ABSTRACT
There is a great interest in natural yellow colorants due to warnings issued about certain yellow food colorings of synthetic origin. However, no comparative studies have been reported of their thermal stability. For this reason, the thermal stabilities of six natural yellow colorants used in foods--lutein, riboflavin, curcumin, ß-carotene, gardenia yellow and Opuntia betaxanthins--were studied in simple solutions over a temperature range 30-90 °C. Spectral properties and visual color were investigated during 6 h of heat treatment. Visual color was monitored from the CIEL*a*b* parameters. The remaining absorbance at maximum wavelength and the total color difference were used to quantify color degradation. The rate of color degradation increased as the temperature rose. The results showed that the thermal degradation of the colorants followed a first-order reaction kinetics. The reaction rate constants and half-life periods were determined as being central to understanding the color degradation kinetics. The temperature-dependent degradation was adequately modeled on the Arrhenius equation. Activation energies ranged from 3.2 kJmol(-1) (lutein) to 43.7 kJmol(-1) (Opuntia betaxanthins). ß-carotene and lutein exhibited high thermal stability, while betaxanthins and riboflavin degraded rapidly as temperature increased. Gardenia yellow and curcumin were in an intermediate position.
Subject(s)
Food Coloring Agents/chemistry , Hot Temperature , Pigments, Biological/chemistry , Betaxanthins/chemistry , Curcumin/chemistry , Drug Stability , Food Handling/methods , Gardenia/chemistry , Kinetics , Lutein/chemistry , Opuntia/chemistry , Plant Extracts/chemistry , Riboflavin/chemistry , Solutions , Thermodynamics , beta Carotene/chemistryABSTRACT
Hypertension is one of the most important causes of cardiovascular and renal morbidity and mortality, and it represents a serious health problem in Western countries. Over the last few decades scientific interest in food-derived antihypertensive peptides has grown as an alternative to drugs in the control of systemic blood pressure. Most of these peptides target the angiotensin I-converting enzyme (ACE) but emerging evidence points to other antihypertensive mechanisms beyond ACE inhibition. The milk protein lactoferrin (LF) is a good source of orally active antihypertensive peptides the characterization of which, including ex vivo functional assays and in vivo approaches, shows that they might act on several molecular targets. This review summarizes the mechanisms of action underlying the blood pressure-lowering effects of LF-derived peptides, focusing on their interaction with different components of the renin-angiotensin (RAS) and endothelin (ET) systems. The ability of LF-derived peptides to modify the expression of genes encoding proteins involved in the nitric oxide (NO) pathway and prostaglandin synthesis is also described.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/pharmacology , Antihypertensive Agents/pharmacology , Hypertension/drug therapy , Lactoferrin/pharmacology , Peptides/pharmacology , Angiotensin-Converting Enzyme Inhibitors/chemistry , Animals , Antihypertensive Agents/chemistry , Humans , Hypertension/genetics , Hypertension/metabolism , Lactoferrin/chemistry , Peptides/chemistry , Peptidyl-Dipeptidase A/genetics , Peptidyl-Dipeptidase A/metabolismABSTRACT
One of the complications related to central venous catheters is the so-called "fibrin sheath or sleeve", the persistence of this structure after central venous catheter removal is uncommon, especially within a cardiac chamber. A neonate with symptoms of infection and portal vein thrombosis with suspected umbilical catheter fragment retained in right atrium was consulted for possible removal by catheterization. Prior to the procedure, the echocardiography findings guided us to the diagnosis of persistent fibrin sheath. The procedure was discontinued and the patient received anticoagulant therapy and antibiotics. In our case, echocardiography was useful in confirming the diagnosis of retained fibrin sheath and rule out the presence of residual central venous catheter after its removal, thereby avoiding an unnecessary and invasive procedure.
Subject(s)
Central Venous Catheters/adverse effects , Fibrin , Heart Diseases/etiology , Female , Heart Diseases/diagnostic imaging , Humans , Infant, Newborn , UltrasonographyABSTRACT
Una de las complicaciones relacionadas con los catéteres venosos centrales es la denominada "vaina o manguito de fibrina". La persistencia de esta estructura después de extraer el catéter venoso central no es habitual, especialmente dentro de una cámara cardíaca. Un neonato con proceso infeccioso y trombosis de la vena porta, en quien se sospechó la presencia de un fragmento del catéter venoso umbilical retenido en la aurícula derecha, fue traído a la consulta para su eventual extracción mediante cateterismo. Antes del procedimiento, los hallazgos ecocardiográfcos orientaron al diagnóstico de vaina de fibrina persistente. El cateterismo se suspendió y el paciente recibió tratamiento anticoagulante y antibiótico. En este caso, la ecocardiografía fue útil para confrmar el diagnóstico de vaina de fibrina retenida y descartar la presencia del remanente del catéter venoso central, lo que evitó un procedimiento cruento e innecesario.
One of the complications related to central venous catheters is the so-called "fibrin sheath or sleeve", the persistence of this structure after central venous catheter removal is uncommon, especially within a cardiac chamber. A neonate with symptoms of infection and portal vein thrombosis with suspected umbilical catheter fragment retained in right atrium was consulted for possible removal by catheterization. Prior to the procedure, the echocardiography fndings guided us to the diagnosis of persistent fibrin sheath. The procedure was discontinued and the patient received anticoagulant therapy and antibiotics. In our case, echocardiography was useful in confrming the diagnosis of retained fibrin sheath and rule out the presence of residual central venous catheter after its removal, thereby avoiding an unnecessary and invasive procedure.
Subject(s)
Female , Humans , Infant, Newborn , Central Venous Catheters/adverse effects , Fibrin , Heart Diseases/etiology , Heart DiseasesABSTRACT
Una de las complicaciones relacionadas con los catéteres venosos centrales es la denominada "vaina o manguito de fibrina". La persistencia de esta estructura después de extraer el catéter venoso central no es habitual, especialmente dentro de una cámara cardíaca. Un neonato con proceso infeccioso y trombosis de la vena porta, en quien se sospechó la presencia de un fragmento del catéter venoso umbilical retenido en la aurícula derecha, fue traído a la consulta para su eventual extracción mediante cateterismo. Antes del procedimiento, los hallazgos ecocardiográfcos orientaron al diagnóstico de vaina de fibrina persistente. El cateterismo se suspendió y el paciente recibió tratamiento anticoagulante y antibiótico. En este caso, la ecocardiografía fue útil para confrmar el diagnóstico de vaina de fibrina retenida y descartar la presencia del remanente del catéter venoso central, lo que evitó un procedimiento cruento e innecesario.(AU)
One of the complications related to central venous catheters is the so-called "fibrin sheath or sleeve", the persistence of this structure after central venous catheter removal is uncommon, especially within a cardiac chamber. A neonate with symptoms of infection and portal vein thrombosis with suspected umbilical catheter fragment retained in right atrium was consulted for possible removal by catheterization. Prior to the procedure, the echocardiography fndings guided us to the diagnosis of persistent fibrin sheath. The procedure was discontinued and the patient received anticoagulant therapy and antibiotics. In our case, echocardiography was useful in confrming the diagnosis of retained fibrin sheath and rule out the presence of residual central venous catheter after its removal, thereby avoiding an unnecessary and invasive procedure.(AU)
ABSTRACT
One of the complications related to central venous catheters is the so-called "fibrin sheath or sleeve", the persistence of this structure after central venous catheter removal is uncommon, especially within a cardiac chamber. A neonate with symptoms of infection and portal vein thrombosis with suspected umbilical catheter fragment retained in right atrium was consulted for possible removal by catheterization. Prior to the procedure, the echocardiography findings guided us to the diagnosis of persistent fibrin sheath. The procedure was discontinued and the patient received anticoagulant therapy and antibiotics. In our case, echocardiography was useful in confirming the diagnosis of retained fibrin sheath and rule out the presence of residual central venous catheter after its removal, thereby avoiding an unnecessary and invasive procedure.
ABSTRACT
We report the case of an infant with an episode of loss of consciousness, in whom ventricular fibrillation was diagnosed. He was successfully defibrillated and long QT syndrome was diagnosed as his baseline disease. This case constitutes a documented example of this entity as a cause of the sudden infant death syndrome.
Subject(s)
Brief, Resolved, Unexplained Event/etiology , Long QT Syndrome/complications , Brief, Resolved, Unexplained Event/therapy , Humans , Infant, Newborn , Long QT Syndrome/therapy , Male , Pacemaker, Artificial , Sudden Infant Death/etiology , Ventricular Fibrillation/therapyABSTRACT
Se presenta el caso de un lactante con un episodio de pérdida de conocimiento, en quien se diagnosticó fibrilación ventricular. Se realizó desfibrilación externa con éxito, permitiendo luego arribar al diagnóstico etiológico de síndrome de QT prolongado, constituyendo un ejemplo documentado de esta entidad como causa del síndrome de muerte súbita del lactante.
We report the case of an infant with an episode of loss of consciousness, in whom ventricular fibrillation was diagnosed. He was successfully defibrillated and long QT syndrome was diagnosed as his baseline disease. This case constitutes a documented example of this entity as a cause of the sudden infant death syndrome.
Subject(s)
Humans , Infant, Newborn , Male , Brief, Resolved, Unexplained Event/etiology , Long QT Syndrome/complications , Brief, Resolved, Unexplained Event/therapy , Long QT Syndrome/therapy , Pacemaker, Artificial , Sudden Infant Death/etiology , Ventricular Fibrillation/therapyABSTRACT
Se presenta el caso de un lactante con un episodio de pérdida de conocimiento, en quien se diagnosticó fibrilación ventricular. Se realizó desfibrilación externa con éxito, permitiendo luego arribar al diagnóstico etiológico de síndrome de QT prolongado, constituyendo un ejemplo documentado de esta entidad como causa del síndrome de muerte súbita del lactante.(AU)
We report the case of an infant with an episode of loss of consciousness, in whom ventricular fibrillation was diagnosed. He was successfully defibrillated and long QT syndrome was diagnosed as his baseline disease. This case constitutes a documented example of this entity as a cause of the sudden infant death syndrome.(AU)
Subject(s)
Humans , Infant, Newborn , Male , Brief, Resolved, Unexplained Event/etiology , Long QT Syndrome/complications , Brief, Resolved, Unexplained Event/therapy , Long QT Syndrome/therapy , Pacemaker, Artificial , Sudden Infant Death/etiology , Ventricular Fibrillation/therapyABSTRACT
The color degradation of aqueous solutions of six natural red pigment extracts (elderberry, red cabbage, hibiscus, red beet, Opuntia fruits and red cochineal) used commercially as food colorants was investigated at temperatures between 50 and 90 °C. Color degradation was studied in respect to both spectral properties and visual color. The remaining absorbance at 535 nm as a function of the incubation time and temperature was used to quantify the degradation process. Red cochineal was the most thermoresistant extract with a remaining absorbance of 95 % after 6 h at 90 °C. Anthocyanin extracts (elderberry, red cabbage, hibiscus) showed remaining absorbance percentages of 63.8, 46.1 and 26.7, respectively. Betacyanin extracts (red beet, Opuntia fruits) were the most thermosensitive maintaining only 12.5 and 1.7 %, respectively, of the initial absorbance at 535 nm. Applying a first-order kinetic model to the degradation processes, reaction rate constants (k) and half-life periods (t 1/2 ) were calculated. The temperature dependence of the degradation rate constant obeyed the Arrhenius relationship, with activation energies (E a ) ranging between 3.02 and 53.37 kJ mol(-1). The higher activation energy values indicated greater temperature sensitivity. Changes in visual color attributes corroborated the high thermal stability of the red cochineal extract.
Subject(s)
Anthocyanins/chemistry , Azo Compounds/chemistry , Betacyanins/chemistry , Food Coloring Agents/chemistry , Hot Temperature , Magnoliopsida/chemistry , Plant Extracts/chemistry , Animals , Color , Food Technology , Hemiptera , NaphthalenesulfonatesABSTRACT
We report the case of an infant with an episode of loss of consciousness, in whom ventricular fibrillation was diagnosed. He was successfully defibrillated and long QT syndrome was diagnosed as his baseline disease. This case constitutes a documented example of this entity as a cause of the sudden infant death syndrome.
Subject(s)
Brief, Resolved, Unexplained Event/etiology , Long QT Syndrome/complications , Humans , Infant, Newborn , Brief, Resolved, Unexplained Event/therapy , Long QT Syndrome/therapy , Male , Pacemaker, Artificial , Sudden Infant Death/etiology , Ventricular Fibrillation/therapyABSTRACT
Bioactive ACE inhibiting peptides are gaining interest in hypertension treatment. We have designed and screened six synthetic heptapeptides (PACEI48 to PACEI53) based on two hexapeptide leads (PACEI32 and PACEI34) to improve ACE inhibitory properties and assess their antihypertensive effects. ACE activity was assayed in vitro and ex vivo. Selected peptides were administered to spontaneously hypertensive rats (SHRs) and normotensive Wistar-Kyoto (WKY) rats. In vitro cytotoxicity was assessed with the MTT reduction test. The six heptapeptides at low micromolar concentration produced different degrees of in vitro inhibition of ACE activity using the synthetic substrate HHL or the natural substrate angiotensin I; and ex vivo inhibition of ACE-dependent, angiotensin I-induced vasoconstriction, but not angiotensin II-induced vasoconstriction. Oral administration of the hexapeptide PACEI32L, and the heptapeptides PACEI50L and PACEI52L, induced reductions in systolic blood pressure lasting up to 3h in SHRs but not in WKY rats. Intravenous injection of PACEI32L and PACEI50L, but not PACEI52L, induced acute transient reductions in mean blood pressure of SHRs. d-Amino acid peptides showed five-fold less ACE inhibitory potency, no inhibitory effect on angiotensin I-induced vasoconstriction, and antihypertensive effect in SHRs after i.v. injection, but not after oral administration. The toxicity of peptides to reduce the viability of cultured cells was in the millimolar range. In conclusion, we have obtained novel rationally designed heptapeptides with improved ACE inhibitory properties when compared to lead hexapeptides. One selected hexapeptide and two heptapeptides show oral antihypertensive effects in SHRs and appear safe in cytotoxicity assays.
Subject(s)
Angiotensin I/pharmacology , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Antihypertensive Agents/pharmacology , Blood Pressure/drug effects , Carotid Arteries/drug effects , Hypertension/drug therapy , Oligopeptides/pharmacology , Peptidyl-Dipeptidase A/blood , 3T3 Cells , Administration, Oral , Angiotensin I/metabolism , Angiotensin-Converting Enzyme Inhibitors/chemical synthesis , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Animals , Antihypertensive Agents/chemical synthesis , Antihypertensive Agents/therapeutic use , Carotid Arteries/physiology , Cell Survival/drug effects , Hep G2 Cells , Humans , Hypertension/blood , Hypertension/physiopathology , Infusions, Intravenous , Male , Mice , Oligopeptides/chemical synthesis , Oligopeptides/therapeutic use , Rabbits , Rats , Rats, Inbred SHR , Rats, Inbred WKY , Tissue Culture Techniques , Vasoconstriction/drug effectsABSTRACT
A set of eight lactoferricin B (LfcinB)-derived peptides was examined for inhibitory effects on angiotensin I-converting enzyme (ACE) activity and ACE-dependent vasoconstriction, and their hypotensive effect in spontaneously hypertensive rats (SHR). Peptides were derived from different elongations both at the C-terminal and N-terminal ends of the representative peptide LfcinB(20-25), which is known as the LfcinB antimicrobial core. All of the eight LfcinB-derived peptides showed in vitro inhibitory effects on ACE activity with different IC(50) values. Moreover, seven of them showed ex vivo inhibitory effects on ACE-dependent vasoconstriction. No clear correlation between in vitro and ex vivo inhibitory effects was found. Only LfcinB(20-25) and one of its fragments, F1, generated after a simulated gastrointestinal digestion, showed significant antihypertensive effects in SHR after oral administration. Remarkably, F1 did not show any effect on ACE-dependent vasoconstriction in contrast to the inhibitory effect showed by LfcinB(20-25). In conclusion, two LfcinB-derived peptides lower blood pressure and exhibit potential as orally effective antihypertensive compounds, yet a complete elucidation of the mechanism(s) involved deserves further ongoing research.
Subject(s)
Antihypertensive Agents/administration & dosage , Hypertension/drug therapy , Lactoferrin/administration & dosage , Peptides/administration & dosage , Amino Acid Sequence , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/chemical synthesis , Angiotensin-Converting Enzyme Inhibitors/chemistry , Animals , Antihypertensive Agents/chemical synthesis , Antihypertensive Agents/chemistry , Disease Models, Animal , Humans , Male , Molecular Sequence Data , Peptides/chemical synthesis , Peptides/chemistry , Peptidyl-Dipeptidase A/metabolism , Rabbits , Rats , Rats, Inbred SHRABSTRACT
We present the case of a 23-year-old woman with a parotid gland tumor, the fine-needle aspiration biopsy smears of which showed epithelial cells with wide cytoplasm, isolated or arranged in micropapillary groups together with psammoma bodies. The surgical specimen contained a 5-cm tumor with the histologic features of an acinic cell carcinoma (ACC) with papillary areas. Notably, the cells of the tumor seemed to follow a sequence from large cells with rounded nuclei with open chromatin and prominent nucleoli to vacuolated cells with granular material, and finally to cells undergoing apoptosis. This finding was followed by the appearance of concentrically laminated, round to polygonal, Congo red-positive, birefringent bodies that in areas accumulated and formed extensive areas with massive deposits. The picture suggested that those amyloid bodies (psammoma bodies) resulted from the accumulation of residual masses of apoptotic cells. Huge globular amyloid deposits, the suggested name for this material irrespective of the type of amyloid, have not been previously reported in ACC of salivary gland.
Subject(s)
Amyloid/metabolism , Carcinoma, Acinar Cell/pathology , Parotid Neoplasms/pathology , Adult , Biomarkers, Tumor/metabolism , Biopsy, Fine-Needle , Birefringence , Carcinoma, Acinar Cell/metabolism , Carcinoma, Acinar Cell/surgery , Cellular Structures/pathology , Coloring Agents , Congo Red , Female , Humans , Parotid Neoplasms/metabolism , Parotid Neoplasms/surgeryABSTRACT
Objetivo: Evaluar la colangigrafía endoscópica retrógrada (CER) como método diagnóstico de la litiasis coledociana y la esfinterotomía endoscópica (EE) como recurso terapéutico en pacientes que van a ser sometidos a colecistectomía laparoscópica, y en aquellos con sospecha de litiasis residual, y así mismo compararlos con otros procedimientos actuales tal como la exploración translaparoscópica. Lugar de aplicación: Instituto de Enfermedades Digestivas, Hospital Italiano de Córdoba. Diseño: Estudio retrospectivo. Población: 161 CER en 163 pacientes, con evidencia o sospecha de coledocolitiasis; 92 CER se realizaron previa a la colecistectomía (CCT) laparoscópica y 69 por litiasis residual. Resultados: De los 163 pacientes, se logró realizar CER en 161. En forma preoperatoria en 92 pacientes por evidencia o sospecha de coledocolitiasis, corroborando litiasis en la via biliar en 62 (67,39 por ciento). Se practicó EE en todos, (100 por ciento de efectividad). En 71 pacientes con evidencia de litiasis residual, se practicó el procedimiento en 69 (97,18 por ciento), encontrándose coledocolitiasis en 59 (85,50 por ciento) y se efectuó EE en 58 de ellos (98,30 por ciento de efectividad). Sobre un total de 120 EE, las complicaciones fueron del 8,68 por ciento, 14 pacientes, falleció 1 por pancreatitis (0,62 por ciento). Conclusiones: En nuestra experiencia, la CER con eventual EE fue un procedimiento eficaz y seguro para el tratamiento de la coledocolitiasis, ya sea previa a la CCT laparoscópica; o en las litiasis residuales (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Gallstones/surgery , Cystoscopy , Retrospective Studies , Sphincterotomy, Endoscopic , Cholangiography/methods , Cholecystectomy, Laparoscopic/methods , Evaluation of Results of Therapeutic Interventions , Cholangiopancreatography, Endoscopic Retrograde , Treatment OutcomeABSTRACT
Objetivo: Evaluar la colangigrafía endoscópica retrógrada (CER) como método diagnóstico de la litiasis coledociana y la esfinterotomía endoscópica (EE) como recurso terapéutico en pacientes que van a ser sometidos a colecistectomía laparoscópica, y en aquellos con sospecha de litiasis residual, y así mismo compararlos con otros procedimientos actuales tal como la exploración translaparoscópica. Lugar de aplicación: Instituto de Enfermedades Digestivas, Hospital Italiano de Córdoba. Diseño: Estudio retrospectivo. Población: 161 CER en 163 pacientes, con evidencia o sospecha de coledocolitiasis; 92 CER se realizaron previa a la colecistectomía (CCT) laparoscópica y 69 por litiasis residual. Resultados: De los 163 pacientes, se logró realizar CER en 161. En forma preoperatoria en 92 pacientes por evidencia o sospecha de coledocolitiasis, corroborando litiasis en la via biliar en 62 (67,39 por ciento). Se practicó EE en todos, (100 por ciento de efectividad). En 71 pacientes con evidencia de litiasis residual, se practicó el procedimiento en 69 (97,18 por ciento), encontrándose coledocolitiasis en 59 (85,50 por ciento) y se efectuó EE en 58 de ellos (98,30 por ciento de efectividad). Sobre un total de 120 EE, las complicaciones fueron del 8,68 por ciento, 14 pacientes, falleció 1 por pancreatitis (0,62 por ciento). Conclusiones: En nuestra experiencia, la CER con eventual EE fue un procedimiento eficaz y seguro para el tratamiento de la coledocolitiasis, ya sea previa a la CCT laparoscópica; o en las litiasis residuales
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gallstones/surgery , Cholangiography , Cholangiopancreatography, Endoscopic Retrograde , Cholecystectomy, Laparoscopic/methods , Cystoscopy , Evaluation of Results of Therapeutic Interventions , Retrospective Studies , Sphincterotomy, Endoscopic , Treatment OutcomeABSTRACT
Antecedentes: El cáncer de páncreas exocrino continúa aumentando su incidencia, el diagnóstico suele ser tardío y la terapéutica actualmente no muestra buenos resultados en general. Objetivo: Analizar logros obtenidos en aquellos enfermos portadores de cáncer de páncreas sometidos a cirugía resectiva, comparándolos con aquellos en que se realizaron operaciones no resectivas; como asimismo formas de presentación clínica, metodología diagnóstica y complicaciones postoperatorias. Consideraciones costo-beneficio en este tipo de intervenciones. Lugar de aplicación: Los pacientes fueron estudiados e intervenidos en los Hospitales Córdoba, Ferroviario e Italiano de la ciudad de Córdoba. Diseño: Estudio retrospectivo comparativo. Población: Cincuenta y nueve pacientes tratados entre 1986 y 1996, con una edad media de 61 años. Métodos: Se efectuó resección en 13 pacientes (22 por ciento), cirugía no resectiva en 31 (52 por ciento), de las cuales 19 fueron derivativas, realizando hepaticoyeyunostomía en 14 oportunidades. El estadio clínico de los pacientes fue de tumores mayores de 3 cm. Resultados: La supervivencia media con resección fue de 16 meses. En los enfermos no resecados con cirugía derivativa no se registró supervivencia al cabo de 1 año. La mortalidad postoperatoria con cirugía resectiva fue de 1 paciente (7,7 por ciento). Conclusiones: La resección mejoró levemente los resultados con respecto a la derivación, sin embargo entendemos que estas cifras deben mejorar con detección precoz y centralización de la patología en grupos quirúrgicos especializados. El costo-beneficio es un aspecto fundamental en el análisis del tratamiento del carcinoma pancreático
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cost-Benefit Analysis , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy/standards , Diagnostic Imaging , Pancreatectomy , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/mortality , Pancreaticoduodenectomy/adverse effects , Portal Vein/surgery , Retrospective Studies , Survival RateABSTRACT
Antecedentes: El cáncer de páncreas exocrino continúa aumentando su incidencia, el diagnóstico suele ser tardío y la terapéutica actualmente no muestra buenos resultados en general. Objetivo: Analizar logros obtenidos en aquellos enfermos portadores de cáncer de páncreas sometidos a cirugía resectiva, comparándolos con aquellos en que se realizaron operaciones no resectivas; como asimismo formas de presentación clínica, metodología diagnóstica y complicaciones postoperatorias. Consideraciones costo-beneficio en este tipo de intervenciones. Lugar de aplicación: Los pacientes fueron estudiados e intervenidos en los Hospitales Córdoba, Ferroviario e Italiano de la ciudad de Córdoba. Diseño: Estudio retrospectivo comparativo. Población: Cincuenta y nueve pacientes tratados entre 1986 y 1996, con una edad media de 61 años. Métodos: Se efectuó resección en 13 pacientes (22 por ciento), cirugía no resectiva en 31 (52 por ciento), de las cuales 19 fueron derivativas, realizando hepaticoyeyunostomía en 14 oportunidades. El estadio clínico de los pacientes fue de tumores mayores de 3 cm. Resultados: La supervivencia media con resección fue de 16 meses. En los enfermos no resecados con cirugía derivativa no se registró supervivencia al cabo de 1 año. La mortalidad postoperatoria con cirugía resectiva fue de 1 paciente (7,7 por ciento). Conclusiones: La resección mejoró levemente los resultados con respecto a la derivación, sin embargo entendemos que estas cifras deben mejorar con detección precoz y centralización de la patología en grupos quirúrgicos especializados. El costo-beneficio es un aspecto fundamental en el análisis del tratamiento del carcinoma pancreático (AU)
Subject(s)
Comparative Study , Humans , Male , Female , Adult , Middle Aged , Aged , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy/standards , Cost-Benefit Analysis , Retrospective Studies , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/mortality , Pancreatectomy/methods , Pancreaticoduodenectomy/adverse effects , Portal Vein/surgery , Diagnostic Imaging , Survival RateABSTRACT
RESUMEN: ANTECEDENTES:La compresión vascular del duodeno es una patología de presentación infrecuente que determina un síndrome oclusivo alto. Su etiología se debe a múltiples causas, pudiendo ser tratada en forma médica o quirúrgica. OBJETIVOS: Analizar tres casos presentados, realizar una revisión de la literatura dentro de las distintas técnicas quirúrgicas propuestas, describir la "desrotación intestinal"; contribuir a la escasa casuística publicada al respecto y analizar los resultados. DISEÑO: Estudio clínico restropectivo. POBLACION: Se analizan tres pacientes operados por compresión vascular del duodeno. RESULTADOS: Se operaron tres pacientes: a uno se le realizó una duodenoyeyunostomía, y a los otros dos una desrotación intestinal. CONCLUSIONES; Proponemos la desrotación intestinal para el tratamiento de la compresión vascular del duodeno, por ser una técnica que no abre órgano, ni requiere sutura como la doudenoyeyunostomía, si bien esta última mantiene vigencia y ha demostrado un porcentaje de éxitos satisfactorios.
Subject(s)
Duodenum/surgery , Intestine, SmallABSTRACT
RESUMEN: ANTECEDENTES:La compresión vascular del duodeno es una patología de presentación infrecuente que determina un síndrome oclusivo alto. Su etiología se debe a múltiples causas, pudiendo ser tratada en forma médica o quirúrgica. OBJETIVOS: Analizar tres casos presentados, realizar una revisión de la literatura dentro de las distintas técnicas quirúrgicas propuestas, describir la "desrotación intestinal"; contribuir a la escasa casuística publicada al respecto y analizar los resultados. DISEÑO: Estudio clínico restropectivo. POBLACION: Se analizan tres pacientes operados por compresión vascular del duodeno. RESULTADOS: Se operaron tres pacientes: a uno se le realizó una duodenoyeyunostomía, y a los otros dos una desrotación intestinal. CONCLUSIONES; Proponemos la desrotación intestinal para el tratamiento de la compresión vascular del duodeno, por ser una técnica que no abre órgano, ni requiere sutura como la doudenoyeyunostomía, si bien esta última mantiene vigencia y ha demostrado un porcentaje de éxitos satisfactorios.(AU)
