[Cholelithiasis during pregnancy and postpartum: prevalence, presentation and consequences in a Referral Hospital in Baja California Sur]. / Colelitiasis en el embarazo y posparto. Prevalencia, presentación y consecuencias en un hospital de referencia en Baja California Sur.

INTRODUCTION: Pregnancy and the postpartum period are risk factors for developing biliary sludge, gallstones, and any of their complications. OBJECTIVE: To determine the prevalence, presentation, and consequences of cholestasis during pregnancy and postpartum in a referral hospital of Baja California Sur. MATERIAL AND METHODS: This was a retrospective, observational study that enrolled pregnant or postpartum patients diagnosed with gallstones with any presentation. RESULTS: 137 patients were included, with 22 ± 4 years of age; 33 were pregnant and 104 in the postpartum period. Only 14% of the group had a history of cholelithiasis, and overweight/obesity was observed in 66.7 and 66.3% of pregnant and postpartum patients, respectively (p = 0.94). Of pregnant patients, 33.3% presented with acute cholecystitis, a condition observed in 16.3% of the postpartum patients (p = 0.04). Pancreatitis and choledocholithiasis were slightly more common in pregnant women (21.23% vs. 19.2%; p = 0.56). There was no maternal mortality and one case of spontaneous abortion was exclusively observed. CONCLUSIONS: It is a priority to diagnose and monitor cholelithiasis in pregnant women because the acute cases observed occurred more frequently, but choledocholithiasis and pancreatitis occurred similarly in both groups.

Oral glutamine reduces myocardial damage after coronary revascularization under cardiopulmonary bypass. A randomized clinical trial.

BACKGROUND: Glutamine is the most abundant free amino acid in the body. It modulates immune cell function and is an important energy substrate for cells in critically ill patients. Reduction of injury cardiac markers had been observed in patients receiving intravenous glutamine and in a pilot study with oral glutamine. The aim of this study was to analyze the effect of preoperative oral supplementation of glutamine on postoperative serum levels of cardiac injury markers. METHODS: A randomized clinical trial was performed in 28 Mexican patients with ischemic heart disease who underwent cardiopulmonary bypass with extracorporeal circulation. Patients were randomly assigned to receive oral glutamine (0.5 g/kg/day) or maltodextrin 3 days before surgery. Cardiac injury markers as troponin-I, creatine phosphokinase, and creatine phosphokinase-Mb were measured at 1, 12, and 24 hours postoperatively. RESULTS: At 12 and 24 hours serum markers levels were significantly lower in the glutamine group compared with controls (p = 0.01 and p = 0.001, respectively) (p = 0.004 and p < 0.001, respectively). Overall, complications were significantly lower in the glutamine group (p = 0.01, RR = 0.54, 95% CI 0.31-0.93). Mortality was observed with 2 cases of multiple organ failure in control group and 1 case of pulmonary embolism in glutamine group (p = 0.50). CONCLUSION: Preoperative oral glutamine standardized at a dose of 0.5 g/kg/day in our study group showed a significant reduction in postoperative myocardial damage. Lower cardiac injury markers levels, morbidity and mortality were observed in patients receiving glutamine.

Prevalence of dry eye syndrome in residents of surgical specialties.

BACKGROUND: The aim of this study was to determine the prevalence and severity of dry eye syndrome in a group of Mexican residents of different surgical specialties. METHODS: A cross-sectional descriptive study where the residents were studied using the Ocular Surface Disease Index, together with diagnostic tests for dry eye syndrome, such as tear breakup time, Oxford Schema, Schirmer's test I, and meibomian gland dysfunction testing. Statistical analyses were performed by Pearson's chi-squared test for categorical variables and student's t-test for quantitative variables. Any P value < 0.05 was considered statistically significant. RESULTS: One hundred and twenty-three residents were included (246 eyes); 90 (73 %) were male and 33 (27 %) were female. The mean age was 27.8 ± 2.1 years. A higher number of residents with dry eye syndrome was found in the cardiothoracic surgery (75 %) and otorhinolaryngology (71 %) specialties; 70 % of them reported ocular symptoms, with teardrop quality involvement in >50 % of them. CONCLUSIONS: We found a prevalence of 56 % for mild-to-moderate/severe stages of the condition. Their presence in the operating room predisposes surgical residents to dry eye syndrome because of environmental conditions.