Background and study aims: Overall, 5 % to 15 % of patients undergoing cholecystectomy for cholelithiasis have concomitant bile duct stones, and the incidence of choledocholithiasis increases with age. There is no clear consensus on the best therapeutic approach (endoscopic versus surgical). Patients and methods: A prospective randomized controlled clinical trial was performed to compare three treatment options for patients with choledocholithiasis at the National Center for Minimally Invasive Surgery in Havana, Cuba from November 2007 to November 2011. The patients were randomized in three groups. Group I: patients who underwent intraoperative cholangiography (IOC) to confirm the choledocholithiasis followed by laparoscopic cholecystectomy (LC) associated with intraoperative endoscopic retrograde cholangiopancreatography (ERCP), group II: patients who underwent preoperative ERCP followed by LC during the same hospital admission and group III: patients who underwent IOC to confirm the choledocholithiasis followed by LC associated with laparoscopic common bile duct exploration (LCBDE). Results: A total of 300 patients with suspected choledocholithiasis were included in the trial and were randomized. As a result, a total of 134 patients were diagnosed with the presence of choledocholithiasis and treated during the study period. There were no significant differences in success rates of ductal stone clearance, but retained stone, postoperative complications and length of hospital stay were better in group I. Conclusions: Intraoperative ERCP/ES shows a higher rate of common bile duct stones clearance, a shorter hospital stay, and lower morbidity, but further research with a larger study population is necessary to determine the additional benefits of this procedure. The results to date suggests that in appropriate patients, single-stage treatments are the best options.

We emphasise the importance of measuring ammonia levels in patients with neurological or psychiatric symptoms as part of their diagnostic work-up.

No abstract

No abstract

La uchuva, Physalis peruviana L., crece como planta silvestre en las zonas tropicales altas de América, estando el centro de origen y diversificación en los Andes Suramericanos, principalmente de Colombia, Perú y Ecuador. Se realizó la caracterización morfológica de 46 accesiones de uchuva provenientes del Banco de Germoplasma de la nación Colombiana, a cargo de La Corporación Colombiana de Investigación Agropecuarias, CORPOICA, en el Centro de Investigación La Selva, ubicado en la vereda Llanogrande del municipio de Rionegro (Antioquia, Colombia). Los genotipos de uchuva se sembraron utilizando un diseño látice siete por siete simple desbalanceado duplicado. Las accesiones se ubicaron en parcelas constituidas por cinco plantas, de las cuales se evaluaron las tres plantas centrales de las dos replicaciones y cinco estructuras por planta. Se empleó un listado de 69 descriptores, 40 de ellos cualitativos y 29 cuantitativos, 56 de los cuales (81,16%) fueron útiles en la diferenciación de las accesiones. Para las variables cualitativas se estimaron los coeficientes de disimilaridad de Gower, que fluctuaron desde 0 a 0,20; y para las variables cuantitativas se estimaron los valores de distancia Euclediana, que fluctuaron entre 0,25 y 1,22.

Potatoes with pulp coloration, have a large number of antioxidant compounds, new varieties with agronomic and nutritional properties have been developed, from which the diploid potato cv Primavera was selected, a process of vacuum frying was applied. The aim of the present study was to evaluate the effect of the process conditions on the snacks quality of potatoes. Response surface methodology was used by a central composite design, with independent variables: ΔT (Toil-Tboiling point water) (°C), vacuum pressure (25-70 kPa), frying time (240-420 s) and dependent variables: antioxidant capacity, peroxides index, moisture, aw, texture, color, fat content for potato chips and polar compounds inside the frying oil. The results for the optimization process were: vacuum pressure = 59.4 kPa, ΔT = 50.8 °C and t =420 s. The optimization allowed to obtain a diploid potato snack with good quality 2538 Manuela Gallon Bedoya et al.

Religiousness, spirituality, and social support have all been identified as having a positive impact on overall mental health outcomes. The current study describes quantitative and qualitative assessment of parental and God representations among individuals diagnosed with schizophrenia or schizoaffective disorder (N = 46). Six salient themes emerged; participants described the importance of caregiver love and nurturance, need for God, loss of family members, love of God, concrete support provided by parents, and the ability to tolerate ambivalent feelings toward parents. Participants linked their relationships with parents and God to their process of recovery. Implications for clinical practice are discussed.

It is necessary to study the photosynthate distribution pattern and allocation in Guaneña and Latina potato varieties, which come from the Colombia variety and are relatively new in agriculture, for potato crops in Colombia. The aim of this study was to determine the distribution behavior of dry matter among the organs that make up the potato plant in order to determine the key moments in the crop cycle, where the filling of the tubers takes place, and to establish the pattern of biomass distribution in these varieties. Three consecutive experiments were performed at the "EstaciónAgraria Paysandú" in Santa Elena (Medellin - Antioquia), at 2,538 m a.s.l. with average temperatures of 13.6, 14.6 and 13.81°C. The field trials were established under a random complete blocks design with a 3x2 factorial layout and five replications. The first factor corresponded to the potato varieties and the second factor corresponded to the two fertilization levels: 7 and 21 g of fertilizer per planting site, representing 259.25 and 777.77 kg of fertilizer per ha. The higher fertilizer dose is the one normally used by farmers. An NPK fertilizer compound (10 - 20 - 20 - 5(S)) was used. There were 30 experiment units with an area of 18.27 m2 (seven 2.7 m furrows separated by 0.90 m); the distance between the plants was 0.30 m, for a density of 37,037 planting sites per ha. Weekly samplings were taken, a whole plant per experiment unit. The direct measuring evaluated variables for the dry weights of each organ, which were used to obtain curves and the distribution pattern. The development time was evaluated in accumulated growing degree-days and threshold temperatures of 2 and 29°C were used. In all of the varieties and the two fertilization treatments, most of the assimilates in the early stages of the cycle were concentrated in the roots, leaves and stems; once the tuber formation started, the leaves and stems started to allocate dry matter towards the filling of the accumulation organs.