Surgical and functional outcome of laparoscopic vaginal suspension combined with suture rectopexy for management of pelvic organ prolapse

Purpose: Laparoscopic techniques to treat pelvic organ prolapse are gaining popularity around the globe due to their low recurrence rates and better functional results compared to perineal techniques. However, the optimum surgical procedures are not yet determined. In the current research, we suggest a novel surgical approach, laparoscopic vaginal suspension with suture rectopexy, to treat multiorgan pelvic prolapse. Methods: This prospective cohort trial was conducted from March 2018 to March 2022 and comprised 35 females with multiorgan pelvic organ prolapse with obstructed defecation symptoms. A residual rectal prolapse was still present despite the manual reduction of uterine prolapse. Patients' conditions before and after the operation were monitored regarding the obstructed defecation score, sexual function, need for laxatives, anorectal manometry pressures, anorectal sensations, and recurrence. The mean follow-up duration was one year. Results: Modified Longo score for obstructed defecation significantly decreased at six and twelve months after surgery. Additionally, a significant reduction was reported in the number of patients who needed laxatives at six and twelve months after surgery. Anorectal manometry pre- and post-surgery showed a significant elevation in the mean squeeze pressure and a decline in all rectal sensations. All parameters of the female sexual function scoring system increased postoperatively. No recurrence was reported during follow-up. Conclusion: For multiorgan pelvic prolapse, laparoscopic vaginal suspension combined with suture rectopexy has excellent functional outcomes, minimal morbidity, and low cost. (AU)

Clinical outcomes of the liver-first approach in the management of synchronous colorectal liver metastases: a retrospective study

Introduction: Almost 25% of colorectal cancer (CRC) patients have synchronous colorectal liver metastasis (SCLM) coinciding with the disease diagnosis. Liver-first approach for the treatment of SCLM involves neoadjuvant chemotherapy, subsequent liver resection, and then primary tumor resection. This strategy is adopted as the prognosis of the disease depends mainly on the metastases, not the primary tumor. This study aims to evaluate the feasibility of the liver-first approach and clinical prognosis in managing SCLM. Materials and Methods: This retrospective study included 25 patients with SCLM from July 2015 to July 2020. All patients were subjected to a liver-first approach with an "intention-to-treat" approach. Follow-up was planned for at least 3 years. Data were collected from the hospital records and included survival rates and univariate analyses of the prognostic factors, such as gender, age, and number of chemotherapy cycles to evaluate their effect on the survival probability. Results: Nineteen patients completed the treatment paradigm. Long-term outcomes reported a median overall survival (OS) of 32 months. One-year and 3-year survival probabilities were 89.5% and 42.1%, respectively. The median disease-free survival was 13 months. The number of metastatic lesions, unilobar versus bilobar disease, and the frequency of administered chemotherapy cycles significantly affected survival (p < 0.05). Seven patients (36.84%) remained disease free (no recurrence) while 2 patients (10.53%) survived with recurrence. The overall mortality included 10 deaths (52.63%) due to recurrence. Conclusion: Synchronous colorectal liver metastasis treated with the liver-first approach achieved a notable overall advantage. However, the recurrence rate remained relatively high. (AU)

Actividad antiinflamatoria de amirona y 4 7-dimetoxiapigenina aislados de Alnus acuminata / Anti-inflammatory activity of amyrone and Apigenin-4, 7- dimethylether isolated from Alnus acuminata

El presente trabajo determinó el efecto antiinflamatorio de -amirona (olean-13(18)-en-3-ona) y 4', 7-dimetoxiapigenina (5-hidroxi-4,7-dimetoxiflavona), aislados de Alnus acuminata (Betulaceae), por el método del edema plantar en ratas hembra, en dosis de 30, 60 y 100 mg/kg y de 30, 60 y 80 mg/kg respectivamente. Ambas sustancias mostraron una actividad antiinflamatoria significativa. El efecto más alto de -amirona se presentó a la primera hora en las tres dosis ensayadas comparable con el efecto antiinflamatorio obtenido a las tres horas con el patrón indometacina en la dosis de 5 mg/kg, mientras que el mejor efecto de 4,7-dimetoxi-apigenina se observó a la tercera hora, en las tres dosis ensayadas, siendo de un nivel comparable en las dosis de 60 y 80 mg/kg al presentado por el patrón indometacina en la dosis de 5 mg/kg

Efecto abortivo, aislamiento e identificación de principios activos de Alnus acuminata / Abortive effect, isolation and identification of actives principes of Alnus acuminata

Se aislaron tres sustancias puras de la fracción clorofórmica del extracto alcohólico de las hojas de Alnus acuminata, que fueron identificados por métodos espectroscópicos como Olean-13(18)-en-ona; 5-hidroxi-4,ï7-dimetoxiflavona y un alcohol alifático cuya estructura química esta en estudio. El estudio farmacológico mostró un efecto abortivo alto (80-100 por ciento) en ratones hembras preñadas. El estudio histopatológico mostró cambios significativos en las células del útero tanto a nivel del trofoblasto como del endotelio vascular

Fito y bioanálisis de algunas plantas utilizadas en medicina popular con posible actividad farmacológica / Phyto and Bioassay of some plants utilized in popular medicine with possible activity pharmacology

El bioanálisis de 29 especies medicinales y seis sustancias patrones para determinar la CL 50 por el método de Artemia salina, demostró que 22 de las 29 plantas estudiadas presentan CL 50 menor a 500µg/ml. Las especies que presentan CL 50 menor a 100 µg/ml son Lantana camara, Bauhinia picta, Pitiviria alliacea, Caléndula officinalis, Rumex obtusifolius, Salvia palaefolia, taraxacum officinale, Senecio formosus, Malvia rotundifolia, Solanum nigrum y Plantago major. Según el análisis fitoquímico en el presente trabajo la mayoría de las plantas estudiadas presentan alcaloides, esteroles, triterpenos, flavonoides, taninos y saponinas. Los derivados de antraquinonas se encontraron únicamente en Rumex obtusifolius

Contribución al estudio farmacognóstico de algunas especies de coca cultivadas en Colombia / Contribution to the pharmacognostic study of some species of coca grown in Colombia

En el presente trabajo se realizó un estudio macroscópico y microscópico de las hojas de cinco taxa del género Erythroxylum, que permite una identificación adecuada de las mismas