Functional Outcomes 18 Months After Total and Midarm Transplantation: A Case Report

Background

The function reported after arm transplantation is deemed beneficial relative to the marked disability that upper arm amputation causes.

Colecistostomía percutánea como tratamiento de colecistitis aguda: ¿qué ha pasado en los últimos 5 años? Revisión de la literatura

Acute cholecystitis is one of the most frequent diseases faced by the general surgeon. In recent decades, different prognostic factors have been observed, and effective treatments described, to improve the results in patients with said pathology (lower morbidity and mortality, shorter hospital stay, and minimum conversion of laparoscopic to open procedures). In general, laparoscopic cholecystectomy is the standard treatment for acute cholecystitis, but it is not exempt from complications, especially in patients with numerous comorbidities or those that are critically ill. Percutaneous cholecystostomy emerged as a less invasive alternative for the treatment of acute cholecystitis in patients with organ failure or a prohibitive surgical risk. Even though it is an effective procedure, its usefulness and precise indications are subjects of debate. In addition, there is little evidence on cholecystostomy catheter management. We carried out a review of the literature covering the main aspects physicians involved in the management of acute cholecystitis should be familiar with.     

Associations between Consumption of Ultra-Processed Foods and Intake of Nutrients Related to Chronic Non-Communicable Diseases in Mexico

BackgroundUltra-processed foods are highly palatable and can be consumed anywhere at any time, but typically have a poor nutritional profile. Therefore, their contribution to total energy intake has been proposed as an indicator for studying overall dietary quality.ObjectiveThe aim of this study was to investigate the associations between the energy contribution from ultra-processed foods and the intake of nutrients related to chronic non-communicable diseases in Mexico.DesignThis study used a secondary analysis of cross-sectional data from the 2012 Mexican National Health and Nutrition Survey.Participants/settingThis study included participants aged 1 year and older (n=10,087) who had completed a 1-day 24-hour recall.Main outcome measuresIntake from added sugar (% kcal), total fat (% kcal), saturated fat (% kcal), protein (% kcal), dietary fiber (g/1,000 kcal), and dietary energy density (kcal/g) were measured.Statistical analysisMultiple linear regression models adjusted for sociodemographic variables were fitted to assess the association between quintiles of energy contribution from ultra-processed foods and nutrient intake.ResultsMean reported energy contribution from ultra-processed foods to the Mexican population’s diet ranged from 4.5% kcal in quintile 1 (Q1) to 64.2% kcal in quintile 5 (Q5). An increased energy contribution from ultra-processed foods was positively associated with intake from added sugar (Q1: 7.4% kcal; Q5: 17.5% kcal), total fat (Q1: 30.6% kcal; Q5: 33.5% kcal) and saturated fat (Q1: 9.3% kcal; Q5: 13.2% kcal), as well as dietary energy density (Q1: 1.4 kcal/g; Q5: 2.0 kcal/g) (P≤0.001); and inversely associated with intake from protein (Q1: 15.1% kcal; Q5: 11.9% kcal) and dietary fiber (Q1: 16.0 g/1,000 kcal; Q5: 8.4 g/1,000 kcal) (P≤0.001).ConclusionsIn the Mexican population, an increased energy contribution from ultra-processed foods was associated with a lower dietary quality with regard to intake of nutrients related to chronic non-communicable diseases. Future research is needed to identify barriers to eating a variety of unprocessed and minimally processed foods for the Mexican population, as well as effective public health strategies and policies to overcome these barriers.     

Linfoma del manto con afección del tubo digestivo

Introduction and aimMantle cell lymphoma is an aggressive subtype of B-cell non-Hodgkin lymphoma and its incidence is 0.5/100,000 inhabitants. Gastrointestinal involvement at diagnosis is 15-30%. The aim of our study was to analyze the clinical and endoscopic characteristics of mantle cell lymphoma affecting the digestive tract.Material and methodsA retrospective study was conducted, based on a case series of patients with mantle cell lymphoma affecting the gastrointestinal tract that were diagnosed over a 10-year period.ResultsTen patients (11.7%) had gastrointestinal tract involvement. The upper endoscopic findings were polypoid lesions (66%), thickened folds (44%), and nonspecific changes in the mucosa (33%). At colonoscopy, polypoid lesions were viewed in 100% of the patients and ulcerated lesions in 40%.ConclusionPolypoid lesions are the most common endoscopic characteristics in patients with mantle cell lymphoma of the gastrointestinal tract. Upper endoscopy and colonoscopy should be carried out on patients with mantle cell lymphoma, even those with nonspecific symptoms, to check their gastrointestinal status. Gastrointestinal involvement has an impact on disease staging.     

Association of Outcomes and Socioeconomic Status in Mexican Patients Undergoing Allogeneic Stem Cell Transplantation

The association of clinical outcomes after hematopoietic stem cell transplantation (HSCT) with the patient's socioeconomic status (SES) remains controversial, with the majority of studies reported to date performed in developed countries. Data from low- and middle-income regions where the SES varies greatly remain scarce. The objective of this study was to associate SES with outcomes after allogeneic HSCT in a referral center in Mexico. A retrospective study was performed including 124 consecutive patients. Patients were dichotomized into 2 groups based on a consensus with the Department of Social Work: low SES (level I-II) and high SES (level ≥III). Most patients were of low SES (n = 84; 68%). Age, educational attainment, employment status, and financial support were the sociodemographic characteristics that statistically differed between the 2 groups. All patients with low SES received financial support from governmental agencies or nongovernmental organizations (NGOs). Nonrelapse mortality and overall survival were similar in the 2 groups. Our study found no statistically significant differences in survival outcomes between patients of low SES and high SES. This demonstrates that our HSCT approaches are standardized and that all patients can benefit from HSCT irrespective of their financial status. It also suggests that the good outcomes in patients with low SES probably are related to the substantial governmental, NGO, and/or institutional subsidies these patients receive.