[Sepsis and septic shock: a turmoil of inflammatory mediators with difficult therapeutic management]. / Sepsis y shock séptico: un torbellino de mediadores inflamatorios de difícil manejo terapéutico.

Sepsis and septic shock continue being a topic of enormous interest for their high frequency, and for not existing a decrease in the figures of mortality in spite of the new acquired knowledges relation with their physiopathology and the advances arisen in the diverse applied treatments. The purpose of the present study is to update the present notions in the specialized literature, trying to summarize the complex existent interaction among different mediators of double character: exogenous and endogenous, and to enunciate the possible causes for those that the novel treatments applied in the sepsis continue not to be very promising.

Sepsis y shock séptico: un torbellino de mediadores inflamatorios de difícil manejo terapéutico / Sepsis and septic shock: a turmoil of inflammatory mediators with a difficult therapeutic management

La sepsis y el shock séptico continúan siendo un capítulo de enorme interés por su elevada frecuencia, y por no existir una disminución en las cifras de mortalidad a pesar de los nuevos conocimientos adquiridos en su fisiopatología y los avances surgidos en los diversos tratamientos aplicados. El propósito de la presente revisión es actualizar los conceptos presentes en la literatura especializada, tratando de resumir la compleja interacción existente entre diferentes mediadores de doble carácter: exógenos y endógenos, y enunciar las posibles causas por las que los tratamientos novedosos aplicados en la sepsis siguen siendo poco prometedores (AU)

Protagonism of the arterial circulation in the preservation of the pig's liver by simple perfusion and hypothermic storage.

A modified technique to perform the successive perfusions of the liver that are necessary for its preservation by the simple perfusion method and hypothermic storage is presented. This technical variety has been tested on Large White pig's livers and consists in doing the successive perfusions of cooling, preservation and washout, first through the hepatic artery and there after through the portal vein. The macroscopic and biochemical characteristics of the effluents obtained through the infrahepatic inferior vena cava during the perfusion-washout of the livers at the end of the period cold ischemia shows its effectiveness. Likewise, the hepatic perfusion-washout begun via the arterial vein and finished via the portal one avoids post-revascularization hyperpotassemia in the receptor animals. It is hypothesized that the arterial protoganism of perfusions, when the simple perfusion and hypothermic storage method of hepatic preservation is used, could be a prophylaxis against complications of a post-transplant biliary origin.

[Effect of verapamil on hepatorenal toxicity induced by cyclosporin]. / Efecto de verapamil sobre la toxicidad hepatorrenal inducida por ciclosporina.

The immunosuppressive and nephrotoxic effects of cyclosporine A (CsA) have been ascribed to a calcium-dependent mechanism of action. However, verapamil, a slow-calcium-channel blocking agent, enhances the immunosuppressive action of CsA and reduces its nephrotoxicity. The present experimental study performed in Wistar rats demonstrates that 0.1 mg..24 h.-1 IM verapamil prevents reduction of liver weight caused by treatment with 20 mg..kg.-1..24 h.-1 IM, as well as a rise in SGOT, SGPT, serum LDH and creatinine. The nephro-protective effects of verapamil in rats treated with CsA could be ascribable to the increased plasma clearance of the immunosuppressive agent.

[Segmental portal hypertension caused by aneurysm of the distal splenic artery]. / Hipertensión portal segmentaria por aneurisma de la arteria esplénica distal.

A case is reported of segmental portal hypertension secondary to compression of the splenic vein by an aneurysm of the distal splenic artery. Splenectomy was used to treat the aneurysm and segmental portal hypertension, as well as the hypersplenism existent. Collateral circulation through the short gastric veins originated grade V gastroesophageal varices, which makes this mechanism of production equivalent to that described in cases of thrombosis of the splenic vein.

[Ductal adenocarcinoma of the head of the pancreas: associated pathology of body and tail]. / Adenocarcinoma ductal de la cabeza del páncreas: patología asociada de cuerpo y cola.

Histologic study of the body and tail of the pancreas in a patient in whom total duodenopancreatectomy was carried out for ductal adenocarcinoma of the head (ADC) demonstrates the existence of dysplasia of the pancreatic duct in its entire length associated with intente parenchymal atrophy. It is considered that cephalic duodenopancreatectomy in ductal adenocarcinoma of the head of the pancreas should be based on an adequate anatomic, histologic and functional evaluation of the residual pancreas.