Crosectomía alta sin sección vascular frente a safenectomía clásica. Ensayo clínico aleatorizado: análisis de la recidiva varicosa / High crossectomy without vascular sectioning vs classic saphenectomy. Randomized clinical trial: analysis of recurrent varicose

Fundamento. El presente estudio fue diseñado con el propósito de definir un nuevo procedimiento quirúrgico para la cirugía de las varices y compararlo con estudios de crosectomía clásica en términos de reducir la tasa derecidiva varicosa. Material y métodos. El estudio presentado es un ensayo clínico aleatorizado, doble ciego. Para facilitar el acceso se seleccionaron 150 pacientes que acudieron a consulta Unidad de Flebología, que facilitaron su consentimiento cumpliendo los criterios de inclusión. Se hicieron dos grupos: Grupo 1: safenectomía clásica (CS); 75 pacientes. Grupo 2 : crosectomía alta sin sección vascular (HCWVS) . En ambos grupos el seguimiento se realizó a los 12 y 24 meses por estudio eco- Doppler. Resultados. La incidencia de recidiva varicosa a los 12meses de seguimiento fue de 69,3 % en el grupo de pacientes sometidos a safenectomía clásica, mientras que en el grupo que recibió HCWVS fue 29,3 % (p < 0,0001).Estas diferencias, aunque menores, siguen siendo estadísticamente significativa a los 24 meses de evolución (76 % vs 48 %, p = 0,0004). El tipo más común de recurrencia es del tipo I, con diferencias estadísticamente significativas a los 12 y 24 meses. Conclusiones. La crosectomía alta sin sección vascular tiene una probabilidad global de recurrencia significativamente menor que la safenectomía clásica a los 12 meses (29,3 % frente a 69,3 % ) , que sigue siendo , aunque más pequeña , estadísticamente significativa a los dos años de evolución ( 48 % vs 76 % ) . La tasa de recurrencia del tipo reticular es significativamente menor en el grupo de pacientes sometidos a alta crosectomía sin sección vascular que en los sometidos a safenectomía clásica (AU)

Background. This study was designed with the purpose of defining a new surgical procedure for varicose veins surgery and to be compared with classic crossectomy interms of reducing varicose recurrence rate. Material and methods. Double-blind randomized clinical trial. For easy access, we selected 150 patients who came to Phlebology Unit Consultation, meeting the criteria for inclusion in the study with their informed consent, to be included in a study group using random table numbers table numbers. Group 1: (CS) Saphenectomy classic 75 patients. Group 2: (HCWVS) High crossectomy without vascular sectioning. In both groups the monitoring was conducted at 12 and 24 months by Eco-Doppler study. Results. The incidence of varicose recurrence at 12months follow up was 69.3% in the group of patients undergoing CS, while in the group receiving HCWVS was29.3% (p <0.0001). These differences, though minor, remain statistically significant at 24 months of evolution (76% vs. 48%, p = 0.0004). The most common type of recurrence is the type I with statistically significant differences at 12 and 24 months. Conclusions. High crossectomy without vascular section has a global recurrence probability significantly lower than with classic saphenectomy at 12 months (29.3% vs. 69.3%), which remains, though smaller, statistically significant at two years of evolution (48% vs.76%). The recurrence reticular type rate is significantly lower in the group of patients undergoing high crossectomy without vascular section compared to those undergoing saphenectomy with classic crossectomy (AU)

Pseudo-hypertriglyceridaemia or hyperglycerolemia?

Hyperglycerolemia is a very rare genetic disorder caused by glycerol kinase deficiency. Although usually is presented unexpectedly in routine checks, there are severe forms, especially in children. In general, glycerol and glycerol kinase activity analyses are not included in routine laboratory determination. Glycerol presents positive interferences with some biochemical analytic techniques, e.g. in serum triglycerides and plasma ethylene glycol levels assays. Here, we report a Spanish patient with a pseudo-hypertriglyceridaemia, a falsely elevated triglycerides concentration that was not corrected with lipid-lowering therapy for 3 years (AU)

La hiperglicerolemia es una patología debida a la deficiencia de la enzima glicerol cinasa que cursa con concentraciones elevadas de glicerol. Hay diferentes manifestaciones de la enfermedad, especialmente en niños. La dificultad diagnóstica se debe a que la actividad de la enzima glicerol cinasa no está disponible en la mayoría de laboratorios públicos. Además, la cuantificación de triglicéridos en suero presenta una interferencia analítica con la determinación de glicerol ya que la mayoría de los métodos no realizan un blanco de glicerol, y este se cuantifica junto con los triglicéridos. Presentamos un caso de un niño con hiperglicerolemia de 3 años de evolución, enmascarada por una falsa elevación de triglicéridos en sangre debido a una interferencia analítica

Pseudo-hypertriglyceridaemia or hyperglycerolemia?

Hyperglycerolemia is a very rare genetic disorder caused by glycerol kinase deficiency. Although usually is presented unexpectedly in routine checks, there are severe forms, especially in children. In general, glycerol and glycerol kinase activity analyses are not included in routine laboratory determination. Glycerol presents positive interferences with some biochemical analytic techniques, e.g. in serum triglycerides and plasma ethylene glycol levels assays. Here, we report a Spanish patient with a pseudo-hypertriglyceridaemia, a falsely elevated triglycerides concentration that was not corrected with lipid-lowering therapy for 3 years.

High crossectomy without vascular sectioning vs classic saphenectomy. Randomized clinical trial: analysis of recurrent varicose veins.

BACKGROUND: This study was designed with the aim of defining a new surgical procedure for varicose veins and for comparison with classic crossectomy in terms of reducing the recurrence rate of varicose veins. MATERIAL AND METHODS: Double-blind randomized clinical trial. For easy access, we selected 150 patients who came to the Phlebology Consultation Unit meeting inclusion criteria. With their informed consent, they were included in a study group using random table numbers. Group 1: (CS) Classic saphenectomy, 75 patients. Group 2: (HCWVS) High crossectomy without vascular sectioning. Both groups were monitorised at 12 and 24 months by Eco-Doppler study. RESULTS: The incidence of varicose vein recurrence at 12 month follow-up was 69.3% in the group of patients undergoing CS, while in the group receiving HCWVS it was 29.3% (p <0.0001). These differences, though minor, remained statistically significant at 24 months of evolution (76% vs. 48%, p = 0.0004). The most common recurrence type was type I, with statistically significant differences at 12 and 24 months. CONCLUSIONS: We believe that saphenectomy with crossectomy without vascular sectioning is the appropriate procedure to treat varicose veins, reducing type 1 or reticular relapse rate and maintaining the principles of classic surgery to reduce type 2 or truncular recurrence rate. This technique should be implemented with procedures based on saphenous sclerosis with foam art the saphenous femoral junction, in order to assess the recurrence rate of type 2 or truncular varicose veins.

Insuficiencia de venas perforantes en miembros inferiores. ligadura subfascial endoscópica / Incompetent perforating veins in the lower extremities. Endoscopic subfascial ligature

El papel de las venas perforantes incompetentes en la enfermedad venosa crónica está bien establecido. La localización de las venas perforantes y la valoración de su alteración hemodinámica se realizó mediante exploración clínica y eco-Doppler. De 1999 a 2000, 50 pacientes diagnosticados de insuficiencia de venas perforantes fueron sometidos a ligadura subfascial endoscópica de venas perforantes incompetentes, con o sin safenectomía por stripping. La ligadura subfascial permite la curación de las úlceras venosas y la drástica reducción de la tasa de recurrencia de las mismas, así como una rápida curación de las heridas quirúrgicas y un buen resultado estético. (AU)

[Breast metastasis of bladder carcinoma: report of a case]. / Metástasis mamaria de carcinoma vesical: a propósito de un caso.

OBJECTIVE: To report a case of carcinoma of the bladder metastatic to the mammary gland. METHODS: A 72-year-old male with mammary gland metastasis secondary to a bladder carcinoma is described. The more common routes of tumor spread and the approach to these lesions are discussed. CONCLUSIONS: The prognosis for this type of lesion is poor except in a rare few.