The epidemiology of strabismus and cataracts within a pediatric population in Saint Vincent and the Grenadines: an analysis of 201 consecutive cases.

PURPOSE: Childhood cataracts and strabismus are among the most common causes of visual impairment in children worldwide, and prompt diagnosis and correction can significantly reduce disease burden. In certain regions, including the Eastern Caribbean, access to adequate treatment can be limited and epidemiological data scarce. This study aims to analyze the epidemiological data of pediatric strabismus and cataract cases in St. Vincent and the Grenadines. METHODS: The setting of the study is a clinical practice including 201 patients between the age of 0 to 19 who received care with World Pediatric Project (WPP). Factors analyzed include patient age, sex, and type of cataract or strabismus. The findings were compared to publicly available demographic information. RESULTS: The cases were divided into cataract (n=51), strabismus (n=134), and both strabismus and cataract (n=16). Mean ages (years) were 5.96, 5.54, and 4.50, respectively. The most frequent type of cataract and strabismus were congenital (n=25) and esotropia (n=95), respectively. The highest annual cumulative incidence was 31 and 49 cases per 100,000 people for cataracts and strabismus, respectively. CONCLUSION: This study provides regional epidemiological data on pediatric strabismus and cataracts. Further studies can expand the patient population by increasing collaboration with local providers. Ultimately, these findings can offer a basis for which additional epidemiological studies can be performed and help guide public health efforts to prevent visual impairment in St. Vincent and the Grenadines.

PLGA nanoparticles from nano-emulsion templating as imaging agents: Versatile technology to obtain nanoparticles loaded with fluorescent dyes.

The interest in polymeric nanoparticles as imaging systems for biomedical applications has increased notably in the last decades. In this work, PLGA nanoparticles, prepared from nano-emulsion templating, have been used to prepare novel fluorescent imaging agents. Two model fluorescent dyes were chosen and dissolved in the oil phase of the nano-emulsions together with PLGA. Nano-emulsions were prepared by the phase inversion composition (PIC) low-energy method. Fluorescent dye-loaded nanoparticles were obtained by solvent evaporation of nano-emulsion templates. PLGA nanoparticles loaded with the fluorescent dyes showed hydrodynamic radii lower than 40nm; markedly lower than those reported in previous studies. The small nanoparticle size was attributed to the nano-emulsification strategy used. PLGA nanoparticles showed negative surface charge and enough stability to be used for biomedical imaging purposes. Encapsulation efficiencies were higher than 99%, which was also attributed to the nano-emulsification approach as well as to the low solubility of the dyes in the aqueous component. Release kinetics of both fluorescent dyes from the nanoparticle dispersions was pH-independent and sustained. These results indicate that the dyes could remain encapsulated enough time to reach any organ and that the decrease of the pH produced during cell internalization by the endocytic route would not affect their release. Therefore, it can be assumed that these nanoparticles are appropriate as systemic imaging agents. In addition, in vitro toxicity tests showed that nanoparticles are non-cytotoxic. Consequently, it can be concluded that the preparation of PLGA nanoparticles from nano-emulsion templating represents a very versatile technology that enables obtaining biocompatible, biodegradable and safe imaging agents suitable for biomedical purposes.

Methanol-based fixation is superior to buffered formalin for next-generation sequencing of DNA from clinical cancer samples.

BACKGROUND: Next-generation sequencing (NGS) of tumour samples is a critical component of personalised cancer treatment, but it requires high-quality DNA samples. Routine neutral-buffered formalin (NBF) fixation has detrimental effects on nucleic acids, causing low yields, as well as fragmentation and DNA base changes, leading to significant artefacts. PATIENTS AND METHODS: We have carried out a detailed comparison of DNA quality from matched samples isolated from high-grade serous ovarian cancers from 16 patients fixed in methanol and NBF. These experiments use tumour fragments and mock biopsies to simulate routine practice, ensuring that results are applicable to standard clinical biopsies. RESULTS: Using matched snap-frozen tissue as gold standard comparator, we show that methanol-based fixation has significant benefits over NBF, with greater DNA yield, longer fragment size and more accurate copy-number calling using shallow whole-genome sequencing (WGS). These data also provide a new approach to understand and quantify artefactual effects of fixation using non-negative matrix factorisation to analyse mutational spectra from targeted and WGS data. CONCLUSION: We strongly recommend the adoption of methanol fixation for sample collection strategies in new clinical trials. This approach is immediately available, is logistically simple and can offer cheaper and more reliable mutation calling than traditional NBF fixation.

Galantamine-loaded PLGA nanoparticles, from nano-emulsion templating, as novel advanced drug delivery systems to treat neurodegenerative diseases.

Polymeric nanoparticles could be promising drug delivery systems to treat neurodegenerative diseases. Among the various methods of nanoparticle preparation, nano-emulsion templating was used in the present study to prepare galantamine-loaded nano-emulsions by a low-energy emulsification method followed by solvent evaporation to obtain galantamine-loaded polymeric nanoparticles. This approach was found to be suitable because biocompatible, biodegradable and safe nanoparticles with appropriate features (hydrodynamic radii around 20 nm, negative surface charge and stability higher than 3 months) for their intravenous administration were obtained. Encapsulation efficiencies higher than 90 wt% were obtained with a sustained drug release profile as compared to that from aqueous and micellar solutions. The enzymatic activity of the drug was maintained at 80% after its encapsulation into nanoparticles that were non-cytotoxic at the required therapeutic concentration. Therefore, novel galantamine-loaded polymeric nanoparticles have been designed for the first time using the nano-emulsification approach and showed the appropriate features to become advanced drug delivery systems to treat neurodegenerative diseases.

Tumoración cervical y disfonía / Cervical tumor and dysphonia

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Fístula arteriovenosa ilio-ilíaca iatrogénica / Iatrogenic ilio-iliac arteriovenous fistula

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Complicación tras acceso vascular para hemodiálisis. Aneurisma de la arteria humeral / Complications after vascular access for hemodialysis: humeral artery aneurysm

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Luxación de la primera cuña en paciente diabético / Luxation of the first cuneiform bone in a diabetic patient

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[Encephalitis associated to anti-NMDA receptor antibodies: a description of two cases in the child/youth population]. / Encefalitis asociada a anticuerpos antirreceptor de NMDA: descripcion de dos casos en poblacion infantojuvenil.

INTRODUCTION: The clinical diagnosis of encephalitis due to anti-glutamate receptor N-methyl D-aspartate (NMDA) antibodies (anti-NMDA encephalitis) is made more complex by the fact that psychiatric clinical features are usually predominant in the early stages. This can lead to a delay in the diagnosis, treatment and prognosis of the disease. CASE REPORTS: We report on two clinical cases attended by the Child/Youth Psychiatry Section of our hospital, in collaboration with the Paediatric and Neurology services. Case 1: a 4-year-old male who was referred owing to behavioural alterations and the regression of previously acquired skills. Case 2: a 13-year-old female who was admitted due to a behavioural disorder within the context of a possible initial psychotic episode. In both cases appropriate complementary tests were performed, including lumbar puncture and anti-NMDA antibodies, which were positive. Once the diagnosis of anti-NMDA encephalitis had been reached, treatment was started: in the first case, with intravenous perfusion of corticoids and immunoglobulins, while in the second rituximab had to be associated. Both patients progressed towards clinical improvement. CONCLUSIONS: Over the last two years there has been an increase in the number of cases of anti-NMDA encephalitis diagnosed in the child/youth population. It is a neuropsychiatric, autoimmune condition, which can correspond to a paraneoplastic syndrome. Follow-up and transvaginal ultrasonography as well as thoracoabdominal computerised axial tomography scans are recommended for at least two years after diagnosis. Early diagnosis and treatment are important, which means that a multi- and interdisciplinary approach is required.

Cool and hot executive functions in medication-naive attention deficit hyperactivity disorder children.

BACKGROUND: This study aimed to compare 'cool' [working memory (WM) and response inhibition] and 'hot' (delay aversion) executive functions (EFs) in children with and without attention deficit hyperactivity disorder (ADHD). METHOD: A total of 100 ADHD children (45 with family history of ADHD and 55 with no family history) and 100 healthy controls, all medication free, were tested on tasks related to the 'hot' (i.e. two choice-delay tasks) and 'cool' domains of EF (i.e. Digits backward, Corsi Block Task backward, Go/No-Go Task, Stop-Signal Task, and the Stroop). RESULTS: Compared with the controls, children with ADHD were found to perform significantly worse on one or more measures of response inhibition, WM, and delay aversion after controlling for co-morbidities and estimated IQ. In addition, comparisons between ADHD children with family history of ADHD and those with no family history found significant differences on measures of response inhibition and WM but not delay aversion. These results are largely supported by results of two logistic regressions. CONCLUSIONS: ADHD was found to be associated with deficits on both cool and hot EFs. There is also evidence to suggest that cool EFs impairment is related to a family history of ADHD. Findings of this study have helped to elucidate the nature and extent of EF deficits in children with ADHD.

La nueva gripe A (H1N1) 2009 en Atención Primaria: ¿qué nos hemos encontrado? / New influenza A (H1N1) 2009 in Primary Care: what have we found?

Objetivo: describir las características clínicas de los casos de gripe pandémica A (H1N1) 2009 diagnosticados por pediatras centinela del programa PIDIRAC (Programa de información diaria de las infecciones respiratorias agudas de Catalunya) en atención primaria (AP). Material y métodos: la muestra de estudio estaba formada por los casos visitados por cuatro de los pediatras centinela que participan en el programa PIDIRAC. Se recogieron de forma sistemática, para evitar sesgo de muestreo, muestras faríngeas y nasales de los casos sospechosos de gripe para su estudio virológico. Cada semana del periodo de estudio se seleccionaron los dos primeros pacientes que acudieron a la consulta y cumplían con los criterios de caso sospechoso, se recogieron sus datos demográficos y clínicos y se cursó el estudio viral. A los 55 niños con gripe pandémica A (H1N1) 2009 se les realizó un seguimiento telefónico para conocer la evolución del cuadro. Resultados: la mayor parte de los casos tenían una edad entre cinco y 14 años (89,1%; intervalo de confianza del 95% [IC 95%]: 77,8-95,9). Los síntomas más frecuentes fueron la fiebre (criterio de inclusión), que duró una media de 3,6 días (desviación estándar [DE]: 1,6) y la tos. Más de la mitad refirieron también odinofagia, rinitis o cefalea. En general, el cuadro clínico fue leve, aunque un niño fue ingresado durante 48 horas por presentar una neumonía. De los 13 niños que tenían antecedentes de asma, dos presentaron exacerbaciones leves. Ningún niño recibió tratamiento antiviral. Conclusión: a pesar de los temores iniciales, los casos de gripe pandémica A (H1N1) 2009 en los niños atendidos en nuestras consultas de AP han sido generalmente leves (AU)

Objective: to describe the clinical features of pandemic influenza cases diagnosed in primary health care by sentinel pediatricians who participate in the PIDIRAC surveillance scheme (Programa de información diaria de las infecciones respiratorias agudas de Catalunya). Methods: study sample included the cases of confirmed influenza A (H1N1) 2009 attended by sentinel pediatricians that collaborate with PIDIRAC. Pharyngeal and nasopharyngeal swabs for virologic analysis of suspected influenza cases were collected on a systematic basis in order to avoid bias. Every week during the study period the first two patients that consult and comply with the definition of suspicious case of influenza were recruited, if consent was obtained. Demographic characteristics and clinical features were recorded, and virologic studies were performed. The fifty-five children with confirmed pandemic influenza A (H1N1) 2009 were contacted by telephone in order to obtain information regarding their clinical status. Results: most of the cases were 5-14 years old children and adolescents (89.1%, 95% CI 77.8-95.9). The most frequent symptoms were fever (inclusion criteria), that lasted a mean of 3.6 days (SD = 1.6) and cough. More than 50% of patients also presented with sore throw, rhinitis or headache. In general, the disease was mild even though one child was hospitalised during 48 hours because he (or she) had a pneumonia. Of the thirteen patients who suffered from asthma only two had mild exacerbations. None of the patients needed antiviral treatment. Conclusions: despite initial fears, the cases of pandemic influenza A (H1N1) 2009 treated in our community health centres have been generally mild (AU)

Control de iliacas en el aneurisma de aorta abdominal roto / Iliac arteries control in the ruptured abdominal aneurysm

La intervención sobre un aneurisma de aorta roto conlleva una celeridad y eficacia de los movimientos quirúrgicos. Sin embargo, esto puede en ocasiones ser fuente de complicaciones nada desdeñables, a veces facilitadas por la dificultad para reconocer estructuras en el seno de grandes hematomas. Las lesiones venosas iatrogénicas son infrecuentes en manos expertas, pero son por lo general relevantes en el pronóstico inmediato (AU)

The intervention of a ruptured aortic aneurysm involves rapid and effective surgical movements. However, it can be a source of serious complications, sometimes facilitated by the difficulty to differentiate anatomical structures within large hematomas. Iatrogenic venous injuries are uncommon in experienced hands, but are generally relevant in the immediate prognosis (AU)

Efecto de dosis bajas de ketamina en la analgesia postoperatoria y consumo de morfina tras cirugía de revascularización miocárdica / Efficacy of low doses of ketamine in postoperative analgesia and the use of morphine after myocardial revascularisation surgery

Objetivos. Valorar la eficacia de la ketamina administrada intraoperatoriamente a dosis bajas en infusión continua (8mg/kg/min) en la analgesia postoperatoria y en reducir el consumo de morfina en las primeras 24h del postoperatorio de cirugía de derivación coronaria tras anestesia basada en remifentanilo. Material y método. Estudio prospectivo, aleatorio y doble ciego en 60 pacientes, ASA III–IV, programados para ser sometidos a cirugía de revascularización miocárdica sin circulación extracorporea. Técnica anestésica estándar con propofol y remifentanilo entre 0,5–1mg/kg/min, tras la inducción anestésica, el grupo K (n=30) recibió una infusión de ketamina constante de 8mg/kg/min y el grupo P (n=30) suero salino 0,9% al mismo ritmo de infusión por vía intravenosa. Antes de finalizar la cirugía se administró 0,15mg/kg de morfina vía intravenosa. La analgesia postoperatoria se realizó con morfina 3mg cada 5min cuando la escala verbal simple (1). Valoramos el consumo de remifentanilo propofol intraoperatorio, tiempo hasta administrarse el primer analgésico, consumo de morfina en las primeras 24h, intensidad del dolor mediante escala verbal simple y escala visual analógica, parámetros hemodinámicos, respiratorios, nivel de sedación y efectos adversos. Resultados. No hemos encontrado diferencias estadísticamente significativas en las características demográficas, así como en el consumo e infusiones medias de remifentanilo y propofol de ambos grupos. Los pacientes del grupo K retrasaron significativamente el momento de solicitar la primera dosis de analgésico con respecto al grupo P (p<0,03), el consumo de morfina en la reanimación y el consumo total en las primeras 24h no mostró diferencias significativas entre ambos grupos de estudio. Resultados. Los parámetros hemodinámicos, respiratorios y nivel de sedación permanecieron estables durante todo el periodo de estudio sin diferencias estadísticamente significativas entre ambos grupos. El control del dolor postoperatorio fue adecuado en ambos grupos (escala visual analógica <30, escala verbal simple <2) sin diferencias significativas durante las 24h de estudio. En la incidencia de efectos adversos no hubo diferencias significativas entre ambos grupos, la incidencia de nauseas y vómitos postoperatorios fue del 20% en el grupo K y del 30% en el grupo P. Ningún paciente presentó alucinaciones o disforia. Conclusiones. Dosis bajas de ketamina en infusión continua durante el periodo intraoperatorio de cirugía coronaria prolongan el tiempo de demanda de la primera dosis de morfina, sin reducir el consumo de remifentanilo intraoperatorio, ni el consumo total de morfina durante en las primeras 24h de postoperatorio (AU)

Objectives. To assess the efficacy of ketamine in low doses by continuous infusion (8mg/kg/min) given during surgery and the reduction in morphine use in the first 24h after coronary bypass surgery with remifentanil based anaesthesia. Material and method. Randomised, prospective, double blind study on 60 patients, ASA III–IV, scheduled to have off-pump myocardial revascularisation surgery. A standard anaesthetic technique with propofol and remifentanil between 0.5−1mg/kg/min, after induction of anaesthesia, the ketamine (K) group (n=30) received a continuous infusion of 8mg/kg/min and the propofol and remifentanil (P) group (n=30) received 0.9% physiological saline intravenously at the same infusion rate. Before the end of the surgery 0.15mg/kg of morphine was given intravenously. Post-operative analgesia consisted of 3mg of morphine every 5min when the simple verbal scale was <1 (SVS<1). The intra-operative use of remifentanil–propofol was determined, as well as, the time to giving the first analgesic, pain intensity using the SVS and visual analogue scale (VAS), haemodynamic and respiratory parameters, level of sedation and adverse effects. Results. No statistically significant differences were found between the demographic parameters, or in the mean use and infusions of remifentanil and propofol by both groups. The patients from the K group significantly delayed the time of requesting the first analgesic dose compared to the P group (P<0.03). There were no significant differences between both study groups in the use of morphine in recovery and the total use in the first 24h. Results. The haemodynamic and respiratory parameters, and the sedation level remained stable during the whole period of the study, with no statistically significant differences between both groups. Post-operative pain control was adequate in both groups VAS<30, SVS<2), with no significant differences during the 24h of the study. There no significant differences between groups, in the incidence of adverse effects. The incidence of nausea and post-operative vomiting was 20% in group K and 30% in group P. None of the patients had hallucinations or dysphoria. Conclusions. Low doses of ketamine in continuous infusion during the intra-operative period of coronary surgery prolongs the time of demanding the first morphine dose, without reducing the use of intra-operative remifentanil, or the total use of morphine in the first 24h after surgery (AU)

[Epidural anesthesia for coronary revascularization in the conscious patient]. / Revascularización coronaria en el paciente despierto bajo anestesia epidural.

Thoracic epidural anesthesia has been widely used to complement general anesthesia in coronary artery bypass grafting. The main advantages of the combination are excellent pain control and a less pronounced stress response to surgery. The invasiveness of surgery to treat ischemic heart disease has been attenuated thanks to the use of the mini-sternotomy and coronary anastomosis without extracorporeal circulation. In 4 patients, coronary artery revascularization was carried out via a mini-sternotomy, grafting the anterior descending artery to the left internal thoracic artery under high thoracic epidural anesthesia (block of segments T1-T8) with a perfusion of 0.75% ropivacaine and fentanyl in a conscious patient. There were no hemodynamic or respiratory complications during surgery. The mean duration of stay in the intensive care unit was less than 18 hours and the mean hospital stay was less than 5 days. Postoperative coronary arteriograms demonstrated the patency of all grafts and all patients were asymptomatic at 1 month. Our initial experience suggests that the use of only high thoracic epidural anesthesia is feasible in coronary revascularization in selected, cooperative patients who require a single coronary bypass graft.

Revascularización coronaria en el paciente despierto bajo anestesia epidural / Epidural anesthesia for coronary revascularization in the conscious patient

La anestesia epidural torácica ha sido ampliamenteutilizada en cirugía cardiaca como coadyuvante a laanestesia general en pacientes intervenidos de revascularizacióncoronaria. Sus principales ventajas son el excelentecontrol del dolor postoperatorio y la disminuciónde la respuesta al estrés quirúrgico. En el tratamientoquirúrgico de la cardiopatía isquémica la agresión quirúrgicase ha atenuado al reducir del tamaño de la esternotomíay a la realización de las anastomosis coronariassin circuito de circulación extracorpórea.Se han intervenido 4 pacientes de revascularizacióncoronaria a través de mini-esternotomía, revascularizandola arteria descendente anterior con la arteria mamariaizquierda, bajo anestesia epidural torácica alta (bloqueosegmentario T1-T8) con perfusión de ropivacaína0,75% y fentanilo y con el paciente consciente. No hubocomplicaciones hemodinámicas, ni respiratorias durantela cirugía. El tiempo medio de estancia en CuidadosIntensivos fue menor de 18 horas y la estancia mediahospitalaria menor de 5 días. La coronariografía postoperatoriamostró permeabilidad de los injertos en todoslos casos y los 4 pacientes permanecieron asintomáticosal mes.CONCLUSIÓN: Nuestra experiencia inicial indica que eluso exclusivo de la epidural torácica alta para la revascularizacióncoronaria sin circuito de circulación extracorpórea,supone una opción en pacientes seleccionados,colaboradores y que precisen revascularización coronariade un solo vaso

Thoracic epidural anesthesia has been widely used to complement general anesthesia in coronary artery bypass grafting. The main advantages of the combination are excellent pain control and a less pronounced stress response to surgery. The invasiveness of surgery to treat ischemic heart disease has been attenuated thanks to the use of the mini-sternotomy and coronary anastomosis without extracorporeal circulation. In 4 patients, coronary artery revascularization was carried out via a mini-sternotomy, grafting the anterior descending artery to the left internal thoracic artery under high thoracic epidural anesthesia (block of segments T1-T8) with a perfusion of 0.75% ropivacaine and fentanyl in a conscious patient. There were no hemodynamic or respiratory complications during surgery. The mean duration of stay in the intensive care unit was less than 18 hours and the mean hospital stay was less than 5 days. Postoperative coronary arteriograms demonstrated the patency of all grafts and all patients were asymptomatic at 1 month. Our initial experience suggests that the use of only high thoracic epidural anesthesia is feasible in coronary revascularization in selected, cooperative patients who require a single coronary bypass graft

Severity of Citrus tristeza virus Isolates from Texas.

Citrus tristeza virus (CTV) isolates collected from the Lower Rio Grande Valley in south Texas and east Texas were characterized using citrus indicators and molecular methods. The citrus indicators were Mexican lime (Citrus aurantifolia), sour orange (C. aurantium), sweet orange (C. sinensis) grafted to sour orange, Duncan grapefruit (C. × paradisi), and Madam Vinous sweet orange, with some CTV isolates additionally indexed using the Texas commercial grapefruit cvs. Rio Red and Star Ruby, and Marrs and N-33 sweet orange. Severity ratings used 11 biotype groups or cumulative mean relative indices. Molecular characterization was carried out using poly- and monoclonal antibodies, seven strain-specific probes and single-stranded conformational polymorphism, and all were based on the CTV major coat protein or gene. All Texas CTV isolates produced vein clearing symptoms on inoculated Mexican lime plants. Over half of the CTV isolates tested were placed in biotype groups IX and X (causing decline of sweet orange on sour orange, seedling yellows on sour orange and grapefruit seedlings, and stem pitting of grapefruit or sweet orange), and one isolate was in biotype I (mild).

[Analysis of medical/surgical complications of cutaneous ileostomy]. / Análisis de las complicaciones médico-quirúrgicas en las ileostomías cutáneas.

OBJECTIVE: Our objective is to carried out a descriptive study about medical-surgical complications and alterations about quality of life in stoma patients secondary to bladder tumour. PATIENTS AND METHOD: The series are composed of 67 patients. The mean age was 70.3 years. We analyse the following variable: early and late medical-surgical complications, the body mass index (BMI) change and the alteration of quality of life. RESULTS: The most frequent early complication is the ischemic necrosis (7%) without posterior repercussion. The late complications in frequency order are: peristomal dermatitis (18%), plane stoma (12%), peristomal hernia (12%), stenosis (9%) and granuloma (6%). The BMI changes don't conditionate a increase in the complications. The psychological adaptation is good in 92%, although the majority affirm a little changes in life-style, but they don't have a repercussion on quality of life. CONCLUSIONS: In this series we estimate a low incidence of complications. The preoperative counsel and the posterior following by the stoma care nurse-surgeon team, play a fundamental role on psychological adaptation after surgery.

Análisis de las complicaciones médicoquirúrgicas en las ileostomías cutáneas / Analysis about quality of life variables in stoma patients medical-surgical complications

OBJETIVOS: Nuestro objetivo es realizar un estudio descriptivo de las complicaciones médico-quirúrgicas y alteraciones de la calidad de vida de los pacientes portadores de derivación cutánea uretero-ileal por patología tumoral vesical. PACIENTES Y MÉTODO: La serie consta de 67 pacientes con una edad media de 70,3 años. Se analizan las siguientes variables: las complicaciones médico-quirúrgicas precoces tempranas y tardías, las variaciones del índice de masa corporal (IMC) y la afectación de la calidad de vida. RESULTADOS: La complicación precoz más frecuente es la necrosis de mucosa (7%) sin repercusión posterior. Las complicaciones tardías en orden de frecuencia son las dermatitis (18%), estoma plano (12%), hernia paraestomal (12%), estenosis (9%) y granulomas (6%). Las variaciones del IMC no condicionan un aumento del número de complicaciones. La adaptación psicológica es buena en el 92%, aunque la mayoría reconoce pequeños cambios en sus hábitos que no repercute en su calidad de vida. CONCLUSIÓN: En esta serie se aprecia una baja incidencia de complicaciones. Los consejos preoperatorios y el seguimiento posterior por el equipo cirujano-estomaterapeuta juega un papel fundamental en la adaptación psicológica después de la cirugía

OBJECTIVE: Our objective is to carried out a descriptive study about medical-surgical complications and alterations about quality of life in stoma patients secondary to bladder tumour. PATIENTS AND METHOD: The series are composed of 67 patients. The mean age was 70.3 years. We analyse the following variable: early and late medical-surgical complications, the body mass index (BMI) change and the alteration of quality of life. RESULTS: The most frequent early complication is the ischemic necrosis (7%) without posterior repercussion.The late complications in frequency order are: peristomal dermatitis (18%), plane stoma (12%), peristomal hernia (12%), stenosis (9%) and granuloma (6%).The BMI changes don’t conditionate a increase in the complications.The psychological adaptation is good in 92%, although the majority affirm a little changes in life-style, but they don’t have a repercussion on quality of life. CONCLUSIONS: In this series we estimate a low incidence of complications. The preoperative counseland the posterior following by the stoma care nurse-surgeon team, play a fundamental role on psychological adaptation after surgery

[Management of penile and scrotal incarceration by a metal object]. / Manejo de la incarceración del pene y escroto por objeto metálico.

Penile incarceration requires urgent management to prevent chief wound. In this article we present two penile and scrotum incarceration cases happened in our center. We contribute to a literature revision where lots of objects are reported. We try to simplify the different resolution techniques.

Manejo de la incarceración del pene y escroto por objeto metálico / Penile and scrotum incarceration by metallic object

La incarceración del pene requiere una actuación urgente para evitar lesiones mayores. En este artículo presentamos dos casos de incarceración de pene y escroto ocurridas en nuestro centro. Aportamos una revisión de la literatura donde se recogen multitud de objetos, e intentamos simplificar las distintas técnicas para su resolución (AU)

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