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M Castro-Fernández

Publications and source records attributed to M Castro-Fernández.

10 recordsLinked to original sources
PubMed2006

Recurrence of Helicobacter pylori infection after several eradication therapies: long-term follow-up of 1000 patients.

AIM: To study the incidence of Helicobacter pylori recurrence, its chronological aspects, and the variables that might influence it. METHODS: A total of 1000 patients in whom H. pylori had been eradicated were prospectively studied. Therapies were classified as low and high efficacy regimens. Four to eight weeks after completion of therapy, 13C-urea-breath-test was performed, and it was repeated yearly up to 5 years. In some patients, endoscopy with biopsies was also performed to confirm H. pylori eradication. RESULTS: A total of 1000 patients were included, giving 2744 patient-years of follow-up. Seventy-one H. pylori recurrences were observed (2.6% per patient-year). Probability of being H. pylori-negative at 1 year was 94.7%, and at 5 years 90.7%. In the multivariate analysis, low age (OR: 1.84; 95% CI: 1.04-3.26) and low efficacy therapies (OR: 2.5; 1.23-5.04) correlated with 1-year H. pylori recurrence. Differences were observed when Kaplan-Meier curves were compared depending on age and therapy regimen. CONCLUSION: Risk of posteradication H. pylori recurrence is higher during the first year, which suggests that most recurrences during this period are recrudescence and not true reinfections. H. pylori recurrence is more frequent in younger patients and in those treated with low efficacy therapies, but is exceptional if high efficacy therapies are used, in which case post-therapy eradication can be safely confirmed at 4 weeks with 13C-urea-breath-test.

Amoxicillin↗
PubMed2006

[Influence of nonsteroidal antiinflammatory drugs in gastrointestinal bleeding due to gastroduodenal ulcers or erosions in patients with liver cirrhosis].

INTRODUCTION: Peptic ulcer disease, with or without complications, is more common in patients with liver cirrhosis than in the general population. Factors associated with portal hypertension are involved in its pathogenesis. The prevalence of Helicobacter pylori infection in patients with liver cirrhosis and the general population is similar. The aim of the present study was to determine the influence of nonsteroidal antiinflammatory drugs (NSAIDs) in the etiology of bleeding peptic ulcer disease in patients with liver cirrhosis. PATIENTS AND METHODS: We studied 35 patients with liver cirrhosis and gastrointestinal bleeding due to gastroduodenal ulcers or erosions (group A), 125 noncirrhotic patients with gastrointestinal bleeding due to gastroduodenal ulcers or erosions (group B), and 70 patients with liver cirrhosis who were admitted to hospital without gastrointestinal bleeding (group C). All patients were questioned about NSAID consumption, including aspirin, during the week prior to hospital admission. RESULTS: NSAID consumption was reported by 15 patients (42.8%) in group A, 102 patients (58.2%) in group B, and 6 patients (8.5%) in group C. Statistically significant differences were obtained when the results for group A were compared with those for group C. CONCLUSIONS: NSAID consumption in patients with liver cirrhosis without gastrointestinal bleeding was low (8.5%) and was much lower than that observed in patients with cirrhosis admitted to hospital for bleeding due to gastroduodenal ulcers or erosions (42.8%). As occurs in the general population, NSAIDs play a significant role in the pathogenesis of bleeding due to peptic ulcer disease in patients with liver cirrhosis and portal hypertension.

Aged↗
PubMed2004

Diagnosis of Helicobacter pylori infection in patients with bleeding ulcer disease: rapid urease test and histology.

INTRODUCTION: The endoscopic diagnosis of Helicobacter pylori infection in patients with bleeding peptic ulcer is limited by a decreased sensitivity in standard invasive tests, rapid urease test and histology. There is controversy about the convenience of using one, neither, or both diagnostic tests. AIMS: To evaluate the results of simultaneously performed rapid urease test and histology in the diagnosis of Helicobacter pylori infection (H. pylori) in patients with bleeding peptic ulcer. PATIENTS AND METHODS: We included 173 patients, 98 male and 75 female, with an average age of 62 years (18-88), with upper gastrointestinal bleeding secondary to duodenal ulcer (115) or gastric ulcer (58), diagnosed within 24 hours after hospital admission. None of the patients had received treatment for H. pylori, proton pump inhibitors or antibiotics in the two weeks prior to the upper gastrointestinal bleeding episode. H. pylori infection was investigated in all patients by two antral biopsy samples for histological study (hematoxilin-eosin) and one or two antral biopsies for rapid urease test (Jatrox-H.p.-test). In cases with a negative urease test and histology, a 13C urea breath test was performed. Infection was considered present when at least one invasive test or the breath test was positive, whereas both invasive tests and the breath test had to be negative to establish an absent infection. RESULTS: 152 patients (88%) showed H. pylori infection, 104 patients (90%) with duodenal ulcer and 48 patients (83%) with gastric ulcer. In all 119 cases (78%) were diagnosed by the urease test and 112 cases (74%) by histology. Both methods were used to diagnose 134 of 152 cases (88%) (p < 0.05), these being positive in 97 cases and negative in 39 cases. In 18 of these 39 cases, the breath test was positive. CONCLUSIONS: Histology and urease test have similar diagnostic values for the identification of H. pylori in patients with bleeding peptic ulcer. Due to its rapid results, the urease test should be the method of choice. However, additional biopsies should be performed, and, when negative, a histological study should be carried out, since a combination of both methods allows a more precise diagnosis.

Adolescent↗
PubMed2002

The effectiveness of (IgG-ELISA) serology as an alternative diagnostic method for detecting Helicobacter pylori infection in patients with gastro-intestinal bleeding due to gastro-duodenal ulcer.

OBJECTIVES: To establish the sensitivity, specificity, positive predictive value and negative predictive value of serology (IgG ELISA) as an alternative diagnostic method for Helicobacter pylori infection in patients with gastro-duodenal peptic ulcer and digestive hemorrhage. The diagnosis of Helicobacter pylori infection in these patients is difficult due to the low sensitivity of invasive tests and the need to discontinue treatment with proton pump inhibitors to perform a breath test with urea 13C or the detection of Helicobacter pylori antigens in feces. PATIENTS AND METHODS: We included 214 patients (164 men and 50 women) with an average age of 58 +/- 15 years, who were admitted to hospital due to upper gastro-intestinal bleeding caused by a gastro-duodenal peptic ulcer. The presence of Helicobacter pylori was established by means of gastric biopsy (fast urease test histology and/or culture) and a breath test with 13C-labeled urea. Serology was performed with the ELISA method (Pyloriset EIA-G by Orion Diagnostica). Positive Helicobacter pylori infection was accepted with any positive invasive method or breath test, and no infection was established if all invasive tests performed and the breath test with 13C-labeled urea were negative. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of serology in the global series and in different subgroups of patients according to age (> 60 and < 40 years), recent exposure to non-steroidal anti-inflammatory drugs, type of endoscopic wound and history of gastro-duodenal peptic ulcer. RESULTS: 192 patients (89.7%) showed infection due to Helicobacter pylori. In the global series (n = 214) we obtained a sensitivity, specificity, positive predictive value and negative predictive value of 87.5, 54.5, 94.3 and 33.3%, respectively. Specificity was greater in the group not exposed to non-steroidal anti-inflammatory drugs (n = 110) as compared to the exposed group (n = 104), in the < 40 year old group (n = 28) with respect to the > 60 years group (n = 105), in the duodenal ulcer group (n = 141) with respect to the gastric ulcer group (n = 59), and in the group with a history of gastro-duodenal peptic ulcers (n = 92) as compared to the group without any of these past events (n = 122); nevertheless, no significant statistics were reached. CONCLUSIONS: IgG (ELISA) serology shows low specificity and a low negative predictive value in the diagnosis of Helicobacter pylori infection in patients with gastro-intestinal bleeding due to gastro-duodenal peptic ulcer. The diagnostic value of serology did not improve significantly when age, recent exposure to non-steroidal anti-inflammatory drugs, type of endoscopic wound or history of gastro-duodenal peptic ulcer was taken into consideration. We may consider that serology is not a good diagnostic method for the detection of Helicobacter pylori in patients with digestive hemorrhage caused by gastro-duodenal ulcer.

Adolescent↗
PubMedDate not supplied

[Carcinoid tumor of the ileum and self-limited colitis].

Carcinoid tumors of the ileum represent the most frequent localization of this type of tumor in the gastrointestinal tract. The association of this tumor with the presence of inflammatory bowel disease is well characterized. Self-limiting colitis is an entity that poses serious difficulties when performing a differential diagnosed by other causes of colitis. We present the case of a patient who was diagnosed with carcinoid tumor of the ileum. Clinical and histological findings of self-limiting colitis were also observed.

Barium Sulfate↗
PubMedDate not supplied

[The applicability of the International League Against Epilepsy classification. A retrospective study in a Uruguayan hospital].

INTRODUCTION: Epileptic seizures account for 30-40% of the visits to our department. A retrospective study was conducted in an attempt to classify epileptic syndromes and seizures according to the classification developed by the International League Against Epilepsy (ILAE). AIMS: The aim of this study was to verify the applicability of the ILAE's international classification in our population and to analyse the quality of the information contained in the clinical records, thus confirming the importance of having a standardised clinical record. PATIENTS AND METHODS: The clinical records of 352 children aged between 0 and 14 years, between 2000 and 2001, were analysed. The eligibility criterion was determined by the reason for visiting: epilepsy or seizures with an epileptic mechanism. Data was collected according to a protocol that was drawn up for this purpose. RESULTS: Of the 352 cases, 21.3% had febrile seizures; 13.6% had a single seizure; 4.5% had neonatal convulsions; 54.5% were cases of epilepsy and 6% could not be analysed due to a shortage of data. In all, 192 clinical records that satisfied the definition of epilepsy were analysed. Partial epilepsies accounted for 55%, 23% were symptomatic and 2% were cryptogenetic. It was found that 10% of the generalised epilepsies were idiopathic. CONCLUSIONS: Despite the shortcomings in the documentation, the international classification was applicable to our population, as has been the case in other centres. Nevertheless, we came up against some problems, and therefore include some of the more notable points from the current discussion about classifications. We highlight the need to establish a standardised clinical record and to use computer systems to record epileptic patients. Although there were certain limitations, 81.3% of the epilepsies were classified and we therefore give some consideration to the new proposals for classification.

Adolescent↗