RESUMO
BACKGROUND: Aspirin is one of the most used drugs around the Word, it has wide therapeutic indications. From its original indications, as analgesic and anti-inflammatory and due to its platelet antiaggregate properties, this drug has become in the most employed medicine to prevent cardiovascular disease. Never the less, it is a drug with adverse effects and gastrointestinal toxicity indeed. OBJECTIVES: To identify the reasons of using aspirin, endoscopic findings on gastropathy caused by ASA and the relative risk of developing mucosal lesions. This based on a sample of adult patients in a chosen particular institution. MATERIALS AND METHODS: Prospective study of cases and controls, from January 1 to June 31, 2014, with patients with high digestive endoscopy. In the medical center Endocentro Bogotá D.C. it was selected the people with aspirin consumption on 500 mg per day dose or less taken for more than six months prior the endoscopy. RESULTS: We selected 602 patients, 534 (88%) were women and 168 (12%) were men, with an age range from 17 to 92 years and with an average of 51.8 years. 107 patients were the aspirin users, 59 (55%) were women and 48 (45%) were men, with an range from 23 to 85 years and with an average of 58 years. The follow relative risks were found: gastroduodenal erosions RR=4.9 (95%IC 3.87-8.37), gastric ulcer RR=2.4 (95%IC 1.3-9.0), duodenal ulcer RR=2.8 (95%IC 1.3-7.0) any kind of gastrointestinal injury RR=5.5 (95%IC 4.1-7.2) aspirin users without any indication to the risk of develop any mucosa injury RR=2.0 (95%IC 1.4-3.0). CONCLUSIONS: This study showed an important proportion (18%) of dispatched aspirin users adults to digestive endoscopy, the 13.8% of them have a clear indication to use it, a substantial percent (13%) cannot inform any medical reason; the aspirin usage for more than six months in doses lower than 500 mg per day increases the mucosal gastroduodenal injury prevalence (58%)and relative risk of suffering these injuries are high.
Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Duodeno/efeitos dos fármacos , Mucosa Gástrica/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Úlcera Péptica/induzido quimicamente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Colômbia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Endoscopia Gastrointestinal , Feminino , Mucosa Gástrica/diagnóstico por imagem , Mucosa Gástrica/patologia , Humanos , Mucosa Intestinal/diagnóstico por imagem , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/diagnóstico por imagem , Úlcera Péptica/patologia , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Peptic ulcer represents the most common cause of upper gastrointestinal bleeding. Endoscopic therapy can reduce the risks of rebleeding, continued bleeding, need for surgery, and mortality. The objective of this review is to compare the different modalities of endoscopic therapy. METHODS: Studies were identified by searching electronic databases MEDLINE, Embase, Cochrane, LILACS, DARE, and CINAHL. We selected randomized clinical trials that assessed contemporary endoscopic hemostatic techniques. The outcomes evaluated were: initial hemostasis, rebleeding rate, need for surgery, and mortality. The possibility of publication bias was evaluated by funnel plots. An additional analysis was made, including only the higher-quality trials. RESULTS: Twenty-eight trials involving 2988 patients were evaluated. Injection therapy alone was inferior to injection therapy with hemoclip and with thermal coagulation when evaluating rebleeding and the need for emergency surgery. Hemoclip was superior to injection therapy in terms of rebleeding; there were no statistically significant differences between hemoclip alone and hemoclip with injection therapy. There was considerable heterogeneity in the comparisons between hemoclip and thermal coagulation. There were no statistically significant differences between thermal coagulation and injection therapy, though their combination was superior, in terms of rebleeding, to thermal coagulation alone. CONCLUSIONS: Injection therapy should not be used alone. Hemoclip is superior to injection therapy, and combining hemoclip with an injectate does not improve hemostatic efficacy above hemoclip alone. Thermal coagulation has similar efficacy as injection therapy; combining these appears to be superior to thermal coagulation alone. Therefore, we recommend the application of hemoclips or the combined use of injection therapy with thermal coagulation for the treatment of peptic ulcer bleeding.
Assuntos
Hemostase Endoscópica , Técnicas Hemostáticas , Úlcera Péptica Hemorrágica/terapia , Úlcera Péptica/patologia , Humanos , Úlcera Péptica/diagnóstico por imagem , Úlcera Péptica Hemorrágica/diagnóstico por imagem , Úlcera Péptica Hemorrágica/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Resultado do TratamentoRESUMO
Los autores hacen un análisis retrospectivo de 1085 estudios radiológicos de estómago y duodeno para estudiar la relación entre la úlcera péptica y los disturbios de tonicidad y motilidad ganstricas.Fueran observados alteraciones del tono y de la motilidad en mayor número de pacientes con úlcera péptica,en comparación con los pacientes sin úlcera .Fué verificado disminución significativa de la tonicidad del estómgo en la úlcera gástrica, sin predominio de hiper o hipomotilidad en las úlceras duodenales y gástricas.Luego del análisis ,presentan sugestiones acerca de la etiopatogenia de la enfermedad,proponiendo la técnica de vagotomía,antrectomía y anastomosis gastroduodenal a nivel de la curvatura menor,como una cirugía eficaz para la corrección de la úlcera,hoy principalmente,en la obstrucción del píloro,llevando en consideración la preservación del tono y de la motilidad gástrica
Assuntos
Adulto , Úlcera Péptica/cirurgia , Úlcera Péptica/diagnóstico por imagemRESUMO
Experiencia de 1.336 exámenes S.E.G.D. desde marzo de 1993 hasta marzo de 1994, de los que 792 (59,3 por ciento) son de sexo femenino y 544 (40,7 por ciento) masculino. En 198 casos (14,8 por ciento) presentó patología duodenal, de los que 158 (79,8 por ciento) corresponden a Enfermedad Péptica Duodenal (E.P.D.) y 40 (20,2 por ciento) a otras patologías. Se describe la Técnica de Doble Contraste y se presenta una clasificación desde el punto de vista de la imagen pesquisada y sus similitudes y diferencias con la clasificación de O.M.E.D. (Organización Mundial de Endoscopía Digestiva) (AU)
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Úlcera Duodenal/diagnóstico , Úlcera Péptica/diagnóstico por imagem , Radiografia/métodos , Úlcera Duodenal/classificação , Úlcera Duodenal/diagnóstico por imagem , Úlcera Péptica/diagnóstico , Radiografia/classificação , ArgentinaRESUMO
The ultrasonographic study of gastroduodenal lesions has received little attention. We report the results of ultrasound examination in 39 patients with gastric ulcer and 14 patients with duodenal ulcers, all endoscopically confirmed. We describe six varieties of ultrasonographic images that change with front or side views of the crater, according to the contents of the crater (liquid, sediment of air-mucus) and according to its localization (proximal or distal to the transducer). The importance of gastroduodenal segment exploration during ultrasound examination is emphasized.
Assuntos
Úlcera Péptica/diagnóstico por imagem , Humanos , UltrassonografiaRESUMO
Los autores realizan la técnica de doble contraste gastroduodenal, con el objeto de demosatrar lesiones que pasarían desapercibidas con otras técnicas radiológicas. En razón de los progresos de la Endoscopía en los últimos años, se hace necesario un estudio radiológico minucioso para poder alcanzar las posibilidades diagnósticas que aquella ha logrado. Un buen aporte en este sentido, se logra con la compresión con balón inflable en decúbito pronto y con las movilización del paciente bajo control radioscópico (AU)
Assuntos
Humanos , Postura , Mucosa Gástrica/diagnóstico por imagem , Úlcera Péptica/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagem , Brometo de Butilescopolamônio/diagnósticoRESUMO
The authors perform the upper gastrointestinal examination in order to demonstrate lesions that would not be seen by other radiologic techniques. Due to the progress of Endoscopy in the last years, it is necessary a detailed radiologic examination to reach the diagnostic possibilities that the former did. A good help to do that is the compression in prone dedecubitus with inflatable balloon and the patient's mobilization under radioscopic control.
Assuntos
Mucosa Gástrica/diagnóstico por imagem , Úlcera Péptica/diagnóstico por imagem , Postura , Neoplasias Gástricas/diagnóstico por imagem , Sulfato de Bário , Brometo de Butilescopolamônio , Humanos , RadiografiaAssuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Feminino , Alumínio/diagnóstico , Tecnécio/diagnóstico , Úlcera Péptica/diagnóstico por imagemAssuntos
Úlcera Péptica/diagnóstico , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Úlcera Duodenal/diagnóstico , Endoscopia , Feminino , Gastrite/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/diagnóstico por imagem , Estudos Prospectivos , Radiografia , Neoplasias Gástricas/diagnóstico , Úlcera Gástrica/diagnósticoRESUMO
The double contrast radiologic examination performed routinely allows us to improve the study of the mucosal relief, thus increasing the diagnosis of gastric ulcers, polyps and gastric cancer. In the operated stomach one can obtain better results with this technique than with the conventional examinations.