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.

[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.

[HCV / HIV co-infection: a different perspective].

The clinical significance of HCV-HIV co-infection has notoriously changed due to the introduction of new anti-retroviral therapeutic combinations against HIV infection. Their effectiveness in dramatically reducing AIDS mortality, and the corresponding increase in hospitalization and death related to liver disease. Considerations facing this new reality will have to include epidemiological aspects, pathogenetic interactions, the influence of highly active anti-retroviral therapies (HAART) on the natural history of HCV infection, including their HCV--enhanced liver toxicity, and current new strategies about therapeutic measures against HCV infection in the frame of the most recent advances in HIV therapy.

[Hepatitis C and alcohol: notes for consensus].

Alcohol abuse is accompanied by a high prevalence of hepatitis C virus (HCV) infection, which arise in the Great La Plata up to 20%. This condition worsen the histological necro-inflamatory activity of HCV chronic hepatitis patients, accelerating the evolution to liver cirrhosis, to cirrhosis decompensation, and surely facilitating the development of hepatocellular carcinoma. Besides of that, active alcohol abuse implies severe decrease in therapeutic response and yet more, a real contraindication for IFN mono-drug or combined treatment.

[Idiopathic portal hypertension with splenic infarct. An unreported complication].

We present a case of Idiopathic Portal Hypertension (IPH) with Splenic infarct in a 23-year-old female. She was referred to the hospital because of enlargement of liver and spleen. A computed axial tomography revealed Splenic infarct.

[Evidence-based Medicine and continuing education in gastroenterology and hepatology].

Evidence Based Medicine (EBM) provide a new philosophy and useful tools to incorporate the scientific method to medical practice in Gastroenterology, Hepatology and Digestive Endoscopy. Large and well designed multicenter randomized clinical trials validated if necessary by metaanalysis, are the main support to the system; in spite of that individual decisions will owe to take into account interests and beliefs of patients and their relatives, doctors and society National or regional consensus and guide-lines elaborated by experts of scientific institutions are published in first line publications and easily available by computerized ways. Incorporation of econometric studies specially centered on quality of life quantification would be excellent weapons in the process of decision making Computers technology as a tool of fast access to scientific bases of medical problems and as a real participant of the process of health care, should owe to be inserted to educational programs at the universities and scientific institutions, at levels of specialization and continuing medical education.

[Clinic-epidemiological significance of drug hepatotoxicity in liver disease consultation].

To assess epidemiological and clinical significance of drug hepatotoxicity in the setting of liver diseases consultation, ten thousand and three hundred forty two prospectively designed clinical records from patient cared for in our Liver Unit in the period 1988-1998 were incorporated into the study; 58 out of 10,342 (prevalence = 5.6%) fulfilled at least the first three of the following causality requirements: 1.--Liver injury associated in time to drug exposition; 2.

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.

[Ethical dilemmas in gastroenterology practice in Latin-American countries: the AIGE survey].

A survey sponsored by the Interamerican Association of Gastroenterology (AIGE) related to decision making in conflictive ethical situations in the setting of gastroenterological practice was designed (AJ-JCG). Seven problem-cases with 3 to 5 pre-established and not-excluding answers each, demographic and occupational data were included, by public invitation during 1996-97 AIGE educational activities in La Plata (Argentina), Montevideo (Uruguay) and Santo Domingo (Dominican Republic). Data were inserted in a computerised data base, and chi square, Fischer and Maentel-Henzel tests were used for statistical studies.

Hepatic sinusoidal dilatation associated to giant lymph node hyperplasia (Castleman's): a new case in a patient with periorbital xanthelasmas and history of celiac disease.

We present a new case of hepatic sinusoidal dilatation associated to giant lymph node hyperplasia or Castleman's disease in a 23-year-old patient with xanthelasmas and history of celiac disease. He presented with weight loss, hepatomegaly, periorbital xanthomas, anemia, accelerated erythrosedimentation rate, hypoalbuminemia, hypergammaglobulinemia at the expense of immunoglobulin G (IgG), high titers of autoantibodies, and increase of serum alkaline phosphatase and gamma glutamyl transpeptidase activity. A liver biopsy showed sinusoidal dilatation.

[Liver histopathological characteristics in patients with HCV-positive sera].

In order to have knowledge on the histopathologic characteristics of the HCV infections in our geographical area and its relation with some epidemiologic variables, a series of 54 biopsies of Anti HCV (R) patients was analyzed. The histologic lesions found in this study correspond mostly to patients with relatively early infections, on the contrary to other studies of the some kind. The most frequent histopathologic diagnosis were chronic hepatitis 38/54 (70.

[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.

[Hepatitis B and C virus in chronic alcoholic patients: prevalence and influence on liver injury].

The aim of this prospectively designed study is to analyse the prevalence of HBV and HCV infections in 115 chronic alcohol abusers, their relation to epidemiological variables, and their meaning in pathogenesis and severity of alcoholic liver injury. A prevalence of 13.9% anti-HBc and 20.

[New suggestions for the management of alcoholic liver diseases].

Some recent proposals in management of alcoholic liver disease are discussed focusing on early diagnosis and treatment of alcohol abuse itself, alcoholic hepatitis early mortality, clinical meaning of nutritional therapy, serological approach and treatment of hepatic fibrosis, and problems in liver transplantation for end stage alcoholic liver cirrhosis. CAGE or similar systematized brief questionnaires, and desialylated transferrin/total transferrin ratio as serological marker, seems to be interesting contributions to "hidden" alcohol abuse diagnosis and abstinence control while psycho-social support and voluntary incorporation to self-aid groups are the best weapons to reach persistent abstinence. Corticosteroids seems to improve survival in a selected group of patients with severe alcoholic hepatitis, specially in those presenting encephalopathy but free of GI bleeding, decompensated diabetes, active infections, pancreatitis, and other contraindications or adverse effects of these drugs.

[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.

[Viral hepatitis infection and response to the hepatitis B vaccine in hemodialyzed patients].

Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year.

[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.

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.

[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.

[Response of healthy subjects to plasma-derived anti-hepatitis B vaccine].

71 healthy individuals were vaccinated against hepatitis B virus. Each person received 60 mcgrs of HBsAg derived from chronic carriers heat-formalin treated plasma. All the vaccinees were tested for anti-HBs and 94.