Notes

Over-30-dB gain and also 1-dB noise amount phase-sensitive audio using a pump-combiner-integrated fibers I/O PPLN unit.
Complications after endoscopic retrograde cholangiopancreatography (ERCP) are rare, approximately 0.09% to 1.8% are duodenal perforation. This type of injury requires early diagnosis and proper management since the outcomes can be catastrophic, leading to death in 20% of cases.

To show our experience in the management of these injuries in order to establish if there is benefit from minimally invasive management versus conventional management.

Observational, retrospective and descriptive study comparing patients who required surgical management after post-ERCP duodenal perforation in three centers in Bogotá, Colombia, between January 2013 and December 2018.

13 patients were taken to surgical management after duodenal perforation post ERCP, 7 laparoscopically (53.8%), with an average hospital stay of 10.7 days and mortality of 0% and 6 by open route (46.1%), with an average hospital stay of 33 days and mortality of 50%, with a minimum follow-up of 6 months.

Post ERCP duodenal perforation, despite its low incidence, should be suspected due to its high mortality. Laparoscopic surgery is a good tool to address duodenal perforations after ERCP, because it presents a lower rate of complications and mortality.
Post ERCP duodenal perforation, despite its low incidence, should be suspected due to its high mortality. Laparoscopic surgery is a good tool to address duodenal perforations after ERCP, because it presents a lower rate of complications and mortality.
To evaluate the appearance of gastroesophageal reflux in our population after sleeve gastrectomy as management for obesity, with the Gastroesophageal Reflux Disease Questionnaire (GerdQ).

Retrospective study of patients undergoing sleeve gastrectomy during 2016 and 2017, having ruled out gastroesophageal reflux (GER) with pre-surgical upper digestive endoscopy, and post-operative evaluation with the GerdQ scale.

129 patients were included in the study, average age was 45 years, gender of greater male appearance was 77.5%, the most frequent comorbidities were hypothyroidism 25.6% and hypertension 23.3%. 12.4% had a score greater than or equal to 8, 14 were women and 2 men, there was no statistically significant relationship with the preoperative mass index.

Standardizing the gastric sleeve technique in the bariatric surgery services, taking into account the technical factors associated with post-operative GERD de novo, decreases its appearance as evaluated by the GerdQ scale.
Standardizing the gastric sleeve technique in the bariatric surgery services, taking into account the technical factors associated with post-operative GERD de novo, decreases its appearance as evaluated by the GerdQ scale.
Patients with compromised appendix base constitute a subgroup of patients with complicated appendicitis, and there is few available information.

To study the frequency of stump leaks and fistulae in patients with complicated appendicitis with compromised stump.

This is an observational, retrospective study of patients that underwent laparoscopic appendectomy with compromised appendix stump.

From 2015 to 2019, 158 patients with complicated appendicitis were operated, of them 54 had compromised base or stump. There were 66.7% men, with a mean age of 38.7 years. For stump closure, a simple knot was employed in 57.4%, and in 42.6% an invaginated suture was employed. Regarding complications, 16.7% developed intraabdominal abscess, 7.4% ileus and 7.4% had wound infection. We found one stump leak and one stump fistula. selleck The mean length of stay was 5.4 days (range 1-20). There were 5 reoperations, 4 for abscess drainage and 1 for stump leak.

Patients with acute complicated appendicitis with compromised appendicular base, laparoscopic surgery either with simple knot or with invaginated suture resulted in low frequency of stump leaks and fistula.
Patients with acute complicated appendicitis with compromised appendicular base, laparoscopic surgery either with simple knot or with invaginated suture resulted in low frequency of stump leaks and fistula.
Decompressive craniectomy (DC) has been used for the treatment of refractory increased intracranial pressure (ICP) in patients with brain trauma and stroke; its beneficial role is still a matter of debate. Little has been written on the role of DC in the setting of patients with intracranial tumors.

We retrospectively reviewed our institutional tumor registry for all adult patients treated with a DC as an emergency treatment between January 2012 and June 2019.

A total of 61 patients were taken into surgery for a DC secondary to raised ICP related to a central nervous system tumor. The Kaplan-Meier curves in the study showed that 18.9 months was the mean survival time (MST) of the global population, 40 patients died (65.5%) during the follow-up period. Patients in the group of over 60 years had a worst survival time than younger patients (p = 0.01). Patients with intracerebral hemorrhage had the worst MST compared with the patients with other etiologies (p = 0.04).

Our data show that in some selected cases DC is a viable option as a salvage treatment for patients with intracranial tumors.
Our data show that in some selected cases DC is a viable option as a salvage treatment for patients with intracranial tumors.Early diagnosis of SARS-CoV-2 infection is very important to establish timely treatment. In the present report, through the examination carried out in otorhinolaryngology, we found a pearlescent vesicular enanthema in the upper palate in 954/958 patients with the classic strain and it was not found in patients with the English strain. This finding had not been reported. The patients were successfully treated on time, only two patients died, which was associated with decompensated diabetes mellitus. link2 The present report suggests that the vesicular enanthem found is pathognomonic for Covid-19 classic strains.
To identify the epidemiological profile of mandibular fractures in the emergency department.

Observational, retrospective study included records of persons with a diagnosis of mandibular fracture treated between January 1, 2015 and June 30, 2019, from the emergency department of the Hospital de Traumatología Dr. Victorio de la Fuente Narváez. The age, sex, occupation, comorbidities, prevalence of mandibular fractures according to the number of fractures and anatomical area, were obtained from the clinical records.

319 subjects with mandibular fractures were included in the study, which were young people (32.5 years) of the male sex (89.7%), the majority developed some trade (64.2%), 14.4% had some comorbidity, 76% had alcoholism when time of injury. The most affected anatomical site was the mandibular angle followed by the parasymphysis, the most frequent cause of injury was due to physical aggression.

Mandibular fractures in our emergency department are usually simple, mainly affecting the angle of the jaw, occurring mainly in men in their third decade of life, assaults are the most frequent injury mechanism and are generally associated with substance use toxic.
Mandibular fractures in our emergency department are usually simple, mainly affecting the angle of the jaw, occurring mainly in men in their third decade of life, assaults are the most frequent injury mechanism and are generally associated with substance use toxic.
To contribute to the training of specialists by describing in a systematic and detailed way the ten steps to perform a safe and feasible Total Laparoscopic Hysterectomy (HTL).

The detailed description of the steps of the HTL intends that this procedure can be safely and effectively reproduced.

By clearly knowing the steps of HTL, it is possible to favor minimally invasive routes so that patients benefit from its multiple proven benefits.

The benefits of minimally invasive routes for performing a hysterectomy have already been demonstrated in the literature. It is particularly important that specialists are familiar with these techniques and that groups standardize the procedure so that more patients can safely undergo and benefit from the laparoscopic approach.
The benefits of minimally invasive routes for performing a hysterectomy have already been demonstrated in the literature. It is particularly important that specialists are familiar with these techniques and that groups standardize the procedure so that more patients can safely undergo and benefit from the laparoscopic approach.
The delay in surgical management of intestinal obstruction patients who did not respond to conservative management increases morbidity, mortality and days of hospital stay.

This study aimed to describe the clinical and tomographic features associated with surgical management in adhesive small bowel obstruction patients.

We conducted a retrospective review of the electronic medical records during a 5-year period with the diagnosis of adhesive small bowel obstruction. We divided patients in two, those who responded to medical management and those who required surgery.

A total of 162 patients were included, with a mean age of 61.5 years. It was the first case of intestinal obstruction in 63% of the patients and 65.4% underwent surgery 52.8% (n = 56) open surgery and 47.2% (n = 50) laparoscopic surgery. Multivariate analysis showed the following predictors of surgical treatment abdominal rebound (odds ratio [OR] 8.8; 95% confidence interval [95% CI] 1.09-71.6), tomographic free fluid (OR 4.62; 95% CI 1.50-14.20) and transition zone (OR 5.4; 95% CI 1.59-18.80). The history of previous obstruction was a protective factor (OR 0.33; 95% CI 0.17-0.67).

Abdominal rebound, free intrabdominal fluid and transition zone are related with the surgical management of adhesive small bowel obstruction.
Abdominal rebound, free intrabdominal fluid and transition zone are related with the surgical management of adhesive small bowel obstruction.
The role of cytoreductive nephrectomy on the treatment of metastatic renal cell carcinoma (mRCC) is controversial due to its high complexity.

To identify risk factors associated to postoperative complications in patients with mRCC after cytoreductive nephrectomy.

We conducted a retrospective, observational study in 67 patients who underwent cytoreductive nephrectomy for the management of mRCC. Demographic, perioperative and clinicopathologic -characteristics were registered. link3 Surgical complications were classified using the Clavien-Dindo system; major complications were those of grade 3 or higher. We performed a binary logistic regression analysis to identify risk factors associated with surgical complications.

Mean age was 56 years (37-83). Symptoms were present in 58 patients (89.7%). Weight loss was the predominant symptom (50.8%). Mean tumor diameter was 10.8 cm (4.6-22.5 cm). The rate of postoperative complications was 65%; 21 patients (31.4%) had major complications. Risk factors were estimated blood loss > 500 ml (OR 44.5, CI 95% 2.51-789, p = 0.01) and tumor diameter > 10 cm (OR 17.9, CI 95% 1.2-273, p = 0.04).

Cytoreductive nephrectomy is a good option in highly selected patients with mRCC. Our major complication rate was 31.4%. Risk factors associated were blood loss and tumor diameter.
Cytoreductive nephrectomy is a good option in highly selected patients with mRCC. Our major complication rate was 31.4%. Risk factors associated were blood loss and tumor diameter.
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