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1.
Rev. colomb. cir ; 37(3): 480-491, junio 14, 2022.
Artigo em Espanhol | LILACS | ID: biblio-1378833

RESUMO

Introducción. La colelitiasis tiene una prevalencia del 15 % y el 21 % tendrá coledocolitiasis al momento de la colecistectomía, con 50 % de probabilidad de presentar complicaciones asociadas. Desde el advenimiento de la colecistectomía laparoscópica, el abordaje de la coledocolitiasis ha sido endoscópico, usualmente en un tiempo diferente al vesicular, sin embargo, los avances en laparoscopia han permitido explorar la vía biliar común por la misma vía, pudiendo realizar ambos procedimientos en el mismo tiempo de forma segura. Métodos. Se realizó una búsqueda de la literatura existente con relación al enfoque para el manejo de la colecisto-coledocolitasis en un paso comparado con dos pasos. Resultados. Existe evidencia que demuestra mayor efectividad del abordaje en dos pasos, con CPRE y posterior colecistectomía laparoscópica, sobre el abordaje en un paso, especialmente en la tasa de fuga biliar y de cálculos retenidos. El enfoque en un paso con exploración de vías biliares y colecistectomía laparoscópica en el mismo tiempo es seguro, con alta tasa de éxito, baja incidencia de complicaciones, menor estancia hospitalaria y costos. Conclusión. El abordaje laparoscópico en un solo paso es un procedimiento seguro y eficaz para el manejo de la colecisto-coledocolitiasis, con el beneficio de estancia hospitalaria menor, sin embargo, se requieren habilidades técnicas avanzadas en cirugía laparoscópica. En nuestro medio ya existe una infraestructura para el manejo híbrido con CPRE y colecistectomía laparoscópica, pudiéndose realizar ambos en el mismo tiempo, para reducir estancia y costos.


Introduction. Cholelithiasis has a prevalence of 15%, and 21% will have choledocholithiasis at the time of cholecystectomy, with a 50% probability of presenting associated complications. Since the advent of laparoscopic cholecystectomy, the approach to choledocholithiasis has been endoscopic, normative at a different time than the gallbladder; however, advances in laparoscopy have made it possible to explore the common bile duct by the same route, being able to perform both procedures in a single time safely. Methods. A search of the existing literature was performed regarding the one-step approach compared to the two-step approach for the management of cholelithiasis and choledocholithiasis. Results. There is evidence that demonstrates greater effectiveness of the two-step approach with ERCP and subsequent laparoscopic cholecystectomy over the one-step approach, especially in the rate of bile leak and the incidence of retained stones. The one-step approach with bile duct exploration and laparoscopic cholecystectomy at the same time is safe, with a high success rate, low incidence of complications, shorter hospital stay, and lower costs. Conclusion. The one-step laparoscopic approach is a safe and effective procedure for the management cholelithiasis and concomitant choledocholithiasis, with the benefit of a shorter hospital stay; however, advanced technical skills in laparoscopic surgery are required. In our environment there is already an infrastructure for hybrid management with ERCP and laparoscopic cholecystectomy, both of which can be performed at the same time to reduce hospital stay and costs.


Assuntos
Humanos , Ductos Biliares , Colelitíase , Coledocolitíase , Colecistectomia , Colangiopancreatografia Retrógrada Endoscópica , Laparoscopia
2.
Plants (Basel) ; 10(6)2021 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-34071143

RESUMO

Oxidative stress diseases are usually treated or prevented by using antioxidants from natural or artificial sources. However, as a sustainable source of phytochemicals, plants got a renewed interest in obtaining their active agents using green extraction technologies, i.e., sustainable extraction techniques that reduce energy consumption, use renewable sources and result in less post-extraction wastes. The high-pressure homogenization (HPH) technique was introduced into the food industry since it was invented in 1900 to homogenize milk and later to produce fruit juices with a longer shelf-life without preservatives. Recently, HPH was introduced as an eco-friendly method to nanomill plants for improved extraction efficacy without using organic solvents. In this study, sumac was used as an antioxidants-rich spice model to investigate the effects of HPH on its antioxidant capacity (AOC). Sumac was rendered into PlantCrystals by using HPH. Particle size characterization proved the presence of submicron-sized particles (about 750 nm). Thus, HPH was able to produce sumac PlantCrystals and increased the AOC of bulk sumac by more than 650% according to the ORAC (oxygen radical absorbance capacity) assay. The polyphenol and flavonoid contents showed higher values after HPH. Interestingly, the DPPH (1,1-diphenyl-2-picrylhydrazyl) assay also showed a well improved AOC (similar to ascorbic acid) after HPH. In fact, in this study, the PlantCrystal-technology was demonstrated to cause an efficient cell rupture of the sumac plant cells. This caused an efficient release of antioxidants and resulted in sumac PlantCrystals with a 6.5-fold higher antioxidant capacity when compared to non-processed sumac bulk material.

3.
Rev. colomb. cir ; 35(4): 659-664, 2020. fig
Artigo em Espanhol | LILACS | ID: biblio-1147913

RESUMO

El leiomioma primario de pulmón es un tumor benigno raro, de origen mesodérmico, que representa aproximadamente el 2 % de todos los tumores benignos de pulmón. Desde que fue descrito por primera vez por Forkel en 1910, se han reportado al menos 150 casos en la literatura. Se hace una revisión del tema a propósito del caso de una mujer posmenopáusica oligosintomática, con hallazgo de una lesión pulmonar sólida, asociada a una malformación vascular, en quien la biopsia inicial reportó un tumor fusocelular, por lo que fue llevada a lobectomía superior del pulmón derecho, y cuyo diagnóstico patológico definitivo fue leiomioma pulmonar primario. Este caso se presenta por su baja incidencia y la poca literatura sobre este tipo de lesiones tumorales benignas


Primary lung leiomyoma is a rare benign tumor of mesodermal origin, that accounts for approximately 2% of all benign lung tumors. Since it was first described by Forkel in 1910, at least 150 cases have been reported in the literature. A review of the subject is made regarding the case of an oligosymptomatic postmenopausal woman, with the finding of a solid lung lesion, associated with a vascular malformation, in whom the initial biopsy reported a spindle cell tumor, for which she was taken for a right upper lung lobectomy and whose definitive pathological diagnosis was primary pulmonary leiomyoma. This case is presented due to its low incidence and the little literature on this type of benign tumor lesions


Assuntos
Humanos , Leiomioma , Toracoscopia , Cirurgia Torácica Vídeoassistida , Neoplasias Pulmonares
4.
Rev. colomb. cir ; 35(4): 665-674, 2020.
Artigo em Espanhol | LILACS | ID: biblio-1147943

RESUMO

La infección por Helicobacter pylori (H. pylori), es la infección bacteriana crónica más frecuente de la raza humana, afecta al 50 % de la población mundial y, por lo menos, al 80 % de la población colombiana. Esta bacteria es re-conocida desde hace más de 15 años como un carcinógeno tipo I. De acuerdo con las indicaciones del Consenso de "Maastricht V" esta infección debe ser buscada y tratada en los pacientes con úlcera péptica activa, linfoma MALT (por sus siglas en inglés, mucosa associated lymphoid tissue), cáncer gástrico temprano, púrpura que presenten síntomas dispépticos crónicos y usuarios crónicos de AINES. Debido al papel que tiene en la fisiopatología del cáncer gástrico, nace la iniciativa de realizar una búsqueda activa del H. pylori y erradicarlo en todas las personas, incluyendo aquellas asintomáticas en países con alta incidencia de esta neoplasia. Existen diversas publicaciones alrededor del mundo que así lo sugieren, mostrando resultados con impacto positivo en el curso y progresión de la enfermedad, sobre todo en las etapas más tempranas de la infección. Sin embargo, otros autores resaltan la creciente problemática de la resistencia bacteriana, y demuestran que el peso estadístico y los diferentes análisis de los estudios disponibles en la actualidad tienen poca validez para dar una recomendación extendida al paciente asintomático. Se cuestiona que tal vez, estamos utilizando las estrategias inadecuadas para manejar una situación de salud pública, ya que estamos enfocados en impactar a cada individuo con terapias antibióticas complejas, en vez de a la población en general con políticas de salud pública


Helicobacter pylori (H. pylori) infection is the most frequent chronic bacterial infection in humans, affecting 50% of the world population, and at least 80% of the Colombian population. This bacteria has been recognized for more than 15 years as a type I carcinogen. According to the indications of the "Maastricht V" consensus, this infection should be sought and treated in patients with: active peptic ulcer, MALT lymphoma (for its acronym Mucosa associated lymphoid tissue), early gastric cancer, purpura who present with chronic dyspeptic symptoms and chronic users of NSAIDs. Due to the role it plays in the pathophysiology of gastric cancer, the initiative was born to carry out an active search for H. pylori and eradicate it in all people, including those asymptomatic in countries with a high incidence of this neoplasia.There are various publications around the world that suggest the effectiveness of this treatment and the positive impact on the course and progression of the disease, especially in the earliest stages of the infection, since the more advanced stages have less encouraging results regarding progression to malignancy. However, other authors highlight the growing problem of bacterial resistance that we are currently facing and demonstrate that the sta-tistical weight and the different analyzes of the currently available studies have little validity to give an extended recommendation to the asymptomatic patient. It is suggested that perhaps inappropriate strategies to manage this public health situation are being used, since we are focused on impacting each individual with complex antibiotic therapies, instead of the general population with public health policies


Assuntos
Humanos , Helicobacter pylori , Neoplasias Gástricas , Farmacorresistência Bacteriana , Proteína de Translocação 1 do Linfoma de Tecido Linfoide Associado à Mucosa
5.
Rev. colomb. cir ; 34(4): 364-371, 20190000.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1049204

RESUMO

La colecistitis aguda es la inflamación de la vesícula biliar, en la mayoría de los casos, explicada por la presencia de cálculos mixtos o de colesterol que producen obstrucción y desencadenan factores inflamatorios diversos. La colecistectomía por vía laparoscópica se ha convertido en su tratamiento estándar y definitivo. El procedimiento quirúrgico debe realizarse idealmente en las primeras 72 horas después de iniciados los síntomas, lo que habitualmente se denomina como cuadro agudo. Existe controversia sobre cuál es el manejo más adecuado cuando han pasado más de 72 horas del inicio de los síntomas, condición denominada 'colecistitis aguda tardía', cuando se considera que el proceso inflamatorio es mayor y, el procedimiento, técnicamente más complejo y peligroso.Para esta condición, se han establecido dos estrategias iniciales de manejo: la cirugía temprana ­durante la hospitalización inicial­ o el tratamiento conservador con antibióticos para la supuesta resolución completa de la inflamación, es decir, 'enfriar el proceso'; varias semanas después, se practica una colecistectomía laparoscópica tardía ­diferida o electiva­. Existen muchas publicaciones sobre ambas estrategias, en las que se exponen los beneficios y probables complicaciones de cada una; en la actualidad, se sigue debatiendo sobre el momento óptimo para practicar la intervención quirúrgica. Los trabajos más recientes y con mayor peso epidemiológico, resaltan los beneficios de la cirugía temprana pues, aunque las complicaciones intraoperatorias ocurren en las mismas proporciones, la cirugía en la hospitalización inicial reduce los costos, los reingresos y los tiempos hospitalarios.Después de revisar la literatura disponible a favor y en contra, este artículo pretende recomendar el procedi-miento temprano, inclusive cuando hayan pasado más de tres días de iniciados los síntomas y, solo en casos muy seleccionados, diferir la cirugía (AU)


Acute cholecystitis is the inflammation of the gallbladder, in most cases explained by the presence of mixed or cholesterol stones that produce obstruction by triggering various inflammatory factors; for its definitive management, laparoscopic cholecystectomy became the gold standard, the surgical procedure should ideally be performed within the first 72 hours after the onset of symptoms, which is usually referred to as acute condition; There are controversies in what is the most appropriate management when more than 72 hours have elapsed from the onset of symptoms, a condition called late acute cholecystitis, at which time the inflammatory process is commonly believed to be greater and the procedure more technically complex and dangerous.For this condition, two management strategies have been defined, which consist of early surgery (during index hospitalization) versus initial conservative antibiotic treatment for the supposed complete resolution of the inflammation "cooling the process", followed by a late laparoscopic cholecystectomy several weeks later (deferred, elective); For both strategies, there is abundant literature exposing the benefits and probable complications that concern each one, but at the present time the optimal moment to practice the surgical intervention is still being debated. The most recent works show some benefits in favor of early surgery, since although intraoperative complications occur in the same proportions, surgery in the index hospitalization reduces costs, readmissions, and hospital times. The present article, reviewing the wide literature available for and against, has as main objective to recommend this procedure early, even when more than three days of symptoms have passed, and only in very selected cases, defer surgery (AU)


Assuntos
Humanos , Colecistite Aguda , Colecistostomia , Colecistectomia Laparoscópica , Tratamento Farmacológico
6.
Neotrop. ichthyol ; 17(4): e190025, 2019. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1056800

RESUMO

In Colombia the use of glyphosate commercial formulations (Roundup™) for spraying have left deleterious effects on animals and humans. Much of this spraying takes place at the Orinoco basin, habitat of one of the most exported ornamental fish in Colombia, Cardinal neon. To evaluate the effect of Roundup Activo™ four experimental treatments were carried out with 0 mg/L (T1), 0.1 mg/L (T2), 1 mg/L (T3) and 5 mg/L (T4) during 30 days of exposure. The fishes were processed for high-resolution optical microscopy. The main finding of Roundup Activo™ exposure was an increase in mast cells number in brain blood vessels and some neuronal nuclei of the preoptic and posterior diencephalic areas, including hypothalamus. A correlation between concentrations and mast cells number was observed, with the largest mast cells number in T4 treatment. Mast cells presence is a stress benchmark, suggesting the beginning of allergic, inflammatory and apoptotic events. Presence of mast cells in these brain areas may lead to alterations on reproduction, visual and olfactory information integration among other processes. These alterations may result in diminished survival, affecting the conservation of this species in its natural habitat.(AU)


En Colombia, el uso de formulaciones comerciales de glifosato (Roundup™) para la fumigación ha producido efectos nocivos en animales y humanos. Gran parte de esta fumigación se realiza en la cuenca del Orinoco, hábitat de uno de los peces ornamentales más exportados de Colombia, el Neón Cardenal. Para evaluar el efecto de Roundup Activo™ se realizó un experimento con cuatro tratamientos 0 mg/L (T1), 0,1 mg/L (T2), 1 mg/L (T3) y 5 mg/L (T4) durante 30 días. Los peces fueron procesados para microscopía óptica de alta resolución. El principal hallazgo fue el aumento del número de mastocitos en los vasos sanguíneos cerebrales y algunos núcleos neuronales del área preóptica y diencefálica posterior, incluido el hipotálamo. Identificamos una correlación entre las concentraciones y el número de mastocitos, que alcanzó su máximo en T4. La presencia de mastocitos evidencia estrés, promoviendo eventos alérgicos, inflamatorios y apoptóticos. La presencia de mastocitos en estas áreas del cerebro puede llevar a alteraciones en la reproducción e integración de la información visual y olfativa entre otros procesos. Estas alteraciones pueden resultar en una disminución de la supervivencia, afectando la conservación de esta especie en su hábitat natural.(AU)


Assuntos
Animais , Caraciformes/fisiologia , Mastócitos/citologia , Herbicidas
8.
Forensic Sci Int Genet ; 7(1): 194-7, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22578874

RESUMO

DNA barcoding was adopted in our laboratory for the identification of tobacco (Nicotiana spp.) in moassel samples seized from "hookah bars". As recommended by the CBOL Plant Working Group, we used a 2-locus combination of rbcL and matK as the plant barcode. As previously reported rbcL routinely produced high quality bi-directional reads but had a lower discriminating power than matK. It was much more difficult obtaining high quality bi-directional reads with matK possibly because of poor sample quality. DNA barcoding successfully identified tobacco in over 60 commercial tobacco moassel products. On the other hand, negative results (no amplification) or the identification of non-tobacco species were obtained from herbal moassel products. Our study clearly demonstrates the practical utility of DNA barcoding beyond taxonomy.


Assuntos
Código de Barras de DNA Taxonômico , DNA de Plantas/genética , Nicotiana/genética , Sequência de Bases , Primers do DNA , Reação em Cadeia da Polimerase
9.
Isis ; 102(3): 421-45, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22073769

RESUMO

Between the 1910s and the 1940s, American naturalists carried out a number of ornithological expeditions in Colombia. With the help of Colombian naturalists, thousands of skins were brought to natural history museums in the United States. By 1948 these birds had become an important treasure: American ornithologists declared Colombia the nation with the most bird species. This story sheds new light on the role science played in the expansion of U.S. political, economic, and cultural influence in Latin America in the early twentieth century, as well as on the relation between nationalist movements in Latin America and the study of the natural world. Recognizing a complex but fruitful interaction between nationalist policies and imperial practices proves important for understanding the success of the naturalists' enterprise in Colombia.


Assuntos
Aves , Internacionalidade/história , História Natural/história , Animais , Colômbia , História do Século XIX , História do Século XX , Museus/história , Política , Estados Unidos
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