related to cancer, with a mean average age of 50 years in 75% of cases. 5Mortality rate by age in colorectal cancer is higher in men than in women, and is also twofold in developed (11.6/100,000 habitants) in comparison with developing countries (6.6/100,000 inhabitants), highlighting the region of Eastern Europe, with the highest mortality rate for men and women.Worldwide mortality has increased from 1990 to 2013 (57%); however, in some regions of Europe, North America, and Asia, this has decreased, primarily due to the application of screening methods, such as colonoscopy, which is related with early diagnosis and treatment. 5 ABSTRACTThe liver is the most common site of metastasis in patients with colorectal cancer due to its anatomical situation regarding its portal circulation. About 14 to 18% of patients with colorectal cancer present metastasis at the first medical consultation, and 10 to 25% at the time of the resection of the primary colorectal cancer. The incidence is higher (35%) when a computed tomography (CT) scan is used.In the last decades, a significant increase in the life expectancy of patients with colorectal cancer has been achieved with different diagnostic and treatment programs. Despite these improvements, the presence of metastasis, disease recurrence, and advanced local tumors continue to remain poor prognostic factors.Median survival without treatment is <8 months from the moment of its presentation, and a survival rate at 5 years of 11% is the best prognosis for those who present with local metastasis. Even in patients with limited metastatic disease, 5-year survival is exceptional. Patients with hepatic metastasis of colorectal cancer have a median survival of 5 to 20 months with no treatment. Approximately 20 to 30% of patients with colorectal metastasis have disease confined to the liver, and this can be managed with surgery. Modern surgical strategies at the main hepatobiliary centers have proved that hepatectomy of 70% of the liver can be performed, with a mortality rate of <5%.It is very important to have knowledge of predisposing factors, diagnostic methods, and treatment of hepatic metastasis. However, the establishment of newer, efficient, preventive screening programs for early diagnosis and adequate treatment is vital.
Mirizzi syndrome, known as extrinsic bile compression syndrome, is a rare complication of cholecystitis and chronic cholelithiasis, secondary to the obliteration of the infundibulum of the gallbladder or cystic duct caused by the impact of one or more calculations in these anatomical structures, which leads to compression of the adjacent bile duct, resulting in partial or complete obstruction of the common hepatic duct, triggering liver dysfunction. Our aim is to identify and describe the current epidemiology, diagnostic methods, and treatment of Mirizzi syndrome. A literature search was performed using different databases, including Medline, Cochrane, Embase, Medscape, PubMed, using keywords: Mirizzi syndrome, epidemiology, markers, pathophysiology, clinical presentation, diagnosis, and treatment. Selected original articles, review articles or case reports from 1997 to 2015 were collected, written in English or Spanish. The endoscopic retrograde cholangiopancreatography (ERCP) is the most accurate diagnostic method. The traditional treatment has been surgery and involves an incision at the bottom of the gallbladder and calculus removal. If fistulas are observed, it is performed a partial cholecystectomy; otherwise, a cholecystocholedochoduodenostomy is an alternative. Endoscopic treatment includes biliary drainage and stone extraction. Many surgeons claim that laparoscopic cholecystectomy is contraindicated in Mirizzi syndrome because of the presence of inflammatory tissue and adhesions in the Calot's triangle. If dissection is attempt, it can cause unnecessary injury to the bile duct. However, other surgeons consider the laparoscopic approach is feasible, although technically challenging. Currently, laparoscopic cholecystectomy for this condition is considered controversial and technically challenging; however, it has shown that with the right skills and equipment, it is a safe and feasible way to treat some cases of Mirizzi syndrome type I and II.
Colorectal cancer (CCR) is the third most common cancer worldwide in men and women, the second largest cause of death related to cancer, and the main cause of death in gastrointestinal cancer. The risk of developing this cancer is related to bad alimentary habits, smoking, intestinal inflammatory disease, polyps, genetic factors, and aging. Of the patients that are diagnosed with colorectal cancer 90% are older than 50, with a median age of 64 years; however, the disease is more aggressive in patients that are diagnosed at younger ages. According to the American Cancer Association, it was accounted for more than 49,700 deaths in 2015. The goal is to reduce the mortality rate with early diagnosis and treatment. Currently, the survival rate is used to predict a patient’s prognosis. The patient is considered to have a positive familial history if a first-degree relative has been diagnosed with colorectal cancer or colonic polyps before the age of 60, or also if two or more first-degree relatives have been diagnosed with cancer or polyps at any age. There are several methods for detecting colorectal cancer, such as the guaiac test, immunochemical test of stool, DNA stool test, sigmoidoscopy, colonoscopy, and barium enema. The stage in which the cancer is detected determines the prognosis, survival, and treatment of the patient. Provide a review about generalities, genetic basis, risk factors, protective factors, clinical course, diagnostic methods, therapy and survival in colorectal cancer. Conducted research from different databases such as PubMed, Medline, MedScape, on the definition, genetic factors, classification, risk factors, protective factors, diagnostic methods, epidemiology, survival and treatment of colorectal cancer. Articles from 2000 to 2017 were included using the following keywords.
Chronic venous insufficiency (CVI) comprises a complete spectrum of morphological and functional abnormalities of the venous system1 including any long-term functional and morphological alteration. CVI accounts for several abnormalities of the venous system. It is a highly prevalent disease that causes serious economic consequences, a decrease in the quality of life and can lead to serious complications. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to chronic venous insufficiency. The pathophysiology of chronic venous insufficiency begins with chronic venous hypertension and the dilation of the vessel, this leads to a series of pathological changes in the venous wall and surrounding tissues, in advanced stages of CVI, skin lesions are associated with an increased proliferation of skin capillaries and microcirculatory abnormalities that may be the result of an altered level of factors responsible for the angiogenic response, such as vascular endothelial growth factor (VEGF), fibroblast growth factor 2 (FGF2) and angiostatin. In this review, updates on pathophysiology, clinic, diagnosis, classification and treatment of this disease are analyzed, with special emphasis on therapeutic options. Chronic venous insufficiency is a disease that affects the patient at several levels, mainly diminishing his/her quality of life. Currently there are various treatments ranging from habit modifications, pharmacological, to endovenous and surgical treatment.
Tissue engineering has been widely used for its great variety of functions. It has been seen as a solution to satisfy the need for vascular substitutes like small diameter vessels, veins, and nerves. One of the most used methods is electrospinning, due to the fact that it allows the use of various polymers, sizes, mandrels and it can adjust the conditions to create personalized scaffolds. For the creation of scaffolds is fundamental to understand the advantages and disadvantages of each polymer, of this, will depend the biodegradability, biocompatibility, porosity, cellular adhesion, and cell proliferation as it is essential to mimic the extracellular matrix and provide structural support for the cells. The aim of this review was to investigate which materials are being used for the creation of tubular scaffolds by electrospinning. Here we selected only in vivo evaluation to demonstrate remodeling of the grafts into native-like tissues, in vitro evaluations had been excluded from this review. We analyze the conditions like speed, distance and voltage and the modifications like growth factors and combinations of natural and synthetic polymers that allow the authors to have a functional scaffold that will suit its purpose.
Acute pulmonary edema post extubation due to negative pressure with laryngospasm in the early postoperative period has been reported and may occur at any time during anesthesia. The usual treatment consists of respiratory support and diuretics. We present the clinical case of a 15-year-old patient who underwent laparoscopic appendectomy, who presented acute non-cardiogenic pulmonary edema in the postoperative period. This complication can be presented in any surgical patient intubated, so it is important to know the pathophysiological basis to be able to diagnose and treat this pathology.
A.I. Valderrama-Treviño et al. Conclusiones: En nuestro estudio demostramos mejor adquisición de competencias quirúrgicas al utilizar un simulador no biológico, probablemente por el entrenamiento constante y fácil manipulación de dicho modelo.
In our study there is no statistically significant difference between the use of linear stapler or endoloop in the early appendicular phases; being of significant utility in Phase 4 the use of linear stapler for the incidence of abscesses.
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