Scielo RSS http://scielo.isciii.es/rss.php?pid=1130-010820060010&lang=es vol. 98 num. 10 lang. es http://scielo.isciii.es/img/en/fbpelogp.gif http://scielo.isciii.es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000001&lng=es&nrm=iso&tlng=es http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000002&lng=es&nrm=iso&tlng=es Background: short-bowel transplantation has experienced a substantial growth worldwide following improved results from the late 1990s on, and its coverage by Medicare. According to the International Registry (1985-2005), a total of 1,292 intestinal trasplants for 1,210 patients in 65 hospitals across 20 countries have been carried out thus far. Objective: to know short-term (6 months) results regarding patient and graft survival from the first Spanish series of intestinal transplants in adult recipients. Material and methods: we present our experience in the assessment of 20 potential candidates to short-bowel transplantation between June 2004 and October 2005. Of these, 10 patients were rejected and 4 were transplanted, which makes up the sample of our study. Results: to this date 5 transplants have been carried out in 4 patients (2 retransplants, 2 desmoid tumors, 1 short bowel syndrome after excision as a result of mesenteric ischemia). Upon study completion and after a mean follow-up of 180 days (range 90-190 days) all recipients are alive, and all grafts but one (75%) are fully operational, with complete digestive autonomy. All patients received induction with alemtuzumab except one, who received thymoglobulin; in all induction was initiated with no steroids. Conclusions: intestinal transplantation represents a therapeutic option that is applicable in our setting and valid for recipients with an indication who have no other feasible alternative to keep their intestinal failure under control. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000003&lng=es&nrm=iso&tlng=es Background: for advance grades of symptomatic hemorrhoids (grade III and IV) the author has innovated a procedure called radiofrequency ablation and fixation of hemorrhoids. The procedure is performed as a day care surgery. Patients and methods: the surgical technique and clinical follow-up of patients operated by this technique are presented. An Ellman dual frequency radiofrequency generator was used for ablation, which was followed by suture fixation of the hemorrhoids. Patient satisfaction score was assessed using a visual analogue scale. The results of this procedure are presented and are compared with the results of published data of stapled hemorrhoidopexy and Doppler guided hemorrhoidal artery ligation procedures. Results: between 1998 and 2005, 2,376 patients were operated with this technique. Patient's mean age was 34 years and 1,438 patients were males. The postoperative complication rate was 3.5%, which included secondary bleeding, retention of urine and perianal thrombosis. The recurrence rate was less than 1.5%. The satisfaction score was 9.2 on VAS. Conclusions: radiofrequency ablation and fixation of hemorrhoids is a technique that results in less postoperative pain, shorter hospital stay, and early return to normal activity. It seems to be a better alternative to stapled hemorrhoidopexy or Doppler guided hemorrhoidal artery ligation with regard to effectiveness and symptomatic relief on long term. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000004&lng=es&nrm=iso&tlng=es Background: anorectal ultrasonography (ARU) is a simple technique, and its diagnostic value for anorectal diseases either in conventional subjects or in patients with Crohn's disease (CD) is insufficiently reported. The objective of this study is to evaluate the use of ARU, its consistency with clinical orientation, and its ability to provide relevant information for patients with bowel CD and perianal involvement. Methods: thirty ARUs were performed for 24 patients (17 male, mean age 35,7 years; range 19-59 years) with diagnosed CD (bowel and anorectal involvement). The reason to perform an ARU was to evaluate an anal fistula (15 patients, 50%), potential abscesses (9 patients, 30%), and fecal incontinence (2 patients, 6,6%), and for post-treatment monitoring purposes (4 patients, 13,3%). Results: diagnostic orientation coincided for 14 patients (46,6%). An abscess was found in eight patients (26,6%), and five patients were clinically suspicious. The abscess was postanal in 3 patients. Fistulas were found in 17 patients (56,6%), and 15 patients were clinically suspicious. Transsphincterian fistulas were observed in seven patients, and abscesses were associated with fistula in six patients. Transsphincteric defects were observed in 10 patients (four internal sphincters, one external sphincter, and five both) but only two patients suffered from incontinence. ARU provided data relevant to therapeutic approach in 19 patients (63,3%). Conclusions: ARU has provided very important data for the diagnosis and treatment of anorectal diseases. Based on this technique clinical decisions can be improved, which in some instances may prove critical. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000005&lng=es&nrm=iso&tlng=es Background: port-site metastases (PSM) have been reported following oncological laparoscopic surgery. However, their frequency after laparoscopic examination in gastric cancer has not been well established. Material and methods: prospective follow-up of 41 patients having had a staging laparoscopy and a follow-up longer than 12 months. Mean age was 65 years (29-89). After staging, an open gastrectomy was performed in 33 cases. Mean follow-up was 21.4 (12-66) months. PSM was defined as a node in the former port-site wound with adenocarcinoma histology at biopsy. Results: no patient showed clinical signs of PSM or port-site recurrence, even in advanced stages. We had no morbidity or postoperative mortality attributable to laparoscopic manoeuvres, and no need for laparotomy in cases without a gastrectomy indication. Conclusions: our results suggest that staging laparoscopy is a safe procedure in gastric carcinoma, as it is not associated with PSM after even considerable follow-up, and has a very low complication rate. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000006&lng=es&nrm=iso&tlng=es Objectives: 1. To study transfusion requirements in the Department of Gastroenterology of a Tertiary Referral Hospital, and their evolution over the last seven years. 2. To analyze risk factors associated with greater erythrocyte transfusion requirements. Patients and methods: erythrocyte transfusion requirements were compared for patients admitted to the Department of Gastroenterology at Hospital Virgen del Rocío, Seville, from 1999 to 2005. Clinical data of interest have been analyzed in order to determine factors associated with greater transfusion requirements. Results: 1,611 patients with a mean age of 60.45 years (59.7-61.2) were included in this study; 76.41% were males. Gastric ulcers were the cause of bleeding in 18.4% of cases (with 69% requiring transfusions); duodenal ulcers caused 22.2% of cases (with 52.9% requiring transfusions), and portal hypertension caused 33.6% of cases (with 90.2% requiring transfusions). Upper and lower gastrointestinal bleeding of unknown origin requires transfusions in 88.9 and 96.2% of cases, respectively. A multivariate logistic regression analysis showed that clinical presentations such as hematemesis (odds ratio = 3.12), hematochezia (odds ratio = 33.17), gastrointestinal hemorrhage of unknown origin (odds ratio = 6.57), and hemorrhage as a result of portal hypertension (odds ratio = 3.43) were associated with greater transfusion requirements for erythrocyte concentrates. No significant differences were observed between the percentages of patients who received transfusions from 1999 to 2005. Conclusions: 1. No differences have been observed between the percentages of patients who received transfusions over the last seven years at our Department of Gastroenterology. 2. Patients presenting with hematemesis or hematochezia, in addition to those with bleeding of unknown origin or from portal hypertension, are prone to have greater transfusion requirements. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000007&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000008&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000009&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000010&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000011&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000012&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000013&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000014&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000015&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000016&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006001000017&lng=es&nrm=iso&tlng=es In 1979, Warren was first to observe these bacteria in an inflamed gastric epithelium, and subsequently in peptic ulcer-associated gastritis. In 1981, Marshall starts his research and cultivates the bacteria, performs prospective studies, and administers therapy regimens using antibiotics and bismuth salts. The organism was designated Campylobacter-like after its similarity with said genus. In 1984, Marshall manages to meet Koch's postulates using self-inoculation by ingesting a bacterial culture, which resulted in gastritis that was then treated and cured with bismuth salts and metronidazole. The Gastroenterological Society of Australia rejected the abstract with preliminary data. In 1983, "The Lancet" published such data in two brief letters with the same heading, with each being signed by one of these two researchers. Cooperating with microbiologists they classify the new bacteria within the Helicobacter genus as the pylori species. Gastritis and peptic ulcer are currently considered infectious diseases. Their diagnosis and therapy include bacterial detection methods and antibiotics, respectively. In addition, a causal relationship between Helicobacter pylori and both gastric adenocarcinoma and gastric lymphoma has been established, and its association with some extra-digestive conditions has been suggested.