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It has been proven that fiber is effective in the treatment of multiple nosological entities, specially of the colonic pathology. In the present study, two dose of Glucomannan (3 gr/day and 4 gr/day) were evaluated within the modification of the intestinal habit and stool characteristics. 60 patients were included in a random, parallel, double blind, cross over trial study versus placebo. The modification of the intestinal habit was evaluated through variations of daily and weekly evacuations, appraising the stool's consistency and size, satiety after meals tiresomeness between meals, constipation, diarrhea and flatulence. An increase in the number of daily and weekly evacuations during the Glucomannan vs placebo treatment was appreciated and, between the two dose of Glucomannan, a difference was observed as to the large the dose, the large the number of daily and weekly evacuations. Evacuations during the phase of Glucomannan 3 gr/day increased 0.5 times per day, 3 more per week above baseline values. On the 4 gr/day treatment of Glucomannan evacuations increased 0.9 times per day, 6 more per week above baseline values. Patient during the placebo period presented no statistically significant different. No difference was appreciated as to post-meal satiety, nor tiresomeness between meals, possibly due to treatment periods being 5 weeks long. No larger number of cases with diarrhea or flatulence were appreciated with the use of Glucomannan. Glucomannan proved to be superior to placebo, and the 3 gr/day and 4 gr/day doses turned out to beneficial in the improvement of the assessed parameters--better results were obtained using 4 gr/day of Glucomannan than 3 gr/day.

We present a 60 years old female with a history of upper right quadrant pain, fever and eosinophily. We made the diagnosis of fasciolasis on clinical, parasitology studies and radiological findings. In the endoscopic retrograde cholangiopancreatography (ERCP) we found the bile duct of normal caliber, but with many filling defects. Fasciola eggs were found in the bile. This is the first case with endoscopic retrograde cholanglopancreatography and the fourth case of fasciolasis in Venezuela.

To assess the efficacy of recombinant alfa 2b-interferon treatment "Heberon alfa R" in children with chronic active hepatitis (CAH) B virus, we conducted a long-term study (three years) in 22 children infected with hepatitis B virus (17 males and 5 females), age range 3 to 15 years. Diagnostic criteria included the clinical picture, laboratory tests, virus markers (HBeAg, HBsAg), laparoscopy and liver biopsy. Children under 12 years received 3 million IU of interferon per day whereas those older than 12 years received 6 million IU of interferon per day by intramuscular injection, three times per week for four months. Alanine aminotransferase (ALT) levels had been elevated for six months in all patients and hepatitis B viral infection was replicative. A variance analysis was made to evaluate ALT response to interferon administration and the Mc Nemar test was used to analyze HBeAg/anti-HBe behavior. Seventeen (77%) out of 22 patients responded to treatment (clearance of HBeAg and ALT levels returned to normal. HBeAg seroconversion (anti-HBe) occurred in 36% of patients during the first year (p < 0.01) and it increased to 50% by the third year follow-up. ALAT levels also decreased and the difference was statistically significant (p < 0.01). This occurred during and after treatment with a steady and increasing tendency to return to normal levels within the first and third year. Side effects were scarce, transient and tolerable and they only appeared during the initial phase of treatment; symptoms were mainly influenza-like and they disappeared very soon. There were no late side effects such as medullar depression, renal toxicity and glycemia alterations.(ABSTRACT TRUNCATED AT 250 WORDS)

Atypical Epithelium is a localized lesion, which has histological and macroscopic findings similar to gastric cancer. In this paper we evaluated 44 cases of atypical epithelium studied and treated in our institute. We found 3 cases of atypical epithelium associated with early gastric cancer. That is 2.66% of the total of all cases. We established the relationship of these lesions and following variables: age, size, localization, macroscopic shape and intestinal metaplasia. We found atypical epithelium in patients older than 50 years old, most of then smaller than 2 cm., localized in antrum and body gastric, and macroscopically were slight elevated lesions. Histologically all of them had intestinal metaplasia.

The laparoscopy cholecistectomy is a surgical procedure described in 1987, and it has had an important apogee and it's had substitute to open procedure. Between its advantages is notable, the postoperatory evolution without pain, paralytic ileus and the short time of hospitalization besides the patient can go away the same day in some cases. In Venezuela, the procedure has been received with enthusiasm by the surgeons with prefer this procedure however, there are complications derived in part for the lack of experience in the first cases, but occur non related of the experience. The quantization of the complications is not simple to realize for different reasons. We present twelve complications, two belong to patients intervened in the Hospital Universitario de Caracas and ten belong to patient transferred from other center. The complications were: pseudoaneurism of hepatic artery, hematoma of the wall, cutting of common bile duct, section the right bile duct, abscess of vesicular bed in two cases, retropneumoperitoneum, ascites by biliary fistula and four biloma. The treatment varied in every case and the utilization of radiologic technique with percutaneous drainage were useful in five cases. We conclude: first, this technique is not free of complications. Second, the percutaneous drainage (abscess, biloma), endoscopic procedure (biliary prosthesis) in fistulaes and arteriographics (arterial embolization), are useful in some cases, and could prevent the surgical reintervention.

The etiology and pathogenesis of persistent diarrhoea is usually multifactorial and sometimes can not be identified. It is necessary to define if an alteration of the enteric microflora is a risk factor that influence the duration of the diarrhoea. 30 infants with acute diarrhoea and 30 with persistent diarrhoea were studied. A sample of duodenal content was taken by a doble-lumen tube and processed microbiologically in search for enteric microorganisms, anaerobic and Candida. These result were correlated with nutritional status, the previous use of Metroonidazol and the results of the stool culture. The presence of bacterial overgrowth and the identification of the duodenal microflora is an important factor for the persistence of the diarrhoea. There was a quantitative and qualitative alteration of the duodenal flora in both groups of patients.

NSAID's are largely used drugs. Among the reported side effects of this type of drugs is liver damage. 73 patients suffering from diverse rheumatological pathologies (arthrosis 46.6%, rotators 9.68%, rheumatoid arthritis 21.92%, lumbalgia 5.48%, other diagnosis 6.85%) were evaluated. Aceclofenac (AC) 100 mg. dose every 12 hours was administered. A Transaminase value determination was taken both at the beginning and end of medication for each patient. Average age of patients was 52.71 years, 78% being female. Treatment was administered as follows, 42.47% of the patients received a 60 days treatment, 28.8% a 45 days treatment, 23.3% a 30 days treatment and 5.47% received a 15 days treatment. Reported mean GOT value at the beginning was 16.6 U, at the end 17.01 U. GPT initial value was 15.84 U and final 16.53 U. A GOT increase, 20 U to 50 was observed in a single patient. GPT was also increased from 32 U to 47 U in one case. Results led us to a no liver damage report of the NSAID's AC in these group of patients.

A study of the morphology of Blastocystis hominis in stool in ninety-four cases humans is described as central body, ameba and granular form were found as previously described. In addition a "Globulose" form as a variation of granular form is first described. The central body form (96.8%) was the most abundant form. Three parasitological methods as direct microscopical examination sample with saline solution 0.85%, lugol, Sudan III, stained with Quensel, Iron hematoxylin and culture are evaluated to detection the Blastocystis hominis forms. Our results show that the direct microscopical examination (saline solution 0.85%, lugol, Sudan III, stained with Quensel) is the most sensitive and specific method than culture. The identification of Blastocystis hominis in stool difficult due to the diversity of shapes and size, which generate confusion with other intestinal protozoa and host cells.