THE ONE ANASTOMOSIS GASTRIC BYPASS TECHNIQUE: RESULTS AFTER ONE YEAR OF FOLLOW-UP.

BACKGROUND: Obesity is a major health problem. One anastomosis-gastric bypass (OAGB) is a restrictive and malabsorptive weight loss surgery that carries the same characteristics of Roux-en-Y gastric bypass in its status as a weight loss mechanism; but, its results remain controversial. AIM: To describe the technique and outcomes of OAGB and its effects on weight loss and remission of comorbidities. METHODS: Retrospective review of all patients who underwent OAGB procedure from January 2017 to January 2018. Patients' baseline characteristics were recorded. The routine in follow-up were at 1, 3, 6 and 12 months. RESULTS: A total of 51 patients underwent OAGB. The mean age was 43.8±9.3 years, mean weight was 125±31 and mean BMI was 55.8±12 kg/m2. With regard to comorbidities, 64.7% had type 2 diabetes mellitus (T2DM), 43.1% systemic arterial hypertension (SAH) and 51% dyslipidemia. The BMI decreased for 48.4±1.3 to 31±4.4 at 12 months (p=0.0001) and we obtained an average decreased of 65% excess weight loss (EWL) at 12 months of follow-up. There was improvement in the values of total cholesterol (CT) (p=0.348); triglycerides (TGC) (p=0.0001); LDL (p=0.06), HDL (p=0.029) and A1C (p=0.405). Remission of T2DM al 12 months follow-up after surgery was 57% (p=0.124), remission of SAH 37% (p=0.040) and remission of dyslipidemia of 43% (p=0.967). CONCLUSIONS: OAGB is a commonly performed and safe procedure. Short term results appear promising; however, long-term follow-up is necessary to evaluate complications and possible nutritional effects.

Carcinoma linfoepitelial de cuello uterino con recurrencia a distancia / Lymphoepithelioma-like carcinoma of the cervix with distant recurrence

Resumen El carcinoma similar al linfoepitelioma (LELC) del cuello uterino es una variante infrecuente del carcinoma de células escamosas. Se presenta el caso de una mujer con un tumor exofítico en el cuello uterino de consistencia aumentada, sangrado al tacto y parametrios libres de tumor clasificándose como etapa clínica IBI; el estudio histopatológico reportó LELC con recurrencia a distancia al año de seguimiento. Debido a su buen pronóstico existen pocos casos reportados de recurrencia posterior al tratamiento inicial.

Abstract Lymphoepithelioma-like carcinoma (LELC) of the cervix is an uncommon variant of squamous cell carcinoma. We present the case of a woman with an exophytic tumor on the cervix of increased consistency, bleeding to the touch and tumor-free parametriums classified as clinical stage IBI; the histopathological study reported LELC with distant recurrence at one year of follow-up. Due to its good prognosis, there are few reported cases of recurrence after initial treatment.

Retroperitoneal fibrosis associated with immunoglobulin IgG4-related disease in the differential diagnosis in retroperitoneal tumors. Case report. / Fibrosis retroperitoneal nodular asociada a IgG4 como diagnóstico diferencial en tumores retroperitoneales. Reporte de un caso.

The patient was a 55-year-old woman with a 4-month history of pain in left flank that irradiated to the lumbar region. Computed tomography revealed a cystic tumor in the retroperitoneal region that compresses the ureter and left renal pelvis in contact with pancreatic body and tail. Surgery was performed and the definitive pathological report diagnosed nodular retroperitoneal fibrosis associated with IgG4; Ki67-positive in germinal centers (5%) and IgG4-positive (40 plasma cells in 3 fields of 40x) by immunohistochemistry. Retroperitoneal fibrosis is a rare disease, that develops gradually and has an excellent response to steroid management. Surgical treatment is reserved for cases that compromise adjacent structures. Thus, identifying it when studying a retroperitoneal tumor leads to better prognosis and survival.

The one anastomosis gastric bypass technique: results after one year of follow-up / Bypass gástrico com somente uma anastomose: resultados após um ano de acompanhamento

ABSTRACT Background: Obesity is a major health problem. One anastomosis-gastric bypass (OAGB) is a restrictive and malabsorptive weight loss surgery that carries the same characteristics of Roux-en-Y gastric bypass in its status as a weight loss mechanism; but, its results remain controversial. Aim: To describe the technique and outcomes of OAGB and its effects on weight loss and remission of comorbidities. Methods: Retrospective review of all patients who underwent OAGB procedure from January 2017 to January 2018. Patients' baseline characteristics were recorded. The routine in follow-up were at 1, 3, 6 and 12 months. Results: A total of 51 patients underwent OAGB. The mean age was 43.8±9.3 years, mean weight was 125±31 and mean BMI was 55.8±12 kg/m2. With regard to comorbidities, 64.7% had type 2 diabetes mellitus (T2DM), 43.1% systemic arterial hypertension (SAH) and 51% dyslipidemia. The BMI decreased for 48.4±1.3 to 31±4.4 at 12 months (p=0.0001) and we obtained an average decreased of 65% excess weight loss (EWL) at 12 months of follow-up. There was improvement in the values of total cholesterol (CT) (p=0.348); triglycerides (TGC) (p=0.0001); LDL (p=0.06), HDL (p=0.029) and A1C (p=0.405). Remission of T2DM al 12 months follow-up after surgery was 57% (p=0.124), remission of SAH 37% (p=0.040) and remission of dyslipidemia of 43% (p=0.967). Conclusions: OAGB is a commonly performed and safe procedure. Short term results appear promising; however, long-term follow-up is necessary to evaluate complications and possible nutritional effects.

RESUMO Racional: A obesidade é um grande problema de saúde. Bypass gástrico com uma anastomose (OAGB) é operação de perda de peso restritiva e disabsortiva que carrega as mesmas características do bypass gástrico em Y-de-Roux em seu status de mecanismo de perda de peso, mas seus resultados permanecem controversos. Objetivo: Descrever a técnica e os resultados do OAGB e seus efeitos na perda de peso e na remissão de comorbidades. Método: Revisão retrospectiva de todos os pacientes que foram submetidos a OAGB de janeiro de 2017 a janeiro de 2018. As características basais dos pacientes foram registradas. O acompanhamento de rotina foi de 1, 3, 6 e 12 meses. Resultados: Um total de 51 pacientes foi submetido a OAGB-HGM. A idade média foi de 43,8±9,3 anos, o peso médio foi de 125±31 e o IMC médio de 55,8±12 kg/m2. Em relação às comorbidades, 64,7% apresentavam diabete melito tipo 2 (DM2), 43,1% hipertensão arterial sistêmica (HAS) e 51% dislipidemia. O IMC diminuiu para 48,4±1,3 a 31±4,4 em 12 meses (p=0,0001) e a redução média foi de 65% de perda de excesso de peso (EWL) em 12 meses de seguimento. Houve melhora nos valores do colesterol total (CT) (p=0,348); triglicéridos (TGC) (p=0,0001); LDL (p=0,06), HDL (p=0,029) e A1C (p=0,405). A remissão do DM2 ao seguimento de 12 meses após a operação foi de 57% (p=0,124), remissão da HAS 37% (p=0,040) e remissão da dislipidemia de 43% (p=0,967). Conclusões: OAGB-HGM é procedimento comumente realizado e seguro. Resultados de curto prazo parecem promissores; no entanto, o acompanhamento em longo prazo é necessário para avaliar as complicações e possíveis efeitos nutricionais

[Diagnostic of uterine sarcoma, review of 11 cases]. / Diagnóstico de sarcoma uterino, revisión de 11 casos.

BACKGROUND: Uterine sarcomas are rare but extremely aggressive malignant uterine pathology; mostly incidentally diagnosed at an advanced stage, with a higher aggressiveness and poor prognosis. OBJECTIVE: To determine the epidemiological profile of women with this diagnosis in Ginecopediatria Hospital, UMAE 48 of IMSS and its correlation with the literature. MATERIAL AND METHODS: A retrospective and observational study was done from 2007 to 2014 in UMAE 48, IMSS León, Guanajuato, in which the clinical records of patients with such diagnoses were reviewed. RESULTS: A total of 11 cases with age range 21-66 years had abnormal bleeding (82%), abdominal pain (64%), enlarged uterus (64%) and isolated elevation of lactic dehydrogenase (55%). The leiomyosarcoma accounted for 55%, sarcoma mixed Mullerian (SMM) 27% and endometrial stromal sarcoma (SEE) in 22% of cases. The stage I was the most frequent (55%) and histological type, which presented a more advanced stage was the SMM (stage IIIC). The hysterectomy with pelvic and paraaortic lymphadenectomy was the most common treatment (67%). The 45% of patients had tumor activity subsequent to treatment and the use of radiotherapy and chemotherapy was not associated with activity. CONCLUSION: Clinical features, risk factors and distribution of the presentation of the various sarcomas were according with previous studies, requiring further research to improve prognosis and survival in this type of tumor.

Neuroprotective effect of silymarin in a MPTP mouse model of Parkinson's disease.

Parkinson's disease (PD) is a neurodegenerative disease secondary to the loss of dopaminergic neurons in the substantia nigra. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) produces in mice and primates histopathological changes similar to PD in humans. A common feature of PD and MPTP models is neuronal death and dopamine depletion. Silymarin is a complex of flavonolignans derived from the seeds of the plant Silybum marianum and has mainly antioxidant, anti-inflammatory, cytoprotective and neuroprotective effects. In order to explore whether silymarin has a neuroprotective effects in a mouse model of PD we determined the concentration of striatal dopamine by HPLC, the number of apoptotic cells by in situ Tunel assay and the number of tyrosine hydroxylase positive neurons by immunohistochemistry in substantia nigra of vehicle-treated, silymarin-treated, MPTP-intoxicated and MPTP-silymarin treated C57BL/6J male mice. MPTP (30 mg/kg) and silymarin doses (25, 50, 100, 200, 250, 300 or 400mg/kg) were administered intraperitoneally once daily for five consecutive days. Silymarin treatment showed a non-monotonic dose-response curve and only 50 and 100mg/kg doses preserved dopamine levels (62% and 69%, respectively) after MPTP intoxication. Additionally, 100mg/kg silymarin treatment significantly diminished the number of apoptotic cells and preserved dopaminergic neurons in the substantia nigra of MPTP-intoxicated mice. These results show the neuroprotective properties of 100mg/kg silymarin and may be of interest in the treatment of PD.