Lactobacillus fermentum UCO-979C beneficially modulates the innate immune response triggered by Helicobacter pylori infection in vitro.

Helicobacter pylori infection is associated with important gastric pathologies. An aggressive proinflammatory immune response is generated in the gastric tissue infected with H. pylori, resulting in gastritis and a series of morphological changes that increase the susceptibility to cancer development. Probiotics could present an alternative solution to prevent or decrease H. pylori infection. Among them, the use of immunomodulatory lactic acid bacteria represents a promising option to reduce the severity of chronic inflammatory-mediated tissue damage and to improve protective immunity against H. pylori. We previously isolated Lactobacillus fermentum UCO-979C from human gastric tissue and demonstrated its capacity to reduce adhesion of H. pylori to human gastric epithelial cells (AGS cells). In this work, the ability of L. fermentum UCO-979C to modulate immune response in AGS cells and PMA phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 (human monocytic leukaemia) macrophages in response to H. pylori infection was evaluated. We demonstrated that the UCO-979C strain is able to differentially modulate the cytokine response of gastric epithelial cells and macrophages after H. pylori infection. Of note, L. fermentum UCO-979C was able to significantly reduce the production of inflammatory cytokines and chemokines in AGS and THP-1 cells as well as increase the levels of immunoregulatory cytokines, indicating a remarkable anti-inflammatory effect. These findings strongly support the probiotic potential of L. fermentum UCO-979C and provide evidence of its beneficial effects against the inflammatory damage induced by H. pylori infection. Although our findings should be proven in appropriate experiments in vivo, in both H. pylori infection animal models and human trials, the results of the present work provide a scientific rationale for the use of L. fermentum UCO-979C to prevent or reduce H. pylori-induced gastric inflammation in humans.

Sublingual tacrolimus administration provides similar drug exposure to per-oral route employing lower doses in liver transplantation: a pilot study.

BACKGROUND: Per-oral tacrolimus administration is not always practicable. Sublingual administration is a potential alternative, but its feasibility and effectiveness compared with oral route has not been established. AIM: To compare tacrolimus drug exposure after sublingual and oral administration in liver transplant recipients. METHODS: Experimental, open-label, non-randomised, cross-over study. Tacrolimus exposure was evaluated in 32 liver transplant recipients receiving oral administration. 12 h tacrolimus area-under-the-curve (AUC0-12 h ) was calculated using tacrolimus blood concentrations at 0-0.5-1-2-4-6-8-12 hrs post-dose. Recipients were switched to sublingual administration, and dose was adjusted to reach similar trough levels, new AUC0-12 h was calculated. Correlation between AUC0-12 h and trough levels was determined for both oral and sublingual phases. RESULTS: Similar trough levels were accomplished with oral and sublingual administration (6.68 ± 2 ng/mL vs. 6.62 ± 1.9 ng/mL (P = 0.8)). Although concentration 2 h post dose was higher in oral phase (15.36 ± 7.14 vs. 13.18 ± 5.64, P = 0.015), AUC0-12 h was similar in both phases (116.6 ± 34.6 vs. 111.5 ± 36.93 ng/mL* h, P = 0.19). Daily dose of tacrolimus required in sublingual phase was 37% lower than that used in oral phase (P < 0.0001), suggesting significantly increased bioavailability of tacrolimus when employing sublingual route. Good correlation between AUC0-12 h and trough levels was observed in sublingual phase (r2 = 0.74). Twenty-two recipients were maintained on sublingual administration after the end of study (mean follow-up: 18.7 ± 5.8 months). No difference in liver function tests or rejection rates was found during follow-up period. CONCLUSIONS: Sublingual administration of tacrolimus is feasible and provides similar drug exposure compared with oral administration. In our study, at long-term follow-up, sublingual administration was not associated with liver transplant rejection.

Prevalence, geographic distribution and phenotypic differences of Piscirickettsia salmonis EM-90-like isolates.

Early reports accounted for two main genotypes of Piscirickettsia salmonis, a fish pathogen and causative agent of piscirickettsiosis, placing the single isolate EM-90 apart from the prototypic LF-89 and related isolates. In this study, we provide evidence that, contrary to what has been supposed, the EM-90-like isolates are highly prevalent and disseminated across Chilean marine farms. Molecular analysis of 507 P. salmonis field isolates derived from main rearing areas, diverse hosts and collected over 6 years, revealed that nearly 50% of the entire collection were indeed typed as EM-90-like. Interestingly, these isolates showed a marked host preference, being recovered exclusively from Atlantic salmon (Salmo salar) samples. Although both strains produce undistinguishable pathological outcomes, differences regarding growth kinetics and susceptibility to the antibiotics and bactericidal action of serum could be identified. In sum, our results allow to conclude that the EM-90-like isolates represent an epidemiologically relevant group in the current situation of piscirickettsiosis. Based on the consistency between genotype and phenotype exhibited by this strain, we point out the need for genotypic studies that may be as important for the Chilean salmon industry as the continuous surveillance of antimicrobial susceptibility patterns.

[Earthquake in Chile: acute stress and post traumatic stress disorder among women in treatment for severe depression]. / Terremoto en Chile: estrés agudo y estrés post-traumático en mujeres en tratamiento por depresión grave.

BACKGROUND: Depression is a risk factor for developing secondary post-traumatic stress disorder. The earthquake on February 27th, 2010, destroyed the Hospital of Curicó. Despite the prevailing chaos, patients in treatment for severe depression actively maintained their treatment from the first post-earthquake working day AIM: To determine prevalence of acute stress (AS) and post-traumatic stress disorder (PTSD) after the earthquake among women in treatment for severe depression. MATERIAL AND METHODS: Seventy five women aged 20 to 73 years in treatment for depression for at least six months before the oceurrence of the earthquake, who continued in follow up after the event, were studied. According to the Tenth International Classification of Diseases, the frequency of AS was assessed during the consultation oceurring one month after the event and the frequency of PTSD was assessed during the consultation oceurring six months after the event. RESULTS: Fifty nine percent of women had AS symptoms at the first month and 53.3% had PTSD, six months later. AS was significantly associated with a low educational level. PTSD was significantly associated with prior oceurrence of AS and a history of childhood trauma history. CONCLUSIONS: A high frequeney of PTSD was observed in this group of depressive patients, which was significantly associated with a history of previous AS and childhood trauma.

Terremoto en Chile: estrés agudo y estrés post-traumático en mujeres en tratamiento por depresión grave / Earthquake in Chile: acute stress and post traumatic stress disorder among women in treatment for severe depression

Background: Depression is a risk factorfor developing secondary post-traumatic stress disorder. The earthquake on February 27th, 2010, destroyed the Hospital of Curicó. Despite the prevailing chaos, patients in treatment for severe depression actively maintained their treatment from the first post-earthquake workingday Aim: To determine prevalence of acute stress (AS) and post-traumatic stress disorder (PTSD) after the earthquake amongwomen in treatment for severe depression. Material and Methods: Seventy five women aged 20 to 73 years in treatment for depression for at least six months before the oceurrence of the earthquake, who continued in follow up after the event, were studied. According to the Tenth International Classification ofDiseases, thefrequency ofAS was assessed duringthe consultation oceurring one month after the event and thefrequency ofPTSD was assessed during the consultation oceurring six months after the event. Results: Fifty nine percent of women hadAS symptoms at thefirst month and 53.3% had PTSD, six months later. AS was signifi cantly associated with a low educational level. PTSD was significantly associated with prior oceurrence of AS and a history of childhood trauma history. Conclusions: A high frequeney ofPTSD was observed in thisgroup of depressive patients, which was significantly associated with a history ofprevious AS and childhood trauma.

Terremoto en Chile: evolución del estado clínico global y los síntomas post-traumáticos en una cohorte de mujeres con depresión severa en un hospital público enfrentadas al terremoto del 27 de febrero de 2010 / Earthquake in Chile: evolution of the global clinical impression and post-traumatic symptoms in a cohort of women in treatment for severe depression in a public hospital, who confronted the earthquake on february, 27th 2010

Objective: To reveal the impact on the global clinical status and post-traumatic symptoms evolution in women in treatment for severe depression in the Hospital of Curicó, who confronted the F-27 earthquake. Methodology: 75 women in treatment for severe depression were evaluated from the first working day after the catastrophe. According to the ICD-10, acute stress (AS) and post-traumatic stress disorder (PTSD) were clinically determined. The routinary use of the Clinical Global Impression scale (CGI) allowed the monitoring of the clinical status before and after the earthquake. The eight-item treatment-outcome post-traumatic stress disorder scale (TOP-8) was applied twice, at the first and sixth months. Results: AS: 58.7 percent, PTSD: 53.3 percent. Significant deterioration in CGI was observed one month post-event (X² = 3.88; p < 0.05) and an ostensible improvement six months later (X² = 4.65; p < 0.04). The post-traumatic symptoms did not improve significantly. More severe CGI immediately after the earthquake was significantly associated to AS (X² = 13.794; p < 0.008) and to the subsequent development of PTSD (X² = 16.437; p < 0.002). More severe CGI after six months was correlated significantly with previous AS (X² = 15.849; p < 0.003), with PTSD (X² = 17.780; p < 0.001) and with records of childhood trauma (X² = 18.431; p<0.01). Conclusions: After a significant clinical deterioration observed immediately post disaster, at six month the CGI improved the CGI, while post-traumatic symptoms did not. There was no increase in suicidal behavior. Records of childhood trauma were associated with significant aggravation of the CGI six months after the earthquake...

Objetivo: Conocer la evolución clínica global y de síntomas postraumáticos en mujeres enfrentadas al terremoto del 27-F que se encontraban en tratamiento por depresión severa en el Hospital de Curicó. Metodología: 75 mujeres en tratamiento por depresión severa fueron evaluadas a contar del primer día hábil post-catástrofe. Conforme a la CIE-10, se determinó clínicamente estrés agudo (EA) durante el primer mes y postraumático (TEPT) a los seis meses. El uso rutinario de la escala de impresión clínica global (CGI) permitió monitorear el estado clínico desde antes del terremoto. La escala de 8 ítems para la evaluación del trastorno de estrés post-traumático (TOP-8) fue aplicada al primer y sexto mes post-desastre. Resultados: Las prevalencias encontradas fueron: EA 58,7 por ciento y TEPT 53,3 por ciento. Se observó deterioro significativo en CGI al primer mes post- evento (X² = 3,88; p = 0,05) y una ostensible mejoría a los seis meses (X² = 4,65; p = 0,04). No mejoraron significativamente los síntomas postraumáticos. Estados más graves inmediatamente después del terremoto se asociaron significativamente a EA (X² = 13,794; p = 0,008) y a desarrollo posterior de TEPT (X² = 16,437; p = 0,002). Estados más graves a los seis meses se correlacionaron significativamente con EA previo (X² = 15,849; p = 0,003), TEPT X² = 17,780; p = 0,001) y antecedentes de trauma infantil (X² = 18,431;p = 0,01). Conclusiones: Luego del agravamiento clínico inicial post-terremoto, a los seis meses no mejoraron significativamente los síntomas postraumáticos de las pacientes, pero mejoró la CGI y no se observó un aumento de conductas suicidas. El antecedente de trauma infantil se asoció a un deterioro significativo de la CGI a los seis meses post-terremoto...

[Efficacy and associated costs of an outpatient intervention in women with severe depression and early trauma]. / Eficacia y costos asociados a un tratamiento ambulatorio en mujeres con depresión severa y trauma temprano.

BACKGROUND: A high proportion of women consulting for depression have a history of childhood abuse and trauma. AIM: To compare the efficacy and costs associated with a treatment that enquires directly into childhood trauma and understands present interpersonal difficulties as a compulsion to repeat the traumatic past, versus the usual treatment, in women with severe depression and childhood trauma. MATERIAL AND METHODS: Eighty seven women with depression and prior history of early trauma that sought help at the Mental Health Unit of the Hospital de Curicó were studied. Forty four were randomly assigned to the experimental treatment, and 43 to the usual management. Patients were evaluated using the Hamilton Depression Scale, the Outcome Questionnaire (OQ 45.2) and an expenditures sheet at baseline, three and six months. An intention to treat analysis and a simple cost-analysis were performed. RESULTS: Hamilton and OQ 45.2 scores improved in both treatment groups, with significantly better results achieved in the experimental patients. The direct overall costs of experimental and control treatments were CLP 8,628,587 and 9,688,240, respectively. The main contributors to costs in both arms were medications (26.5%), followed by the number of psychiatric consultations (19.2%) in the experimental group and by hospitalizations (25.4%) in the control group. The costs per patient recovered in experimental and control groups were CLP 616,328 and 1,973,649, respectively. CONCLUSIONS: The proposed model resulted more effective for the treatment of this group of women.

Eficacia y costos asociados a un tratamiento ambulatorio en mujeres con depresión severa y trauma temprano / Efficacy and associated costs of an outpatient intervention in women with severe depression and early trauma

Background: A high proportion of women consulting for depression have a history of childhood abuse and trauma. Aim: To compare the effcacy and costs associated with a treatment that inquires directly into childhood trauma and understands present interpersonal diffculties as a compulsion to repeat the traumatic past, versus the usual treatment, in women with severe depression and childhood trauma. Material and Methods: Eighty seven women with depression and prior history of early trauma that sought help at the Mental Health Unit of the Hospital de Curicó were studied. Forty four were randomly assigned to the experimental treatment, and 43 to the usual management. Patients were evaluated using the Hamilton Depression Scale, the Outcome Questionnaire (OQ 45.2) and an expenditures sheet at baseline, three and six months. An intention to treat analysis and a simple cost-analysis were performed. Results: Hamilton and OQ 45.2 scores improved in both treatment groups, with signifcantly better results achieved in the experimental patients. The direct overall costs of experimental and control treatments were CLP 8,628,587 and 9,688,240, respectively. The main contributors to costs in both arms were medications (26.5 percent), followed by the number of psychiatric consultations (19.2 percent) in the experimental group and by hospitalizations (25.4 percent) in the control group. The costs per patient recovered in experimental and control groups were CLP 616,328 and 1,973,649, respectively. Conclusions: The proposed model resulted more effective for the treatment of this group of women.

Effect of estradiol benzoate used at the start of a progestagen treatment on superovulatory response and embryo yield in lactating and non-lactating llamas.

Two experiments were conducted to determine the effect of estradiol benzoate (EB) and intravaginal progestagen treatment on ovarian follicular dynamics and superstimulatory response in eCG-treated llamas. The purpose of Experiment 1 was to evaluate the effect of EB and progestagen treatment starting at different phases of dominant follicle (DF1) development on regression pattern and subsequent follicle wave emergence (WE2) in lactating and non-lactating llamas. Early lactating (n=24, 30+/-4 days postpartum) and non-lactating (n=24) females were assigned in equal numbers (n=8) to one of three groups according to the phase of DF1 (growing, static or regressing) determined by ultrasonography from day -3 to day 0. At day 0, llamas received an intravaginal sponge (MPA, 150 mg) and 5mg of MPA (i.m.). Half of the females (n=4) of each group were injected with 2mg (i.m.) of EB and half were not (control group). A 2 x 2 x 3 (lactational status, EB treatment and follicular phases) factorial design was used. Each sponge was removed 8 days later. Ovaries were monitored from day 0 to day 12. Daily blood samples were taken to determine 17beta-estradiol (E(2)) profiles from day 0 to day 8. The DF1 regression pattern was not affected (P>0.05) by the phase of follicle wave at the start of the treatment or any interactions among main effects. Follicle wave emergence in EB-treated llamas was delayed (P<0.05) by 2.3 days compared with non-treated llamas. Following EB treatment, plasma concentrations of E(2) were greater (P<0.05) from day 1 to day 5 in the treated than in non-treated females, but not from day 6 onward (P>0.05). Experiment 2 was designed to evaluate the effect of this treatment on the ovarian superovulatory response and embryo yield following eCG treatment administered on day of follicular wave emergence as determined in the Experiment 1. The same lactating (n=18, 61+/-4 days postpartum) and non-lactating (n=18) llamas at random stages of follicle wave were treated as those in Experiment 1 and received 1200IU of eCG at the time of WE2 (EB-treated=day 6.5 and non-treated=day 4.5). Llamas were mated 5 days after sponge withdrawal. A second mating was allowed 24h later. Embryos were collected between 7 and 8 days after the first mating and blood samples were taken to determine progesterone (P(4)) concentrations. The mean number of follicles on day of mating and the number of CL on day of embryo collection were not affected by lactational status, EB treatment or their interactions (P>0.05). Ovulation rate and mean (+/-SEM) number of recovered embryos for EB treatment group (67.5% and 2.4+/-0.4) were greater (P<0.05) than for no EB treatment (51.1% and 1.1+/-0.4). Plasma P(4) concentrations and number of CL per llama were correlated (r=0.49; P=0.014). In conclusion, progestagen plus EB treatment facilitates the prediction of the emergence of a new follicular wave approximately 6 days after treatment and resulted in a higher ovulation rate and embryo production in ovarian superstimulated llamas regardless of lactational status.

Total gastrectomy with or without abdominal drains. A prospective randomized trial.

The most common postoperative complications of total gastrectomy are esophagojejunal anastomotic leakage and subphrenic abscess. These complications are a cause of morbidity and mortality, relaparotomy, and longer postoperative stay. The use of abdominal drains is useful for the early diagnosis and management of anastomotic leaks. The aim of this study was to analyze our experience with total gastrectomy for gastric cancer in patients with and without abdominal drains, and to evaluate the results regarding postoperative morbidity, postoperative hospital stay, postoperative days for oral intake, relaparotomy and mortality. This prospective and randomized study examines the results in 60 consecutive patients (43 males and 17 females) with gastric cancer who underwent total gastrectomy in the Regional Clinical Hospital of Concepción, Chile, between 2000 and 2003. Patients were divided into two groups: group I (without drains) and group II (two drains). We found 31 patients in group I and 29 patients in group II. The mean length of postoperative stay was 12.9 days in group I and 18.8 days in group II (p = 0.0242, s.). Morbidity was 9.7% in group I and 37.9% in group II (p = 0.0242, s.). Re-explorations were more frequent in group II (24.1%) versus group I (9.7%) (p = 0.1239, n.s.). Postoperative days for oral intake were 9.4 in group I and 12.8 in group II (p = 0.0514, n.s.) Mortality was 0% in group I and 3.4% in group II (p = 0.4833, n.s.). In our experience, morbidity and postoperative hospital stay were statistically higher in the group of patients with abdominal drains.

Gastrectomía total con o sin drenajes abdominales / Total gastrectomy with or without abdominal drains. A prospective randomized trial

The most common postoperative complications of total gastrectomyare esophagojejunal anastomotic leakage and subphrenicabscess. These complications are a cause of morbilityand mortality, relaparotomy, and longer postoperative stay. Theuse of abdominal drains is useful for the early diagnosis andmanagement of anastomotic leaks. The aim of this study was toanalyze our experience with total gastrectomy for gastric cancerin patients with and without abdominal drains, and to evaluatethe results regarding postoperative morbidity, postoperativehospital stay, postoperative days for oral intake, relapatorotomyand mortality. This prospective and randomized study examinesthe results in 60 consecutive patients (43 males and 17 females)with gastric cancer who underwent total gastrectomy in the RegionalClinical Hospital of Concepción, Chile, between 2000and 2003. Patients were divided into two groups: group I (withoutdrains) and group II (two drains). We found 31 patients ingroup I and 29 patients in group II. The mean length of postoperativestay was 12.9 days in group I and 18.8 days in group II(p = 0.0242, s.). Morbidity was 9.7% in group I and 37.9% ingroup II (p = 0.0242, s.). Re-explorations were more frequent ingroup II (24.1%) versus group I (9.7%) (p = 0.1239, n.s.). Postoperativedays for oral intake were 9.4 in group I and 12.8 ingroup II (p = 0.0514, n.s.) Mortality was 0% in group I and3.4% in group II (p = 0.4833, n.s.). In our experience, morbidityand postoperative hospital stay were statistically higher in thegroup of patients with abdominal drains

Experiencia en traumatismo torácico: Hospital Valparaíso / Experience in thoracic traumatism: Valparaiso Hospital

Las lesiones del tórax son el resultado de trauma cerrado o abierto, que generalmente ocurren como consecuencia de lesiones por arma de fuego, arma blanca, accidentes de tránsito o compresiones torácicas por aplastamientos, entre otros. Se revisaron 163 fichas clínicas del Servicio de Cirugía Torácica del Hospital de Valparaíso entre enero de 1998 y junio de 2001. Se confeccionó un protocolo con datos a obtener de la ficha. Se analizaron los datos en valores absolutos y porcentajes. Posteriormente se efectuó una comparación de algunas variables entre el grupo de trauma abierto y el de cerrado. El 94,5 por ciento (154 pactes) correspondió a hombres y 5,5 por ciento (9 pactes) a mujeres. El promedio de edad fue de 30,9 años (rango 16-86). El mecanismo de trauma más frecuente fueron lesiones por armas blancas, (125 casos), seguido de caídas de altura (19 casos), accidentes de tránsito (9 casos), y armas de fuego (6 casos). Ciento veintiséis pacientes presentaron traumatismo abierto y 37 cerrado. Las lesiones más frecuentes fueron: neumotórax, 116 casos; hemotórax, 92 casos; y fracturas costales, 28 casos. El 87,1 por ciento de los traumatismos se manejó con tubo pleural (142 pactes). Sólo 11 pacientes necesitaron toracotomía de urgencia.

Fetal mortality diagnosis by ultrasound in the vicuña (Vicugna vicugna).

Ultrasonography is widely used in domestic species of camelids, but there is no information about the use of this technique for pregnancy diagnosis and determination of embryonic or fetal losses in the vicuña (Vicugna vicugna). The study was performed in 202 vicuñas (3-year-old females, n = 31; adult females, n = 171) mated during the summer months (January through March 2001) at the Abra Pampa Experimental Farm of Altitude in north-west Argentina. Transrectal ultrasound examination was performed in May (estimated 40-120 days of gestation) to determine the number of pregnant females. The pregnancy rate was 45.5% (92/202). No significant difference (P > 0.05) was observed between the pregnancy rate of 3-year-old females (41.9%) and adult females (46.2%). In December (estimated 250-330 days of gestation) of the same year, a second ultrasonographic study was performed on those vicuñas that were diagnosed as pregnant from the first ultrasound scan. Of 92 animals diagnosed as pregnant in May, only 84 were present in December, because eight females died in the period of study. Overall, 11.9% (10/84) of fetuses were lost during the period (18.1% in 3-year-old vicuñas and 10.9% in adult vicuñas). In conclusion, transrectal ultrasonography was found to provide a rapid and non-invasive means for pregnancy and fetal mortality diagnosis in vicuñas.

Successful transfer of vitrified Ilama (Lama glama) embryos.

The exploitation of the domestic animals species of South American camelids is of great social importance for the native people living in the High Andes. The reproductive physiology of these species is a unique challenge in the development of advanced breeding techniques. At present, the cryopreservation of embryos has not been developed and very few investigations have been conducted. The objective of the present work was to evaluate the in vivo survival of vitrified llama embryos after transfer to recipient females. Donors females were treated with a CIDR-estradiol benzoate-eCG regimen and were mated naturally 6 days after CIDR withdrawal. One ovulatory dose (8 microg) of GnRH was administered immediately after mating. A second mating was allowed 24 h later. Embryo recovery was performed nonsurgically between 8 and 8.5 days after the first mating. Twenty-two ova/embryos were recovered from 12 donor females. Hatched blastocysts were exposed to vitrification solution (20% glycerol + 20% ethylene glycol + 0.3 M sucrose + 0.375 M glucose + 3% polyethylene glycol (P/V)) in three steps, and after loading into 0.25 ml straws, were plunged into liquid nitrogen. For embryo transfer, recipients animals were ovulation-synchronized using GnRH administered at the same time as donors. A total of eight vitrified-warmed embryos and 12 fresh embryos were nonsurgically transferred to four and six recipient females, respectively (two embryo per recipient). The pregnancy rates were 50 and 33.3% for recipients that had received vitrified embryos and fresh embryos, respectively. The results demonstrated the effectiveness of this simple vitrification method for cryopreservation of llama embryos.

Actinomicosis pulmonar / Pulmonary actinomycosis

La actinomicosis torácica pulmonar, rara de ver en la actualidad, ha cambiado considerablemente su presentación clínica, siendo infrecuente ver los antiguos cuadros con destrucción de la pared del tórax y trayectos sinuosos de drenaje. En los últimos tres años en la literatura médica nacional hay sólo algunas publicaciones con 1 ó 2 casos. Presentamos 3 pacientes atendidos en los 2 últimos años en nuestro Servicio con forma de presentación diferente. El diagnóstico definitivo en los tres pacientes se efectuó por el estudio histopatológico de las muestras enviadas. Se analiza las características del germen, formas clínicas de presentación, dificultades diagnósticas y terapia más convenientes

Timectomía total en miastenia gravis / Total thymectomy in myasthenia gravis

Se analiza nuestra experiencia en pacientes con miastenia gravis realizadas en los últimos 10 años. Corresponde a 7 pacientes de sexo masculino y 4 femenino, con una edad media de 35 años. De acuerdo a la clasificación de Osserman, hemos intervenido 4 pacientes en etapa 2A, 5 en 2B y 2 en etapa 1. La histopatología informó: hiperplasia del timo en 8, timo involutivo en 1, grasa con restos de tejido tímico en 1, tejido graso con islotes de células linfocitarias en 1. No hubo mortalidad ni complicaciones quirúrgicas de importancia derivadas de la intervención. Sólo 2 pacientes, en etapa 2B, presentan dentro de las 24 horas del postoperatorio crisis miasténica, que tratadas en forma adecuada evolucionaron bien.

Anatomía quirúrgica de la distribución arterial en el mesocolon transverso / Surgical anatomy of the arterial distribution in the transverse mesocolon

Se presenta la distribución arterial en el mesocolon transverso encontrado en la disección de 58 fetos frescos de ambos sexos a los cuales se les inyectó vía aorta látex coloreado para la visualización. Se resume la descripción de los textos anatómicos clásicos, se compara con nuestro trabajo y se comunican algunas diferencias y hallazgos entre los que se analiza como algo nuevo la presencia de arterias accesorias de la zona pancreática que no se describen en los textos clásicos