Minilaparoscopic hysterectomy.

Minilaparoscopic surgery was performed in a 38-year-old woman scheduled for hysterectomy and ovarian cystectomy. Image resolution was similar to that of conventional laparoscopy. There were no intraoperative or postoperative complications. Since it has many advantages and few complications, minilaparoscopy appears to be an attractive way to decrease morbidity associated with conventional laparoscopy. (J Am Assoc Gynecol Laparosc 5(4):97-100, 1998)

[Microalbuminuria in insulin-dependent diabetics: the prevention of diabetic nephropathy]. / Microalbuminuria en diabéticos insulinodependientes: prevención de la nefropatía diabética.

We evaluated the effects of angiotensin converting enzyme inhibition upon the urinary excretion of albumin in 36 insulin dependent normotensive diabetic patients with adequate metabolic control and no evidence of renal failure. 19 subjects had normal levels of albumin excretion (< 30 mg/24 h) and 17 showed microalbuminuria from 30 to 300 mg/24 h. Half of the patients were randomly selected in each group to receive enalapril, 5 mg/day. A progressive decrease in albumin excretion levels was observed for both enalapril treated subgroups, from 18.9 +/- 8.3 to 8.1 +/- 2.7 mg/24 h (normoalbuminurics) and from 73.1 +/- 25.0 to 40.1 +/- 26.3 mg/24 h (microalbuminurics). In contrast, an increase in albumin excretion from 19.4 +/- 6.8 to 29.4 +/- 14.2 mg/24 h was observed in non treated normoalbuminuric patients. Untreated patients with microalbuminuria remained with stable albumin excretion levels (67.4 +/- 39 to 64.8 +/- 23.4 mg/24 h). Enalapril treatment was associated to a significant (p < 0.05) decrease in creatinine clearance which remained within normal limits. Blood pressure, Na and K plasma levels and total proteins remained normal throughout the study. Thus, angiotensin converting enzyme inhibition reduces the urinary excretion of albumin in insulin dependent diabetics with normo or microalbuminuria.

[The effects of a dietary fiber (white lupine bran) in the treatment of non-insulin-dependent diabetes]. / Efectos de una fibra dietaria (salvado de lupino dulce) en el tratamiento de la diabetes no insulinodependiente.

We evaluated the effect of dietary fiber from sweet lupine hull (SLH) upon metabolic control in 16 non insulin dependent diabetics (11 males, mean age 52). Body mass index was 23 +/- 2 and non fasting glucose levels were < 200 mg/dl. Following a 2 month control period, patients received SLH, 10 g th 3rd month and 20 g the fourth. Eleven patients received in addition oral hypoglycemic drugs. Intake of crude dietary fiber increased from 4.1 +/- 1.7 to 8.4 +/- 2 and 13.1 +/- 1 g from control to the 3rd and 4th month. Blood glucose increased and cholesterol level decreased in the 3rd month (p < 0.05). During the 4th month, blood glucose decreased to control levels. No changes were observed in body mass, HDL cholesterol, triglycerides, glycosylated Hb and non-fasting glucose and insulin levels in relation to fiber intake. We conclude that dietary fiber intake is low in our patients but a supplement of 10 to 20 g of this particular fiber did not improve metabolic control.