Ten years experience of banded gastric bypass: does it make a difference?

Many surgeons support some sort of restriction of the gastric pouch outlet by placing a ring around the gastric reservoir. Previous studies have shown positive results of banded gastric bypass (BGBP); however, there are not many comparative long-term studies to assess the real advantage of placing a ring during gastric bypass (GBP) surgery. This study aims to evaluate the long-term outcome of patients subjected to BGBP and nonbanded GBP procedures. We studied 260 retrospective, nonrandomized obese patients who underwent BGBP and 218 patients without the ring (i.e., GBP). They were followed up for 10 years, and the following parameters were evaluated: excess weight loss (EWL), quality of life (QOL), food tolerance, and correction of comorbidities. The study was approved by the Committee on Ethics, and all the patients gave their informed consent. There is a significant difference in %EWL from the third year until the tenth year of observation, with the proportion being 82% in BGBP versus 63% in nonbanded GBP patients at the end of the study. Although there was some increased intolerance to food intake in the BGBP patients, this was not felt to reduce the QOL. The outcome in terms of comorbidities was not conclusive. There is a clear advantage in terms of %EWL in the BGBP patients. No differences in QOL were found in both groups. Further, selecting the right type of material and the right size of the ring is important to improve results and avoid complications.

Cryptochrome photoreceptors cry1 and cry2 antagonistically regulate primary root elongation in Arabidopsis thaliana.

Cryptochromes are blue-light receptors controlling multiple aspects of plant growth and development. They are flavoproteins with significant homology to photolyases, but instead of repairing DNA they function by transducing blue light energy into a signal that can be recognized by the cellular signaling machinery. Here we report the effect of cry1 and cry2 blue light receptors on primary root growth in Arabidopsis thaliana seedlings, through analysis of both cryptochrome-mutant and cryptochrome-overexpressing lines. Cry1 mutant seedlings show reduced root elongation in blue light while overexpressing seedlings show significantly increased elongation as compared to wild type controls. By contrast, the cry2 mutation has the opposite effect on root elongation growth as does cry1, demonstrating that cry1 and cry2 act antagonistically in this response pathway. The site of cryptochrome signal perception is within the shoot, and the inhibitor of auxin transport, 1-N-naphthylphthalamic acid, abolishes the differential effect of cryptochromes on root growth, suggesting the blue-light signal is transmitted from the shoot to the root by a mechanism that involves auxin. Primary root elongation in blue light may thereby involve interaction between cryptochrome and auxin signaling pathways.

Osteotomía en cúpula tibial alta estabilizada con placa y tornillo en el tratamiento de artrosis por genu varo+ / Osteotomies in tibial cupola kind stabilized with plate and screw in the treatment of the arthrosis for genu varum+

Se trata de 19 pacientes de artrosis del comportamiento medial por genu varo, que se les realizó en cúpula estabilizada con placa y tornillo, más osteotomía diafisiaria del peroné. Los grados varo preoperatorio están entre 16 y 22, lográndose una corrección de 3 a 7 grados de valgo. Técnica de ejecución sencilla, logrando estabilización inmediata, osteotomía en cúpula que permite corregir adecuadamente la deformidad, se puede además realizar un desplazamiento hacia anterior para lograr un efecto tipo Maquet. Con resultados satisfactorios tanto estéticos como funcionales. Puede movilizarse rápidamente y apoyar en forma progresiva con recuperación rápida de la función de la rodilla y consolidación de la osteotomía en todos los casos. Se utiliza una placa 1/2 de tubo 6 y orificios y un tornillo esponjoso de rosca corta de 75,80 y 85 mm de longitud. Seguimiento de 1 a 4 años. Resultados obtenidos: 10 pacientes sin dolor y rango de movilidad que alcanzaba los 120º de flexión. El 73 por ciento de los pacientes estaba satisfecho con la operación. Esta técnica tiene ventajas evidentes por la excelente estabilización que se consigue inicialmente y que permite una rápida movilización

Rol de la colectomía total en la patología de colon / The role of total colectomy in colon disorders

Se analiza la colectomía total como tratamiento de las diversas afecciones colónicas. Se detallan aspectos referidos a esta técnica operatoria, sus principales indicaciones, ventajas y desventajas frente a otros procedimientos, a objeto de intentar precisar cual es su verdadero rol en la actualidad