Status of Endangered and Threatened Sand Area Species of the Illinois Flora

This study was undertaken to determine the distribution and habitat requirements of many of the endangered and threatened plant species associated with the sand deposits of Illinois. Approximately 70 species of endangered and threatened plants are known to grow in these deposits. The habitat fidelity and natural community types were determined for 40 of these species that are restricted to these glacial drift sand habitats. Plant community types, associated species, moisture requirements, and other data concerning each of the plant species were determined by reviewing the pertinent literature, searching the Illinois Department of Natural Resources Natural Heritage Database, through discussions with botanists and natural heritage biologists, examination of herbarium specimens, and our studies of the vegetation of the Illinois sand deposits. Throughout the course of these studies, most of the nature preserves, state parks, and identified natural areas in the sand regions were visited on numerous occasions and vegetation surveys undertaken. The information presented in this paper could allow rare plant conservation in Illinois to become more proactive by encouraging the selection of sites where in situ conservation efforts could be conducted by state, local, and nongovernmental organizations.published or submitted for publicationis peer reviewe

Papel de la ultrasonografía hepatobiliar en el diagnóstico de coledocolitiasis

Background Jaundice is a diagnostic approximation that combines different signs and symptoms. Although Endoscopic Retrograde Cholangiopancreatography (ERCP) can be a therapeutic option for this pathology, it is an invasive procedure with morbidity and mortality risks. Therefore, this procedure should be used therapeutically rather than in diagnosis, and other accurate diagnostic procedures should be used first. If hepatobiliary echography can be adapted to detect pathological signs of obstructive jaundice it would be important, since in our context ultrasound is used to determine the possibility of using an invasive test such as ERCP. The objective of the study was to determine what correlation existed between the hepatobiliary ultrasound and ERCP of the biliary tract in those procedures performed at University Hospital de La Samaritana (UHS) between March 1, 2005 and November 1, 2007. Materials and methods This was a retrospective study of diagnostic test results. Information was collected using a closed-ended set of questions. This questionnaire described patient characteristics and findings from hepatobiliary ultrasound and ERCP reports. First, ERCP patients were descriptively analyzed, then sensitivities, specificities and odds ratios (OR) were calculated. Cohen's kappa index was used (?): Po-Pe/1-Pe) to determine the degree of agreement between the tests Results. During the study period ERCPs were performed on 457 patients of whom 271 fulfilled the inclusion criteria. For the diagnosis of biliary tract expansion hepatobiliary ultrasound's sensitivity was 66.5% (CI 95%: 60.2 to 72.5) and its specificity was 65.6% (CI 95%: 46.8 to 81.4). Negative OR was 49%. For the diagnosis of choledocolithiasis hepatobiliary ultrasound's sensitivity was 25.6% (CI 95%: 18.4 to 33.9) and its specificity was 87.7% (CI 95%: 81.0 to 92.7). Conclusions This study confirms that in our context hepatobiliary ultrasound has low sensitivity and specificity for diagnosis of both obstructive biliary disease and choledocolithiasis. In addition it showed low levels of agreement between the findings detected by hepatobiliary ultrasound and ERCP. The use of other diagnostic tools such as endoscopic echography is recommended prior to performing an ERCP when the probability of choledocolithiasis is low to average. This will decrease the risk of comorbidity and mortality among patients. © 2010 Asociaciones Colombianas de Gastroenterología

Papel de la ultrasonografía hepatobiliar en el diagnóstico de coledocolitiasis

Background Jaundice is a diagnostic approximation that combines different signs and symptoms. Although Endoscopic Retrograde Cholangiopancreatography (ERCP) can be a therapeutic option for this pathology, it is an invasive procedure with morbidity and mortality risks. Therefore, this procedure should be used therapeutically rather than in diagnosis, and other accurate diagnostic procedures should be used first. If hepatobiliary echography can be adapted to detect pathological signs of obstructive jaundice it would be important, since in our context ultrasound is used to determine the possibility of using an invasive test such as ERCP. The objective of the study was to determine what correlation existed between the hepatobiliary ultrasound and ERCP of the biliary tract in those procedures performed at University Hospital de La Samaritana (UHS) between March 1, 2005 and November 1, 2007. Materials and methods This was a retrospective study of diagnostic test results. Information was collected using a closed-ended set of questions. This questionnaire described patient characteristics and findings from hepatobiliary ultrasound and ERCP reports. First, ERCP patients were descriptively analyzed, then sensitivities, specificities and odds ratios (OR) were calculated. Cohen's kappa index was used (?): Po-Pe/1-Pe) to determine the degree of agreement between the tests Results. During the study period ERCPs were performed on 457 patients of whom 271 fulfilled the inclusion criteria. For the diagnosis of biliary tract expansion hepatobiliary ultrasound's sensitivity was 66.5% (CI 95%: 60.2 to 72.5) and its specificity was 65.6% (CI 95%: 46.8 to 81.4). Negative OR was 49%. For the diagnosis of choledocolithiasis hepatobiliary ultrasound's sensitivity was 25.6% (CI 95%: 18.4 to 33.9) and its specificity was 87.7% (CI 95%: 81.0 to 92.7). Conclusions This study confirms that in our context hepatobiliary ultrasound has low sensitivity and specificity for diagnosis of both obstructive biliary disease and choledocolithiasis. In addition it showed low levels of agreement between the findings detected by hepatobiliary ultrasound and ERCP. The use of other diagnostic tools such as endoscopic echography is recommended prior to performing an ERCP when the probability of choledocolithiasis is low to average. This will decrease the risk of comorbidity and mortality among patients. © 2010 Asociaciones Colombianas de Gastroenterología

Hipertensiónportal en el embarazo: presentaciónde un caso

The coexistence of pregnancy and liver disease represents a complex clinical situation. Pregnancy develops hypervolemic state due to increased splachnic blood flow, which contributes to increased portal pressure transmitted to collateral veins that increase the risk of variceal bleeding in these patients. We report the case of a 39 years old patient in the sixth pregnancy and without any previous medical history that presented pre-sinusoidal portal hypertension, and thanks to appropriate multidisciplinary management had an uncomplicated delivery. We review the literature relevant to the case

Hipertensiónportal en el embarazo: presentaciónde un caso

The coexistence of pregnancy and liver disease represents a complex clinical situation. Pregnancy develops hypervolemic state due to increased splachnic blood flow, which contributes to increased portal pressure transmitted to collateral veins that increase the risk of variceal bleeding in these patients. We report the case of a 39 years old patient in the sixth pregnancy and without any previous medical history that presented pre-sinusoidal portal hypertension, and thanks to appropriate multidisciplinary management had an uncomplicated delivery. We review the literature relevant to the case

SAT0192 Abatacept subcutáneo en pacientes con artritis reumatoide: una experiencia de la vida real

Background Therapeutic guidelines draw heavily on evidence from randomised controlled trials undertaken in well-characterised, highly-selective populations and managed in tightly-controlled settings. As such, the extent to which therapeutic efficacy in real-life populations and routine care settings is often unclear

SAT0319 Severidad en pacientes con lupus eritematoso sistémico: un análisis de rasgos latentes

Background Systemic Lupus Erythematosus (SLE) is a complex disease which can potentially involve any organ and, therefore, has a wide range of clinical manifestations (i.e., subphenotypes

SAT0306 ¿Cómo afecta el tabaquismo el síndrome de Sjögren?

Background Cigarette smoking has been found to play a pathogenic role in several autoimmune diseases. However, data about its influence on Sjögren's syndrome (SS) is scarc

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