Dysphagia in Mexican older adults with mild cognitive impairment and dementia.

Introduction: Dysphagia and cognitive impairment are common in older people. It is linked to alterations in brain areas related to swallowing.

Objective: To explore the characteristics of dysphagia using fluoroscopy in patients with mild cognitive impairment (MCI) and dementia.

Dor Vs Toupet Fundoplication After Laparoscopic Heller Myotomy: Long-Term Randomized Controlled Trial Evaluated by High-Resolution Manometry.

Background: Laparoscopic Heller myotomy (LHM) with partial fundoplication is an effective treatment for achalasia. However, the type of fundoplication is still a subject of debate.

Aim: The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores.

[Therapeutic options for portal hypertensive biliopathy: case series and literature review].

Background: Portal hypertensive biliopathy is an underdiagnosed condition because only some patients have symptoms. The major clinical manifestations include cholestasis and cholangitis. The aim of this study is to present a series of cases evaluated, treated and followed at a tertiary-care public institution.

[Renal hemodynamics and its correlation with the Child-Pugh stage in cirrhotic patients and their controls].

Introduction: Portal hypertension is associated with splanchnic vasodilatation and baroreceptors activation with secondary renal vasoconstriction.

Objective: To measure the pulsatility and resistance index in the renal arteries: Segmentaries and arcuates of both kidneys in cirrhotic patients Child-Pugh A, B, C classes and compared them with healthy controls.

Patients And Methods: Thirty patients with cirrhosis were included: Ten patients Child A, 10 were Child B and 10 Child C class and 10 healthy patients, we measured the resistance index (RI = [systolic peak velocity-minimum diastolic velocity]/systolic peak velocity) and the pulsatility index (PI = [systolic peak velocity-minimum diastolic velocity]/medium velocity) with Doppler spectral analysis.

Pregnancy and portal hypertension a pathology view of physiologic changes.

The coexistent of pregnancy and liver disease represent a complex clinical situation, besides the liver complications that present in pregnancy with a previous health liver, like intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy or HELLP syndrome with bleeding disorders and viral hepatitis, the previous liver damage with portal hypertension associated represent a clear stated of hemodynamic changes which increased risk of variceal bleeding. The portal hypertension syndrome has a splanchnic blood flow increase. During pregnancy an hypervolemic stated developed as consequence there is an increased in portal flow that contributed to more portal pressure transmitted to the collaterals veins which increase variceal bleeding risk in this group of patients.

Early experience of Budd-Chiari syndrome treatment with transjugular intrahepatic portosystemic shunt.

The Budd-Chiari syndrome is a heterogeneous group of disorders characterized by obstruction of hepatic venous outflow at any level from the small hepatic veins to the junction of the inferior vena cava with the right atrium. We present two cases of Budd- Chiari syndrome with severe ascites associated with polycythemia vera in first case and protein C deficiency in the second, in both cases transjugular intrahepatic portosystemic shunt were placed, with excellent control of symptoms, no mortality were observed, and just one episode of pulmonary venous thrombosis was observed. To our knowledge this is the first time that transjugular intrahepatic portosystemic shunt are used and reported in Budd-Chiari syndrome in Mexico.

A 57 year old man with chronic renal failure and cardiac tamponade who developed ischemic hepatitis.

Ischemic hepatitis is an infrequent entity, usually associated with low cardiac out put. We present a case of a 57 year-old man with chronic renal failure and cardiac tamponade who developed elevation of serum alanine transferase level of 5,054 U/L, aspartate transferase level of 8,747 U/L and lactate dehydrogenasa level of 15,220 U/L. The patient developed hepatic encephalopathy and hypoglycemia.