Riesgo de sangrado ante la colocación de gastrostomía endoscópica percutánea en pacientes antigregados / Risk of bleeding in patients undergoing percutaneous endoscopic gastrotrostomy tube insertion under antiplatelet therapy

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Hemorragia digestiva alta en paciente con púrpura difusa antral / High intestinal haemorrhage in patient with Schölein-Henoch purpura

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Esquistosomiasis con afectación rectal y hepática / No disponible

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[Gastrointestinal bleeding caused by small bowel leiomyosarcoma]. / Hemorragia digestiva por leiomiosarcoma de intestino delgado.

The small bowel leiomyosarcoma is a infrequent tumour in the clinical practice. We report the case of a 50 year old male admitted to the hospital on two occasions for gastrointestinal bleeding. On the second occasion a push enteroscopy located in jejunum a tumour. The pathologic diagnosis was a low grade jejunal leiomyosarcoma. The patient required a surgical intervention with resection of the affected portion of the jejunum.

Enfermedad celíaca del adulto: a propósito de un caso / No disponible

La enfermedad celíaca es una enfermedad sistémica autoinmune resultante de una intolerancia permanente al gluten. Se caracteriza por la presencia de una inflamación crónica de la mucosa del intestino delgado. Se puede desarrollar a cualquier edad y es relativamente común en adultos. La biopsia duodenal es todavía considerada por la mayoría de los autores la prueba "gold standard" en el proceso diagnóstico. La mayoría de los afectados muestran una remisión clínica sostenida con una dieta estricta libre de gluten, la cual debe mantenerse de forma indefinida toda la vida (AU)

Celiac disease is a autoimmune systemic condition resulting from the permanent gluten intolerante. It is characterized by the presence of chronic mucosal inflammation in the small bowel. It may develop at any age and is relatively common in the adult. Duodenal biopsy is still considered by most authors the gold standard in the diagnostic process. Most affected individuals show sustained clinical remission with a strictly gluten-free diet, which must be kept indefinitely for life (AU)

Hemorragia digestiva por leiomiosarcoma de intestino delgado / Gastrointestinal bleeding caused by small bowel leiomyosarcoma

El leiomiosarcoma de intestino delgado es un tumor infrecuente en la práctica clínica. Presentamos el caso de un hombre de 50 años que ingresó en el hospital en dos ocasiones por hemorragia digestiva. En el segundo ingreso una enteroscopia permitió localizar en yeyuno un tumor. El diagnóstico anatomopatológico fue de un leiomiosarcoma de yeyuno de bajo grado. El paciente precisó cirugía con resección de la porción de yeyuno afectada

The small bowel leiomiosarcoma is a infrequent tumour in the clinical practice.We report the case of a 50 year old male admitted to the hospital on two occasions for gastrointestinal bleeding. On the second ocassion a push enteroscopy located in jejunum a tumour. The pathologic diagnosis was a low grade jejunal leiomyosarcoma. The patient required a surgical intervention with resection of the affected portion of the jejunum

Evaluación y mejora en la información de los pacientes que se realizan una endoscopia / Evaluation and improvement in the information of the patients who carry out a digestive endoscopy

Introducción: La información es una parte importante del proceso asistencial, aunque en ocasiones puede ser inadecuada o deficiente.Objetivo: Detectamos una oportunidad de mejora en la inadecuada información de los pacientes que se realizan una endoscopia. El objetivo es evaluar y mejorar la calidad de la información.Método: Realizamos una primera evaluación con 100 pacientes procedentes de consultas, detectando desconocimiento de la técnica que se les va a realizar. Se aplican acciones de mejora, durante 4 meses, para realizar una segunda evaluación, con el mismo número de pacientes y evaluar mejoría respecto a la situación de partida. Resultados: Se ha detectado un déficit de información en el momento de indicar la endoscopia (poca información aportada por el médico prescriptor y en un número importante de casos no se aportaba consentimiento informado) y tras realizar la prueba, no aportando recomendaciones. Priorizamos nuestra actuación a este nivel con medidas de mejora y después de una nueva evaluación se determina una mejora significativa en estas situaciones.Conclusiones: Los estudios de nivel de calidad nos permiten detectar situaciones deficitarias y mejorar situaciones en los servicios de salud

Introduction: The information is an important part of the attendance process though in occasions it can be inadequate or deficient.Aim: We detect an opportunity of improvement in the inadequate information of the patients who carry out an endoscopia. The aim is to evaluate and to improve the quality of the information.Method: We realize the first evaluation with 100 patients proceeding from consultations, detecting ignorance of the technology. Actions of improvement are applied, for 4 months, to realize the second evaluation, with the same number of patients and to evaluate improvement with regard to the situation of item. Results: A deficit of information has been detected in the moment to indicate the endoscopia (little information contributed by the doctor prescriptor and in an important number of cases informed assent was not contributed) and after realizing the test, not contributing recommendations. We prioritize our action to this level with measures of improvement and after a new evaluation, a significant improvement decides in these situations.Conclusions: The studies of qualit level allow us to detect deficit situations and to improve situations in the services of health

[Evaluation and improvement in the information of the patients who carry out a digestive endoscopy]. / Evaluación y mejora en la información de los pacientes que se realizan una endoscopia.

INTRODUCTION: The information is an important part of the attendance process though in occasions it can be inadequate or deficient. AIM: We detect an opportunity of improvement in the inadequate information of the patients who carry out an endoscopia. The aim is to evaluate and to improve the quality of the information. METHOD: We realize the first evaluation with 100 patients proceeding from consultations, detecting ignorance of the technology. Actions of improvement are applied, for 4 months, to realize the second evaluation, with the same number of patients and to evaluate improvement with regard to the situation of item. RESULTS: A deficit of information has been detected in the moment to indicate the endoscopia (little information contributed by the doctor prescriptor and in an important number of cases informed assent was not contributed) and after realizing the test, not contributing recommendations. We prioritize our action to this level with measures of improvement and after a new evaluation, a significant improvement decides in these situations. CONCLUSIONS: The studies of qualit level allow us to detect deficit situations and to improve situations in the services of health.

Lessons from the history of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic among Spanish drug injectors.

In Spain, approximately 10 years passed between the time when human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) harm-reduction programs should have been developed with sufficient coverage to have an optimum impact on public health (before the HIV/AIDS epidemic's explosion in 1984) and the date of their actual implementation. This delay yielded an enormous cost for the country. The introduction of the virus in drug injector networks during a period of widespread diffusion of heroin injection and the lack of political awareness of the growing problem were 2 important factors that contributed to the important diffusion of the HIV infection among Spanish injection drug users. Lessons can be learned that may be of great interest in countries or territories facing similar challenges now and in the future.