A strange congenital disease, familial megaduodenus: review of the literature.

Familial megaduodenum is an extremely rare congenital disease, with few cases described in the literatura, that is caused by chronic duodenal obstruction of functional type. It presents in the form of nonspecific clinical pseudo-obstruction from infancy, which causes a delay in its diagnosis and treatment. Conservative treatments are rarely sufficient in and of themselves to control the disease, making surgery an effective option in selected patients for relieving or avoiding obstruction, as well as improving duodenal emptying and restoring gastrointestinal tract continuity, paying special attention to the duodenal papilla. We present a case treated at the General Surgery and Digestive Apparatus Service of the Hospital of Mérida and a review of the existing literature.

A strange congenital disease, familial megaduodenus: review of the literature

Familial megaduodenum is an extremely rare congenital disease, with few cases described in the literatura, that is caused by chronic duodenal obstruction of functional type. It presents in the form of nonspecific clinical pseudo-obstruction from infancy, which causes a delay in its diagnosis and treatment. Conservative treatments are rarely sufficient in and of themselves to control the disease, making surgery an effective option in selected patients for relieving or avoiding obstruction, as well as improving duodenal emptying and restoring gastrointestinal tract continuity, paying special attention to the duodenal papilla. We present a case treated at the General Surgery and Digestive Apparatus Service of the Hospital of Mérida and a review of the existing literature. (AU)

Antitumor Anesthetic Strategy in the Perioperatory Period of the Oncological Patient: A Review.

The stress response triggered by the surgical aggression and the transient immunosuppression produced by anesthetic agents stimulate the inadvertent dispersion of neoplastic cells and, paradoxically, tumor progression during the perioperative period. Anesthetic agents and techniques, in relation to metastatic development, are investigated for their impact on long-term survival. Scientific evidence indicates that inhaled anesthetics and opioids benefit immunosuppression, cell proliferation, and angiogenesis, providing the ideal microenvironment for tumor progression. The likely benefit of reducing their use, or even replacing them as much as possible with anesthetic techniques that protect patients from the metastatic process, is still being investigated. The possibility of using "immunoprotective" or "antitumor" anesthetic techniques would represent a turning point in clinical practice. Through understanding of pharmacological mechanisms of anesthetics and their effects on tumor cells, new perioperative approaches emerge with the aim of halting and controlling metastatic development. Epidural anesthesia and propofol have been shown to maintain immune activity and reduce catecholaminergic and inflammatory responses, considering the protective techniques against tumor spread. The current data generate hypotheses about the influence of anesthesia on metastatic development, although prospective trials that determinate causality are necessary to make changes in clinical practice.

Influencia de la actividad física en la prevención, tratamiento antineoplásico y supervivencia de pacientes con cáncer de mama / Influence of physical activity on the prevention, antineoplastic treatment and survival of patients with breast cancer

Introducción Durante las 2 últimas décadas, numerosos estudios han investigado el impacto de la actividad física en el tratamiento del cáncer. El objetivo de esta revisión versa en obtener recomendaciones basadas en la evidencia científica publicada más recientemente acerca de la influencia de la actividad física en el cáncer de mama, tanto en lo que se refiere a prevención, así como durante el tratamiento antineoplásico y supervivencia. Resultados La actividad física es capaz de interaccionar sobre diferentes mecanismos biológicos típicamente alterados en el cáncer de mama, como son: marcadores inflamatorios, hormonas sexuales, eje insulina/IGF-I, hormonas suprarrenales, vitamina D, sistema inmune, estrés oxidativo y reparación del ADN; dando así resultados positivos en cuanto a disminución del riesgo de carcinogénesis, aumento de calidad de vida y mejora de los efectos secundarios derivados del tratamiento, así como disminución de la recurrencia tumoral y aumento de la supervivencia global. Conclusión La actividad física aeróbica y de fuerza-resistencia aparecen ampliamente recomendadas y justificadas en la literatura científica para la prevención y mejora multidimensional de las pacientes con cáncer de mama y supervivientes, estableciendo una serie de precauciones/contraindicaciones ante situaciones de eventual riesgo. El conocimiento de la heterogeneidad del cáncer de mama y de los diferentes mecanismos biológicos implicados en su desarrollo y perpetuación permitirán personalizar la indicación y tratamiento farmacológico/físico para cada paciente. (AU)

Introduction In the last few decades, several studies have investigated the impact of physical activity on the treatment of cancer. The aim of this study was to establish recommendations based on the most recent scientific evidence on the effect of physical activity on breast cancer, in terms of prevention, antineoplastic treatment, and survival. Results Physical activity affects various biological mechanisms typically altered in breast cancer, such as inflammatory markers, sex hormones, insulin axis/IGF-1, adrenal hormones, vitamin D, the immune system, oxidative stress, and DNA repair. These findings indicate a positive impact in terms of reducing the risk of carcinogenesis, adverse treatment effects and tumoural recurrence, enhancing quality of life, and increasing overall survival. Conclusion Aerobic physical activity and strength-resistance training are widely recommended and justified in the scientific literature for prevention and multidimensional improvement in patients with breast cancer and breast cancer survivors, allowing a series of precautions/contraindications to be made in situations of eventual risk. Knowledge of the heterogeneity of breast cancer and of the various biological mechanisms involved in its development and perpetuation will allow personalised indications and drug/physical treatment for each patient. (AU)