Specialized pro-resolvin mediators induce cell growth and improve wound repair in intestinal epithelial Caco-2 cell cultures.

Specialized pro-resolvin mediators (SPMs) are a superfamily of bioactive molecules synthesized from polyunsaturated fatty acids (arachidonic, eicosapentaenoic and docosahexaenoic acids) that include resolvins, protectins and maresins. These metabolites are important to control the resolution phase of inflammation and the epithelial repair, which is essential in restoring the mucosal barriers. Unfortunately, the effects of SPMs on intestinal epithelial cell growth remain poorly understood. Caco-2 cell were used as intestinal epithelial cell model. Cell growth/DNA synthesis, cell signalling pathways, western blot and wound repair assay were performed. Our data demonstrated that SPMs such as lipoxin LxA4, resolvin (Rv) E1, RvD1, protectin D 1 and maresin 1 were able to enhance intestinal epithelial Caco-2 cell growth and DNA synthesis. Furthermore, our results provide evidence that these effects of RvE1 and RvD1 were associated with a pertussis toxin-sensitive G protein-coupled receptor, and that leukotriene B4 receptor 2 could be involved, at least in part, in these effects of RvE1/RvD1. Moreover, these mitogenic effects induced by SPMs were dependent on the ERK 1/2 and p38 MAPK pathways as well as phospholipase C and protein kinase C activation. Thus, these mitogenic effects of RvE1/RvD1 on intestinal epithelial cells could be involved in this signalling circuit involved in wounded epithelium and the catabasis process.

Actividad física y osteoporosis en mujeres postmenopáusica / Physical activity and ossteoporosis in postmenopausical women

La relación entre el buen estado físicao, ejercicio regular y densidad mineral ósea (BMD) de columna lumbar y cuello de fémur, fueron estudiadas en 60 pacientes, entre 113 mujeres psotmenopáausicas de Cleveland Menopause Clinic, dirigida por el Dr. Utian. En cada sujeto se evaluó la masa ósea por densitometría, midiendo el contenido mineral óseo. Se incluyeron sólo las pacientes de tipo corporal normal. Se objservó una diferencia estadisticamente significativa, entre mujeres de vida activa y sedentaria, en relación a pacientes con y sin osteoporosis

Hábitos dietéticos y osteoporosis en la postmenopausia / Dietary habits and osteoporosis in the postmenopausia

Se estudió en 113 mujeres postmenopáausicas (PostM) el efecto de los componentes de una dieta normal, estas pacientes respondieeron a un cuestionario entre 600 mujeres, a quienes se le efectuó una densitometría(BMD) en Cleveland Menopause Clinic, dirigida por el Pro. Dr. Utian. Las mismas fueron divididas en dos grupos de acuerdo a la densidad mineral ósea (BMD) pacientes con ossteoporosis y pacientes sin osteoporosis o normales

Actividad física y osteoporosis en mujeres postmenopáusica / Physical activity and ossteoporosis in postmenopausical women

La relación entre el buen estado físicao, ejercicio regular y densidad mineral ósea (BMD) de columna lumbar y cuello de fémur, fueron estudiadas en 60 pacientes, entre 113 mujeres psotmenopáausicas de Cleveland Menopause Clinic, dirigida por el Dr. Utian. En cada sujeto se evaluó la masa ósea por densitometría, midiendo el contenido mineral óseo. Se incluyeron sólo las pacientes de tipo corporal normal. Se objservó una diferencia estadisticamente significativa, entre mujeres de vida activa y sedentaria, en relación a pacientes con y sin osteoporosis(AU)

Hábitos dietéticos y osteoporosis en la postmenopausia / Dietary habits and osteoporosis in the postmenopausia

Se estudió en 113 mujeres postmenopáausicas (PostM) el efecto de los componentes de una dieta normal, estas pacientes respondieeron a un cuestionario entre 600 mujeres, a quienes se le efectuó una densitometría(BMD) en Cleveland Menopause Clinic, dirigida por el Pro. Dr. Utian. Las mismas fueron divididas en dos grupos de acuerdo a la densidad mineral ósea (BMD) pacientes con ossteoporosis y pacientes sin osteoporosis o normales(AU)

Detección de hipotiroidismo subclínico en pacientes climatéricas / Subclinic hypothyrroidism detection in postmenopausal women

El hipotiroidismo aumenta su frecuencia con la edad. Las formas asintómaticas podrían ser detectadas mediante las determinaciones de Thyroid Stimulating Hormone (TSH) bajo el Test de THR (Thyroid Releasing Hormone) en los primeros estadios. La incidencia del hipotiroidismo subclínico (SCH) en la etapa del cimaterio no es bien conocida. El objetivo de este trabajo es realizar mediante la determinación de TSH, un "Screening" del Hipotiroidismo Subclínico (SCH) En 209 pacientes se determinaron valores de TSH, T3, T4 y anticuerpos antitiroideos y además se realizó ultrasonografía tiroidea

Detección de hipotiroidismo subclínico en pacientes climatéricas / Subclinic hypothyrroidism detection in postmenopausal women

El hipotiroidismo aumenta su frecuencia con la edad. Las formas asintómaticas podrían ser detectadas mediante las determinaciones de Thyroid Stimulating Hormone (TSH) bajo el Test de THR (Thyroid Releasing Hormone) en los primeros estadios. La incidencia del hipotiroidismo subclínico (SCH) en la etapa del cimaterio no es bien conocida. El objetivo de este trabajo es realizar mediante la determinación de TSH, un "Screening" del Hipotiroidismo Subclínico (SCH) En 209 pacientes se determinaron valores de TSH, T3, T4 y anticuerpos antitiroideos y además se realizó ultrasonografía tiroidea(AU)

Synovial sarcoma of the esophagus.

A 14-year-old girl presented with dysphagia and weight loss. Barium swallow, computed tomography, and endoscopy showed a polypoid intraluminal mass in the cervical esophagus. The tumor was locally resected and postoperative chemotherapy and radiotherapy were administered. Histological examination of the surgical specimen established a diagnosis of synovial sarcoma. The patient remains free of discernible disease 30 months after surgery. Esophageal sarcomas are rare tumors. This appears to be the second reported case of esophageal synovial sarcoma in a child.

[Our experience in neonatal surgery in a 15-year period. Follow-up of 1,003 cases]. / Nuestra experiencia en cirugía neonatal a lo largo de 15 años. Seguimiento de 1.003 casos.

From 1982 to 1994, 1.003 cases of surgical newborns have been retrospectively studied. Frequency and epidemiology have been evaluated, so as associated malformations. Prenatal diagnosis was made in 72 cases (7.1%). The most frequent entity was intestinal atresia, with 122 cases (12.1%), followed by necrotizing enterocolitis in 80 cases (7.9%), nevertheless this last one was the most frequent finding in preterm newborns. Esophageal atresia was found in 57 cases (5.6%). Association with other malformations was found in 127 cases (12.6%), and 32 cases of them (3.1%) constituted congenital malformations syndromes. The number of surgical newborns has increased in the last years, mainly due to ambulatory surgery. Global mortality of operated patients was 62 cases (5.9%); the highest mortality index was for congenital diaphragmatic hernia (33.5%), followed by necrotizing enterocolitis (28%). Mortality rate has decreased in recent years, due to improving in management and treatment of these patients, and the consolidation of surgical newborn units. Future efforts should be aimed for decreasing in mortality and improving the standard of life of these patients.

[Rectocolonic plasty using mechanical stapler as a surgical solution in complications of megacolon]. / Rectocoloplastia con sutura mecánica como solución quirúrgica en las complicaciones del megacolon.

Hirschsprung's disease surgically treated with Duhamel's technique in which no mechanical suture has been used, usually presents, as main complication, cronic constipation, due to fecalomas in the rectal pouch. In our experience (30 cases plus four patients sent to our hospital for reintervention), this complication is not present when mechanical suture is introduced to the Duhamel's Technique. This allows us to assure that perineal rectocoloplasty, with auto-suture material is a precise optional treatment, with excellent results and allows the chance of not going through laparotomy in those cases that require reintervention.

Treatment of esophageal varices by endoscopic ligation in children.

Endoscopic variceal ligation (EVL) is an alternative technique to endoscopic variceal sclerotherapy (EVS) to treat esophageal varices. This method consists of mechanical ligature and thrombosis of varices using elastic rubber rings. During an 11-month period, nine pediatric patients with esophageal varices secondary to portal hypertension were treated by EVL. Extrahepatic portal vein obstruction was the cause of portal hypertension in 5 patients and in 4 cases the cause was intrahepatic disease. The average age of the patients was 8 years (range: 2-15). Five patients had bled from esophageal varices previously. Two were actively bleeding at the time of the procedure. Endoligature was performed prophylactically in four patients. Fifty varix ligations were performed in 26 separate sessions. In children older than ten years, EVL was performed under intravenous sedation. Two mild rebleeds have occurred in this group and responded to repeated ligature. Varices were reduced in grade in all patients. Six patients achieved variceal eradication. Recurrence of varices was not encountered. No major complications occurred and there were no treatment failures. These early results suggest that endoscopic ligation is a safe and effective method for the control of esophageal varices in children.

[Ambulatory surgery. Experience at a pediatric surgery department]. / Cirugía de corta estancia. Experiencia de un servicio de cirugía pediátrica.

In October 1987 we opened an Outpatient Surgical Unit, since January 1988 to December 1993 we have treated 8232 patients with an mean age (range of 2 weeks to 17 years). All the patients were given general anesthesia, loco-regional anesthetics or deep sedation. 33.5 percent of the total number of patients operated in our hospital were treated in this Unit, being 41.4 percent if related to programmed surgery. Only 2.5 percent of them were admitted in the inpatient area with no significant complications.

[Treatment of post-traumatic pancreatic pseudocyst by percutaneous Huisman's drainage]. / Tratamiento del pseudoquiste pancreático postraumático mediante drenaje percutáneo de Huisman.

Pancreatic pseudocysts is a complication of acute posttraumatic pancreatitis. They usually cause recurrent abdominal pain, nausea, vomiting and elevation of serum amylase levels. A history of epigastric blunt trauma, the before mentioned clinical signs and echographic or scanning studies may lead to a certain diagnosis. Although most of them resolve spontaneously, some persist and active therapeutic measures are required. Surgical internal drainage has been the operative technique of choice in children. Nevertheless, treatment can be achieved by percutaneous aspiration or drainage of pancreatic recurrent collections. We present our experience in two children with posttraumatic pancreatic pseudocyst, treated successfully by means of a percutaneous transabdominal pig-tail catheter (Huisman catheter). The technique of catheter placement and clinical aspects are discussed.

[Surgical alternatives in congenital tracheal stenosis]. / Alternativas quirúrgicas ante la estenosis traqueal congénita.

Congenital tracheal stenosis is a rare condition with a high mortality. In a 12-year period, 5 cases (ages 5 days to 4 years) with this anomaly were treated. 4 were corrected, the operative repair consisted of segmental resection and anastomosis in one patient, and rib-cartilage tracheoplasty in the other three. The other patient died 12 days after bronchoscopy without attempt of surgical correction. Two patients died during or just after surgery, both of them presenting a similar clinical course consisting on severe air trapping, mechanical pulmonary hypertension and low cardiac output. Long-term follow-up of the survivors is satisfactory.

[Surgery of the structural lesions of the respiratory tract]. / Cirugía de las lesiones estructurales de la vía aérea.

22 clinical files of patients treated in our institution since 1983 for structural lesion of the airway are reviewed. 3 cases presented congenital tracheal stenosis, 15 congenital or acquired subglottic stenosis, 1 severe tracheomalacia, 1 subglottic membrane, 1 congenital subglottic cyst and 1 subglottic granuloma. A conservative or surgical approach (endoscopic, anterior cricoid split, Fearon's laryngotracheoplasty, modified Rethi's procedure, Kimura's tracheoplasty and aortopex) was used. Good results were obtained in 55.5 percent of the conservative cases, 100 percent of the endoscopic procedures, 50 percent of the splits and 75 percent of the laryngotracheoplasties. The Kimura and aortopexy procedures gave also good results. 4 patients are waiting for surgery: 1 anterior laryngotracheoplasty for iatrogenic failure, 2 conservative cases for persistence of the symptoms and 1 congenitaltracheal stenosis. A case of difuse congenital tracheal stenosis died before surgery. There are no significant differences in the complication rates of the surgical and conservative groups, but mean hospital stay was shorter in the former (p < 0.05).

[The indications, technics and results of the use of tissue expanders in pediatric surgery]. / Indicaciones, técnica y resultados del empleo de los expansores tisulares en cirugía pediátrica.

We review our experience in tissue expansion in twenty-four pediatric patients. The most frequent indications for the use of tissue expanders included congenital nevi and burn scars, they were also used with success in alopecia, congenital abdominal wall defects, mammary hypoplasia and microtia. Tissue expanders were always placed subcutaneously. Both, surgery and body deformity during expansion, were well tolerated. We found complications in five cases, but only in one patient treatment was interrupted. Results were considered excellent in nineteen cases.

[Congenital esophageal stenosis associated with corneosclera]. / Estenosis esofagica congenita asociada a esclerocornea.

One case of congenital esophageal stenosis due to tracheobronchial remnants and associated with microphthalmos and corneosclera is reported. Diagnostic and therapeutic methods employed are discussed.

[Locoregional anesthesia in surgery with day hospitalization. Our experience with 240 cases]. / La anestesia loco-regional en cirugía con hospitalización de día. Nuestra experiencia sobre 240 casos.

Locoregional anaesthesia has become an excellent complement of conventional general anaesthesia, because it results in efficient postoperative pain relief and is easy to carry out. We have performed two types of anaesthetic blockade: of peripheral nerve (dorsal nerve of the penis and abdominogenital nerve) and caudal block. Both have been employed in pediatric day surgery with good results in postoperative pain relief and with no complications. Advantages such as early recovery of oral feeding and the normal activity of the child are possible when using these techniques of locoregional anaesthesia.