RSNA Committee on International Radiology Education: 25 Years of Global Education Outreach.

The Radiological Society of North America (RSNA) Committee on International Radiology Education (CIRE) has worked for the past 25 years to create academic programs oriented to the needs of international radiologists. The CIRE develops organized and structured approaches to help build one's capabilities and increase one's capacity for professional growth, which then facilitates better patient care. The authors describe the four programs that CIRE is responsible for and introduces its newest initiative, Global Learning Centers, which is planned to start in 2021. RSNA involvement in global radiology education provides opportunities for early, mid-, and late-career radiologists to participate in these programs as students or teachers. The authors describe some of the programs' success stories and invite readers to become a part of and contribute to the growth of radiologic academic endeavors globally. ©RSNA, 2020.

Study of the physical and chemical changes during the maturation of three cocoa clones, EET8, CCN51, and ICS60.

BACKGROUND: Colombia is known for its production of fine and aromatic cocoa; however, the lack of homogeneity in the ripeness stage of cocoa fruit affects the final quality of cocoa beans. Therefore, the aim of this work was to identify parameters that can be use as indicators of ripeness in cocoa fruit in order to homogenize the characteristics of raw cocoa used in the production of cocoa-products industry. The parameters evaluated were fruit, seed and pod weight, firmness, color, polar and equatorial diameters of the fruit, seed moisture content, total titratable acidity, pH, and total soluble solids of pulp. RESULTS: Factors such as seed weight, firmness, diameters, total soluble solids, pH, and acidity were affected by the clone factor, whereas seed weight, pH, and total titratable acidity were affected by ripeness stage. CONCLUSION: Identification of indicators of ripeness for cocoa fruit is a complex task due to the influence of the clone on the evolution of the physicochemical characteristics of cocoa fruit during its maturation process. Thus, indicators must be developed for each clone, and at least two parameters among color, pH, and total titratable acidity should be used to determine the ripeness stage of cocoa fruit. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Anatomical variations of the ethmoidal roof: differences between men and women.

AIM: During the paranasal sinuses surgery different complications may occur, both vascular and bony. The objective of the present study was to evaluate the ethmoidal roof configuration through the Keros and Yenigun classifications, analyzing results stratified by gender and side. MATERIALS AND METHODS: We retrospectively analyzed 120 high-resolution computed tomography paranasal sinus study images and measured the depth of the cribriform plate in a coronal view and the anterior-posterior length in a cross section. RESULTS: The Keros Type II was the most frequent and no statistically significant difference was found when comparing by gender. Yenigun type I was more prevalent, and a statistically significant difference was found between men and women in types I and II (p = 0.010 and p = 0.049, respectively). Statistical difference was observed in anterior-posterior means in the comparison between both classifications. In both, right and left side for men (p = 0.003 and p = 0.05) and women (p = 0.029 and p = 0.039). CONCLUSION: We demonstrate the morphological variability that exists in this region. Gender differences that must be considered by the surgeon to avoid complications. Further studies are needed to evaluate the value of these findings when predicting surgical complications. A CT before PNS surgery is already widely accepted.

Potential use of sludge from El Ferrol Bay (Chimbote, Peru) for the production of lipids in the culture of Scenedesmus acutus (Meyen, 1829).

Despite the extensive development of microalgae biotechnology, it still requires new methodologies to lower production costs, especially in the field of biofuel production. Therefore, innovative methods that facilitate operations and enable cost-effective production are important in driving this industry. In this study, we propose a new low-cost and easy-to-use procedure, addressed to the generation of a culture medium for Scenedesmus acutus. The medium was obtained by thermal reduction of a sludge sample from El Ferrol Bay (Chimbote, Peru), whereby we obtained an aqueous medium. Our results indicated that the aqueous medium incorporates all necessary nutrients for microalgae production; allowing a maximum biomass of 0.75 ± 0.07 g/L with 60% of the medium; while high lipids production (59.42 ± 6.16%) was achieved with 20%. Besides, we quantified, in the experimental medium and at the end of the cultures, the levels of inorganic nutrients such as ammonium, nitrites, nitrates, and phosphates; in addition to COD and TOC, which were significantly reduced ( p < 0.05) after 7 days of culture, mainly in the treatment with 20%. These results suggest tremendous potential for sludge reuse, which also entails a cost reduction in microalgae biomass production, with additional positive impacts on large-scale application over highly polluted environments.

Acute, subacute and chronic effect of cyclosporin-A on mean arterial pressure of rats with severe spinal cord contusion.

Cyclosporin-A (CsA) protects and regenerates the neural tissue after spinal cord (SC) injury. These beneficial effects are achieved when CsA is administered at a dose of 2.5mg/kg/12h during the first 2 days after lesion. In view of these observations, it is realistic to envision that, CsA could be tested in SC-clinical trials. Since CsA is a drug strongly related to hypertension, results imperative to evaluate experimentally the effect of the above CsA-dose regimen on blood pressure. For this purpose, one hundred and twenty adult rats were subjected (10 groups) or not (10 groups) to SC-injury. Five injured and five Sham-operated groups received CsA. The remaining groups received only vehicle. Mean arterial pressure (MAP) was recorded from these animals at acute (6 and 24h post surgery; p.s.), subacute (96h), or chronic (30 days) stages of injury. In the latter, the therapy (CsA or vehicle) was administered only during the first 2 days p.s. or daily during 30 days of follow-up. The results of this study showed that SC-injury by itself induces a significant decrease of MAP during the acute and subacute phases of injury. CsA therapy was able to reestablish MAP parameters to control values in these phases. Regardless the therapy, a reestablishment of MAP was observed in chronic stages. Only the daily administration of CsA induced a significant increase in MAP, however; such variation remained into the normal ranges of MAP for rats. The potential benefits offered by CsA support its usefulness after SC-injury.

Cáncer de mama metastásico y embarazo: reporte de caso / Metastatic breast cancer and pregnancy: a case report

Resumen ANTECEDENTES: El cáncer de mama es la segunda neoplasia maligna más común asociada con el embarazo. Su tratamiento es complejo debido a los riesgos en el feto en el contexto del tratamiento de la madre. CASO CLÍNICO: Paciente de 28 años, enviada del Hospital Naval de Chetumal, Quintana Roo, con 13.1 semanas de embarazo por fecha de la última menstruación. En la tomografía computada se advirtió la existencia de un derrame pleural del 70%, otro pericárdico y sospecha de metástasis osteoblástica a la columna torácica. En la exploración física se encontró con dinámica ventilatoria, amplexión y amplexación disminuida derecha, hipoventilación interescapular y basal derecha, con disminución a la trasmisión de voz, submatidez basal derecha y, hacia el lado izquierdo, un murmullo vesicular. Los estudios citoquímico y citológico de líquido pericárdico y pleural se reportaron positivos para malignidad. En la resonancia magnética de la columna se encontraron lesiones sugerentes de actividad tumoral en los cuerpos vertebrales T12 a L5. Debido al avanzado estado metastásico del cáncer se propuso la interrupción del embarazo con el propósito de no retrasar el tratamiento. El perfil biológico reportó: inmunofenotipo triple negativo (receptores de estrógeno y progesterona: negativo, HER2: negativo en células neoplásicas). Se le indicó tratamiento con quimioterapia sistémica (carboplatino-paclitaxel). CONCLUSIÓN: El diagnóstico de cáncer de mama durante el embarazo dificulta la detección e interpretación de las anormalidades mamarias, retrasa el diagnóstico, permite el crecimiento del tumor y se incrementa el riesgo metastásico de la enfermedad. El tratamiento oncológico adecuado y su valoración multidisciplinaria son decisivos para favorecer la supervivencia.

Abstract BACKGROUND: Breast cancer is the second most common malignancy associated with pregnancy. Its treatment is complex due to fetal risks in the context of treatment of the mother. CLINICAL CASE: 28-year-old patient, referred from the Naval Hospital of Chetumal, Quintana Roo, with 13.1 weeks of pregnancy by date of last menstrual period. The CT scan showed a 70% pleural effusion, another pericardial effusion and suspicion of osteoblastic metastasis to the thoracic spine. Physical examination showed ventilatory dynamics, decreased right amplexion and amplexation, interscapular and right basal hypoventilation, with decreased voice transmission, right basal submatitis and, to the left side, a vesicular murmur. Cytochemical and cytological studies of pericardial and pleural fluid were positive for malignancy. MRI of the spine showed lesions suggestive of tumor activity in the vertebral bodies T12 to L5. Due to the advanced metastatic stage of the cancer, termination of pregnancy was proposed in order not to delay treatment. The biological profile reported: triple negative immunophenotype (estrogen and progesterone receptors: negative, HER2: negative in neoplastic cells). Treatment with systemic chemotherapy (carboplatin-paclitaxel) was indicated. CONCLUSION: The diagnosis of breast cancer during pregnancy hinders the detection and interpretation of breast abnormalities, delays diagnosis, allows tumor growth and increases the metastatic risk of the disease. Adequate oncologic treatment and its multidisciplinary assessment are decisive in favoring survival.

Indorenate improves motor function in rats with chronic spinal cord injury.

The effect of indorenate (5-methoxytryptamine, beta-methyl carboxylate hydrochloride), a 5-HT1A agonist, was investigated on the motor performance of rats with chronic spinal cord injury. Four months after a ninth thoracic vertebrae spinal cord contusion, 29 rats were randomly allocated into two groups: saline solution and indorenate-treated animals with daily doses incremented at weekly intervals. The locomotor performance of all rats was measured by the Basso, Beattie, and Bresnahan (BBB) rating scale. The results showed that at the end of the treatment, the motor activity of indorenate group was significantly better than that presented by saline solution group. The 80% of indorenate, (against 15% of saline solution) did not show detriment on motor activity. When we analysed the motor activity of rats with basal BBB lower than 10, a significant improvement of motor recovery in indorenate-treated animals was observed. The benefits observed in locomotor function at low doses followed by increasing doses could be associated with pharmacological treatment by indorenate, a well-known 5-HT1A receptor agonist. Our results suggest a potential mechanism by which serotonergic agents may improve motor function in rats with chronic spinal cord injury.

Protective action of amlodipine on cardiac negative inotropism induced by lipopolysaccharide in rats.

Amlodipine has been shown to prevent decrease in vascular responsiveness induced by injection of Salmonella typhosa lipopolysaccharide (LPS); however, there is no study reporting if this protection by amlodipine extends to ventricular contractility. Therefore, we have investigated in rat isolated right ventricle strips contracted by electrical stimulation (1 and 3 Hz and subsequently 1 Hz) whether pre-treatment with amlodipine (15 mg/kg orally for 1 week) precludes the decrease in ventricular contractility related to the induction of nitric oxide synthase stimulated by LPS injection (4 mg/kg intraperitoneally). The induction of septic shock was confirmed in isolated aortic rings from LPS-injected rats by verifying that the contractile response to 1 microM noradrenaline had been (i) decreased after LPS injection and (ii) markedly potentiated by the addition of 10 microM l-arginine. The injection of saline to untreated and amlodipine-treated rats produced a non-significant effect on right ventricular contractility during 180 min. at 3 Hz; the recovery of the contractile response was improved when the stimulation frequency was subsequently returned to 1 Hz after 30 min. In contrast, injection of LPS to untreated and amlodipine-treated rats (amlodipine + LPS) produced a decrease in right ventricular contractility during 180 min. at 3 Hz, an effect that was more pronounced in LPS than in amlodipine-treated rats. These ex vivo results obtained after LPS injection suggest that amlodipine may have inhibited, at least in part, the induction of nitric oxide synthase with a resulting preclusion of the cardiovascular failure produced by septic shock.

Systemic microcirculation after complete high and low thoracic spinal cord section in rats.

Spinal cord injury (SCI) produces multiple systemic and metabolic alterations. Although some systemic alterations could be associated with ischemic organ damage, little is known about microvascular blood flow (MVBF) in organs other than the spinal cord after acute SCI. We used laser Doppler flowmetry in anesthetized rats to assess MVBF in several tissues before and after complete T-2 and T-9 SCI at 1 h and on days 1, 3, and 7 post-SCI. Mean arterial blood pressure (MAP), heart rate and hematologic variables also were recorded. MAP changes after T-2 injury were not significant, while MAP decreased significantly 1 h after T-9 injury. Statistically significant bradycardia occurred after T-2 injury at 7 days; statistically significant tachycardia occurred after T-9 injury at 1, 3, and 7 days. Hematocrit significantly increased at day 1 and decreased at days 3 and 7 after T-2 injury. SCI was associated with significant decreases in MVBF in liver, spleen, muscle and fore footpad skin. Changes in MVBF in hind footpad skin and kidney were not significant. Changes were more pronounced at 1 h and 1 day post-SCI. Significant differences between MVBF after T-2 and T-9 SCI occurred only in liver. MVBF significantly correlated with regional peripheral vascular resistances (assessed using the MAP/MVBF ratio), but not with MAP. In conclusion, organ-specific changes in systemic MVBF that are influenced by the level of SCI, could contribute to organ dysfunction.

Lipid peroxidation by nitric oxide supplements after spinal cord injury: effect of antioxidants in rats.

To determine the extent to which exogenous nitric oxide (NO) might affect hemodynamics and/or increase oxidative damage after acute spinal cord (SC) injury, rats were submitted to SC contusion, and given a NO donor or NO precursor. Intravenous isosorbide dinitrate (10 microg/kg per min) or L-arginine (300 mg/kg per 23 h) showed a tendency to increase lipid peroxidation (LP), although without reaching significance compared to non-treated injured rats 24 h post-injury, and without affecting mean arterial pressure and heart rate importantly. LP due to injury and exogenous NO was significantly inhibited by the co-administration of a cocktail of antioxidants (12 mg/kg superoxide dismutase mimetic, 27000 U/kg catalase, and 12 mg/kg glutathione), but less effectively for the injury-L-arginine condition. These results demonstrate that in order to further test the potential neuroprotective effect of NO enhancing reagents after SC injury, antioxidants must be included in the treatment scheme.

Evaluación del conocimiento de tratamiento de trauma dentoalveolar entre odontólogos de hospitales públicos en Barranquilla, Colombia / Evaluation of the knowledge treatment in dentoalveolar trauma among dentists of public hospitals in Barranquilla, Colombia

Resumen Objetivo: Evaluar el grado de conocimiento de los odontólogos generales de la red pública del distrito de Barranquilla acerca del trauma dentoalveolar. Materiales y métodos: Estudio observacional, descriptivo transversal, basado en encuestas dirigidas a 33 odontólogos generales de la Red Pública del distrito de Barranquilla, acerca del conocimiento en trauma dentoalveolar. La encuesta fue validada previamente por un equipo experto de odontólogos cirujanos y endodoncistas. La población diana estuvo conformada por 51 odontólogos de la red pública del distrito de Barranquilla. Se realizó un muestreo no aleatorio a conveniencia. Se efectuó un análisis descriptivo de los datos de la encuesta: promedio, mediana y moda, con el programa estadístico Microsoft Excel®. Resultados: Se observó que un 12.12 % (n=4) de los sujetos en estudio tiene un nivel de conocimiento malo, un 18.18 % (n=6) un nivel aceptable, mientras que solo un 9.09 % (n=3) tiene un nivel bueno. La categoría con más frecuencia fue la regular, con un 60.6 % (n=20). Conclusión: En este proyecto se observó que la mayoría de odontólogos generales que participaron fueron categorizados con el grado de conocimiento regular (60.6 %) y aceptable (18.18 %) de acuerdo con la escala de respuestas correctas del cuestionario aplicado. Un grado de conocimiento malo se presentó en un 12.12 %, mientras que solo un 9.09 % presento un grado de conocimiento bueno.

Abstract Objective: To evaluate the degree of knowledge of general dentists in the public network of the district of Barranquilla on dentoalveolar trauma. Materials and methods: Observational study, descriptive cross-sectional, based on interviews with 33 general dentists of the public network from Barranquilla, regarding dentoalveolar trauma. The survey was previously validated by an expert team of dental surgeons and endodontists. Results: It was observed a 12.12% (n=4) of the population studied had a low level of knowledge, 18.18% (n=6) an acceptable level, while only 9.09% (n=3) had a good level of knowledge. The most frequent category was "regular" with a 60.6% (n=20). Conclusion: In this project, it was observed that most general dentists who participated were categorized with a "not to standard" level of knowledge (60.6%) and acceptable (18.18%) according to the right answer scale of the applied questionnaire. A "low" level of knowledge was present on 12.12%, while only a 9.09% had a good level of knowledge.

Effect of the knockdown of amyloid precursor protein on intracellular calcium increases in a neuronal cell line derived from the cerebral cortex of a trisomy 16 mouse.

Murine trisomy 16 (Ts16) is a useful model to study the deleterious effect of aneuploidy in neural pathophysiology. The CTb cell line derived from the cerebral cortex of a Ts16 mouse overexpresses the amyloid precursor protein (APP) and exhibits altered intracellular Ca(2+) homeostasis. In the present work, we induced knockdown of APP by transfecting specific mRNA antisense sequences into CTb cells. Forty-eight hours after transfection, the APP expression was knocked down by 40%, reaching levels comparable to those of the cortical line CNh, derived from a normal animal. Calcium measurements showed that the APP knockdown decreased intracellular Ca(2+) basal levels and accelerated the kinetics of the decay of Ca(2+) responses induced by glutamatergic agonists, nicotine, depolarization or ionomycin, to levels similar to those previously reported for CNh cells. The present results suggest that APP overexpression plays an important role on the altered intracellular Ca(2+) homeostasis in the trisomic cells.

Slow inactivation in Shaker K channels is delayed by intracellular tetraethylammonium.

After removal of the fast N-type inactivation gate, voltage-sensitive Shaker (Shaker IR) K channels are still able to inactivate, albeit slowly, upon sustained depolarization. The classical mechanism proposed for the slow inactivation observed in cell-free membrane patches--the so called C inactivation--is a constriction of the external mouth of the channel pore that prevents K(+) ion conduction. This constriction is antagonized by the external application of the pore blocker tetraethylammonium (TEA). In contrast to C inactivation, here we show that, when recorded in whole Xenopus oocytes, slow inactivation kinetics in Shaker IR K channels is poorly dependent on external TEA but severely delayed by internal TEA. Based on the antagonism with internally or externally added TEA, we used a two-pulse protocol to show that half of the channels inactivate by way of a gate sensitive to internal TEA. Such gate had a recovery time course in the tens of milliseconds range when the interpulse voltage was -90 mV, whereas C-inactivated channels took several seconds to recover. Internal TEA also reduced gating charge conversion associated to slow inactivation, suggesting that the closing of the internal TEA-sensitive inactivation gate could be associated with a significant amount of charge exchange of this type. We interpreted our data assuming that binding of internal TEA antagonized with U-type inactivation (Klemic, K.G., G.E. Kirsch, and S.W. Jones. 2001. Biophys. J. 81:814-826). Our results are consistent with a direct steric interference of internal TEA with an internally located slow inactivation gate as a "foot in the door" mechanism, implying a significant functional overlap between the gate of the internal TEA-sensitive slow inactivation and the primary activation gate. But, because U-type inactivation is reduced by channel opening, trapping the channel in the open conformation by TEA would also yield to an allosteric delay of slow inactivation. These results provide a framework to explain why constitutively C-inactivated channels exhibit gating charge conversion, and why mutations at the internal exit of the pore, such as those associated to episodic ataxia type I in hKv1.1, cause severe changes in inactivation kinetics.

Lesiones vasculares iatrogénicas / Iatrogenic vascular lesions

Actualmente con el advenimiento de la cirugía de mínima invasión y los diferentes estudios y procedimientos endovasculares, se ha observado un incremento en el número de lesiones vasculares iatrogénicas. Presentamos 12 años de experiencia acumulada con el manejo de 28 pacientes que sufrieron trauma vascular iatrogénico, secundario a accesos vasculares y cateterismos en el 39.28 por ciento, cirugía ortopédica 35.71 por ciento, cirugía general 14.28 por ciento y en cirugía ginecológica 10.71 por ciento. De éstos, el 85.71 por ciento ocurrió en adultos y el 14.28 por ciento en niños. En el 83.33 por ciento de los casos las lesiones fueron arteriales y en el 16.66 por ciento venosas. Dos pacientes (7.14 por ciento) fallecieron y dos requirieron amputación

Acceso vascular con catéteres Broviac-Hickman / Vascular acces with Broviac-Hickman Catheteres

Presentamos nuestras experiencias acumuladas desde enero de 1988 hasta marzo de 1991 en el Hospital ABC con el manejo de 151 pacientes (54.3 por ciento mujeres y 45.69 por ciento varones), que requirieron de 153 accesos vasculares temporales con catéteres de hule siliconizado (Hickman 9.6 Fr. 71.2 por ciento, Broviac 6.6 Fr. 24.83 por ciento y Hickman 9.0 Fr. 3.9 por ciento). Su indicación fue quimioterapia en el 76.15 por ciento, antibioticoterapia en el 19.20 por ciento y nutrición parenteral en el 4.63 por ciento. Se colocaron con técnica percutánea (97 por ciento) o por venodisección (2.66 por ciento). El tiempo de seguimiento fue de un día a 20 meses (promedio 4.82 meses).Morbilidad: complicaciones intraoperatorias 3.26 por ciento, postoperatorias 15.83 por ciento. Mortalidad: operatoria 0.66 por ciento, no operatoria 32.45 por ciento. El empleo se accesos vasculares temporales con catéteres de hule siliconizado fue de gran ayuda en el manejo de estos enfermos.

Síndromes de isquemia intestinal aguda / Acute ischemic intestinal syndromes

Hoy en día la isquemia mesentérica aguda es una emergencia vascular intraabdominal tratable cuya etiología depende de cuatro causas muy específicas: Oclusión embólica de la arteria mesentérica superior, oclusión trombótica de la vena mesentérica superior e isquemia mesentérica no oclusiva. Para mejorar la supervivencia de estos pacientes se requiere un total índice de sospecha, maniobras tempranas y agresivas de resucitación, y del empleo de procedimientos diagnósticos selectivos (arteriografía mesentérica) que determinen específicamente la etiología. Esto permitirá poder ofrecer revascularizaciones quirúrgicas directas, optimización del funcionamiento cardiaco y corrección de estados de hipercoagulabilidad; todo ello encaminado a maximizar la cantidad de intestino funcionante que pueda ser salvado. Todas estas estrategias son las piedras angulares para el manejo exitoso de esta catástrofe vascular

Catéteres venosos centrales: historia / Central venous catheters: history

Los catéteres venosos centrales han evolucionado desde sus primeros intentos a principios del siglo XX, de rudimentarios tubos de hule de tipo uretral insertados como curiosidad científica en las venas de los propios investigadores, hasta la actualidad en que existe una amplia gama de posibilidades, como implantes permanentes que tienen distintos propósitos, que hacen la vida más llevadera Äentre otrosÄ a pacientes oncológicos que reciben quimioterapia

Conductas actuales ante la litiasis coledociana / Present strategies for cholecholithiasis evaluation

Antecedentes: antes de la cirugía laparoscópica se realizaba con frecuencia la exploración tradicional de las vías biliares en pacientes durante la colecistectomía, arrojando un alto porcentaje de exploraciones negativas. Por lo anterior, se planteó este estudio, a fin de analizar los cambios que han ocurrido en la cirugía de vesícula con el advenimiento de la laparoscopia. Metodología: se revisaron los expedientes de todos los pacientes operados por los autores en un periodo de 14 años, mismos que comprenden siete años, antes y siete después de la introducción de la colecistectomía laparoscópica. Resultados: en 288 pacientes con cirugía tradicional se exploró la vía biliar en 27.8 por ciento de los casos con resultados negativos en 47.6 por ciento de ellos. En 388 operaciones por laparoscopia 0.81 por ciento y 5 con la técnica tradicional 1.28 por ciento. En esta serie ante la sospecha preoperatoria de litiasis coledociana, se efectuaron 17 colangiopancreatografías endoscópicas retrógradas (CPER) con resultados negativos en 70 por ciento de los casos. Conclusiones: los criterios tradicionales para la exploración de las vías biliares durante la colecistectomía deben de ser modificados, pues apegándose a ellos se exploraba la vía biliar innecesariamente, en gran número importante de casos, situación que aún prevalece con la CPER. Por lo anterior, el cirujano debe de cambiar sus técnicas y eliminar los procedimientos innecesarios

Colecistectomía por laparoscopia en pacientes de edad avanzada / Laparoscopic cholecystectomy in the elderly

Se presenta nuestra experiencia en la colecistectomía laparoscópica con 46 pacientes mayores de 60 años sometidos a cirugía de vesícula y vías biliares, en un periodo de tres años. En 74 por ciento de los casos la cirugía fue electiva y de emergencia en 26 por ciento. Hubo morbilidad en dos casos (4.34 por ciento) y una cifra similar de conversiones a cirugía abierta. El 76 por ciento de los pacientes abandonó el hospital en 48 horas en buen estado. Al comparar este estudio con los resultados de cirugía tradicional de vesícula y vías biliares en pacientes de edad avanzada, se ve que la colecistectomía por laparoscopia ofrece resultados muy superiores en cuanto a morbilidad, periodo de hospitalización e incapacidad. Se concluye que la edad avanzada no debería ser obstáculo para privar a estos pacientes de una intervención quirúrgica que les resolverá sus problemas de patología vesicular