Urethral Injury in Rectal Cancer Surgery: A Comprehensive Study Using Cadaveric Dissection, Imaging Analyses, and Clinical Series.

Male urethral injury during rectal cancer surgery is rare but significant. Scant information is available about the distances between the rectourethral space and neighboring structures. The aim of this study is to describe the anatomical relations of the male urethra. This three-pronged study included cadaveric dissection, retrospective MRI analysis, and clinical cases. Measurements included the R-Mu distance (shortest distance between the rectum and the membranous urethra), R-Am distance (distance from the anterior rectal wall to anal margin nearest to the membranous urethra), and the anal canal-rectum axis angle. The clinical study analyzed the incidence of urethral injury and associated factors among 244 consecutive men from January 2016 to January 2023. The overall incidence of urethral injury in our series was low (0.73%), but in men with tumors < 10 cm from the anal margin, it was 4% in abdominoperineal resection and 3.2% in TaTME. On preoperative MRI, the median R-Mu distance was 1 cm (IQR, range, 0.2-2.3), the median R-Am distance was 4.3 cm (range, 2-7.3), and the median anorectal angle was 128° (range, 87-160). In the cadaveric study (nine adult male pelvises), the mean R-Mu distance was 1.18 cm (range 0.8-2), and the mean R-Am distance was 2.64 cm (range 2.1-3). Avoiding urethral injury is crucial. The critical point for injury lies 2-7.3 cm from the anal margin, with a 0.2-2.3 cm distance between the rectum and the membranous urethra. Collaborating with anatomists and radiologists improves surgeons' anatomy knowledge.

Imaging of non-neoplastic duodenal diseases. A pictorial review with emphasis on MDCT.

A wide spectrum of abnormalities can affect the duodenum, ranging from congenital anomalies to traumatic and inflammatory entities. The location of the duodenum and its close relationship with other organs make it easy to miss or misinterpret duodenal abnormalities on cross-sectional imaging. Endoscopy has largely supplanted fluoroscopy for the assessment of the duodenal lumen. Cross-sectional imaging modalities, especially multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), enable comprehensive assessment of the duodenum and surrounding viscera. Although overlapping imaging findings can make it difficult to differentiate between some lesions, characteristic features may suggest a specific diagnosis in some cases. Familiarity with pathologic conditions that can affect the duodenum and with the optimal MDCT and MRI techniques for studying them can help ensure diagnostic accuracy in duodenal diseases. The goal of this pictorial review is to illustrate the most common non-malignant duodenal processes. Special emphasis is placed on MDCT features and their endoscopic correlation as well as on avoiding the most common pitfalls in the evaluation of the duodenum. TEACHING POINTS: • Cross-sectional imaging modalities enable comprehensive assessment of duodenum diseases. • Causes of duodenal obstruction include intraluminal masses, inflammation and hematomas. • Distinguishing between tumour and groove pancreatitis can be challenging by cross-sectional imaging. • Infectious diseases of the duodenum are difficult to diagnose, as the findings are not specific. • The most common cause of nonvariceal upper gastrointestinal bleeding is peptic ulcer disease.

Transformaciones alrededor del discurso, prácticas educativas, actitudes y relaciones sociales de las madres comunitarias del icbf. "Pueblo Viejo" (Magdalena) y el programa "Nichos Pedagógicos" / Transformations regarding the discourse, educational practices, attitudes and social relationships of conmunity mothers from de icbf(colombian institute of family WELFARE). "Pueblo Viejo" (Magdalena) and "Pedagogical Niches" program

Este artículo presenta los resultados de un proceso de investigación que da cuenta de las transformaciones que las madres comunitarias tuvieron en torno a su discurso, práctica educativa y relaciones sociales, en el seno del programa de capacitación "Nichos Pedagógicos", orientado por el Instituto de Estudios en Educación iese, de la Universidad del Norte, bajo el patrocinio de la fundación promigas. Inicialmente, se exponen los referentes contextuales relacionados con los aspectos misionales del Instituto Colombiano de Bienestar Familiar - icbf-y con el municipio de Pueblo Viejo, Magdalena (Colombia), lugar de origen de las madres comunitarias participantes. En segunda instancia, se presentan los referentes de teóricos de las categorías de análisis: Discurso, prácticas e interacciones y, finalmente, se expone una conceptualización de "Nicho Pedagógico", denominación del Programa de Capacitación ofrecido a las madres comunitarias.

This article shows the results of a research dealing with transformations of community mothers regarding their discourse, education practices and social relationships, in the training program "Pedagogical Niches", coordinated by the Institute of Studies in Education (iese) of Universidad del Norte and sponsored by Promigas Foundation. Firstly, the article shows the contextual referents related to mission aspects of Instituto Colombiano de Bienestar Familiar (Colombian Institute of Family Welfare) and that of Pueblo Viejo (Magdalena, Colombia), the village from which participants community mothers are. Secondly, it exposes the theoretical referents of the categories of analysis: discourse, practices and interactions. Finally, it discusses a conceptualization of "Pedagogical Niche", name of the Training Program offered to community mothers.

Gastric perforations from abdominal trauma.

BACKGROUND: Gastric rupture due to abdominal trauma is rare (0.02-1.7%); it is usually caused by traffic accidents. Delayed diagnosis, abdominal contamination and associated lesions cause morbidity and mortality. PATIENTS AND METHODS: Retrospective review of 2,083 patients with abdominal traumatism treated at our center over 20 years. We reviewed recent ingestion of a meal, etiology, time to surgery, site, Stomach Injury Scale, abdominal contamination, treatment, associated injuries, complications and mortality. RESULTS: Gastric perforation occurred in 25 patients (1.2%), median age 35 years. Stomachs were distended from recent meals in 16 (64%). The commonest causes were traffic accidents (n = 13) and blunt weapon injury (n = 7). The median time to surgery was 1 h. Gastric lesions occurred predominantly in the anterior wall (n = 12) followed by the greater curvature (n = 7). Type II lesions repaired with simple suturing were the most usual. Abdominal contamination occurred in all cases. Associated lesions were present in 22 patients; the most commonly affected intra-abdominal organ was the liver, and the lungs were the most affected extra-abdominal organ. The morbidity rate was 60% (n = 15) and the mortality rate 4% (n = 1). CONCLUSION: Early diagnosis and surgical treatment are important for reducing the morbidity and mortality in these patients.

Evaluación de una intervención educativa para prevenir el tabaquismo en escolares Colombianos / Evaluation of educative interventions to prevenmt smoking among scholl students in Colombia

Introducción: El tbaquismo es el principal factor de riesgo para cáncer y su prevención está aumentando en los adolescentes colombianos. En este artículo se evalúa una intervención para prevenir el tabquismo en escolares Colombinanos. Métodos: Intervención no aleotorizada con base en el concepto de habilidades para la vida, en escolares de séptimo a noveno grados de instituciones educativas en seis ciudades de Colombia. se utilizaron como control escuelas equiparadas por sexo, estrato social, rango educativo y promedio de alumnos por curso. se realizó una encuesta global de prevalencia y se midieron el uso experimental, la prevalencia y el desarrollo de habilidades en alumnnos de intervención y control. Resultados: Se incluyeron 7862 alumnos en la encuesta de prevalencia y 1096 en la evaluación de eficacia. Las mayores prevalencias estuvieron en Manizales y Bogotá. La intervención tuvo efecto únicamente sobre el manejo del estrés (OR:1,6IC95 por ciento 1,15-2,23). La menor edad se asoció a menor prevalencia. Prevalencias bajas en el entorno se asociaron con mayor capcidad en la toma de decisiones. El bajo tabaquismo en amigos se asoció con menor conocimiento sobre el efecto nocivo del cigarrillo. Conclusiones: Es la única evaluación de una intervención sobre tabaquismo en Colom,bia. No hubo diferencias inmediatas para las princupales variables de desenlance. Se debe revisar el diseño de la intervención para incluir sesiones de refuerzo, estandarizar la aplicación en un único nivel escolar y lograr mayor uniformidad en la aplicación de la metodología. Se debe complementar la acción educativa con intervenciones comunitarias y de política.

Tratamiento de lesiones hepáticas tumorales con RENIO188- LIPIODOL. Experiencia en Colombia / Treatment of liver cancer injuries with RENIO188- LIPIODOL. Experience in Colombia

Objetivo: Evaluar pacientes con lesiones tumorales hepáticas, no quirúrgicas, a quienes se les administro Renio 188 -Lipiodol vía transarterial, como alternativa terapéutica.Método: Once pacientes con cáncer de hígado no operable se trataron con dosis entre 170 y 4181 MBq de Renio 188 Lipiodol a través de la arteria hepática. Los pacientes fueron evaluados clínicamente, con test hematológicos, de función hepática y TAC hepático periódicamente.Resultados: El tratamiento con Renio 188 Lipiodol fue bien tolerado . Tres pacientes desarrollaron fiebre leve y un paciente Neumonitis Intersticial que resolvió completamente. En el TAC de control siete pacientes evidenciaron reducción significativa del tamaño de la lesión , 1 sin cambios, 1 progresión y 2 no se han evaluado.Conclusiones: Renio 188 Lipiodol es un tratamiento seguro, la técnica de preparación fácilmente reproducible y se constituye en una alternativa terapéutica para este tipo de pacientes.