Search

Introduction: the current indicated first-line treatment for Helicobacter pylori (H. pylori) infection is the quadruple therapy with bismuth (Pylera®), or the quadruple concomitant therapy without bismuth. The triple therapy was abandoned due to its low eradication rates, partly derived from an increase in antibiotic resistance. The aim of this study was to compare the H. pylori eradication rates guided by antibiotic susceptibility testing (AST) versus Pylera®., Methods: a specimen was taken prospectively for culture and antibiotic susceptibility testing (AST) from all patients diagnosed with H. pylori infection using gastroscopy, and they were randomized to receive triple therapy depending on the results of the AST, or quadruple therapy with Pylera®. The eradication rates of both groups were analyzed using fecal antigen. The adherence and side effects of the treatment were also analyzed., Results: of the 108 patients with H. pylori infection, 55 received Pylera® and 53 AST-guided triple therapy. The eradication rates were 92.7 % with Pylera® and 90.6 % in the AST-guided group, and the difference was statistically significant. There were also no differences found in adherence or side effects., Conclusions: the treatment of H. pylori with AST-guided triple therapy is effective, especially in regions with high rates of antibiotic resistance.

Sweet Syndrome or Acute Febrile Neutrophilic Dermatosis is an uncommon extraintestinal manifestation of inflammatory bowel disease, also related with other pathologies. Its diagnosis is anatomopathological and presents a good evolution with the treatment of the underlying disease.

A 41-year-old patient presented to the Dermatology clinic with a papular rash on the trunk and orange-colored maculopapular lesions on the soles of both feet. This was associated with general symptoms including myalgia, fatigue, epigastric pain, nausea and vomiting. The patient had been taking omeprazole and cinitapride with little improvement.

Background: satisfaction with healthcare is focused on the patient and is known as "patient-centered care". However, user satisfaction is not always synonymous with good care. Healthcare practitioners should determine and understand what patients need and expect in order to improve the quality of care., Aims: the main objective of this study was to determine the perceived quality of care of patients diagnosed with colorectal cancer in our unit., Methods: a cross-sectional study was performed in all patients diagnosed with colorectal cancer (CRC) that underwent staging studies and were hospitalized in the Gastroenterology Department from May 2013 to October 2013. Furthermore, outpatients with rapid consultations for CRC staging from November 2013 to November 2014 were also included. Two questionnaires were administered: a) a survey of 20 questions with closed responses regarding the competence of treating physicians and nurses, the information received and the waiting time; b) the European Organization for Research and Treatment of Cancer (EORTC) QLQ-INFO25: information on the disease, medical tests, treatment and other services, with eight single items., Results: there were no differences in the perceived healthcare quality, delays in starting treatment, the tumor stage, symptoms (performance status) or the time spent studying the disease. In-patients and those with advanced disease started treatment earlier than outpatients and those with disease stage I or II. Likewise, outpatients perceived a better psychological support., Conclusions: outpatient study did not reduce the quality of care and did not delay treatment.

Introduction: deep sedation with propofol monitored by an endoscopist in different endoscopy units is a controversial subject and the source of conflicts of interest between the various scientific societies of Anesthesiology and Gastroenterology. Many studies have already demonstrated the efficacy, efficiency and low incidence of complications associated with sedation when under the control of a trained endoscopist vs an anesthesiologist., Material and Methods: the rate of severe cardiorespiratory complications during various endoscopic examinations (gastroscopy, colonoscopy, endoscopic retrograde cholangiopancreatography [ERCP] and endoscopic ultrasound [EUS]) where sedation was controlled by an endoscopist within our unit, from 2011 to 2016, was reviewed., Results: during the study period, 33,195 examinations were analyzed. The rate of cardiorespiratory complications was 0.13% and the majority were severe desaturations. Most cases responded to an opening in the airway associated with the interruption of drug infusion and an ambu bag was required in a few cases. There were no statistically significant differences between the different groups, except for mean age, risk by type of examination and ASA risk, where the difference between ERCP and the rest of examinations was statistically significant., Conclusion: there is a high level of evidence in the scientific literature suggesting that sedation controlled by a trained endoscopist is safe, effective and efficient. However, further prospective studies are required in order to confirm this conclusion due to the fact that the majority of studies to date are retrospective.