Decerebration induced by surgical transection of cerebral ganglion of crayfish

Background: Since the neural structures of the crayfish brain closely resemble their equivalent in the mammals. This can be suggested by observing the similarity that exists in the brain divided by the surgical transection of the crayfish brain in which the protocerebrum remains attached to the first two cranial nerves, findings also described by Frederic Bremer in 1935 in cats with cerebral transection.Methods: Total 11 Adult male crayfish were trained to respond with defense reflex, the animals were placed in water at 0°C, remained without any movement, and subsequently through a small incision of 3 mm in diameter in the medial antero region and dorsal cephalothorax region, a surgical section of the cerebral ganglion was performed. Immediately after surgery, metal microelectrodes were implanted to collect the activity of the photoreceptors and visual fibers.Results: Once the defense reflex begins to recover in previously decerebrated crayfish, it means that it shows signs of reconnection. The isolated protocerebrum with the deutocerebrum olfactory lobe remain alive for several days and the neuronal connections were reestablished, as measured throughout the bilateral defense activity. The defense reflex was observed in all animals and then recovered after surgery.Conclusions: The crayfish is an excellent model to work the visual activity, all coding of visual information was suppressed in de-cerebrated crayfish. The recovery of the neural disconnection is observed from 40 days, where the defence reflex appears again before visual stimuli.

Biological characterization of a biodegradable scaffold for common bile duct replacement in an experimental model

Background: The nanofiber scaffolds achieved by the electrospinning technique have been used to develop several biological tissues, the nanofibers obtained by electrospinning procure a favorable microenvironment to mimic the extracellular matrix. Methods: Study type was of experimental. Study conducted at National Autonomous University of Mexico, from May 2018- May 2022. The protocol was approved by the research and ethics commissions of the UNAM school of medicine. A viscoelastic solution of polylactic-co-glycolic acid (PLGA) and polycaprolactone (PCL) in a 70:30 ratio and gelatin (Gel) in an 80:20 ratio was prepared while a dynamic collector was used with the electrospinning technique. Results: Mechanical and biological tests were carried out on the scaffold obtained by electrospinning; the resultant scaffold achieves good mechanical matching and structural similarity between the graft and the extrahepatic bile duct. Conclusions: In this study we managed to create a porous, biocompatible scaffold with good cell adhesion and proliferation, potentially applicable to tissue engineering, especially for the replacement of tubular organs such as blood vessels, bile ducts, and urethra

Acute pulmonary non-cardiogenic edema after extubation with laryngospasm: a case report

Acute pulmonary edema post extubation due to negative pressure with laryngospasm in the early postoperative period has been reported and may occur at any time during anesthesia. The usual treatment consists of respiratory support and diuretics. We present the clinical case of a 15-year-old patient who underwent laparoscopic appendectomy, who presented acute non-cardiogenic pulmonary edema in the postoperative period. This complication can be presented in any surgical patient intubated, so it is important to know the pathophysiological basis to be able to diagnose and treat this pathology

Affordable laparoscopic simulator to acquire basic skills in undergraduate surgery students

Background: The simulation emerges as an option that allows students to practice in a safe environment, all this in a scenario that resembles the real situation.Methods: We developed a prototype of a low-cost simulator that mimics the dimensions of the abdominal cavity and allows the undergraduate students to acquire the basic skills in minimally invasive surgery.Results: In the 10 competencies evaluated, statistically significant improvement was found in both groups being higher in the students who were trained by our simulator of laparoscopic surgery compared with students who attended surgeries and participated as seconds assistants, taking as reference a value of p ≤0.05.Conclusions: The simulation as new teaching strategy generates a real environment and scenarios that can be recreated in multiple occasions, being able to change depending on the objectives for the acquisition of skills. This simulator gives the user skills for more types of simulation as it progresses in its surgical training

Current treatment of difficult airway: a practical review of advanced techniques for airway management

The airway by definition is a conduit through which the air passes; or it is the route by which the air travels from the nose or mouth to the lungs. An exhaustive review was performed with the available literature using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2009 to 2021. The search criteria were formulated to identify reports related to difficult airway management. To allow controlled ventilation, the airway must meet two characteristics in priority order, be permeable and airtight. In assessing risk, in addition to looking for predictors of difficult airway, it was important to understand the global clinical circumstances. Faced with a patient with a difficult airway, decision-making must be agile and correct since any decision can modify the clinical outcome

Heparin-induced bleeding treatment in microsurgery

Microsurgery is associated with prolonged surgical times with an increased risk of deep vein thrombosis, pulmonary embolism and myocardial infarction. The use of antithrombotic means is a commonly employed tactic to prevent vascular thrombosis after microvascular free flap surgery. Flap loss is a devastating complication of microsurgical procedures that leads to detrimental outcomes. A 32-year-old male patient has a ruptured calcaneal tendon. He underwent 5 surgical cleanings with multiple failed sequential attempts at wound closure. Traumatology department in its microsurgery division where it is proposed to perform neo-tendon with graft of palmaris longus of the right thoracic extemity and radial antebrachial microvascular flap. The neo tendon was performed in addition to the micro surgical coverage with the radial antebrachial flap.When having vascular control with micro-clamps, 6000 U of unfractionated heparin was initiated, approximately 20 minutes after the end of the microvascular anastomosis, there was incoercible bleeding, which is initially treated with spray fibrin. Continued bleeding after 3 hours, so it was decided to reverse the effect of heparin with transfusion of fresh frozen plasma, 10 mg of vitamin K and fibrinogen. The effect of heparin was reversed without having thrombotic complications of microvascular anastomoses. The flap was not reexplored since they showed no signs of vascular compromise. If anticoagulants have been used and an incoercible hemorrhage is found, the effect of heparin must be reversed. In the transfer of tissues with microsurgery, the recommended and safe anticoagulation are prophylactic doses and not therapeutic doses

Surgical management of enchondroma with joint transfer: a case report

The enchondromas are the most common benign bone tumor in the hands, mainly in young patients and its treatment is surgical in most cases due to its possible complications avoided through different procedures such as joint transfer, which allows to maintain a good quality of life for the patient. We present the case of a 42-year-old woman who came to the clinic for blunt trauma in the right hand where she was incidentally diagnosed with enchondroma on the third finger of the proximal interphalangeal joint of the right hand. Articular transfer of the proximal interphalangeal joint was performed. Second toe on the right, at 6 weeks corroborates correct evolution with bone consolidation of the articular transfer grade III and donor zone grade II, without infection complications, the correct recovery of the extensor movement range of this joint improving so their state of life should be the main objective of these procedures

The deep inferior epigastric artery perforator flap: a review

Breast cancer is recognized worldwide as a major health problem among women due to its high incidence and high mortality and morbidity rates. Breast reconstruction is an approach of great value for those patients who underwent mastectomy, impacting their quality of life and psychological stress. The deep inferior epigastric artery perforator (DIEP) flap was described as the preferred graft for breast reconstruction with an autologous flap by surgeons because it represented a decrease in complications for the time and obtained better results. DIEP flap reconstruction requires microsurgical skills as well as continuous monitoring of the patient to identify and resolve possible associated complications.

Hypospadias: a review

Hypospadias is a congenital malformation of the male external genitalia, which includes: anomalous location proximal to the urethral meatus, in any portion of the glans penis and perineum, hooded dorsal foreskin, and inverted penile curvature on the dorsal side of the foreskin. The etiology has been considered multifactorial, secondary to the interaction of environmental factors with specific genetic background. It represents the second most frequent congenital defect in male newborns. It has increasing prevalence rates of 0.25 new cases per 10,000 newborns per year. Risk factors that have been identified include infants small for gestational age with weight below the 10th percentile, head length and/or circumference, intrauterine growth restriction, and placental insufficiency. Regarding environmental risk factors, maternal exposure to pesticides has been linked. Prenatal diagnosis has been described, however proximal hypospadias is usually detected, making it difficult to diagnose distal hypospadias using this method. So usually the diagnosis is made after birth during the physical examination. To date, more than 300 surgical techniques are known for the correction of hypospadias. The treatment of distal hypospadias is currently performed in one time; the management of proximal hypospadias is controversial; one group favors the one-stage procedure, while other groups choose to perform the two-stage procedure

Transfusion related acute lung injury-TRALI: a review

Acute pulmonary damage caused by transfusion is characterized by the sudden onset of respiratory distress in newly transfused patients within 6 hours after the transfusion, bilateral infiltrative changes in chest X-ray, PaO2/FIO2 <300 mmHg, absence of other risk factors for acute lung injury and absence of signs suggesting cardiogenic origin of pulmonary edema. Being one of the most serious complications of blood transfusion, plasma is the most involved factor, although all blood components can cause it, and is caused by antigen reactions/leukocyte antibody and lipid activity with ability to modify the biological response on primitive leukocytes. The diagnosis is based on the integration of clinical, radiological and gasometric elements, ruling out the rest of the possible causes of acute lung injury. Its differential diagnosis should include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products and transfusion hemolytic reaction. The treatment is supportive measures based on the needs and does not differ from the treatment of acute lung injury secondary to other etiologies, severe cases require endotracheal intubation and mechanical ventilation while the non-severe can be managed with oxygen therapy