Publisher: SciELO   (Total: 911 journals)

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Showing 601 - 800 of 911 Journals sorted alphabetically
Revista Chilena de Anatomia     Open Access  
Revista Chilena de Cardiología     Open Access  
Revista Chilena de Cirugía     Open Access   (Followers: 1)
Revista Chilena de Derecho     Open Access   (Followers: 2, SJR: 0.645, CiteScore: 0)
Revista Chilena de Derecho Privado     Open Access   (Followers: 1)
Revista Chilena de Enfermedades Respiratorias     Open Access  
Revista Chilena de Infectología     Open Access   (SJR: 0.202, CiteScore: 0)
Revista Chilena de Literatura     Open Access   (Followers: 2, SJR: 0.16, CiteScore: 0)
Revista Chilena de Neuro-Psiquiatria     Open Access   (SJR: 0.137, CiteScore: 0)
Revista Chilena de Nutricion     Open Access   (Followers: 2, SJR: 0.167, CiteScore: 0)
Revista Chilena de Obstetricia y Ginecologia     Open Access   (Followers: 1, SJR: 0.139, CiteScore: 0)
Revista Chilena de Pediatria     Open Access   (Followers: 1, SJR: 0.171, CiteScore: 0)
Revista Chilena de Radiologia     Open Access   (SJR: 0.124, CiteScore: 0)
Revista Ciência Agronômica     Open Access   (SJR: 0.498, CiteScore: 1)
Revista Ciencia y Cultura     Open Access  
Revista Ciencias Técnicas Agropecuarias     Open Access  
Revista Científica Ciencia Médica     Open Access  
Revista Científica de la UCSA     Open Access  
Revista Científica General José María Córdova     Open Access  
Revista Clínica de Medicina de Familia     Open Access   (Followers: 4)
Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral     Open Access   (Followers: 2)
Revista Colombiana de Anestesiología     Open Access   (Followers: 1, SJR: 0.154, CiteScore: 0)
Revista Colombiana de Antropologia     Open Access   (Followers: 2, SJR: 0.232, CiteScore: 0)
Revista Colombiana de Biotecnología     Open Access   (Followers: 1)
Revista Colombiana de Cancerología     Open Access   (SJR: 0.106, CiteScore: 0)
Revista Colombiana de Cardiologia     Open Access   (SJR: 0.113, CiteScore: 0)
Revista Colombiana de Ciencias Químico-Farmacéuticas     Open Access   (Followers: 1)
Revista Colombiana de Educación     Open Access  
Revista Colombiana de Entomología     Open Access   (Followers: 1, SJR: 0.184, CiteScore: 0)
Revista Colombiana de Estadística     Open Access   (SJR: 0.361, CiteScore: 1)
Revista Colombiana de Matemáticas     Open Access   (Followers: 1, SJR: 0.136, CiteScore: 0)
Revista Colombiana de Psicología     Open Access   (SJR: 0.151, CiteScore: 0)
Revista Colombiana de Química     Open Access   (Followers: 1, SJR: 0.115, CiteScore: 0)
Revista Contabilidade & Finanças     Open Access   (SJR: 0.145, CiteScore: 0)
Revista Costarricense de Cardiología     Open Access  
Revista Costarricense de Psicología     Open Access  
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista Cubana de Angiología y Cirugía Vascular     Open Access  
Revista Cubana de Cirugía     Open Access  
Revista Cubana de Endocrinología     Open Access   (Followers: 1)
Revista Cubana de Enfermería     Open Access   (Followers: 2, SJR: 0.102, CiteScore: 0)
Revista Cubana de Estomatologí­a     Open Access   (SJR: 0.128, CiteScore: 0)
Revista Cubana de Hematología, Inmunología y Hemoterapia     Open Access   (SJR: 0.196, CiteScore: 0)
Revista Cubana de Información en Ciencias de la Salud     Open Access   (SJR: 0.229, CiteScore: 0)
Revista Cubana de Informática Médica     Open Access  
Revista Cubana de Investigaciones Biomédicas     Open Access   (Followers: 1, SJR: 0.13, CiteScore: 0)
Revista Cubana de Medicina     Open Access   (Followers: 2)
Revista Cubana de Medicina General Integral     Open Access   (Followers: 1, SJR: 0.263, CiteScore: 0)
Revista Cubana de Medicina Militar     Open Access   (Followers: 1, SJR: 0.202, CiteScore: 0)
Revista Cubana de Medicina Tropical     Open Access   (SJR: 0.143, CiteScore: 0)
Revista Cubana de Obstetricia y Ginecología     Open Access   (SJR: 0.191, CiteScore: 0)
Revista Cubana de Oftalmología     Open Access   (Followers: 1)
Revista Cubana de Ortopedia y Traumatologí­a     Open Access   (SJR: 0.101, CiteScore: 0)
Revista Cubana de Plantas Medicinales     Open Access   (Followers: 1, SJR: 0.127, CiteScore: 0)
Revista Cubana de Salud Pública     Open Access   (SJR: 0.262, CiteScore: 0)
Revista da Educação Física : UEM     Open Access   (Followers: 1)
Revista da Escola de Enfermagem da USP     Open Access   (Followers: 2, SJR: 0.279, CiteScore: 1)
Revista da Faculdade de Educação     Open Access  
Revista da Sociedade Brasileira de Fonoaudiologia     Open Access  
Revista da Sociedade Brasileira de Medicina Tropical     Open Access   (SJR: 0.658, CiteScore: 1)
Revista de Administração - RAUSP     Open Access   (Followers: 1)
Revista de Administração Contemporânea     Open Access  
Revista de Administração de Empresas     Open Access   (Followers: 1, SJR: 0.16, CiteScore: 0)
Revista de Administração Pública     Open Access   (SJR: 0.294, CiteScore: 0)
Revista de Análisis Económico     Open Access   (SJR: 0.112, CiteScore: 0)
Revista de Antropologia     Open Access   (Followers: 4, SJR: 0.102, CiteScore: 0)
Revista de Bioética y Derecho     Open Access  
Revista de Biología Marina y Oceanografía     Open Access   (SJR: 0.23, CiteScore: 0)
Revista de Biología Tropical     Open Access   (Followers: 1, SJR: 0.326, CiteScore: 1)
Revista de Ciencia Politica     Open Access   (Followers: 2, SJR: 0.368, CiteScore: 1)
Revista de Ciencia y Tecnología     Open Access  
Revista de Ciências Agrárias     Open Access  
Revista de Ciencias Médicas de Pinar del Río     Open Access  
Revista de Ciencias Sociales     Open Access   (Followers: 1)
Revista de Cirugía     Open Access   (SJR: 0.121, CiteScore: 0)
Revista de Derecho     Open Access   (SJR: 0.364, CiteScore: 0)
Revista de Derecho (Concepción)     Open Access   (Followers: 2)
Revista de Derecho (Coquimbo)     Open Access  
Revista de Economía     Open Access   (Followers: 1)
Revista de Economia Contemporânea     Open Access   (SJR: 0.121, CiteScore: 0)
Revista de Economía del Caribe     Open Access  
Revista de Economia e Sociologia Rural     Open Access   (Followers: 2, SJR: 0.265, CiteScore: 0)
Revista de Economía Institucional     Open Access   (SJR: 0.141, CiteScore: 0)
Revista de Economia Poli­tíca     Open Access   (Followers: 1, SJR: 0.282, CiteScore: 0)
Revista de Enfermagem Referência     Open Access   (Followers: 2)
Revista de Estudios Historico-Juridicos     Open Access   (Followers: 1, SJR: 0.123, CiteScore: 0)
Revista de Estudios Sociales     Open Access   (Followers: 2, SJR: 0.166, CiteScore: 0)
Revista de Filosofia     Open Access   (SJR: 0.102, CiteScore: 0)
Revista de Filosofía Open Insight     Open Access  
Revista de Geografía Norte Grande     Open Access   (Followers: 1, SJR: 0.296, CiteScore: 1)
Revista de Gestão Costeira Integrada     Open Access   (SJR: 0.251, CiteScore: 1)
Revista de Historia (Concepción)     Open Access   (Followers: 1)
Revista de Historia del Derecho     Open Access   (Followers: 1)
Revista de Ingeniería     Open Access  
Revista de Investigacion Psicologica     Open Access  
Revista de la Academia Colombiana de Ciencias Exactas, Físicas y Naturales     Open Access   (Followers: 1)
Revista de la Asociación Española de Neuropsiquiatría     Open Access  
Revista de la Ciencia del Suelo y Nutricion Vegetal     Open Access   (Followers: 1, SJR: 0.224, CiteScore: 0)
Revista de la Construcción     Open Access   (SJR: 0.234, CiteScore: 1)
Revista de la Facultad de Agronomía     Open Access   (Followers: 3)
Revista de la Facultad de Derecho : Universidad de la República     Open Access  
Revista de la Facultad de Derecho y Ciencias Políticas     Open Access  
Revista de la Facultad de Medicina (México)     Open Access   (Followers: 1)
Revista de la Sociedad Boliviana de Pediatría     Open Access  
Revista de la Sociedad Española de Enfermería Nefrológica     Open Access  
Revista de la Sociedad Química del Perú     Open Access   (Followers: 1)
Revista de la Sociedad Venezolana de Microbiologia     Open Access  
Revista de la Universidad Industrial de Santander. Salud     Open Access  
Revista de Medicina Veterinaria     Open Access  
Revista de Microbiologia     Open Access   (Followers: 1)
Revista de Nutrição     Open Access   (SJR: 0.282, CiteScore: 0)
Revista de Odontologia da UNESP     Open Access  
Revista de Odontologia da Universidade de São Paulo     Open Access  
Revista de Osteoporosis y Metabolismo Mineral     Open Access   (Followers: 2, SJR: 0.121, CiteScore: 0)
Revista de Otorrinolaringología y Cirugía de Cabeza y Cuello     Open Access  
Revista de Protección Vegetal     Open Access  
Revista de Psicología del Trabajo y de las Organizaciones     Open Access   (SJR: 0.418, CiteScore: 1)
Revista de Psiquiatria Clínica     Open Access   (Followers: 1, SJR: 0.271, CiteScore: 1)
Revista de Psiquiatria do Rio Grande do Sul     Open Access   (Followers: 1)
Revista de Salud Animal     Open Access  
Revista de Salud Pública     Open Access   (Followers: 1, SJR: 0.171, CiteScore: 0)
Revista de Saúde Pública     Open Access   (Followers: 1, SJR: 0.807, CiteScore: 2)
Revista de Sociologia e Polí­tica     Open Access   (Followers: 2, SJR: 0.482, CiteScore: 0)
Revista del Instituto de Medicina Tropical     Open Access  
Revista del Nacional     Open Access   (Followers: 1)
Revista Dental Press de Ortodontia e Ortopedia Facial     Open Access   (Followers: 1)
Revista Diacrítica     Open Access  
Revista Direito GV     Open Access   (Followers: 1)
Revista do Colégio Brasileiro de Cirurgiões     Open Access   (SJR: 0.221, CiteScore: 1)
Revista do Departamento de Psicologia. UFF     Open Access  
Revista do Hospital das Clinicas     Open Access  
Revista do Instituto de Estudos Brasileiros     Open Access   (Followers: 1)
Revista do Instituto de Medicina Tropical de São Paulo     Open Access   (SJR: 0.669, CiteScore: 1)
Revista Dor     Open Access  
Revista Ecuatoriana de Neurología     Open Access   (Followers: 1)
Revista EIA     Open Access   (Followers: 1)
Revista electrónica de investigación educativa     Open Access   (Followers: 1, SJR: 0.187, CiteScore: 0)
Revista Electronica Educare     Open Access   (Followers: 2)
Revista Española de Cirugía Oral y Maxilofacial     Open Access   (Followers: 1, SJR: 0.117, CiteScore: 0)
Revista Española de Enfermedades Digestivas     Open Access   (SJR: 0.417, CiteScore: 1)
Revista Española de Salud Pública     Open Access   (SJR: 0.249, CiteScore: 1)
Revista Española de Sanidad Penitenciaria     Open Access   (SJR: 0.135, CiteScore: 0)
Revista Estudos Feministas     Open Access   (SJR: 0.208, CiteScore: 0)
Revista Facultad de Ciencias Económicas: Investigación y Reflexión     Open Access  
Revista Facultad de Ingenieria - Universidad de Tarapaca     Open Access   (Followers: 1)
Revista Facultad de Ingeniería Universidad de Antioquia     Open Access   (Followers: 1, SJR: 0.172, CiteScore: 0)
Revista Facultad de Medicina de la Universidad Nacional de Colombia     Open Access   (SJR: 0.125, CiteScore: 0)
Revista Facultad Nacional de Agronomía, Medellín     Open Access   (SJR: 0.138, CiteScore: 0)
Revista Facultad Nacional de Salud Pública     Open Access   (Followers: 1)
Revista Gaúcha de Enfermagem     Open Access   (SJR: 0.225, CiteScore: 1)
Revista Geológica de América Central     Open Access  
Revista Geológica de Chile     Open Access   (Followers: 1)
Revista Gerencia y Políticas de Salud     Open Access   (SJR: 0.136, CiteScore: 0)
Revista Habanera de Ciencias Médicas     Open Access   (SJR: 0.211, CiteScore: 0)
Revista Historia y Sociedad     Open Access  
Revista IBRACON de Estruturas e Materiais     Open Access   (Followers: 1)
Revista Ingeniería Biomédica     Open Access   (Followers: 1)
Revista Ingenieria de Construcción     Open Access   (Followers: 1, SJR: 0.204, CiteScore: 0)
Revista Ingenierías Universidad de Medellín     Open Access  
Revista Integra Educativa     Open Access  
Revista Interamericana de Bibliotecología     Open Access   (Followers: 7)
Revista Internacional de Contaminación Ambiental     Open Access   (SJR: 0.152, CiteScore: 0)
Revista ION     Open Access  
Revista IUS     Open Access  
Revista Katálysis     Open Access  
Revista Lasallista de Investigación     Open Access   (SJR: 0.146, CiteScore: 0)
Revista Latino-Americana de Enfermagem     Open Access   (SJR: 0.339, CiteScore: 1)
Revista Latinoamericana de Bioética     Open Access  
Revista Latinoamericana de Ciencias Sociales, Niñez y Juventud     Open Access   (Followers: 1)
Revista Latinoamericana de Derecho Social     Open Access   (Followers: 2, SJR: 0.101, CiteScore: 0)
Revista Latinoamericana de Desarrollo Económico     Open Access  
Revista Latinoamericana de Educación Inclusiva     Open Access   (Followers: 1)
Revista Latinoamericana de Filosofía     Open Access   (Followers: 1)
Revista Latinoamericana de Hipertension     Open Access   (SJR: 0.158, CiteScore: 0)
Revista Latinoamericana de Investigación en Matemática Educativa     Open Access   (SJR: 0.171, CiteScore: 0)
Revista Latinoamericana de Psicopatologia Fundamental     Open Access   (SJR: 0.201, CiteScore: 0)
Revista Medica de Chile     Open Access   (SJR: 0.259, CiteScore: 1)
Revista Médica del Hospital Nacional de Niños Dr. Carlos Sáenz Herrera     Open Access   (Followers: 1)
Revista Médica del Uruguay     Open Access  
Revista Médica Electrónica     Open Access  
Revista Médica La Paz     Open Access  
Revista Médico-Científica : Luz y Vida     Open Access  
Revista Mexicana de Análisis de la Conducta     Open Access   (SJR: 0.405, CiteScore: 1)
Revista Mexicana de Astronomía y Astrofísica     Open Access   (Followers: 2, SJR: 0.596, CiteScore: 1)
Revista Mexicana de Biodiversidad     Open Access   (SJR: 0.421, CiteScore: 1)
Revista Mexicana de Ciencias Agrícolas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Farmaceuticas     Open Access   (Followers: 1)
Revista Mexicana de Ciencias Geológicas     Open Access   (SJR: 0.308, CiteScore: 1)
Revista Mexicana de Ciencias Pecuarias     Open Access   (Followers: 1, SJR: 0.17, CiteScore: 0)
Revista Mexicana de Economía y Finanzas     Open Access   (Followers: 1)
Revista Mexicana de Física     Open Access   (SJR: 0.203, CiteScore: 0)
Revista mexicana de física E     Open Access  
Revista Mexicana de Fitopatología     Open Access  
Revista Mexicana de Ingeniería Biomédica     Open Access   (Followers: 1)
Revista Mexicana de Ingeniería Química     Open Access   (SJR: 0.328, CiteScore: 1)
Revista Mexicana de Investigación Educativa     Open Access   (Followers: 3, SJR: 0.291, CiteScore: 0)
Revista Mexicana de Micologí­a     Open Access  
Revista Mexicana de Sociologí­a     Open Access   (Followers: 9, SJR: 0.142, CiteScore: 0)
Revista Musical Chilena     Open Access   (SJR: 0.1, CiteScore: 0)
Revista MVZ Córdoba     Open Access   (SJR: 0.173, CiteScore: 0)

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Revista Española de Enfermedades Digestivas
Journal Prestige (SJR): 0.417
Citation Impact (citeScore): 1
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Online) 1130-0108
Published by SciELO Homepage  [911 journals]
  • Cholangioscopy: seeing to believe, seeing to know, seeing to cure

    •  
  • Single-operator cholangiopancreatoscopy in pancreatobiliary diseases:
           clinical experience in a tertiary referral hospital

    • Abstract: ABSTRACT Background and aims: to assess the usefulness, efficacy and safety of single-operator cholangiopancreatoscopy (SOCP) with the SpyGlass(tm) system for the management of biliopancreatic diseases. Methods: a retrospective analysis of patients undergoing SOCP with the SpyGlass(tm) between September 2008 and April 2016 was performed. Data was obtained from a prospectively-maintained database at a tertiary referral center. The primary study outcomes were technical and complete endoscopic success of the procedure. Two different SpyGlass(tm) systems were employed; the former is called legacy and the latter, digital system (DS). Results: a total of 107 SOCP procedures in 93 patients performed by a single operator were analyzed. Technical success of the SpyGlass(tm) examination was achieved in 90/93 (97%) of patients and complete success by resolving the biliopancreatic condition in 82/93 (88%) cases. In indeterminate biliary strictures, a complete success was achieved in 45/52 (85%) of cases. With regard to stone treatment, technical success was achieved in 34/34 (100%) patients and complete success, in 31/34 (91%) cases. Electrohydraulic lithotripsy was applied in 16/34 (47%) of cases. There were a total of 7/93 adverse effects (7.5%). Conclusions: SOCP is a useful and safe technique for the treatment of biliopancreatic diseases with a low rate of adverse effects. The procedure seems technically demanding and dedication is required.
       
  • Appropriateness of the use of proton pump inhibitors in the Emergency
           Department of a Spanish university hospital

    • Abstract: ABSTRACT Background: the use of proton pump inhibitors (PPI) has increased substantially during the last years, possibly due to a significant proportion of prescriptions that do not follow the approved indications. Objective: to assess the prevalence of PPI prescription and the appropriateness of the prescription within the Emergency Department (ED) of a Spanish university hospital. Materials and methods: a cross-sectional, retrospective prescription-indication drug-use study was performed, which selected 384 patients that presented to the ED over two days in January 2016. Results: of the total cohort, 23.2% were taking PPI before their hospital visit and only 20.2% had a correct indication and dosage; 2.9% of the patient cohort had an indication for PPI treatment but had not been prescribed them. A drug other than omeprazole was used in 25% of cases; 30.47% of the patients were discharged with a PPI and only 28.2% of them had the correct indication and dosage. Finally, 5.7% were not prescribed PPI even though it was warranted. PPI prescription increased with age whereas the indication for the prescription decreased. Furthermore, the use of these drugs was higher in hospitalized patients compared to discharged patients. Conclusions: these results are in line with similar studies, which demonstrate the existence of an over-prescription of PPI. PPI prescription needs to be improved, thereby reducing drug interactions, adverse effects and unnecessary economical expenses.
       
  • Colon lymphomas: an analysis of our experience over the last 23 years

    • Abstract: RESUMEN Introducción: el linfoma de colon (LC) es una variedad poco frecuente de los linfomas no Hodgkin (LNH) que representa menos del 0,6% de todas las neoplasias primarias del colon. Realizar un diagnóstico precoz es difícil debido a que las manifestaciones clínicas son inespecíficas. El objetivo de esta revisión fue presentar nuestra experiencia en los últimos años en cuanto a características clínicas, endoscópicas, histológicas, diagnóstico, tratamiento y evolución de los LC. Pacientes y métodos: se realizó un análisis retrospectivo y descriptivo de pacientes con LC diagnosticados desde 1994 hasta 2016 en el Hospital Universitario de la Princesa, Madrid. Resultados: se identificaron 29 pacientes con LC (mediana de edad 67 años, 18 hombres [62%]). Las manifestaciones clínicas más comunes fueron dolor abdominal, síndrome constitucional, diarrea y masa abdominal palpable. Ocho (27,6%) pacientes se encontraban asintomáticos y seis (20,6%) debutaron con complicaciones quirúrgicas. En 24 pacientes se realizó colonoscopia y los hallazgos más frecuentes fueron infiltración difusa y tumoración. La localización más común fue el colon descendente y sigma. Los subtipos histológicos más frecuentes fueron: LNH de células B del manto y linfoma difuso de células grandes tipo B. Se trató con quimioterapia a 28 pacientes (96,5%), con cirugía a seis (20,7%) y uno recibió quimio y radioterapia. La mediana del tiempo de supervivencia fue de 156 meses. La supervivencia al año fue del 100,0% y a los diez años, del 55,0%. Conclusiones: debido al aspecto endoscópico variable del LC, es necesario el estudio histológico de todos los segmentos del colon. El tratamiento de elección es la quimioterapia y en casos de complicaciones es necesaria la cirugía urgente con quimioterapia posterior. Los principales factores asociados a peor supervivencia son la edad mayor de 65 años, la existencia de recidiva y las respuestas parciales o nulas.ABSTRACT Introduction: colon lymphoma (CL) is an uncommon variety of non-Hodgkin lymphoma (NHL) that represents less than 0.6% of all primary colonic neoplasms. Early diagnosis is challenging as clinical manifestations are non-specific. The goal of this review was to discuss our experience over the last few years regarding the clinical, endoscopic, histological, diagnostic, therapeutic and evolutionary characteristics of CL. Patients and methods: a retrospective, descriptive analysis of patients with CL diagnosed from 1994 to 2016 at the Hospital Universitario de La Princesa (Madrid, Spain) was performed. Results: a total of 29 patients with CL were identified, with a median age of 67 years; 18 were male (62%). The most common clinical manifestations included abdominal pain, constitutional syndrome, diarrhea and a palpable abdominal mass. Eight (27.6%) patients were asymptomatic and six (20.6%) initially presented with surgical complications. A colonoscopy was performed in 24 patients and the most common findings included diffuse infiltration and solid growth. The most common location was the descending and sigmoid colon. The most common histological subtypes included mantle B-cell NHL and diffuse large B-cell lymphoma. Chemotherapy was administered to 28 patients (96.5%), surgery was performed in six (20.7%) and combined chemo-radiotherapy was administered to one patient. Median survival was 156 months. Survival was 100.0% at one year and 55.0% at ten years. Conclusions: due to the variable aspects of CL on endoscopy, a histological study of all colonic segments is required. Chemotherapy is the treatment of choice and emergency surgery followed by chemotherapy is required for complications. Primary factors associated with poorer survival include age above 65 years, relapsing disease and partial or nil responses.
       
  • Intraductal papillary mucinous neoplasm (IPMN) of the pancreas:
           clinicopathological features and long-term outcomes following a
           pancreatectomy

    • Abstract: ABSTRACT Objective: the objective of this study was to analyze the anatomical and clinical features and long-term oncologic outcomes of 25 patients that underwent surgery due to intraductal papillary mucinous neoplasm of the pancreas. Material and methods: patients undergoing surgery for intraductal papillary mucinous neoplasm of the pancreas were identified from a prospective database of pancreatic resections. Demographic data, symptoms, type of surgery and type of lesion (branch type, main duct or mixed) were recorded. The lesions were classified into invasive (high grade dysplasia and carcinoma) and noninvasive (low- or intermediate-grade dysplasia). Postoperative complications were analyzed as well as the pattern of recurrence and disease-free survival at five and ten years. Results: the most common symptoms in the 25 patients (14 males and eleven females) were abdominal pain and weight loss. Eight (32%) cases were diagnosed incidentally. Twelve (48%) of the lesions were of the branch type, three affected the main duct and ten (40%) were mixed. Twelve cephalic duodenopancreatectomies and seven total pancreatectomies were performed; three were central; two, distal; and one, enucleation. Seven cases (32%) had an invasive phenotype. Three patients had locoregional and distant recurrence at six, 16 and 46 months after surgery with a median follow-up of 7.7 years. Disease-free survival at five and ten years for the noninvasive type was 94% and 57% for invasive phenotypes (p < 0.05). Conclusions: intraductal papillary mucinous neoplasm is a heterogeneous entity with well differentiated phenotypes, which requires a tailored strategy and treatment, as established in the current consensus guidelines due to its malignant potential.
       
  • The role of pancreatic juice cytology in the diagnosis of pancreatic
           intraductal papillary mucinous neoplasm

    • Abstract: ABSTRACT Background and aim: pancreatic juice cytology (PJC) is an important predictor of malignant intraductal papillary mucinous neoplasm (IPMN). This study aimed to determine the role of PJC for the prediction of malignant IPMN (intraductal papillary mucinous cancer [IPMC]). Methods: medical records of IPMN patients who underwent surgery between 2012 and 2016 at the Nagasaki University Hospital were reviewed. Patients who underwent preoperative PJC were classified as high risk stigmata (HRS), worrisome features (WF) and no-criteria, based on imaging criteria. PJC class III or higher was considered as positive and only invasive IPMN was defined as IPMC. PJC was validated in each group with regard to sensitivity, specificity, accuracy with the corresponding 95% confidence intervals (95% CI) and area under receiver operating curve (AUROC) analysis. A p-value of < 0.05 was considered as statistically significant. Results: preoperative pancreatic juice was obtained in 33/52 IPMN patients; only patients with adequate aspirate for cytology (n = 29) were included. In the HRS group (n = 9), 4/6 non-IPMC had a negative PJC and 3/3 IPMC had a positive PJC. In the WF group (n = 17), 9/11 non-IPMC had a negative PJC and 3/6 IPMC had a positive PJC. Adding PJC to imaging results improved the AUROCs of HRS and WF from 0.63 and 0.62 to 0.83 and 0.66, respectively. PJC was negative in all no-criteria cases (n = 3; one IPMC and two non-IPMC). In all 29 patients, PJC sensitivity was 60% (95% CI: 26%-88%), specificity was 79% (95% CI: 54%-94%), accuracy was 72% (95% CI: 63%-89%) and the AUROC was 0.69 (p = 0.03). Conclusion: PJC is a statistically significant IPMC predictor that can improve the validity of imaging for IPMC prediction.
       
  • Graft survival after liver transplantation: an approach to a new Spanish
           risk index

    • Abstract: RESUMEN Introducción: existen diversos indicadores para la valoración de la supervivencia del injerto hepático (DRI americano y ET-DRI europeo, entre otros), pero existen diferencias importantes entre los programas de trasplante de los diferentes países y podría ser que dichos indicadores no sean válidos en nuestro medio. Objetivos: el objetivo de este estudio es describir un nuevo indicador nacional de riesgo del injerto hepático a partir de los resultados del Registro Español de Trasplante Hepático (RETH) y validar el DRI y el ET-DRI. Metodología: el RETH incluye un análisis de Cox de los factores relacionados con la supervivencia del injerto. En base a sus resultados se define el indicador graft risk index (GRI). Las variables que contempla dependen del proceso de donación: edad, causa de muerte, compatibilidad sanguínea y tiempo de isquemia fría; y del receptor: edad, enfermedad de base, virus C, número de trasplante, estado UNOS y técnica quirúrgica. Se obtuvo la curva de la regresión logística y se calcularon las curvas de supervivencia del injerto por estratificación. La precisión se evaluó mediante el área ROC. Resultados: un GRI de 1 se corresponde con una probabilidad de pérdida del injerto del 23,25%; cada punto de aumento del GRI supone que la probabilidad se multiplica por 1,33. El GRI mostró la mejor discriminación por estratificación. El área ROC del DRI fue 0,54 (95% IC, 0,50-0,59) y del ET-DRI, 0,56 (95% IC, 0,51-0,61), frente al GRI 0,70 (95% IC, 0,65-0,73) (p < 0,0001). Conclusiones: el DRI y el ET-DRI no parecen útiles en nuestro medio y sería necesario disponer de un indicador propio. El GRI requiere un estudio nacional que perfile más el indicador y realice una validación más amplia.ABSTRACT Introduction: several indicators are available to assess liver graft survival, including the American DRI and the European ET-DRI. However, there are significant differences between transplant programs of different countries, and the previously mentioned indicators might be not valid in our setting. Objectives: the aim of the study was to describe a new national liver graft risk indicator based on the results obtained from the Registro Español de Trasplante Hepático (RETH) and to validate the DRI and ET-DRI indicators. Methods: the RETH includes a Cox analysis of factors associated with graft survival; the graft risk index (GRI) indicator was defined based on these results. The variables considered are dependent upon the donation conditions (age, cause of death, blood compatibility and cold ischemia time) and the transplant recipient (age, underlying disease, hepatitis C virus, transplant number, UNOS status and surgical technique). A logistic regression curve was obtained and graft survival curves were calculated by stratification. Precision was assessed using the ROC analysis. Results: a GRI of 1 represents a probability of graft loss of 23.25%; each point increase in the GRI score multiplies this probability by 1.33. The best discrimination of GRI was obtained by stratification. The DRI ROC area was 0.54 (95% CI, 0.50-0.59) and the ET-DRI ROC area was 0.56 (95% CI, 0.51-0.61), compared to 0.70 (95% CI, 0.65-0.73) (p < 0.0001) for the GRI. Conclusions: both the DRI and ET-DRI do not seem to be useful in our setting. Hence a national indicator is more desirable. The GRI requires a national study in order to further streamline and assess this indicator.
       
  • High-resolution and high-definition anorectal manometry: rediscovering
           anorectal function

    • Abstract: RESUMEN Los trastornos motores y funcionales anorrectales son frecuentes en la población general. La manometría anorrectal permite estudiar la actividad motora anorrectal en reposo y simulando diferentes situaciones fisiológicas. La manometría anorrectal de alta resolución (MAR-AR) y de alta definición (MAR-AD) están utilizándose cada vez con más frecuencia en la práctica clínica. Con respecto a la técnica convencional, los catéteres de la MAR-AR y los de la MAR-AD proporcionan un mayor número de puntos de registro, ya que disponen de muchos sensores circunferenciales muy próximos entre sí. Ello permite la visualización en relación témporo-espacial (modo topográfico en 2 o 3 planos) al obtener un registro de presión continuo en el espacio por interpolación entre sensores muy próximos. La MAR-AR y la MAR-AD nos permiten realizar la técnica de una forma más estandarizada y reproducible y obtener un mejor estudio y comprensión de la anatomía funcional del complejo esfinteriano. Están desarrollándose nuevos parámetros específicos apropiados para utilizarse en la actualidad con estos sistemas y están siendo evaluados por diversos grupos de investigación, por lo que muchos de ellos no están disponibles para utilizarse en la práctica clínica. No obstante, aportan información muy relevante que está permitiendo redefinir la anatomía y la fisiología anorrectales. El objetivo de la presente revisión es describir las técnicas existentes para MAR-AR y MAR-D, exponer los valores publicados de normalidad y analizar los nuevos parámetros que estas técnicas permiten evaluar y que, posiblemente, en un futuro próximo serán de gran utilidad en la práctica clínica.ABSTRACT Anorectal motor and functional disorders are common among the general population. Anorectal manometry allows the study of anorectal motor activity both at rest and mimicking different physiological situations. High-resolution anorectal manometry (HR-ARM) and high-definition anorectal manometry (HD-ARM) are increasingly used in clinical practice. In comparison with the conventional technique, HR-ARM and HD-ARM catheters provide a higher number of recording points because of their many, closely packed circumferential sensors. This allows time-space visualization (topographic or 2-3-plane mode) as spatially continuous measurements are obtained by interpolation between near sensors. HR-ARM and HD-ARM allow a more standardized, reproducible technique, and a better assessment and understanding of the functional anatomy of the sphincter complex. Newer specific parameters are now being developed for use with these systems. They are being currently assessed by multiple research teams, and many of them remain unavailable for clinical practice as of today. However, they provide highly relevant information, which is now prompting a redefinition of anorectal anatomy and physiology. The goal of the present review was to describe the currently available HR-ARM and HD-ARM techniques, to discuss the normal values so far reported, and to analyze the newer parameters that may be assessed with these techniques, and which will likely be highly useful for clinical practice in the upcoming future.
       
  • Consensus document on exclusion diets in irritable bowel syndrome (IBS)

    • Abstract: RESUMEN Este documento resume el contenido del documento de consenso sobre las dietas de exclusión en el síndrome del intestino irritable elaborado por el grupo de trabajo de la SEPD, FEAD, SENPE, FESNAD, SEÑ, SEEN, SEGHNP, SEDCA y ADENYD. El documento completo está disponible en la web de la SEPD. El síndrome del intestino irritable es un trastorno funcional digestivo muy prevalente en el que, aparte del farmacológico, el tratamiento dietético y la adquisición de hábitos saludables son básicos para su control. Para facilitar el consejo dietético a estos pacientes en la práctica diaria se ha elaborado el presente documento de consenso sobre el papel de las dietas de evitación en el síndrome del intestino irritable. Para ello se ha recogido la opinión consensuada de diferentes expertos que representan a las principales sociedades científicas nacionales para establecer unas recomendaciones aplicables en la práctica asistencial en los pacientes con síndrome del intestino irritable.ABSTRACT This paper summarizes the contents of a consensus document on exclusion diets in irritable bowel disease that was developed by a task force from SEPD, FEAD, SENPE, FESNAD, SEÑ, SEEN, SEGHNP, SEDCA and ADENYD. The complete document is available at the SEPD website. Irritable bowel syndrome is a highly prevalent functional digestive disorder where, in addition to drugs, therapy includes diet and acquisition of healthy habits as basic elements for its control. In order to facilitate dietary counseling for these patients in daily practice, the present consensus document on the role of exclusion diets was developed. To this end, consensus opinions were collected from various experts in the national scientific societies aiming at establishing recommendations applicable to the health care of patients with irritable bowel syndrome.
       
  • Treatment of gastric GIST using endoscopic techniques combined with the
           application of endoloop and intralesional cyanoacrylate in a non-surgical
           patient

    • Abstract: RESUMEN Este documento resume el contenido del documento de consenso sobre las dietas de exclusión en el síndrome del intestino irritable elaborado por el grupo de trabajo de la SEPD, FEAD, SENPE, FESNAD, SEÑ, SEEN, SEGHNP, SEDCA y ADENYD. El documento completo está disponible en la web de la SEPD. El síndrome del intestino irritable es un trastorno funcional digestivo muy prevalente en el que, aparte del farmacológico, el tratamiento dietético y la adquisición de hábitos saludables son básicos para su control. Para facilitar el consejo dietético a estos pacientes en la práctica diaria se ha elaborado el presente documento de consenso sobre el papel de las dietas de evitación en el síndrome del intestino irritable. Para ello se ha recogido la opinión consensuada de diferentes expertos que representan a las principales sociedades científicas nacionales para establecer unas recomendaciones aplicables en la práctica asistencial en los pacientes con síndrome del intestino irritable.ABSTRACT This paper summarizes the contents of a consensus document on exclusion diets in irritable bowel disease that was developed by a task force from SEPD, FEAD, SENPE, FESNAD, SEÑ, SEEN, SEGHNP, SEDCA and ADENYD. The complete document is available at the SEPD website. Irritable bowel syndrome is a highly prevalent functional digestive disorder where, in addition to drugs, therapy includes diet and acquisition of healthy habits as basic elements for its control. In order to facilitate dietary counseling for these patients in daily practice, the present consensus document on the role of exclusion diets was developed. To this end, consensus opinions were collected from various experts in the national scientific societies aiming at establishing recommendations applicable to the health care of patients with irritable bowel syndrome.
       
  • Complete resolution of dysphagia after sequential Polyflex(tm) stenting in
           a case of recurrent anastomotic stenosis in an adult with congenital
           esophageal atresia

    • Abstract: ABSTRACT We present a case of intractable dysphagia in a 23-year-old female with type 1 esophageal atresia (EA) and subsequent postsurgical refractory esophageal strictures. The patient was referred due to increasing symptomatology and a slight response to balloon dilations. A biodegradable polydioxanone stent (ELLA) was placed, but this did not relieve the dysphagia. After the sequential placement of two siliconated polypropylene stents (Polyflex(tm), Boston Scientifics), the dysphagia was definitively relieved. To our knowledge, this is the first published case with a full resolution of dysphagia using this strategy in an adult patient.
       
  • Endoscopic submucosal hydro-dissection as a rescue treatment of a large
           recurrent lateral spreading tumor in an ileorectal anastomosis

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
  • Laparoscopic cholecystectomy complications: a new case report of a right
           hepatic artery pseudoaneurysm that caused jaundice

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
  • A giant abdominal collection: when things are not what they seem

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
  • Comment to the letter "Acute appendicitis after a colonic endoscopic
           submucosal resection"

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
  • Meckel's diverticulitis: a laparoscopic approach

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
  • A new reported case of ileocecal infiltrative endometriosis, a disease
           which is probably underdiagnosed

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
  • Crohn's disease and cystic fibrosis: there is still a lot to learn

    • Abstract: ABSTRACT Background: subtotal colectomy with ileorectal anastomosis (IRA) is currently the most common surgical option in young patients with familial adenomatous polyposis (FAP). However, this surgery does prevent the appearance of lesions in the rectal remnant. In these cases, the endoscopic submucosal dissection might be a feasible option. However, drawbacks such as extreme fibrosis and a difficult maneuverability in the rectal remnant make this technique rather challenging. An ESD by the pocket creation method was planned with the purpose of overcoming these handicaps. Case report: an en-bloq resection of 30 mm of the recurrent adenoma located in rectal remnant of a 42-year-old woman with FAP was successfully achieved following this approach. Two months of follow up endoscopy did not show residual adenomatous tissue. Discussion: in summary, endoscopic submucosal dissection by the pocket creation method allowed a safe and effective dissection and an en-bloc resection of this challenging polyp was achieved.
       
 
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