Caracterización de los pacientes con hemorragia de vías digestivas altas no varicosa en un hospital de tercer nivel de Cundinamarca, Colombia

Upper gastrointestinal tract bleeding is a common emergency whose most common etiology is a peptic ulcer. Restoration of intravascular volume and blood pressure management are priorities before identifying the cause of bleeding. After initial resuscitation and after hemodynamic stabilization has been achieved, an esophagogastroduodenoscopy (EGD) should be performed to identify the cause of bleeding and determine the treatment needed. This is a study performed at a third level referral hospital in Cundinamarca, Colombia. Materials and Methods: This is a retrospective study of data from electronic medical records of adult patients admitted to the emergency room of the Hospital Universitario de la Samaritana (HUS) because of upper gastrointestinal tract bleeding which ahd been diagnosed because of hematemesis, melena, rectal bleeding and/or anemia. Patients all underwent EGD between April 2010 and April 2011. Results: 385 patients with upper gastrointestinal tract bleeding were seen during the study period, but 100 were excluded because of bleeding secondary esophageal varices, incomplete clinical histories and lower gastrointestinal bleeding. A total of 285 patients were included. 69.1 % were older than 60 years, 73.3 % had hypertension, 55.1 % reported use of inflammatory drugs (NSAIDs) and aspirin (ASA), 19.6 % reported previous bleeding episodes, and 17.9 % had hemodynamic instability. 63 patients (22.1 %) required endoscopic hemostasis, and 32 (11.2 %) experienced rebleeding. Overall mortality reported was 13.1 % of which 55.3 % were men. Mortality attributable to gastrointestinal bleeding was 3.1 %. Conclusions: The majority of patients served by the HUS with upper GI bleeding are adults over 60 years. Peptic ulcers remain the most common diagnosis associated with the use of NSAIDs and ASA. The mortality rate is comparable to international standards. © 2013 Asociaciones Colombianas de Gastroenterología

Caracterización de los pacientes con hemorragia de vías digestivas altas no varicosa en un hospital de tercer nivel de Cundinamarca, Colombia

Upper gastrointestinal tract bleeding is a common emergency whose most common etiology is a peptic ulcer. Restoration of intravascular volume and blood pressure management are priorities before identifying the cause of bleeding. After initial resuscitation and after hemodynamic stabilization has been achieved, an esophagogastroduodenoscopy (EGD) should be performed to identify the cause of bleeding and determine the treatment needed. This is a study performed at a third level referral hospital in Cundinamarca, Colombia. Materials and Methods: This is a retrospective study of data from electronic medical records of adult patients admitted to the emergency room of the Hospital Universitario de la Samaritana (HUS) because of upper gastrointestinal tract bleeding which ahd been diagnosed because of hematemesis, melena, rectal bleeding and/or anemia. Patients all underwent EGD between April 2010 and April 2011. Results: 385 patients with upper gastrointestinal tract bleeding were seen during the study period, but 100 were excluded because of bleeding secondary esophageal varices, incomplete clinical histories and lower gastrointestinal bleeding. A total of 285 patients were included. 69.1 % were older than 60 years, 73.3 % had hypertension, 55.1 % reported use of inflammatory drugs (NSAIDs) and aspirin (ASA), 19.6 % reported previous bleeding episodes, and 17.9 % had hemodynamic instability. 63 patients (22.1 %) required endoscopic hemostasis, and 32 (11.2 %) experienced rebleeding. Overall mortality reported was 13.1 % of which 55.3 % were men. Mortality attributable to gastrointestinal bleeding was 3.1 %. Conclusions: The majority of patients served by the HUS with upper GI bleeding are adults over 60 years. Peptic ulcers remain the most common diagnosis associated with the use of NSAIDs and ASA. The mortality rate is comparable to international standards. © 2013 Asociaciones Colombianas de Gastroenterología

Tuberculosis esofágica: Informe de un caso

We report the case of an immune-competent man with symptoms of upper gastrointestinal bleeding secondary to esophageal ulcers of tubercular origin. Gastrointestinal involvement from Mycobacterium tuberculosis is rare even in patients with numerous occurrences of pulmonary and extrapulmonary diseases. The most frequently affected sites are the terminal ileum and the peritoneum. Esophageal tuberculosis is exotic and is usually secondary to extension from neighboring infected organs such as the mediastinal nodes and/or the bronchi. Clinical, endoscopic and radiological pictures of the esophageal disease often mimic malignancy. Tuberculosis treatment is the mainstay of treatment, and surgery is rarely required. © 2014 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología

Tuberculosis esofágica: Informe de un caso

We report the case of an immune-competent man with symptoms of upper gastrointestinal bleeding secondary to esophageal ulcers of tubercular origin. Gastrointestinal involvement from Mycobacterium tuberculosis is rare even in patients with numerous occurrences of pulmonary and extrapulmonary diseases. The most frequently affected sites are the terminal ileum and the peritoneum. Esophageal tuberculosis is exotic and is usually secondary to extension from neighboring infected organs such as the mediastinal nodes and/or the bronchi. Clinical, endoscopic and radiological pictures of the esophageal disease often mimic malignancy. Tuberculosis treatment is the mainstay of treatment, and surgery is rarely required. © 2014 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología

Enfermedad de Alzheimer y disfagia. Desarrollo del compromiso deglutorio

Dysphagia is a common symptom in many neurological diseases, particularly occurring after a stroke or head trauma. Another important group of patients who develop swallowing dysfunctions are older adults with progressive loss of cognitive functions such as patients with Alzheimer's disease. This type of disease is accompanied by difficulty swallowing that has been associated with increased mortality due to respiratory complications that are potentially preventable if dysphagia is recognized early so that appropriate strategies for treatment can be used. © 2013 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología

Enfermedad de Alzheimer y disfagia. Desarrollo del compromiso deglutorio

Dysphagia is a common symptom in many neurological diseases, particularly occurring after a stroke or head trauma. Another important group of patients who develop swallowing dysfunctions are older adults with progressive loss of cognitive functions such as patients with Alzheimer's disease. This type of disease is accompanied by difficulty swallowing that has been associated with increased mortality due to respiratory complications that are potentially preventable if dysphagia is recognized early so that appropriate strategies for treatment can be used. © 2013 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection. © 2019, The Author(s)