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D del Pozo

Publications and source records attributed to D del Pozo.

10 recordsLinked to original sources

[Autoimmune hepatitis with prolonged IGM antibodies to HAV. Are serological markers reliable in ruling out a diagnosis of autoimmune hepatitis?].

We present the case of a 44-year-old woman who was referred to us for jaundice, choluria and acholia. Review of the patient's clinical history revealed that tests for hepatitis A virus (HAV) IgM antibody had been positive 4 and 2 years previously and continued to be so. The patient showed a score of 16 in the International Autoimmune Hepatitis Group's system when the HAV marker was not taken into account and a score of 13 when this marker was taken into account. The persistence of this viral marker for so many years in such patients is probably associated with polyclonal hypergammaglobulinemia. Consequently, we believe that the inclusion of this antibody as a negative datum in the diagnosis of autoimmune virus should be viewed with caution.

Adult↗

[Evolution and treatment response in microscopic colitis].

AIM: To study the clinical characteristics, treatment response and evolution in patients with microscopic colitis. MATERIAL AND METHODS: We performed a retrospective analysis of 24 patients (15 with collagenous colitis and 9 with lymphocytic colitis). Clinical and diagnostic features, treatment response and evolution according to the presence of maintenance therapy were evaluated. RESULTS: The mean age of the patients was 59.7 years and most were male. Nine patients took non-steroidal anti-inflammatory drugs (NSAID). No significant association was found with other drugs. Four patients presented associated rheumatological disease. Most patients presented insidious-onset diarrhea without pathological products, which was frequently associated with other symptoms (abdominal pain, bloating, weight loss, asthenia, tenesmus, and incontinence). Seven patients showed a slight increase in globular sedimentation rate. Fat in stools and radiological investigations (transit and opaque enema) were normal in patients who underwent these tests. Endoscopy revealed non-specific alterations in 42% of the patients while results were normal in the remaining patients. One patient showed clinical improvement on withdrawal of NSAIDs and 4 patients improved spontaneously. Clinical response was achieved in 7 of 13 patients treated with antimotility drugs, in 8 of 9 patients treated with salicylates, in 3 treated with oral corticoids, in 1 treated with cholestyramine and in 1 treated with topical budesonide. Nineteen patients required no maintenance therapy, 4 were administered salicylates and 1 was administered cholestyramine. After a mean follow-up of 42 months, evolution was chronic and intermittent in 14 patients and chronic and continuous in 1; 9 patients presented a single episode. No significant differences were found between patients administered maintenance therapy and those who were not or between collagenous colitis and lymphocytic colitis in the parameters analyzed. CONCLUSIONS: Microscopic colitis constitutes a group of diseases characterized by chronic diarrhea, few systemic effects and minimal radiological and/or endoscopic alterations. Evolution is characterized by recurrent episodes, with good response to treatment with cholestyramine, salicylates or corticoids when required.

Adult↗

[Collagenous colitis: an entity with diverse therapeutic options].

Collagenous colitis is a disorder which has been diagnosed with increasing frequency in the last few years, probably due to the routine obtention of colon biopsy specimens in the study of patients with chronic diarrhoea. Good responses have been reported with a number of therapies, although only a scarce number of clinical trials have been performed, partly because of the small number of patients studied. Two cases of collagenous colitis with different therapeutic approaches are here reported. All medical therapy options for this interesting disorder are reviewed.

Administration, Topical↗

[Idiopathic chronic pancreatitis (with diffuse stenosis of Wirsung's duct) in ulcerative colitis].

We describe a case of chronic idiopathic pancreatitis associated with ulcerative colitis. Pancreatitis is a rare extra-intestinal manifestations of inflammatory bowel disease. Chronic idiopathic pancreatitis associated with ulcerative colitis are usually painless, without calcification, with stricture of the main pancreatic duct and with severe exocrine pancreatic insufficiency.

Chronic Disease↗

Post-traumatic transient cortical blindness.

Five patients: three children, one adolescent, and one young adult, examined in an emergency room setting were diagnosed with post-traumatic transient cortical blindness. This syndrome is characterized by transient visual loss, normal pupillary response and normal funduscopic examination following minor head trauma. In each case, vision returned to normal within minutes to hours following injury, leaving no neurological sequelae. Headache, confusion, irritability, anxiety, nausea and vomiting were the most common related symptoms. While the mechanism responsible for the transient blindness is unknown, most authors propose an abnormal vascular response to trauma with resultant transient hypoxia and cerebral dysfunction. The similarity between the symptoms accompanying this syndrome and those seen during a classic migraine attack has led many investigators to suggest a common underlying pathophysiology. The purpose of this report is to highlight the salient clinical features and diagnostic approaches to this syndrome, thereby providing ophthalmologists and emergency room physicians a heightened awareness of this entity and the means to detect it.

Adolescent↗

Epidural anesthesia in a patient with single ventricle.

BACKGROUND AND OBJECTIVES: Single ventricle is a complex congenital cardiopathy characterized by a unit ventricular chamber. Changes of the cardiovascular system in response to epidural anesthesia in these patients have yet to be clearly elucidated. METHODS: A 26-year-old man with single ventricle underwent an orchiopexy under lumbar epidural anesthesia with intravenous sedation. RESULTS: Orchiopexy was successfully performed and the patient was discharged from hospital 4 days later. CONCLUSION: This case report emphasizes the issues of importance to anesthesiologists in regard to this cardiopathy and describes a successful technique of caring for a patient with a complex problem in an emergency situation.

Adjuvants, Anesthesia↗