RESUMEN
In recent years, significant progress has been made in laser wakefield acceleration (LWFA), both regarding the increase in electron energy, charge and stability as well as the reduction of bandwidth of electron bunches. Simultaneous optimization of these parameters is, however, still the subject of an ongoing effort in the community to reach sufficient beam quality for next generation's compact accelerators. In this report, we show the design of slit-shaped gas nozzles providing centimeter-long supersonic gas jets that can be used as targets for the acceleration of electrons to the GeV regime. In LWFA experiments at the Centre for Advanced Laser Applications, we show that electron bunches are accelerated to [Formula: see text] using these nozzles. The electron bunches were injected into the laser wakefield via a laser-machined density down-ramp using hydrodynamic optical-field-ionization and subsequent plasma expansion on a ns-timescale. This injection method provides highly controllable quasi-monoenergetic electron beams with high charge around [Formula: see text], low divergence of [Formula: see text], and a relatively small energy spread of around [Formula: see text] at [Formula: see text]. In contrast to capillaries and gas cells, the scheme allows full plasma access for injection, probing or guiding in order to further improve the energy and quality of LWFA beams.
RESUMEN
Los objetivos de este trabajo son estudiar y valorar si han existido cambios en las indicaciones de broncoscopia en la Unidad de Endoscopia Respiratoria (UER) del Hospital Universitario (H.U.) 12 de Octubre en los últimos años, puesto que se han observado cambios epidemiológicos en distintas patologías respiratorias y se han incorporado nuevas técnicas endoscópicas. Por otra parte y dado que el trasplante pulmonar se introdujo en este hospital en el año 2008, también hemos valorado las diferencias en cuanto a las indicaciones de broncoscopia entre los pacientes sometidos a trasplante frente al resto en un segundo periodo de tiempo. Para realizar el estudio se ha utilizado la base de datos de la Unidad de Endoscopia Respiratoria del H.U. 12 de Octubre. Se han comparado pacientes de dos periodos de tiempo similares de 5 años: 2003-2008 vs. 2013-2018. En este último grupo se han valorado las diferencias entre los pacientes con trasplante pulmonar frente al resto. En los últimos cinco años se ha observado un mayor requerimiento de técnicas diagnósticas más complejas, una utilización mayoritaria de la sedación y un mayor número de pacientes en régimen hospitalario. Los pacientes con trasplante pulmonar tienen mayor necesidad de exploraciones urgentes y en régimen hospitalario, con mayor requerimiento de técnicas como la biopsia transbronquial y el lavado broncoalveolar. Por tanto como conclusión podemos decir que se han producido cambios en las indicaciones con una mayor complejidad en los últimos cinco años (AU)
Since epidemiologic changes regarding bronchogenic carcinoma had been related and new endoscopic techniques are available, one of the objectives of this study is evaluate the changes in bronchoscopy indications in the Unity of Respiratory Endoscopy of the H.U. 12 de Octubre. On the other hand, since lung transplantation has been introduced in H.U. 12 de Octubre in 2008, another objective is evaluate the differences related to bronchoscopy indication between patients with lung transplantation and not. We have used the database from the Unity of Respiratory Endoscopy of the H.U. 12 de Octubre. We have compared patients from two different periods: 2003-2008 (Period 1) and 2013-2018 (Period 2). We have also evaluated the differences between lung transplantation and not during period 2. Along the last five years we have related the following changes: a larger requirement of diagnostic techniques (TBP, BAL), a main use of sedation and a larger number of patients under hospital admission. As a conclusion, the bronchoscopy has become more complex. Patients with lung transplantation have more necessity of urgent examination under hospital admission and a larger request of specific techniques such as transbronchial biopsy and bronchoalveolar lavage. Therefore, this patients had entailed changes in the complexity if the bronchoscopy techniques in the last five years (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Hospitales Universitarios/estadística & datos numéricos , Trasplante de Pulmón/métodos , Broncoscopía/estadística & datos numéricos , Estudios Longitudinales , Estudios RetrospectivosRESUMEN
La amebiasis es una enfermedad infecciosa causada por el protozoo E. hystolitica con múltiples manifestaciones clínicas. La afectación torácica es la segunda localización extraintestinal más frecuente tras la hepática. Presentamos un caso de derrame pleural secundario a un absceso hepático amebiano y realizamos una revisión de esta entidad poco frecuente
Amebiasis is an infectious disease caused by the protozoan E. hystolitica with multiple clinical manifestations. Chest involvement is the second most frequent extraintestinal location after the liver. We present a case of pleural effusion secondary to an amebic liver abscess and we review this rare entity
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/etiología , Absceso Hepático Amebiano/complicaciones , Absceso Hepático Amebiano/diagnóstico por imagen , Radiografía Torácica , Tomografía Computarizada por Rayos X , Ultrasonografía , Derrame Pleural/tratamiento farmacológico , Absceso Hepático Amebiano/tratamiento farmacológico , Metronidazol/uso terapéutico , Antiprotozoarios/uso terapéuticoRESUMEN
Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.
Asunto(s)
Técnicas de Ablación/métodos , Braquiterapia/métodos , Carcinoma Hepatocelular/radioterapia , Neoplasias Hepáticas/radioterapia , Radioterapia Guiada por Imagen/métodos , Anciano , Carcinoma Hepatocelular/diagnóstico por imagen , Humanos , Radioisótopos de Iridio , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Dosis de Radiación , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.
Asunto(s)
Humanos , Masculino , Anciano , Braquiterapia/métodos , Carcinoma Hepatocelular/radioterapia , Técnicas de Ablación/métodos , Radioterapia Guiada por Imagen/métodos , Neoplasias Hepáticas/radioterapia , Dosis de Radiación , Radioisótopos de Iridio , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Carcinoma Hepatocelular/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagenRESUMEN
LPS-ligation to CD14/TLR-4 on monocytes/macrophages triggers the production of IL-12-family cytokines. IL12/18 promote TH1-differentiation, counteracting the TH2-driven asthma. Therefore, CD14 modulation could alter the TH2-differentiation and should be taken into account when studying asthma. To analyse the alteration in CD14 levels and its association with CD14 (-159 C/T) SNP (rs2569190) in Caucasian adults with stable allergic asthma, we performed a cross-sectional study (277 healthy subjects vs. 277 patients) where clinical parameters, CD14 values and the CD14 (-159 C/T) SNP were studied. Apart from typical biomarkers, we found an increment of neuron-specific enolase (NSE) in allergic asthma, probably linked to monocyte activity. Indeed, we evidenced increased monocyte numbers, but lower CD14 expression and normalised sCD14 values in patients. Moreover, we noticed an association of the T allele (P = 0.0162) and TT genotype (P = 0.0196) of the CD14 SNP with a decreased risk of allergic asthma and augmented sCD14 levels. In conclusion, monocyte CD14 expression and normalized sCD14 values were reduced in stable state asthmatics, and this could be related to the presence of an expanded CD14low monocyte subset. This study also demonstrates that the CD14 (-159 C/T) polymorphism is a risk factor for moderate-severe allergic asthma in adult Caucasians.
Asunto(s)
Asma/genética , Receptores de Lipopolisacáridos/genética , Monocitos/metabolismo , Polimorfismo de Nucleótido Simple , Adulto , Asma/sangre , Asma/patología , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Regulación de la Expresión Génica , Humanos , Recuento de Leucocitos , Receptores de Lipopolisacáridos/biosíntesis , Masculino , Persona de Mediana Edad , Monocitos/patologíaRESUMEN
BACKGROUND AND OBJETIVE: The pathogenesis of asthma is dependent on the balance between regulatory and effector T cells, which display differential expression of CD25 and CD26. Therefore, alteration of circulating levels of sCD25 and sCD26 during allergic asthma could be conditioned by changes in leukocyte phenotype. Objectives: To analyze expression of CD25 and CD26 on T lymphocytes and their soluble derivatives (sCD25, sCD26) during stable phases of moderate-severe allergic asthma. METHODS: Cross-sectional study with 2 adult cohorts of allergic asthmatics. Clinical, anthropometric, pulmonary, hematological, and biochemical parameters were measured. Phenotyping was performed with flow cytometry in both circulating and cultured leukocytes. Dipeptidyl peptidase 4 (DPP4) activity was assayed in culture supernatants. RESULTS: In vitro studies revealed upregulation of CD26 on human T lymphocytes upon activation, especially under TH17-favoring conditions, and a correlation with soluble DPP4 activity (rs=0.641; P<.001). CD26 expression on lymphocytes was higher in asthmatics, while serum sCD26 was lower in women and patients. The latter finding could be associated with an expanded CD25low/CD26low/CD127low subset of effector CD4+ T cells in allergic asthma, with no changes in Treg percentages. However, women showed an increased Teff/Treg ratio, which could explain their greater susceptibility to asthma. CONCLUSIONS: Allergic asthma causes an increment in CD25lowCD26low helper T cells detected in stable stages. These changes are mirrored in serum and should be considered in the light of the downmodulating role of CD26 in major chemokines related to the pathogenesis of asthma such as CCL11 (eotaxin), CCL5 (RANTES), and CXCL12a (SDF-1α).
Asunto(s)
Asma/inmunología , Linfocitos T CD4-Positivos/inmunología , Dipeptidil Peptidasa 4/inmunología , Hipersensibilidad/inmunología , Linfocitos T Reguladores/inmunología , Células Th17/inmunología , Adulto , Quimiocina CCL11/inmunología , Quimiocina CCL5/inmunología , Quimiocina CXCL12/inmunología , Estudios Transversales , Regulación hacia Abajo/inmunología , Femenino , Citometría de Flujo/métodos , Humanos , Subunidad alfa del Receptor de Interleucina-2/inmunología , Masculino , Persona de Mediana Edad , Regulación hacia Arriba/inmunología , Adulto JovenRESUMEN
BACKGROUND: Teaching practice is one of the most complex topics of the training process in medicine and other health care careers. The Teaching Practices Questionnaire (TPQ) evaluates teaching skills. AIM: To assess the factor structure and internal consistency of the Spanish version of the TPP among health care teachers. MATERIAL AND METHODS: The TPQ was answered by 315 university teachers from 13 of the 15 administrative Chilean regions, who were selected through a non-probabilistic volunteer sampling. The internal consistency of TPP factors was calculated and the correlation between them was analyzed. RESULTS: Six factors were identified: Student-centered teaching, Teaching planning, Assessment process, Dialogue relationship, Teacher-centered teaching and Use of technological resources. They had Cronbach alphas ranging from 0.60 to 0.85. CONCLUSIONS: The factorial structure of TPQ differentiates the most important functions of teaching. It also shows a theoretical consistency and a practical relevance to perform a diagnosis and continuous evaluation of teaching practices. Additionally, it has an adequate internal consistency. Thus, TPQ is valid and reliable to evaluate pedagogical practices in health care careers.
Asunto(s)
Docentes , Escuelas para Profesionales de Salud , Enseñanza , Adulto , Anciano , Chile , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto JovenRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Conferencias de Salud/organización & administración , Astenia/complicaciones , Astenia/tratamiento farmacológico , Exantema/complicaciones , Derrame Pleural/complicaciones , Hierro/uso terapéutico , Síndromes de Malabsorción/complicaciones , Síndromes de Malabsorción/diagnóstico , Linfoma/complicaciones , Enfermedad de Whipple/complicaciones , Radiografía Torácica/métodos , Gastroscopía/instrumentación , Pérdida de Peso , Gastroscopía/métodos , Enfermedad de Whipple/diagnóstico , Colonoscopía/métodos , Intestino Delgado/patología , Intestino Delgado , Pericarditis Constrictiva/complicaciones , Pericarditis Constrictiva/diagnósticoRESUMEN
BACKGROUND: Squamous Cell Carcinoma (SCC) of the lip represents about 20% of all oral carcinomas. It is more common in men, peaking during their sixth and seventh decade, and is more prevalent in the lower lip. AIM: To determine the five years survival rate of Chilean patients with lip SCC. MATERIAL AND METHODS: The registry of the Chilean National Cancer Institute was reviewed to retrieve the clinical records of patients with lip SCC. Information about age, sex, alcohol consumption, smoking, degree of pathological differentiation, lip location, type of treatment and metastases was recorded. Survival was determined with death certificates from the National Identification Service. RESULTS: Seventy four patients were identified. Their 5-year survival was 73%. CONCLUSIONS: The survival rate of this group of patients is lower than that of patients from Unites States who have an 89.5% survival, according to the Surveillance, Epidemiology, and End Results Program of the North American National Cancer Institute.
Asunto(s)
Carcinoma de Células Escamosas/mortalidad , Neoplasias de los Labios/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Chile/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Análisis de Supervivencia , Tasa de Supervivencia , Factores de TiempoRESUMEN
Background: Squamous Cell Carcinoma (SCC) of the lip represents about 20% of all oral carcinomas. It is more common in men, peaking during their sixth and seventh decade, and is more prevalent in the lower lip. Aim: To determine the five years survival rate of Chilean patients with lip SCC. Material and Methods: The registry of the Chilean National Cancer Institute was reviewed to retrieve the clinical records of patients with lip SCC. Information about age, sex, alcohol consumption, smoking, degree of pathological differentiation, lip location, type of treatment and metastases was recorded. Survival was determined with death certificates from the National Identification Service. Results: Seventy four patients were identified. Their 5-year survival was 73%. Conclusions: The survival rate of this group of patients is lower than that of patients from Unites States who have an 89.5% survival, according to the Surveillance, Epidemiology, and End Results Program of the North American National Cancer Institute.
Asunto(s)
Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Escamosas/mortalidad , Neoplasias de los Labios/mortalidad , Chile/epidemiología , Prevalencia , Factores de Riesgo , Análisis de Supervivencia , Tasa de Supervivencia , Factores de TiempoRESUMEN
La caries dental es una de las enfermedades mas prevalentes en la población mundial y más aún en los países en desarrollo, por lo que se necesitan nuevas medidas para su prevención. Estudios previos señalan que el efecto de cepas probióticas inhibe la colonización de los patógenos responsables de la caries dental como el Streptococcus mutans, previniendo la aparición de la caries dental. El objetivo fue medir el efecto de las cepas probióticas Lactobacillus casei variedad rhamnosus (LCR32) y Lactobacillus johnsonii (LA1) sobre le crecimiento in vitro de Streptococcus mutans. Se midió el efecto in vitro de las cepas de dos probióticos comercializados en Chile; Lactobacillus casei variedad rhamnosus (LCR32) contenidas en Lactil® y Lactobacillus johnsonii (LA1) contenidas en Chamyto, sobre el crecimiento in vitro de Streptococcus mutans. Se realizaron medios de cultivo selectivos para Streptococcus mutans a los cuales se les adicionaron cuatro diluciones diferentes de cada probiótico y se midió el halo de inhibición de los Streptococcus mutans con un pie de metro. Los probióticos con las cepas Lactobacillus casei variedad rhamnosus (LCR32) y Lactobacillus johnsonii (LA1) inhiben el crecimiento sobre Streptococcus mutans. Ambos probióticos en las dos concentraciones más altas no obtuvieron diferencias significativas en relación a los halos de inhibición. Sin embargo, el probiótico con la cepa Lactobacillus casei variedad rhamnosus (LCR35), mostró halos de inhibición más significativos en comparación a la cepa Lactobacillus johnsonii (LA1). Las cepas probióticas Lactobacillus casei variedad rhamnosus (LCR35) y Lactobacillus Johnosonii (LA1) disminuyen la colonización de las principales bacterias productoras de caries dental, de tal forma estos probióticos podrían ser utilizados como apoyo en la prevención y profilaxis de la enfermedad en pacientes de alto riesgo cariogénico, en forma adicional a otros medios de prevención.
Dental caries is one of the most prevalent diseases in the world and even more in the population of developing countries, so it is necessary to use new measures for prevention. Previous studies indicate that the effect of probiotic strains inhibit colonization of pathogens responsible for dental caries such as Streptococcus mutans, preventing the onset of dental caries. The aim was to measure the effect of the probiotic strains Lactobacillus casei variety rhamnosus (LCR32) and Lactobacillus johnsonii (LA1) on in vitro growth will Streptococcus mutans. We measured the effect in vitro of two probiotic strains marketed in Chile; Lactobacillus casei variety rhamnosus (LCR32) contained in Lactyl ® and Lactobacillus johnsonii (LA1) contained in Chamyto on in vitro growth of Streptococcus mutans. Culture media were made selective for Streptococcus mutans to which were added four different dilutions of each probiotic and measured the zone of inhibition of Streptococcus mutans with a foot tube. The probiotic strains Lactobacillus casei variety rhamnosus (LCR32) and Lactobacillus johnsonii (LA1) inhibit the growth of Streptococcus mutans. Both probiotics in the two higher concentrations no significant differences in relation to the zones of inhibition. However, the probiotic strain Lactobacillus casei rhamnosus variety (LCR35) showed the most significant zones of inhibition compared to the strain Lactobacillus johnsonii (LA1). The probiotic strains Lactobacillus casei rhamnosus variety (LCR35) and Lactobacillus Johnosonii (LA1) decreased the colonization of the main dental caries producing bacteria, so these probiotic could be used as support in the prevention and prophylaxis of the disease in high-risk cariogenic patients, additionally in other means of prevention.
Asunto(s)
Humanos , Caries Dental/microbiología , Caries Dental/prevención & control , Lactobacillus/fisiología , Probióticos , Streptococcus mutans/crecimiento & desarrollo , Lacticaseibacillus casei/fisiologíaRESUMEN
AIM: To study the prevalence of hypertriglyceridemic waist (HTGW) in an urban adult Spanish population and its association with type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). METHODS: We undertook a cross-sectional analysis in a random sample of 2270 individuals (18-80 years of age). All participants provided a clinical history and underwent a physical examination. Blood and urine analyses were conducted. HTGW was diagnosed using anthropometric criteria for the European population (waist circumference: for men, ≥ 94 cm; for women, ≥ 80 cm) and fasting plasma triglycerides (TGs) ≥ 1.71 mmol l(-1) (≥ 150 mg per 100 ml). RESULTS: The prevalence of HTGW was 14.5% (men: 18.2%, women: 10.8%) and was significantly greater in men <59 years (P<0.001). HTGW was associated with older individuals, a low educational level and, in men, with a sedentary lifestyle (P<0.001). Subjects with HTGW had higher levels of total cholesterol, low-density lipoprotein-cholesterol (LDL-c) and uric acid, lower levels of high-density lipoprotein-cholesterol, a higher blood pressure, a greater degree of obesity and a higher prevalence of T2DM (20.00 vs 6.4%, P<0.001) (odds ratio (OR) 3.61; 95% confidence interval (95% CI), 2.60-5.01) and CVD (8.5 vs 3.4%, P<0.001) (OR 2.63; 95% CI, 1.66-4.16). The association of HTGW with T2DM and CVD disappeared after adjusting for age. The degree of concordance between HTGW and the metabolic syndrome (MS) was moderate, with both the Adult Treatment Panel III Report (ATP-III) and the International Diabetes Federation criteria (κ=0.51 and κ=0.58, respectively). Subjects with isolated HTGW as compared with those with isolated MS (ATP-III) were younger, had greater levels of total cholesterol, LDL-c and TGs and a lower prevalence of obesity, high blood pressure and dysglycemia. CONCLUSION: HTGW is a phenotype of cardiometabolic risk prevalent in the adult population in our environment. HTGW may be an alternative to MS to detect the population at risk for T2DM and CVD, especially in young individuals who do not fulfill the criteria for MS.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Angiopatías Diabéticas/epidemiología , Hipertrigliceridemia/epidemiología , Obesidad Abdominal/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/sangre , Colesterol/sangre , HDL-Colesterol/sangre , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Angiopatías Diabéticas/sangre , Angiopatías Diabéticas/fisiopatología , Femenino , Humanos , Hipertrigliceridemia/sangre , Masculino , Persona de Mediana Edad , Obesidad Abdominal/sangre , Factores de Riesgo , España/epidemiología , Triglicéridos/sangre , Salud Urbana , Circunferencia de la Cintura , Adulto JovenRESUMEN
OBJETIVO: Analizar la dosimetría en braquiterapia ginecólogica para el dispositivo Fletcher-Suit-Delclos con alta tasa de dosis, mediante placas radiográficas ortogonales (anteroposterior y lateral) versus tomografía axial computada (TAC). MATERIAL Y MÉTODOS: Se compararon dosimetrías de 4 implantes, realizadas con placas ortogonales y TAC pélvico en la Unidad de Braquiterapia del Instituto Nacional del Cáncer durante el mes de febrero del año 2006. Se prescribieron dosis de 8 Gy/fracción a punto H y se evaluó dosis a vejiga, recto y vagina según norma internacional. RESULTADOS: Las dosimetrías por TAC mostraron puntos calientes superiores a las placas ortogonales, para recto un 133% y para vejiga un 260% más aproximadamente. El porcentaje de volumen blanco incluido es subestimado con la dosimetría efectuada por placas ortogonales. CONCLUSIONES: La dosimetría por placas ortogonales muestra menor exactitud que el TAC. Los volúmenes blanco no son satisfactoriamente cubiertos por la curva de isodosis prescrita. La dosis acumulada, probablemente, sea más relevante que la dosis fracción.
OBJECTIVE: We analyze the gynecologycal high dose rate brachytherapy dosimetry using the Fletcher-Suit-Delclos device, comparing orthogonal films (anteroposterior and lateral) versus axial computarized tomography. METHODS: 4 implants were analized with orthogonal films and axial computarized tomography in the Brachyhterapy Unit of the National Cancer Institute on February 2006. The dose/fraction was 8 Gy to the H point. The bladder, rectal and vaginal dose point were evaluated according to international specifications. RESULTS: Axial computarized tomography reveals hot points higher than orthogonal films dosimetries (133% and 260% for bladder and rectum respectively). The target volumen included was underestimated with the classical orthogonal film dosimetry. CONCLUSIONS: The orthogonal film dosimetry shows smaller accuracy than axial computarized tomography. The target volumens were not satisfactorily covered by the prescribed isodosis curve. The dose accumulated could, probably, be more prominent than the dose/fraction.
Asunto(s)
Humanos , Femenino , Dosificación Radioterapéutica , Braquiterapia/métodos , Neoplasias del Cuello Uterino/radioterapia , Radiometría/normas , Recto/efectos de la radiación , Vejiga Urinaria/efectos de la radiación , Radioterapia Asistida por ComputadorRESUMEN
OBJECTIVE: Double-barrelled wet colostomy is a urinary diversion technique indicated when a concurrent faecal diversion is needed. It is a simple procedure, technically easy to accomplish and well received by patients. The purpose of this study is to report the results of double-barrelled wet colostomy, with emphasis on operating technique, morbidity, functional results and a review of the literature on the subject. METHODS: The medical records of 9 consecutive patients, between January 2001 and May 2005, who underwent surgical extended resections with double-barrelled wet colostomy for a malignant central pelvic mass, were reviewed retrospectively. The patients were asked to respond to a questionnaire assessing quality of life. The questionnaire used was the QLQ-C30 version 3, proposed by the European Organization for Research and Treatment of Cancer (EORTC). RESULTS: This study presents results obtained from 9 patients, emphasizing morbidity and quality of life. One patient presented with pyelonephritis. We did not identify complications such as hydroelectrolytic disturbances, peristomal dermatitis or hydronephrosis. The patients who submitted to the procedure exhibited high levels of quality of life and found caring for the stomas straight forward. CONCLUSIONS: We conclude that double-barrelled wet colostomy is an excellent choice for patients who require concurrent urinary and faecal diversion, one that does not present technical difficulties and does not require a prolonged operating time. It avoids the complications frequently present in standard wet colostomy and does not rule out making a continent urinary reservoir later, in patients that meet healing criteria.
Asunto(s)
Anastomosis en-Y de Roux/métodos , Neoplasias del Ciego/cirugía , Neoplasias Colorrectales/cirugía , Colostomía/métodos , Derivación Urinaria/métodos , Neoplasias Uterinas/cirugía , Adulto , Anastomosis en-Y de Roux/efectos adversos , Neoplasias del Ciego/patología , Neoplasias Colorrectales/patología , Colostomía/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Calidad de Vida , Estudios Retrospectivos , Resultado del Tratamiento , Derivación Urinaria/efectos adversos , Neoplasias Uterinas/patologíaRESUMEN
No disponible