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Biomedical subjects

Raúl Pichardo-Bahena

Publications and source records attributed to Raúl Pichardo-Bahena.

3 recordsLinked to original sources

Prospective study of factors affecting postoperative pain and symptom persistence after stapled rectal mucosectomy for hemorrhoids: a need for preservation of squamous epithelium.

PURPOSE The purpose of the study was to determine the variables associated with postoperative pain and the clinical response of patients with uncomplicated hemorrhoidal disease treated with stapled rectal mucosectomy in the medium term. METHODS Patients with Grade II to IV, uncomplicated hemorrhoidal disease who underwent stapled rectal mucosectomy were prospectively included. The basal characteristics of the population were evaluated and level of stapling and placement of hemostatic suture determined. Histologically, the type of resected epithelium and presence of muscle fibers was evaluated. Postoperative pain was evaluated by means of a visual analog scale. Complications and clinical response were evaluated. RESULTS One hundred patients with a mean age of 43.9 years were included. Only columnar epithelium was resected in 48, transitional epithelium in 47, and squamous epithelium in 5 patients. Smooth muscle fragments were found in 55 patients, and, in 12 of these, fibers from the external muscular layer of rectum were also seen. Follow-up was 12.6 +/- 3.4 (range, 7-24) months. A total of 79 patients were completely asymptomatic at the end of follow-up. Resected squamous epithelium was associated with a higher postoperative pain level in the multivariate analysis (coefficient beta = 1.16 (95 percent confidence interval, 0.08-2.24); P = 0.035). CONCLUSIONS Rectal mucosectomy with stapler is an effective method for the treatment of uncomplicated prolapsing hemorrhoidal disease. Intensity of postoperative pain was associated with the type of resected epithelium. This suggests that low transection of hemorrhoids must be avoided.

Adult↗

[Relation between hepatocarcinoma and hepatitis C virus infection].

The incidence of hepatocarcinoma (HCC) has increased in industralized countries. Its relation with hepatitis C virus (HCV) has already been established. The mechanisms by which HCV promotes HCC development are poorly understood. The continuous necrotic and inflammatory effect with subsequent liberation of various cytoquines and modifications in hepatocyte genome have been proposed. Chronic infection with HCV leads to chronic liver disease and cirrhosis which is described as the main precursory lesion to HCC. The assessment methods for patients with chronic liver diseases allow those patients with high risk for HCC to be identified and the process to identify this tumor at an early stage to be initiated.

Biomarkers, Tumor↗

[Microscopic colitis].

BACKGROUND: Microscopic colitis is responsible for a proportion of difficult diagnosis cases with chronic diarrhea. Diagnosis is clinically suspected when chemical and macroscopic examination result negative and is made only by histopathologic findings. OBJECTIVE: To describe clinical, biochemical, colonoscopic, and histologic features and the treatment response of four cases with microscopic colitis. METHODS: We inform on the findings in four females patients presenting with chronic watery diarrhea with normal biochemical and colonoscopic tests. RESULTS: In these cases, diagnoses mode were lymphocytic colitis two and collagenous colitis two. The long term duration of watery diarrhea was 5 months. The average number of depositions were 10 in 24 h. Diagnosis was made after microscopic examination of the colonic mucosa in the absence of endoscopic abnormalities and normal chemistries. All patients had a satisfactory response to treatment. CONCLUSIONS: The diagnosis of microscopic colitis is made by histopathology findings. The therapeutic response is generally satisfactory.

Adult↗