An Intraprocedural Endoscopic Cleansing Device for Achieving Adequate Colon Preparation in Poorly Prepped Patients.

Background And Aims: An effective bowel preparation is essential for quality colonoscopy. Inadequate preparation results in missed lesions, need for earlier repeat procedures, prolonged colonoscopy duration, an increased likelihood of adverse events, reduced patient satisfaction, and increased costs. The MOTUS GI Pure-Vu System (Tirat Carmel, Israel) is an Food and Drug Administration-cleared device designed to improve visualization in an inadequately prepared colon by facilitating intraprocedural cleaning.

Hepatocyte growth factor and chronic hepatitis C.

Objective: The hepatocyte growth factor (HGF) is a pleiotropic cytokine produced by hepatic stellate cells and implicated in liver regeneration and fibrosis. Serum levels of HGF vary in liver diseases, reflecting hepatic damage and hepatocellular dysfunction. In this study, serum levels of HGF and the relationship between HGF and biochemical, histological and virological data, have been analysed in patients suffering from chronic hepatitis C (CHC).

[A high-resolution gastroenterology clinic in Andalusia: what is it, and how should it work].

Introduction: The present concept in our healthcare system is that medical care should be given on an outpatient basis with hospitalization occurring only when essential. We therefore put forth the development of the "all in one" outpatient office or "high resolution" outpatient clinic. For such purpose we administered a questionnaire to various Andalusian hospitals to define and determine those aspects necessary in the development of the aforementioned outpatient office.

[Effectiveness of percutaneous drainage in the treatment of abdominal fluid collections in inflammatory pancreatic disease].

Aims: To assess the effectiveness of ultrasonography-guided percutaneous drainage (UGPD) in the management of fluid collections (FC) in acute and chronic pancreatitis, and to evaluate factors associated with treatment results.

Method: Seventy-two patients with pancreatic fluid collections ranging from 5 to 20 cm (median 9 cm) were studied. There were 27 type I pseudocysts (PC), 12 type II PC, 13 type III PC, 16 abscesses, and 4 acute fluid collections.

Modulation of the anti-inflammatory interleukin 10 and of proapoptotic IL-18 in patients with chronic hepatitis C treated with interferon alpha and ribavirin.

The aim of this work was to analyse apoptosis rate, measured by the serum levels of proapoptotic interleukin (IL)-18 and of soluble Fas (sFas), as well as of anti-inflammatory IL-10, in patients with chronic hepatitis C, at baseline and after treatment with interferon alpha and ribavirin. Twenty-seven patients with biopsy-proven chronic hepatitis C were studied, at baseline and after treatment with interferon alpha (21 cases) or pegylated interferon (6 cases) plus ribavirin. A group of 15 healthy sex- and age-matched individuals was selected as control.

Adhesion molecules as a prognostic marker of liver cirrhosis.

Objective: Endothelial activation plays an active role in modifications of the circulatory status of cirrhotic patients. Soluble endothelial adhesion molecules, induced by pro-inflammatory cytokines, could be considered markers of endothelial activation. Their role in the natural history of cirrhosis and portal hypertension has not been reported.

Implication of inflammation-related cytokines in the natural history of liver cirrhosis.

Background/aims: Increased serum concentrations of pro-inflammatory cytokines have been detected in patients with liver cirrhosis. However, their role in the natural history of cirrhosis and portal hypertension, in the absence of infection, and the prognostic significance of inflammation-related cytokines have not been reported. Our objective was the analysis of the prognostic value of inflammation-related cytokines in cirrhotic patients.

Septic arthritis due to Streptococcus bovis in a patient with cirrhosis of enolic etiology.

We present a case of bacteremia and septic arthritis due to Streptococcus bovis biotype I after shock, in a patient with liver cirrhosis of enolic etiology. Diagnosis was made based on a clinical setting of fever and a painful shoulder. The presence of colonic neoplasia was ruled out in this patient and the bacteremia developed without endocarditis.

Ultrasonography in patients with chronic liver disease: its usefulness in the diagnosis of cirrhosis.

Objective: To prospectively assess the usefulness of ultrasonography in predicting the presence of cirrhosis in patients with asymptomatic chronic liver disease in unknown stage.

Experimental Design: Eighteen doppler and ultrasonographic features were prospectively assessed immediately before performing laparoscopy and/or liver biopsy. Usefulness of predictive variables selected by multiple regression analysis and included in a scoring scale was determined by ROC curves.

Progression of chronic hepatitis C to liver fibrosis and cirrhosis in patients coinfected with hepatitis C virus and human immunodeficiency virus.

To evaluate the factors associated with the evolution of chronic hepatitis C in human immunodeficiency virus (HIV)-infected patients, a cross-sectional analysis of 41 HIV-infected patients with chronic hepatitis C (known as "HIV-HCV [hepatitis C virus]-coinfected patients") and a control group of patients with chronic hepatitis C who did not have HIV infection (known as "non-HIV-infected patients") was performed. The association of histological variables with demographic parameters, HCV load and genotype, HIV load, CD4(+) T cell count, and response to highly active antiretroviral therapy (HAART) was evaluated. HIV-HCV-coinfected patients showed a significantly higher HCV load, more-advanced fibrosis, and a higher liver fibrosis progression rate (FPR) than did non-HIV-infected patients.

Dilutional hyponatremia in patients with cirrhosis and ascites.

Objectives: To analyze the predisposing factors, modifications of vasoactive systems, and prognosis of patients with cirrhosis and hyponatremia.

Patients And Methods: Fifty-four patients with hyponatremia (serum sodium level of <130 mEq/L after 5 days of hyponatremic diet and no diuretic therapy). Twenty cirrhotic patients served as controls.

Expression of proinflammatory cytokines and their inhibitors during the course of spontaneous bacterial peritonitis.

The aim of this work was the evaluation, in cirrhotic patients with noninfected ascites and with spontaneous bacterial peritonitis (SBP), of serum and ascitic fluid levels of proinflammatory cytokines [interleukin (IL) 1-beta, tumor necrosis factor alpha (TNF-alpha), and IL6] and antiinflammatory compounds [IL10, soluble IL-1 receptor antagonist (sIL-1Ra), soluble receptors of TNF p55 and p75 (sTNFR55 and sTNFR75), and soluble receptor of IL6 (sIL6R)], as well as their relationship with the outcome of the infection in those with SBP. These molecules were assayed by ELISA in noninfected cirrhotic controls (n = 15), patients with SBP (n = 32), and healthy controls (n = 20). Serum levels of IL6 and of the majority of antiinflammatory mediators, sIL1Ra, sTNFR75, and sIL6R, were higher in control cirrhotic patients compared to healthy subjects.

Doppler ultrasonography in the assessment of renal hemodynamics in patients with chronic liver disease.

Aim: To assess renal hemodynamics by Doppler analysis of resistive index (RI) in small intrarenal arteries in patients with chronic liver diseases at different stages, and to analyze renal RI in patients with cirrhosis as a function of the absence or presence of ascites and the response to diuretic therapy.

Methods: Prospective cross-sectional study of 24 patients with chronic hepatitis, 39 with compensated cirrhosis, and 34 with ascites. The last group was divided into two subgroups: 1) responders to sodium restriction and a low dose of diuretics, and 2) patients with refractory ascites or those requiring high-dose therapy.

[Renal Doppler ultrasonography and its relationship with the renal function in patients with liver cirrhosis].

Background: To relate the renal hemodynamic changes, as assessed by Doppler ultrasonography,with the development of ascites, renal function, and endogenous vasoactive systems in patients with liver cirrhosis.

Patients And Methods: 60 cirrhotic patients were studied prospectively, 31 of these compensated and 29 with ascites. The renal resistive index, renal function and plasmatic levels of renin, aldosterone, noradrenaline and ADH activity were determined.

Serial analysis of serum and ascitic fluid levels of soluble adhesion molecules and chemokines in patients with spontaneous bacterial peritonitis.

The aim of this work was the evaluation of serum and ascitic fluid levels of chemokines (IL-8, growth-regulated oncogene (Gro-alpha), and monocyte chemotactic protein-1 (MCP-1)), and of soluble adhesion molecules (P-selectin, E-selectin, L-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)) in patients with spontaneous bacterial peritonitis (SBP). These compounds were serially analysed in serum and ascitic fluid by ELISA in patients with SBP (n = 20), non-infected cirrhotic controls (n = 12), and healthy controls (n = 15). Infected and non-infected cirrhotic patients showed significantly higher serum levels of adhesion molecules.

[Hepatic abscesses: is simple aspiration puncture with echography control an alternative to catheter drainage?].

Unlabelled: Percutaneous drainage is currently the treatment of choice in liver abscess. The most commonly used technique is catheter placement but this procedure is not free of complications.

Objective: To analyze the safety and efficacy of needle aspiration in the treatment of liver abscesses.

Risk factors for hepatocellular carcinoma in patients with liver cirrhosis.

Objective: Although cirrhosis is known to predispose toward hepatocellular carcinoma (HCC), there is no agreement on the factors that can influence the risk for HCC in patients with cirrhosis. This study was designed to identify differences in cirrhosis-related risk factors for developing HCC in relation to epidemiological characteristics, stage of the disease and etiology.

Methods: 512 patients from southwestern Spain with Child-Pugh stage A or B cirrhosis were examined periodically by ultrasonography, and alpha-fetoprotein (AFP) concentration was measured.

Prognostic usefulness of ultrasonographic signs of portal hypertension in patients with child-pugh stage A liver cirrhosis.

Objective: The aim of this study was to identify factors related with mortality in patients with cirrhosis in the absence of habitual biochemical markers of liver dysfunction.

Methods: Seventy-five cirrhotic patients in Child-Pugh stage A, without hepatocellular carcinoma, were followed until death or the end of the study period. We analyzed the association between cumulative survival and 15 variables determined at the moment of inclusion: age, sex, time from diagnosis of cirrhosis, alcohol abuse, history of variceal bleeding, hepatitis B and C virus infection, Child-Pugh score, plasma albumin and bilirubin levels, prothrombin activity, and four sonographic parameters (size of liver, portal vein diameter, size of spleen, and presence of collateral circulation).

Abdominal tuberculous abscesses in AIDS patients: percutaneous treatment.

Objective: to analyze certain epidemiological and ultrasonographic features, and the response to percutaneous treatment, of abdominal tuberculous abscesses in patients with human acquired immunodeficiency syndrome.

Methods: we reviewed the clinical records and ultrasonographic findings in 7 patients with abdominal tuberculous abscesses who were treated in our service by ultrasonography-guided percutaneous drainage.

Results: in 5 patients there was a previous diagnosis of AIDS.

Focal splenic lesions in patients with AIDS: sonographic findings.

Background: The purpose of this study was to describe the sonographic features of the focal splenic lesions in patients with AIDS and to know the frequency and etiology of these features.

Methods: Sonographic exams of 278 AIDS patients were reviewed retrospectively. We recorded the clinical indications for sonograms and sonographic findings of those patients with focal splenic lesions.