The Experts below are selected from a list of 24 Experts worldwide ranked by ideXlab platform
Tello Echeandia Ricardo - One of the best experts on this subject based on the ideXlab platform.
-
Giardiasis asociada a gastroparesia en pacientes del servicio de gastroenterologia del hospital regional lambayeque
Universidad Privada Antenor Orrego - UPAO, 2019Co-Authors: Tello Echeandia RicardoAbstract:La giardiasis es una parasitosis muy prevalente en nuestro medio que se manifiesta con varios síntomas característicos de la gastroparesia. Por tal motivo el presente estudio está orientado a evaluar la asociación que existe entre la giardiasis y la gastroparesia en pacientes atendidos en el HRL durante el año 2017; para ello se desarrolló un estudio analítico retrospectivo de casos y controles donde fueron seleccionados 162 pacientes con síntomas de gastroparesia de los cuales 81 fueron casos y 81 controles quienes debían de contar con biopsia de duodeno y copro-parasitológico seriado para identificar la presencia o no de giardia; luego se determinó su asociación entre estos dos mediante el uso del OR. Los resultados encontrados muestran que el 56.3% de varones presentaron gastroparesia a diferencia de un 46.7% de mujeres. Además los varones también tuvieron más giardiasis y gastroparesia que las mujeres con un 38.2% frente a 25.2%. Las edades en las que más se presentó giardiasis y gastroparesia fue entre los 36-50 años. El dolor abdominal fue el síntoma más frecuente en los casos (72.9%), pero este predomino aún más en los pacientes con gastroparesia y giardiasis (79.1%) mientras que los que no tenían gastroparesia predomino la distensión abdominal (77.7%). La proporción de pacientes con gastroparesia que tuvieron giardiasis, fue de 59.3% mientras que los que no tenían gastroparesia fue del 33.3%. X 2 = 10.94 y un OR: 2.9 (IC = 1.534 – 5.518). Por lo que existe asociación significativa entre giardiasis con gastroparesia en pacientes atendidos en el HRL, 2017.Giardiasis is a very frequent parasitosis in our environment that manifests itself with several characteristic symptoms of gastroparesis. For this reason, the present study is aimed at evaluating the association that exists between giardiasis and gastroparesis in patients treated at the HRL during the year 2017; For this, an analytical study of cases and controls was analyzed, where 162 patients with symptoms of gastroparesis were selected, 81 of whom were cases and 81 controls who had to have a Duodenum Biopsy and a copro-parasitological exam to identify the presence or absence of giardia. Then their association was determined through the use of OR. The results found show 56.3% of males with gastroparesis while just 46.7% in females. In addition, men also had more giardiasis and gastroparesis than women with 38.2% compared to 25.2%. The ages in which giardiasis and gastroparesis occurred the most were between 36-50 years. Abdominal pain was more frequent in the cases (72.9%), but this predominated even more in patients with gastroparesis and giardiasis (79.1%), while those who did not have gastroparesis predominate abdominal distension (77.7%). The proportion of patients with gastroparesis who had giardiasis was 59.3%, while those who did not have gastroparesis was 33.3%. X2 = 10.94 and an OR: 2.9 (CI = 1.534 - 5.518). Therefore, there is a significant association between giardiasis and gastroparesis in patients treated at the HRL, 2017.Tesi
Casella Edelweiss - One of the best experts on this subject based on the ideXlab platform.
-
Detección de enfermedad celíaca en una población de estudiantes de medicina.
2019Co-Authors: Casella EdelweissAbstract:Tesis-Doctor en Medicina y Cirugía-Universidad Nacional de Córdoba. Facultad de Ciencias Médicas, 2019 140 h.Fil: Casella, Edelweiss. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de medicina II; Argentina.Fil: Casella, Edelweiss. Provincia de Córdoba. Hospital Córdoba. Cátedra de medicina II; Argentina.Introducción: La enfermedad celíaca (EC) es un importante problema de salud pública a nivel mundial. Afecta tanto a niños como a adultos ya sean de países desarrollados como en desarrollo, provocando complicaciones y secuelas que por su gravedad pueden incluso poner en riesgo la vida. El impacto negativo en la economía de la salud puede alcanzar niveles muy altos. Esta enfermedad se caracteriza por la interacción entre factores inmunológicos, genéticos y ambientales que generan atrofia de las vellosidades intestinales y daño en diferentes sistemas del organismo. Actualmente se describe como un trastorno inflamatorio, multiorgánico, mediado inmunológicamente y desencadenado por un factor ambiental, el gluten que se encuentra en cereales como trigo, avena, cebada y centeno. Su único tratamiento es la dieta libre de gluten (DLG). Afecta alrededor del 1% de la población mundial sin distinción de edad o raza. Es la enteropatía crónica autoinmune más frecuente en el mundo. La proporción de casos de EC conocidos versus no diagnosticados es de de 1/3-10. Material y Método: Se recolectaron los datos de la historia clínica en relación a la EC de 638 estudiantes de los últimos años de la carrera de Medicina (Universidad Nacional de Córdoba). A todos ellos se les solicitaron análisis generales y específicos para EC. A aquellos con alto nivel de sospecha de ser celíacos (clínica o de laboratorio) se les requirió endoscopía y biopsia de duodeno. Resultados: El 6,99% de los alumnos a quienes se les realizaron los análisis de laboratorio resultaron ser celiacos confirmados posteriormente por biopsia duodenal. Sólo uno de ellos fue de sexo masculino. Las edades fueron entre 19 y 38 años ya que era un estudio basado en un muestreo por conveniencia de estudiantes. EL 68,84% de los estudiantes fueron mujeres, mientras que entre los celíacos la proporción fue del 92,31%. El 69,23% de los alumnos celíacos diagnosticados en este grupo estuvo dentro de los criterios de alto índice de sospecha es decir entre 50 y 80% de posibilidades de ser celíacos. El índice de masa corporal de los estudiantes con diagnóstico de celiaquía fue de bajo peso, o en el límite inferior del normopeso. No se observaron diferencias significativas en relación a la edad de presentación de la menarca de las alumnas celíacas comparadas con el grupo general. El 38,46% de los celíacos con biopsia positiva tenían laboratorio negativo, a pesar de haber realizado dos anticuerpos (IgA antitransglutaminasa e IgA antiendomisio). El 30,77% tenían IgA total baja. Sólo el 13,71% de los alumnos del grupo general no tenían síntomas, signos o enfermedades asociadas en relación a la celiaquía. El 50% de los estudiantes celíacos tuvo un familiar directo celíaco, mientras que en el grupo general, el 7,37% refirió tener familiares celíacos. Conclusiones: En una población de 186 alumnos “asintomáticos” o aparentemente “sanos” a quienes se les realizaron análisis de laboratorio, se encontraron 13 celíacos (6,99%), una cifra superior al 1% referida como prevalencia en la bibliografía mundial. La celiaquía es una enfermedad altamente prevalente con una presentación clínica muy heterogénea que se encuentra subestimada y subdiagnosticada en general en el mundo entero y en particular en el grupo estudiado. En el grupo de estudio, 4 de cada 10 estudiantes con biopsia positiva para EC (detectados por alto índice de sospecha) presentaron anticuerpos negativos, por esto la biopsia en el adulto (clasificación de Marsh) es indispensable y sigue siendo el patrón de referencia para establecer el diagnóstico. El diagnóstico precoz es prioritario ya que mientras mayor es el tiempo de exposición al gluten, más posibilidades tiene el paciente de presentar complicaciones y enfermedades asociadas. Luego de 4-5 años de estricta DLG se equiparan los riesgos con la población general de padecer otras enfermedades.Introduction: Celiac disease is a major public health problem worldwide. It affects both children and adults whether from developed or developing countries, causing complications and sequelae that, due to their severity, can even put life at risk. The negative impact on the health economy can reach very high levels. This disease is characterized by the interaction between immunological, genetic and environmental factors that generate atrophy of the intestinal villi and damage in different systems of the organism. It is currently described as a multiorganic inflammatory disorder, mediated immunologically and triggered by an environmental alimentary factor, gluten, which is found in cereals such as wheat, oats, barley and rye. Its only treatment is the gluten-free diet. It affects around 1% of the world population without distinction of age or race. It is the most frequent chronic autoimmune enteropathy in the world. The proportion of known celiac disease cases versus undiagnosed cases is 1 / 3-10. Material and Method: Data of the clinical history were collected in relation to the celiac disease, in 638 students of the last years of the School of Medicine (Córdoba National University). All of them were asked for general and specific analysis for celiac disease. Those with a high level of suspicion (clinical or laboratory) of being celiac were asked for endoscopy and Duodenum Biopsy. Results: Six with ninety-nine percent (6,99%) of the students who underwent laboratory tests turn out to be celiac and then confirmed by duodenal Biopsy. Only one of them was male. The ages were between 19 and 38 years since it was a study based on convenience sampling. Sixty-eight eighty-four percent (68.84%) of the students were women, while among the celiacs the proportion was 92.31%. Sixty-nine twenty-three percent (69.23%) of the celiac students diagnosed in this group were within the criteria of high index of suspicion that is to say between 50 and 80% of possibilities of being celiac. The body mass index of the students diagnosed with celiac disease was low weight, or at the lower limit of normal weight. No significant differences were observed in relation to the age of presentation of the menarche of the celiac students compared with the general group. Thirty eight forty six percent (38.46%) of the celiacs with a positive Biopsy had a negative laboratory, in spite of having carried out two antibodies (anti-transglutaminase IgA and antiendomysial IgA). Thirty seventy seven percent (30.77%) had low total IgA. Fifty percent (50%) of the celiac students had a direct celiac relative, while in the general group, 7.37% reported having celiac relatives. Only 13.71% of the students in the general group did not have symptoms, signs or associated diseases in relation to celiac disease. Conclusions: In a population of 186 "asymptomatic" or apparently "healthy" students who underwent laboratory analysis, 13 celiacs patients were found (6,99%) a figure higher than 1% referred to as prevalence in the world literature. Celiac disease is highly prevalent disease, with a very heterogeneous clinical presentation which is underestimated and underdiagnosed in general in the whole world and in particular in the group studied. In the study group, four of ten students with positive Biopsy for celiac disease (detected by high index of suspicion) had negative antibodies, for this reason the Biopsy in the adult (Marsh classification) is indispensable and remains the reference standard to establish the diagnosis. Early diagnosis is a priority because the longer time of exposure to the gluten, more complications and associated diseases provoke. After 4-5 years of strict gluten-free diet, the chances of suffering other diseases decrease.2021-09-0
Stylianos Chatzipanagiotou - One of the best experts on this subject based on the ideXlab platform.
-
Cerebral Whipple’s Disease Diagnosed Using PCR
Molecular Diagnosis, 2003Co-Authors: Marianna Papadopoulou, Michael Rentzos, Chryssoula Nicolaou, Vassiliki Ioannidou, Anastassios Ioannidis, Stylianos ChatzipanagiotouAbstract:Background: Whipple’s disease (WD) is a rare multisystemic bacterial infection, with variable clinical manifestations occasionally involving the central nervous system. As the cultivation of the etiologic agent, Tropheryma whippelii , is difficult, a laboratory diagnosis is usually based on histological methods. In the last few years, molecular detection of the bacterial 16SrRNA genes by PCR, with 2 primer sets, has greatly contributed to the ability of clinicians to diagnose this disease. We present a cerebral case of WD in a 48-year-old male, successfully diagnosed using PCR with T. whippelii in the blood and feces. As far as we know this is the first case reported from Greece. Methods: For the diagnosis of WD, histological examination of Duodenum Biopsy for diastase-resistant, non-acid fast, periodic acid Schiff (PAS)-positive inclusions in macrophages, and molecular detection of the 16SrRNA genes of T. whippelii by PCR in cerebrospinal fluid, blood, and feces, were performed. Results: The histological detection was negative. PCR results were positive in the blood and feces of the patient and negative in the cerebrospinal fluid. Seven months after the onset of antimicrobial therapy, PCR was negative in all three clinical specimens. Conclusions: The application of PCR proved to be an invaluable tool for the recognition, differential diagnosis and early initiation of antimicrobial therapy for the patient diagnosed with WD, a disease which is generally fatal if it remains untreated.
Marianna Papadopoulou - One of the best experts on this subject based on the ideXlab platform.
-
Cerebral Whipple’s Disease Diagnosed Using PCR
Molecular Diagnosis, 2003Co-Authors: Marianna Papadopoulou, Michael Rentzos, Chryssoula Nicolaou, Vassiliki Ioannidou, Anastassios Ioannidis, Stylianos ChatzipanagiotouAbstract:Background: Whipple’s disease (WD) is a rare multisystemic bacterial infection, with variable clinical manifestations occasionally involving the central nervous system. As the cultivation of the etiologic agent, Tropheryma whippelii , is difficult, a laboratory diagnosis is usually based on histological methods. In the last few years, molecular detection of the bacterial 16SrRNA genes by PCR, with 2 primer sets, has greatly contributed to the ability of clinicians to diagnose this disease. We present a cerebral case of WD in a 48-year-old male, successfully diagnosed using PCR with T. whippelii in the blood and feces. As far as we know this is the first case reported from Greece. Methods: For the diagnosis of WD, histological examination of Duodenum Biopsy for diastase-resistant, non-acid fast, periodic acid Schiff (PAS)-positive inclusions in macrophages, and molecular detection of the 16SrRNA genes of T. whippelii by PCR in cerebrospinal fluid, blood, and feces, were performed. Results: The histological detection was negative. PCR results were positive in the blood and feces of the patient and negative in the cerebrospinal fluid. Seven months after the onset of antimicrobial therapy, PCR was negative in all three clinical specimens. Conclusions: The application of PCR proved to be an invaluable tool for the recognition, differential diagnosis and early initiation of antimicrobial therapy for the patient diagnosed with WD, a disease which is generally fatal if it remains untreated.
Anastassios Ioannidis - One of the best experts on this subject based on the ideXlab platform.
-
Cerebral Whipple’s Disease Diagnosed Using PCR
Molecular Diagnosis, 2003Co-Authors: Marianna Papadopoulou, Michael Rentzos, Chryssoula Nicolaou, Vassiliki Ioannidou, Anastassios Ioannidis, Stylianos ChatzipanagiotouAbstract:Background: Whipple’s disease (WD) is a rare multisystemic bacterial infection, with variable clinical manifestations occasionally involving the central nervous system. As the cultivation of the etiologic agent, Tropheryma whippelii , is difficult, a laboratory diagnosis is usually based on histological methods. In the last few years, molecular detection of the bacterial 16SrRNA genes by PCR, with 2 primer sets, has greatly contributed to the ability of clinicians to diagnose this disease. We present a cerebral case of WD in a 48-year-old male, successfully diagnosed using PCR with T. whippelii in the blood and feces. As far as we know this is the first case reported from Greece. Methods: For the diagnosis of WD, histological examination of Duodenum Biopsy for diastase-resistant, non-acid fast, periodic acid Schiff (PAS)-positive inclusions in macrophages, and molecular detection of the 16SrRNA genes of T. whippelii by PCR in cerebrospinal fluid, blood, and feces, were performed. Results: The histological detection was negative. PCR results were positive in the blood and feces of the patient and negative in the cerebrospinal fluid. Seven months after the onset of antimicrobial therapy, PCR was negative in all three clinical specimens. Conclusions: The application of PCR proved to be an invaluable tool for the recognition, differential diagnosis and early initiation of antimicrobial therapy for the patient diagnosed with WD, a disease which is generally fatal if it remains untreated.
