Tourniquet modification of the associating liver partition and portal ligation for staged hepatectomy procedure.

BACKGROUND: In staged liver resections, associating liver partition and portal ligation for staged hepatectomy (ALPPS) achieves sufficient hypertrophy of the future liver remnant (FLR) in 7 days. This is based on portal vein ligation and transection, and on occlusion of intrahepatic collaterals. This article presents a new surgical technique for achieving rapid hypertrophy of the FLR, which also involves adding intrahepatic collateral occlusion to portal vein transection. METHODS: Patients scheduled for two-stage liver resection for primary or secondary liver tumours, in whom the FLR was considered too small, were enrolled prospectively. In the first stage, a tourniquet was placed around the parenchymal transection line, and the right portal vein was ligated and cut (associating liver tourniquet and portal ligation for staged hepatectomy, ALTPS). The tourniquet was placed on the umbilical ligament if a staged right trisectionectomy was planned, and on Cantlie's line for staged right hepatectomy. RESULTS: From September 2011, 22 ALTPS procedures were carried out (right trisectionectomy in 15, right hepatectomy in 7). Median FLR at 7 days increased from 410 to 700 ml (median increase 61 (range 33-189) per cent). The median duration of the first stage was 125 min and no patient received a blood transfusion. The median duration of the second stage was 150 min and five patients required a blood transfusion. Fourteen patients had complications, most frequently infected collections, and five patients developed postoperative liver failure. Two patients died. CONCLUSION: The ALTPS technique achieved adequate hypertrophy of the FLR after 7 days. It may provide a less aggressive modification of the ALPPS procedure.

Producción científica internacional sobre farmacoepidemiología. Análisis bibliométrico del periodo 1970-1999 / Scientific literature on pharmacoepidemiology. Bibliometric analysis of the period 1970-1999

Se estudió la producción científica sobre farmacoepidemiología durante el período de 1970 a 1999, a partir de los artículos originales recuperados en la base de datos IPA. Los 467 artículos recuperados procedían mayoritariamente de Estados Unidos (31.9 por ciento), predominando las áreas temáticas de farmacovigilancia y los estudios de utilización de medicamentos. La media de firmas por artículo era de 2.5 ñ 1.3, con un grado de colaboración entre autores del 68.4 por ciento y un índice de transitoriedad del 80.1 por ciento. La distribución de autores por número de artículos publicados se ajustaba a la ley de Lotka. El país mayoritario de edición de las revistas en que se publicaron los artículos era Inglaterra (51.4 por ciento), siendo el inglés el idioma preferente (83.5 por ciento).La investigación científica sobre farmacoepidemiología presenta unas características que corresponden a una disciplina joven, siendo necesarios otros estudios que analicen la metodología y complejidad de dicha investigación (AU)

Presence of pharmacoepidemiology in three bibliographic databases: Medline, IPA and SCI.

OBJECTIVE: The objective of this study is to make a comparative description of the evolution and distribution of international research into pharmacoepidemiology, using three bibliographic databases, in order to select the most appropriate for future bibliometric studies. METHODS: Bibliographic searches were performed using the following databases: Medline (1966-99), IPA (1970-99) and SCI (1990-99), using the term 'pharmacoepidemiology'. On the basis of these searches, the number of original articles per year and per journal title were noted. The growth of the output of scientific writing was found to fit Price's law. RESULTS: A total of 845 original articles were recovered: 467 from IPA, 219 from Medline and 159 from SCI. The highest mean number of original articles per year (33.4) was obtained with the IPA database. Price's exponential growth pattern was observed among all three databases. The total numbers of journals in which the original articles were published were 102 in Medline, 65 in IPA and 60 in SCI. The journals providing a single original article comprised 65% of the Medline titles and 61% of those in IPA and SCI. CONCLUSIONS: International research into pharmacoepidemiology presents an exponential growth pattern, in accordance with Price's law. There is a large degree of publishing dispersion. IPA was found to be the bibliographic database that recovered the greatest number of original articles, nearly half of which were published in Pharmacoepidemiology and Drug Safety. We therefore consider the latter database appropriate for bibliometric studies in the field of pharmacoepidemiology.

[Descriptive study of statistical methods in the original article published on the cigarette smoking habit in four Spanish medical journals (1985-1996)]. / Métodos estadísticos empleados en los artículos originales publicados sobre tabaquismo en cuatro revistas médicas españolas (1985-1996).

BACKGROUND: Being the tobacco use a high-priority subject of investigation and having itself increased the utilization of statistical techniques in biomedical publication the used statistical techniques are described and the statistical accessibility is quantified in the original articles on tobacco use published in four Spanish medical journals. METHODS: Retrospective descriptive study of 154 original articles on the cigarette smoking habit published in 1985-1996 in the journals Atención Primaria, Medicina Clínica (Barcelona), Revista Española de Salud Pública and Revista Clínica Española. An only observer codified the statistic techniques in 14 categories in agreement with the classification processed by Carré et al (1995) from the classification settled down by Emerson and Colditz (1983). The knowledge of bivariable techniques, to simple lineal regression, was stablished as the reference for the study of statistical accessibility. RESULTS: 81.8% original articles used inferential statistics. The most frequently used categories were "Contingency tables" (37.0%), "Descriptive statistics" (18.2%) and "Life tables and analysis of survival" (9.7%). A reader familiarized with bivariable techniques has statistical access to 96.0% for the originals of Revista Española de Salud Pública, 86.2% of Atención Primaria, 66.7% of Medicina Clínia (Barcelona) and 33.3% of Revista Clínica Española. The same reader had statistical access to 100% for the originals published from 1985 to 1987 and 68.1% from 1994 to 1996. CONCLUSIONS: The use of statistical methods depends on the investigation subject and design, the journal and the year of the publication. The decrease of the statistical accessibility recommends to identify the profile of the standard reader in Spain, to adjust his knowledge to the current biomedical literature demand.

[Methodology used in the original articles on smoking in 4 Spanish medical journals (1985-1996)]. / Metodología empleada en los artículos originales publicados sobre tabaquismo en cuatro revistas médicas españolas (1985-1996).

BACKGROUND: Planning being the one factor entailed in doing any research that has the greatest bearing on the quality of the findings thereof, and the cigarette smoking habit being a prime topic for research, a description is provided of the methodological aspects of the original articles on the cigarette smoking habit which have been published in four Spanish medical journals. METHODS: A descriptive study was conducted regarding the original articles on the cigarette smoking habit from Spanish centers which were published in 1985-1996 in the journals Atención Primaria (Primary Care), Medicina Clínica (Clinical Medicine) (Barcelona), Revista Española de Salud Pública (Spanish Public Health Journal) and Revista Clínica Española (Spanish Clinical Journal). RESULTS: Most of the 154 original articles studied dealt with the topics of smoking patterns (31.8%) and the cigarette smoking habit as a risk factor (27.3%) and were conducted within a municipal scope (41.7%) or provincial scope (36.1%) with subjects from primary care (71.6%) who visited the doctor (20.8%) falling within the age 25-65 group (30.4%) or over age 15 (27.0%). Surveys were used for collecting the data (38.3%) and were conducted throughout a 12-month period (24.5%) or longer (19.3%). The types most frequently used were descriptive (67.5%), retrospective (79.2%) and cross-sectional (81.8%). CONCLUSIONS: Spanish research on the cigarette smoking habit must cover certain subjects which have not been dealt with in sufficient depth and must invest greater care regarding certain methodological aspects which will improve the quality of the publications, this being a need also brought to fore in other studies.

Bibliometric analysis of Spanish scientific publications on tobacco use during the period 1970-1996.

Spanish scientific publications on tobacco use during the period 1970-1996 were studied, including all published work carried out in Spanish institutions indexed in IME or in MEDLINE and available on CD-ROM, using the search criteria fuma* and taba* in the first database, and tobacco and smoking in the second. A total of 405 papers were found by IME, published in Spanish journals, and another 194 in MEDLINE, published in foreign journals. In the latter database, a time-related increase in the number of papers was detected. Original articles accounted for 80.6% of the papers analyzed. The degree of collaboration between authors, research centres and institutions was 88.6%, 30.7% and 21.8%, respectively. The most productive Spanish communities were Catalonia and Madrid. The Spanish papers were published in 83 Spanish journals, of which 36 (43.4%) published just one paper, and in 124 foreign journals, of which 85 (68.5%) published a single paper. The average number of authors per paper was 4.02+/-2.46 in Spanish journals and 4.96+/-2.26 in foreign ones. The total number of authors was 1633, of whom 1162 (71.2%) appeared on a single paper. The contribution of Spanish scientific production concerning tobacco use, in international terms, has increased in recent years, but a higher level of cooperation between research centres and institutions is desirable.

Physiological changes in human erythrocyte cholinesterase as measured with the "pH-stat".

Cholinesterase activity in human erythrocytes was determined in 1903 blood samples by the "pH-stat" method. Differences in activity were examined as a function of sex, age, and pregnancy. Reliability intervals for the population average and approval or normality intervals for individual values were established. Sex- and age-related differences were very significant.