Imagen endoscópica de afectación gastrointestinal por linfoma del manto / Endoscopic image of gastrointestinal involvement by mantle cell lymphoma

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Resolución endoscópica de perforación gástrica con penetración a páncreas por espina de pescado / Endoscopic resolution of gastric perforation with pancreas penetration by a fish bone

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Diagnostic incidence of the presence of positive HBsAg: epidemiologic, clinical, and virological characteristics.

OBJECTIVE: To analyze the epidemiological, clinical, and virological characteristics of patients newly diagnosed with active hepatitis B virus (HBV) infection based on the presence of positive hepatitis B surface antigen (HBsAg) in the digestive diseases department of a district hospital. PATIENTS AND METHODS: We performed a 3-year prospective study in patients newly diagnosed with HBV infection. We analyzed epidemiological, clinical, and virological characteristics, complete HBV markers, quantification of HBV DNA, and infection by hepatitis delta virus. We performed genotyping and resistance testing in patients with a high viral load. Results were obtained for patientswho required liver biopsy. RESULTS: We diagnosed 213 patients (18.8/10,000 inhabitants/year). Men accounted for 61%, and 59% were aged 20 to 40 years. Immigrants accounted for 53% of the population: 46% were from Rumania and 37% from Sub-Saharan African countries. At diagnosis, 2.3% had acute hepatitis (all with jaundice) and 3.3% had cirrhosis with portal hypertension. With the exception of cases of acute hepatitis, positive HBeAg was observed in 9%. Serum transaminase levels were normal in 62.2% of patients, HBV DNA was > 2,000 IU/mL in 33.8%, and delta virus was present in 3.3%. Genotyping and resistance testing were performed in 70 patients: the most common genotype was D, followed by A. Resistance was detected at baseline in only 2 cases: to adefovir in one case and to entecavir in another. Among the 36 biopsies performed, 32.4% showed inflammatory activity > or = 2, and 23.5% had fibrosis > or = 2 according to the METAVIR scoring system. According to clinical practice, specific treatment for HBV infection was necessary (any reason) in 17.4% of those diagnosed (3 patients per 100,000 inhabitants/year). CONCLUSIONS: Despite prevention and vaccination, HBV infection is a health problem that most commonly affects the immigrant population and men. Serum transaminase levels are normal in 62.2% of patients. The most frequent genotype is D, followed by A, and baseline resistance is scarce.

Incidencia diagnóstica de AgHBs positivo. Características epidemiológicas, clínicas y virológicas / Diagnostic incidence of the presence of positive HBsAg: epidemiologic, clinical, and virological characteristics

Objetivo: analizar las características epidemiológicas, clínicas y virológicas de los pacientes que han sido nuevos diagnósticos de infección activa por VHB, por la presencia de AgHBs positivo, en el servicio de Aparato Digestivo de un hospital de área. Pacientes y métodos: se trata de un estudio prospectivo realizado durante 3 años, en pacientes de nuevo diagnóstico de infección por VHB, donde se han analizado las características epidemiológicas, clínicas, marcadores completos de VHB, cuantificación de DNAVHB e infección por virus Delta. En los pacientes con alta carga viral se han estudiado genotipos y resistencias. En los pacientes con indicación de biopsias hepáticas sus resultados. Resultados: se han diagnosticado 213 pacientes, 18,8/10.000 habitantes y año. El 61% son varones, el 59% con edad comprendida entre 20 y 40 años. El 53% corresponde a población inmigrante, 46% procedentes de Rumanía y 37% de países subsaharianos. En el momento del diagnóstico, el 2,3% tenían una hepatitis aguda, todos los casos con ictericia, y el 3,3% una cirrosis hepática con hipertensión portal. El AgHBe positivo, descontando los cuadros de hepatitis aguda, estaba presente en el 9%. Las transaminasas eran normales en el 62,2%, el DNA-VHB en el 33,8% es superior a 2.000 UI/ml y la asociación del virus Delta está presente en el 3,3%. En 70 pacientes se analiza el genotipo y resistencias, siendo el más frecuente el D, seguido del A; solo se han detectado dos resistencias basales, una a adefovir y otro a entecavir. En las 36 biopsias hepáticas realizadas, el 32,4% tenían una actividad inflamatoria mayor o igual a 2, y el 23,5% una fibrosis igual o superior a 2, valorada según la clasificación de METAVIR. El 17,4% de los diagnosticados ha precisado tratamiento específico para el VHB según práctica clínica por algún motivo, lo que ha supuesto iniciar tratamiento a unos 3 pacientes por cada 100.000 habitantes y año. Conclusión: a pesar de la prevención y vacunación, la infección por VHB es un problema de salud, afecta de forma más frecuente a población inmigrante, varones y cursa en el 62,2% con transaminasas normales. El genotipo más frecuente es el D seguido del A y las resistencias basales son escasas(AU)

Objective: to analyze the epidemiological, clinical, and virological characteristics of patients newly diagnosed with active hepatitis B virus (HBV) infection based on the presence of positive hepati - tis B surface antigen (HBsAg) in the digestive diseases department of a district hospital. Patients and methods: we performed a 3-year prospective study in patients newly diagnosed with HBV infection. We analyzed epidemiological, clinical, and virological characteristics, complete HBV markers, quantification of HBV DNA, and infection by hepatitis delta virus. We performed genotyping and resistance testing in patients with a high viral load. Results were obtained for patients who required liver biopsy. Results: we diagnosed 213 patients (18.8/10,000 inhabitants/ year). Men accounted for 61%, and 59% were aged 20 to 40 years. Immigrants accounted for 53% of the population: 46% were from Rumania and 37% from Sub-Saharan African countries. At diagnosis, 2.3% had acute hepatitis (all with jaundice) and 3.3% had cirrhosis with portal hypertension. With the exception of cases of acute hepatitis, positive HBeAg was observed in 9%. Serum transaminase levels were normal in 62.2% of patients, HBV DNA was > 2,000 IU/mL in 33.8%, and delta virus was present in 3.3%. Genotyping and resistance testing were performed in 70 patients: the most common genotype was D, followed by A. Resistance was detected at baseline in only 2 cases: to adefovir in one case and to entecavir in another. Among the 36 biopsies performed, 32.4% showed inflammatory activity >= 2, and 23.5% had fibrosis >= 2 according to the METAVIR scoring system. According to clinical practice, specific treatment for HBV infection was necessary (any reason) in 17.4% of those diagnosed (3 patients per 100,000 inhabitants/year). Conclusions: despite prevention and vaccination, HBV infection is a health problem that most commonly affects the immigrant population and men. Serum transaminase levels are normal in 62.2% of patients. The most frequent genotype is D, followed by A, and baseline resistance is scarce(AU)