RESUMO
Caspases are crucial mediators of programmed cell death (apoptosis). Apoptosis can occur in spermatozoa during spermatogenesis or epididymal transit, as well as in ejaculated spermatozoa. A high proportion of apoptotic sperm would be a poor indicator of the freezability of a raw seminal sample. Alpaca spermatozoa are notoriously difficult to freeze successfully. Therefore, the objectives of this study were to study caspase activation during incubation (37°C) of fresh alpaca spermatozoa, as well as before and after cryopreservation, to gain some insight into the mechanisms behind the vulnerability of alpaca spermatozoa. Eleven sperm samples were incubated for 4 h at 37°C (Study 1), and 23 samples were frozen using an automated system (Study 2). Caspase-3/7 activation was assessed at 0,1,2,3, and 4 h in samples incubated at 37°C (Study 1); and before/after cryopreservation (Study 2) using CellEvent™ Caspase 3/7 Green Detection Reagent and flow cytometry. The proportions of alpaca spermatozoa with caspase-3/7 activated increased (p < 0.05) after 3-4 h of incubation at 37°C; however, caspase activation was similar before and after cryopreservation (36.2 ± 11.2% vs. 36.6 ± 33.7%, p > 0.05). The high standard deviation found after freezing could be explained by the existence of two subpopulations: one subpopulation where caspase-3/7 activation decreased during cryopreservation (from 36.6 ± 9.1% to 1.5 ± 2.2%), and the other subpopulation where caspase-3/7 activation increased after cryopreservation (from 37.7 ± 13.0% to 64.3 ± 16.7%). In conclusion, after 3-4 h of incubation, caspase-3/7 activation increased in fresh alpaca sperm, whereas cryopreservation affects alpaca sperm samples in different ways.
Assuntos
Camelídeos Americanos , Preservação do Sêmen , Masculino , Animais , Camelídeos Americanos/fisiologia , Caspase 3 , Sêmen/fisiologia , Espermatozoides/fisiologia , Criopreservação/veterinária , Caspases/metabolismo , Preservação do Sêmen/veterinária , Motilidade dos Espermatozoides/fisiologiaRESUMO
Caroli disease is a rare congenital disorder characterized by dilatation of intrahepatic bile ducts. The treatment could correspond to hepatic resection for localized disease. This paper describes a case of Caroli's disease in a 60 years old female patient, who presented jaundice and diffuse abdominal pain. Further examinations suggested the diagnosis of Caroli disease associated with cholestatic syndrome. We decided to perform a Hepp Couinaud biliodigestive bypass by video laparoscopy with Roux-en-Y reconstruction. There were no immediate complications and no longterm complications after 6 months of follow-up. The VLP biliodigestive bypass in patients with associated cholestatic syndromes should be considered a treatment prior to a more aggressive approach.
La enfermedad de Caroli es un raro trastorno congénito que consiste en una dilatación de las vías biliares intrahepáticas. Su tratamiento definitivo debe consistir en resección hepática por la enfermedad localizada. Este artículo describe un caso de enfermedad de Caroli en una paciente de sexo femenino de 60 años de edad, quien presentó ictericia y dolor abdominal difuso. Exámenes posteriores sugirieron el diagnóstico de enfermedad de Caroli asociada con síndrome colestásico. Los médicos decidieron realizar un bypass biliodigestivo de Hepp Couinaud mediante videolaparoscopia con reconstrucción en Y de Roux. No hubo complicaciones inmediatas ni complicaciones a largo plazo después de 6 meses de seguimiento. El bypass biliodigestivo VLP en pacientes con síndromes colestásicos asociados debe considerarse un tratamiento previo a un abordaje más agresivo.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença de Caroli , LaparoscopiaRESUMO
The complexity of intimate partner violence and the impossibility of understanding it from single factors have been studied from different biological, psychological, and socio-cultural factors. A cross-sectional study was conducted on 187 men involved in legal proceedings for problems of violence in their intimate partner relationships in the Dominican Republic in order to explore whether insecure attachment represents a risk factor for alexithymia in men with violent behaviors. The attachment style was determinate by the Casullo and Fernández-Liporace Attachment Styles Scale, and alexithymia was assayed using the Latin American Consensual Toronto Alexithymia Scale (LAC TAS-20), a modification of the Toronto Alexithymia Scale (TAS-20). Chi-square test and multiple binary logistic regression analysis were performed to explore the phenomena of alexithymia and attachment styles in the context of a confinement center for male intimate partner offenders in the Dominican Republic. The results showed that insecure attachment represents a risk factor for alexithymia, being highest for avoidant attachment in the population studied. The results also highlight the influence of other factors such as education and maternal-familial relationships as a factor risk for alexithymia.
RESUMO
In this work, a current application of rhamsan gum, a biological macromolecule which belongs to the sphingans group, as an efficient stabilizer of emulsions and emulgels is investigated. The main objective of this investigation was 1) to study the influence of glycerol and sweet fennel oil concentration on microfluidized emulsion properties; and 2) to develop stable emulgels stabilized with rhamsan gum. The emulsions and emulgels were characterized by droplet size, rheological properties, physical stability and microstructure. An analysis by surface response methodology of the results obtained revealed that essential oil concentration was the most determining factor affecting emulsion mean droplet sizes and rheological properties. An optimal emulsion with minimum d4,3 was obtained for the sample formulated with 10â¯wt% sweet fennel oil and 0â¯wt% glycerol. However, all of these emulsions suffered destabilization by creaming. The results of the rheological characterization of emulsions formulated with the biological macromolecule showed that the addition of 0.2â¯wt% of rhamsan gum allows an emulgel with enhanced physical stability to be obtained. Thus, we provide valuable information concerning the use of rhamsan gum as emulsion stabilizer and the development of stable emulsions and emulgels for use in the food industry.
Assuntos
Alphaproteobacteria/química , Géis , Óleos Voláteis , Polissacarídeos Bacterianos , Algoritmos , Emulsões , Géis/química , Modelos Teóricos , Óleos Voláteis/química , Polissacarídeos Bacterianos/química , Reologia , Análise EspectralRESUMO
Introducción: Los accidentes de tránsito constituyen un grave problema de salud pública, sin embargo, su impacto socioeconómico no se conoce en el Paraguay. Objetivos: determinar el impacto socioeconómico de los accidentes de moto en <19 años en el año 2016. Materiales y Métodos: estudio descriptivo, observacional, retrospectivo. Se incluyeron todos los pacientes ≤19 años que acudieron al Hospital de Trauma (HT) con antecedente de accidente de moto en el año 2016. Los datos y los costos fueron obtenidos de la base de datos del Dpto. de Estadísticas y del Dpto. de Ingresos del HT, respectivamente. Resultados: se incluyeron 700 pacientes que acudieron al HT por accidente de moto. La edad media de los pacientes fue de 15,6 ± 4.33 años. El 78% (546/700) era de sexo masculino. De los accidentados 450 (64,2%) era conductor y 250 (35,7%) acompañante. La media de edad de los conductores fue de 17 ± 4,3 años (rango 11 - 19 años) y de los acompañantes 12,3 ± 4,4 (rango <1 - 19 años). Entre los conductores solo el 50.4% (227/450) tenía la edad reglamentaria para obtener licencia de conducir. Solo el 7,7% (54/695) de los accidentados usaba casco al momento del accidente. Requirió hospitalización por 2 o más días el 89,2% (625/700) de los pacientes, de los cuales el 7.6% requirió ser hospitalizado en UCIP. La media de días de hospitalización en sala y UCIP fue de 11.04 días (DS 14,85 días) y 16.57 (DS 23 días). El 25,1% (176/700) tuvo algún grado de discapacidad o secuela y el 5,4% (38/700) falleció. Los costos directos por hospitalización por día en sala y en UCIP fueron de 275,4 y 737,2 $, respectivamente. Los costos directos por accidentes de moto en el año 2016 fue de 2.587.179,2$. Los años de vida potencialmente perdidos (AVPP) en el año 2016, fueron de 2159 años. Conclusiones: El impacto socioeconómico de los accidentes de motos, representa un costo social extremo derivado de una causa de muerte que podría prevenirse.
Introduction: Traffic accidents are a serious public health problem, however, their socio-economic impact has not been described in Paraguay. Objectives: to determine the socioeconomic impact of motorcycle accidents in victims <19 years of age in 2016. Materials and Methods: this was a descriptive, observational, retrospective study. All patients aged ≤19 years who were admitted to the Trauma Hospital (TH) with a history of a motorcycle accident in 2016 were included. The data and costs were obtained from the Statistics Department and the Admissions Department of the TH. Results: 700 patients were included, all of whom were admitted to the TH due to a motorcycle accident. The average age of the patients was 15.6 ± 4.33 years. 78% (546/700) were male. Of those injured, 450 (64.2%) were drivers and 250 (35.7%) were passengers. The average age of the drivers was 17 ± 4.3 years (range 11-19 years) and that of the passengers was 12.3 ± 4.4 years (range <1-19 years). Among the drivers, only 50.4% (227/450) were of the legal age to obtain a driver's license. Only 7.7% (54/695) of the victims wore a helmet at the time of the accident. 89.2% (625/700) of patients required hospitalization stays of 2 or more days of length, of which 7.6% required PICU admission. The mean number of regular ward hospitalization days and PICU days were 11.04 days (SD 14.85 days) and 16.57 days (SD 23 days), respectively. 25.1% (176/700) had some degree of disability or long-term effects and 5.4% (38/700) died. The direct costs per hospitalization per day in the ward and in the PICU were US$ 275.4 and 737.2, respectively. The direct costs for motorcycle accidents in 2016 was US$ 2,587,179.2. The years of potential life lost (YPLL) in 2016 were 2159 years. Conclusions: The socioeconomic impact of motorcycle accidents represents an extremely high social cost, stemming from a preventable cause of death.
RESUMO
BACKGROUND: Most children with cancer live in resource-limited countries where malnutrition is often prevalent. We identified the relationship between malnutrition and treatment-related morbidity (TRM), abandonment of therapy, and survival of children with cancer in Nicaragua to better inform targeted nutritional interventions. PROCEDURE: We conducted a retrospective review of patients aged 6 months to 18 years with newly diagnosed acute lymphoblastic leukemia, acute myeloid leukemia (AML), Wilms tumor, Hodgkin lymphoma, or Burkitt lymphoma (BL) who were treated between January 1, 2004, and December 31, 2007 at Children's Hospital Manuel de Jesus Rivera in Managua, Nicaragua. Statistical analysis examined the relations among nutritional status and cancer type, risk category, TRM, and event-free survival (EFS). RESULTS: Sixty-seven percent of patients (189/282) were malnourished at diagnosis. Malnutrition was highest among patients with Wilms tumor (85.7%), BL (75%), and AML (74.3%). A total of 92.2% of patients (225/244) experienced morbidity during the first 90 days. Malnutrition was associated with severe infection (P = 0.033). Severely malnourished patients had ≥grade 3 TRM on more days (P = 0.023) and were more likely to experience severe TRM on >50% of days (P = 0.032; OR, 3.27 [95% CI, 1.05-10.16]). Malnourished patients had inferior median EFS (2.25 vs. 5.58 years; P = 0.049), and abandoned therapy more frequently (P = 0.015). CONCLUSIONS: In Nicaragua, pediatric oncology patients with malnutrition at diagnosis experienced increased TRM, abandoned therapy more frequently, and had inferior EFS. Standardized nutritional evaluation of patients with newly diagnosed cancer and targeted provision of nutritional support are essential to decrease TRM and improve outcomes.
Assuntos
Linfoma de Burkitt/mortalidade , Doença de Hodgkin/mortalidade , Leucemia Mieloide Aguda/mortalidade , Desnutrição/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Tumor de Wilms/mortalidade , Adolescente , Linfoma de Burkitt/etiologia , Linfoma de Burkitt/terapia , Criança , Pré-Escolar , Países em Desenvolvimento , Feminino , Seguimentos , Doença de Hodgkin/etiologia , Doença de Hodgkin/terapia , Humanos , Lactente , Neoplasias Renais/etiologia , Neoplasias Renais/mortalidade , Neoplasias Renais/terapia , Leucemia Mieloide Aguda/etiologia , Leucemia Mieloide Aguda/terapia , Masculino , Desnutrição/fisiopatologia , Morbidade , Estadiamento de Neoplasias , Nicarágua , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Tumor de Wilms/etiologia , Tumor de Wilms/terapiaRESUMO
Krukenberg tumor is a malignancy in the ovary from a primary lesion in the gastrointestinal tract and a metastatic signet ring cell adenocarcinoma to the ovary. Stomach is the most common primary site, but other organs can serve as a primary site. The lymphatic system is the most likely route for metastasis. CA 125 levels can be used for screening for early detection of ovarian metastasis as well as for monitoring the course of disease. The prognosis of Krukenberg tumor is poor and no curative treatment is currently available.
Assuntos
Carcinoma de Células em Anel de Sinete/secundário , Tosse/etiologia , Dispneia/etiologia , Tumor de Krukenberg/secundário , Neoplasias Pulmonares/secundário , Neoplasias Ovarianas/diagnóstico , Pneumonia/diagnóstico , Neoplasias Gástricas/patologia , Biomarcadores Tumorais/análise , Carcinoma de Células em Anel de Sinete/diagnóstico , Carcinoma de Células em Anel de Sinete/patologia , Diagnóstico Diferencial , Fadiga/etiologia , Feminino , Humanos , Tumor de Krukenberg/complicações , Tumor de Krukenberg/diagnóstico , Tumor de Krukenberg/diagnóstico por imagem , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Metástase Linfática , Pessoa de Meia-Idade , Neoplasias Ovarianas/diagnóstico por imagem , Derrame Pleural Maligno/etiologia , Tomografia por Emissão de Pósitrons , Neoplasias Gástricas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
This article presents the medical history and management of a 44-year-old Hispanic male with metastatic extra-abdominal gastrointestinal stromal tumor including a literature review on this rare clinical presentation.
Assuntos
Neoplasias Ósseas/secundário , Neoplasias Esofágicas/secundário , Osso Frontal , Tumores do Estroma Gastrointestinal/secundário , Hispânico ou Latino , Adulto , Humanos , MasculinoRESUMO
We report the synthesis and characterization of one-dimensional silver nanostructures using single-wall carbon nanotubes (SWCNT) as a template material. Transmission electron microscopy and scanning tunneling microscopy are consistent with the formation of a one-dimensional array of silver particles on SWCNT. We observe evidence for the excitation of the longitudinal silver plasmon mode in the optical absorption spectra of Ag-SWCNT dispersions, even in the lowest silver concentrations employed. The results indicate that silver deposits on SWCNT may be candidates for light-to-energy conversion through the coupling of the electric field excited in arrays of plasmonic particles.
RESUMO
This case report describes the clinical presentation, imaging findings and pathologic features of a rare aggressive breast tumor in a pre-menopausal woman, namely primary angiosarcoma. Recognition of this extremely rare entity is needed to make an early diagnosis, institute early therapy and eventually improve patient's survival.
Assuntos
Neoplasias da Mama/patologia , Hemangiossarcoma/patologia , Adulto , Feminino , Humanos , Pré-MenopausaRESUMO
Overexpression of the HER2/NEU gene is associated with aggressive behavior and poor prognosis in breast cancer, making the Her2/neu protein a directed-therapy target. Tumors of two Puerto Rican (PR) patients overexpressed Her2/neu and resulting partial clinical responses motivated us to compare Her2/neu expression in PR (n = 101) and Caucasian non-Hispanic (n = 95) patients. Immunohistochemistry of tumors showed overexpression of p-Stat3, Cyclin D1, and Her2/neu, compared to non-neoplastic mucosa. Her2/neu and EGF-R protein levels were statistically significantly different with higher levels of both proteins in the PR group. Importantly, Her2/neu expression was strong and diffuse in tumors with signet-ring morphology, while other histo-pathological subtypes showed higher intra-tumoral Her2/neu heterogeneity than typically observed in breast cancer. Targeted therapies in gastric cancer directed at EGF-R and Hers-2/neu pathways warrant further investigation. These therapies may be especially effective in PR patients and in patients with signet-ring cell morphologies with a dismal prognosis.
Assuntos
Proteínas Adaptadoras de Transdução de Sinal/análise , Adenocarcinoma , Antineoplásicos/uso terapêutico , Carcinoma de Células em Anel de Sinete , Hispânico ou Latino , Seleção de Pacientes , Neoplasias Gástricas , População Branca , Adenocarcinoma/química , Adenocarcinoma/etnologia , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adulto , Carcinoma de Células em Anel de Sinete/química , Carcinoma de Células em Anel de Sinete/tratamento farmacológico , Carcinoma de Células em Anel de Sinete/etnologia , Carcinoma de Células em Anel de Sinete/patologia , Ciclina D , Ciclinas/análise , Receptores ErbB/análise , Feminino , Florida , Humanos , Imuno-Histoquímica , Masculino , Porto Rico , Receptor ErbB-2/análise , Estudos Retrospectivos , Fator de Transcrição STAT3/análise , Neoplasias Gástricas/química , Neoplasias Gástricas/etnologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapiaRESUMO
Se realizó un estudio trasversal, analítico, descriptivo, que evaluó los resultados del tratamiento quirúrgico de los pacientes ingresados en el Servicio de Cirugía del Hospital Abel Santamaría en el período de mayo de 1998 a mayo de 2004 y con diagnóstico de neumotórax espontáneo persistente o recidivante y se evaluaron los resultados de las toracotomías convencionales y las videotoracoscópicas. La muestra quedó conformada por 60 pacientes que fueron divididos en dos grupos: grupo I (control), integrado por los pacientes operados por toracotomía convencional y el grupo II (estudio), formado por los operados mediante videotoracoscopia. Cada grupo tuvo 30 pacientes. Los datos fueron obtenidos de las historias clínicas y fueron analizados según las variables siguientes: tiempo quirúrgico, complicaciones, estadía hospitalaria y costes. Se aplicó el test de proporciones para dos grupos independientes. Los principales resultados fueron: en el grupo II el 50 por ciento de los pacientes fueron operados en un tiempo de 60 a 120 minutos, mientras que en el grupo I, en la mayoría de los pacientes (14; 46,7 por ciento), la operación se realizó en un tiempo que osciló entre 120 y 180 minutos. Las complicaciones se presentaron con mayor frecuencia en el grupo control, en el que predominaron las neuralgias intercostales (33,3 por ciento). Veintiún pacientes del grupo estudio (70 por ciento) fueron dados de alta en 6 a 10 días del postoperatorio, en contraposición con los del grupo control, donde sólo 8 pacientes (26,7 por ciento) recibieron el alta entre los 6 a 10 días, pues la mayoría de ellos (50 por ciento) permaneció ingresada entre 11 y 20 días. El grupo operado mediante videotoracoscopia significó costes hospitalarios menores con relación al grupo operado por toracotomía convencional(AU)
He/she was carried out a study trasversal, analytic, descriptive, that evaluated the results of the surgical treatment of the patients entered in the Service of Surgery of the Hospital Abel Santamaría in the period of May of 1998 to May of 2004 and with diagnosis of persistent spontaneous neumotórax or recidivante and the results of the conventional toracotomías and the videotoracoscópicas were evaluated. The sample was conformed by 60 patients that were divided in two groups: group I (control), integrated by the patients operated by conventional toracotomía and the group II (I study), formed by those operated by means of videotoracoscopia. Each group had 30 patients. The data were obtained of the clinical histories and they were analyzed according to the following variables: surgical time, complications, hospital demurrage and costs. The test of proportions was applied for two independent groups. The main results were: in the group II 50 percent of the patients was operated at one time from 60 to 120 minutes, while in the group I, in most of the patients (14; 46,7 percent), the operation was carried out at one time that it oscillated between 120 and 180 minutes. The complications were presented with more frequency in the group control, in which the neuralgias intercostales prevailed (33,3 percent). patient Veintiún of the group study (70 percent) they were given of high in 6 to 10 days of the postoperative one, in opposition with those of the group control, where only 8 patients (26,7 percent) they received the discharge among the 6 to 10 days, because most of them (50 percent) it remained entered between 11 and 20 days. The group operated by means of videotoracoscopia meant smaller hospital costs with relationship to the group operated by conventional toracotomía(AU)
Assuntos
Humanos , Pneumotórax/diagnóstico , Toracotomia/métodos , Análise Custo-Benefício/métodos , Cirurgia Torácica Vídeoassistida/métodos , Epidemiologia Descritiva , Estudos TransversaisRESUMO
Se realizó un estudio transversal, analítico, retrospectivo, que evaluó los resultados de las modalidades de ingreso ambulatorio y electivo en las pacientes operadas con diagnóstico de cáncer de mama en estadios I y II, en el Hospital General Docente Abel Santamaría Cuadrado (Pinar del Río), durante el período comprendido entre el 1,o de enero de 1995 y el 31 de diciembre de 2004. La muestra objeto de estudio estuvo constituida por 120 pacientes, divididos en dos grupos de 60 pacientes cada uno: grupo I (cirugía en paciente con ingreso electivo) y grupo II (cirugía en paciente con ingreso ambulatorio). Se conocieron las ventajas de ambos métodos en cuanto a complicaciones sépticas y no sépticas, estadía hospitalaria y costes. No se presentaron diferencias significativas en la comparación de las complicaciones sépticas y no sépticas. Las estadías preoperatoria, posoperatoria y media total fueron mayores en la cirugía con ingreso electivo, así como sus costes. Se demostró, por tanto, que la cirugía ambulatoria en el cáncer de mama en estadios I y II es económicamente ventajosa y no aumenta los riesgos para las pacientes(AU)
He/she was carried out a traverse, analytic, retrospective study that evaluated the results of the modalities of entrance national health clinic and elective in the patients operated with cancer diagnosis of he/she suckles in stadiums I and II, in the Educational General Hospital Abel Squared Santamaría (Pinegrove of the River), during the period understood between January 1,o 1995 and December 31 2004. The sample study object was constituted by 120 patients, divided in two groups of 60 patients each one: group I (surgery in patient with elective entrance) and group II (surgery in patient with entrance national health clinic). the advantages of both methods were known as for septic and not septic complications, hospital demurrage and costs. Significant differences were not presented in the comparison of the septic and not septic complications. The demurrages preoperatoria, posoperatoria and half total were bigger in the surgery with elective entrance, as well as their costs. It was demonstrated, therefore that the ambulatory surgery in the cancer of he/she suckles in stadiums I and II it is economically advantageous and it doesn't increase the risks for the patients(AU)
Assuntos
Humanos , Neoplasias da Mama/cirurgia , Neoplasias da Mama/diagnóstico , Procedimentos Cirúrgicos Ambulatórios/métodos , Estudos Transversais , Estudos Retrospectivos , Custos e Análise de CustoAssuntos
Humanos , Masculino , Feminino , Ferimentos e Lesões , Congresso , Sociedades Científicas/organização & administração , Ciência , Venezuela , Saúde PúblicaRESUMO
Recientemente, en USA, se viene utilizando el pentetreoide (análogo sintético de la somatostatina) marcado con indio 111, para la detección y tratamiento de tumores neuroendocrinos con un notable éxito. Dado el alto costo de este procedimiento y la dificultad de obtención del radiofármaco indio 111, en nuestro país demostramos en una paciente con tumor suprarrenal funcionante diagnosticado por clínica y resonancia magnética nuclear que el pentetreoide marcado con tecnecio 99m (generado en el país), ofrecía el mismo resultado, obteniéndose excelente correlación entre las imágenes logradas con nuestro procedimiento, imagenología y la pieza in vivo, a un costo muy inferior
Assuntos
Neoplasias das Glândulas Suprarrenais , TecnécioRESUMO
Presentamos a través de un recuento pormenorizado, el origen y evolución de unas ideas, que a través del tiempo hemos plasmado en lo que consideramos una linea curricular, con énfasis en la preparación médica para atención de emergencias y desastres, la cual se ha desarrollado en la Escuela de Medicina José maría Vargas de la UCV
Assuntos
Emergências em Desastres , DesastresRESUMO
Con el objetivo de evaluar el estado actual del tratamiento de la hipertensión portal en la hemorragia digestiva superior por várices esofágicas evaluamos retrospectivamente en el Hospital Vargas de Caracas a 19 pacientes que requirieron de cirugía para la hipertensión portal. El período evaluado estuvo comprendido entre Enero de 1996 y Mayo de 1997. El 57,89 por ciento correspondió al sexo masculino, la edad media del grupo estaba en 47,6 años. En 16 pacientes (84,21 por ciento) se realizó transección esofágica y en el resto una derivación porto sistémica. La cirrosis hepática fue responsable de más del 90 por ciento de los casos con hipertensión portal y la mortalidad global del tratamiento quirúrgico fue de 63,16 por ciento que al correlacionarla con la clasificación de Child-Pugh correspondió con el tipo B en 5 pacienttes (41,66 ppor ciento) y para el tipo C en 6 pacientes (50 por ciento). La sobrevida fue de 37,5 por ciento en los que recibieron transección esofágica. La causa de muerte postoperatoria más frecuente fue la insuficiencia hepática. En vista de nuestros resultados creemos que existe una posibilidad quirúrgica para el tratamiento del sangrado por várices esofágicas que no responden o no son susceptibles de tratamiento médico y/o endoscópico
Assuntos
Humanos , Masculino , Feminino , Cirrose Hepática/mortalidade , Hipertensão Portal/cirurgia , Hipertensão Portal/patologia , Varizes Esofágicas e Gástricas/cirurgia , Varizes Esofágicas e Gástricas/sangue , VenezuelaRESUMO
Presentamos un paciente con diagnóstico de feocromocitoma de la vejiga urinaria a quien se le realizó cistectomía parcial con linfadenectomía regional, evolucionando satisfactoriamente. Se revisa la literatura, encontrandose que la escisión quirúrgica completa es el único tratamiento de elección
Assuntos
Humanos , Masculino , Adolescente , Oncologia , Feocromocitoma/diagnóstico , Bexiga Urinária/anormalidades , Urologia/estatística & dados numéricosRESUMO
Las lesiones penetrantes del tórax inferior pueden ir acompañadas de una lesión diafragmática-abdominal. Dichas lesiones pueden ser evidentes pero en casos seleccionados resultan de difícil diagnóstico. Una lesión diafragmática aislada diagnósticada acarrea graves consecuencias tardías para el paciente. La laparoscopia es un método ideal para la evaluación del diafragma en casos seleccionados donde las opciones diagnósticas son el lavado peritoneal y la laparotomía mandatoria. Las lesiones diafragmáticas aisladas pueden resultar ocultas para el lavado peritoneal ya que para ser diagnosticada por este método requiere un criterio de positividad en el recuento eritrocitario muy bajo, lo que estaria acompañada de un alto índice de laparotomia no terapeútica, al igual, que si se realizaran laparotomias mandatorias a todos los pacientes con potencial lesión del diafragma. Presentamos nuestra experiencia en 22 pacientes con trauma penetrante del tórax inferior que reunían los criterios de inclusión para nuestra serie. Por este método se identificaron 9 pacientes con lesión diafragmática-abdominal sin registrarse falsos negativos