Body contouring using laser diode 980-nm (LSDL 980-nm) assisted lipolysis: a safe procedure

Introduction: Liposuction has undergone several improvements since its first description, including changes in the cannulas, variation in the concentration of the infiltrating solution, and the use of different devices and technologies. The use of laser technology devices for lipolysis and stimulation of skin retraction has contributed to the procedure. This article presents the authors’ experience with laser lipolysis in 400 patients, within a 5-year period, and discusses the principles of the technology and its effect on tissues. Methods: This is a study performed between July 2007 and July 2012 and included 400 patients who underwent laser lipolysis. All procedures were performed following the original protocol – infiltration of cold saline, passage of the cannula with an optic fiber for conducting the energy needed for laser lipolysis, skin retraction, and finally, conventional liposuction. Results: Hospitalization type ranged from outpatient to overnight surgery. Approximately 45% (180 of 400) of patients had minimal bruising, with involvement of 2% or more of the affected body surface. Hematoma, seroma, and dehiscence occurred in a total of 9% (36 of 400) of patients. We did not find any case of thermal burn of the skin. Conclusions: Laser lipolysis performed according to the described technique was safe and reproducible.; Introdução: A técnica de lipoaspiração recebeu várias contribuições desde sua primeira descrição, como modificações nas cânulas, variação na concentração da solução de infiltração e uso de aparelhos com tecnologias variadas. A utilização de aparelhos com tecnologia laser vem contribuir com o procedimento por meio da lipólise e com o estímulo de retração cutânea. Neste artigo é apresentada a experiência dos autores com a laserlipólise em 400 pacientes, no intervalo de 5 anos, sendo discutidos aspectos dos princípios da tecnologia e sua ação sobre os tecidos. Método: Estudo realizado entre julho de 2007 e julho de 2012, que incluiu 400 pacientes submetidos a procedimento de laserlipólise. Os procedimentos foram realizados seguindo protocolo original, com infiltração de soro gelado, passagem da cânula com fibra óptica para a condução da energia laser visando à laserlipólise, retração cutânea e, por último, lipoaspiração convencional. Resultados: O período de internação variou de cirurgia em regime ambulatorial a pernoite. Cerca de 45% (180/400 pacientes) dos pacientes evoluíram com equimoses mínimas, com acometimento de 2% ou mais da superfície corporal comprometida. Os casos de hematoma, seroma e deiscência totalizaram 9% (36/400 pacientes). Em nenhum caso foi constatada queimadura por lesão térmica na pele. Conclusões: O procedimento de laserlipólise realizado com a técnica descrita demonstrou segurança e reprodutibilidade
Authors: Centurion, Patricio; Cuba, J.L.; Noriega, A.
Source: Cirugía Plástica Iberolatinoamericana

URL: http://hdl.handle.net/10757/320971

Internal abdominal hernia: Intestinal obstruction due to trans-mesenteric hernia containing transverse colon

INTRODUCTION Internal abdominal hernias are infrequent but an increasing cause of bowel obstruction still often underdiagnosed. Among adults its usual causes are congenital anomalies of intestinal rotation, postsurgical iatrogenic, trauma or infection diseases. PRESENTATION OF CASE We report the case of a 63-year-old woman with history of chronic constipation. The patient was hospitalized for two days with acute abdominal pain, abdominal distension and inability to eliminate flatus. The X-ray and abdominal computerized tomography scan (CT scan) showed signs of intestinal obstruction. Exploratory laparotomy performed revealed a trans-mesenteric hernia containing part of the transverse colon. The intestine was viable and resection was not necessary. Only the hernia was repaired. DISCUSSION Internal trans-mesenteric hernia constitutes a rare type of internal abdominal hernia, corresponding from 0.2 to 0.9% of bowel obstructions. This type carries a high risk of strangulation and even small hernias can be fatal. This complication is specially related to trans-mesenteric hernias as it tends to volvulize. Unfortunately, the clinical diagnosis is rather difficult. CONCLUSION Trans-mesenteric internal abdominal hernia may be asymptomatic for many years because of its nonspecific symptoms. The role of imaging test is relevant but still does not avoid the necessity of exploratory surgery when clinical features are uncertain.
Authors: Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Orendo-Velásquez, Edwin; Andrade, Felipe P.
Source: International Journal of Surgery Case Reports

URL: http://hdl.handle.net/10757/320534

Phylogenetic relationships of Shiga toxin-producing Escherichia coli isolated from Peruvian children

The aim of this study was to determine the prevalence, virulence factors (stx, eae, ehxA and astA) and phylogenetic relationships [PFGE and multilocus sequence typing (MLST)] of Shiga toxinproducing Escherichia coli (STEC) strains isolated from four previous cohort studies in 2212 Peruvian children aged ,36 months. STEC prevalence was 0.4% (14/3219) in diarrhoeal and 0.6% (15/2695) in control samples. None of the infected children developed haemolytic uraemic syndrome (HUS) or other complications of STEC. stx1 was present in 83% of strains, stx2 in 17 %, eae in 72 %, ehxA in 59% and astA in 14 %. The most common serotype was O26: H11 (14%) and the most common seropathotype was B (45 %). The strains belonged mainly to phylogenetic group B1 (52 %). The distinct combinations of alleles across the seven MLST loci were used to define 13 sequence types among 19 STEC strains. PFGE typing of 20 STEC strains resulted in 19 pulsed-field patterns. Comparison of the patterns revealed 11 clusters (I–XI), each usually including strains belonging to different serotypes; one exception was cluster VI, which gathered exclusively seven strains of seropathotype B, clonal group enterohaemorrhagic E. coli (EHEC) 2 and phylogenetic group B1. In summary, STEC prevalence was low in Peruvian children with diarrhoea in the community setting. The strains were phylogenetically diverse and associated with mild infections. However, additional studies are needed in children with bloody diarrhoea and HUS.
Authors: Contreras, C. A.; Ochoa, T. J.; Ruiz, J.; Lacher, D. W.; Rivera, F. P.; Saenz, Y.; Chea-Woo, E.; Zavaleta, N.; Gil, A. I.;Lanata, C. F.
Source: Journal of Medical Microbiology
URL: http://hdl.handle.net/10757/320507

Training programs in Gastroenterology. Where we are and where do we want to be

A lo largo de este año hemos recibido la colaboración de diferentes personalidades de la gastroenterología nacional e internacional comentándonos los esfuerzos que se hacen en relación a la educación médica moderna y la investigación en gastroenterología (1-3). Es por eso que considero relevante ahondar en el tema y revisar lo que se está haciendo en la formación de nuestros residentes en el contexto de las tendencias actuales determinadas por la Organización Mundial de Gastroenterología (WGO por sus siglas en inglés) y otras organizaciones internacionales.
Autor: Piscoya, Alejandro
Fuente: Rev. gastroenterol. Perú

URL: http://hdl.handle.net/10757/316349

Teaching to publish since undergraduate

En el año 2001, cuando era estudiante de medicina y miembro de la sociedad científica (SOCEM) de mi universidad en Lima, Perú, me encargaron una labor que no tenía la menor idea de lo que significaría para mi futuro, ser el Director del V Encuentro Internacional de Revistas Científicas de Estudiantes de las Ciencias de la Salud (EIRCECS ). Digo esto, porque a pesar de estar involucrado en una SOCEM, que traducía mi alto interés por la investigación, no sabía que un estudiante de medicina podía publicar en una revista científica, y mucho menos, hacer una.
Autor: Mayta Tristán, Percy
Fuente: Rev. Méd. Risaralda

URL: http://hdl.handle.net/10757/316348