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BACKGROUND AND OBJECTIVES: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an effective but complex treatment for peritoneal metastasis (PM). Our objective was to identify risk factors for postoperative morbidity and mortality following CRS-HIPEC. METHODS: Retrospective study of prospectively collected data of patients undergoing CRS-HIPEC for PM arises from colorectal cancer between January 2008 and December 2017. Perioperative variables were correlated with morbidity outcomes using a logistic regression model. RESULTS: Sixty-seven patients underwent CRS-HIPEC, and overall morbidity and mortality were 31.3% and 4.5% respectively. Major morbidity rate was 19.4%; 7.5% of patients were re-operated. Intraoperative blood transfusion (p = 0.01), liver resection (p < 0.01), and intestinal anastomosis (p < 0.01) were associated with a higher morbidity in univariate analysis. A multivariate analysis identified blood transfusion and liver resection as independent risk factors (OR 3.66, IC 1.13-16.54; OR 4.33, IC 1.17-11.46, respectively). Extension of visceral resection did not correlate with morbidity. Patients with lymph-node infiltration had a higher major complication rate (p = 0.01). CONCLUSIONS: CRS-HIPEC is a feasible treatment for colorectal PM with an acceptable morbi-mortality rate in experienced centers. In our study, digestive anastomosis, perioperative blood transfusion, hepatic resection, and lymph-node infiltration were associated with higher morbidity rates.

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BACKGROUND: Cytoreductive surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in peritoneal carcinomatosis treatment causes significant hemodynamic, metabolic, and hematological alterations. Studies on the anesthetic intraoperative management are heterogeneous and scarce. There is a great heterogeneity in the anesthetic management of CRS and HIPEC. The aim of this study is to analyze perioperative hemodynamic goal-directed management and to evaluate the complications arisen until the seventh postoperative day. METHODS: Prospective, observational study of all CRS and HIPEC patients from March 2014 to May 2017. Hemodynamic and clinical parameters were registered during surgery and the first 3 postoperative days. We correlated intraoperative data with the postoperative course until the seventh day. RESULTS: A total of 92 patients were included in the study (age 58.5 ± 10.9 years, 47% colorectal carcinoma, and 38% ovarian carcinoma). Peritoneal Carcinomatosis Index (PCI) (median and ranges) was 10 [0-39]. Cardiac Index (CI) 3.15 l/min-1/m-2 [1.79-5.60]) and Systolic Volume Variation (SVV) (10% [3%-17%]) remained within the values of normality in all surgery phases. A large difference was observed between the minimum and maximum ranges of fluid therapy administered (median 9.8 ml/kg/h [5.3-24.3]), showing a great interindividual variation in the fluids requirement. A direct relationship was observed between PCI and surgery duration, fluid therapy, and intraoperative transfusion percentage (p < 0.02). CONCLUSIONS: There is a great variability in the intraoperative fluid therapy needs of the patients. SVV monitoring makes it possible to adjust the fluid therapy needs in each surgery phase. The use of a hemodynamic goal-directed anesthetic protocol in CRS and HIPEC enables to individually adjust the fluid therapy, avoiding over-hydration and ensuring hemodynamic stability in all surgery phases.

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El objetivo del estudio fue comprobar si existen diferencias entre el lado dominante y no dominante de las medidas antropométricas en los mejores jugadores y jugadoras españoles de bádminton, así como verificar si el lado del cuerpo donde se realiza la medición puede influir en el cálculo de la composición corporal y del somatotipo. Participaron voluntariamente en el estudio 46 jugadores de bádminton de élite, 31 eran hombres (edad=21,7+/-4,3 años) y 15 mujeres (edad=19,1+/-4,4 años). Se tomaron las medidas de 6 pliegues cutáneos, 3 diámetros, 3 longitudes y 5 perímetros del lado dominante y no dominante de los sujetos. Se calculó la composición corporal y el somatotipo con los valores registrados en cada uno de los lados. No se encontraron diferencias en los pliegues ni en las longitudes entre el lado dominante y no dominante, como consecuencia tampoco se encontraron diferencias significativas en el porcentaje de grasa (dominante=11,20+/-4,45 por ciento; no dominante=11,12+/-4,48 por ciento; ns). Aparecieron valores superiores (p<0,05) en los diámetros óseos y en los perímetros en el lado dominante. El porcentaje óseo fue mayor calculado a partir de las mediciones del lado dominante (dominante=16,37+/-1,14 por ciento, no dominante=15,66+/-1,12 por ciento; p<0,001). El porcentaje muscular fue mayor calculado a partir de las mediciones del lado no dominante (dominante=49,39+/-2,60 por ciento, no dominante=50,18+/-2,69 por ciento; p<0,001). Como conclusión podemos afirmar que existen asimetrías corporales en los jugadores de bádminton de alto nivel, al encontrarse diferencias en los diámetros óseos y en los perímetros entre el lado dominante y no dominante. Al calcular la composición corporal con el lado dominante de los jugadores de bádminton se está sobreestimando el porcentaje óseo e infraestimando el porcentaje muscular...

The purpose of this study was to determine whether differences exist between the dominant and non-dominant side in anthropometric measurements in the best Spanish badminton players, and to verify if the side of the body where the measurement was made could influence the calculation of body composition and somatotype. Forty-six elite badminton players voluntarily participated in the study, 31 were men (age=21.7+/-4.3 years) and 15 women (age=19.1+/-4.4 years). Anthropometric measurements consisting of 6 skinfolds, 3 lengths, 3 breadths and 5 girths, were taken on the dominant and non-dominant side of each participant. Body composition and somatotype were calculated with the values ??recorded on each side. No differences were found in the skinfolds or the lengths between the dominant and non-dominant side, as a result neither were significant differences found in the fat percentage (11.20 +/- 4.45 percent dominant; 11.12 +/- 4.48 percent, non-dominant, ns). Values were higher (p <0.05) in bone breadths and girths on the dominant side. Bone percentage was greater when calculated from measurements on the dominant side (dominant=16.37+/-1.14 percent, non-dominant=15.66+/-1.12 percent; p<0.001). Muscle percentage was higher when calculated from measurements on the non-dominant side (dominant=49.39+/-2.60 percent, non-dominant=50.18+/-2.69 percent; p<0.001). In conclusion we can confirm that there are body asymmetries in high level badminton players, because differences were found in bone breadths and girths between the dominant and non-dominant side. When calculating the body composition with the badminton players' dominant side, bone percentage was overestimated and muscle percentage was underestimated...

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In the presence of K(+), addition of ATP or ethanol to yeast mitochondria triggers the depletion of the transmembrane potential (DeltaPsi) and this is prevented by millimolar concentrations of phosphate (PO(4)). Different monovalent and polyvalent anions were tested for their protective effects on mitochondria from Saccharomyces cerevisiae. Only arsenate (AsO(4)) and sulfate (SO(4)) were as efficient as PO(4) to protect mitochondria against the K(+) mediated swelling, depletion of the DeltaPsi, and decrease in the ratio of uncoupled state to state 4 respiration rates. Protection by PO(4), SO(4) or AsO(4) was inhibited by mersalyl, suggesting that these anions interact with a site located in the matrix side. In addition, the effects of SO(4) and AsO(4) on the F(1)F(0)-ATPase were tested: both SO(4) and AsO(4) inhibited the synthesis of ATP following competitive kinetics against PO(4) and non-competitive kinetics against ADP. The mersalyl sensitive uptake of (32)PO(4) was not inhibited by SO(4) or AsO(4), suggesting that the synthesis of ATP was inhibited at the F(1)F(0)-ATPase. The hydrolysis of ATP was not inhibited, only a stimulation was observed when AsO(4) or sulfite (SO(3)) were added. It is suggested that the structure and charge similarities of PO(4), AsO(4) and SO(4) result in undiscriminated binding to at least two sites located in the mitochondrial matrix: at one site, occupation by any of these three anions results in protection against uncoupling by K(+); at the second site, in the F(1)F(0)-ATPase, AsO(4) and SO(4) compete for binding against PO(4) leading to inhibition of the synthesis of ATP.

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