Aterosclerosis cérvico-cerebral subclínica: evaluación del índice REGICOR, el grosor íntima-media y el índice tobillo-brazo en la detección de sujetos en riesgo en la población

La aterosclerosis cérvico-cerebral es una de las principales causas de ictus isquémico, y por tanto, de morbimortalidad en nuestro medio. La detección de la misma en su fase asintomática mediante instrumentos como la función REGICOR, el grosor íntima-media y el índice tobillo-brazo podría mejorar las estrategias de prevención primaria. Comprobamos que, en nuestra cohorte de 933 sujetos sin antecedentes cardiovasculares, los tres factores (REGICOR≥10, GIM≥0.9, ITB≤ 0.9) se asociaron de forma independiente con la presencia de aterosclerosis cérvico-cerebral y de cualquier localización (extracraneal-intracraneal-combinada). La utilización conjunta de REGICOR e ITB podría facilitar el diagnóstico precoz de la aterosclerosis cérvico-cerebral subclínica.

Vaginal hysterectomy with the autosuture stapler

Our objective was to assess the applicability of hysterectomy by the vaginal route completely performed with Autosuture staples. Between January 1992 and September 1993, 5 vaginal hysterectomies using Autosuture staplers were performed by the authors. Five vaginal hysterectomies matched for age, parity, and uterine size performed by the same surgeons using reabsorbable sutures during the same period were used as case controls. No febrile morbidity, cuff infections, thrombophlebitis, bladder injury, or hemorrhage complications were observed in the 10 women who entered the study. In summary, vaginal hysterectomy can be performed with Autosutures easily, probably faster with experience, and with less oozing from the operative field, thus providing a safe procedure.

Posterior vaginal wall repair with synthetic absorbable mesh: A new technique for and old procedure

The objective of this study was to assess the applicability of posterior wall repair with a synthetic absorbable mesh. Between January and September 1996, five posterior repairs using absorbable synthetic meshes were performed. Five posterior wall repairs in patients matched for age, parity, and rectocele degree were performed according to usual procedures during the same period, and were used as controls. No febrile morbidity, cuff or posterior vaginal wall infections, thrombophlebitis, rectal injury, or hemorrhagic complications were observed in the 10 women who entered the study. In summary, posterior wall repair can be easily performed with an absorbable soft tissue patch, theoretically preserving sexual activity, and probably offers better functional results with longer experience, thus providing a safe and useful procedure in sexually active women.