Revista Clínica Escuela de Medicina UCR-HSJD, Volumen 2, Número 3
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Ítem Enfermedad Celíaca: tema de creciente interés en nuestro país.(2011-05-01 00:00:00) Barguil Meza, IbrahimÍtem ESTENOSIS URETRAL(2011-05-01 00:00:00) Morera Hidalgo, Herman; Araya Vargas, WilbertÍtem UTILIDAD DE LOS ANTICUERPOS ANTITRANSGLUTAMINASA TISULAR Y SU RELACIÓN CON ENFERMEDAD CELÍACA EN PACIENTES DEL HOSPITAL SAN JUAN DE DIOS DE ENERO DEL 2008 A DICIEMBRE DEL 2010(2011-05-01 00:00:00) Barahona Brenes, Rándall; Duarte Sancho, Paolo C.Background: Celiac disease (CD) is a smallintestine enteropathy that is caused by the ingestion of gluten protein in food. The main determinant found is the enzyme tissue transglutaminase, an enzyme of the small intestine. Thisstudy pretends to assess the validity of anti-tTGin patients admitted to HSJD with the diagnosisof CD, because the clinic experience suggests afewer sensitivity as the report in literature. Methods: The population studied was patientstwelve years or older with positive serology foranti-tTG and excluded patients receiving steroidsor immunosuppressive therapy, patients with gastrointestinal surgery, HIV/AIDS or being on aglutenfree diet. We consider patients as havingCD those with symptoms, classic pathological changes and/or a response to freegluten diet. Age, ethnicity, gender and frequency of chronic diseases were documented; and also sensitivity,specificity, PPV and NPV for anti-tTG was measured. A distribution according Marsh histological classification was made. The presence ofIgA deficiency was evaluated. Findings: We found CD was more frequent inwomen and older patients. The sensitivity andspecificity found for anti-tTG IgA was 17% and96%, whereas anti-tTG IgG was 14.2% and100% respectively. The PPV and NPV were 75%and 100% in the case of IgA and 65% and 62.5%for IgG. Most of the histologic specimens wereMarsh 3 or superior. IgA deficiency was notfound. Interpretation: The epidemiologic features in CD were similar to those describe in literature. It was not found classic associated disorders to CD. The validity of anti-tTG for diagnosis of CD waslower as described.Ítem ENFERMEDAD CELÍACA Y ANEMIA(2011-05-01 00:00:00) Duarte Sancho, Paolo C.Celiac disease (CD) is characterized by a chronicinflammatory state induced by an increased immunologic response to ingested gluten in genet-ically predisposed individuals. Clinical manifestations of CD are multiple and highly variable. In addition to this variability, the belief that CD is arare disease has lead to important under diagnosis. Hematological findings are common, andanemia represents one of its principal manifestations. This review focuses on the pathophysiological mechanisms involved in the genesis ofanemia in CD.Ítem QUEMADURA ELÉCTRICA DE PARED ABDOMINAL COMO CAUSA DE PERFORACIÓN DE INTESTINO DELGADO(2011-05-01 00:00:00) Jiménez Pereira, Eliécer; Jiménez Montero, Valeska; Navarro Coto, José FranciscoA 49 years old male patient who suffered anelectric burn by direct contact with a currentwhile manipulating a metallic object ispresented. He showed minor dermal manifestations of 5% burnt body surface areaand on the seventh day of hospitalizationdeveloped an acute abdomen which required anexploratory laparotomy that documented aperforation of the jejunum that was resected without complications.Ítem COLONIZACIÓN PULMONAR POR SHEWANELLA ALGAE EN PACIENTE CON SECUELAS DE TUBERCULOSIS PULMONAR TRATADA.(2011-05-01 00:00:00) Rodríguez Rodríguez, Jonathan; Barguil Meza, IbrahimA 53-year-old male with, with a history of drugabuse (Cannabis and crack) and pulmonary tuberculosis treated 10 years ago, arrived to the ER with respiratory symptoms aggravating hislung disease, and sputum and bronchial aspiratecultures positive for Shewanella algae. The clinical behaviour suggested colonization.