Magnetic-Assisted Reduced-Port Sleeve Gastrectomy Versus Laparoscopic Sleeve Gastrectomy: a Comparative Study.

BACKGROUND: Sleeve gastrectomy is one of the most popular bariatric surgeries. With the advent of new technologies, a reduced-port approach assisted by magnets for sleeve gastrectomy (RPSG-MA) has been developed. The aim of our study is to compare the short-term results of RPSG-MA vs conventional laparoscopic SG (CLSG). METHODS: A comparative study was performed. We compared two groups who underwent RPSG-MA (n=150) and CLSG (n=135) between January 2020 and January 2022. RESULTS: Both groups were similar in body mass index, age, sex, and type of comorbidities. The operative time was similar in both groups (RPSG-MA, 52.5 min vs CLSG, 52.9 min; p = 0.829). Length of hospital (1.07 days) stay was significantly shorter in the RPSG-MA group (p = 0.00) than in the CLSG group (1.51 days). There were no conversions to open surgery in any patient or any fatal event. Complications encountered were similar in both groups postoperative. There were minor adverse events directly related to the magnetic device in 3 cases, these being mild hepatic lacerations, resolved with hemostatic measures. CONCLUSION: The magnet-assisted reduced-port gastric sleeve compared to the conventional technique has proven to be safe, technically feasible and with multiple benefits.

Hybrid revisional surgery: biliary limb distalization plus endoscopic transoral outlet reduction (eTOR).

Roux-en-Y gastric bypass (RYGB) is one of the best procedures for the treatment of obesity and associated comorbidities. However, the percent of revisional procedures after a gastric bypass by weight regain has been increased, therefore several surgical options are available for the treatment of weight regain. In this case report, we combined a biliary limb distalization with endoscopic transoral outlet reduction (eTOR). The purpose of this case report is to expose the viability to perform combined procedures such as the distalization of the biliopancreatic limb plus eTOR increasing malabsorptive and restrictive components that would represent a secure and efficient weight loss in our patient. We could demonstrate the technical feasibility of the combination of both procedures to increase the restrictive and malabsorptive components at the same time with a low-risk range.

Lesiones de punta de dedo: experiencia en el manejo en los últimos 5 años en un centro pediátrico / Fingertip injuries: experience in handling the last 5 years in a pediatric center

Las lesiones de punta de dedo son comunes en pacientes pediátricos que acuden a salas de Emergencia; son causadas por accidentes en el hogar y con aplastamiento en puerta como principal mecanismo de trauma. El tratamiento se realiza individualizado por cirujanos plásticos y cirujanos pediátricos en dependencia de la herida y el compromiso tisular. El propósito de este estudio es describir el manejo de pacientes con lesiones de punta de dedo en un centro pediátrico. Se realizó un análisis de historias clínicas en el período entre enero 2015 y diciembre 2020, se evaluaron 228 pacientes atendidos en el Hospital de Niños Dr. Roberto Gilbert Elizalde, en Guayaquil, Ecuador. Los resultados incluyen un predominio de pacientes en edad preescolar (67%), masculinos (56%) y de mano derecha (53%). Los dedos más afectados fueron el medio y anular. Los procedimientos fueron realizados por cirujanos plásticos (55%) y la técnica electiva fue bajo anestesia general. La extensión del daño involucró tejidos blandos (92%), avulsión de uña (29%) y fracturas asociadas (15%). El 3% de los pacientes presentó complicaciones que requirieron seguimiento. El tipo de reparo se seleccionó en dependencia de la extensión de la herida, se realizaron suturas simples (37%) y suturas complejas con reparo de la uña (27%). Nuestros datos son similares a los descritos en la literatura internacional, con buenos resultados a largo plazo, menor tasa de complicaciones y respuestas similares en los reparos realizados por cirujanos plásticos y cirujanos pediatras.

Fingertip injuries are common in pediatric patients who present to the emergency room. They are usually caused by accidents at home, being door-crush the main mechanism. Treatment is performed on an individual basis, by a Plastic or General Pediatric Surgeon, according to the wound findings and tissue involvement. The purpose of this study is to describe the management on a pediatric center in patients with a fingertip wound. A descriptive and retrospective analysis of medical records was carried out from January 2015 until December 2020. In this period 228 patients were seen in the Dr. Roberto Gilbert Elizalde Children´s Hospital in Guayaquil, Ecuador. A high incidence was found in the preschool age with 67% of cases. The injuries were more common in males (56 %) and more predominant on the right hand (53%). The most affected fingers were the middle and annular. Procedures were mostly performed by Pediatric Surgeons (55%) and the elective technique was under general anesthesia. Damage extension of the fingertip included soft tissues in 92% of patients, nail avulsion in 29% and associated fractures in 15%. Only 3% of patients developed complications that required follow up. The type of repair was selected according to the extension of the injury. Mostly simple sutures (37%) and complex sutures with nail repair (27%)were used.Our data is similar to the one found in international literature, with good long-term outcomes, minor complications and similar results when the repair was performed by a Plastic or Pediatric surgeon

Manejo quirúrgico de heridas por mordeduras de perro en pacientes pediátricos: nuestra experiencia en 8 años / Surgical management of dog bite wounds in pediatric patients: our experience in 8 years

Introducción. Hasta un 90% de las mordeduras de animales son producidas por perros. Los niños son la población más vulnerable frente a las mordeduras ya que suelen afectar una mayor proporción de superficie corporal. Objetivo. Analizar la casuística de mordeduras de perro y su repercusión en nuestro entorno. Métodos. Estudio observacional, descriptivo, retrospectivo de un período de 8 años, que incluyó a todos los pacientes de 0 a 18 años con diagnóstico de mordedura de perro. Resultados. Se incluyeron 183 pacientes con diagnóstico de mordedura de perro. El promedio de edad fue de 6,1 años, y el grupo etario más afectado fue el de los niños de 3 a 5 años (38,3%). El tratamiento quirúrgico fue dividido en pacientes que requirieron rafia por planos (84,6%), colgajos (11,4%), injertos (3,4%) y puntos de aproximación (1%). Se reportaron 8 pacientes con complicaciones (4,4%). Conclusión. Los niños de 3 a 5 años son los más afectados por mordeduras de perro y la zona de cabeza y cuello es la más común. Un porcentaje importante de pacientes requirieron colgajos e injertos con buenos resultados.

Introduction. Up to 90% of animal bites are produced by dogs. Children are the most vulnerable population because bites tend to affect greater body surface area. Outcome. Analyze dog bites cases and their impact on our environment. Methods. An observational, descriptive, retrospective study during an 8 year period was carried out, which included all patients from 0 to 18 years with a diagnosis of dog bite. Results. A total of 183 patients with a diagnosis of dog bite were found. The average age was 6.1 years, and the age group most affected was children from 3 to 5 years old (38.3%). Surgical treatment was divided into: patients who required suture by planes (84.6%), flaps (11.4%) and grafts (3.4%) and approximation stitches (1%). Complications were reported in 8 patients (4.4%). Conclusion. Children from 3 to 5 years old are the most affected by dog bites, the head and neck area is the most common. A significant percentage of patients required flaps and grafts with good results.

Urinary incontinence in Chilean women: a prevalence study of the health profile and associated factors / Incontinencia urinaria en mujeres chilenas: estudio de prevalencia de perfil de salud y de factores asociados

PURPOSE: This research seeks to determine the prevalence of urinary incontinence in adult women in La Serena, Chile, exploring its association with known risk factors. METHODS: We conducted a cross-sectional, descriptive study with an analytical component. A validated questionnaire was applied to 371 women who consented, were aged 30 or older, and were users of primary health care centers. RESULTS: The prevalence obtained was 45.01%, associated with four main factors: hard work (odds ratio: 2.29; 95% confidence interval: 1.45 to 3.62), constipation (odds ratio: 1.99; 95% confidence interval: 1.21 to 2.76), type 2 diabetes (odds ratio: 1.88; 95% confidence interval: 1.16 to 3.06) and obesity (odds ratio: 1.09; 95% confidence interval: 1.05 to 1.14). CONCLUSIONS: Given the high prevalence of urinary incontinence, its association with prevalent health problems, and its known impact on women's quality of life, the authors suggest that strategies be implemented to deal with this health problem at the primary care level.

OBJETIVO: Determinar la prevalencia de incontinencia urinaria en mujeres adultas de la ciudad de La Serena, explorando la asociación con factores de riesgo conocidos. MÉTODOS: Estudio descriptivo transversal, con componente analítico. Se aplicó un cuestionario validado a 371 mujeres mayores de 30 años y usuarias de centros de atención primaria, que dieron su consentimiento. RESULTADOS: Se obtuvo una prevalencia de 45,01%, asociándose con trabajo pesado (Odds ratio: 2,29; intervalo de confianza 95%: 1,45 a 3,62); estreñimiento (Odds ratio: 1,99; intervalo de confianza 95%: 1,21 a 2,76); diabetes mellitus tipo 2 (Odds ratio: 1,88; intervalo de confianza 95%: 1,16 a 3,06) y obesidad (Odds ratio: 1,09; intervalo de confianza 95%: 1,05 a 1,14). CONCLUSIONES: Dada la alta prevalencia de incontinencia urinaria, su asociación con problemas de salud prevalentes y el impacto conocido en la calidad de vida de las mujeres, los autores sugieren la implementación de estrategias que aborden este problema en el nivel de atención primaria.

Haemocystidium spp., a species complex infecting ancient aquatic turtles of the family Podocnemididae: First report of these parasites in Podocnemis vogli from the Orinoquia.

The genus Haemocystidium was described in 1904 by Castellani and Willey. However, several studies considered it a synonym of the genera Plasmodium or Haemoproteus. Recently, molecular evidence has shown the existence of a monophyletic group that corresponds to the genus Haemocystidium. Here, we further explore the clade Haemocystidium spp. by studying parasites from Testudines. A total of 193 individuals belonging to six families of Testudines were analyzed. The samples were collected in five localities in Colombia: Casanare, Vichada, Arauca, Antioquia, and Córdoba. From each individual, a blood sample was taken for molecular analysis, and peripheral blood smears were made, which were fixed and subsequently stained with Giemsa. The prevalence of Haemocystidium spp. was 1.55% (n = 3/193); all infected individuals belonged to Podocnemis vogli (Savanna Side-necked turtle) from the department of Vichada. This is the first report of Haemocystidium spp. in Colombia and in this turtle species. The phylogenetic analysis of a mitochondrial cytb fragment revealed Haemocystidium spp. as a monophyletic group and as a sister taxon of Haemoproteus catharti and the genus Plasmodium. Haemocystidium spp. are difficult to identify by morphology only. As a result, it is possible that some of the taxa, such as Haemocystidium (Simondia) pacayae, represent a species complex. The parasite found in our study is morphologically indistinguishable from Haemocystidium (Simondia) pacayae reported in Peru. However, the new lineage found in P. vogli shows a genetic distance of 0.02 with Hae. pacayae and 0.04 with Hae. peltocephali. It is proposed that this divergent lineage might be a new species. Nevertheless, additional molecular markers and ecological features could support this hypothesis in the future.

Intraoral reconstruction with "thinned" peroneal artery perforator flaps: An alternative to classic donor areas in comorbid patients.

Free fasciocutaneous flaps like the radial forearm free flap (RFFF) and the anterolateral thigh (ALT) are the most commonly used flaps in intraoral reconstruction. However, certain conditions preclude the use of either of these flaps. The aim of this report was to show applicability of "thinned" peroneal artery perforator (PAP) flaps in intraoral reconstruction. We report two cases of squamous cell carcinoma involving the tongue and floor of the mouth, where one patient had advanced scleroderma with tight forearm skin and the other with a history of Reynaud's disease precluding the use of RFFF. In addition, both patients were morbidly obese with thick adipose tissue in the thigh making ALT flap not a suitable option. Instead, a PAP flap was chosen. After the harvest, the subcutaneous tissue thickness was measured to be 2.2 and 1.8 cm, respectively. The thinning was performed by removing the deep fat lobules of the superficial fat layer down to a final thickness of 0.4 and 0.3 cm, respectively. A 2 × 2 cm area surrounding the perforators were kept untouched. Both patients had uneventful postoperative course with one patient having a small donor area dehiscence that healed with local wound care. The functional outcomes at 1 year were good. "Thinned" PAP flap is a unique and novel application that may be an alternative in intraoral reconstruction when primary choices are not available.

Evaluacion de la respuesta a la tuberculina en estudiantes del area de la salud / Evaluation of the response to tuberculin among university students in the health field

Se realizo un estudio transversal con el fin de evaluar la respuesta a la tuberculina en estudiantes del area de la salud (medicina, odontologia, enfermeria y bacteriologia) en comparacion con estudiantes de otras areas de la Universidad de Antioquia (Medellin, Colombia) en tres niveles, (inicial, intermedio y final) del programa academico. La muestra comprendio 490 estudiantes, 273 del area de la salud y 217 de las otras areas; la seleccion se hizo de manera aleatoria con base en los listados del Departamento de Admisiones y Registros de la Universidad para el segundo semestre de 1998. Se determino la presencia de cicatriz de vacunacion BCG y factores de riesgo de tuberculosis. La tuberculina se evaluo 72 horas despues de la aplicacion intradermica de 2 UT de PPD, RT-23. La respuesta a la tuberculina no mostro deferencias por nivel de estudios ni nivel socioeconomico; solo la presencia de cicatriz BCG estuvo significativamente asociada (P=0,007). Estos resultados indican que los estudiantes del area de la salud tienen un contacto reducido con pacientes con tuberculosis o sus muestras durante su formacion, lo cual no descarta la tuberculosis como riesgo profesional para el personal de salud

A cross-sectional study was done at the University of Antioquia, Medellín, Colombia, to evaluate the response to a tuberculin skin test among students in undergraduate health programs (medicine, odontology, nursing, and bacteriology) as compared to undergraduate students in nonhealth programs. The study included students from the beginning, middle, and end of the university's academic programs. The sample of 490 students included 273 from health programs and 217 from nonhealth programs. Participants were randomly selected using lists provided by the university registrar, for the second semester of 1998. The presence of a BCG vaccination scar was determined, and all the participants were also questioned about TB-related risk factors. Tuberculin skin test reactivity was evaluated by the size of induration 72 hours after intradermal injection of two tuberculin units of purified protein derivative RT 23. There were no differences in tuberculin reactivity between students from the health programs and from the nonhealth programs, irrespective of the academic level. However, there was a significantly higher proportion of positive skin tests among students with a BCG scar. These results suggest that undergraduate health students do not have extensive contact with TB patients or with clinical samples from such patients. Nevertheless, the results do not rule out TB as an occupational risk for health personnel.