[Changes in the fat composition and histomorphology of the liver in TPN, with and without ultra-short bowel]. / Cambios en la composición de la grasa y en la histomorfología hepáticas tras NPT, con y sin intestino ultra-corto.

BACKGROUND & AIMS: Short Bowel syndrome is a serious intestinal insufficiency. The most common etiology in adults nowadays is intestinal ischemia and inflammatory disease, while in children the most common are congenital anomalies, volvolus and necrotizing enterocolaitis, which makes the TPN obligatory. However the intestine is intimately related to the liver through the entero-hepatic circulation and different endocrinological entero-hepatic systems. Massive intestinal resections and TPN would alter this relationship, and could change the hepatic tissue composition and its histomorphology. The aim of this work is to know these changes in more detail. MATERIALS AND METHODS: We used 3 experimental groups: Group A (10 guinea pigs), which was given anesthetic and a simple laparotomy and fed for 10 days with NPT. Group B (10 guinea pigs), underwent total thin intestine resection and were fed for 10 days with NTP. The control group (6 guinea pigs) underwent anesthetic and a simple sham laparotomy and were fed orally. After this period blood and hepatic tissue samples were taken in order to study the liver fat (total fat, proportion of neutral and polar lipids, proportion of phospholipids and fatty acids). Liver biopsies were taken and studied under an optical microscope. RESULTS: The animals from group A and B, underwent NPT, showed a significant increase in glycemie and serum triglycerides, decreasing the cholesterol in GB. There was a significant decrease in weight and in the proportion of fat per g of the liver tissue, at a maximum level in GB, and an even higher decrease in the LP/LN ratio in GA and GB. There was also a change in the proportion of phospholipids, decreasing the Phosphatidilinositol and increasing the Phosphatidiletanolamine. There was also a decrease in the AG w6/w3 ratio. Histologically appear a steatohepatitys, with a striking decrease in the mitochondrial density, being more intensive in GB. CONCLUSIONS: NPT alters the composition of the hepatic fat and the hystomorphology of the liver. The short bowel syndrome have more lesional mechanisms, favouring the hepatic damage caused by NPT.

Calidad de vida en mamoplastia de reducción / No disponible

Objetivo: En nuestro estudio medimos la calidad de vida enun grupo de mujeres con hipertrofia mamaria que se encuentranen lista de espera quirúrgica para someterse a una mamoplastiade reducción, así como en otro grupo de pacientesdonde ya se ha llevado a cabo esta intervención, en nuestroServicio de Cirugía entre los años 2000-2005.Pacientes y métodos: Estudio observacional de tipo descriptivoy transversal.Utilizamos dos cuestionarios validados como son el ShortForm 36 (SF-36) y Beck Depresión Inventory (BDI), asícomo un cuestionario propio de signos y síntomas físicos másespecíficos de la hipertrofia mamaria. Estas pruebas objetivasfueron administradas a 53 pacientes sometidas a una mamoplastiade reducción y a 17 que se encontraban en lista de esperaen el momento de realizar el estudio.Resultados: Las mujeres intervenidas obtuvieron una puntuaciónmayor en el SF-36 que las que se encontraban en listade espera (82,06 ± 21,4 operadas vs. 72,12 ± 13,54 lista deespera). La mayoría de las pacientes intervenidas vieron cumplidassus expectativas con respecto a la intervención (81,1%).Los síntomas físicos en las pacientes operadas están muy disminuidoscon respecto a los que se presentan en el grupo delas no operadas con hipertrofia mamaria.Conclusiones: Las mujeres operadas demuestran disfrutarde mayor calidad de vida. La mamoplastia de reducción es unaintervención que reporta gran satisfacción a las pacientes quese someten a ella. Los síntomas derivados de la hipertrofiamamaria, sobre todo físicos, fueron menos frecuentes en elgrupo de las pacientes operadas. Los cuestionarios de calidadde vida son una herramienta muy útil para nuestra práctica clínicahabitual(AU)

Objetive: In our study we measured the quality of life in agroup of women with mammary hypertrophy who are in surgicalwaiting list to surrender to a reduction mammoplasty,and in another group of patients already operated with reductionmammoplasty in our Service of Surgery between theyears 2000-2005.Patients and methods: We used two validated questionnaireslike the Short Form 36 (SF-36) and Beck Depression Inventory(BDI), as well as an own questionnaire of signs and more specificphysical symptoms of the mammary hypertrophy. These testswere administered to 53 patients submitted to a reduction mammoplastyand to 17 women who were in waiting-list for reductionmammoplasty in the moment to realize the study.Results: The operated on women obtained a major punctuationin the SF-36 that those who were in waiting-list[82,06±21,4 operated on ones vs 72,12 ±13,54 waiting-list].The majority of the operated on patients saw her expectationsfulfilled with regard to the intervention (81,1 %). The physicalsymptoms in the operated on patients are very diminishedwith regard to those who appear in the group of the not operatedon ones with mammary hypertrophy.Conclusions: The operated on women demonstrate to enjoymajor quality of life. The reduction mammoplasty is an interventionthat reports great satisfaction to the patients whosurrender to it. The symptoms resulting from breast hypertrophy,especially physical, were less frequent until almost disappearin the group operated questionnaires of quality of life area very useful tool for our clinical habitual practice(AU)