Control del entrenamiento con datos GPS y medidas subjetivas de fatiga y recuperación en futbolistas hondureños durante un periodo preparatorio para los Juegos Olímpicos de Tokio 2020/2021 / Training Monitoring With GPS Data and Subjective Measures of Fatigue and Recovery in Honduran Soccer Players During a Preparatory Period for Tokyo 2020/2021 Olympic Games / Monitoramento do treinamento com dados GPS e medidas subjetivas de fadiga e recuperação dos jogadores de futebol hondurenhos durante um período preparatório para os Jogos Olímpicos de Tóquio 2020/2021

Resumen: Introducción: El control de cargas de entrenamiento es importante para optimizar el rendimiento. Por lo tanto, se deben documentar metodologías que mejoren la preparación de selecciones nacionales en eventos como los juegos olímpicos. Objetivo: Determinar si los datos del GPS en combinación con medidas subjetivas de bienestar, fatiga y recuperación son apropiados para el control de las cargas durante un periodo preparatorio para los Juegos Olímpicos. Metodología: Participaron 22 jugadores profesionales sub-23 durante 5 microciclos y 27 sesiones de entrenamiento. Se recopilaron datos de carga externa a través de un sistema global de posicionamiento (GPS): Distancia total (DT), zonas de rendimiento Z0 (0-15 km/h), Z1 (15.1-18 km/h), Z2 (18.1-24 km/h), Z3 (>24.1 km/h)), velocidad máxima (Vmax (km/h)), aceleraciones (>2.5m/s2) y desaceleraciones (<2.5m/s2). También, se obtuvo la carga interna a través de medidas subjetivas de percepción del esfuerzo (RPE), calidad de la recuperación (TQR), predisposición para entrenar (RTT%) derivada de las variables de calidad del sueño, dolor muscular, niveles de energía, estado de ánimo, estrés, calidad de la alimentación y la salud. Luego se calculó la ratio subjetiva de fatiga-recuperación (F-R). Se aplicó un test ANOVA, análisis de componentes principales (ACP) y una regresión múltiple lineal. Resultados: Las variables DT (p=0.00 TE=0.22), Z0 (p= 0.00 TE=0.08), Z2 (p=0.00 TE= 0.05), Vmax (p=0.00 TE=0.42), suma de aceleración y deceleración (p=0.00 TE=0.08) y valores relativos de la carga/min (p=0.00 TE=0.17) se identificaron como variables más sensibles al cambio de la carga entre microciclos. El RTT% y ratio subjetivo F-R mostraron un tamaño del efecto moderado (p=0.04 TE=0.06 y p=0.06 TE=0.06), pero fueron sensibles al cambio entre los microciclos. El ACP extrajo 15 variables GPS y 11 variables subjetivas que explicaron el 78% de la varianza de la carga de entrenamiento. Conclusión: Utilizar datos GPS junto con medidas subjetivas implicadas en la fatiga-recuperación puede ser una buena estrategia para el control de la carga de entrenamiento en futbolistas.

Abstract: Background: Training control is essential to optimize performance. Therefore, methodologies that improve the preparation of national teams in events such as the Olympic Games should be documented. Purpose: To determine whether GPS data in combination with subjective measures of well-being, fatigue and recovery are appropriate for load monitoring during a preparatory period for the Olympic Games. Methodology: Twenty-two under-23 professional players participated during 5 micro-cycles and 27 training sessions. External load data was collected via a global positioning system (GPS): Total distance (DT), performance zones Z0 (0-15 km/h), Z1 (15.1-18 km/h), Z2 (18.1 -24 km/h), Z3 (>24.1 km/h), maximum speed (km/h), accelerations (>2.5m/s.) and decelerations (<2.5m/s.). Also, internal load was obtained through subjective measures of Rating Perceived Exertion (RPE), Total Quality Recovery (TQR), Readiness to Train (RTT%) obtained from the sleep quality, muscle pain, energy levels, mood, stress, food quality and health. The subjective rate of fatigue-recovery (F-R) was then calculated. An ANOVA test, Principal Component Analysis (PCA) and multiple linear regression were applied. Results: the variables DT (p=0.00 ES=0.22), Z0 (p= 0.00 TE=0.08), Z2 (p=0.00 ES= 0.05), maximum speed (p= 0.00 ES=0.42), sum of acceleration and deceleration (p=0.00 ES=0.08) and values relative to load/min (p=0.00 ES=0.17) were identified as variables more sensitive to load change between micro-cycles. RTT% and subjective rate F-R showed a moderate effect size (p=0.04 ES=0.06 and p=0.06 ES=0.06), but were sensitive to change between micro-cycles. PCA extracted 15 GPS variables and 11 subjective variables that explained 78% of the training load variance. Conclusion: Using GPS data together with subjective measures involved in fatigue-recovery may be a good strategy to control training load in footballers.

Resumo: Introdução: O monitoramento das cargas de treinamento é importante para otimizar o desempenho. Portanto, as metodologias devem ser documentadas para melhorar a preparação das equipes nacionais para eventos como os Jogos Olímpicos. Objetivo: Determinar se os dados GPS em combinação com medidas subjetivas de bem-estar, fadiga e recuperação são apropriados para o monitoramento da carga durante um período preparatório para os Jogos Olímpicos. Metodologia: 22 jogadores profissionais U-23 participaram durante 5 microciclos e 27 sessões de treinamento. Os dados de carga externa foram coletados através de um sistema de posicionamento global (GPS): distância total (DT), zonas de desempenho Z0 (0- 15 km/h), Z1 (15,1-18 km/h), Z2 (18,1-24 km/h), Z3 (>24,1 km/h), velocidade máxima (Vmax (km/h)), acelerações (>2,5m/ s2) e desacelerações (<2,5m/s2). Além disso, a carga interna foi obtida através de medidas subjetivas de percepção do esforço (RPE), qualidade de recuperação (TQR), predisposição para o treinamento (RTT%) derivada das variáveis de qualidade do sono, dor muscular, níveis de energia, humor, estresse, qualidade alimentar e saúde. Posteriormente a taxa subjetiva de fadiga-recuperação (F-R) foi calculada. Um teste ANOVA, análise de componentes principais (ACP) e regressão linear múltipla foram aplicados. Resultados: As variáveis DT (p=0,00 TE=0,22), Z0 (p= 0,00 TE=0,08), Z2 (p=0,00 TE= 0,05), Vmax (p=0,00 TE=0,42), soma de aceleração e desaceleração (p=0,00 TE=0,08) e valores de carga relativa/min (p=0,00 TE=0,17) foram identificadas como as variáveis mais sensíveis à mudança de carga entre microciclos. RTT% e a relação F-R subjetiva mostraram tamanho de efeito moderado (p=0,04 TE=0,06 e p=0,06 TE=0,06 TE=0,06), mas foram sensíveis à mudança entre microciclos. O ACP extraiu 15 variáveis GPS e 11 variáveis subjetivas que explicaram 78% da variância na carga de treinamento. Conclusão: O uso de dados GPS junto com medidas subjetivas envolvidas na fadiga#recuperação pode ser uma boa estratégia para o monitoramento da carga de treinamento em jogadores de futebol.

Can We Predict Prostate Cancer Metastasis Based on Biomarkers? Where Are We Now?

The incidence of prostate cancer (PC) has risen annually. PC mortality is explained by the metastatic disease (mPC). There is an intermediate scenario in which patients have non-mPC but have initiated a metastatic cascade through epithelial-mesenchymal transition. There is indeed a need for more and better tools to predict which patients will progress in the future to non-localized clinical disease or already have micrometastatic disease and, therefore, will clinically progress after primary treatment. Biomarkers for the prediction of mPC are still under development; there are few studies and not much evidence of their usefulness. This review is focused on tissue-based genomic biomarkers (TBGB) for the prediction of metastatic disease. We develop four main research questions that we attempt to answer according to the current evidence. Why is it important to predict metastatic disease? Which tests are available to predict metastatic disease? What impact should there be on clinical guidelines and clinical practice in predicting metastatic disease? What are the current prostate cancer treatments? The importance of predicting metastasis is fundamental given that, once metastasis is diagnosed, quality of life (QoL) and survival drop dramatically. There is still a need and space for more cost-effective TBGB tests that predict mPC disease.

Nitrogen Sources Affect the Long-Chain Polyunsaturated Fatty Acids Content in Thraustochytrium sp. RT2316-16.

The psychrophilic marine microorganism Thraustochytrium sp. RT2316-16 can produce carotenoids as well as lipids containing the omega-3 polyunsaturated fatty acids (PUFA) eicosapentaenoic acid and docosahexaenoic acid. This work reports on the effects of the composition of the culture medium, including certain amino acids, on growth and lipid synthesis by RT2316-16. Compared with the culture on glutamate, the use of lysine, alanine, or serine, increased the content of the omega-3 PUFA in total lipids. In the media that contained yeast extract, glutamate, and glucose, lipid accumulation occurred when organic ammonium was exhausted earlier than glucose. In contrast, lipid mobilization was promoted if glucose was exhausted while organic ammonium (supplied by yeast extract and glutamate) remained in the medium. The total content of carotenoids in the lipid-free biomass decreased during the first 12 to 24 h of culture, simultaneously with a decrease in the total lipid content of the biomass. The experimental data suggested a possible interrelationship between the metabolism of carotenoids and lipids. A high content of omega-3 PUFA in the total lipids could be obtained by growing the thraustochytrid in a medium with a low glucose concentration (6 g L-1) and a high concentration of organic nitrogen (yeast extract 12 g L-1; glutamate 1.06 g L-1), after glucose was exhausted. These observations may guide the development of a strategy to enhance omega-3 PUFA in the biomass.

Biodanza en adultos mayores con enfermedades crónicas pa ra la promoción de la salud / Biodance in elderly adults with chronic diseases for the promotion of health

Objetivos: develar el significado que tuvo para un grupo de adultos mayores su participación en Taller de Biodanza y descubrir la relación entre la opinión de éstos con las líneas vivenciales de la Biodanza, segundo semestre del 2015, Facultad de Medicina, Universidad de La Frontera, Temuco-Chile. Materiales y métodos: investigación cualitativa, por medio de Técnica de Redes Semánticas Naturales. Población de 19 adultos mayores con enfermedades crónicas, de diferentes sectores de la ciudad, quienes en forma individual­previo Consentimiento Informado­ se les solicitó escribieran en cinco minutos seis palabras relacionadas a la pregunta estímulo: ¿Qué sintió usted cuando participó en el Taller de Biodanza?, priorizándolas posteriormente de uno a seis, correspondiendo el uno al de mayor valor. Análisis realizado mediante reducción progresiva de la información de acuerdo a técnica mencionada. El rigor del estudio fue cautelado por triangulación de investigadores. Resultados: el significado de la Biodanza para los participantes es lograr un estado emocional gratificante sintiéndose libres y autónomos. Sus expresiones reflejan la concordancia con las cinco líneas vivenciales. Conclusiones: la relevancia de consultar a la comunidad participante, radica en tener información desde su perspectiva, para utilizar estrategias metodológicas, similares a la Biodanza, en la promoción de salud, constituyéndose en pieza clave de cualquier programa efectivo con datos valiosos y utilizables para la toma de decisiones de la Institución respecto a la vinculación con el medio. El esfuerzo desplegado con esta experiencia fue valioso al comprobar la satisfacción de los participantes..(AU)

Objectives: to reveal the meaning that a participation in the Biodanza Workshop had for a group of elder adults and the relationship between their opinion and the living lines of the Biodanza, second semester of 2015, Faculty of Medicine, University of La Frontera, Temuco-Chile. Materials and methods: qualitative research, by means of natural semantic networks technique. Population of 19 older adults with chronic diseases, all of them from different sectors of the city, who individually - with prior informed consent - were asked to write in five minutes six words related to the stimulus question: What did you feel when you participated in the biodance workshop? prioritizing them later from one to six, corresponding one of greater value. Analysis carried out by means of progressive reduction of the information according to the before mentioned technique. The rigor of the study was guarded by triangulation of researchers. Results: the meaning of the Biodance for the participants is to achieve a rewarding emotional state feeling free and autonomous. Their expressions reflect the agreement with the five experiential lines.Conclusions: relevance of consulting the participating community, lies in having information from their perspective, to use methodological strategies, similar to Biodanzain health promotion, becoming a key piece of any effective program with valuable and usable data for the decision making of the Institution for connection with the environment. The effort deployed with this experience was valuable to verify the satisfaction of the participants..(AU)

Infected Hepatic Echinococcosis: Results of Surgical Treatment of a Consecutive Series of Patients.

BACKGROUND: One of the progressive complications of hepatic echinococcosis (HE) is cyst infection and subsequent liver abscess of a hepatic formation (LAHO). To date, this entity has not been studied or reported on extensively. Traditionally, the issue has been addressed with cystectomy and drainage, but this is associated with unsatisfactory outcomes. The aim of this study was to describe the results of surgical treatment in a group of patients with LAHO in terms of post-operative morbidity (POM). METHODS: We describe a case series of 64 consecutive patients with LAHO treated at two medical centers in Temuco, Chile. General and liver laboratory parameters were determined, thoracic radiographs, and abdominal ultrasound and computed tomography scans were performed. Study variables were POM, hospital stay, mortality rate, and recurrence. The minimum follow-up was three months, and clinical checkups were undertaken at months 1, 6, 12, 24, 36, 48, and 60. Descriptive statistics were applied. RESULTS: Sixty-four patients were treated with a median age and cyst diameter of 51 years and 16 cm, respectively. Of the series, 57.8% were female. The median hospital stay was 8 days. General POM and mortality rates were 23.4% and 3.1%, respectively. With a median follow-up of 67 months, non-hydatid recurrences were observed. CONCLUSION: The POM of LAHO is high, and the mortality rate is significant if we consider it a clinical entity within the context of a benign disease.

[Post surgery morbidity in patients with complicated hepatic hydatidosis]. / Morbilidad postoperatoria en pacientes con hidatidosis hepática complicada.

INTRODUCTION: Hepatic echinococcosis (HE) surgery is common in southern's Chile hospitals; however, related publications are scarce and with conflicting results, especially with regard to postoperative morbidity (POM), due to the diversity in it severity. The aim of this study is to determine POM in patients undergoing surgery for complicated HE (CHE). MATERIAL AND METHODS: Case series part of a prospective cohort. Patients undergoing surgery for CHH in hospitals Hernán Henríquez Aravena hospital and Clínica Mayor of Temuco, between 2000 and 2012 were included. The main outcome variable was development of POM using the Clavien scale. Other variables of interest were hospital stay, mortality and recurrence. Descriptive statistics were applied and incidence of POM was determined. RESULTS: 73 patients with a median age of 41 years and 58.9% female were studied. The median ultrasound diameter cysts were 15.0 cm. The average surgical time was 125.4 ± 26.3 min. The surgical procedure used most often was the pericystectomy (84.9%); and 84.9% of cases was performed concomitantly some other surgical procedure. The incidence of POM was 19.2%, 78.6% of whose cases were Grade I or II Clavien. The aetiology was 10.9% of medical complications and 8.2% of surgical complications. 1.4% of mortality was recorded; and with a median follow up of 97 months, no recurrence was verified. CONCLUSIONS: POM in a cohort of patients with CHE is lower than the published and low severity. Subgroups with higher POM were: patients with coexistence of more than one complication, those with colangiohydatidosis and patients with liver abscess of hydatid origin.

Morbilidad postoperatoria en pacientes con hidatidosis hepática complicada / Post surgery morbidity in patients with complicated hepatic hydatidosis

Introduction: Hepatic echinococcosis (HE) surgery is common in southern's Chile hospitals; however, related publications are scarce and with conflicting results, especially with regard to postoperative morbidity (POM), due to the diversity in it severity. The aim of this study is to determine POM in patients undergoing surgery for complicated HE (CHE). Material and Methods: Case series part of a prospective cohort. Patients undergoing surgery for CHH in hospitals Hernán Henríquez Aravena hospital and Clínica Mayor of Temuco, between 2000 and 2012 were included. The main outcome variable was development of POM using the Clavien scale. Other variables of interest were hospital stay, mortality and recurrence. Descriptive statistics were applied and incidence of POM was determined. Results: 73 patients with a median age of 41 years and 58.9% female were studied. The median ultrasound diameter cysts were 15.0 cm. The average surgical time was 125.4 ± 26.3 min. The surgical procedure used most often was the pericystectomy (84.9%); and 84.9% of cases was performed concomitantly some other surgical procedure. The incidence of POM was 19.2%, 78.6% of whose cases were Grade I or II Clavien. The aetiology was 10.9% of medical complications and 8.2% of surgical complications. 1.4% of mortality was recorded; and with a median follow up of 97 months, no recurrence was verified. Conclusions: POM in a cohort of patients with CHE is lower than the published and low severity. Subgroups with higher POM were: patients with coexistence of more than one complication, those with colangiohydatidosis and patients with liver abscess of hydatid origin.

Introducción: La cirugía de la hidatidosis hepática (HH) es habitual en hospitales del sur de Chile; sin embargo, las publicaciones relacionadas son escasas y sus resultados disímiles, en especial respecto de la morbilidad postoperatoria (MPO), debido a la diversidad en la gravedad. El objetivo de este estudio es determinar la incidencia de MPO en pacientes intervenidos quirúrgicamente por HH complicada. Material y Método: Serie de casos, parte de una cohorte prospectiva. Se incluyeron pacientes intervenidos quirúrgicamente por HH complicada, en el hospital Hernán Henríquez Aravena y en la Clínica Mayor de Temuco, entre 2000 y 2012. La variable resultado principal fue desarrollo de MPO aplicando la escala de Clavien. Otras variables de interés fueron estancia hospitalaria, mortalidad y recurrencia. Se aplicó estadística descriptiva y, se determinó incidencia de MPO. Resultados: 73 pacientes, con mediana de edad de 41 años (16 a 84 años); 58,9% de género femenino. La mediana del diámetro ultrasonográfico de los quistes fue de 15,0 cm. El tiempo quirúrgico promedio fue de 125,4 ± 26,3 min. El procedimiento quirúrgico utilizado con mayor frecuencia fue periquistectomía (84,9%); y en 84,9% de los casos se realizó de forma concomitante algún otro procedimiento quirúrgico. La incidencia de MPO fue 19,2% (10,9% de tratamiento médico y 8,2% de tratamiento quirúrgico); 78,6% de cuyos casos eran Grado I o II de Clavien. Se registró 1,4% de mortalidad; y con una mediana de seguimiento de 97 meses, no se verificó recurrencia. Conclusiones: La incidencia de MPO en pacientes con HH complicada es inferior a la publicada y de bajo nivel de gravedad. Los subgrupos de complicaciones evolutivas con mayor MPO fueron la co-existencia de más de una complicación, la colangiohidatidosis y el absceso hepático de origen hidatídico.

Surgical Considerations of the Cystic Duct and Heister Valves.

Objectives Heister valves are mucosal folds located on the endoluminal surface of the cystic duct (CD) and were first described by Lorenz Heister in 1732. Their presence could represent an obstacle that impedes transcystic exploration. It has been suggested that the distribution of Heister valves follows a steady rhythmic pattern in a spiral disposition; however, there is no conclusive data to support this claim. The aim of this study was to describe the main characteristics of the CD and Heister valves in adult human cadavers. Methods A descriptive cross-sectional study was performed on 46 extrahepatic biliary tracts. Results The CD has an average length of 25.37 mm and diameter of 4.53 mm. The most frequent level of junction was the middle union. Heister valves were present on 32 CDs; in most cases, they were distributed uniformly on the duct and presented an oblique disposition. A nonreticular pattern was the most frequent reticular pattern. The most frequent type of the nonreticular type was the B1 subtype. The most frequent type of distribution was the nonreticular type, particularly the B1 type. Conclusions The cystic fold could hinder transcystic exploration. The cysticotomy incision should not be determined by the distribution of the fold on the CD. The morphology of the Heister valves does not show evidence of a steady systematic pattern.

Therapeutic alternatives for the treatment of infected pancreatic necrosis: an overview / Alternativas terapéuticas para el tratamiento de la necrosis pancreática infecciosa: una visión general

Despite diagnostic and therapeutic advances, the treatment of infected pancreatic necrosis (IPN) continues to be a complex problem to solve. The aim of this study is to evaluate the effectiveness of different surgical alternatives for the treatment of IPN. Articles published between 2000 to 2013, and related to effectiveness of open surgery (OS) and minimally invasive treatmente (MIT) in patients with IPN were evaluated. PubMed, MEDLINE, The Cochrane Database of Systematic Reviews, Cochrane Central Register RCT, DARE, IBECS, SciELO, LILACS, PAHO, WHOLIS, ASERNIP-S, NIHR, HTA, Clinical Excellence, York Health Economic Consortium and Tripdatabase were reviewed, searching systematic reviews (SR), randomized clinical trials (RCT) and observational studies (OST), in which the effectiveness of OS and MIT was evaluated in relation to the variables mortality, intra-abdominal bleeding, development of enterocutaneous fistula or hollow viscera perforation, development of pancreatic fistula, reoperations for complications, reoperations for new necrosectomy, development of diabetes mellitus and pancreatic enzyme requirements. Three hundred eighty-nine articles were retrieved, 10 of which met the selection criteria (2 SR, 1 RCT and 7 OST). The studies have a level of evidence of 2a, 2b, 3a and 4. MIT are associated with better results than OS in all variables analyzed, but significantly only in the development of diabetes mellitus and pancreatic enzyme requirement. Articles found are few and heterogeneous, making meaningful conclusions difficult. Studies with a better level of evidence, methodological quality and population size are needed to make conclusions and recommendations.

A pesar de los avances diagnósticos y terapéuticos, el tratamiento de la necrosis pancreática infecciosa (NPI) sigue siendo un problema complejo de resolver. El objetivo de este estudio es evaluar la eficacia de las diferentes alternativas quirúrgicas para el tratamiento del NPI. Fueron evaluados artículos publicados entre 2000 y 2013, relacionados con la efectividad de la cirugía abierta (CA) y el tratamiento mínimamente invasivo (TMI) en pacientes diagnosticados con NPI. Se PubMed, MEDLINE, The Cochrane Database of Systematic Reviews, Cochrane Central Register RCT, DARE, IBECS, SciELO, LILACS, PAHO, WHOLIS, ASERNIP-S, NIHR, HTA, Clinical Excellence, York Health Economic Consortium y Tripdatabase, en búsqueda de revisiones sistemáticas (RS), ensayos clínicos aleatorios (ECA) y estudios observacionales (EO). En estos estudios se evaluó la eficacia de la cirugía y el TMI en relación con diferentes variables, como la mortalidad, el sangrado intra-abdominal, el desarrollo de fístula enterocutánea o la perforación de víscera hueca, el desarrollo de fístula pancreática, reintervenciones por complicaciones, reintervenciones por necrosectomía, el desarrollo de diabetes mellitus y la necesidad de enzimas pancreáticas. Se consiguieron 389 artículos, de los cuales 10 cumplieron con los criterios de selección (2 RS, 1 ECA y 7 EO). Los estudios presentaron un nivel de evidencia de 2a, 2b, 3a y 4. El TMI se asocia con mejores resultados que la CA en todas las variables analizadas, pero en forma significativa sólo en el desarrollo de la diabetes mellitus y la necesidad de enzimas pancreáticas. Los artículos encontrados son pocos y heterogéneos, lo que hace difícil poder alcanzar conclusiones significativas. Se necesitan estudios con un mejor nivel de evidencia, calidad metodológica y tamaño de población estudiada para poder establecer conclusiones y recomendaciones.

Risk factors of postoperative morbidity in patients with uncomplicated liver hydatid cyst.

PURPOSE: To determine postoperative morbidity (POM) in patients undergoing surgery for uncomplicated hepatic echinococcosis (HE) and determine associations with the variable POM looking for possible risk factors for POM. METHODS: Nested case-control study. We included patients undergoing surgery for uncomplicated HE in two hospitals in Temuco between 2000 and 2012. The main outcome variable was development of POM. Other variables of interest were hospital stay, mortality and recurrence. Surgical techniques used were pericystectomy and liver resection. Descriptive statistics and analytical statistics were applied using T-test, ANOVA and Kruskal-Wallis test to compare continuous variables; Chi(2) and Fisher's exact test for categorical variables, and logistic regression models were used, estimating OR. RESULTS: 126 patients, median age 41 years, 61% female. The incidence of POM was 10.3%, with 76.9% Clavien grade I or II. The etiology was 6.5% and 4.1% of medical and surgical complications, respectively. There was no mortality and with a median follow-up of 83 months, recurrence incidence was 0.8%. Association was found between cases and controls and the variables age, alkaline phosphatase, cyst location and hospital stay. Applying regression models age (p = 0.002 and OR 1.07) and cyst location (p = 0.003 and OR 3.94) were found to be risk factors. CONCLUSIONS: Observed POM is lower and of less severity than those previously published. Risk factors were determined.

[Effectiveness of mesh inguinal hernia repair: a systematic review]. / Uso versus no uso de malla en hernioplastía inguinal: ¿existe un rol para la reparación sin malla? Revisión global de la evidencia.

There is controversy about the effectiveness of mesh techniques for inguinal hernia repair (IHR) when compared with non-mesh procedures. The aim of this study was to systematically review the available evidence on the effectiveness of mesh compared to non-mesh IHR techniques. Cochrane Central and MEDLINE databases and the TRIP Database engine were reviewed looking for systematic reviews (SR) and clinical trials (CT) published from 1990 to 2012, comparing the effectiveness, in terms of operative time, postoperative pain, morbidity, hospital stay, return to work, costs and recurrence, of mesh and non-mesh IHR techniques. We retrieved 3,069 articles, 17 of which met the selection criteria (3 SR and 14 RCT), representing a population of 15,124 subjects (7361 mesh and 7763 non-mesh IHR). According to these studies, mesh IHR techniques are associated with less surgical time, pain, hospital stay, recurrence and sooner return to work than non-mesh techniques. It is concluded that mesh techniques are more effective than those not using a mesh.

Calidad de vida relacionada con salud: una variable resultado a considerar en investigación clínica / Health-related quality of life. measurement tools to assessing upper gastrointestinal surgery outcomes

Es aceptada la conveniencia de medir calidad de vida relacionada a salud (CVRS) como variable de interés en investigación clínica, para lo cual, existe una gran variedad de instrumentos de medición disponibles. El objetivo de este artículo es describir los conceptos básicos referentes a CVRS y algunos ejemplos de instrumentos utilizados para valorar este constructo. Material y método: Se realizó una búsqueda en los motores Google y Yahoo; en los metabuscadores Ixquick y Copérnico; y en la base de datos "Documents in Information Science" (DoIS). En la estrategia de búsqueda, se utilizaron los términos "calidad de vida", "calidad de vida relacionada con salud" y "CVRS". Una vez localizados los resúmenes de los artículos localizados, se evaluaron los documentos en extenso y se desarrolló un documento resumen de la información recolectada. Resultados: La búsqueda realizada arrojó una gran variedad de instrumentos genéricos y específicos. Conclusión: Existen múltiples instrumentos para medir CVRS. Conocerlos constituye una ayuda para la práctica profesional y la investigación clínica.

It is accepted the desirability of measuring related quality of life (HRQOL) as a variable of interest in clinical research, for which there is a great variety of measurement tools. The aim of this article is to describe basic concepts concerning HRQOL and some examples of instruments used to assess this construct. Material and methods: A search on engines Altavista, Google and Yahoo, in Ixquick and Copérnico metasearch and in the database "Documents in Information Science" (DoIS) was performed. The search strategy used the terms "Quality of Life", "Health-related quality of life", "HRQOL" and "Outcome Assessment (Health Care)". After locating articles, these were evaluated and a summary document of collected information was developed. Results: The performed search gave a wide variety of generic and specific instruments. Conclusion: There are many instruments to measure HRQOL. Knowing constitutes an aid for professional practice and clinical research.

Uso versus no uso de malla en hernioplastía inguinal: ¿existe un rol para la reparación sin malla? Revisión global de la evidencia / Effectiveness of mesh inguinal hernia repair: A systematic review

There is controversy about the effectiveness of mesh techniques for inguinal hernia repair (IHR) when compared with non-mesh procedures. The aim of this study was to systematically review the available evidence on the effectiveness of mesh compared to non-mesh IHR techniques. Cochrane Central and MEDLINE databases and the TRIP Database engine were reviewed looking for systematic reviews (SR) and clinical trials (CT) published from 1990 to 2012, comparing the effectiveness, in terms of operative time, postoperative pain, morbidity, hospital stay, return to work, costs and recurrence, of mesh and non-mesh IHR techniques. We retrieved 3,069 articles, 17 of which met the selection criteria (3 SR and 14 RCT), representing a population of 15,124 subjects (7361 mesh and 7763 non-mesh IHR). According to these studies, mesh IHR techniques are associated with less surgical time, pain, hospital stay, recurrence and sooner return to work than non-mesh techniques. It is concluded that mesh techniques are more effective than those not using a mesh.

Treatment of the residual cavity during hepatic hydatidosis surgery: a cohort study of capitonnage vs. omentoplasty.

PURPOSE: To determine the efficacy of omentoplasty (OP) and capitonnage (CA) in residual cavity management during the hepatic hydatidosis (HH) surgery in terms of the postoperative morbidity. METHODS: Prospective cohort study. Patients with non-complicated HH treated with subtotal pericystectomy in the Department of Surgery of the Temuco Regional Hospital between 2001 and 2008 were studied. We compared those managed with CA with those managed with OP. A sample size of 40 patients in each group was estimated to be needed to adequately compare the outcomes of the approaches. The primary endpoint was postoperative morbidity. Descriptive statistics, bivariate analyses and logistic regression models were applied. The absolute risk (AR) and relative risk (RR) were calculated. RESULTS: The cohorts comprised 88 patients (CA 40 and OP 48), with a median age of 40 years (15-84), and 62.5 % were females. A general postoperative morbidity rate of 11.4 % was noted after a median follow-up of 60 months (12-84 months). Significant differences in postoperative morbidity were found (p = 0.044). Logistic regression models verified that there were no confounding variables. The AR of the postoperative morbidity for the CA and PO cohorts was 0.025 and 0.1875, respectively, and the RR was 0.13 [0.03, 0.70] 95 % CI. CONCLUSION: Residual cavity management with CA is associated with a lower postoperative morbidity risk than OP.

Laparostomía contenida con bolsa de Bogotá. Resultados de una serie de casos / Contained laparostomy with a Bogota bag. Results of case series

Introducción Una opción de laparostomía contenida (LC) es la «bolsa de Bogotá» (BB). El objetivo de este estudio es comunicar los resultados observados en una serie de pacientes relaparotomizados con LC utilizando la BB, en términos de morbilidad hospitalaria asociada al procedimiento (MHAP). Material y método Serie de casos prospectiva de pacientes relaparotomizados en el Hospital Hernán Henríquez de Temuco, entre 2002 y 2008. La variable resultado fue «desarrollo de MHAP». Otras variables de interés fueron: indicaciones de la LC, tiempo hasta el primer recambio de la BB, periodicidad de las intervenciones quirúrgicas, tiempo hasta la retirada de la BB, tipo de reparación de la pared abdominal, mortalidad hospitalaria y desarrollo de hernia incisional. Se utilizó estadística descriptiva; con cálculo de porcentajes, medidas de tendencia central y dispersión. Resultados En el período de estudio, se utilizó la BB en 86 pacientes (63% eran de género femenino), con una mediana de edad de 53 años. La MHAP fue 38% (infección de sitio operatorio y fístula enterocutánea). La indicación más frecuente de LC fue sepsis intra-abdominal (60%). Las medianas del tiempo hasta el primer recambio de la BB, periodicidad de las intervenciones quirúrgicas y tiempo hasta la retirada de la BB fueron 65 horas, 2 días y 9 días, respectivamente. La reparación de la laparostomía fue con cierre de piel exclusivo, cierre aponeurótico o injerto dermoepidérmico en 50, 39 y 10%, respectivamente. La mortalidad hospitalaria fue 12%. Tras un seguimiento de 48 meses se verificó que el 60% de los pacientes desarrollaron hernia incisional (AU)

Introduction: The «Bogota bag» (BB) is one of the options for contained laparostomy (CL). The aim of this study was to report the procedure associated hospital morbidity (PAHM) in patients undergoing relaparotomy followed by a laparostomy using the BB. Material and method: Between 2002 and 2008, a prospective series of patients who underwent relaparotomy at the Hospital Hernan Henrýquez, Temuco (Chile) was evaluated. The main end point was «development of PAHM». Secondary end points were: indications of the CL, time to first change of the BB, type of abdominal wall repair, hospital mortality and development of ventral hernia. Descriptive statistics were used, with the calculations of percentages and measures of central tendency and dispersion. Results: The BB was used in 86 patients (median age of 53 years, 63% female). The PAHMwas38% (surgical-site infection and enterocutaneous fistula). The most frequent indication of CL was intra-abdominal sepsis (60%). The median time until the first change of the BB, the time period between surgical operations, and the time until removal of the BB were 65 hours,2 days and 9 days, respectively. Laparostomy was repaired exclusively with skin, fascia closure or dermal-epidermal graft in 50, 39 and 10%, respectively. In hospital mortality was12%. Sixty percent of the patients developed a ventral hernia within a 48 month follow-up. Conclusions: CL with a BB is associated with a high rate of PAHM and delayed complications (AU)

[Contained laparostomy with a Bogota bag. Results of case series]. / Laparostomía contenida con bolsa de Bogotá. Resultados de una serie de casos.

INTRODUCTION: The «Bogota bag¼ (BB) is one of the options for contained laparostomy (CL). The aim of this study was to report the procedure associated hospital morbidity (PAHM) in patients undergoing relaparotomy followed by a laparostomy using the BB. MATERIAL AND METHOD: Between 2002 and 2008, a prospective series of patients who underwent relaparotomy at the Hospital Hernán Henríquez, Temuco (Chile) was evaluated. The main end point was «development of PAHM¼. Secondary end points were: indications of the CL, time to first change of the BB, type of abdominal wall repair, hospital mortality and development of ventral hernia. Descriptive statistics were used, with the calculations of percentages and measures of central tendency and dispersion. RESULTS: The BB was used in 86 patients (median age of 53 years, 63% female). The PAHM was 38% (surgical-site infection and enterocutaneous fistula). The most frequent indication of CL was intra-abdominal sepsis (60%). The median time until the first change of the BB, the time period between surgical operations, and the time until removal of the BB were 65 hours, 2 days and 9 days, respectively. Laparostomy was repaired exclusively with skin, fascial closure or dermal-epidermal graft in 50, 39 and 10%, respectively. In hospital mortality was 12%. Sixty percent of the patients developed a ventral hernia within a 48 month follow-up. CONCLUSIONS: CL with a BB is associated with a high rate of PAHM and delayed complications.

Organising metabolic networks: Cycles in flux distributions.

Metabolic networks are among the most widely studied biological systems. The topology and interconnections of metabolic reactions have been well described for many species. This is, however, not sufficient to understand how their activity is regulated in living organisms. These descriptions depict a static set of possible chains of reactions, with no information about the dynamic activity of reaction fluxes. Cyclic structures are thought to play a central role in the homeostasis of biological systems and in their resilience to a changing environment. In this work, we present a methodology to help investigating dynamic fluxes associated to biochemical reactions in metabolic networks. We introduce an algorithm for partitioning fluxes between cyclic and acyclic sub-networks, adapted from an algorithm initially developed to study fluxes in trophic networks. Using this algorithm, we analyse three metabolic systems: the central metabolism of wild type and a deletion mutant of Escherichia coli, erythrocyte metabolism and the central metabolism of the bacterium Methylobacterium extorquens. This methodology unveils the role of cycles in driving and maintaining metabolic fluxes under perturbations in these examples, and may be used to further investigate and understand the organisational invariance of biological systems.

Hernia incisional: técnicas y resultados / Incisional hernia: techniques and results

Incisional hernia continues to be an important post-operative complication since it is a significant source of morbility and unfitness for work.The aim of the present paper is to analyse different surgical techniques used in repairing IH, complications and recurrence as well predisposing factors in theiroccurrence.A retrospective analysis was made of 300 case histories of patients who had undergone surgical repair of IH in the Surgery Department of the Hospital San Juan de Dios between December 1999 and May 2002.The most frequently used surgical procedures nowadays were analysed (anatomical repair by sheets; repair with pre-aponeurotic mesh and repair with retromuscular preperitoneal mesh).The incidence of this pathology is between 2 per cent and 15 per cent. The uses of prosthetic meshes and tensionlessrepair techniques have helped to lower recurrences considerably.