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Search Results: 1 - 10 of 189835 matches for " Susana de la; Mu?oz-Navas "
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Herpetic esophagitis: a case report on an immunocompetent adolescent Esofagitis herpética: presentación en adolescente inmunocompetente
Susana de la Riva,Miguel Muoz-Navas,Iago Rodríguez-Lago,Juan Carrascosa
Revista Espa?ola de Enfermedades Digestivas , 2012,
Abstract: Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected clinically by an acute onset of symptoms, and without apparent cause of a symptomatic triad consisting on odynophagia, heartburn and fever. Its occurrence may be due to reactivation of a previous infection or less often a primary infection. Herpes simplex type 1 is the most common cause. Upper endoscopy establishes the diagnosis of suspicion of herpetic esophagitis. It also allows to take multiple biopsy samples and viral culture, leading to a definitive diagnosis. The severity of symptoms is related to the degree of oesophageal involvement. In immunocompromised patients treatment is indicated with acyclovir, but the indication in immunocompetent patients is controversial because the process is time, limited with a low probability of complications. We present a case of acute herpetic esophagitis in an immunocompetent host that debuted acutely with severe upper gastrointestinal tract symptoms, associated with an insidious and non-specific onset of flu-like symptoms. Endoscopic findings showed a severe involvement in the lower third of the oesophageal mucosa. La esofagitis herpética en individuos inmunocompetentes, es una entidad rara, que debe de sospecharse clínicamente por el inicio agudo, y sin aparente causa, de una triada sintomática consistente en odinofagia, pirosis y fiebre. Su aparición puede deberse a una reactivación de una infección viral previa o con menor frecuencia a una primoinfección como tal, siendo el herpes tipo 1 el responsable en la mayoría de las ocasiones. La realización de una gastroscopia permite establecer el diagnóstico de sospecha de esta enfermedad y la toma de múltiples muestras para estudio histológico y cultivo viral, lo que lleva al diagnóstico definitivo. La severidad de los síntomas está en relación con el grado de afectación esofágica y aunque en los pacientes inmunocomprometidos el tratamiento con aciclovir está indicado, su administración en pacientes inmunocompetentes es controvertida puesto que se trata de un proceso autolimitado con baja probabilidad de complicaciones. Presentamos un caso de esofagitis herpética en un adolescente inmunocompetente, que debutó de forma aguda, con síntomas severos del tracto digestivo alto asociados a un comienzo insidioso que se atribuyó inicialmente a un proceso gripal. Los hallazgos endoscópicos muestran una importante y llamativa afectación de la mucosa esofágica en su tercio inferior y la toma de múltiples biopsias durante el procedimiento permitieron el diagnóstico.
Herpetic esophagitis: a case report on an immunocompetent adolescent
Riva,Susana de la; Muoz-Navas,Miguel; Rodríguez-Lago,Iago; Carrascosa,Juan; Idoate,Miguel ángel; Carías,Rafael;
Revista Espa?ola de Enfermedades Digestivas , 2012, DOI: 10.4321/S1130-01082012000400009
Abstract: herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected clinically by an acute onset of symptoms, and without apparent cause of a symptomatic triad consisting on odynophagia, heartburn and fever. its occurrence may be due to reactivation of a previous infection or less often a primary infection. herpes simplex type 1 is the most common cause. upper endoscopy establishes the diagnosis of suspicion of herpetic esophagitis. it also allows to take multiple biopsy samples and viral culture, leading to a definitive diagnosis. the severity of symptoms is related to the degree of oesophageal involvement. in immunocompromised patients treatment is indicated with acyclovir, but the indication in immunocompetent patients is controversial because the process is time, limited with a low probability of complications. we present a case of acute herpetic esophagitis in an immunocompetent host that debuted acutely with severe upper gastrointestinal tract symptoms, associated with an insidious and non-specific onset of flu-like symptoms. endoscopic findings showed a severe involvement in the lower third of the oesophageal mucosa.
Capsule endoscopy
Miguel Muoz-Navas
World Journal of Gastroenterology , 2009,
Abstract: Capsule endoscopy (CE) is a simple, safe, non-invasive, reliable technique, well accepted and tolerated by the patients, which allows complete exploration of the small intestine. The advent of CE in 2000 has dramatically changed the diagnosis and management of many diseases of the small intestine, such as obscure gastrointestinal bleeding, Crohn’s disease, small bowel tumors, polyposis syndromes, etc. CE has become the gold standard for the diagnosis of most diseases of the small bowel. Lately this technique has also been used for esophageal and colonic diseases.
Prevention or cure in times of crisis: the case of screening for colorectal cancer Prevenir o curar en época de crisis: a propósito del cribado de cáncer de colon y recto
Fernando Carballo,Miguel Muoz-Navas
Revista Espa?ola de Enfermedades Digestivas , 2012,
Abstract: Colorectal cancer is a serious health problem in which screening is capable of reducing both the mortality and the incidence of the disorder. Colonoscopy, the mainstay of this type of screening, allows to establish an early diagnosis and also to eliminate malignant precursor lesions. The screening test which is performed in Spanish programs is the determination of fecal occult blood using the immunochemical method which gives around 70% of positive values for colonoscopy for any type of neoplasia. As a result, in 2009 the National Health System set as an objective that these programs cover 50% of the population by 2015. It is well known that colon screening is highly cost effective with a ratio of around 2500€ per QALY, much lower than ratios of other programs. Only the direct costs of colon and rectal cancer in Spain can be estimated at more than one thousand million euros per year. Early diagnosis and the cancers avoided thanks to screening can reduce these costs by 40%. The impact that the introduction of this screening has on health services can be lessened if the indications for colonoscopy are followed adequately. In conclusion, there is no justification for not acting to prevent CRC and this is especially so in times of crisis as there is no better social cost invested than that which saves suffering, deaths and even money. El cáncer colorrectal es un grave problema de salud en el que el cribado es capaz de reducir su mortalidad e incidencia. La colonoscopia, acto central de este tipo de cribado, permite tanto el diagnóstico precoz como la eliminación de los precursores malignos que son los adenomas. La prueba de cribado que se realiza en los programas espa oles es la determinación de sangre oculta en heces por método inmunoquímico con lo que se consiguen valores predictivos positivos para la colonoscopia para cualquier tipo de neoplasia cercanos al 70%. Por todo ello, en 2009, el Sistema Nacional de Salud estableció el objetivo de un 50% de cobertura poblacional para 2015 para estos programas. Se sabe que el cribado de colon es altamente coste-efectivo con una ratio alrededor de los 2.500 euros por AVAC ganado, muy inferior al de otros programas. Solo los costes directos del cáncer de colon y recto en Espa a pueden estimarse en más de mil millones de euros anuales. El diagnóstico precoz y los cánceres evitados gracias al cribado pueden disminuir estos costes en un 40%. El impacto que sobre los servicios sanitarios tiene implantar este cribado puede atenuarse si se trabaja en la adecuación de las indicaciones de la colonoscopia. En conclusión, no
Recognition and management of hereditary colorectal cancer syndromes
Herráiz,M.; Muoz-Navas,M.;
Revista Espa?ola de Enfermedades Digestivas , 2009, DOI: 10.4321/S1130-01082009000200006
Abstract: over 1.900 colorectal tumors will arise in association with a hereditary colorectal cancer syndrome in spain in 2009. the genetic defects responsible for the most common syndromes have been discovered in recent years. genetic testing helps diagnose affected individuals and allows identification of individuals at-risk. colonoscopy and prophylactic colectomy decrease colorectal cancer incidence and overall mortality in patients with hereditary colon cancer. extracolonic tumors are frequent in these syndromes, so specific surveillance strategies should be offered.
Recognition and management of hereditary colorectal cancer syndromes Identificación y tratamiento de los síndromes de cáncer colorrectal hereditario
M. Herráiz,M. Muoz-Navas
Revista Espa?ola de Enfermedades Digestivas , 2009,
Abstract: Over 1.900 colorectal tumors will arise in association with a hereditary colorectal cancer syndrome in Spain in 2009. The genetic defects responsible for the most common syndromes have been discovered in recent years. Genetic testing helps diagnose affected individuals and allows identification of individuals at-risk. Colonoscopy and prophylactic colectomy decrease colorectal cancer incidence and overall mortality in patients with hereditary colon cancer. Extracolonic tumors are frequent in these syndromes, so specific surveillance strategies should be offered.
Nuevas aplicaciones de la cápsula endoscópica: PILLCAM TM ESO
Fernández-Urién,I.; Carretero,C.; Armendáriz,R.; Muoz-Navas,M.;
Anales del Sistema Sanitario de Navarra , 2007, DOI: 10.4321/S1137-66272007000500002
Abstract: capsule endoscopy has opened a new era in small bowel examination. its indications are now well-defined and currently, wireless capsule endoscopy is considered as the first-line imaging tool for the diagnosis of small bowel diseases. ece has been shown to be feasible, safe and a good alternative technique in patients refusing conventional endoscopy. although results reported in both gerd and cirrhotic patients are encouraging, great differences in terms of accuracy (particularly in gerd patients) have been found in published studies. these differences have been attributed to study designs, the lack of adequate experience and inconvenience of ingestion protocols. in summary, more large-scale studies evaluating the new 14-fps capsule, adequate ece-experience and new modified ingestion protocols are still needed.
Complications of percutaneous endoscopic gastrostomy-jejunostomy for levodopa/carbidopa infusion in advanced Parkinson's disease
Ana Olivares,David Collado,Miguel Muoz-Navas,Marta Calvo
Gastroenterology Insights , 2012, DOI: 10.4081/gi.2012.e4
Abstract: Continuous infusions of levodopa directly into the duodenum-yeyunum is an effective therapy to reduce daily off time in an advanced stage of Parkinson's disease, but it is not without complications, particularly device related problems. We present our experience in three Spanish hospitals with these complications, including a severe case with migration, several decubitus ulcers, and one case of perforation of the bowel and finally death.
Blue Rubber Bled Nevus syndrome: three cases Síndrome de Blue Rubber Bled Nevus: tres casos
M. Muoz-Navas,I. Fernández-Urién,E. Espinet,M. Betés
Revista Espa?ola de Enfermedades Digestivas , 2004,
Abstract:
Nuevas aplicaciones de la cápsula endoscópica: PILLCAM TM ESO New applications of Capsule Endoscopy: PILLCAM TM ESO
I. Fernández-Urién,C. Carretero,R. Armendáriz,M. Muoz-Navas
Anales del Sistema Sanitario de Navarra , 2007,
Abstract: La enteroscopia con cápsula abre una nueva era en el estudio de las enfermedades del intestino delgado. En estos momentos sus indicaciones están bien definidas y este procedimiento se ha convertido en una herramienta de primera línea en el estudio del intestino delgado. La esofagoscopia con cápsula se ha mostrado como una alternativa eficaz y segura en pacientes con sospecha de patología esofágica y en aquellos pacientes que no desean ser sometidos a una esofagoscopia convencional. No obstante y a pesar de que los resultados obtenidos hasta la fecha en pacientes cirróticos o con reflujo gastroesofágico son positivos, existen diferencias, en términos de rendimiento, entre algunos de los estudios publicados (fundamentalmente en pacientes con reflujo gastroesofágico). Estas diferencias pueden deberse al dise o de algunos estudios, a la ausencia de una adecuada experiencia con este nuevo procedimiento y finalmente, al protocolo de ingestión de la cápsula. Por todo ello, parecen necesarios nuevos estudios que incluyan series más amplias y cambios en el protocolo de ingestión de la cápsula, con el fin de confirmar los resultados obtenidos hasta la fecha. Capsule endoscopy has opened a new era in small bowel examination. Its indications are now well-defined and currently, wireless capsule endoscopy is considered as the first-line imaging tool for the diagnosis of small bowel diseases. ECE has been shown to be feasible, safe and a good alternative technique in patients refusing conventional endoscopy. Although results reported in both GERD and cirrhotic patients are encouraging, great differences in terms of accuracy (particularly in GERD patients) have been found in published studies. These differences have been attributed to study designs, the lack of adequate experience and inconvenience of ingestion protocols. In summary, more large-scale studies evaluating the new 14-fps capsule, adequate ECE-experience and new modified ingestion protocols are still needed.
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