To assess the reasons and forms of presentation and to correlate disease status to the degree of spread and outcome.
Descriptive and retrospective study was performed on patients with DVT by review ...of clinical records. The patient was divided into non-cirrhotic, cirrhotic and cirrhotic with hepatocarcinoma; age, gender, a form of diagnosis, degree of spread of thrombosis and outcome were assessed. Qualitative variables were expressed as frequency and percentage, and numerical variables as means and standard deviation.
We studied sixteen patients with a median age of 61 years. 3 (18.75%) were non-cirrhotic, 7 (43.75%) were cirrhotic and 6 (37.5%) were cirrhotic with hepatocarcinoma, 4 (30. 76%) due to HCV, 2 (15.38%) autoimmune, 1 (7.69%) due to alcohol, 1 (7.69%) MAFLD, mixed in 2 patients and 3 (23.07%) undetermined. Non-cirrhotic patients, 1 (33.33%) protein C deficiency, 1 (33.33%) antithrombin deficiency; 100% with abdominal pain, the cirrhosis without HCC, 2 (28.57%) were asymptomatic and 5 (71.4%) with decompensation, the patients with CH+HCC, 3 (50%) with encephalopathy. Complete DVT was onset in 14 (87.5%) and in 2 (12.5%), it was partially. It was located in the PV and/or its intrahepatic branches in 13 (81.2%) and in 3 (18.75%) extensions to the superior mesenteric vein and/or splenic vein. Patients without cirrhosis all received anticoagulant treatment; of patients with DVT with cirrhosis with or without HCC, 53% received treatment. They were mainly being treated with low-molecular weight heparin, and oral anticoagulants. In cirrhotic patients, 8 (61.52%) died as compared to non-cirrhotic patients who were discharged.
In our setting, DVT was more frequent in patients with cirrhosis, particularly those with late liver disease and HCC, with uncompensation as the main clinical manifestation in this group of patients.
The resources used in this study were from the hospital without any additional financing
The authors declare no potential conflicts of interest.
Detection of hepatitis C virus (HCV) infection is effective because there is an effective treatment. In Mexico, a seroprevalence of 1.4% is reported for the population, with the main risk factors ...being transfusion of blood products and unprotected sexual intercourse. This study aimed to detect anti-HCV and risk factors in La Raza National Medical Center.
Observational, longitudinal and descriptive study. A survey of risk factors was applied to the general population, signing informed consent, and a capillary sample was taken to determine anti-HCV with rapid immunochromatographic tests with colloidal gold for qualitative detection. Data were expressed as means, frequencies and percentages.
279 tests were performed. There were 175 women (62.7%) and 104 men (37.2%), and the average age was 44.3 years. The risk factors were: unprotected sexual contact (n=141, 50.5%), presence of piercings or tattoos (n=86, 30.8%), accidents with sharp material (n=67, 24%), contact with catheters or endoscopes (n=52, 18.6%), sharing razor blades or toothbrushes (n=38, 13.6%), multiple sexual contacts (n=35, 12.5%), contact with HCV-positive patients (n=27, 9.6 %), transfusions before 1995 (n=17, 6%), STDs (n=14, 5%), intranasal drug use (n=8, 2.8%), sexual drug use (n=5, 1.7%) and others (n=19, 6.8%). None was reactive. Figure 1.
No anti-HCV reactive cases were detected. The risk factor, unprotected sexual intercourse, is the main one and the second is the presence of tattoos and piercings, but this did not influence the prevalence.
The resources used in this study were from the hospital without any additional financing
The authors declare no potential conflicts of interest.
The Mexican consensus on alcoholic hepatitis Velarde-Ruiz Velasco, J A; Higuera-de la Tijera, M F; Castro-Narro, G E ...
Revista de gastroenterologia de Mexico (English),
07/2020, Letnik:
85, Številka:
3
Conference Proceeding
Coagulation management in the patient with cirrhosis has undergone a significant transformation since the beginning of this century, with the concept of a rebalancing between procoagulant and ...anticoagulant factors. The paradigm that patients with cirrhosis have a greater bleeding tendency has changed, as a result of this rebalancing. In addition, it has brought to light the presence of complications related to thrombotic events in this group of patients.
These guidelines detail aspects related to pathophysiologic mechanisms that intervene in the maintenance of hemostasis in the patient with cirrhosis, the relevance of portal hypertension, mechanical factors for the development of bleeding, modifications in the hepatic synthesis of coagulation factors, and the changes in the reticuloendothelial system in acute hepatic decompensation and acute-on-chronic liver failure. They address new aspects related to the hemorrhagic complications in patients with cirrhosis, considering the risk for bleeding during diagnostic or therapeutic procedures, as well as the usefulness of different tools for diagnosing coagulation and recommendations on the pharmacologic treatment and blood-product transfusion in the context of hemorrhage. These guidelines also update the knowledge regarding hypercoagulability in the patient with cirrhosis, as well as the efficacy and safety of treatment with the different anticoagulation regimens. Lastly, they provide recommendations on coagulation management in the context of acute-on-chronic liver failure, acute liver decompensation, and specific aspects related to the patient undergoing liver transplantation.
El manejo de la coagulación en el paciente con cirrosis ha sufrido una transformación significativa a partir de principios de este siglo, con el concepto de un rebalanceo entre factores procoagulantes y anticoagulantes. Esto ha cambiado el paradigma de que los pacientes con cirrosis tienen una mayor tendencia a la hemorragia, ya que existe un rebalanceo entre factores procoagulantes y anticoagulantes. Además, ha traído a la luz la presencia de complicaciones relacionadas a eventos trombóticos en este grupo de pacientes.
En estas guías se detallan aspectos relacionados con los mecanismos fisiopatológicos que intervienen en el mantenimiento de la hemostasia en el paciente con cirrosis, la relevancia de la hipertensión portal, factores mecánicos para el desarrollo de sangrado, modificaciones en la síntesis hepática de factores de coagulación, y los cambios en el sistema reticuloendotelial en la descompensación hepática aguda e insuficiencia hepática aguda sobre crónica (IHAC). Se abordan nuevos aspectos relacionados a las complicaciones hemorrágicas en pacientes con cirrosis, considerando el riesgo de hemorragia durante procedimientos diagnósticos o terapéuticos, así como la utilidad de diferentes herramientas diagnósticas de la coagulación y recomendaciones en el tratamiento farmacológico y transfusión de hemoderivados en el contexto de hemorragia. En estas guías se actualiza el conocimiento respecto al diagnóstico y abordaje de complicaciones relacionadas a hipercoagulabilidad en el paciente con cirrosis, así como la eficacia y seguridad del tratamiento con diferentes esquemas de anticoagulación. Finalmente, se mencionarán recomendaciones en el manejo de la coagulación en el contexto de IHAC, descompensación hepática aguda y aspectos específicos relacionados al paciente en protocolo de trasplante hepático.
The term cholestasis refers to bile acid retention, whether within the hepatocyte or in the bile ducts of any caliber. Biochemically, it is defined by a level of alkaline phosphatase that is ...1.67-times higher than the upper limit of normal. Cholestatic diseases can be associated with an inflammatory process of the liver that destroys hepatocytes (hepatitis), withjaundice (yellowing of the skin and mucus membranes, associated with elevated serum bilirubin levels), or with both, albeit the three concepts should not be considered synonymous. Cholestatic diseases can be classified as intrahepatic or extrahepatic, depending on their etiology. Knowing the cause of the condition is important for choosing the adequate diagnostic studies and appropriate treatment in each case. A complete medical history, together with a thorough physical examination and basic initial studies, such as liver ultrasound and liver function tests, aid the clinician in deciding which path to follow, when managing the patient with cholestasis. In a joint effort, the Asociación Mexicana de Hepatología (AMH), the Asociación Mexicana de Gastroenterología (AMG) and the Asociación Mexicana de Endoscopia Gastrointestinal (AMEG) developed the first Mexican scientific position statement on said theme.
El término colestasis se refiere a la retención de ácidos biliares ya sea dentro del hepatocito o en los ductos biliares de cualquier calibre. Por laboratorio, se define por la elevación de fosfatasa alcalina arriba de 1.67 veces su valor normal. Las enfermedades colestásicas pueden asociarse a un proceso inflamatorio de la glándula hepática que provoca destrucción de los hepatocitos (hepatitis), a ictericia (coloración amarillenta de piel y mucosas asociada a elevación en niveles séricos de bilirrubinas) o ambas, aunque estos tres conceptos no deben considerarse sinónimos. Los padecimientos colestásicos pueden clasificarse como intra o extrahepáticos dependiendo de su etiología, y esto es importante para elegir los estudios diagnósticos adecuados y la terapéutica indicada en cada uno de los casos. Una historia clínica completa, aunada a exploración física exhaustiva y estudios iniciales básicos como el ultrasonido hepático y las pruebas de funcionamiento del hígado pueden ayudar al clínico a decidir el camino a seguir al enfrentarse al paciente con colestasis. La Asociación Mexicana de Hepatología, la Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Endoscopia Gastrointestinal decidieron trabajar en el primer posicionamiento científico mexicano sobre este tema.
The Mexican consensus on the treatment of hepatitis C Aiza-Haddad, I; Ballesteros-Amozurrutia, A; Borjas-Almaguer, O D ...
Revista de Gastroenterología de México (English Edition),
2018 Jul - Sep, 20180701, Letnik:
83, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The aim of the Mexican Consensus on the Treatment of HepatitisC was to develop clinical practice guidelines applicable to Mexico. The expert opinion of specialists in the following areas was taken ...into account: gastroenterology, infectious diseases, and hepatology. A search of the medical literature was carried out on the MEDLINE, EMBASE, and CENTRAL databases through keywords related to hepatitisC treatment. The quality of evidence was subsequently evaluated using the GRADE system and the consensus statements were formulated. The statements were then voted upon, using the modified Delphi system, and reviewed and corrected by a panel of 34 voting participants. Finally, the level of agreement was classified for each statement. The present guidelines provide recommendations with an emphasis on the new direct-acting antivirals, to facilitate their use in clinical practice. Each case must be individualized according to the comorbidities involved and patient management must always be multidisciplinary.
Bolitoglossa mombachoensis is an endemic neotropical salamander of the Mombacho Volcano, Nicaragua. Canopy communities within the tropics are hubs for biodiversity, and many tropical plethodontids ...have a foraging preference for epiphytic plants, such as bromeliads, which provide moist microclimates for shelter, foraging, and nesting. Habitat loss continues to be the biggest threat to amphibians worldwide. This species is highly dependent on nocturnal arboreal climbing. We describe their plant preference, which extends beyond bromeliads, and their arboreal dependence used for refuge and foraging. Foraging behavior is constricted to nighttime, plant availability, geography, and altitude.
There are physiological changes in the hepatobiliary system during pregnancy. However, there are also pregnancy-related liver diseases, which occur in up to 3% of all pregnancies and can have ...potentially serious consequences for the mother and fetus. The most frequent are hyperemesis gravidarum, preeclampsia/eclampsia, elevated liver enzymes and low platelet count syndrome (HELLP), intrahepatic cholestasis of pregnancy (ICP) and acute fatty liver of pregnancy (AFLP). The prognosis depends on timely diagnosis and treatment. This study aimed to report the epidemiological characteristics of liver diseases in a Mexican population of pregnant women.
A retrospective descriptive observational study that included information collected from the electronic file of pregnant patients treated at UMAE HGO No. 3, of CMN La Raza, assessed by the Gastroenterology service of HE CMN “La Raza” in the period March 2021- May 2023.
142 patients were included, the mean age was 30 years, 54% were multiparous women, 8.4% of the patients were in the first trimester, 27% in the second trimester and 64% in the third trimester. In our total sample, alterations in liver biochemistry that met clinical and biochemical criteria for pregnancy-associated liver disease were analyzed, where 49% reported hypertransaminasaemia due to etiologies such as preeclampsia, HELLP syndrome, metabolic dysfunction associated fatty liver disease (MAFLD) and biliary pathology, 41% met criteria for ICP, 6% hyperemesis gravidarum, 1.4% were diagnosed with portal hypertension and liver cirrhosis, only 0.7% were diagnosed with autoimmune hepatitis and AFLP.
Based on solicited assessments over a 2-year period of women at any stage of pregnancy, hospitalized due to changes in liver biochemistry, most changes occurred In the third trimester of pregnancy, the most frequent disorder was intrahepatic cholestasis of the pregnancy, the rest of the pathologies were included in the hypertransaminasaemia group, where the most frequent causes were: MAFLD and cholelithiasis, less frequently: preeclampsia, HELLP syndrome or intrahepatic bile duct disorders.
PDF
