Development of type 2 diabetes mellitus thirty-one years after Billroth II in a patient asking for diabetes surgery

Introduction: Diabetes surgery in obese and slim patients seems to be a superior alternative to the current medical treatment. Gastric bypass is an alternative treat- ment for diabetes. Nevertheless, there are still doubts whether diabetes can recur if you gain weight or if the effects are maintained over time. Other questions refer to the type of surgery to make the bypass limb length or reservoir size for the resolution of the Diabetes Mellitus. Presentation of case: Male patient 69-year-old came to us in order to perform tailored One Anastomosis Gastric Bypass (BAGUA) to treat his type 2 diabetes mellitus and metabolic syndrome. He has a history of peptic ulcer treated with subtotal gastrectomy and Billroth II recons- truction 49 years ago. He currently is not obese and deve- loped diabetes 31 years after surgery. Discussion: Globally there are no reports of patients with normal BMI that after performing gastric bypass developed diabetes mellitus. There are cases where obese diabetic patients after gastric bypass improve or remits the T2DM, but it relapses due to insufficient weight loss or gain it. The patient with gastric bypass Billroth II type, should not developed diabetes. He is normal weight and not had weight gain that could be linked to the develop- ment of diabetes. Conclusions: The results generated by bariatric surgery are encouraging, but still do not clarify the precise way how surgery produces rapid improvement of systemic metabolism as in diabetes, but in our patient, the effect was quite different because the gastric bypass had no protective effect against diabetes

Bochdalek hernia associated with intestinal malrotation as an incidental finding in an adult patient: case report

Bochdalek hernia (BH) is the most common congenital diaphragmatic hernia, however in adults the clinical presentation and diagnosis is rare. Intestinal malrotation (IM) is a congenital anomaly that results in an alteration in intestinal anatomy secondary to inadequate intestinal rotation, which occurs at the end of the first trimester of embryonic development, some digestive anomalies may be related, such as diaphragmatic hernia, its Diagnosis is made in the neonatal period although it can be diagnosed in older children and adults, debuting with symptoms of intestinal obstruction or being an incidental finding. Below we present a case report of an adult patient with a diagnosis of Bochdalek congenital diaphragmatic hernia (CDH) in whom an incidental diagnosis of IM was made, who underwent elective surgery, performing laparoscopic diaphragmatic plasty with favorable results

Yeserías históricas de Valdemoro, Madrid

Valdemoro es un municipio del Sur de Madrid que se asienta sobre terrenos yesíferos del Aragoniense (Mioceno Medio). La pureza de estos minerales ha hecho que, en palabras de ANASTASIODE LA CALLE (1890), sea "apreciado como yeso de la mejor calidad". En definitiva por su cercanía a la capital y características del yacimiento, en esta localidad se han ubicado históricamente mas de 20 industrias yeseras, algunas de una cierta entidad. Estas fábricas desparecieron cuando los homos discontinuos y de escasa capacidad dejaron paso a procesos continuos de gran capacidad. En los años 60-70del siglo XX dejaron de funcionar centenares de homos de yeso en la Comunidad de Madrid. Ahora, por causa de la presión antrópica que supone el incremento poblacional e industrial de Valdemoro, solo quedan escasos restos de la ingente producción yesera local. Los cuales conviene preservar como memoria de la principal actividad industrial del municipio. Con motivo de un Proyecto de Investigación de la Consejería de Educación y Cultura de la Comunidad de Madrid (programa de Humanidades y Ciencias Sociales), titulado:"Arqueología Industrial: Conservación del Patrimonio Minero Metalúrgico madrileño (IV)"hemos inventariado las ruinas de algunos homos antiguos empleados para fabricar yeso

Yeserías y caleras de Valverde de Alcalá (Madrid)

En el SE de Madrid hemos reconocido en campo decenas de antiguas yeserías en el marco de un proyecto de investigación de la Consejería de Educación de la Comunidad de Madrid titulado: Arqueología Industrial: Conservación del Patrimonio Minero-Metalúrgico madrileño (IV) (06/HSE/0115/2004). Hemos inventariado y valorado los restos arqueoindustriales, reconstruyendo los procesos productivos, gracias al análisis de datos en campo, aportes bibliográficos, así como entrevistar, en algún caso, a algún antiguo yesero. Estas industrias históricas han perdurado durante siglos sin variación metodológica, hasta que en los años sesenta-setenta los tradicionales procesos discontinuos fueron sustituidos por otros continuos y de mayor capacidad. Los trabajadores ya jubilados van desapareciendo a la par que estos restos

Yeserías históricas de Morata de Tajuña (Madrid)

En Morata de Tajuña y pueblos limítrofes hay una importante tradición yesera y calera, así como de otras industrias de materiales de la construcción ya desaparecidas, sobre todo en los años 60-70 del pasado siglo, debido a cambios en los sistemas productivos (paso de sistemas discontinuos a continuos, hornos mayores, etc.). Por eso aún se conservan algunos hornos y también viven antiguos productores, a los que hemos podido preguntar sobre los procesos productivos

Chloroplasts modulate elongation responses to canopy shade by retrograde pathways involving HY5 and abscisic acid

Plants use light as energy for photosynthesis but also as a signal of competing vegetation. Using different concentrations of norflurazon and lincomycin, we found that the response to canopy shade in Arabidopsis (Arabidopsis thaliana) was repressed even when inhibitors only caused a modest reduction in the level of photosynthetic pigments. High inhibitor concentrations resulted in albino seedlings that were unable to elongate when exposed to shade, in part due to attenuated light perception and signaling via phytochrome B and phytochrome-interacting factors. The response to shade was further repressed by a retrograde network with two separate nodes represented by the transcription factor LONG HYPOCOTYL 5 and the carotenoid-derived hormone abscisic acid. The unveiled connection among chloroplast status, light (shade) signaling, and developmental responses should contribute to achieve optimal photosynthetic performance under light-changing conditions

Neonatal spontaneous biliary perforation: Case report

AbstractObjectiveSpontaneous biliary perforation in neonates is rare. The etiology of this pathology is idiopathic and various management strategies ranging from non-operative treatment to complex operations, such as biliary-enteric reconstruction, are performed, with few reported outcomes.Case reportA 3-week-old female, born at term, presented fever, abdominal distension, and acholic stool. An ultrasound was performed, which revealed generalized ascites and a poorly-defined collection. An emergency laparotomy confirmed perforation in the distal common bile duct and a biliary-enteric-anastomosis was performed.DiscussionWide drainage has been reported as the best initial management strategy for spontaneous biliary perforation, although it depends on the patient's clinical status and intraoperative findings.ConclusionsSpontaneous infantile biliary perforation is rare. Main management is wide drainage with, most perforations being resolved in 2 weeks