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N Chopita

Publications and source records attributed to N Chopita.

At least 19 recordsLinked to original sources
PubMed2005

Endoscopic gastroenteric anastomosis using magnets.

BACKGROUND: Current management of malignant obstruction of the upper digestive tract includes surgical gastrointestinal bypass or endoscopic insertion of self-expandable metal stents. The safety, efficacy, and long-term patency rates of anastomoses created using the novel technique of endoscopic gastroenteric anastomosis using magnets (EGAM) are evaluated in this study. PATIENTS AND METHODS: 15 patients (13 men, 2 women; mean age 64.5 years) with malignant obstruction, who underwent EGAM and had monthly follow-up between December 2001 and May 2003, were included in this study. RESULTS: The procedure was successful in 13 patients (88.66 %). The mean survival was 5.23 months. There were four minor complications (30.76 %) during the follow-up period. CONCLUSION: Our results demonstrate the feasibility, safety. and efficacy of this technique for creating a gastroenteric anastomosis. The success rate was 86.6 %, there were no immediate complications, and there was no mortality related to the procedure.

Aged↗
PubMed2003

[Complications of endoscopic retrograde cholangiopancreatography].

INTRODUCTION: Endoscopic sphincterotomy (ES) is commonly used to remove bile-duct stones and to treat other problems. We prospectively investigated complications and mortality of endoscopic retrograde cholangiopancreatography (ERCP). PATIENTS AND METHODS: Between june 6, 1998 and june 6, 1999 553 ERCP were performed in our centers. Inclusion criteria for protocol were: ERCP indication, complete follow-up and informed consent. We prospectively studied complications of ECRP in consecutive patients treated at 2 institutions (San Martin Hospital, La Plata, Argentina and Hadassah University Hospital, Jerusalem, Israel). The follow-up was done during 365 days with a clinical examination, laboratory test and ultrasonography to determine the possible complications. RESULTS: Of 553 ERCP, 43 had a complications; including pancreatitis in 16 cases, cholangitis in 12, hemorrhage in 5, perforation in 3 and miscellaneous in 7. 3-1) ES frequency: 241 patients (pts). 3-2) FOLLOW-UP: 365 days in 504 pts. 3-3) Sex and age: women 274 pts, men 230 pts. Age range 1 month to 90 year old. 3-4) Final diagnoses: choledocholitiasis (38.8%), strictures (18%), pancreatic cancer (4.3%), ampullary cancer (2.3%) and normal ERCP (24.4%). CONCLUSIONS: The rate of complications after ES can vary in different circumstances and is primarily related to the indication for the procedure and to endoscopic technique. Our percentage of complications (7.53%) coincide with consulted studies. Today, diagnostic ERCP has been challenged by magnetic resonance cholangiography (MRC). MRC provides images of the billary and pancreatic ducts that are nearly equal to those of ERCP without the procedural risk associated.

Adolescent↗
PubMed2003

[Role of chromoendoscopy in colorectal polyps handling].

INTRODUCTION AND AIM: Endoscopic polipectomy and its further histopathologic study are current gold standard in diagnosis of colorectal polyps is. It was proposed that colonoscopy with high resolution videoendoscopes with or without magnification combined with indigo carmin dye (ICD) could distinguish between adenomatous and nonadenomatous polyps according to their pit pattern. The aim of this study was to establish sensitivity and specificity of chromoendoscopy with ICD using conventional videoendoscopes and fiber-endoscopes with videocamera, to make a differential diagnosis of polyp histology and their possible role in colon cancer screening. PATIENTS AND METHODS: Step 1: Using previous trial data, the first 20 polyps < = 1 cm was retrospectively correlated with their known histology to determine the pit pattern of each histologic type; this data was used in the step 2 patients. Step 2: 46 patients with colorectal polyps were enrolled in this prospective study. Polyps were sprayed with 0.4% ICD, after that the polyps were sorted into adenomatous or non, they were all removed and submitted for histophatologic evaluation. STATISTICAL ANALYSIS: The chi square method was used. RESULTS: 19 patients were evaluated with videoendoscopes (group 1) and 27 with fiberendoscopes (group 2); in seven cases the pattern of the polyps could not be identified and the patients were excluded. Group 1: coincidence prediction/histology 94.7% (p < 0.0001), sensitivity 100% and especificity 88%. Group 2: coincidence prediction/histology 65.8% (p < 0.05), sensitivity 86% and especificity 60%. CONCLUSIONS: Adenomatous and non-adenomatous polyps can be distinguished by chromoendoscopy with high sensitivity and specificity. However, because fiberendoscopy could ot be identify pit pattern in 15.2% and has a low negative predictive value we do not recommend to use it. Nevertheless, the results obtained with ideo-endoscopes involve potential usefulness in colon cancer screening and possible decrease in their risks and costs.

Adenomatous Polyps↗
PubMed2000

Efficacy of octreotide and sclerotherapy in the treatment of acute variceal bleeding in cirrhotic patients. A prospective, multicentric, and randomized clinical trial.

BACKGROUND: Sclerotherapy is the most widely used method for treatment of acute variceal bleeding. Previous reports have suggested that octreotide infusion is as effective as sclerotherapy. Our aim was to investigate the efficacy and safety of octreotide in comparison with sclerotherapy in controlling variceal bleeding. METHODS: Seventy-six cirrhotic patients were randomized to receive either sclerotherapy (n = 37) or octreotide (n = 39) infusion of 50 microg/h intravenously for 48 h after a bolus of 100 microg, followed by subcutaneous injection of 100 microg/8 h for an additional 72 h. RESULTS: The two groups were similar in base-line data. A similar initial control of bleeding was obtained in 94.6% for sclerotherapy and 84.6% for octreotide (NS). No difference was observed between sclerotherapy and octreotide in rebleeding (23% versus 33%) and treatment failure (22% versus 36%, respectively). Furthermore, the overall success of treatment was 78% for sclerotherapy and 64% for octreotide. No significant difference in mortality was observed between treatments (eight patients for octreotide and three patients for sclerotherapy, NS). CONCLUSIONS: These results show that both treatments present a very high and similar initial and final control of bleeding. However, there is a trend that could be clinically important towards better results in the patients treated with sclerotherapy.

Acute Disease↗
PubMed2000

High frequencies of telomeric associations, chromosome aberrations, and sister chromatid exchanges in ulcerative colitis.

OBJECTIVE: Chromosome instability provides a predisposing background to malignancy, contributing to the crucial genetic changes in multistep carcinogenesis. The aim of this work was to analyze chromosome instability in patients with ulcerative colitis (UC) to achieve a better understanding of the increased risk for colorectal cancer. METHODS: Peripheral blood lymphocyte cultures from 20 untreated UC patients and 24 controls were used to study chromosome instability by assessing telomeric associations (TAS), chromosome aberrations (CA), and sister chromatid exchanges (SCE). RESULTS: Mean frequencies of TAS and CA were significantly increased in UC patients compared to controls (p < 0.001). Chromosomes 10, 11, 21, 16, and 19 were the most frequently involved in TAS. A total of 104 CA clustered in 66 breakpoints could be exactly localized. Seven nonrandom bands significantly affected in UC patients were found (p < 0.004), showing a significant correlation with the location of cancer breakpoints (p < 0.003), particularly with colorectal carcinoma rearrangements. SCE analysis showed higher levels in patients compared to controls (p < 0.006), but no differences were observed in cell cycle kinetics. CONCLUSIONS: Our results demonstrate the presence of an unstable genome in UC patients that could be related to the cancer development observed in this disease.

Adolescent↗
PubMed2000

[Randomized prospective study to compare the efficiency between standard plastic and polyurethane stents in biliary tract malignant obstruction].

UNLABELLED: The aim of this paper is to compare the efficiency between standard plastic stents and polyurethane stents used in biliary tract malignant obstruction. The main problem of the plastic prosthesis is their early occlusion. On the other hand there is the hypothesis that due to the less porousness of the polyurethane surface, there might be lesser adherence and consequently a late occlusion. Thirty-eight patients in two groups of 19 were evaluated prospectively and at random in the Jerusalem Hadassah Hospital and the HIGA San Martín La Plata. They had biliary tract obstruction due to inoperable tumors. Biliary endoprosthesis (plastic standard or polyurethane 10 French diameter) were placed, according to the randomization, after a previous staging with clinical examination, laboratory analysis and images. The follow-up with the same parameters was monthly done. Twelve of the 38 patients were female and 26 male; age average 62.73 (range 81-49). The stents were placed in 17 patients with biliary cancer, 14 pancreatic cancer, 2 papila cancer, 2 gallbladder cancer with bile duct invasion and 3 liver metastasis with biliary tract compression. The clinical and laboratory parameters in 36 patients at 30 days improved. On the contrary, 2 (1 plastic standard and 1 polyurethane stent) did not improve. There were 29 deaths due to the basic illness and not related to the endoscopic method. The mean obstruction occurred at 12.76 weeks (range 32-4) in the standard stents and 12.05 (range 24-2) in the polyurethane ones. CONCLUSION: There were no significant differences in the two groups patients.

Aged↗
PubMed2000

[Treatment of pain in chronic calcifying pancreatitis with endoscopy and extracorporeal shock wave lithotripsy. A case report].

Abdominal pain is the most frequent symptom of chronic pancreatitis and may, on occasions, lead to great treatment problems. The case of a 56-years-old patient with idiopathic chronic pancreatitis calcifying who showed intracanalicular lithiasis is reported. Treatment with endoscopy and extracorporal shock wave lithotripsy (ESWL) was successful.

Abdominal Pain↗
PubMed2000

Evidence of chromosome instability in chronic pancreatitis.

In the current study we analyzed chromosome instability on peripheral blood lymphocytes cultured from 7 untreated patients with chronic pancreatitis (CP) by assessing telomeric associations (TAS), chromosome aberrations (CA) and sister chromatid exchanges (SCE). Seven healthy individuals were also analyzed. Mean frequencies of TAS were significantly higher in CP patients (X +/- SE: 11.00 +/- 2.37) compared to controls (1.00 +/- 0.30) (p<0.001). Chromosomes preferentially involved in TAS were: 9, 20, 16 and 21, being the most affected arms: 9p, 20q, 16p, 9q and 21q. All these terminal bands were coincident with cancer breakpoints (p<0.03), two of them (40%) were specifically associated to pancreatic carcinoma rearrangements. Three bands (60%) were coincident with oncogene location. The mean frequency of CA was significantly higher in patients (3.88 +/- 0.80) compared to controls (0.63 +/- 0.49) (p<0.001). Chromosomes 1, 2 and 13 were the most damaged. No specifically affected breakpoints were found. SCE analysis showed higher levels in patients (8.33 +/- 0.70) than in controls (6.62 +/- 0.34) (p<0.025), but no differences were observed in cell cycle kinetics. Our results clearly indicate that CP patients exhibit chromosome instability, showing the presence of an unstable genome that could be related to the cancer development observed in this disease.

Aged↗
PubMed1998

EsophaCoil: long-term results in 81 patients.

BACKGROUND: Cancer of the esophagus and gastric cardia cause progressive dysphagia. Half of patients are not amenable to surgical resection; of those who are, about 20% will suffer either from local recurrence or anastomotic strictures. Self-expandable metallic stents of diverse characteristics have been used in these clinical conditions. However, expandable metallic stents have several drawbacks: low radial force, migration, epithelial trauma, and tumor ingrowth. We herein report our long-term experience with EsophaCoil, a self-expandable esophageal metallic coil, in 81 patients. METHODS: From January 1993 to July 1996, 84 stents were placed in 81 consecutive patients (53 men and 28 women, mean age 69.8 years (range 40 to 90 years). 41 patients had esophageal squamous cell carcinoma, 32 adenocarcinoma of the esophagus and cardia, 5 mediastinal metastasis, 1 sarcoma, and 2 had benign esophageal strictures. Five patients had bronchoesophageal fistulas. Mean dysphagia score before treatment was 3.5, mean stricture length 6 cm. Most patients were hospitalized for at least 24 hours after stent implantation. Patients were followed and early and late complications were recorded. RESULTS: Stents were successfully placed in all patients. Dysphagia improved in 96% of patients (score dropped from 3.5 to 1.2). Mean patient survival after stent insertion was 4 months (range 0.5 to 20 months). Bronchoesophageal fistulas were closed in all 5 cases. Early complications occurred in 11 patients. These were severe in 3 (esophageal perforation) and mild in 8 patients (precordial pain lasting 24 to 48 hours). Late complications occurred in 18 patients and included migration to the stomach (5 patients), stent breakage (5 among the first 20 cases), food impaction (5), tumor overgrowth (2), and bleeding (1). CONCLUSIONS: In a long-term follow-up, EsophaCoil was effective in the palliative treatment of dysphagia caused by malignant esophageal strictures, including cases of fistulas, having low malfunction and migration rates. No tumor ingrowth was seen.

Adenocarcinoma↗
PubMed1996

[Endoscopic treatment of pancreas divisum].

The pancreas divisum is the most frequent congenital anomaly of the pancreas. It is caused by the absence of fusion in the dorsal and ventral pancreatic buds, so that most of the gland drains through the Santorini duct in the minor papilla. It has been suggested that the relative obstruction of the pancreatic pain and pancreatitis in these patients. According to this the treatment consists in facilitating the minor papilla drainage via surgery or endoscopy. Two endoscopic treatment cases are presented. In both pancreatic duct stent and further sphinterotomy were performed. This treatment and their follow-up are evaluated, coming to the conclusion that this method should be taken into account in the future, due to its viability and low morbimortality.

Adult↗
PubMed1994

[Expandable prosthesis of the biliary tract in malignant stenosis: initial experience].

The endoscopic or percutaneous placement of a stent in the palliative treatment of the malignant obstructions of the biliary tract is a very well established and accepted method in our country. In the last few years the placement of metallic stents has been preconized because they offer advantage over the standard ones. The first three cases where this type of material was used by our team are presented. Effectivity and facility of the method is demonstrated and no early complications were related to it. We make a critical analysis of the presentation world it be advisable to write about this analysis?

Aged↗
PubMed1993

[Endoscopic sphincterotomy. Complications and follow-up].

Between April 1981 and April 1991, there were 547 EPT performed, seventy-five of which had in situ gall bladder. They were performed in two groups, who were similar from the technical-anatomical point of view, and sociocultural background. The early morbidity showed 31 complications (5.6%). The most frequent ones were: perforation in 8 cases and haemorrhage in 5. Medical treatment, which included the endoscopic technique in 20 cases (3.7%) and surgical procedures in 11 cases (2.0%) was used. The mortality rate was 1.8% (10 cases), perforation (4) and cholecystitis (3) being the main causes. There were three deaths (0.5%) not related to the method. The morbi-mortality was not significantly increased by the complementary methods. After analysing the complications related to the cause of EPT performance, it was observed that they were more frequently produced in choledochal stones: 20 (3.6%), followed by choledochal and gall bladder stones: 7 (1.3%). However the mortality was 0.7% in the former and 0.5% in the latter. The morbi-mortality of the last two years is compared to that of the preceding ones. The follow-up was done in 114 (20.8%) of the cases with a marked difference between the high sociocultural group (76 cases) and the low one (36). Eighteen pathological cases were found (3.3%). The treatment of each complication in long term is shown.

Follow-Up Studies↗
PubMed1992

Pre-cancerous lesions of the oesophagus in Argentina: prevalence and association with tobacco and alcohol.

The prevalence of pre-cancerous lesions of the oesophagus and their association with alcohol and tobacco were examined in an endoscopic survey carried out in La Plata, Argentina. The study included 406 subjects over 15 years of age attending several gastroenterology clinics because of various gastrointestinal symptoms. Among males, the prevalence rates of chronic oesophagitis, epithelial atrophy and dysplasia were 42%, 3.8% and 2.4% respectively, and in females these prevalences were 36%, 2.5% and 0.0%. The presence of these pre-cancerous lesions was significantly associated with alcohol drinking and tobacco smoking.

Adolescent↗
PubMed1992

[Endoscopic sphincterotomy. Its complications and their follow-up].

Between April 1981 and April 1991, there were 547 EPT performed, seventy-five of which had in situ gall bladder. They were performed in two groups, who were similar from the technical-anatomical point of view, and sociocultural background. The early morbidity showed 31 complications (5.6%). The most frequent ones were:perforation in 8 cases and haemorrhage in 5. Medical treatment, which included the endoscopic technique in 20 cases (3.7%) and surgical procedures in 11 cases (2.0%) was used. The mortality rate was 1.8% (10 cases), perforation (4) and cholecystitis (3) being the main causes. There were three deaths (0.5%) not related to the method. The morbimortality was not significantly increased by the complementary methods. After analysing the complications related to the cause of EPT performance, it was observed that they were more frequently produced in choledochal stones: 20 (3.6%), followed by choledochal and gall bladder stones: 7 (1.3%). However the mortality was 0.7% in the former and 0.5% in the latter. The morbimortality of the last two years is compared to that of the preceding ones. The follow-up was done in 114 (20.8%) of the cases with a marked difference between the high sociocultural group (76 cases) and the low one (36). Eighteen pathological cases were found (3.3%). The treatment of each complication in long term is shown.

Argentina↗
PubMed1991

[Primary risk of hemorrhage due to esophageal varices in cirrhotic patients: significance of the associated endoscopic signs and hepatic functional reserve].

Significance of endoscopic findings associated to esophageal varices (Japanese Research Society for Portal Hypertension) and hepatic dysfunction (Child-Pough classification) as predictive factors of variceal bleeding in cirrhotic patients is analyzed. In a cooperative prospective experience 137 cirrhotic patients with esophageal varices were examined in the period May 1987/89: 83 out of them had never bled from their varices (VENS group) while 54 recently had (VES group). A highly significative association was found between variceal size over 3 mm (grade II-III) and bleeding: 96.3% vs. 34.9% in VENS group (p = 0.01); similar association was found with regard to endoscopic detection of "red signs": 92.6% in bleeding group vs. 20.5% in VENS one (p = 0.01). "Red signs" were found on grade II-III varices in 98.5% of cases, and this association were related to variceal bleeding in 75.5%. Hepatic dysfunction was not directly related to bleeding episodes but "red signs" endoscopic detection in VENS group increased with liver function deterioration: 9.1% in Child A class, 27.3% in Child B, and 41.2% in Child C (p = 0.01). The strong association founded between bleeding and both grade II-III variceal size and "red signs" detection, suggest the possibility to identify a high risk group of cirrhotic patients candidate to prophylactic methodologies.

Adult↗
PubMed1991

[Endoscopic prosthesis of the bile ducts].

During the period 30/5/84-30/7/90, 70 endoscopic prosthesis were settled in 47 patients; 18 men and 28 women; age average 73.17 and ranging 33 to 70. The distribution in ethnic groups showed a top between 70 to 79. The main causes for the implantation were bile ducts cancer, ampullary carcinoma and biliary stones; which were not likely to endoscopic gallstone extraction all of them in 13 opportunities (18.57). The more widely diameter used were 7 and 10 French and the more used was the straight line. Two prosthesis were way implanted without previous sphincterotomy and 1 in Billroth II. The early complications were present in 4 cases (5.7) and all of them led to death independently of the treatment used. The most frequent complication was cholangitis (37.14) most of which were treated by endoscopy, only 2 of them were chirurgical, there was no mortality. The evolution is being analyzed so far.

Adult↗