ABSTRACT
Resumen Introducción: la miotomía endoscópica por vía oral (POEM) se diseñó inicialmente para el manejo de la acalasia, que es un trastorno crónico y progresivo de la motilidad esofágica con hipertensión del esfínter esofágico inferior (EEI), para la cual el manejo estándar, hasta ahora, ha sido la cirugía de Heller; sin embargo, esta nueva técnica ofrece resultados muy comparables y prometedores. Materiales y métodos: se realizó una revisión retrospectiva de las historias clínicas de los pacientes con acalasia operados por POEM en una institución de Colombia por un solo cirujano endoscopista. Resultados: se encontraron 4 pacientes con acalasia, todas con Eckardt ≥10 y presión EEI ≥30 mm Hg; el tiempo quirúrgico osciló entre 81-120 minutos; en el seguimiento, la reducción en la presión del EEI fue mayor al 50% prácticamente en todos los pacientes, encontrando valores cercanos a la normalidad y con resultados de Eckardt que demuestran éxito en la terapia POEM a los 2 meses de evaluación. Las complicaciones fueron resueltas en el intraoperatorio, con mortalidad de 0%. Conclusiones: El manejo de la acalasia mediante POEM ha demostrado ser una técnica eficaz y segura. Nuestros primeros hallazgos concuerdan con los resultados descritos en la literatura. Este es el primer paso para la implementación de este novedoso abordaje en el manejo de la acalasia en la población colombiana.
Abstract Introduction: Peroral endoscopic myotomies (POEMs) were initially designed to manage achalasia, a chronic and progressive esophageal motility disorder with lower esophageal sphincter hypertension (LES). Until recently, standard treatment had been Heller's surgery, but this new technique offers very promising pressure. Materials and methods: This is a retrospective review of the clinical histories of patients with achalasia who underwent POEM performed by one endoscopic surgeon at a Colombian institution. Results: Four patients with achalasia were found. All had Eckardt scores of ten or more and lower esophageal sphincter (LES) pressure of 30mm Hg or more. Surgical times ranged between 81 and 120 minutes. Follow-up examinations found that LES pressure had decreased by more than 50% in practically all patients. Eckardt scores were close to normal. This demonstrates success of POEM therapy after two months of evaluation. Complications were resolved intraoperatively without mortality. Conclusions: Management of achalasia by POEM has proven to be a safe and effective technique. Our first findings agree with the results described in the literature. This is the first step in the implementation of this novel approach for management of achalasia in our Colombian population.
Subject(s)
Humans , Therapeutics , Esophageal Achalasia , Myotomy , Esophageal Motility DisordersABSTRACT
In addition to their high nutritional value, red algae are of great interest as a source of therapeutic substances. However, despite their abundance on the Lebanese coast red algae have never been studied before. Therefore, we attempted to study among the available biomass one of the species of red algae growing on the Lebanese coast “Pterocladia”. We performed the extraction of trace elements, fatty acids, sulfated galactans and watersoluble polysaccharides of the phycocolloids family (carrageenans) whose physicochemical gelling or stabilizing effects attract many industrial sectors. The analysis of trace elements shows large amounts of potassium, calcium, silicon and iron. Moreover, Pterocladia appears to be rich in saturated fatty acids (69%) with palmitic acid as major fatty acid and 31% of monounsaturated fatty acids. The extraction yields were 2.7% for sulfated galactans and 11.5% for carrageenan. In order to elucidate their structures, H¹ NMR spectroscopy was performed as well as Infra-Red spectroscopy which allowed us to reveal their functional groups. A study of the antioxidant effect by the electrolysis method showed a greater effect for sulfated galactans. Furthermore, the study of the anticoagulant effect by APTT test, activated partial thromboplastin time, showed more pronounced anticoagulant power of sulfated galactans. The results of the present study confirmed the potential use of the red algae Pterocladia as a source of active known molecules.
ABSTRACT
Os autores apresentam um novo tipo de mola de aco e sua tecnica de colocacao nas palpebras, para a correcao do lagoftalmo paralitico. A mola atua levantando a palpebra inferior e movimentando a palpebra superior, de forma a reproduzir o fechamento da fenda palpebral, o mais proximo possivel das condicoes normais. Relatam o resultado de 10 casos operados com 2 anos de seguimento. Concluem pela validade da tecnica proposta, na terapeutica do lagoftalmo paralitico