Effects of concurrent canine Cushing's syndrome and diabetes Mellitus on insulin requirements, trilostane dose, and survival time.

Trilostane and insulin requirements and survival time of dogs with concurrent naturally-occurring Cushing's syndrome (CS) and diabetes mellitus (DM) has not been fully investigated. This retrospective study evaluated trilostane and insulin doses in dogs with concurrent CS and DM compared to dogs with only CS or DM. Additionally, a survival analysis was performed using a Kaplan-Meier survival curve. Survival time was compared through Log-rank test. Cox proportional regression method was used to screen predictor factors of death in dogs with CS, DM or concurrent CS and DM. A total of 95 dogs were included, 47 dogs had CS, 31 dogs had DM and 17 dogs had concurrent CS and DM. After long-term follow-up, dogs with concurrent CS and DM required higher final median doses of insulin than dogs with DM [0.90 (0.73-1.1) vs 0.67 (0.55-0.73) u/kg/12 h; P = 0,002]. Conversely, the median trilostane requirements in dogs with concurrent CS and DM did not differ from the median trilostane requirements of dogs with CS [1.52 (0.76-2.80) vs 1.64 (1.19-4.95) mg/kg/day; P = 0.283]. No statistical difference was found for the median survival time between dogs with CS and dogs with concurrent CS and DM (1245 vs 892 days; p = 0.152). Although, median survival time of dogs with DM was not reached, it was longer than median survival time of dogs with CS and DM (892 days; P = 0.002). In conclusion, diabetic dogs with concurrent CS need higher insulin doses and have a shorter survival time compared to diabetic dogs without CS.

Prevalence and seasonal variation of Fasciola hepatica in slaughtered cattle: the role of climate and environmental factors in Mexico.

The objective of this study is to determine the prevalence of Fasciola hepatica infection in cattle slaughterhouses, as well as its association with climatic/environmental factors (derived from satellite data), seasonality and climate regions in two states in Mexico. Condemned livers from slaughtered animals were obtained from three abattoirs in the states of Puebla and Veracruz. The overall prevalence of the parasite in cattle between January and December of 2017 was 20.6% (1407 out of 6834); the highest rate of condemnation was observed in Veracruz (26.3%; tropical climate), and the lowest rate was found in Puebla (15.5%; temperate climate). The seasonal prevalence of fluke infection was 18.6%, 14.8% and 28.4% during the wet season, and 17.1%, 12.4% and 22.8% during the dry season in the three abattoir sites, located in the districts of Zacatlán, Teziutlán and Ciudad Alemán, respectively. Liver condemnations due to bovine fasciolosis were prevalent in the Zacatlán, Teziutlán and Ciudad Alemán districts during summer, autumn and summer, respectively. Using generalized estimating equations analysis, we determined six variables - rainfall (wet/dry), land surface temperature day, land surface temperature night, normalized difference vegetation index, seasonality and climate regions (temperate/tropical) - to be significantly associated with the prevalence of condemned livers. Climate region was the variable most strongly associated with F. hepatica infection (odds ratio (OR) 266.59; 95% confidence interval (CI): 241.90-353.34), followed by wet and dry seasons (OR 25.56; 95% CI: 20.56-55.67).

Mercury in sediment cores from the southern Gulf of Mexico: Preindustrial levels and temporal enrichment trends.

Spatial and temporal variability of mercury concentrations in sediments was evaluated in 210Pb-dated sediment cores from offshore and intertidal areas in the southern Gulf of Mexico. In offshore cores, mercury concentrations were comparable (11.2-69.2 ng g-1), and intermediate between concentrations in intertidal cores from the eastern (6.0-34.4 ng g-1) and the western (34.9-137.7 ng g-1) inlets of Términos Lagoon. The enrichment factor (EF) indicated minimal contamination (EF < 2) in most offshore cores, whereas in some intertidal cores steadily increasing mercury enrichment and fluxes were observed along the past century. No evidence of oil industry related mercury contamination was found, as the minor but increasing enrichment in intertidal cores is most likely related to land-derived sources such as catchment eroded soils and waste water runoff. Results highlight the importance to control catchment erosion and untreated sewage releases to reduce mercury loadings to the coastal zone.

Carbon burial and storage in tropical salt marshes under the influence of sea level rise.

Coastal vegetated habitats can be important sinks of organic carbon (Corg) and mitigate global warming by sequestering significant quantities of atmospheric CO2 and storing sedimentary Corg for long periods, although their Corg burial and storage capacity may be affected by on-going sea level rise and human intervention. Geochemical data from published 210Pb-dated sediment cores, collected from low-energy microtidal coastal wetlands in El Salvador (Jiquilisco Bay) and in Mexico (Salada Lagoon; Estero de Urias Lagoon; Sian Ka'an Biosphere Reserve) were revisited to assess temporal changes (within the last 100years) of Corg concentrations, storage and burial rates in tropical salt marshes under the influence of sea level rise and contrasting anthropization degree. Grain size distribution was used to identify hydrodynamic changes, and δ13C to distinguish terrigenous sediments from those accumulated under the influence of marine transgression. Although the accretion rate ranges in all sediment records were comparable, Corg concentrations (0.2-30%), stocks (30-465Mgha-1, by extrapolation to 1m depth), and burial rates (3-378gm-2year-1) varied widely within and among the study areas. However, in most sites sea level rise decreased Corg concentrations and stocks in sediments, but increased Corg burial rates. Lower Corg concentrations were attributed to the input of reworked marine particles, which contribute with a lower amount of Corg than terrigenous sediments; whereas higher Corg burial rates were driven by higher mass accumulation rates, influenced by increased flooding and human interventions in the surroundings. Corg accumulation and long-term preservation in tropical salt marshes can be as high as in mangrove or temperate salt marsh areas and, besides the reduction of Corg stocks by ongoing sea level rise, the disturbance of the long-term buried Corg inventories might cause high CO2 releases, for which they must be protected as a part of climate change mitigation efforts.

Experimental evidences of 95 mTc production in a nuclear reactor.

95 mTc has been identified as by-product in some solutions of 99 mTc obtained by irradiation of molybdenum trioxide in a reactor neutron flux. The characterization was carried out using both measurements by gamma spectrometry and half-life determination. The possible ways that lead to the 95 mTc production in a nuclear reactor are discussed.

Gestational surrogacy. Medical, psychological and legal aspects: 9 years of experience in Mexico.

STUDY QUESTION: What are the medical, psychological and legal aspects involved in running a gestational surrogacy (GS) program in Mexico? SUMMARY ANSWER: The correct and complete implementation of a medical protocol, adherence to legality and psychological screening are key elements for the success of a GS program. WHAT IS KNOWN ALREADY: To our knowledge, this is the first reported GS case series in Mexico. STUDY DESIGN SIZE DURATION: This was a retrospective, descriptive study of 135 cycles performed between 2007 and 2016 at a fertility center in Villahermosa, Tabasco, Mexico. PARTICIPANTS/MATERIALS SETTING METHOD: We analyzed data from 135 GS cycles, 57 intended parents (IP) and 63 gestational carriers (GC). MAIN RESULTS AND THE ROLE OF CHANCE: GS in Mexico is only allowed in its altruistic mode. The legal requirements for the GCs are age 25-35 years and a complete medical examination that certifies no pregnancy during the last 365 days before embryo transfer and excludes infectious and chronic diseases. The IPs must be aged 25-40 years of age, have Mexican citizenship, and provide life insurance and medical expenses for the GCs. The GC recruitment was carried out by word of mouth. Of the 150+ women that requested information, 89 were identified as possible candidates. In total, 77 underwent the psychological evaluation protocol and nine were rejected owing to behavior and emotional alterations, giving 68 who began the medical selection protocol. Five women were not accepted as they were positive for human papilloma virus, or had experienced endometrial polyposis or recurrent pregnancy loss. Finally, 63 women entered the IVF protocol as GCs. The indications for GS were: hysterectomy 32%, implantation failure 21%, single fathers 14%, maternal medical condition 14%, recurrent pregnancy loss 11%, previous pregnancy complication 5% and uterine pathologies 3%. The mean age of intended mothers was 38.8 years. The average number of embryos transferred per cycle was 1.9, with 22.2% of cycles resulting in pregnancies. The live-birth rate per IP was 33.3%, 18.5% of cycles resulted in live births, with 24% of live births being twins. LIMITATIONS REASONS FOR CAUTION: Owing to the retrospective nature of this study conclusions must be drawn accordingly. WIDER IMPLICATIONS OF THE FINDINGS: As the first article addressing GS in Latin America, it may serve as a reference for future practice and publications. The results demonstrate the importance of having an assisted reproduction program in the form of GS. STUDY FUNDING/COMPETING INTERESTS: There was no external funding used and there are no conflicts to report.

Concepto actual de la patogénesis de la periimplantitis y el papel que ocupan las bacterias / Actual concept of the pathogenesis of the periimplantitis and the role that bacterial have

A través de una extensa revisión de la literatura, nuestro objetivo será esclarecer el concepto actual que existe sobre la patogénesis de la periimplantitis, así como las implicaciones que pueden tener las bacterias sobre la misma. Hasta la fecha diferentes estudios longitudinales y transversales han identificado algunos de los factores de riesgo o indicadores de riesgo de la periimplantitis. Historia previa de enfermedad periodontal, diabetes, carga genética, pobre higiene oral, tabaco, consumo de alcohol, ausencia de encía queratinizada y la superficie de los implantes son algunos de factores que han sido analizados en detalle en la literatura. La colonización de nuevas superficies implantadas quirúrgicamente suponen una situación de riesgo en pacientes parcialmente edéntulos, donde las bacterias periodontopatógenas de la bolsa residual tienen un importante papel

With the intention of clarifaying the current concept of the pathogenesis of the periimplantitis and the implications that bacteria could have in it, an extensive literature review has been made. Till the date, different longuitudinal and cross-sectional studies have identified some of the periimplantitis risk factors or risk indicators. Factors as history of periodontitis, diabetes, genetic traits, poor oral hygiene, smoking, alcohol consumption, absence of keratinized mucosa and implant surface have been analyzed in detail. The colonization of the surgical implanted new surfaces act as a risky situation for partial edentulous patients, where periodontopathogenic bacteria of the residual pocket have and important role

Evolución nutricional de niños y niñas menores de 5 años usuarios de un Programa Alimentario Nutricional Integral en Paraguay

Introducción: La desnutrición es un desafío pendiente que influye nocivamente en el desarrollo de los niños/as y de una nación. Objetivo: Evaluar la evolución del estado nutricional de niños/as <5 años ingresados a un programa alimentario durante el año 2012. Materiales y Métodos: Estudio longitudinal (cohorte), descriptivo, analítico de beneficiarios del Programa Alimentario Nutricional Integral (PANI) en el 2012.Variables sociodemográficas fueron consideradas, el diagnóstico nutricional según criterios OMS según puntaje zPeso/Edad (zP/E), Índice de Masa Corporal/Edad (zIMC/E), Talla/Edad (zT/E). Resultados: Fueron procesados datos de 4946 niños/as <5años. Edad media 17,5m (0,03-59 m), 50,3% varones; 51,4% del área rural. Al ingreso, tuvieron media zP/E-1,71±0,7DE, zIMC/Edad -1,31±1,12DE y zT/E -1,34±1,30 DE. El zP/E en controles sucesivos aumentó a -0,36 DE en el 12vo. control, el zIMC/E a 0,26DE,zT/E a -0,91 de manera significativa (ANOVA p<0,0001). 22,6% presentaban Desnutrición Global-DG y 77,4% de riesgo de desnutrir al ingreso, estas prevalencias fueron de 3,4% y 21% respectivamente con 75,6% de niños/as sin desnutrición al último control ((2,p<0,0001). 21,9% tuvieron desnutrición por IMC, y 38,5%% de riesgo de desnutrir, estas prevalencias fueron de 3,1% y 10,7% al 12vo. control. Del 26% de Desnutrición Crónica-DC, se pasó a 16% al final de la intervención. Conclusiones: La desnutrición infantil disminuye significativamente con el apoyo de un programa alimentario.

Introduction: Malnutrition is a pending challenge which has a harmful influence on children's development of and for a nation. Objective: To evaluate the evolution of nutritional status of children <5 years admitted to an Integrated Nutritional Food Program (PANI) during the year 2012. Materials and Methods: Longitudinal (cohort), descriptive and analytical study of beneficiaries of the Integrated Nutritional Food Program (PANI) in 2012. Sociodemographic variables were considered, nutritional diagnosis was according to WHO criteria with zscore Weigth/Age (z(W/A), Body Mass Indesx/Age (zBMI/A) and Heigth/Age (zH/A). Results: Data were processed from 4946 children <5 years old. Mean age 17.5m (0.03-59 m), 50.3% males; 51.4% of the rural area. At entry, they had mean zW/A -1.71 ± 0.7DE, zBMI/A -1.31 ± 1.12 DE and zH/A -1.34 ± 1.30DE. The zW/A in successive controls increased to -0.36DE in the 12th control, zBMI/A at 0.26DE, zH/A at -0.91 significantly (ANOVA p <0.0001). 22.6% presented Global Malnutrition-DG and 77.4% risk of malnutrition at admission, these prevalences were 3.4% and 21%, respectively, with 75.6% of children without malnutrition at the last control ((2, p<0.0001). 21.9% had malnutrition due to BMI, and 38.5% had a risk of malnutrition, these prevalences were 3.1% and 10.7% at the 12th control. Of the 26% of Chronic Malnutrition-DC, it was changed to 16% at the end of the intervention. Conclusions: Child undernutrition decreases significantly with the support of a food program.

Lipids rich in ω-3 polyunsaturated fatty acids from microalgae.

Despite microalgae recently receiving enormous attention as a potential source of biodiesel, their use is still not feasible as an alternative to fossil fuels. Recently, interest in microalgae has focused on the production of bioactive compounds such as polyunsaturated fatty acids (PUFA), which provide microalgae a high added value. Several considerations need to be assessed for optimizing PUFA production from microalgae. Firstly, a microalgae species that produces high PUFA concentrations should be selected, such as Nannochloropsis gaditana, Isochrysis galbana, Phaeodactylum tricornutum, and Crypthecodinium cohnii, with marine species gaining more attention than do freshwater species. Closed cultivation processes, e.g., photobioreactors, are the most appropriate since temperature, pH, and nutrients can be controlled. An airlift column with LEDs or optical fibers to distribute photons into the culture media can be used at small scale to produce inoculum, while tubular and flat panels are used at commercial scale. Depending on the microalgae, a temperature range from 15 to 28 °C and a pH from 7 to 8 can be employed. Relevant conditions for PUFA production are medium light irradiances (50-300 µmol photons m(-2) s(-1)), air enriched with (0-1 % (v/v) CO2, as well as nitrogen and phosphorous limitation. For research purposes, the most appropriate medium for PUFA production is Bold's Basal, whereas mixotrophic cultivation using sucrose or glucose as the carbon source has been reported for industrial processes. For cell harvesting, the use of tangential flow membrane filtration or disk stack centrifugation is advisable at commercial scale. Current researches on PUFA extraction have focused on the use of organic solvents assisted with ultrasound or microwaves, supercritical fluids, and electroporation or are enzyme assisted. Commercial-scale extraction involves mainly physical methods such as bead mills and expeller presses. All these factors should be taken into account when choosing a PUFA production system, as discussed in this review.

Boston type I keratoprosthesis for treatment of gelatinous drop-like corneal dystrophy after repeated graft failure.

PURPOSE: To describe the use of a Boston type I keratoprosthesis as a secondary penetrating procedure to treat gelatinous drop-like corneal dystrophy (GDLD), with presentation of pathologic findings, genetic analysis, and discussion of other surgical options. METHODS: A 43-year-old woman with GDLD in both eyes, best corrected visual acuity (BCVA) of counting fingers in both eyes, and recurrent corneal opacification following two penetrating keratoplasties presented for visual rehabilitation. A Boston type I keratoprosthesis was implanted in her left eye after extracapsular clear lens extraction. RESULTS: The surgery was uneventful and one month after surgery, best corrected vision improved to 20/30, which has been maintained for a period of more than nine months. At the 12-month visit, her vision was noted to be diminished to 20/200 due to a retroprosthetic membrane and improved to 20/25 two weeks after a Yag capsulotomy. Histopathologic examination of the corneal specimen disclosed predominantly subepithelial amyloid deposition. Genetic analysis is presented. CONCLUSIONS: GDLD is a rare disorder of primary corneal amyloidosis. Recurrence of this condition following surgery is very common. Boston type I keratoprosthesis as a secondary procedure can be successful in restoring vision in affected patients.

Morphology and mycelial growth rate of Pleurotus spp. strains from the Mexican mixtec region.

Two native Pleurotus spp. strains (white LB-050 and pale pink LB-051) were isolated from rotten tree trunks of cazahuate (Ipomoea murucoides) from the Mexican Mixtec Region. Both strains were chemically dedikaryotized to obtain their symmetrical monokaryotic components (neohaplonts). This was achieved employing homogenization time periods from 60 to 65 s, and 3 day incubation at 28 °C in a peptone-glucose solution (PGS). Pairing of compatible neohaplonts resulted in 56 hybrid strains which were classified into the four following hybrid types: (R(1-n)xB(1-n), R(1-n)xB(2-1), R(2-n)xB(1-n) and R(2-n)xB(2-1)). The mycelial growth of Pleurotus spp. monokaryotic and dikaryotic strains showed differences in texture (cottony or floccose), growth (scarce, regular or abundant), density (high, regular or low), and pigmentation (off-white, white or pale pink). To determine the rate and the amount of mycelium growth in malt extract agar at 28 °C, the diameter of the colony was measured every 24 h until the Petri dish was completely colonized. A linear model had the best fit to the mycelial growth kinetics. A direct relationship between mycelial morphology and growth rate was observed. Cottony mycelium presented significantly higher growth rates (p < 0.01) in comparison with floccose mycelium. Thus, mycelial morphology can be used as criterion to select which pairs must be used for optimizing compatible-mating studies. Hybrids resulting from cottony neohaplonts maintained the characteristically high growth rates of their parental strains with the hybrid R(1-n)xB(1-n) being faster than the latter.

Morphology and mycelial growth rate of Pleurotus spp. strains from the Mexican mixtec region

Two native Pleurotus spp. strains (white LB-050 and pale pink LB-051) were isolated from rotten tree trunks of cazahuate (Ipomoea murucoides) from the Mexican Mixtec Region. Both strains were chemically dedikaryotized to obtain their symmetrical monokaryotic components (neohaplonts). This was achieved employing homogenization time periods from 60 to 65 s, and 3 day incubation at 28 °C in a peptone-glucose solution (PGS). Pairing of compatible neohaplonts resulted in 56 hybrid strains which were classified into the four following hybrid types: (R1-n xB1-n, R1-n xB2-1, R2-n xB1-n and R2-n xB2-1). The mycelial growth of Pleurotus spp. monokaryotic and dikaryotic strains showed differences in texture (cottony or floccose), growth (scarce, regular or abundant), density (high, regular or low), and pigmentation (off-white, white or pale pink). To determine the rate and the amount of mycelium growth in malt extract agar at 28 °C, the diameter of the colony was measured every 24 h until the Petri dish was completely colonized. A linear model had the best fit to the mycelial growth kinetics. A direct relationship between mycelial morphology and growth rate was observed. Cottony mycelium presented significantly higher growth rates (p < 0.01) in comparison with floccose mycelium. Thus, mycelial morphology can be used as criterion to select which pairs must be used for optimizing compatible-mating studies. Hybrids resulting from cottony neohaplonts maintained the characteristically high growth rates of their parental strains with the hybrid R1-n xB1-n being faster than the latter.

Consideraciones anatómicas durante la cirugía periodontal / Anatomic considerations during periodontal surgery

En el presente trabajo hemos realizado una revisión bibliográfica de la literatura con el objetivo de esclarecer las consideraciones anatómicas que deben tenerse en cuenta a la hora de realizar cirugía periodontal, que posibles estructuras anatómicas podemos encontrarnos al elevar un colgajo y cómo podemos evitar la lesión de las mismas. También aportamos un breve repaso sobre conceptos y referencias anatómicas que los especialistas debemos tener presentes durante el manejo de los tejidos blandos y duros

For the present work, we have made a revision through the literature with the objective to clarify the anatomic considerations that should be considered during periodontal surgery, which anatomic structures we could find when raising a flap and how could we avoid injury. Also we have made a short review of the concepts and anatomic references that the specialists should take into consideration during the management of soft and hard tissues

On the role of Rab5 in cell migration.

Uncontrolled endosome trafficking is a common feature of certain cancer cells, which has been acknowledged during the last decade. Migration and invasiveness of metastatic tumor cells are both regulated by components of the endocytic machinery, including Rab proteins. Rab GTPases are essential in processes of endosome fusion, as well as targeting, tethering and transport along the cytoskeleton. In addition to this canonical role, some Rabs depict other functions, such as controlling cell proliferation, apoptosis, adhesion and motility. Here, we review our current knowledge on the role of Rab5, a key regulator of early endosome dynamics, in migration of normal and tumor cells. Rab5 promotes cell migration in vitro and in vivo by mechanisms described at different levels. One such mechanism is by controlling the rates of integrin internalization and recycling, thereby affecting its activation and availability at the cell surface. On the other hand, Rab5 promotes focal adhesion disassembly and modulates downstream pathways of integrin signaling, involving proteins such as Ras and Rho family GTPases. In this context, identification of upstream regulators and downstream effectors of Rab5, and their study represents a big challenge in order to understand how cancer cells depend on endosome control, in order to acquire more aggressive traits that lead to metastatic disease.

Stapled transanal longitudinal posterior proctectomy (STALPP) in total rectal prolapse: a 7-year experience.

BACKGROUND: Surgical management of complete rectal prolapse is challenging. We present our results with the novel technique stapled transanal longitudinal posterior proctectomy (STALPP) in patients with complete rectal prolapse. METHODS: We performed a retrospective study in two hospitals from January 2005 to December 2012. Twenty-one patients with complete rectal prolapse were included. In all patients, STALPP was performed. The study variables were operative time, intraoperative bleeding, number of cartridges used, length of rectum prolapsed through the anus, length of rectal wall resected, length of hospital stay and preoperative and postoperative Wexner continence score and manometric measurement of anal canal resting tone and squeeze pressure. RESULTS: The median length of prolapsed tissue was 13 cm; the mean Wexner score in the preoperative and postoperative period was 15.95 and 4.95, respectively (p = 0.025). The mean resting tone improved from 23.3 to 32.85 mmHg postoperatively (p = 0.03), as did maximal squeeze pressure from 31 to 62.7 mmHg (p = 0.003). Median operative time was 65 min; median intraoperative bleeding was 12 ml; there was no postoperative bleeding, and no reinterventions were required. The median number of cartridges used was 4. The median length of resected wall in the right posterolateral sector was 8 and 6 cm in the left. The median length of hospital stay was 4 days, and the mean follow-up period was 2 years. No mortality was reported. CONCLUSIONS: Stapled transanal longitudinal posterior proctectomy is a safe and feasible surgical alternative for patients with complete rectal prolapse.

[Staging gastritis with the OLGA system: prevalence of advanced stages of gastric atrophy in Mexican patients]. / Estadificación de la gastritis con el sistema OLGA; prevalencia de estadios avanzados de atrofia gástrica en pacientes mexicanos.

INTRODUCTION: Gastric adenocarcinoma of intestinal type is preceded by inflammation, which produces mucosal atrophy and intestinal metaplasia, progressing eventually to dysplasia and invasive cancer. Recently an international group, the Operative Link on Gastritis Assessment (OLGA) proponed a staging system for gastric biopsies. OBJECTIVE: To recognize the distribution of advanced stages of gastric mucosal atrophy in Mexican patients with dyspepsia according to the OLGA system. METHODS: We apply the OLGA system for cancer risk (Stages 0 to IV) to 322 gastric biopsies from consecutive patients with dyspepsia. Using the Sydney protocol, we recorded the presence of atrophy, dysplasia and the relationship with ulcer disease. We report the stage of atrophy for each region and the Helicobacter pylori infection status. RESULTS: We documented 72 (22.4%) cases with atrophy, 50 of them (69.4%) were metaplastic-type. Overall, nine biopsies (2.78%) were stage III (all of them with metaplastic-type atrophy) and there was not stage IV cases. We did not find high-grade dysplasia or intramucosal carcinoma. In 8 of subjects with stage III, we observed low-grade dysplasia. We documented gastric ulcer in 5 patients with stage II, 60% of them with associated low-grade dysplasia. Five patients with duodenal ulcer were found in stages 0 and I. CONCLUSIONS: We found low prevalence of advanced stages of mucosal gastric atrophy among patients with dyspepsia. However we recognized 9 patients with stage III according to OLGA system worthy of follow-up because the high risk for developing gastric cancer.

The current state of robot assisted radical prostatectomy.

AIM: The introduction of robotics in the operating room made its first major impact in the arena of prostate cancer. Robot assisted radical prostatectomy (RARP) is the most commonly performed surgery for prostate cancer in the United States. METHODS: In this review article, we discuss the history of robotic prostatectomy as well as the benefits and drawbacks of the robotic surgical platform. Our University of Pennsylvania technique is described. Patient selection, peri-operative factors, oncological data, and functional outcomes specific to RARP are addressed. RESULTS: While cost remains a valid criticism to the robotic technique, some of the additional expenditure is offset by improved convalescence, fewer medical complications, and decreased morbidity. Data with follow up approaching 10 years demonstrates equal if not superior outcomes with respect to continence, sexual and oncological factors. CONCLUSION: The diligent efforts of many have led to the rapid evolution of robot assisted radical prostatectomy. There is a renewed interest in the anatomy, oncological outcomes, and functional consequences of prostatectomy. With technological advances occurring at an accelerating rate, the advances in surgery should be very exciting indeed.

¿Existe suficiente evidencia en la literaturapara considerar el tabaco y el alcohol como principales factores de riesgo del cáncer de lengua? / Is there enough evidence to consider tobacco and alcohol as the main risk factors in tongue cancer?

Para el presente trabajo hemos hecho una revisión en la literatura con el fin de esclarecer los posibles interrogantes sobre la influencia que pueden tener los factores de riesgo como tabaco y alcohol sobre el cáncer de lengua. Nos centraremos principalmente en la etiología, incidencia, localización, distribución geográfica, prevalencia, pronóstico y supervivencia de la enfermedad, prestando especial atención a la prevención, a las medidas que se deben tomar enfocadas a mejorar el estilo de vida y a la realización del diagnóstico precoz. De esta manera mejorará al mismo tiempo el pronóstico, siendo más fácil de curar la enfermedad. Finalmente, tras la revisión realizada, afirmamos que el tabaco y el alcohol son los principales factores de riesgo del Cáncer Oral de Células Escamosas (COCE) de lengua, independientemente de que se encuentren de manera conjunta o por separado (AU)

For the present paper, we have made a revision through the literature with the objective to clarify some questions about the influence that tobacco and alcohol can have as risk factors on tongue cancer. We will focus on the aetiology, incidence, location, geographic distribution, prevalence, prognosis and survival of the disease, paying special attention to prevention. We will also review the measures that should be taken to improve patient life quality and the early diagnose. In this way prognoses will be improved making it easier for the elimination of the disease. Finally we conclude that tobacco and alcohol are the main risk factors for tongue cancer, acting together or in a separate way (AU)