Bone remodeling, around an anatomical hip stem: a one year prospective study using DEXA. / Estudio prospectivo del remodelado óseo femoral alrededor de un vástago anatómico de cadera: un año de seguimiento densitométrico.

INTRODUCTION: The loss of bone mass, as a consequence of bone remodelling, in the proximal third of the femur, is a factor that contributes to the failure of hip prostheses in the medium to long term. This periprosthetic remodelling occurs mainly during the first 12 months after the operation. The aim is to evaluate the behaviour at one year of a new anatomical stem, the ANATO® stem (2015-Stryker®), which is a redesign of its predecessor (ABG-ii®-Stryker stem) by means of bone densitometry. METHOD: Prospective, controlled study in which the changes in bone mineral density (BMD) observed around the seven areas of Gruen in a group of 61 patients affected by primary coxarthrosis, in whom an ANATO® stem was implanted, are analysed densitometrically. The healthy hip was taken as the control group. The existence of differences in the remodelling pattern according to sex, age and body mass index (BMI) was compared. The follow-up was during the first year after the intervention. RESULTS: After one year of follow-up, decreases of bone mineral density in zone seven of -5.9% were observed, being this decrease statistically significant. No differences were found in the remodelling pattern according to age, sex and body mass index. CONCLUSION: The ANATO® stem allows an efficient transmission of loads from the stem to the proximal femur. Only in zone seven significant bone atrophy is observed. Differences in age, BMI and sex do not seem to influence the bone remodelling around this new stem.

Características del accidente por ingestión de cuerpo extraño en la población pediátrica

Introducción : El accidente por ingestión de cuerpo extraño es un problema importante en la población pediátrica. Se investigaron sus características en el Hospital de Especialidades Pediátricas Omar Torrijos Herrera (HEPOTH). Objetivos: Describir las características del accidente por ingestión de cuerpo extraño en la población pediátrica asegurada atendida en el HEPOTH y compararlas con la literatura nacional e internacional. Materiales y métodos: Estudio descriptivo retrospectivo en todos los pacientes pediátricos asegurados admitidos al HEPOTH el diagnóstico de cuerpo extraño en la vía digestiva desde julio de 2004 hasta junio de 2008. Resultados: Ciento cincuenta casos ( 82 masculinos, 68 femeninos) cumplieron los criterios de inclusión. La edad promedio 3.19 (0.42 -12.85) años. Los sitios de alojamiento fueron esófago, estómago y colon en su mayoría. Los síntomas de presentación fueron sialorrea (32.7%) , vómitos /náusea y disnea; 36.7% cursaron asintomáticos. Los cuerpos extraños más frecuentes fueron monedas ( 60.7%) , baterías de botón y joyas (9.3% cada uno) . Se realizó endoscopio en 71.3% de los casos y la complicación más frecuente fue la laceración esofágica. Conclusión: El accidente por ingestión de cuerpo extraño en la población pediátrica asegurada tiene características propias, distintas a las descritas en la población no asegurada y en la literatura internacional que requieren atención al momento de su manejo.

Introduction: Foreign body ingestion accident is an importan problem in the pediatric population. We researched its characteristics in the Omar Torrijos Herrera Pediatric Specialties Hospital (HEPOTH). Aims: To describe the characteristics of foreign body ingestion accident in the insured pediatric population that attends the HEPOTH and compare them with national and international literature. Material and methods: Descriptive retrospective study in all the insured pediatric patients admitted to HEPOTH with the diagnosis of foreign body in the digestive tract from july 2004 until june 2008. Results: One hundred fifty cases ( 82 males , 68 females) fulfilled the inclusion criteria. Average age was 3.19 (0.42 -12.85) years. Lodging sites were esophagus, stomach, and colon mostly. The most frequent presentation symptoms were syalorrea (32.7%) vomits/nausea, and diarrhea; 36.7% were asymptomatic. Most frequent complication was esophageal laceration. Conclusion: Foreign body ingestion accident in the insured pediatric population has its own characteristics, distinctive to those described in the non-insured population and in the international literature, which require attention when managing it.

Lipid peroxidation in ischemia-reperfusion oxidative injury of the graft preserved in Celsior and University of Wisconsin solutions on a pig pancreas transplantation model.

BACKGROUND: Graft pancreatitis (GP) is one the main technical problems associated with pancreas transplant (PT). It occurs in 20% of patients representing a risk factor for thrombosis and cause of graft loss. GP is related to oxidative effects from oxygen-derived free radicals (OFR) in ischemia-reperfusion injury. We evaluated lipid peroxidation by the OFR in the PT of pig organs preserved with either Celsior or Wisconsin solutions. METHODS: In Landrace pigs we performed 24 pancreas allografts, which were preserved 18 or 24 hours: 12 with Celsior solution (CS) and 12 with Wisconsin solution (UW). No immunosuppression was administered. The oxidative effects were determined by quantification of malondialdehyde (MDA) and 4-hydroxyalkenals (4-HDA) and of the carbonyl groups of proteins in our pancreatic tissue samples and measured at different times: (A) baseline in the donor, (B) after perfusion of the graft, (C) after the ischemia period, and (D) 30 minutes after ischemia-reperfusion of the graft. RESULTS: The MDA and 4-HDA values were similar in conditions A, B, and C, but showed an extraordinary increase after ischemia-reperfusion in D, among both the 18- or 24-hour preserved grafts and in the same proportion with CS and UW. The carbonyl groups of the proteins rose in conditions B and C (cold ischemia), but less so in state D (reperfusion). CONCLUSIONS: The oxidative injury of a pancreatic graft preserved for 18 or 24 hours occurs during reperfusion, with an extraordinary intensity, but similarly with CS and UW, an observation that may help to explain graft pancreatitis.

[Complications in laparoscopic nephrectomy]. / Complicaciones de la nefrectomía laparoscópica.

OBJECTIVE: To report the complications and their respective management in our series of laparoscopic nephrectomy. MATERIAL AND METHODS: Between November 1992 and March 2004, 319 patients underwent laparoscopic ablative renal surgery: 152 were women and 167 were men, mean age was 45 years (range: 0,5-82 years). There were 70 radical nephrectomies, 16 radical nephroureterectomies, 63 partial nephrectomies, 124 simples nephrectomies, 15 simples nephroureterectomies, 8 heminephrectomies and 23 living donor nephrectomies. RESULTS: The complication rate was 5.64%. The most frequent complications were bleeding (2.5%) and retroperitoneal haematoma (1.2%). There was not statically difference in complications rate by age, sex, or approach via: transperitoneal versus retroperitoneal. Complication rate was alike with laparoscopic or hand assisted technique. There was not mortality in the series. CONCLUSIONS: We have a low complication rate in laparoscopic nephrectomy. We believe that laparoscopy is a safe technique for patients that require ablative renal surgery when the surgical team has experience in advanced laparoscopic surgery.

Complicaciones de la nefrectomía laparoscópica / Complications in laparoscopic nephrectomy

Objetivos: Presentamos las complicaciones en nuestra serie de nefrectomía laparoscópica y el manejo dado a cada una de ellas. Métodos: Entre noviembre de 1992 y marzo de 2004, 319 pacientes fueron llevados a cirugía renal ablativa con técnica laparoscópica: 152 mujeres y 167 hombres, con edad promedio de 45 años (rango: 0,5 - 82 años). Se realizaron 70 nefrectomías radicales, 16 nefroureterectomías radicales, 63 nefrectomías parciales, 124 nefrectomías simples, 15 nefroureterectomías simples, 8 heminefrectomías y 23 nefrectomías de donante vivo para trasplante. Resultados: La tasa de complicaciones fue del 5,64%. Las complicaciones más frecuentes fueron sangrado (2,5%) y hematoma retroperitoneal (1,2%). No hubo diferencia estadísticamente significativa en la tasa de complicaciones por sexo, edad o vía de abordaje: transperitoneal o lumboscópica. El realizar una técnica laparoscópica pura o con asistencia manual, no representó cambio en la tasa de complicaciones. No hubo casos de mortalidad en la serie. Conclusiones: Nuestra serie de nefrectomía laparoscópica muestra una baja tasa de complicaciones. Consideramos que en manos experimentadas, la laparoscopía es una técnica segura en pacientes que requieren cirugía renal ablativa

Objective: To report the complications and their respective management in our series of laparoscopic nephrectomy. Material and methods: Between November 1992 and March 2004, 319 patients underwent laparoscopic ablative renal surgery: 152 were women and 167 were men, mean age was 45 years (range: 0,5 - 82 years). There were 70 radical nephrectomies, 16 radical nephroureterectomies, 63 partial nephrectomies, 124 simples nephrectomies, 15 simples nephroureterectomies, 8 heminephrectomies and 23 living donor nephrectomies. Results: The complication rate was 5.64%. The most frequent complications were bleeding (2.5%) and retroperitoneal haematoma (1.2%). There was not statically difference in complications rate by age, sex, or approach via: transperitoneal versus retroperitoneal. Complication rate was alike with laparoscopic or hand assisted technique. There was not mortality in the series. Conclusions: We have a low complication rate in laparoscopic nephrectomy. We believe that laparoscopy is a safe technique for patients that require ablative renal surgery when the surgical team has experience in advanced laparoscopic surgery

Sindrome poiquilodermia congenita / Sindrome poiquilodermia congenita

El síndrome de poiquilodermia congénita, denominado también síndrome de Tothmund Thomson o poiquilodermia atrófica, es una genodermatosís rara que presenta una gama variada de manifestaciones clínicas, siendo las características más comunes: Estatura baja, eritema irregular que progresa a poiquilodermia, altraciones esqueléticas, cabellos escasos y catarata juvenil. Describimos el caso de un adolescente masculino de 13 años de edad que fue atendido en el Servicio de Pediatría del "Hospital Obrero N§ 3" - CNS, por presentar el mencionado síndrome.

Nódulo pulmonar en paciente cirrótico / Pulmonary nodle in a cirrhotic patient

No disponible

A study on carbothermal reduction of sulfur dioxide to elemental sulfur using oilsands fluid coke.

Experiments and reaction equilibrium calculations were carried out for the SO2 gas and oilsands fluid coke system. The goal was to develop a coke-based sulfur-producing flue gas desulfurization (SP-FGD) process that removes SO2 from flue gases and converts it into elemental sulfur. The conversion of SO2 to elemental sulfur proceeded efficiently at temperatures higher than 600 degrees C, and the sulfur yield reached a maximum (> 95%) at about 700 degrees C. An increase of temperature beyond 700 degrees C enhanced the reduction of product elemental sulfur, resulting in the formation of reduced sulfur species (COS and CS2), which lowered the sulfur yield at 900 degrees C to 90%. Although equilibrium calculations suggest that a lower temperature favors the conversion of SO2 as well as the yield of elemental sulfur, experiments showed no formation of elemental sulfur at 600 degrees C and below, likely due to hindered kinetics. Faster reduction of SO2 was observed at a higher temperature in the range of 700-1000 degrees C. A complete conversion of SO2 was achieved in about 8 s at 700 degrees C. Prolonging the product gas--coke contact, the yield of elemental sulfur decreased due to the formation of COS and CS2 while the SO2 conversion remained complete. Equilibrium calculations suggest that the ultimate yield of elemental sulfur maximizes at the C/SO2 ratio of 1, which represents the stoichiometry of SO2 + C-->CO2 + S. For the C/SO2 ratio < 1, equilibrium calculations predict elemental sulfur and CO2 being major products, suggesting that SO2 + C-->CO2 + S is the predominant reaction if SO2 is in excess. Experiments revealed that elemental sulfur and CO2 were only major products if the conversion of SO2 was incomplete, which is in agreement with the result of the equilibrium modeling.

[Radiation induced tumors]. / Tumores radioinducidos.

Radiations at cellular level produce different effects, depending on type of radiation and irradiated tissue. The radiation-induced cancers are associated to non-letals genetics mutations, and to classify like radiation induced tumors is necessary that appear in the treatment volume, a long latency period (years), histolo-different to the primary lesion, enough doses quantitatively and that exists a greater incidence in the irradiated populations. The genetics mutations affect at tumoral suppressors gen(Gen RB I, p53, BRCA I, BRCA 2) and repressors gen (hMSH 2, hMLH I,...), they could be longer and multifocals mutations, and produce lack of cellular control and a greater predisposition to develop tumors and a probable risk of increment of radiosensitivity. We present some of the more representatives studies about radiation-induced tumors.

Morbilidad y mortalidad en el Servicio de Cirugía, Hospital San Juan de Dios, Bogotá, 1989 / Morbidity and mortality in the Department of Surgery, San Juan de Dios Hospital, Bogotá, 1989

Con el fin de conocer la patologia atendida y los resultados obtenidos en el servicio de cirugia del Hospital San Juan de Dios de Bogota, se desarrollo un estudio descriptivo retrospectivo, con base en una muestra probatoria. De las historias clinicas estudiadas se obtuvo la información sobre las variables de edad y sexo, tipo de patologia traumatica y no traumatica, dias de estancia, ingreso a la Unidad de Cuidado Intensivo, (UCI) y estado de salud al egreso. Como hallazgos mas importantes se encontró que el 64.0 por ciento del servicio lo utilizan los hombres; la patologia traumatica representó el 45.0 por ciento del total de los egresos; el arma cortopunzante fue el agente de la lesion en el 78.1 por ciento de los casos; la mortalidad ocurrió en el 7.7 por ciento de los pacientes. Con relación a la patologia no traumatica se encontró una mortalidad del 9.5 por ciento, en la cual los tumores y la patologia biliar aportaron el 44.8 por ciento del total de las muertes. Se destaca la necesidad de estudios mas profundos de tipo clinico y administrativo, asi como la urgencia de llegar hasta la prevención del trauma y el diagnostico temprano dentro de la comunidad, a traves del conocimiento de la causalidad, especialmente en lo relacionado con tumores de patologia biliar.

Hemorragía cerebelosa / Cerebellar haemorrhage

Las hemorragias de cerebelo constituyen el 10-12% de las hemorragias cerebrales. Anteriormente consideradas infrecuentes y usualmente fatales sin cirugía, son un hallazgo bastante común en la práctica neurológica cotidiana desde el advernimiento de la TC y no pocas veces tienen una evolución benigna. Se presentan 10 casos de hemorragia cerebelosa y se analizan los signos y síntomas clínicos así como las características tomográficas, quienes en conjunto influencian definitivamente en la evolución benigna o maligna de esta condición, muchas veces independientemente del tratamiento médico o quirúrgico empleado

Hemorragía cerebelosa / Cerebellar haemorrhage

Las hemorragias de cerebelo constituyen el 10-12% de las hemorragias cerebrales. Anteriormente consideradas infrecuentes y usualmente fatales sin cirugía, son un hallazgo bastante común en la práctica neurológica cotidiana desde el advernimiento de la TC y no pocas veces tienen una evolución benigna. Se presentan 10 casos de hemorragia cerebelosa y se analizan los signos y síntomas clínicos así como las características tomográficas, quienes en conjunto influencian definitivamente en la evolución benigna o maligna de esta condición, muchas veces independientemente del tratamiento médico o quirúrgico empleado (AU)