Notes

Function involving AKT and ERK path ways in controlling awareness to ionizing rays along with adaptable result caused by simply low-dose light throughout human immune cellular material.
Endoscopic treatment of local complications in patients with chronic pancreatitis has gained ground over the surgical alternative in the last years. ICEC0942 mouse The less aggressiveness of endoscopic treatment, as well as the possibility to apply it repeatedly in high-risk patients, has favored this development. In addition, the incorporation of new highly accurate endoscopic therapeutic options such as pancreatoscopy-guided lithotripsy and endoscopic ultrasound-guided treatments, make endoscopic treatment the first choice in many cases, despite discordant data in the literature. This article reviews the endoscopic treatment of the most common local complications of chronic pancreatitis, such as pancreatolithiasis, pseudocysts, and pancreatic, biliary, and duodenal ductal stenosis.
SARS-CoV-2 is mainly a respiratory virus that has relevant systemic effects. We assessed the impact of baseline liver function (aspartate aminotransferase [AST], alanine aminotransferase [ALT], bilirubin) on COVID-19-related outcomes, including mortality, intensive care unit (ICU) admissions, and non-fatal severe complications.

after a systematic review of the relevant studies the odds ratio (OR), mean difference, sensitivity, specificity, and both positive and negative likelihood ratios were calculated for the prediction of relevant COVID-19 outcomes by performing a meta-analysis using fixed and random effects models. A Fagan nomogram was used to assess clinical usefulness. Heterogeneity was explored by sensitivity analysis and univariate meta-regression.

twenty-six studies were included (22 studies and 5,271 patients for AST, 20 studies and 5,440 subjects for ALT, and nine studies and 3,542 patients for bilirubin). The outcomes assessed by these studies were survival (n = 8), ICU admission (n = 4), anests at admission. We should include the assessment of AST, ALT, and total bilirubin (TB) routinely in the workup of patients affected by SARS-CoV-2 in order to predict those at risk of developing COVID-19-related outcomes.
Though endoscopic and percutaneous drainage has emerged as the most common minimally invasive treatments for Pancreatic fluid collections (PFCs), estimates of therapeutic superiority of the two treatments have yielded inconsistent results.

We retrieved studies compared the efficacy and safety of the two approaches in PubMed, Embase, and the Cochrane Library. Primary outcomes were differences in technical success, clinical success and adverse events, and the secondary outcomes were differences in reintervention, the need for surgical intervention, mortality, recurrence and length of hospital stay.

There were nonsignificant differences in technical success rate (OR, 0.54;CI, 0.15-1.86), clinical success rate (OR, 1.39; CI, 0.82-2.37), adverse events rate (OR, 1.21; CI, 0.70-2.11), mortality rate (OR, 0.81; CI, 0.30-2.16), and recurrence rate (OR, 1.94; CI, 0.74-5.07) between the two groups. The reintervention rate (OR, 0.19; CI, 0.08-0.45) and the proportion of the need for surgical intervention (OR, 0.08; CI, 0.02-0.39) in the endoscopic drainage group were much lower than those in the percutaneous drainage group. The total length of hospital stay (SMD, -0.60; CI, -0.84 to -0.36) in the endoscopic drainage group was shorter, however, there was a nonsignificant difference in the length of post-procedure hospital stay (SMD, -0.30; CI, -1.05-0.44) between the two groups.

Endoscopic drainage is effective for PFCs with the superiority in less reintervention and less surgical need over traditional percutaneous drainage, despite the similar clinical efficacy and safety compared with traditional percutaneous drainage.
Endoscopic drainage is effective for PFCs with the superiority in less reintervention and less surgical need over traditional percutaneous drainage, despite the similar clinical efficacy and safety compared with traditional percutaneous drainage.
dermatological manifestations are normally found in one third of patients with inflammatory bowel disease. Here, we determined the prevalence, clinical characteristics, intestinal disease activity and treatment response of neutrophilic dermatoses (pyoderma gangrenosum and Sweet´s syndrome) in patients with inflammatory bowel disease.

We performed a retrospective observational study of patients with inflammatory bowel disease and neutrophilic dermatoses between March 2012 and March 2018.

Of 444 patients analyses, 10 complied with the inclusion criteria seven had pyoderma gangrenosum and three presented Sweet's syndrome. One patient developed both pathologies. The prevalence of neutrophilic dermatoses was 2.3% (10/444), comprising 1.6% pyoderma gangrenosum and 0.7% Sweet's syndrome. Six out of seven patients with pyoderma gangrenosum were female and had ulcerative colitis. The most frequent clinical presentation of pyoderma gangrenosum was the ulcerative subtype. Active moderate-to-severe intestinal diseasease activity. Anti-tumor necrosis factor was effective in patients with partial cutaneous and intestinal disease response.
Hepatic osteodystrophy, including osteoporosis, is an abnormal bone metabolism related with chronic liver diseases. Osteoporosis is associated with an increased risk of bone fractures, with a significant impact on morbidity, mortality and healthcare costs. Nevertheless, bone disorders tend to be undervalued in cirrhosis due to alcohol-related liver disease (ALD cirrhosis). We aimed to assess the prevalence of hepatic osteodystrophy and osteoporosis in ALD cirrhosis.

We conducted a prospective observational study including patients with ALD cirrhosis between September/2017-December/2018. Bone mineral density was determined by dual energy X-ray absorptiometry at the lumbar spine and the femoral neck. Hepatic osteodystrophy was defined as a T-score below -1 SD and osteoporosis as a T-score below -2.5 SD.

94 patients included. 24.5% (n=23) had prior fragility fractures and 10 patients suffer new osteoporotic fractures during the study period. Hepatic osteodystrophy was diagnosed in 79.8% (n=75) and osteopor with lower BMI) and a concerning high rate of fragility fractures. Bone mineral density should be assessed in order to allow early diagnosis and implementation of preventive measures.
Infection with hepatitis C virus (HCV) is a global health problem; chronic infection induces the development of fibrosis and cirrhosis together with all their related complications. The use of direct-acting antiviral (DAA) drugs has proven highly effective. Telemedicine is a present-day resource that brings treatment closer to distant areas and may result in savings.

To implement a microelimination program for HCV using DAAs with support from a telemedicine program to minimize expenses.

The program was developed at the Medical Services department of Petróleos Mexicanos (SMPM) with national coverage; patients diagnosed with chronic hepatitis C were included. These were classified into locals and outsiders. Treatment for foreign patients was indicated, monitored, and completed through telemedicine, thus avoiding their transport to the country's capital city, in order to save up on transportation costs and travel allowances.

A total of 136 patients, 74 locals and 62 outsiders participated. Transfer was avoided for 62 patients (45.5 %), which meant that telemedicine resulted in USD 3,176.20 savings per patient, with overall savings of USD 196,924,40 from cost minimization. A total of 30 patients remained untreated for lack of medication, hence coverage amounted to 86 %. Sustained virological response (SVR) was achieved in 99% of cases. Only 2 patients had treatment failure. Adverse events included headache and fatigue in 5 % of the sample.

With the aid of a telemedicine approach significant savings were achieved by minimizing costs, since nearly half of patients were outsiders. Coverage reached 86 %. Treatment with DAAs was successful for 99 % of our cases.
With the aid of a telemedicine approach significant savings were achieved by minimizing costs, since nearly half of patients were outsiders. link2 Coverage reached 86 %. Treatment with DAAs was successful for 99 % of our cases.We present the case of a patient with a history of recurrent acute necrotizing pancreatitis, chronic pancreatitis and a pancreatic pseudocyst with associated pseudoaneurysm in the superior mesenteric artery. He presents active bleeding from the pseudoaneurysm into the lumen of the pseudocyst, reaching the pancreatic duct and through it the intestinal lumen causing hematochezia. link3 This is a case of hemosuccus pancreaticus trated with an interventional approach.Not applicable.
Early cholecystectomy is the gold standard treatment for acute calculous cholecystitis (AC), although for grade II, many surgeons still prefer delayed cholecystectomy, to avoid surgical complications. The aim of this study is to analyze postoperative morbidity and mortality for Tokyo Guidelines grade II AC treated with cholecystectomy, taking in to account the days of symptoms and the days since hospital admission.

Unicentre, retrospective study based on a prospective database. Patients with grade II AC treated with cholecystectomy were selected. Patients were analyzed according to Days of Symptoms (DS) and Days of Hospital Admission (DHA) until cholecystectomy. Patients were subdivided in < 3 days, 3-5 days, >5 days. Univariant and multivariant analysis for morbidity and mortality. Categorical variables were compared using chi square or Fischer's exact test. Continuous variables were compared using the Mann Whitney U test. Level of statistical significance was set at p < 0.05.

998 patients with AC diagnoses were included; 567 with grade II AC; 368 treated with cholecystectomy. Nearly 90% were treated laparoscopically; 48.1% were operated the same day of emergency admission. For DS and DHA there were no statistical differences for severe postoperative complications, although a greater number of complications were detected in >5 DS (p 0.32) and >5 DHA (p 0.00). Statistically differences were found in DS for mortality (p0.04). Postoperative length of stay was longer for >5 DHA cholecystectomies, (p > 0.05). No differences for hospital readmission.

Regardless of DS or DHA until cholecystectomy, do not exist statistically significant differences related to severe postoperative complications, length of stay or mortality.
Regardless of DS or DHA until cholecystectomy, do not exist statistically significant differences related to severe postoperative complications, length of stay or mortality.Gluten-free diet (GFD) is the treatment of celiac disease (CD), with adherence oscillating between 42 % and 91 %. Our purpose was to assess adherence to GFD and its relation to quality of life in Chilean celiac patients.
three surveys were administered online sociodemographic-health status, adherence to GFD, and quality of life.

48 % of respondents reported an excellent adherence to GFD, and 49 % a good quality of life.

adherence to GFD is low among Chilean celiac patients.
adherence to GFD is low among Chilean celiac patients.Obscure gastrointestinal bleeding is defined as bleeding from a source that cannot be identified on upper or lower gastrointestinal endoscopy, being capsule endoscopy the next step in those patients. Some patients may be unsuitable for conventional endoscopy and performing a capsule pan-endoscopic test as a first line procedure might potentially reduce the number of endoscopies and their subsequent risk. The aim of our study was to analyse our experience with capsule endoscopy in the bleeding patient setting. We retrospectively reviewed the first 100 pan-endoscopic capsule procedures performed in our centre from August 2011 until December 2016. 61.2% of our patients had positive findings; 46.26% had a previous negative gastroscopy and in 67.7% of them the capsule detected small bowel lesions and in 80.64%, colonic findings. Taking into consideration that our population were high-risk patients (mainly because of comorbidities), and that we use up to 45 ml of sodium phosphate, we analysed sodium, potassium and creatinine changes before and after procedure.
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