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A Caunedo Alvarez

Publications and source records attributed to A Caunedo Alvarez.

9 recordsLinked to original sources
PubMed2002

Role of capsule endoscopy in the management of patients with obscure gastrointestinal bleeding.

The recent emergence of capsule endoscopy has entailed a relevant diagnostic imaging advance for gastrointestinal conditions, especially those involving the small bowel. Gastrointestinal haemorrhage of obscure origin is probably the most widely accepted indication for this new technique, and promising results have been reported from series extant to date. In view of data available on this new modality, and looking forward to having wide, well designed studies fr corroboration, this paper suggests a tentative algorithm for the management of this patient group.

Algorithms↗
PubMed2001

Utility of the endo-rectal ultrasonography with sectorial transducer in the study of rectoanal pathology.

OBJECTIVE: Assessing the usefulness of endorectal ultrasonography with a sectorial transducer to diagnose and determine the degree of rectoanal disease. MATERIAL AND METHODS: We used a 5 MHz sectorial echographic transducer to study 61 successive patients, 22 of them with a suspicion or diagnosis of anorectal neoplasia (group I); 25 with perianal suppurating disease (group II); 9 with faecal incontinence (group III) and 5 with chronic idiopathic anal disease (group IV). RESULTS: In group I, 3 patients (13.63%) were sent to us with a suspicion of anorectal cancer which was not confirmed for any of them. For other 3 patients (13.63%) we had to rule out a neoplastic relapse which was only confirmed in one case; in 16 patients (72.72%) we had to establish tumour stage, which we achieved in 81.25% of cases. In group II, 2 patients had Crohn's perianal disease (8%), 10 patients showed a perianal abscess (40%) and 13 (52%) individuals had fistula tracts whose internal orifices could be found in 53.84% of cases. In all patients sent with faecal incontinence (group III) we could delimit sphincter interruption. A sphincter abscess was found in one of the 5 patients sent to us with chronic idiopathic anal pain, although it had not been diagnosed before. CONCLUSIONS: Sectorial endorectal ultrasonography is a very useful technique in the study of tumour and rectoanal suppurating diseases, as well as of faecal incontinence. It is also of great importance for patients with chronic idiopathic anal pain.

Adolescent↗
PubMed2001

Wireless endoscopy.

Wireless endoscopy consists of a small-sized device which allows gastrointestinal tract images to be taken as it physiologically advances along its lumen after being orally ingested. Its primary contribution is the study of small bowel conditions, a gastrointestinal tract segment in which diagnosis difficulties still arise when using current tests, including enteroscopy. Preliminary studies in animals and healthy subjects have revealed data on image quality, sensitivity, specificity, and safety that demonstrate the benefits of this new technique. This review discusses technical aspects, indications and contraindications, as well as studies reported so far on this endoscopic diagnostic procedure.

Endoscopes, Gastrointestinal↗
PubMed2001

Use of recombinant factor VII in hepatology.

Understanding the key role of factor VII (FVII) in the cascade of blood coagulation has led to consider its administration as an effective treatment for selected situations with altered haemostasis. Advances in genetic engineering have made it possible to obtain this factor by recombinant techniques (rFVII), rendering it both safe and widely available as a haemostatic treatment. So far, it has been commonly used for haemophilic patients with inhibiting antibodies against factors FVIII-FIX, but its use is currently extending to other areas. The presence of decreased FVII levels in patients with advanced, chronic liver disease has recently raised an interest in the study of this molecule as a new therapeutic option in the field of Hepatology. This paper will discuss the characteristics, indications, and studies existing to this day on the use of rFVII, particularly in cirrhotic patients.

Blood Coagulation Disorders↗
PubMed1999

Deflazacort for long-term maintenance of remission in type I autoimmune hepatitis.

OBJECTIVE: most patients with autoimmune hepatitis require long-term treatment, but up to 80% of them will develop collateral effects. The aim of this study was to evaluate the efficacy of deflazacort, an oxazolinic derivative of prednisolone with fewer effects on bone and glucose metabolism, in the maintenance of remission of type I autoimmune hepatitis in patients treated previously with conventional immunosuppressive therapy. METHODS: fifteen patients with type I autoimmune hepatitis were included. All patients had been treated previously with prednisone with or without azathioprine until biochemical remission was obtained and the dose could be reduced. Prednisone was then discontinued and deflazacort was started at a dose adjusted to a ratio of 5 mg prednisone per 7.5 mg deflazacort. The biochemical activity (serum ALT and IgG levels) of liver disease was monitored during a follow-up period of 25.8 +/- 7. 7 months. RESULTS: prednisone therapy was followed by a statistically significant decrease in serum ALT (0P: 386 +/- 345 U/L vs 2M 80 +/- 22 U/L, p < 0.02) and IgG (0P 3029 +/- 1934 mg/dL vs 2M 2064 +/- 933 mg/dL, p < 0.05), from the second month of treatment. After changing to deflazacort no alterations in ALT and IgG serum levels were detected except for a mild, transient increase in serum IgG during the first 3 months. During follow-up, 94% of the patients had normal or slightly increased (less than 50% above normal) ALT levels. The titers of ANA and ASMA remained the same in 82% of the patients, decreased in 12%, and increased in the remaining 6%. During follow-up no patient developed arterial hypertension, diabetes mellitus, or changes in visual acuity. Eight patients, all women, complained of dorsolumbar pain which was not related to osteoporosis. CONCLUSIONS: deflazacort seems to be useful in maintaining remission of autoimmune hepatitis during a prolonged period of follow-up. Future studies should include a histological evaluation of the patients and a prospective comparative analysis of side-effects.

Adolescent↗
PubMedDate not supplied

[The assessment of colonic polyps found via colonoscopy].

AIM: To evaluate the histopathological characteristics of colonic polyps, found during colonoscopy examination and endoscopic polypectomy, and their relation to age, tumor location, sex, histological type and degree of epithelial dysplasia. MATERIAL AND METHODS: Between 1996 and 1997, 2,465 total colonoscopies were performed at the Gastroenterology Department of the Virgin Macarena University Hospital in Seville. Different size polyps were found in 318 patients who had been referred because of several symptoms/by several centers. The mean age was 59.2 years in men and 61.5 years in women. RESULTS: 446 polyps were removed by endoscopic polypectomy, 32 (7.2%) were hyperplastic polyps, 402 were adenomas (90.2%) and 12 (2.6%) were adenomas with adenocarcinoma. Seventy-five percent of adenomas were located in the left colon and rectum and 25% in right colon. Hyperplastic polyps were found in left colon. Of the polyps removed, 55.1% were smaller than 1 cm, 26.5% were between 1 and 2 cm and 18.4% were between 2 and 7 cm. Histopathologic study of adenomas revealed that 17% were villous adenoma, 80% were tubular adenomas and 3% were tubulovillous adenomas. Adenocarcinomas were found in 12 (2.8%) adenomas. Of the adenomatous polyps, 87.4% had low-grade dysplasia and 12.6% high-grade dysplasia. Statistical analysis showed a strong correlation between size of adenoma and degree of dysplasia (p < 0.05). Similar significant relation was found between histological type and size (p < 0.05) but there were no statistically significant differences between location, sex or age, and degree of dysplasia (p < 0.05). CONCLUSIONS: Size of colonic polyps is related to epithelial dysplasia and histological type (p < 0.05). No correlation was found between location, sex or age and degree of dysplasia.

Adenocarcinoma↗