Efecto de la goma ar\ue1biga como aditivo a las sales de rehidrataci\uf3n oral en la recuperaci\uf3n de ratas sometidas a una diarrea secretora-osm\uf3tica

Introducci\uf3n: La diarrea aguda es una de las primeras causas de morbi-mortalidad en la poblaci\uf3n infantil a nivel mundial. Su principal complicaci\uf3n es la deshidrataci\uf3n, la cual es tratada con sales de rehidrataci\uf3n oral (SRO). Actualmente se han desarrollado investigaciones en b\ufasqueda de aumentar la eficacia de dicha terapia adicionando ciertas sustancias. Objetivo: evaluar el efecto de la Goma Ar\ue1biga (GA) como aditivo a las S.R.O. en ratas sometidas a diarrea secretora-osm\uf3tica. Metodolog\ueda: estudio experimental en 28 animales de experimentaci\uf3n (ratas), se dividieron en cuatro grupos: control, agua, S.R.O., S.R.O.+GA; se les indujo diarrea osm\uf3tica secretora, posteriormente fueron sometidas a un tratamiento de acuerdo al grupo al cual pertenec\uedan. Resultados: el grupo con S.R.O+GA gan\uf3 30,13\ub10,56 g de peso (7,95%), ingiri\uf3 101\ub132,48 ml de l\uedquido, increment\uf3 los niveles s\ue9ricos de sodio y potasio en 7,47% y 90,84%, respectivamente; mientras que el grupo con S.R.O. gan\uf3 4,38\ub13,23 g (1,32%), ingiri\uf3 69,5\ub121,72 ml, los niveles s\ue9ricos de sodio y potasio se incrementaron en 12,58% y 56,55%, respectivamente. Se encontr\uf3 diferencias significativas para el grupo de S.R.O+GA en cuanto al incremento de peso, ingesta de l\uedquidos y niveles s\ue9ricos de potasio; mientras que para el grupo con S.R.O, fue en el incremento de los valores s\ue9ricos de sodio. Conclusi\uf3n: la Goma Ar\ue1biga tiene un efecto proabsortivo como aditivo de las Sales de Rehidrataci\uf3n Oral y se recomienda la realizaci\uf3n de otros estudios para as\ued tratar de incrementar la eficacia de las S.R.O

Cavernosal Nerve Preservation During Robot-Assisted Radical Prostatectomy Is A Graded Rather Than An All-Or-None Phenomenon: Objective Demonstration By Assessment Of Residual Nerve Tissue On Surgical Specimens

Purpose: To determine whether the presence of median lobe (ML) affects perioperative outcomes, positive surgical margin (PSM) rates, and recovery of urinary continence after robot-assisted radical prostatectomy (RARP). Patients and Methods: We analyzed 1693 consecutive patients undergoing RARP performed by a single surgeon. Patients were analyzed in two groups based on the presence or not of a ML identified during RARP. Perioperative outcomes, PSM rates, and recovery of urinary continence were compared between the groups. Continence was assessed using validated questionnaires, and it was defined as the use of no pads postoperatively. Results: A ML was identified in 323 (19%) patients. Both groups had similar estimated blood loss, length of hospital stay, pathologic stage, complication rates, anastomotic leakage rates, overall PSM rates, and PSM rate at the bladder neck. The median overall operative time was slightly greater in patients with ML (80 vs 75min, P\u3c0.001); however, there was no difference in the operative time when stratifying this result by prostate weight. Continence rates were also similar between patients with and without ML at 1 week (27.8% vs 27%, P=0.870), 4 weeks (42.3% vs 48%, P=0.136), 12 weeks (82.5% vs 86.8%, P=0.107), and 24 weeks (91.5% vs 94.1%, P=0.183) after catheter removal. Finally, the median time to recovery of continence was similar between the groups (median: 5wks, 95% confidence interval [CI]: 4.41-5.59 vs median: 5wks, CI 4.66-5.34; log rank test, P=0.113). Conclusion: The presence of a ML does not affect outcomes of RARP performed by an experienced surgeon. © 2012, Mary Ann Liebert, Inc

The Role Of The Prostatic Vasculature As A Landmark For Nerve Sparing During Robot-Assisted Radical Prostatectomy

To investigate the effects of nitrate enrichment, phosphate enrichment, and light availability on benthic algae, nutrient-diffusing clay flowerpots were colonized with algae at two sites in a Hawaiian stream during spring and autumn 2002 using a randomized factorial design. The algal assemblage that developed under the experimental conditions was investigated by determining biomass (ash-free dry mass and chlorophyll a concentrations) and composition of the diatom assemblage. In situ pulse amplitude-modulated fluorometry was also used to model photosynthetic rate of the algal assemblage. Algal biomass and maximum photosynthetic rate were significantly higher at the unshaded site than at the shaded site. These parameters were higher at the unshaded site with either nitrate, or to a lesser degree, nitrate plus phosphate enrichment. Analysis of similarity of diatom assemblages showed significant differences between shaded and unshaded sites, as well as between spring and autumn experiments, but not between nutrient treatments. However, several individual species of diatoms responded significantly to nitrate enrichment. These results demonstrate that light availability (shaded vs. unshaded) is the primary limiting factor to algal growth in this stream, with nitrogen as a secondary limiting factor. © 2011 Springer Science+Business Media B.V

VESÍCULA BILIAR DOBLE. REPORTE DE UN CASO

Se presenta caso clínico de vesícula biliar doble en paciente femenino de 68 años quien consultó por presentar clínica de colecistitis aguda; el procedimiento quirúrgico se inicia por vía laparoscópica y ante la imposibilidad de identificación de estructuras anatómicas es convertido a cirugía convencional abierta donde se evidencia vesícula biliar doble, cada una de las cuales desembocaba en un conducto cístico separado, ambas con signos de inflamación aguda; una de ellas con múltiples cálculos; la otra, acalculosa, con un pólipomayor de 1 cm en su interior. El estudio anatomopatológico reportó colecistitis crónica, colecistitis aguda severa y pólipo necrótico,respectivamente. La vesícula biliar doble es una variante anatómica poco frecuente la cual puede ser diagnosticada preoperatoriamentepor imaginología y cuyo abordaje laparoscópico resulta exitoso.ABSTRACT: We present a case of double gallbladder in a 68 year old female patient with diagnosis of acute cholecystitis. The procedure was converted to conventional open surgery due to difficult identification of biliary tract structures. In the laparotomy we found a doublegallbladder with independent cystic duct. In one of gallbladder there was a cholelythiasis and a one centimetre in diameter polyp in the secondone. The pathology study concluded acute cholecystitis and necrotic polyp. The double gallbladder is a very unusual anatomic variant. Thepreoperative diagnosis is based on imagenology and the laparoscopic approach is safe and effective in some cases

Critical Review Of \u27Pentafecta\u27 Outcomes After Robot-Assisted Laparoscopic Prostatectomy In High-Volume Centres

Historically, the ideal outcome of radical prostatectomy (RP) has been measured by achievement of the so-called \u27trifecta\u27, or the concurrent attainment of continence and potency with no evidence of biochemical recurrence. However, in the PSA era, younger and healthier men are more frequently diagnosed with prostate cancer. Such patients have higher expectations from the advanced minimally invasive surgical technologies. Mere trifecta is no longer an ideal outcome measure to meet the demands of such patients. Keeping the limitations of trifecta in mind, we have earlier proposed a new method of outcomes analysis, called the \u27pentafecta\u27, which adds early complications and positive surgical margins (PSMs) to trifecta. We performed a Medline search for articles reporting the complications, PSM rates, continence, potency and biochemical recurrence after robot-assisted RP. Related articles were selected and individual outcomes were reviewed. © 2011 BJU INTERNATIONAL

Entrenamiento en cirugía robótica: Propuesta de un modelo de entrenamiento para la cirugía laparoscópica de la vía biliar principal asistida por el sistema DaVinci®

La incorporación de nuevas tecnologías ha permitido un desarrollo cada vez mayor de la cirugía mínimamente invasiva. La reciente introducción de la cirugía robótica promete ser un gran avance en el desarrollo de la cirugía laparoscópica al aportar grandes ventajas en relación con la visión y los grados de libertad de las extremidades. Sin embargo, el éxito y la seguridad de los procedimientos depende del adecuado entrenamiento del equipo quirúrgico. En el presente reporte mostramos el desarrollo de un modelo de entrenamiento para la cirugía laparoscópica de la vía biliar principal asistida por robot, este modelo permite la práctica y adquisición de habilidades en pasos fundamentales de la cirugía.TitleRobotic surgery: A proposal for a training program in laparoscopic surgery of the main bile duct using the DaVinci® systemAbstractNew technologies have promoted the development of minimally invasive surgery. The recently introduced robotic technology seems to be a great advance in laparoscopic surgery. This system has some advantages in optical systems and degrees of freedom of the arms. However, the efficacy and safety of surgical procedures is determined by the training of the surgical team. In this paper we show a training model for robot assisted laparoscopic of the common bile duct exploration that allows the surgeons to acquired practice and skills in critical steps of this type of surgery

Entrenamiento en cirugía robótica: Propuesta de un modelo de entrenamiento para la cirugía laparoscópica de la vía biliar principal asistida por el sistema DaVinci®

New technologies have promoted the development of minimally invasive surgery. The recently introduced robotic technology seems to be a great advance in laparoscopic surgery. This system has some advantages in optical systems and degrees of freedom of the arms. However, the efficacy and safety of surgical procedures is determined by the training of the surgical team. In this paper we show a training model for robot assisted laparoscopic of the common bile duct exploration that allows the surgeons to acquired practice and skills in critical steps of this type of surgery.La incorporación de nuevas tecnologías ha permitido un desarrollo cada vez mayor de la cirugía mínimamente invasiva. La reciente introducción de la cirugía robótica promete ser un gran avance en el desarrollo de la cirugía laparoscópica al aportar grandes ventajas en relación con la visión y los grados de libertad de las extremidades. Sin embargo, el éxito y la seguridad de los procedimientos depende del adecuado entrenamiento del equipo quirúrgico. En el presente reporte mostramos el desarrollo de un modelo de entrenamiento para la cirugía laparoscópica de la vía biliar principal asistida por robot, este modelo permite la práctica y adquisición de habilidades en pasos fundamentales de la cirugía