure and triggered the largest wave of internally displaced populations and refugees since World War Two. Conflicts in transitioned countries such as Ukraine create new non-communicable disease (NCD) challenges, especially for cancer care for refugees and humanitarian assistance in host countries. In the early days, rapid attempts were made to model possible impacts. METHODS: By evaluating open source intelligence used in the first three months of the conflict through snowball search methods, we aimed to address: (i) burden of cancer in Ukrainian population, specifically considering translating to the refugees population, and its cancer care capacity; ii) baseline capacity/strengths of cancer systems in initial host countries. Moreover, using a baseline scenario based on crude cancer incidence in Ukraine, and considering data from UNHCR, we estimated how cancer cases would be distributed across host countries. Finally, a surveillance assessment instrument was created, intersecting health system's capacity and influx of internally displaced populations and refugees. FINDINGS AND CONCLUSIONS: The total new cancer patients per month in pre-conflict Ukraine was estimated as 13,106, of which < 1 % are paediatric cases. The estimated cancer cases in the refugee population (combining prevalent and incident), assuming 7.5 million refugees by July 2022 and a female:male ratio of 9:1, was 33,121 individuals (Poland: 19284; Hungary: 3484; Moldova: 2651; Slovakia: 2421; Romania: 5281). According to our assessments, Poland is the only neighbouring country classified as green/yellow for cancer capacity, i.e. sufficient ablility to absorb additional burden into national health system; Slovakia we graded as yellow, Hungary and Romania as yellow/red and Moldova as red.


Assuntos
Neoplasias , Doenças não Transmissíveis , Refugiados , Socorro em Desastres , Humanos , Masculino , Feminino , Criança , Nações Unidas , Atenção à Saúde , Neoplasias/epidemiologia
9.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3572-3576, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36085978

RESUMO

AIMS: The hepatitis C virus (HCV) has developed a strategy to coexist with its host resulting in varying degrees of tissue and cell damage, which generate different pathological phenotypes, such as varying degrees of fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). However, there is no integrated information that can predict the evolutionary course of the infection. We propose to combine Near-infrared spectroscopy (NIRS) and machine learning techniques to provide a predictive model. In this work, we propose to discriminate HCV positivity in biobank patient serum samples. METHODS: 126 serum samples from 38 HCV patients in different stages of the disease were obtained from the Biobank of Hospital Universitario Fundación Alcorcon. NIRS spectrum was captured by a FT-NIRS Spectrum 100 (Perkin Elmer) device in reflectance mode. For each patient, the HCV positivity was identified (PCR) and labeled as detectable =1 and undetectable =0. We propose an L1-penalized logistic regression model to classify each spectrum as positive (1) or negative (0) for HCV presence (x). The regularization parameter is selected using 5- fold cross-validation. The penalized model will induce sparsity in the solution so that only a few relevant wavelengths will be different from zero. RESULTS: L1-penalized logistic regression model provided 167 wavelengths different from zero. The accuracy on an independent test set was 0.78. CONCLUSIONS: We present a straightforward promising approach to detect HCV positivity from patient serum samples combining NIRS and machine learning techniques. This result is encouraging to predict HCV progression, among other applications. Clinical relevance- We presented a simple while promising approach to use machine learning and NIRS to analyze viral presence on sample serums.


Assuntos
Carcinoma Hepatocelular , Hepatite C , Neoplasias Hepáticas , Hepacivirus/genética , Hepatite C/complicações , Hepatite C/diagnóstico , Humanos , Espectroscopia de Luz Próxima ao Infravermelho
10.
Rev. med. Chile ; 150(7): 861-867, jul. 2022. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1424149

RESUMO

BACKGROUND: Bile duct reconstruction (BDR) secondary to bile duct injury during cholecystectomy (BDIC) is a complex surgery, and an important issue is the quality of life (QL) after the procedure. AIM: To compare the QL of a cohort of patients who underwent BDR due to BDIC with a cohort of patients who underwent a cholecystectomy without incidents. MATERIAL AND METHODS: The cohort was composed of 32 patients aged 47 ± 18 years (78% women) who underwent BDR due to BDIC. For purposes of comparison, a cohort of patients who underwent a cholecystectomy without incident was chosen. These cohorts were paired 1:1 by age (± 1 year), gender and type of surgery. The SF-36 quality of life survey was applied in person or by telephone. The score was calculated as proposed by the RAND group. RESULTS: The cohort of BDR patients was comprised of 32 patients, with an average age of 47 ± 17.6 years, with a predominance of women (78%). The mean number of hospitalization days among BDR patients was 20 ± 11.8. The average follow-up was 7 ± 5 years. The mean score of patients undergoing RVB or cholecystectomy without complications was evaluated, without finding differences in the score of the different domains of the SF-36 scale. Conclusions: In the present study no significant differences were found in QL between the patients with BDIC who underwent BDR and patients who underwent a cholecystectomy without complications.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade de Vida , Colecistectomia/efeitos adversos , Ductos Biliares/cirurgia , Ductos Biliares/lesões , Inquéritos e Questionários
11.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-209513

RESUMO

JUSTIFICACIÓN: en nuestras sociedades modernas, el aumento del estrés debido al actual ritmo de vida y la desregulación de los ciclos luz-oscuridad hacen que una gran cantidad de personas se planteen el consumo de plantas medicinales y suplementos en fitoterapia relacionados con la ansiedad, el nerviosismo y la falta de sueño, buscando un mínimo de efectos secundarios. Sin embargo, la venta de estos suplementos alimentarios no exige prescripción médica ni una evaluación por la AEM con la rigurosidad requerida para los medicamentos de síntesis. Por ello, un gran porcentaje de pacientes consumen estos preparados vegetales sin consultar con un profesional.La fitomelatonina fue descubierta en 1995 y está presente en todas las plantas. Es una hormona de origen vegetal con igual estructura química (N-acetil-5-metoxitriptamina) que la melatonina sintetizada por la glándula pineal en humanos, y que posee propiedades fisiológicas, hormonales y antioxidantes bien conocidas. Destaca su papel como regulador de los ciclos vigilia/sueño, pero también ha sido investigado como agente antitumoral, inmunomodulador y antidepresivo. Se ha estudiado su efecto en el insomnio, el desfase horario del sueño o jet-lag, y en trastornos depresivos. En las farmacias comunitarias encontramos la melatonina en distintas formas farmacéuticas, como bolsas de infusiones, cápsulas, comprimidos, tabletas, bien en forma de grageas o en extracto fluido (jarabe, gotero), entre otras.OBJETIVOS: n este trabajo se analizan los contenidos en fitomelatonina de varias plantas medicinales (valeriana, melisa e hipérico) y en suplementos destinados a combatir el estrés, la agitación generada por el actual ritmo de vida, y a la mejora del sueño.MATERIAL Y MÉTODOS: para el análisis de la fitomelatonina se utilizó la técnica de cromatografía líquida de alta resolución (HPLC) con detector de fluorescencia, una técnica habitual, sensible y precisa. (AU)


Assuntos
Humanos , Hipnóticos e Sedativos , Pacientes , Ansiedade , Distúrbios do Início e da Manutenção do Sono , Plantas Medicinais
12.
Food Chem ; 378: 132140, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35042111

RESUMO

Impact of applying monosilicic acid to grapevines during ripening on chemical composition of Mencía red wines in an area where fungal diseases during summer are common was examined. The foliar application of monosilicic acid to grapevines led to a less oxidized wine, with lower levels of acetic acid, acetaldehyde, ethyl acetate and diacethyl; this should be considered as positive from a sensory point of view. Wines made with silicon-treated grapes also contained lower levels of gluconic acid and glycerol, which are chemical markers of wines made with botrytized grapes, as well as higher contents of total phenols, anthocyanins and tannins. Furthermore, the contents of several mid-chain alcohols were higher (p < 0.05) in wines made with grapes from silicon-treated plants.


Assuntos
Vitis , Vinho , Antocianinas/análise , Frutas/química , Fenóis/análise , Vinho/análise
13.
Rev Med Chil ; 150(7): 861-867, 2022 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-37906819

RESUMO

BACKGROUND: Bile duct reconstruction (BDR) secondary to bile duct injury during cholecystectomy (BDIC) is a complex surgery, and an important issue is the quality of life (QL) after the procedure. AIM: To compare the QL of a cohort of patients who underwent BDR due to BDIC with a cohort of patients who underwent a cholecystectomy without incidents. MATERIAL AND METHODS: The cohort was composed of 32 patients aged 47 ± 18 years (78% women) who underwent BDR due to BDIC. For purposes of comparison, a cohort of patients who underwent a cholecystectomy without incident was chosen. These cohorts were paired 1:1 by age (± 1 year), gender and type of surgery. The SF-36 quality of life survey was applied in person or by telephone. The score was calculated as proposed by the RAND group. RESULTS: The cohort of BDR patients was comprised of 32 patients, with an average age of 47 ± 17.6 years, with a predominance of women (78%). The mean number of hospitalization days among BDR patients was 20 ± 11.8. The average follow-up was 7 ± 5 years. The mean score of patients undergoing RVB or cholecystectomy without complications was evaluated, without finding differences in the score of the different domains of the SF-36 scale. CONCLUSIONS: In the present study no significant differences were found in QL between the patients with BDIC who underwent BDR and patients who underwent a cholecystectomy without complications.


Assuntos
Colecistectomia , Qualidade de Vida , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Colecistectomia/efeitos adversos , Inquéritos e Questionários , Ductos Biliares/cirurgia , Ductos Biliares/lesões
14.
Arch Clin Neuropsychol ; 37(2): 352-364, 2022 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-34312664

RESUMO

OBJECTIVE: Semantic verbal fluency constitutes a good candidate for identifying cognitive impairment. This paper offers normative data of different semantic verbal fluency tests for middle-aged and older adults natives from Spain considering sociodemographic factors, and different measures for each specific category (number of words produced, errors, and words evoked every 15 s). METHOD: Two thousand and eighty-eight cognitively unimpaired subjects aged between 50 and 89 years old, community dwelling, participated in the study. The statistical procedure includes the conversion of percentile ranges into scalar scores. Secondly, the effects of age, education and gender were verified. Linear regressions are used to calculate the scalar adjusted scores. RESULTS: Scalar scores and percentiles corresponding to all semantic verbal fluency tests across different measures are shown. Additional tables, which show the points that must be added or subtracted from direct scores, are provided for Education regarding the total number of "animals" and "clothes" evoked by participants, as well as for Age and Education in case of the total number of "clothes". Gender affects the number of "clothes" produced by participants in the first two 15-second segments. CONCLUSIONS: The current norms should provide clinically useful data for evaluating Spanish-speaking natives from Spain aged from 50 to 89 years.


Assuntos
Semântica , Comportamento Verbal , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Animais , Escolaridade , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Comportamento Verbal/fisiologia
16.
Rev. cir. (Impr.) ; 73(4): 470-475, ago. 2021. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1388856

RESUMO

Resumen Objetivo: Determinar si la nutrición vía oral precoz (NVOP) disminuye la estancia hospitalaria y no se asocia a mayor reactivación de pancreatitis aguda (PA), ni a deterioro del pronóstico. Materiales y Método: Cohorte prospectiva de pacientes con PA, a los cuales se les aplicó un protocolo de NVOP y se evaluó tolerancia, tiempo de realimentación, estancia hospitalaria, reactivación de PA, complicaciones locales y necesidad de cama en unidad de cuidado crítico. Comparamos resultados entre pacientes que toleraron y no toleraron dicho protocolo. Resultados: Incluimos 65 pacientes, 69,2% de género femenino. El 49,3% presentó pancreatitis aguda grave (PAG) y 90,8% toleró protocolo de NVOP, con promedio de estancia hospitalaria de 13,3 ± 5 días vs. 19 ± 8,2 días en quienes no toleraron (p = 0,0177). Hubo reactivación de PA en 1 (1,5%) paciente sin tener relación con el protocolo. No hubo necesidad de cama UTI/UCI, ni mortalidad. Nueve pacientes fueron excluidos por no cumplir criterios para iniciar o mantener protocolo. Discusión: La PA es motivo frecuente de consulta en los servicios de urgencia de nuestro país, por lo que lograr una estandarización en la terapia nutricional resulta de mucha importancia para disminuir la morbimortalidad. Nuestros resultados son comparables con estudios internacionales que apoyan la nutrición enteral precoz. Conclusión: La tolerancia a la NVOP en el tratamiento de la PA, se asocia a menor estancia hospitalaria, menor tasa de reactivación de PA, menos complicaciones locales y sin aumentar la mortalidad, en relación con los que no toleran la NVOP.


Aim: To determínate if the tolerance to early oral nutrition (NVOP) decreases hospital stay and is not associated with greater reactivation of acute pancreatitis (AP) or worst prognosis compared to patients that did not tolerate NVOP protocol. Materials and Method: A prospective cohort of patients with AP who NVOP protocol was applied then we evaluated protocol tolerance, feedback time, hospital stay, AP reactivation, presence of local complications, and need for bed in critical care unit. The results were compared between patients who tolerate and did not tolerate this protocol. Results: 65 patients were included, 69.2% female. 49.3% presented severe acute pancreatitis (PAG) and 90.8% tolerated the NVOP protocol, with a mean hospital stay of 13.3 ± 5 days vs. 19 ± 8.2 days in those who did not tolerate it (p = 0,0177). There was reactivation of AP in 1 (1.5%) patient without relation to the protocol. Nine patients were excluded, because they did not achieve criteria to start or maintain protocol. Discussion: The AP is a frequent reason for consultation in the emergency services of our country, so achieving standardization in nutritional therapy is of great importance to reduce morbidity and mortality. Our results are comparable with international studies supporting early enteral nutrition. Conclusion: The tolerance to NVOP as treatment of AP it is associated with shorter hospital stay, and is not related to a higher rate of reactivation of AP, local complications, or increased mortality compared to the patients who did not tolerate this protocol.


Assuntos
Humanos , Masculino , Feminino , Pancreatite/terapia , Doença Aguda , Estado Nutricional , Estudos de Coortes , Resultado do Tratamento , Medição de Risco
17.
Sensors (Basel) ; 21(11)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34064285

RESUMO

We report on recent advances in the use of inexpensive polymer optical fibres (POFs) for sensing applications in avionics. The sensors analysed in this manuscript take advantage of the unique properties of polymers, such as high flexibility, elasticity, and sensitivity, and they range from strain, elongation, and vibration interrogators to level and temperature meters, leading to cost-effective techniques for structural health monitoring in aircraft structures. We also highlight recent power-supply methods using Power-over-POF in order to feed sensors remotely, and we discuss the constraints imposed by connectors on the performance of POF networks in aircrafts.

18.
Parkinsons Dis ; 2021: 8871549, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34094501

RESUMO

INTRODUCTION: In a degenerative disorder such as Parkinson's disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr's motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient's quality of life (QoL) with regard to a defined clinical stage. MATERIALS AND METHODS: Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0-20; B: NMSS = 21-40; C: NMSS = 41-70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale. RESULTS: A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB (p < 0.0001). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively (p < 0.005; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; p < 0.0001). CONCLUSION: The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the H&Y. Patients with a lower H&Y stage may be more affected if they have a greater NMS burden.

19.
Rev. cir. (Impr.) ; 73(2): 212-216, abr. 2021. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1388798

RESUMO

Resumen Introducción Los tumores del estroma gastrointestinal (GIST) corresponden al 1% de todas las neoplasias gastrointestinales, sin embargo, sólo el 3-5% de estos se desarrollan en el duodeno. Objetivo Reportar el caso de un paciente masculino con localización atípica de un tumor de estroma gastrointestinal y su manejo. Caso clínico paciente masculino de 50 años con antecedente de traumatismo encefalo craneano (TEC) con daño orgánico cerebral secundario, tabaquismo, consumidor de alcohol ocasional y sometido a quistectomía branquial en la infancia, que consulta en el servicio de urgencias por cuadro de hemorragia digestiva alta con compromiso hemodinámico. Tras realizar endoscopia digestiva alta (EDA), resonancia nuclear magnética (RNM) y tomografía computada (TC) de abdomen, se pesquisa masa tumoral en segunda porción de duodenal. Discusión A pesar de que la presentación clínica de los GIST es variable, lo más frecuente es que sean pacientes asintomáticos. En algunas ocasiones, al igual que en este reporte, pueden presentarse con dolor abdominal y/o hemorragia digestiva alta. El diagnóstico preoperatorio fue difícil ya que el estudio con imágenes (TC, RNM, EDA) sólo permite establecer la sospecha; el diagnóstico definitivo se realizó con biopsia (no contamos con endosonografía en nuestro centro). Debido a los sitios de reparo anatómico, no existe una cirugía estandarizada; en este caso, debido a la localización, infiltración y características, se decidió realizar una pancreatoduodenectomía.


Introduction Gastrointestinal stromal tumors (GIST), corresponds to 1%, of all gastrointestinal neoplasms, however, only 3%-5% developed in duodenum. Aim To report a case of a male patient with atypical location of gastrointestinal stroma tumor and the treatment proposed. Case report 50-year-old male patient, with medical history of organic brain damage secondary a traumatic brain injury, smoker, occasional alcohol consumer and branquial cystomy during childhood. Consulted in the emergency department for a high digestive hemorrhage case with hemodynamic compromise. Upper digestive endoscopy, computed tomography and nuclear magnetic resonance were performed, which impresses tumor-like lesion in the second duodenal portion. Discussion Although the GIST clinical presentation is variable, most often they are asymptomatic patients. In some times, as in this report, they may present with abdominal pain and/or upper gastrointestinal bleeding. The preoperative diagnosis was difficult, because the imaging study (CT, RNM, EDA) only stablished the suspicion and the final diagnosis was made by biopsy (we don't have endosonography in our center). Due to the anatomic repair, there is not a standardized surgery, in this case, due tumor location, infiltration and characteristics, it was decided to perform a pancreatoduodenectomy.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Tumores do Estroma Gastrointestinal/diagnóstico , Neoplasias Gastrointestinais/patologia , Hemorragia Gastrointestinal/etiologia , Tomografia Computadorizada por Raios X , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/patologia , Hemorragia Gastrointestinal/complicações
20.
Rev. cir. (Impr.) ; 73(1): 73-79, feb. 2021. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1388791

RESUMO

Resumen Objetivo: Describir resultados en términos de morbilidad y mortalidad del tratamiento de quistes hidatídicos hepáticos (QHH) por vía laparoscópica en una serie de pacientes consecutivos. Comparar calidad de vida (CV) de pacientes sometidos a quistectomía laparoscópica (QL) con pacientes llevados a colecistectomía laparoscópica. Materiales y Método: Serie de casos con seguimiento de pacientes con QHH, sometidos a QL. Analizamos datos con Stata® 10.0, mediante medidas de tendencia central y dispersión. Describimos 4 variables, realizando seguimiento con tomografía computada (TC) abdominal. Aplicamos encuesta de calidad de vida SF-36. Resultados: Incluimos 12 pacientes, 58,3% de género femenino. Número de quistes 2,02 ± 1,56, volumen quístico mayor 809,16 ± 766,05 ml, diámetro de quiste mayor 11,77 ± 4,33 cm, predominando en lóbulo hepático derecho (58%). Tiempo operatorio promedio 234,1 ± 52,9 minutos. Estadía hospitalaria promedio 11,5 ± 14,5 días. Morbilidad en 16,6%, sin mortalidad posoperatoria. Seguimiento con imágenes promedio fue 7,9 ± 4,3 meses, encontrando cavidades residuales pequeñas y asintomáticas en 50% de pacientes. No reportamos recidivas. Al comparar CV con grupo de colecistectomía sólo encontramos diferencia respecto a vitalidad (p = 0,04). Discusión: Aunque nuestra serie es pequeña y presenta mayor tiempo quirúrgico (por selección de pacientes) y mayor estancia hospitalaria que en otras series de QL, presenta menor porcentaje de recidivas, de fístulas biliares y no presenta mortalidad, concordando con otras series de QL que la recomiendan como opción terapéutica. Conclusiones: La QL para el tratamiento de los QHH resulta una cirugía aceptable, con morbilidad y mortalidad comparable con reportes de cirugía abierta.


Aim: To describe results in morbidity and mortality terms of the hepatic hydatidosis (HHC) treatment by laparoscopic route in selected patients. In addition, compare the quality of life (QL) of cystomectized vs cholecystectomized patients, both laparoscopically. Materials and Method: Case series with follow-up of patients with HHC, undergoing laparoscopic cystectomy (LC). Data analysis, through measures of central tendency and dispersion, performed with Stata® 10.0. Analyzing 4 variables followed-up with abdominal computed tomography. A quality of life survey SF-36" was applied. Results: 12 patients were included, 58.3% female gender. Cysts number 2.02 ± 1.56, largest cystic volume 809.16 ± 766.05 ml, larger cyst diameter 11,77 ± 4,33 cm. Right hepatic lobe is predominantly 58%. Surgical time, 234.16 ± 52.95 minutes. Hospital stay, 11.58 ± 14.55 days. Morbidity 16.6%, with no postoperative mortality. Follow-up, performed at 7.9 ± 4.3 months, finding residual cavity in 50%, no recurrences were reported. At comparing QL with cholecystectomy group, we only found differences at the vitality item (p = 0,04). Discussion: Although our series is small and has a longer surgical time (by patient selection) and a longer hospital stay than in other LC series, it has a lower recurrences percentage, biliary fistulas, and no mortality, agreeing with other LC series that recommend it as a therapeutic option. Conclusions: The laparoscopic approach for the HHC treatment, is an acceptable surgery, with morbidity and mortality comparable to the reports of laparotomy surgery.


Assuntos
Humanos , Cistectomia/efeitos adversos , Laparoscopia/efeitos adversos , Equinococose Hepática/cirurgia , Período Pós-Operatório , Qualidade de Vida , Cistos/cirurgia , Equinococose Hepática/diagnóstico , Equinococose Hepática/mortalidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...