Increased rate of cholecystectomies performed with doubtful or no indications after laparoscopy introduction: a single center experience

Background During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes. Methods 831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed. Results At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic cholecystitis; 14.68% were operated on because of an increase in bilirubin level; 1.56% were operated on because of a previous episode of jaundice with normal bilirubin at admission; 0.72% had gallbladder adenomas, 0.72% had cholangitis, 0.36% had biliodigestive fistula and one patient (0.12%) had acalculous cholecystitis. By excluding all these patients, 21.18% were operated on without indications. Conclusions The broadening of indications for laparoscopic cholecystectomy is undisputed and can be considered a consequence of new technologies that have been introduced, increased demand from patients, and the need for practice by inexperienced surgeons. If not prevented, this trend could continue indefinitely.

Molecular diversity, cultivation, and improved detection by fluorescent in situ hybridization of a dominant group of human gut bacteria related to Roseburia spp. or Eubacterium rectale

Peer reviewed

Molecular diversity, cultivation, and improved detection by fluorescent in situ hybridization of a dominant group of human gut bacteria related to Roseburia spp. or Eubacterium rectale

Peer reviewed

Floristic And Ethnobotanical Studies Of Medicinal Plants Of The City Of El -Jadida (MOROCCO)

Abstract: BRIGUICHE. H, ZIDANE. L. Floristic And Ethnobotanical Studies Of Medicinal Plants Of The City Of El -Jadida (MOROCCO). In the framework of the ethnobotanical studies on medicinal plants undertaken by the Laboratory of Biodiversity and Natural Resources of the Faculty of Sciences of Kenitra (Morocco), we are interested in the area of El Jadida which presents a rather important floristic richness thanks to changes in its ecological conditions By using 204 questionnaire, the ethnobotanical surveys were conducted in the field during the years 2012-2013. The location of the different sampling sites was determined by the stratified sampling method. The analysis of the results obtained from the questionnaires and forms using statistical processing allowed us to identify 70 plant species distributed in 69 genera and 37 families. These results also show that most of these species are mainly used in the care of the digestive system and respiratory system. The seed is the most used part in local traditional medicines and the decoction is the most frequent mode with a rate of 31%. The species Origanum compactum is the most used by the population of the city of El Jadida 47 quotes.  

Ontogenia del sistema digestivo y caracterización de la actividad enzimática de las larvas de chita Anisotremus scapularis (Tschudi, 1846)

La chita Anisotremus scapularis es un pez marino que habita las costas de Perú, es muy valorado para el consumo humano directo, y, es considerada una especie con potencial acuícola. El cultivo larval en muchas especies de peces marinos se considera como uno de los cuellos de botella para el desarrollo de la tecnología de cultivo a escala comercial, este es el caso de la chita. Como primer alimento y durante los primeros días de vida de las larvas se les suministra presas vivas, y posteriormente, cuando poseen un sistema digestivo más desarrollado, se les suministra alimento balanceado. Sin embargo, los alimentos vivos más empleados no satisfacen los requerimientos nutricionales de las larvas convirtiéndose en un punto crítico. Es por ello, que en los últimos años diversas investigaciones han concentrado sus esfuerzos en la sustitución del alimento vivo por alimento balanceado; no obstante, esto exige un buen conocimiento de la organización y funcionalidad del sistema digestivo. En este sentido, en el presente trabajo se investigan algunos aspectos de la fisiología nutricional de las larvas de chita durante los primeros 30 días de vida. Las larvas fueron cultivadas a partir de huevos obtenidos de desoves naturales de un lote de reproductores mantenidos en cautiverio en el Laboratorio de Cultivo de Peces del Instituto del Mar del Perú (IMARPE). El estudio del crecimiento en longitud, los análisis histológicos y la caracterización enzimática se realizaron a partir de muestras de larvas colectadas a los 0, 1, 2, 3, 4, 6, 8, 10, 14, 18, 22, 26 y 30 días después de la eclosión (DDE). Para los análisis histológicos, las larvas fueron sometidas a un proceso de deshidratación e inclusión en parafina, y teñidos utilizando la técnica de hematoxilina-eosina. La cuantificación de las enzimas digestivas de la chita, proteasas totales (ácidas y alcalinas), tripsina, leucina aminopeptidasa, lipasas dependientes de sales biliares y alfa-amilasa se llevó a cabo con técnicas espectrofotométricas. Al momento de la eclosión, las larvas poseen un tubo digestivo recto e histológicamente indiferenciado ubicado dorsalmente con respecto al saco vitelino, que se caracteriza por poseer una gota de aceite. Entre los 2 y 4 DDE, se observaron los mayores cambios en el desarrollo del sistema digestivo, entre los más importantes están la diferenciación de la bucofaringe, esófago e intestino, plegamiento de la mucosa intestinal, la formación de las microvellosidades en los enterocitos y el desarrollo de sus glándulas anexas, hígado y páncreas, los cuales permitieron la ingestión, digestión y absorción de los primeros alimentos exógenos ingeridos por las larvas. El mayor cambio que se observó en días posteriores fue la observación de un estómago en desarrollo, con la diferenciación de las glándulas gástricas (26 DDE). Las enzimas digestivas analizadas, fueron detectadas desde el momento de la eclosión de las larvas, antes de la apertura de la boca, y se incrementaron con la edad de los organismos. En general, se observó incrementos en la actividad total de las enzimas digestivas a partir de los 8 y 10 DDE o a los 4 mm de longitud total (LT), particularmente con aumentos más marcados en la actividad de las lipasas y de la leucina aminopeptidasa. Para la actividad de proteasas alcalinas totales, tripsina y alfa-amilasa, los aumentos fueron evidentes a partir de los 22 DDE o entre 6 y 7 mm de LT. La actividad de las proteasas ácidas se evidenció e incrementó a partir del 26 DDE o a los 9 mm de LT. En cuanto los patrones de actividad específica, en general, se observaron incrementos súbitos de la actividad que se relacionan con los periodos de transición de la alimentación endógena a exógena (3-6 DDE), y con el cambio de alimentación de rotíferos a metanauplios de Artemia (26 DDE). También, exceptuando la actividad de la leucina aminopeptidasa, se observaron estos incrementos súbitos antes de la primera alimentación. Con base al análisis histológico y bioquímico de las larvas de chita, se recomienda iniciar el destete a los 26 DDE.

Survey on the digenean and monogenean helminthes of clupeidae (teleosts) from southern part of Caspian Sea

The helminthes parasites fauna of 313 specimens of Caspian herrings (Clupeonella cultriventris, Clupeonella engrauliformis, Clupeonella grimmi) caught from catching localities situated in southeast of Caspian Sea Were investigated during winter 2008 until autumn 2009. A total of 3 helminthes species were found. They were including Pseudopentagramma symmetrica from intestine (mid gut, hind gut and cecae) Bunocotyle cingulata in intestine, Mazocreas alosae the only monogenean with Marine origin in the gills of infected specimens. In addition to two zoonotic species including Contracecum sp. and Anisakis sp. in digestive system, muscle and ovary and an Acanthocephal, Corynosoma strumosum in intestine which were previously reported. We can conclude that the main characteristic of the helminthes parasites community of Clupeidae species studied is the dominance of the endoparasites species due mainly to the digenean Pseudopentagramma symmetrica and Bunocotyle cingulata and the relative scarcity of ectohelminthes fauna. In this paper the latest data of helminthes fauna and community ecology of digenean of Clupeidae species are presented and the community structure of Pseudopentagramma symmetrica is discussed.

The experimentally pathogenesis of Aeromonas hydrophila in Astacus leptodactylus with emphasis on temperature in bacterial pathogenesis

In this study, four hundred freshwater Crayfish (A. leptodactylus) with average weight of 25-40g were purchased from Aras dam reservoirs in west Azerbayjan province and transported to Iranian Artemia Research Center of Uromya province in September 2010. (One hundred crayfish extra purchased for probably mortality). Before implement of experiment the Crayfish were acclimated for ten days. These experiments was designed in four group treatments (Number, 1,2,3,4) and one control group (Number 5) in triplicate with 20 Crayfish in each repetition prepared of glass aquarium with size (50x40x30cm). Many of infected Crayfish were used for isolation of bacteria. Haemolymph sample had been gathered from infected Crayfish with cutting their antennules and transferred to TSA medium (tryptic soy agar) and then A. hydrophila were determined in order to biochemical test. The treatments and repetitions has exposed to A. hydrophila. The concentrations of the bacteria in 4 treatments were respectively 3 x 108 (T=10-15°C), 3x106 (T=25°C), 3 x 106 and 3 x 104 Cfu mL-1 (T=10- i5oc) (4, 2, 3 and 1) that were prepared in individual containers for exposure of treatments. The control (5) prepared without any bacteria and disinfected by oxytetracycline antibiotic with concentration 100 ppm for 24 hours. The hemolymph samples were withdrawn from abdominal second segments of Crayfish for measuring of THC and TPC in interval hours (2, 6, 12, 24, 48, 96, 144, 240 and 336). For histopatological studies the crayfish samples fixed in Davidson fixative. The results indicated that interval 2 hours after experiment the difference of THC value between treatment 4 with control and treatments 1,2, and 3 was significant (P< 0.05). After 48 hours of experiment the difference of THC value between control group with treatment 1 ,2 and 3 was significant (P< 0.05). The interval 336 hours after experiment also the difference of THC value between treatment 2 with treatments 1, 3 and 4 was significant (P< 0.05). The finding of TPP value showed that the last time after challenge (336 h) there was significant difference between treatment 2 with treatment 4 and control group (P< 0.05). In histopathology studying, in hepatopancreas observed hemocyte aggregated and necrosis withof peknosis nucleus that with increased concentration of bacteria and temperature, The value of hemocyte has increased. Gill revealed necrosis and cell death especially with increased concentration of bacteria and temperature. In lower concentration of bacteria in heart no difference observed, but with increased concentration of bacteria (3 x 108) the low aggregation of hemocyte observed in heart. In treatment 3 x 106 with high temperature also distributed of high hemocyte in heart was observed. In digestive system didn't appear any difference in treatments land 3 but in concentration of 3 x 108 Cfu m1-1 and 3 x 106 (T=25°C) in digestive system was revealed the low aggregation of hemocyte.

The potential of Asparagopsis armata to control the bacterial load associated to live feed to improve Seabream (Sparus aurata) larvae performance

Dissertação de mestrado, Aquacultura e Pescas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2014

Morbidity and temporary cycles for the outpatient service at Universidad Estatal a Distancia in Costa Rica

No data has apparently been published on morbidity and outpatient service of faculty and staff of a distance university.  This report presents such data from the Universidad Estatal a Distancia (Costa Rican State University for Distance Education). The participants in this study were the employees who were outpatients between January 15, 2004 and December 15, 2006.  Instead of using a sample, the entire population was studied with a total of 1,526 medical records. Procedure: During the first stage all of the medical records were read and the morbidity data was tabulated.  Subsequently, this information was statistically analyzed using Statgraphics Centurion XV. The main findings were that 50% of the patients used the outpatient service only once during the study period and that most of them were between 20 and 50 years of age.  The days with the most consultations were Mondays, Tuesdays, and Wednesdays.  The number of consultations was relatively stable throughout the year, with a slight increase in June. The three main causes for visiting the service were: upper respiratory tract diseases, muscular-skeletal disorders, and irritated digestive system problems. Main conclusions: Most of the consultations were from the departments with the more faculty and staff members; however, some departments had extremely high or low consultation rates per capita, maybe due to factors such as pathologies that require periodic control, geographical proximity, and psycho-social issues of patients who create a vicious circle due to the somatization of such problems.  The hypothesis that this population’s morbidity rate would differ from the national average because of its high educational level was rejected.  Nevertheless, the hypothesis that there are weekly and yearly cycles was maintained.

Crescimento e estruturas do sistema digestório de larvas de pacu alimentadas com dieta microencapsulada produzida experimentalmente

Foram comparados os efeitos de diferentes dietas e da transição alimentar sobre o desempenho zootécnico e a morfologia do trato digestório de larvas de pacu alimentadas com duas dietas comerciais e uma dieta experimental microencapsulada produzida por gelificação interna. Larvas com quatro dias de vida receberam os seguintes protocolos alimentares: somente náuplios de artêmia em quantidades crescentes (controle positivo); larvas mantidas em jejum (controle negativo); três tipos de alimento formulado durante todo o experimento (dieta experimental microencapsulada, dieta comercial NRD1.2/2.0, Inve, USA, e dieta Poli-Peixe 450F, PoliNutri, Brasil); e três protocolos de transição alimentar com náuplios de artêmia durante os seis primeiros dias, seis dias de coalimentação, e somente as respectivas dietas formuladas após esse período. O experimento foi conduzido por 23 dias em delineamento inteiramente casualizado, com avaliações periódicas do crescimento e do sistema digestório. A taxa de sobrevivência foi determinada ao final do experimento. Os melhores desempenhos de crescimento e sobrevivência, assim como mais acelerada organogênese do sistema digestório, foram verificados entre os animais que receberam alimento vivo. As larvas que passaram pela transição alimentar apresentaram médias intermediárias de crescimento e sobrevivência e não diferiram entre si. Entre os grupos que receberam apenas dieta inerte, somente naquele alimentado com a dieta nacional houve sobrevivência até o final do experimento. Nenhuma das dietas formuladas é adequada para uso como alimento exclusivo para larvas de pacu. Na fase de transição alimentar, a dieta experimental microencapsulada proporciona resultados de sobrevivência e crescimento semelhantes aos obtidos com dietas comerciais.

Cáncer gástrico en pacientes de Méderi – Hospital Universitario Mayor entre los años 2011 - 2014

Introducción: El cáncer gástrico es uno de los más frecuentes a nivel mundial y Colombia se sitúa entre los países de mayor incidencia en este tipo de patología. Objetivo: Describir las características epidemiológicas, clínicas, el tratamiento administrado y los desenlaces inmediatos de los pacientes con diagnóstico de cáncer gástrico atendidos en el Hospital Universitario Mayor de Bogotá entre los años 2011 y 2014. Metodología: Se realizó un estudio observacional descriptivo con diagnóstico de cáncer gástrico. Se realizaron análisis univariados por medio de proporciones para las variables cualitativas y medidas de tendencia central para las variables cuantitativas según la distribución. Resultados: Un total de 189 pacientes fueron analizados. El dolor fue el síntoma más frecuente en los pacientes (30.7%) y el principal signo encontrado fue una masa palpable en abdomen (9,5%). Los pacientes fueron sometidos a diferentes abordajes terapéuticos, la mayoría recibieron manejo paliativo no quirúrgico (52.9%) y la opción quirúrgica más usada en los pacientes fue la gastrectomía total (20.6%), y la subtotal (16,4) seguidas de quimioterapia y/o radiación perioperatoria. Los pacientes que sobrevivieron a los 2 años fueron 7,4% del total. Conclusiones: El registro de los pacientes con cáncer gástrico es bueno en el Méderi-Hospital Universitario Mayor es bueno y permite caracterizar los pacientes, la presentación de la patología y los resultados del tratamiento que concuerdan con los presentados en contextos similares en la literatura.

Identification and characterization of parasitism genes from the pinewood nematode Bursaphelenchus xylophilus reveals a multilayered detoxification strategy.

The migratory endoparasitic nematode Bursaphelenchus xylophilus, which is the causal agent of pine wilt disease, has phytophagous and mycetophagous phases during its life cycle. This highly unusual feature distinguishes it from other plantparasitic nematodes and requires profound changes in biology between modes. During the phytophagous stage, the nematode migrates within pine trees, feeding on the contents of parenchymal cells. Like other plant pathogens, B. xylophilus secretes effectors from pharyngeal gland cells into the host during infection.We provide the first description of changes in the morphology of these gland cells between juvenile and adult life stages. Using a comparative transcriptomics approach and an effector identification pipeline, we identify numerous novel parasitism genes which may be important for the mediation of interactions of B. xylophilus with its host. In-depth characterization of all parasitism genes using in situ hybridization reveals two major categories of detoxification proteins, those specifically expressed in either the pharyngeal gland cells or the digestive system. These data suggest that B. xylophilus incorporates effectors in a multilayer detoxification strategy in order to protect itself from host defence responses during phytophagy.

Studies on the intrinsic nervous system of the wild rodent Calomys callosus digestive tract. II: The submucous plexus

The submucous plexus of the normal small and large intestine of Calomys callosus was studied by NADH and AChE histochemical techniques and by transmission and scanning electron microscopy. The plexus contains (mean ± SD) 7,488 ± 293 neurons/cm2 in the duodenum, 5,611 ± 836 in the jejunum, 2,741 ± 360 in the ileum, 3,067 ± 179 in the cecum, and 3,817 ± 256 in the proximal colon. No ganglia or nerve cell bodies were seen in the esophagus, stomach, distal colon or rectum. The neurons are pear-shaped with a round or oval nucleus and the neuronal cell profile areas were larger in the large intestine than in the small intestine. Most of the neurons display intense AChE activity in the cytoplasm. AChE-positive nerve fibers are present in a primary meshwork of large nerve bundles and in a secondary meshwork of finer nerve bundles. At the ultrastructural level, the ganglia are irregular in shape and covered with fibroblast-like cells. The nucleoplasm of the neurons is finely granular with a few condensations of chromatin attached to the nuclear envelope. In the neuropil numerous varicosities filled with vesicles of different size and electron densities are seen. The pre- and post-synaptic membrane thickenings are asymmetric. Characteristic glial cells with oval nuclei and few organelles are numerous. These data provide a detailed description of this submucosal meshwork.

A treatise on diet : with a view to establish, on practical grounds, a system of rules for the prevention and cure of the diseases incident to a disordered state of the digestive functions.

Mode of access: Internet.