Effectiveness of autologous lipoinjection into the hand to improve function in patients with scleroderma: pilot study

Background: Scleroderma is a rare disease of the tissues that is characterized for being inflammatory and developing fibrosis in the skin. Typically, this disease affects middle-aged women.Methods: A study was conducted in which 10 patients with scleroderma with involvement in the sclerotic stage were included. One of the hands was chosen randomly for treatment with fatty graft processed by Coleman technique and the other hand, physiological solution was placed. Patients were evaluated at 45 and 90 days after the procedure using the Cochin Hand Functional Scale (CHFS) questionnaire, modified Rodnan scale for the skin (mRSS), grip strength with dynamometer and measurement of fingertip to palm of hand in flexion.Results: The average of CHFS before treatment was 42.30 and 25.70 at 90 days p=0.007. The average strength in the experimental hand before treatment was 11.67 and 14.58 at 90 days p=0.007, in the control hand p=0.873. The mean finger-palm tip distance before treatment was 44.80 and from 36.00 to 90 days p=0.019, in the control hand p=0.149. There is a significant difference in the degree of severity at 90 days of the mRSS of the back of the hands p=0.011 and phalanges p=0.000 between the patients with lipoinjection and physiological solution.Conclusion: Significant improvement was observed in patients with scleroderma treated with autologous lipoinjection.

Íleo biliar, una causa infrecuente de oclusión intestinal. Presentación de un caso clínico y revisión de la literatura / Gallstone ileus, a rare cause of intestinal obstruction: report of a case and review of the literature

Resumen: El íleo biliar, es una causa poco frecuente de oclusión intestinal. Representa del 1-4% de los casos de oclusión intestinal mecánica. Debe tenerse en mente en pacientes de edad avanzada con signos y síntomas de oclusión intestinal, antecedentes de litiasis vesicular y cuadros repetitivos de cólico biliar. La sospecha de esta patología y el diagnóstico temprano permiten brindar un tratamiento quirúrgico oportuno. En el siguiente artículo documentamos el abordaje diagnóstico y terapéutico de un caso de íleo biliar.

Abstract: Gallstone ileus is an uncommon cause of intestinal obstruction. It represents the 1-4% cases of mechanical intestinal obstruction. It should be considered in elderly patients with symptoms of intestinal obstruction, a history of gallstones and biliary colic repetitive episodes. The suspicion of this disease and early diagnosis, allow to provide a timely surgical treatment. In the following article we document the diagnosis and treatment of a case of gallstone ileus.