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J M García Montes

Publications and source records attributed to J M García Montes.

13 recordsLinked to original sources
PubMed2003

Measuring colonic transit time in chronic idiophatic constipation.

INTRODUCTION AND OBJECTIVES: Colonic transit time can define three types of delay: right colon (colonic inertial), left colon and recto sigmoid. The aim of this study is to compare clinic characteristics and manometric results among the different groups with segmental colonic transit disorder. PATIENTS AND METHODS: 61 subjects were included in our study (5 men and 56 women) with and average age of 47.5 years (range: 17-84 years). We carried our a study of segmental and total colonic transit time, with the use of radio-opaque markers and sequential abdominal X-rays. We considered that transit time was prolonged when it was longer than 72 hours, and segmental transit time, when right colon was longer than 22 hours, left colon 37.2 hours and recto-sigmoid 37.2 hours. We included different clinic data: age, sex, place of residence stool frequency, abdominal pain, painful evacuation, incomplete evacuation, evacuation desire, dietary fibre intake, use of laxatives. We practised anorectal manometry in 20 patients. RESULTS: The average total colonic transit time was 38.2 hours in normal transit and 103 hours with disorder. The frequency in the three colonic segments, when there was a long total colonic transit time, was: 40% in the left colon, 33% in the recto-sigmoid and 27% in the right colon. We analysed the clinical characteristics of these three groups, finding more frequency of painful evacuation and defecation desire and lower dietary fibre intake in recto sigmoid. The most important abnormality in anorectal manometry was the hiposensitivity in the anorectal area, that only appeared in subjects with long segmental transit time in the right colon (colonic inertia), statistically significant. CONCLUSIONS: The measurement of colonic transit time with radio-opaque markers is a simple technique that allows for the objective detection of the different groups of patients with chronic idiopathic constipation. The exact typification of the abnormality is important for the individualization of each treatment.

Adolescent↗
PubMed2003

Hepatic encephalopathy: nomenclature, pathogenesis and treatment.

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome in patients with liver failure and/or a portal-systemic bypass. Since 2002 a new nomenclature of HE exists, that classifies HE in encephalopathy type A (associated with acute liver failure), type B (associated with portal-systemic bypass), and type C (associated with liver cirrhosis). HE type A is characterized by a rapid development to coma, cerebral edema, and a poor short-term prognosis. Therefore, these patients should be referred to a liver transplantation center. Standard treatment of HE consists of non absorbable disaccharides, non absorbable antibiotics, and a diet with an appropriate amount of proteins. In addition, the possibility of performing a liver transplantation should be evaluated. In patients with intractable HE other alternative treatments adjunct to standard treatment, like zinc, sodium benzoate, ornithine aspartate, branched chain amino acids, flumazenil, and bromocriptine should be considered.

Anti-Bacterial Agents↗
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

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↗
PubMed1998

[Usefulness of ultrasonography in the diagnosis of portal hypertension].

Portal hypertension syndrome is a common evolutive complication of several hepatic and extrahepatic diseases, being liver cirrhosis responsible for more than 80% of cases. When diagnosed it has prognostic value because of the high incidence of hemorrhagic, metabolic and infectious complications that these patients may develop. Clinical suspicion must be confirmed by objective complementary studies that provide information about the etiology and severity of the disease. In this review article we describe the contribution of ultrasonography in the evaluation of patients with portal hypertension as an objective diagnostic method and the usefulness of doppler ultrasound in the non-invasive hemodynamic assessment of the splanchnic and portal circulation.

Collateral Circulation↗
PubMed1996

[Isolated jejunal Crohn disease].

Crohn Disease (CD) is a chronic granulomatous inflammatory disorder of not well known etiology. It may affect the whole digestive tract, segmentally, from the mouth to the anus although the rectum is usually not involved. Digestive symptoms of CD depend on the location and extension of the disease, its fistulating or stenosing evolution as well as the presence of local or systemic complications. 40% of the patients affected with CD have simultaneous terminal ileal and colonic involvement, 30% have terminal ileitis and 25% have granulomatous colitis. Isolated esophageal, gastroduodenal and perianal affection reach no more than 5% of the patients. We describe a case of a patient affected with CD with isolated jejunal involvement who was admitted to the hospital because of iron deficiency anemia and bowel subocclusion as an atypical clinical manifestation of the disease. After surgical resection of the affected segment of the bowel, the patient became asymptomatic up to now.

Anemia, Hypochromic↗
PubMed1989

[A comparative cross-over study of pellet pancreatin and tablet pancreatin in chronic pancreatitis].

We have made a comparative cross study of 30 patients with chronic pancreatitis and steatorrhea. The aim of the study has been to compare the effectiveness of a new galenic form of pancreatin, in pellets, with the common galenic presentation, in tablets. In all the cases the cause of pancreatic failure was alcoholism. In both groups the treatment was administered during seven days, after a period of wash out. We evaluated steatorrhea and clinical symptoms, including the typical abdominal pain. (The doses administrated were 12 tablets/day or 9 pellets/day.) Statistically there was a significant decrease of steatorrhea p less than 0.01.

Abdominal Pain↗
PubMed1989

[Serum determination of N-terminal peptide of type III procollagen as a marker of fibrotic activity].

Among the noninvasive methods proposed for the study of collagen metabolism as an of fibrosis and inflammation, the most widely accepted method is quantitation in serum of the N-terminal peptide of type III procollagen (P-III-Ps). We measured this variable in 87 subjects classified into five study groups: 19 controls (C), 18 alcoholics (E), 15 patients diagnosed as liver cirrhosis (CH), 11 chronic liver disease (HC) and 24 pregnant women (EMB). In our environment, the serum level of P-III-P in the healthy population was 9.12-12.8 ng/ml. In 27.77% of the alcoholics studied (5 cases) the mean value exceeded this level, 19.35 +/- 3.05 ng/ml. Forty percent of the cirrhotics (6 cases) presented the highest values, 26.54 +/- 11.45 ng/ml, while 83.33% of the patients with chronic active hepatitis presented a mean value of 18.53 +/- 3.8 ng/ml. Of the 24 pregnant women, 95.83% (23 cases) had higher than normal values, and concentrations roses in the last trimester of gestation with respect to the previous trimesters. Analysis of the correlations of all the biochemical parameters of liver function with P-III-Ps disclosed a relationship between P-III-Ps and alkaline phosphatase in the groups of cirrhotics and chronic persistent hepatitis (p less than 0.05). We conclude that the N-terminal peptide of type III procollagen is a useful marker of active fibrosis.

Adult↗
PubMed1989

[Anorectal melanoma].

Anorectal melanoma is a malignant lesion constituted by melanoma-producing cells which has a very poor prognosis. It is a rare proctologic pathology, representing 0.5-1% of anorectal tumors. It is predominant in females and in the sixth and seventh decades of life. The evolution is more benign in elderly patients due to hormonal factors. The diagnosis is histological and the treatment is surgery, with radical resection being suggested for shallow lesions, and local excision if lesions are deep and the disease is disseminated. We present a case of anorectal melanoma in a 76-year-old woman which had an unusual location on the right anterolateral face of the rectal ampulla. The histological study demonstrated the presence of intracytoplasmatic melanin deposits (Fontana-Mason stain). Abdominoperineal resection of the anus and rectum was performed, confirming the absence of lymph node or hepatic involvement.

Aged↗