ABSTRACT
RESUMEN Introducción: los octogenarios son un grupo demográficamente en crecimiento. Este aumento en la esperanza de vida pone al cirujano frecuentemente frente a pacientes de edad avanzada con una hernia inguinal. Objetivo: analizar la aplicabilidad, seguridad y eficacia del tratamiento quirúrgico ambulatorio de la hernia inguinal en pacientes mayores de 80 años. Material y método: estudio comparativo, de cohorte retrospectiva. Se analizaron todas las hernio plastias inguinales por vía abierta con técnica de Lichtenstein realizadas entre 2008 y 2017, con al menos un mes de seguimiento. Estos pacientes fueron comparados de forma retrospectiva con todos aquellos de iguales características de entre 50 y 79 años tratados durante el mismo período de tiempo. Resultados: entre 2008 y 2017, 491 pacientes ingresaron en el Programa de Cirugía Mayor Ambulato ria y fueron sometidos a reparación de una hernia inguinal con técnica de Lichtenstein. De estos, 133 pacientes (27, 1%) eran mayores de 80 años, y 358 pacientes (72,9%) de entre 50 y 79 años. La mor bilidad posoperatoria global de la serie fue del 9,75% (13,5% para mayores de 80 años y 8,4% para el grupo control, p = NS). Tampoco hubo diferencia estadísticamente significativa en admisión temprana (3,8% vs. 2,8% del grupo control, p = NS). Conclusión: la cirugía ambulatoria en la hernioplastia por vía abierta, en pacientes mayores de 80 años, fue aplicada de forma segura y eficaz.
ABSTRACT Background: Octogenarians are a demographically growing group. This increase in life expectancy of ten makes surgeons face older patients with inguinal hernia. Objective: The aim of this study was to analyze the applicability, safety and efficacy of ambulatory inguinal hernia in patients > 80 years, Material and methods: We conducted a retrospective and observational cohort study. Data from all the open inguinal hernia repair procedures performed using the Lichtenstein technique between January 2008 and December 2017 and followed-up after one month were analyzed. These patients were retrospectively compared with similar patients aged 50-79 years who were treated during the same period. Results: Between 2008 and 2017, 491 patients admitted in the Major Ambulatory Surgery program underwent inguinal hernia repair using the Lichtenstein technique. 133 (27.1%) were > 80 years and 358 (72.9%) were between 50 and 79 years. Overall postoperative morbidity was 9.75% (13.5% in > 80 years and 8.4% in the control group; p = NS). There were no significant differences in unanticipated mortality (3.8% vs. 2.8%un the control group, p = NS). Conclusion: Ambulatory surgery for open inguinal hernia repair in patients > 80 years is a safe and effective strategy.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Efficacy , Hernia, Inguinal/surgery , Argentina , Safety , Aged , Retrospective Studies , Cohort Studies , Herniorrhaphy/methods , Ambulatory Surgical Procedures/methodsABSTRACT
El bypass gástrico en Y-de-Roux (RYGB) trata eficazmente la obesidad y a la vez la enfermedad por reflujo gastroesofágico (ERGE). Desafortunadamente, algunos pacientes que finalmente se presentan para cirugía bariátrica han sido previamente sometidos a una funduplicatura de Nissen por ERGE. La conversión a RYGB después de esta funduplicatura ha demostrado ser segura y eficaz, pero con una mayor morbilidad, tiempo operatorio más prolongado y mayor estancia hospitalaria. Se presenta una paciente de 50 años, con IMC 40,4 kg/m², evaluada para cirugía bariátrica. Había sido sometida a funduplicatura de Nissen laparoscópica siete años atrás. Informamos un caso de eliminación laparoscópica de funduplicatura de Nissen y conversión a RYGB. La funduplicatura previa no es una contraindicación para LRYGB. Estos procedimientos deben ser llevados a cabo por cirujanos experimentados, y el abordaje laparoscópico debe ser el método de elección.
Roux-en-Y gastric bypass (RYGB) effectively treats both obesity and gastroesophageal reflux disease (GERD). Unfortunately, some patients finally present for bariatric surgery have previously undergone Nissen fundoplication due to GERD. Conversion to EYGB after Nissen fundoplication is safe and effective, but is associated with greater morbidity and longer operative time and hospital stay. A 50-year-old female patient with a body mass index (BMI) of 40.4 kg/m² was evaluated for bariatric surgery. She had a history laparoscopic Nissen fundoplication seven years before. We report a case of laparoscopic take-down of Nissen fundoplication and conversion to RYGB. A previous fundoplication is not a contraindication for laparoscopic RYGB. These procedures should be performed by well-trained surgeons and laparoscopic approach should be the method of choice.
Subject(s)
Gastric Bypass/methods , Laparoscopy/methods , Fundoplication/adverse effects , Obesity, Morbid/complications , Gastroesophageal Reflux/surgery , Bariatric Surgery/methods , Contraindications, ProcedureABSTRACT
Los microimplantes son pequeños pines de titanio o de aleación de titanio de 1,2 mm de diámetro y 6 mm de longitud. Están diseñados con una superficie suave para que no se oseointegren. Son utilizados en Ortodoncia como anclaje temporal. Han sido usados como anclaje esqueletal, también para distalizar y protraer molares, intruir molares e incisivos, para el cierre de espacios edéntulos extensos que con los métodos convencionales en ortodoncia habría sido imposible. Los microimplantes son removidos con relativa facilidad una vez efectuado el procedimiento. Como toda técnica nueva, es importante que los clínicos sepan elegir bien en qué casos van a utilizar los micro implantes y los sitios de su colocación.
The miniimplants are small devices of 1,2 mm of wide and 6 mm of length. Manufactured with a smooth machined surface that is not designed to osseointegrate. In orthodontics they are used as temporary anchorage for molar distalization, protraction and intrusion of molars and incisors. Also for closing wide edentulous spaces once considered impossible with conventional orthodontics.. The miniimplants are easily removed. As with any new technique clinicians should be aware in which cases use this devices and the sites of placing them.
ABSTRACT
BACKGROUND: B-Raf is a serine/threonine protein kinase activating the MAP kinase/ERK-signaling pathway. It has been shown that 50% of melanomas harbor activating BRAF mutations, with over 90% being the V600E mutation. OBJECTIVE: The goal of this research was to determine the prevalence of the BRAF V600E mutation in patients from Central Mexico diagnosed with primary melanoma. METHODS: Skin biopsies from 47 patients with melanoma were obtained from the dermatology department of the Hospital General 'Dr. Manuel Gea González' in Mexico City. For BRAF mutation determination, after DNA isolation, the gene region where the mutation occurs was amplified by PCR. Subsequently, the presence or absence of the V600E mutation was detected by Sanger sequencing performed at the private molecular diagnostic laboratory Vitagénesis in Monterrey, Mexico. RESULTS: Of the 47 patients sampled, 6.4% harbored the V600E mutation. No statistical significance was found between mutations and the type of tumor.
ABSTRACT
Sweet syndrome is the prototype of neutrophilic dermatosis, which typically presents an intense inflammatory infiltrate of neutrophils in the epidermis and/or dermis, apparently due to a hypersensitivity reaction. This is a case of a 31 year-old woman with fever of more than three weeks duration and erythematous nudosities on her arms and legs. The histological study of a skin lesion showed a lobular inflammatory infiltrate of lymphocytes and neutrophils, with excellent response to prednisone. Therefore, it was concluded as subcutaneous sweet syndrome.