Hospital Universitario Virgen Of La Arrixaca Murcia

Valverde de la Virgen, Spain

Hospital Universitario Virgen Of La Arrixaca Murcia

Valverde de la Virgen, Spain

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Monroy-Torres R.,University of Guanajuato | Naves-Sanchez J.,Hospital Materno Infantil Of La Ssg | Ortega-Garcia J.A.,Hospital Universitario Virgen Of La Arrixaca Murcia
Revista de Investigacion Clinica | Year: 2012

Background. Morbidity and mortality rates are higher among preterm infants due to physiological immaturity and greater growth demands. Nutritional intervention contributes to proper weight gain, which translates into better growth and neurological development, and prevents the onset of metabolic complications. The effect of breastfeeding duration was studied in the analytic profile at the end of the first six months of life. Objective. To describe the nutritional and metabolic markers effect in preterm infants at the end of the first semester of life. Material and methods. We performed an analytical, transversal and comparative study in 100 preterm infants, 30 to 36 weeks gestational age. Measures for weight, length and head circumference at birth were taken from the subjects' clinical files. A follow-up conducted at 6 to 9 months of age evaluated the same nutritional indicators (weight, length, head circumference) and compared them with values at birth and recommendations. Metabolic indicators (glucose, hemoglobin, cholesterol, triglycerides, insulin, urea, creatinine, gamma-glutamyl-transferase and alkaline phosphatase) were compared with the recommendations. Follow-up study in 100 preterm infants (30 to 36 weeks gestational age). Weight, length and head circumference were measured at birth and 6 to 9 months later. We measured analytic parameters related to metabolic syndrome (glucose, hemoglobin, cholesterol, triglycerides, insulin, urea, creatinine, gamma-glutamyl transferase and alkaline phosphatase). Confusing factors like income level and access to public services were also studied. Results. The mean age at follow-up was 7.3 ± 1.4 months. Levels of hemoglobin, creatinine and urea showed significant differences with regard to reference values (Wilcoxon ranks test, < 0.05). The average duration of breastfeeding was 4.3 months. The mean age at follow-up was 7.3 ± 1.4 months. Risk factors for hypercholesterolemia, as well as levels of hemoglobin, creatinine and urea showed significant differences with regard to reference values (Wilcoxon ranks test, < 0.05). Conclusions. Premature infants showed deficiencies in weight gain. Biochemical parameters could reflect metabolic risk, therefore we recommend prolonging breastfeeding as well as extending the follow-up of these infants for monitoring their growth and development once out of the hospital.


PubMed | Hospital Universitario Virgen Of La Arrixaca Murcia and Hospital Universitario Virgen Of La Arrixaca
Type: Journal Article | Journal: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva | Year: 2016

An 84-year-old woman presented to her local emergency department for abdominal pain. Her medical history included hemodialysis in the treatment of chronic renal failure, Parkinsons disease, chronic atrial fibrillation, chronic constipation, appendicectomy and cholecystectomy. The patient complained of diffuse abdominal pain for 4 days, associated with nausea and vomiting in the last 24 hours. Physical examination revealed a soft and depressible abdomen, diffusely painful, without signs of peritoneal irritation. A digital rectal exam revealed large amount of stool in the rectal vault without palpable masses. Blood tests showed a creatinine level of 2.7 mg/dl due to chronic renal failure and the plain abdominal radiography revealed a dolichocolon completely contrasted. The patient denied the realization of any medical imaging-proofs with oral or rectal contrast. Reviewing home treatment, the patient was taking lanthanum carbonate (2 tablets of 750 mg per day) since 1 month ago, a drug that contrasts the digestive tract. Appreciating contrast in the colon, intestinal subocclusion was excluded and the clinical picture was attributed to her chronic constipation. In conclusion, it should be noted that lanthanum carbonate contrasts the digestive tract, with radiopaque appearance on the plain abdominal radiography and without any pathological significance.


PubMed | Hospital Universitario Virgen Of La Arrixaca Murcia and Hospital Clinico Universitario Virgen Of La Arrixaca
Type: Journal Article | Journal: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva | Year: 2016

Refractory esophageal stenosis (RES) is a major health problem in the pediatric population. Several techniques such as stent placement or C-mitomycin (CM) have been described as alternative treatments. We present our experience with both techniques, in our case with biodegradable stents (BS) and sometimes the association with stents and CM.Six patients have been included: 2 post-operative fistulas in patients with type I esophageal atresia; 1 operated atresia without fistula; and 3 caustic strictures. 5 BS were placed in 4 children: 3 of them in cases of atresia (2 prosthesis in one case) and the other one in a case of stricture. CM was used in 5 cases: in 2 of them from the beginning, and in the other 3 cases after failure of the stent.When placed in fistulas, BS were fully covered. One of them successfully treated the fistula, but the other one was not effective. One stenosis was successfully treated with SB (in the case of persistent fistula), but recurrence was observed in the other 2 cases. One of these was solved with CM, and the other one needed a second stent. In the remaining 2 cases (one atresia and one caustic stricture) CM was effective after 1 and 2 sessions respectively. Overall, 5 out of 6 stenosis have been successfully treated (83.3%), and 1 out of 2 fistulas (50%).Association of BS and CM has been effective in the management of RES in children.


PubMed | Hospital Universitario Virgen Of La Arrixaca Murcia, University of Murcia, Hospital Universitario Virgen Of La Arrixaca and Hospital Clinico Universitario Virgen Of La Arrixa
Type: Journal Article | Journal: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva | Year: 2016

Capsule endoscopy is an extended tool for the diagnosis of small bowel Crohns disease. However, factors associated with positive findings of this technique have not been well established. Our aim is to asses which factors are associated with a better diagnostic yield of capsule endoscopy in suspected small bowel Crohns disease.This was a retrospective study including patients under capsule endoscopy because of suspected small bowel Crohns disease. Demographic data of these patients, as well as symptoms and laboratory data including hemoglobin levels, count of leucocytes and platelets, and levels of C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin were collected. Capsule endoscopy studies were classified as negative (no lesions) or positive (lesions suggestive of Crohns disease). Descriptive, univariate and multivariate analysis were done, as well as diagnostic yield tests of the different markers for predicting lesions in capsule studies.One hundred and twenty-four patients were included (85 women and 39 men). The average age was 38.21 years. Levels of C-reactive protein and fecal calprotectin were the markers more frequently associated with positive findings in capsule endoscopy. Calprotectin presented the best sensitivity as isolated marker. The association of altered levels of C-reactive protein and calprotectin showed the best specificity and predictive values.C-reactive protein and fecal calprotectin are appropriate biomarkers for selecting patients with suspected Crohns disease of the small bowel for capsule endoscopy studies.


PubMed | Hospital Universitario Virgen Of La Arrixaca Murcia
Type: Journal Article | Journal: Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva | Year: 2016

We present the case of a 44-year-old woman with past history of repeated miscarriage and Budd-Chiari syndrome secondary to primary myelofibrosis. Because of this she was under treatment with oral anticoagulant agents. The patient was admitted in hospital as she presented with gastrointestinal bleeding (melena), asthenia and progressive anemia. In an initial upper endoscopy an extrinsic duodenal compression associated with an ulcer on the posterior face of the first portion of duodenum and upper duodenal knee was observed. In the following days a huge spontaneous retroperitoneal hematoma due to anticoagulation was diagnosed by computed tomography. This was treated with a percutaneous drainage and withdrawal of the antithrombotic drugs. The evolution of the patient was initially satisfactory but she suffered subclavian and jugular vein thrombosis, and reintroduction of anticoagulant agents at the lowest therapeutic doses was required.


PubMed | Hospital Universitario Virgen Of La Arrixaca Murcia
Type: Journal Article | Journal: Journal of Crohn's & colitis | Year: 2010

Infliximab, an anti-tumor necrosis factor (TNF-) antibody, is useful in the treatment of rheumatoid arthritis, Crohns disease etc. It has been related to increases in the rate of several infections. We present the case of a 53-year-old woman diagnosed with community-acquired pneumonia due to Nocardia cyriacigeorgica who was taking infliximab, azathioprine and prednisone for Crohns disease.

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