Sutureless colic anastomoses with cyanoacrylates

BACKGROUNO ANO AIMS. The present research Project has been made mainly with the idea of comparing the tensile strength values and histological answers of threetypes of colon anatomises: sutured with silk and sutureless anastomoses with 2-octyl-cyanocrylate and N-butyl-2-cyanoacrylate. Methods. 112 Wistar rats distributed into three groups of 35 animals and a last control group of 7 have been used for this. Group 1: silk, group 2:2-octyl-cyanocrylate, group 3: N-butyl-2-cyanoacrylate,group 4: Control group_. The following surgical interventions were practiced on them:A cross section of the colon,followed by: group 1: an end-to-end discontinuous suture anastomoses with Silk; group 2: sutureless anastomoses with 2-octyl-cyanocrylate;group 3:sutureless anastomoses With N-butyl-2-cyanoar1ylate. On the 10th, 20th, 30th, 40th and 50th days we proceeded to measure the anastomoses tensile strength value for each series.In the same period of time we carried out the following anatomic-pathological determinations: a) sharp inflammation; b) oedema; c) non-specif chronic inflammatory infiltrate; d) granulomatous inflammatory infiltrate to foreign e) fibrosis. Results.The results obtained indicate a greater anastomeses tensile strength for group 2 and 3. The anatomic-pathological values show a better response to anastomoses with adhesive than with conventional sutures. CONCLUSIONS. All these experimental results lead us to conclude that the cyanocrilates used to carry out sutureless anastomoses may be an n alternative to the handmade conventional anastomoses. Moreover they are easy to be implemented

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true