RESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Candida glabrata/isolamento & purificação , Candidíase/diagnóstico , Colite/microbiologia , Obesidade Mórbida/complicações , Evolução Fatal , Fatores de RiscoRESUMO
Lower gastrointestinal tract infection caused by Candida species are rarely reported and, Candida albicans and tropicalis have been the only pathogens identified. We present the first documented case of candida colitis caused by Candida Glabrata in a 56-year-old man with a personal history of morbid obesity and bariatric surgery. The presenting symptoms were diarrhea, rectal bleeding and septic shock. Diagnosis was obtained by histological and microbiological study of the colonoscopy biopsies. Gastroenterologists should be aware of Candida as a cause of colonic infection. Fungal culture is the key to identify specific Candida species and lead to an appropriate antifungal therapy.
Assuntos
Candida glabrata , Candidíase/complicações , Colite/microbiologia , Candidíase/diagnóstico por imagem , Colite/diagnóstico por imagem , Colonoscopia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Obstrução da Saída Gástrica/complicações , Obstrução da Saída Gástrica/diagnóstico , Balão Gástrico/efeitos adversos , Balão Gástrico , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica , Obstrução da Saída Gástrica/fisiopatologia , Obstrução da Saída Gástrica/cirurgia , Obstrução da Saída Gástrica , Redução de Peso , Dor Abdominal/complicações , Dor AbdominalRESUMO
OBJECTIVE: Only a few reports have addressed non-anesthesiologist-administered propofol for endoscopic ultrasonography (EUS), but none specifically in high-risk patients. Our aim was to study the application of a propofol sedation protocol for EUS in average-risk and high-risk patients. METHODS: This was a prospective observational study including 446 patients referred for EUS. We analyzed the induction time, procedure duration, recovery times, and patients' comfort and safety. Sedation was administered by a trained nurse, under the guidance of the endoscopist. We continuously monitored vital signs as well as patient cooperation and tolerance. Complications, patient, and endoscopist satisfaction were analyzed. RESULTS: No major complications occurred. The rate of minor complications was 9%, the most frequent being hypoxemia (8%). One hundred and thirty-eight high-risk patients were included [American Society of Anesthesiologists (ASA) III-IV]. Average-risk patients received higher propofol doses (202.9 ± 84.8 vs. 164.8 ± 84.3; P=0.003). No differences were found in the rate of complications or procedure-related variables. Overall patient and endoscopist satisfaction was excellent. The logistic regression model identified propofol doses (P=0.02) as a risk factor and ASA-I classification (P=0.03) as a protective factor for the appearance of complications. CONCLUSION: Non-anesthesiologist-administered propofol for upper EUS in high-risk and average-risk patients is safe and could be routinely offered to high-risk and elderly patients.
