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Main Author:	HUGO A GORI GIMÉNEZ
Format:	Artículo científico
Language:	es
Published:	Sociedad Venezolana de Oncología 2014
Subjects:	Medicina crónica coagulación Argón Plasma radioterapia telangiectasias
Online Access:	https://www.redalyc.org/articulo.oa?id=375633968004
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RESPUESTA ENDOSCÓPICA A LA TERAPIA CON ARGÓN PLASMA EN RECTITIS ACTÍNICA CRÓNICA HUGO A GORI GIMÉNEZ SYLVIA F BENÍTEZ MARÍA RODRÍGUEZ WALLIA WEVER Medicina crónica coagulación Argón Plasma radioterapia telangiectasias La rectitis actínica se presenta posterior a la radioterapia (5 % -15 %). La radiosensibilidad de la mucosa produce ulceraciones y sangrado debido a una endarteritis obliterante. La coagulación con Argón Plasma ha demostrado gran efectividad. MÉTODO: Se incluyeron 23 pacientes con antecedente de radioterapia, rectorragia y sospecha de rectitis actínica. Se estableció la escala clínica de sangrado rectal y se aplicó la escala de Zinicola para los hallazgos endoscópicos. Se aplica Argón Plasma en sesiones variables para cada paciente. RESULTADOS: 17 pacientes eran del sexo masculino (73,9 %), todos los pacientes consultaron por rectorragia, el promedio de inicio de la rectorragia fue 17 meses. El principal hallazgo son las telangiectasias en todos los pacientes. 14 pacientes tenían sangrado activo en la primera endoscopia (60,8 %). La forma moderada es la presentación más frecuente (47,82 %). Se realizaron un total de 49 sesiones. Hay disminución progresiva del número y la extensión de las telangiectasias y sustitución progresiva por fibrosis, así como disminución del sangrado activo en las sesiones posteriores. CONCLUSIONES: La respuesta al Argón Plasma es individual, a mayor puntaje en escala de Zinicola mayor número de sesiones. El Argón Plasma es un método seguro y eficaz en el tratamiento de la rectitis actínica crónica. 2014 artículo científico 0798-0582 https://www.redalyc.org/articulo.oa?id=375633968004 es http://www.redalyc.org/revista.oa?id=3756 Revista Venezolana de Oncología application/pdf Sociedad Venezolana de Oncología Revista Venezolana de Oncología (República Bolivariana de Venezuela) Num.1 Vol.26

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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