Emilio Prieto-Díaz-Chávez

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México

OBJECTIVE Determining risk factor frequency regarding obesity and being overweight in university students. METHODS A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. RESULTS 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 % of males were overweight and 14.7 % suffered from obesity; this was 17 % and 5.2 % in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 % CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 % CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 % CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 % CI; p=0.01). CONCLUSIONS 31.6 % of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Direct trocar insertion without pneumoperitoneum and the veress needle in laparoscopic cholecystectomy : a comparative study

Abstract Purpose: The purpose of this study is to compare the safety and complications of direct trocar insertion without pneumoperitoneum (DTI) with Veress needle (VN) in laparoscopic cholecystectomy (LC). Methods: We studied 84 patients admitted to our hospital for LC, in a random simple blind design, 42 patients were assigned to DTI and 42 to VN. The variables analysed were: procedure complications, laparoscope insertion time and duration of surgery. Results: Complication percentages between the groups were significantly different (DTI 2.3% versus VN 23.8%, p = 0.009). The duration of surgery between the two groups was also significantly different (DTI 56 ±31 versus VN 71 ± 28 minutes, p < 0.02). Finally, laparoscope insertion time between the two techniques was significantly different (DTI 1.5 ± 0.5 versus VN 3.0 ± 0.4 minutes p < 0.001). Conclusions: Our results show DTI to be a safe, efficient, rapid and easily-learned alternative technique, reducing the number of procedure-related complications.

Reduction of Peritoneal Adhesion to Polypropylene Mesh with the Application of Fibrin Glue

Abstract Purpose: The purpose of our study was to evaluate the possibility of the reduction of peritoneal adhesions to a polypropylene mesh with fibrin glue. Methods: Forty Wistar rats were assigned to two treatment groups: Group 1) hernioplasty with polypropylene mesh plus fibrin glue sealant, and Group 2) hernioplasty with polypropylene mesh without fibrin glue sealant. The variables evaluated were: presence and density of adhesion, organs or abdominal structures adhered to the polypropylene mesh, inflammatory tissular reaction and cell recount. Results: Group 1 presented a statistically lower adhesion percentage than Group 2 (40% versus 100%, P = 0.0003). The mean areas of mesh patch surfaces covered with adhesions were statistically different between Groups 1 and 2 (0.67 ± 0.65 cm2 versus 1.60 ± 0.51 cm2; P = 0.00001). Twelve rats presented with adhesions in Group 1; eleven were adhesions to the epiploon and one to the colon. In Group 2 there were 16 adhesions to the epiploon, 2 to the colon, 1 to the small intestine and 1 to the stomach. Tissular reaction comparison showed a significant difference (21 ± 4.9 versus 17 ± 4.1; P = 0.006). Conclusions: Fibrin glue sealant significantly reduced the frequency and severity of intra-abdominal adhesions.

Tension-free hernioplasty versus conventional hernioplasty for inguinal hernia repair.

PurposeTo show the effectiveness of tension-free hernioplasty for inguinal hernia repair.MethodsWe studied 106 patients who underwent inguinal hernia repair, as conventional hernioplasty in 52 and as tension-free hernioplasty in 54. We analyzed the operation time, postoperative complications, pain, time to resume daily activities, and frequency of recurrence in the short and long term.ResultsThe average age of the patients was 46.2 years. The operation time was significantly shorter in the tension-free group than in the conventional group, at 33 ± 11.1 versus 49 ± 8.8 min, respectively (P < 0.05). The overall complication rate was 10%, being 1.5% in the tension-free group and 13% in the conventional group (P = 0.4). The visual-analogue pain scores after surgery were lower in the tension-free group than in the conventional group (P = 0.01). Patients in the tension-free group returned to their normal activities sooner than those in the conventional group (P < 0.05).ConclusionsTension-free hernioplasty resulted in less pain and allowed patients to return to their daily activities sooner than conventional hernioplasty.

Calidad de vida y grado de satisfacción de pacientes postoperados de funduplicatura de Nissen laparoscópica

BACKGROUND Today, antireflux surgery has an established position in the management of gastroesophageal reflux disease. Some case series have shown good short-term results, but there is still little information regarding long-term results. Studies have recently focused on evaluating residual symptomatology and its impact on quality of life. OBJECTIVES To determine the postoperative quality of life and degree of satisfaction in patients that underwent laparoscopic Nissen fundoplication. PATIENTS AND METHODS A total of 100 patients (59 women and 41 men) were studied after having undergone laparoscopic Nissen fundoplication. The variables analyzed were level of satisfaction, gastrointestinal quality of life index (GIQLI), residual symptoms, and the Visick scale. RESULTS No variation was found in relation to sex; 49 men and 51 women participated in the study. The mean age was 49 years. The degree of satisfaction encountered was: satisfactory in 81 patients, moderate in 3, and bad in 2 patients. More than 90% of the patients would undergo the surgery again or recommend it. The Carlsson score showed improvement at the end of the study (p<0.05). In relation to the GIQLI, a median of 100.61 points±21.624 was obtained. Abdominal bloating, regurgitation, and early satiety were the most frequent residual symptoms. The effect on lifestyle measured by the Visick scale was excellent. CONCLUSIONS The level of satisfaction and quality of life obtained were comparable with reported standards; and the residual symptoms after antireflux surgery were easily controlled.