Dopaminergic activation anticipates daily nursing in the rabbit.

Maternal care is a motivated behavior and in the rabbit it is restricted to the spontaneous return of the mother to nurse her pups for just a few minutes once a day. Previously we have reported neural activation of brain areas and neuroendocrine cells after nursing. However, this daily spontaneous return suggests that the mother is in a high motivational state to nurse her pups. Here we hypothesized that during anticipation of nursing there is an activation of dopaminergic neurons of the mesolimbic system and in their target areas. Then we explored, by the expression of FOS protein, possible activation of the mesolimbic system as well as dopaminergic cells of the A10 cell group before and after nursing and in control does. Additionally, we measured FOS expression in the preoptic area and lateral septum. We found a significant increase of FOS before nursing, and a further increase after nursing, in the mesolimbic system and dopaminergic cells as well as in the preoptic area and lateral septum. Interestingly, the medial prefrontal area shows an intense activation during anticipation of nursing, which remains after nursing. We conclude that the activation of the mesolimbic system before nursing is related to the high locomotor behavior prior to the next nursing bout and support the proposal that the mother is in a high motivational state at the time of returning to the nest. The additional activation after nursing can be related to the neuroendocrine and neural consequences of the milk ejection reflex by suckling.

Aerial pesticide application causes DNA damage in pilots from Sinaloa, Mexico.

The use of pesticides in agricultural production originates residues in the environment where they are applied. Pesticide aerial application is a frequent source of exposure to pesticides by persons dedicated to agricultural practices and those living in neighboring communities of sprayed fields. The aim of the study was to assess the genotoxic effects of pesticides in workers occupationally exposed to these chemicals during their aerial application to agricultural fields of Sinaloa, Mexico. The study involved 30 pilots of airplanes used to apply pesticides via aerial application and 30 unexposed controls. Damage was evaluated through the micronucleus assay and by other nuclear abnormalities in epithelial cells of oral mucosa. The highest frequency ratios (FR) equal to 269.5 corresponded to binucleated cells followed by 54.2, corresponding to cells with pyknotic nuclei, 45.2 of cells with chromatin condensation, 3.7 of cells with broken-egg, 3.6 of cells with micronucleus, and 2.0 of karyolytic cells. Age, worked time, smoking, and alcohol consumption did not have significant influence on nuclear abnormalities in the pilots studied. Pesticide exposure was the main factor for nuclear abnormality results and DNA damage. Marked genotoxic damage was developed even in younger pilots with 2 years of short working period, caused by their daily occupational exposure to pesticides.

Linfoma No-Hodgkin y pancreatitis aguda en gestante: reporte de caso / Non-Hodgkin's lymphoma and acute pancreatitis in pregnant women: case report

ANTECEDENTES: El linfoma no Hodgkin durante el embarazo es una entidad rara, el tipo difuso de células grandes es aún menos frecuente y se caracteriza por una alta tasa de progresión tumoral con poca expresión clínica. Su diagnóstico y tratamiento representan un reto clínico debido a la baja incidencia de la enfermedad y a las posibles repercusiones fetales a causa del tratamiento. CASO CLÍNICO: Gestante secundípara de 31 años que ingresa por cuadro de dolor abdominal y cifras elevadas de lactato deshidrogenasa. Durante la gestación precisa varios ingresos por pancreatitis aguda de repetición y cuadro de colestasis intrahepática. Tras el parto evoluciona tórpidamente con aparición de edema en esclavina en cuello y miembros superiores, siendo diagnosticada de gran masa torácica cuya biopsia es informada como Linfoma No Hodgkin tipo B difuso de células grandes primario mediastinal. Se administran dos ciclos de tratamiento quimioterápico tras lo cual remite completamente la enfermedad. Se induce el parto con prostaglandinas intravaginal, con recién nacido de 3350 gramos y APGAR 8/10. Tras un año la paciente permanece en remisión completa.

BACKGROUND: During pregnancy, Non-Hodgkin's lymphoma is a rare entity; the diffuse large cell lymphoma is still less common, and it has a high rate of tumor progression with a little clinical expression. Diagnosis and treatment is a huge challenge due to the low incidence of the condition and to the possible fetal effects because of the treatment. CLINICAL CASE: A 31-year-old woman -in her second delivery- was admitted with abdominal pain and elevated lactate dehydrogenase levels. During pregnancy, she was required several admissions reporting repeated acute pancreatitis and intrahepatic cholestasis. After delivery, it evolves into facial and upper extremity oedema, diagnosed with a large chest mass, resulting in the diagnosis of primary mediastinal large B-cell lymphoma through the biopsy. The disease goes into remission completely after two cycles of chemotherapy treatments are given. Labor is induced with intravaginal prostaglandins, with a newborn of 3350 g and Apgar 8/10. After a year, the patient remains in complete remission.

Mothers and offspring: The rabbit as a model system in the study of mammalian maternal behavior and sibling interactions.

UNLABELLED: This article is part of a Special Issue "Parental Care". Jay Rosenblatt effectively promoted research on rabbit maternal behavior through his interaction with colleagues in Mexico. Here we review the activities of pregnant and lactating rabbits (Oryctolagus cuniculus), their neuro-hormonal regulation, and the synchronization of behavior between mother and kits. Changing concentrations of estradiol, progesterone, and prolactin throughout gestation regulate nest-building (digging, straw-carrying, fur-pulling) and prime the mother's brain to respond to the newborn. Nursing is the only mother-young contact throughout lactation. It happens once/day, inside the nest, with ca. 24h periodicity, and lasts around 3min. Periodicity and duration of nursing depend on a threshold of suckling as procedures reducing the amount of nipple stimulation interfere with the temporal aspects of nursing, though not with the doe's maternal motivation. Synchronization between mother and kits, critical for nursing, relies on: a) the production of pheromonal cues which guide the young to the mother's nipples for suckling; b) an endogenous circadian rhythm of anticipatory activity in the young, present since birth. Milk intake entrains the kits' locomotor behavior, corticosterone secretion, and the activity of several brain structures. Sibling interactions within the huddle, largely determined by body mass at birth, are important for: a) maintaining body temperature; b) ensuring normal neuromotor and social development. Suckling maintains nursing behavior past the period of abundant milk production but abrupt and efficient weaning occurs in concurrently pregnant-lactating does by unknown factors. CONCLUSION: female rabbits have evolved a reproductive strategy largely dissociating maternal care from maternal presence, whose multifactorial regulation warrants future investigations.

Organochlorine pesticide level differences among female inhabitants from Veracruz, Puebla and Tabasco, Mexico.

Organochlorine pesticides have been used in Mexico in malaria control programs and against ectoparasites. The objective of this study was to compare the levels of organochlorine pesticides: HCB, α-ß-γ-HCH, pp'-DDE, op'-DDT and pp'-DDT in adipose tissue of female inhabitants from three Mexican states: Veracruz, Puebla and Tabasco. Data analyses indicated higher ß-HCH levels in Puebla inhabitants. When comparing the mean values of the pp'-DDE concentrations among the three states, no statistically significant differences were noted. A trend of increasing concentrations of op'-DDT from Veracruz to Puebla and Tabasco was observed. Significantly higher pp'-DDT concentrations in Veracruz as compared to Puebla and Tabasco were determined. Using factorial analysis of three age categories (>30, 31-50, <51) organochlorine pesticide concentrations increases with age of participants, indicating time of exposure as a principal factor of organochlorine pesticides accumulation in adipose tissue.

Food-entrained patterns in orexin cells reveal subregion differential activation.

Rats under a restricted feeding schedule develop food anticipatory activity 2-3h prior food access, characterized by increased arousal, foraging and exploratory behavior. This anticipatory behavior is not observed when rodents are allowed ad libitum food access and reappears for several cycles when food-entrained animals are fasted. Previously we reported that food entrainment also produces increased expression of c-Fos protein in the dorsomedial nucleus (DMH), in the perifornical area (PeF) and in the lateral hypothalamic area (LH) anticipating food intake. These hypothalamic structures contain abundant orexin (ORX) producing neurons and promote arousal, reward and metabolic balance, thus we explored the participation of the orexinergic system in food-entrainment by evaluating in food entrained rats (RF) the expression of c-Fos in ORX cells in anticipation, during and after food access, and in rats exhibiting persistent activation in fasting after interruption of the food-entrainment protocol (RF-Fast). Data were compared with ad libitum controls and with a 22-h fasted group. RF rats exhibited a food-entrained rhythm of c-Fos in ORX cells in the DMH, LH and PeF with highest levels at the time of meal delivery and after food ingestion. In RF-Fast rats the food-entrained pattern of ORX cells persisted in the PeF and LH and partially in the DMH, which in addition exhibited an earlier activation. We conclude that ORX cells in PeF and LH exhibit self sustained oscillations driven by food-entrainment, whereas the DMH may mediate arousal mechanisms that elicit anticipatory activity.

Levels of organochlorine pesticides residues in human adipose tissue, data from Tabasco, Mexico.

The objective of this study was to determine the levels of organochlorine pesticides HCB, α-ß-γ-HCH, p,p'-DDE, o,p'-DDT and p,p'-DDT in 150 adipose tissue of inhabitants of Tabasco, Mexico. The following pesticides were detected: p,p'-DDE in 100% of samples at mean 1.034 mg/kg; p,p'-DDT in 96.7% at mean 0.116 mg/kg; o,p'-DDT in 78.7% at mean 0.022 mg/kg and ß-HCH in 58.0% at mean 0.049 mg/kg. The pooled sample was divided according to sex of donors (75 female and 75 male). Significantly higher levels of all organochlorine pesticides in females were found. The sample was divided into three age's ranges (15-28, 29-45 and 46-84 years). The mean and median levels of ß-HCH, p,p'-DDE and Σ-DDT increase significantly (p < 0.05) from the first to the second and third group. The presence of organochlorine pesticide residues in Tabasco inhabitants is still observed, indicating sources of exposure to the pesticides.

Hematological and biochemical blood values in wild populations of black howler monkeys (Alouatta pigra) of Campeche, México.

BACKGROUND: The clinical analyses of free-ranging New World primates are extremely limited. The aim of this study was to obtain baseline data of blood chemistry and hematological values of free-ranging Alouatta pigra. METHOD: 17 males and 17 females were captured. We collected blood from the caudal tail vein; conventional techniques were used to analyze the samples RESULTS: Hemoglobin, hematocrit, and erythrocytes were significantly higher in males than in females. In relation to biochemical blood values, albumin/globulin ratio, cholesterol, triglycerides, calcium, phosphorus, magnesium, and iron were significantly higher in males than in females, while creatinine was significantly higher in females than in males. CONCLUSIONS: In general, measured parameters are similar to those of other primates and will be used as reference values for futures studies.

Organochlorine pesticide residue levels in blood serum of inhabitants from Veracruz, Mexico.

The objective of the present study was to monitor the levels of organochlorine pesticides HCB; α-, ß-, γ-HCH; pp'DDE; op'DDT; and pp'DDT in blood serum of Veracruz, Mexico inhabitants. Organochlorine pesticides were analyzed in 150 blood serum samples that constituted that which remained after clinical analyses, using gas chromatography-electron-capture detection (GC-ECD). The results were expressed as milligrams per kilogram on fat basis and micrograms per liter on wet weight. Only the following pesticides were detected: p,p'-DDE was the major organochlorine component, detected in 100% of samples at mean 15.8 mg/kg and 8.4 µg/L; p,p'-DDT was presented in 41.3.% of monitored samples at mean 3.1 mg/kg and 1.4 µg/L; ß-HCH was found in 48.6% of the samples at mean 4.9 mg/kg and 2.7 µg/L; op'DDT was determined to be in only 3.3% of monitored samples at mean 2.7 mg/kg and 1.4 µg/L. The pooled samples divided according to sex showed significant differences of ß-HCH and pp'DDE concentrations in females. The samples grouped according to age presented the third tertile as more contaminated in both sexes, indicating age as a positively associated factor with serum organochlorine pesticide levels in Veracruz inhabitants.

Organochlorine pesticide levels in female adipose tissue from Puebla, Mexico.

The objective of this study was to determine the levels of organochlorine pesticides HCB, α-ß-γ-HCH, pp'DDE, op'DDT and pp'DDT in adipose tissue of females living in Puebla, Mexico. Organochlorine pesticides were analyzed in 75 abdominal adipose tissue samples taken during 2010 by autopsy at the Forensic Services of Puebla. The results were expressed as mg/kg on fat basis. In analyzed samples the following pesticides were detected: p,p'-DDE in 100% of samples at mean 1.464 mg/kg; p,p'-DDT in 96.0.% of samples at mean 0.105 mg/kg; op'DDT in 89.3% of monitored samples at mean 0.025 mg/kg and ß-HCH in 94.7% of the samples at mean 0.108 mg/kg. To show if organochlorine pesticide levels in monitored female's adipose tissues are age dependant, the group was divided in three ages ranges (13-26, 26-57 and 57-96 years). The mean and median levels of all organochlorine pesticides increase significantly (p < 0.05) from the first to second and from the first to third group. At the same time, the increase of mean and medians levels from the second to third group were not statistically significant (p > 0.05). The present results compared to previous ones from 2008 indicates an increase in the concentrations during the 2010 study, but only the differences for pp'DDE and op'DDT were statistically significant. The 2010 group of females was older compared to the 2008 group. The presence of organochlorine pesticide residues is still observed, indicating uniform and permanent exposure to the pesticides by Puebla inhabitants.

Digital flexion contracture and severe carpal tunnel syndrome due to tophaceus infiltration of wrist flexor tendon: first manifestation of gout.

The authors report an unusual case of flexor tenosynovitis, severe carpal tunnel syndrome, and triggering at the carpal tunnel as the first manifestation of gout. A 69-year-old man presented with digital flexion contracture and severe carpal tunnel syndrome of his right hand and was treated surgically. A flexor tenosynovectomy and a median nerve neurolysis were performed through an extended carpal tunnel approach. The sublimis and the profundus tendons were involved. Partial ruptures and multiple whitish lesions suggestive of tophacceous infiltration of the flexor tendons were seen. Macroscopically, the removed synovial tissue was involved by multiple whitish nodules that were milimetric in size and was suggestive of monosodium urate crystals deposits. By light microscopy examination, numerous nonnecrotizing granulomas of different sizes were observed that were compounded by large aggregations of acellular nonpolarized material, surrounded by epithelioid histiocytes, mononuclear cells, and foreign body multinucleated giant cells. Postoperatively, the patient recovered with resolution of the median nerve symptoms and a near-to-full range of motion of the affected digits.To the authors' knowledge, this patient is the first case report with flexor tendons tophacceous infiltration as the first clinical sign of gout. Gouty flexor tenosynovitis can occur in the absence of a long history of gout. A high index of suspicion is paramount to the initiation of proper management. Operative treatment of gouty flexor tenosynovitis is mandatory to debulk tophaceous deposits, improve tendon gliding, and decompress nerves. Routine uric acid determination could be helpful in the preoperative evaluation of patients with flexor tenosynovitis.

Monitoring of organochlorine pesticide residue levels in adipose tissue of Veracruz, Mexico inhabitants.

The objective of the present study was to monitor the levels of organochlorine pesticides HCB, α-ß-γ-HCH, pp'DDE, op'DDT and pp'DDT in 150 adipose tissue samples of Veracruz, Mexico inhabitants. In analyzed samples, the following pesticides were detected: p,p'-DDE in 100% of the samples at mean 1.643 mg/kg; p,p'-DDT in 99.3.% of the samples at mean 0.227 mg/kg; ß-HCH in 97.3% of the samples at mean 0.063 mg/kg; and op'DDT in 93.3% of the samples at mean 0.022 mg/kg. Comparing mean, median and geometric mean concentrations of organochlorine pesticides shows a decrease in values from mean to median and to geometric mean which points out a prevalence of lower concentrations among the total samples and the existence of occasional cases of extreme exposure expressed in range values. The pooled samples divided according to sex, showed only significant differences of pp'DDE median concentrations between sexes. The other organochlorine pesticides indicated no statistical differences between sexes, including the pp'DDE/pp'DDT ratio. The samples grouped according to age, showed that the third tertile was more contaminated for both sexes, indicating age as a positively associated factor with organochlorine pesticide levels in adipose tissue of Veracruz inhabitants. Comparing organochlorine pesticide levels between 2008 and 2010 years, a decreased tendency for ß-HCH, pp'DDE, Σ-DDT and pp'DDE/pp'DDT ratio levels was observed.

Circadian nursing induces PER1 protein in neuroendocrine tyrosine hydroxylase neurones in the rabbit doe.

Rabbit does nurse their pups once a day with circadian periodicity and pups ingest up to 35% of their body weight in milk in < 5 min. In the doe, there is a massive release of prolactin. We hypothesised that periodic suckling synchronises dopaminergic populations that control prolactin secretion. We explored this by immunohistochemical colocalisation of PER1 protein, the product of the clock gene Per1 on tyrosine hydroxylase (TH) cells in three dopaminergic populations: tuberoinfundibular dopaminergic (TIDA), periventricular hypophyseal dopaminergic (PHDA) and incertohypothalamic dopaminergic (IHDA) cells. PER1/TH colocalisation was explored every 4 h through a complete 24-h cycle at postpartum day 7 in does that nursed their pups either at 10.00 h (ZT03) or at 02.00 h (ZT19; ZT0 = 07.00 h, time of lights on). Nonpregnant, nonlactating females were used as controls. In control females, there was a rhythm of PER1 that peaks at ZT15. By contrast, in nursed does, the PER1 peak shifted in parallel to scheduled nursing in TIDA and PHDA cells but not in IHDA cells, which are not related to the control of prolactin. Next, we determined that the absence of suckling for 48 h significantly decreases the number of PER1/TH colocalised cells in PHDA but not TIDA cells. Locomotor behaviour in control subjects was maximal at around the time of lights on but, in nursed females, shifted at around the time of scheduled nursing. Finally, in the suprachiasmatic nucleus, there is a maximal expression of PER1 at ZT11 in the three groups. However, this maximal expression was significantly lower in the nursed groups in relation to the control group and in the groups deprived of nursing for 48 h. We conclude that suckling synchronises dopaminergic cells related to the control of prolactin and appears to be a nonphotic stimulus for the suprachiasmatic nucleus.

Blood parameters are little affected by time of sampling after the application of ketamine in black howler monkeys (Alouatta pigra).

BACKGROUND: Ketamine hydrochloride is an anesthetic commonly utilized to obtain biological samples in various non-human primates. Its application alters individual hematologic and biochemical values. The aim of this study was to analyze its effect on blood parameters of Alouatta pigra. METHOD: We collected blood samples at 10 and 40 minutes after the application of ketamine in 12 adult female A. pigra living in free-ranging conditions. RESULTS: The analysis showed that 40 minutes after application of ketamine, the number of platelets, lymphocytes and concentration of phosphorus decreased; however, creatinine, cholesterol, triglycerides, and potassium values increased. CONCLUSIONS: Our results suggest that ketamine appears to have little effect on the hematology and blood biochemistry of Alouatta pigra females with respect to those reported for other non-human primates. It is also important to consider the elapsed time after their application when taking blood samples for proper interpretation of the hemogram of Alouatta pigra females.

Organochlorine pesticide gradient levels among maternal adipose tissue, maternal blood serum and umbilical blood serum.

The objective of the present study was to determine levels and calculate ratios of copartition coefficients among organochlorine pesticides ß-HCH, pp'DDE, op'DDT and pp'DDT in maternal adipose tissue, maternal blood serum and umbilical blood serum of mother-infant pairs from Veracruz, Mexico. Organochlorine pesticides were analyzed in 70 binomials: maternal adipose tissue, maternal serum and umbilical cord serum samples, using gas chromatography with electron capture detection (GC-ECD). The results were expressed as mg/kg on fat basis. p,p'-DDE was the major organochlorine component, detected in every maternal adipose tissue (0.770 mg/kg), maternal serum sample (5.8 mg/kg on fat basis) and umbilical cord blood sample (6.9 mg/kg on fat basis). p,p'-DDT was detected at 0.101 mg/kg, 2.2 mg/kg and 5.9 mg/kg respectively, according to the order given above. ß-HCH was detected at 0.027 mg/kg, 4.2 mg/kg and 28.0 mg/kg respectively. op'DDT was detected only in maternal adipose tissue at 0.011 mg/kg. The copartition coefficients among samples identify significant increases in concentrations from adipose tissue to maternal blood serum and to umbilical blood serum. The increase indicated that maternal adipose tissue released organochlorine pesticides to blood serum and that they are carried over to umbilical cord blood.

Organochlorine pesticide levels in umbilical cord blood of newborn in Veracruz, Mexico.

Organochlorine pesticides accumulate in lipid rich compartments of organisms. During pregnancy, the compounds pass through the placental barrier appear in cord blood. The aim of this study was to monitor the levels of organochlorine pesticides in 70 umbilical cord blood samples taken during deliveries in Veracruz in 2009. For organochlorine pesticides, only the presence ß-HCH (4%, 3.9 µg/L median concentration on wet weight), pp'DDE (100%, 0.7 µg/L) and pp'DDT (4%, 1.4 µg/L) were detected. The total pool of samples divided according to sex of new born babies, showed no statistical differences among median concentrations. The number of deliveries considered as a determinant contamination factor affirmed there were no statistical differences among median concentrations; however pp'DDE levels increased from the one to two childbirth groups. Age of pregnant women as a discriminate factor manifests in a significant increase in contamination levels among first, second and third tertile. In general, umbilical cord blood samples in Veracruz contained organochlorine pesticides, especially pp'DDE, confirming the presence of these compounds in the environment and their transfer from the mother to the developing fetus.

Organochlorine pesticide levels in adipose tissue of pregnant women in Veracruz, Mexico.

DDT and Lindane (gamma-HCH) which were used until 1999 in Mexico, have provided great benefits in the combat of vectors that spread infection-borne diseases and in agriculture for crop protection. The persistence in the environment and their accumulative properties results in bioconcentration in lipid rich tissues of the human body that reflect the extent of environmental pollution. Human adipose tissue samples were taken during 2009 from abdominal cavities of 69 pregnant women by cesarean surgery and from 34 samples of control donors by autopsy in Veracruz State. The samples were analyzed by gas chromatography with ECD. The results of mean levels (mg/kg on fat basis) were higher in controls compared to pregnant women beta-HCH 0.064 vs 0.027; pp'DDE 1.187 vs. 0.745; op'DDT 0.016 vs. 0.011; pp'DDT 0.117 vs. 0.099 and Sigma-DDT 1.337 vs. 0.854. The pregnant women group was divided according to age: up to 20, 20-30, and more than 30 years, and presented an increase for the more persistent pesticides with age in terms of mean concentrations and a more pronounced higher correlation in medians levels. Pairing Body Mass Index to organochlorine pesticide mean levels revealed no correlation between these factors in pregnant women.

[The influence of hygroscopic expansion on nanohybrid composite restorations]. / Influenta expansiunii higroscopice asupra restaurarilor realizate cu un compozit nanohibrid.

UNLABELLED: Hygroscopic expansion of resin materials is a common phenomena due to water adsorption into the resin matrix. This expansion is dependent upon the chemical structure of the material. Water sorption of resin dental material may contribute to stress release immediately after polymerization shrinkage has occurred. The aim of this study was to evaluate the influence of water storage on nanohybrid composite by assessment of marginal enamel sealing of restorations. MATERIAL AND METHOD: 30 human teeth extracted for periodontal or orthodontic reasons were used in these study. Cavities were prepared and restored using a nanohybrid composite (Ceramix Mono, Dentsply DeTrey) and a total-etch adhesive system (Prime&Bond NT, Dentsply DeTrey). The teeth were then randomly divided in three groups which were stored for various times in deionized water (one hour, 24 hours and 7 days). After the storage period, the teeth were immersed in methylen blue 1% for 24 h. Then specimens were axially cut and the dye penetration within the occlusal enamel interface was evaluated using optic microscope. RESULTS: Kruskal-Wallis test showed significant differences of dye penetration between the long-term hydrated groups and the group hydrated for only one hour (p < 0.05). The mean value of dye penetration decreased from 0.04 mm to 0.1 mm after water storage for both 24 hours and 7 days. However, good sealing in enamel margins of restorations was observed even without hydration. CONCLUSION: Our results confirm that nanohybrid composites used with total etch adhesives systems have good ability to seal the enamel margins and water sorption can improve this sealing.

Incontinencia urinaria de esfuerzo en la mujer. Comparación de la técnica de Raz y de la técnica de Bologna / Comparison of Raz bladder neck suspension and the Bologna procedure for the treatment of urinary stress incontinence

Nuestra situación es la de comparar las complicaciones y los resultados sobre la incontinencia de esfuerzo de 2 técnicas de suspensión cervicouretral: la técnica de Raz y la técnica de Bologna. Se ha evaluado retrospectivamente a 199 pacientes que se han beneficiado de un tratamiento de incontinencia urinaria de esfuerzo, bien mediante la técnica de Bologna (grupo 1, 99 pacientes), bien por la técnica de Raz (grupo 2, 100 pacientes). Los datos clínicos preoperatorios, los parámetros urodinámicos y las complicaciones postoperatorias se han comparado en cada uno de los 2 grupos. El margen entre el tratamiento de la incontinencia urinaria y la recidiva se ha comparado con los 2 grupos por un test logarítmico. Se fabricó un modelo multivariante con la ayuda de un modelo de Cox, a fin de exponer los parámetros explicativos del fracaso quirúrgico. La duración de la curación en el grupo 1 es significativamente más larga que en el grupo 2 (p = 0,00001). La mediana de duración del intervalo libre sin incontinencia (éxito) es de 51 meses en el grupo 1 y de 21 meses en el 2 (p = 0,00001). La frecuencia de las complicaciones operatorias (lesión vesical y hemorragia) y postoperatorias (hemorrágicas, infecciosas y embólicas) no difieren en los 2 grupos. El análisis multivariante según el modelo de Cox muestra que la única variable preoperatoria explicativa de las recidivas es la técnica de colposuspensión realizada: Raz y Bologna. Después de este estudio comparativo, la técnica de Bologna debe preferirse a la de Raz para tratar los pacientes con IUE por el hecho de la presencia de suficiente pared vaginal anterior para confeccionar las cinchas vaginales. Si tal no es el caso, la técnica de Raz, tal y como nosotros la habíamos practicado, se debe abandonar en beneficio de otros métodos de colposuspensión (AU)

The aim of this study was to evaluate and compare perioperative morbidity and the long-term results of Raz colposuspension and the Bologna procedure in the treatment of urinary stress incontinence in women. Data from 199 women who underwent either the Bologna procedure (group 1; n = 99) or Raz colposuspension (group 2; n =100) for urinary stress incontinence were retrospectively analyzed. Preoperative clinical data, urodynamic parameters and postoperative complications were compared between the two groups. Logarithmic analysis was used to compare time to recurrence of stress incontinence between the two groups. Multivariate analysis using a Cox proportional hazards regression model was performed to identify possible outcome predictors. The success rate was significantly higher in group 1 than in group 2 (p = 0.00001). The median incontinence- free interval was 51 months in group 1 and was 21 months in group 2 (p = 0.00001). No differences were found between the two groups in the frequency of intraoperative complications (inadvertent cystotomy, hemorrhage) and postoperative complications (hemorrhagic, infectious and embolic complications). Multivariate analysis using the Cox regression model showed that the only variable correlated with the surgical cure rate was the type of surgical anti-incontinence procedure adopted: Bologna or Raz (p = 0.00001). The results of this study indicate that the Bologna procedure should be preferred over Raz colposuspension in the treatment of urinary stress incontinence when sufficient anterior vaginal tissue is available to create vaginal bands. When this is not the case, Raz colposuspension, as performed in the present study, should be abandoned in favor of other colposuspension methods (AU)

Leptina, embarazo y reproducción / Leptin, pregnancy and reproduction

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