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E Torrella

Publications and source records attributed to E Torrella.

4 recordsLinked to original sources

Double-balloon enteroscopy: a descriptive study of 50 explorations.

AIM: To evaluate the utility of double-balloon enteroscopy for small-bowel disease. DESIGN: A prospective study of 50 consecutive enteroscopies performed from December 2004 to July 2005 to analyze diagnoses and treatments. PATIENTS: 44 patients (33 had undergone a previous capsule endoscopy) with indications for obscure digestive hemorrhage, angiodysplasia, Peutz-Jeghers syndrome, ulcer, suspected Crohn's disease, tumors, and refractory celiac disease. RESULTS: We carried out enteroscopy studies in 44 patients by the oral route and, in 6 additional patients, by both the oral and anal routes. We reached the ileon with the oral route in all cases but one (jejunal stenosis), and in 4 cases out of 7 with the anal route, with an average duration of 73 minutes. We found angiodysplasia in 19 cases, as well as NSAID-related enteropathy, Crohn's disease, diverticulosis, and Waldenström's disease. We performed biopsies in 31% of cases with diagnoses of adenocarcinoma, lymphangiectasia secondary to tumor in celiac disease, and Whipple's disease. We treated 19 patients with angiodysplasia (1 to 20 synchronous lesions) with argon, and 4 patients with polyps using polipectomy (sporadic polyps or Peutz-Jeghers syndrome). A retained capsule in one patient with stenosis was removed. CONCLUSIONS: Double-balloon enteroscopy is a useful and effective technique in the diagnosis and treatment of small intestine diseases, thus complementing capsule endoscopy. More studies are needed to analyze its impact on the management of this condition.

Capsules↗

Hepatitis C in liver transplant patients.

The aim of this study was to determine whether infection by the hepatitis C virus (HCV) recurs after orthotopic liver transplantation (OLT) and to define the natural history of post-transplantation chronic hepatitis due to HCV. Of 70 patients, 10 (14.3%) were found to have antibodies to HCV before transplantation. After OLT 14 of the 70 patients (20%) had positive anti-HCV antibodies: 8 of 10 positive pre-OLT (80%) and 6 of 60 negative pre-OLT (10%). Of 14 patients anti-HCV+ post-OLT (57%), developed 8 chronic hepatitis: chronic persistent hepatitis in three patients, chronic lobular hepatitis in three patients and chronic, active hepatitis in two patients. We treated four patients with interferon obtaining normalization of transaminases in three of them after 6 months, but with a severe relapse in two. These results suggest that hepatitis C recurs in a majority, of liver transplant recipients and that morbidity is an important consideration. Interferon treatment of these patients requires further study to obtain conclusive results.

Adolescent↗

[Quality of life of cirrhotic patients before and after liver transplantation].

In this study we assessed the quality of life of a group of cirrhotic patients who underwent liver transplant using a psychological test to evaluate family relations, work activity, emotional state and social relations. The quantification of hospital dependence and degree of fitness for work, before and after the transplant were also analyzed. 32 patients were included in the study with the diagnosis of hepatic cirrhosis and minimum post-transplant follow-up of 6 months. The average age of the study population was 44.8 +/- 10.5 years; there were 23 males and 9 females, with an average follow-up of 15 months. The psychological test used was the Quality of Life Scale (QLS), which consists of 21 items, each scoring from 1 to 6 points. The questionnaire was completed before the transplant by all the patients, and after the transplant by 32 patients at 6 months, 20 at 12 months and 12 at 24 months. Hospital dependence was evaluated by number of admissions and number of days per admission. Lastly, we compare the rate of unfitness for work before the transplant and at one and two years after the transplant. The QLS test showed a post-transplant improvement in the 4 aspects assessed, specially in the personal aspects (emotions and family) (p < 0.001). Hospital dependence following pre-transplant situation (p < 0.01). Finally, the post-transplant percentage of unfitness for work decreased with time, reaching significant differences 2 years after the liver transplant (p < 0.05).

Adult↗