Genetic Factors Associated with Postoperative Nausea and Vomiting: a Systematic Review.

BACKGROUND: In previous studies, there seems to be a relationship between different genetic polymorphisms and postoperative nausea and vomiting (PONV). We perform a systematic review of the current literature about the relationship between genetic polymorphisms and the presence of PONV. METHODS: Two bibliographic searches were carried out in three databases (PubMed, Web of Science, and Scopus) of studies, preferably prospective, about PONV following abdominal surgery. It was completed with a backward citation searching. A total of 73 articles were found of which 6 were selected after their critical lecture using CASPe network criteria. Relative frequency and relative risk were taken in each study according to the polymorphism. RESULTS: Studies about 5-HT3B gene receptor polymorphisms, ABCB1 transporter, and dopamine D2 receptor showed a significant association with the presence of PONV (p = 0.02, 0.01, and 0.034 respectively). In relation to cytochrome P-450 2D6 (CYP2D6) polymorphisms, two of the three analysed articles showed a significant association with postoperative vomiting (p = 0.007). CONCLUSION: Genetic polymorphisms could play an important role in PONV. The AAG deletion in both alleles of the 5-HT3B receptor gene, the Taq IA polymorphism of the dopamine D2 receptor, and the presence of three or more functional alleles of CYP2D6 seem to be related with a higher incidence of PONV, especially in the first 24 h after surgery. The 2677TT and 3435TT genotypes of the ABCB1 transporter could reduce the PONV due to their association with a greater effectiveness of ondansetron. However, new quality studies are needed to consider this relationship.

[Clinical and pathological features of gastrointestinal stromal tumors (GIST) in a single institution: A descriptive study and review of the literature]. / Perfil clínico y anatomopatológico de los tumores estromales gastrointestinales de un hospital de área: Estudio descriptivo y revisión de la literatura.

INTRODUCTION: This study was aimed to assess the main clinical, pathological and therapeutic characteristics of a cohort of gastrointestinal stromal tumors (GIST). METHODS: Observational study including 66 patients diagnosed with GIST admitted to our hospital between 2002 and 2015. Parameters related to medical history, clinical manifestations, medical and surgical treatment, histopathology, and morbi-mortality were studied. A review of the literature was included to correlate with the results. RESULTS: The most frequent location of GIST in our patients was the stomach (65.2%), in which the gastric fondo was the predominant region. The most common clinical manifestation was gastrointestinal hemorrhage (45.5%), followed by incidental finding after imaging or invasive procedures (33.3%). 58 patients underwent surgery (90.6%), 15.5% were urgent. A total of 69% of the GISTs had a size between 2 and 10cm. The one-year mortality was 7.9%, all cases related to local or remote extension, or surgical complications. CONCLUSION: There is a large clinical variability among GIST cases. The first choice of treatment is surgery, which is feasible in most cases and should be as conservative as possible. The prognosis varies depending on the size and proliferation index, thus close follow-up should be performed. No tumor marker is clearly associated with a poor prognosis. New molecular biology studies are needed in order to find therapeutic targets.

Uso del plasma rico en plaquetas autólogo en abdominoplastías / Using platelet rich plasma in abdominoplasty

Objective: Evaluation of the effectiveness of autologous platelet rich plasma administered topically in the healing and prevention of complications of abdominoplasty after bariatric surgery. Material and Methods: The data from 30 patients who underwent abdominoplasty were analyzed: Group I: Rich plasma was administered autologous platelets in the surgery. Group II: Control. Study variables: complications (seroma, local infection and bleeding), length of stay and cost. Results: No significant differences were observed in the frequency of complications or length of stay. The use of platelet rich plasma raises the cost of the procedure. Conclusion: Even considering the limitations of the study because of its small sample size and lack of blinding, the results do not support the use of this complementary technique. Further studies are needed in the field of adhesives, sealants and local hemostatic.

Objetivo: Evaluación de la eficacia del plasma rico en plaquetas autólogo administrado de forma tópica en la cicatrización y prevención de las complicaciones de la abdominoplastía y dermolipectomía tras cirugía bariátrica. Material y Método: Serie de 30 pacientes afectos de faldón abdominal tras cirugía bariátrica, a los que se practicó dermolipectomía y abdominoplastía, divididos en dos grupos de 15 casos con aletorización simple. Grupo I: Se administró plasma rico en plaquetas autólogo en el lecho quirúrgico. Grupo II: Control. Variables de estudio: complicaciones (seroma, infección local y hemorragia), tiempo de estancia y coste. Resultados: No se aprecian diferencias significativas en la frecuencia de complicaciones ni en estancia media. El uso de plasma rico en plaquetas eleva el coste del procedimiento. Conclusión: Aun considerando las limitaciones del estudio por su corto número de casos y no cegamiento, los resultados no apoyan el uso de esta técnica complementaria. Estudios más avanzados son necesarios en el campo de los adhesivos, sellantes y hemostáticos locales.