RESUMO
La afectación gástrica por el virus varicela-zóster es una entidad clínica poco frecuente, cuya sospecha y diagnóstico precoz es importante para evitar las consecuencias derivadas de su elevada morbimortalidad que en pacientes inmunocomprometidos varía entre un 9% y 41% según las series. A continuación se describen dos casos de afectación gástrica por el virus de la varicela-zóster (VVZ) en dos pacientes con enfermedad hematooncológica. Habitualmente las lesiones gástricas van precedidas de la aparición de lesiones cutáneas pápulo-vesiculares características. Cuando la afectación gástrica es el primer síntoma de la enfermedad se puede producir un retraso en el diagnóstico y tratamiento de esta infección que puede conllevar consecuencias graves para el paciente inmunocomprometido. Es por ello que proponemos que sea una entidad tenida en cuenta en el algoritmo de estudio del paciente inmunocomprometido que presenta dolor abdominal y lesiones endoscópicas de tipo ulceroso (AU)
Gastric involvement with the varicella-zoster virus is an uncommon clinical condition where early suspicion and diagnosis are important to prevent the consequences deriving from its high morbidity and mortality, which in immunocompromised patients oscillate between 9% and 41% according to the various series. Two cases of gastric involvement with the varicella-zoster virus (VZV) in two patients with blood cancer are reported below. Gastric lesions are usually preceded by typical papulovesicular skin lesions. When gastric involvement is the first symptom of the disease its diagnosis and management may be delayed, which may entail severe consequences for immunocompromised patients. It is therefore that we suggest its inclusion in the algorithm for immunocompromised patients with abdominal pain and ulcer-like endoscopic lesions (AU)
Assuntos
Humanos , Varicela/complicações , Herpesvirus Humano 3/patogenicidade , Gastrite/virologia , Hospedeiro Imunocomprometido , Úlcera Gástrica/virologia , Dor Abdominal/etiologia , Leucemia/complicações , Linfoma não Hodgkin/complicaçõesRESUMO
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Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma/diagnóstico por imagem , Esôfago de Barrett/complicações , Neoplasias Esofágicas/patologia , Ácido Acético/uso terapêutico , Biópsia , Ressecção Endoscópica de Mucosa/métodosRESUMO
Aim: the adenoma detection rate is the quality indicator of colonoscopy that is most closely related to the development of interval colorectal cancer or post-colonoscopy colorectal cancer. However, the recording of this indicator in different units of gastrointestinal endoscopy is obstructed due to the large consumption of resources required for its calculation. Several alternatives have been proposed, such as the polyp detection rate. The objective of this study was to evaluate the relationship between the polyp detection rate and its influence on post-colonoscopy colorectal cancer rate. Patients and methods: in this study, 12,482 colonoscopies conducted by 14 endoscopists were analyzed. The polyp detection rate was calculated for each endoscopist. Endoscopists were grouped into quartiles (Q1, Q2, Q3, and Q4), from lowest to highest polyp detection rate, in order to evaluate whether there were any differences in the development of post-colonoscopy colorectal cancer. Results: the lowest polyp detection rate was 20.66% and the highest was 52.16%, with a median of 32.78 and a standard deviation of +/- 8.54. A strong and positive association between polyp endoscopy diagnosis and adenoma histopathology result was observed and a linear regression was performed. A significantly higher post-colonoscopy colorectal cancer rate was observed in the group of endoscopists with a lower polyp detection rate (p < 0.02). Conclusion: polyp detection rate is a valuable quality indicator of colonoscopy and its calculation is much simpler than that of the adenoma detection rate. In our study, the prevalence of post-colonoscopy colorectal cancer was inversely and significantly related to the endoscopists' polyp detection rate
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Assuntos
Humanos , Pólipos do Colo/diagnóstico por imagem , Colonoscopia/métodos , Neoplasias Colorretais/diagnóstico por imagem , Detecção Precoce de Câncer/métodos , Pólipos do Colo/patologia , Colonoscopia/estatística & dados numéricos , Neoplasias Colorretais/patologia , Sensibilidade e Especificidade , Lesões Pré-Cancerosas/diagnóstico por imagem , Estudos RetrospectivosRESUMO
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Assuntos
Humanos , Masculino , Adulto , Hepatite B/tratamento farmacológico , Interferon-alfa/farmacocinética , Vírus da Hepatite B/patogenicidade , Carga ViralRESUMO
La tuberculosis es una entidad frecuente en todo el mundo. En los países desarrollados se describía hasta hace unos años un descenso en su incidencia, pero debido al aumento de flujos migratorios y a la aparición del sida, se ha detectado un notable aumento en su frecuencia en los últimos tiempos. A pesar de que la localización clásica con afectación pulmonar continúa siendo la forma de presentación más comunicada, se ha descrito un incremento en el diagnóstico en otras localizaciones. La afectación de otros órganos y aparatos, como el sistema muscular esquelético, el genitourinario, el neurológico o el abdominal, ha dejado de ser infrecuente. La abdominal es una localización extrapulmonar cada vez más frecuente, zona en la que se ha descrito una afectación de diversas estructuras: cadenas linfáticas mesentéricas, intestino delgado, peritoneo, hígado y bazo. La afectación pancreática es una entidad muy infrecuente
Tuberculosis is a common infection worldwide. In developed countries, the incidence of this disease was low until a few years ago. However, due to the rise in immigration and HIV infection, the frequency of tuberculosis has recently shown a marked increase. Although the most frequent location of tuberculosis infection continues to be respiratory, infection in other sites, such as musculoskeletal, genitourinary, neurological and abdominal areas, has recently become more common. Abdominal infection, the most frequently described extrapulmonary localization, commonly affects the spleen, liver, ileocecal region, peritoneum, and regional lymph nodes. Tuberculosis of the pancreas is considered a rare entity (AU)
Assuntos
Humanos , Masculino , Adulto , Tuberculose/diagnóstico , Fístula Intestinal/diagnóstico , Pancreatopatias/diagnóstico , Mycobacterium tuberculosis/isolamento & purificação , Mycobacterium tuberculosis/patogenicidade , Infecções por HIV/complicações , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Biomarcadores/análiseRESUMO
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