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Cugat E.,Hospital Mutua Of Terrassa | Perez-Romero N.,Hospital Mutua Of Terrassa | Rotellar F.,Hepato Bilio Pancreatic Unit | Suarez M.A.,Hospital Carlos Haya | And 11 more authors.
Journal of Hepato-Biliary-Pancreatic Sciences | Year: 2010

Background: To present the data of laparoscopy in liver surgery and to assess the real indications and outcomes of this kind of approach. Methods: From February 2000 to March 2008, a prospective study was performed on 182 patients from 15 Spanish surgical centres. Results: A total of 308 lesions was collected. The mean age was 57 years old, and 61.5% were female. Among patients with cystic lesions we found: 45 simple cysts, 19 policystic diseases, 12 hydatidic cysts and 2 cystoadenomas. Among solid lesions (n = 104), we found 34 patients with benign pathology (12 focal nodular hyperplasia, 10 adenomas, 7 haemangyomas and 5 other lesions) and 70 with malignant pathology (38 metastases, 29 hepatocellular carcinomas, 2 cholangiocarcinomas and 1 lymphoma). The global rate of conversion was 8.8%. The global morbidity rate was 14.8%, and 5 of them required re-intervention. Conclusions: Nowadays there are strong criteria for patients being submitted to laparoscopy procedures based both on type and location features. The postoperative morbidity rate is low, also for hepatocellular carcinoma in cirrhotic liver. In case of malignant pathology, we think the use of ultrasonography is mandatory to obtain a free margin, which implies a long-term survival rate. © Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2009.

Benevides B.S.,Hospital Batista Memorial | Menezes Junior J.M.S.,Santa Casa Of Misericordia Hospital | Holanda M.E.,Hospital Santa | Sousa F.B.,Oral Pathologist to Oral Pathology | And 4 more authors.
International Archives of Medicine | Year: 2015

The Aneurysmal Bone Cyst (ABC) is an expansive osteolytic, radiolucent, multilocular, eccentric lesion of unknown origin consisting of spaces filled with blood in any segment of the skeleton, being most frequently encountered in the diaphysis of the long bones or the spinal cord. It may occur as distinct clinico-pathological entity or as pathophysiological alteration of a preexisting lesion, like giant-cells lesion, fibrous dysplasia, ossifying fibroma, osteoblastoma, epiphysary chondroblastoma and even malignant lesions such as osteossarcoma. This paper reports a rare case of ABC in the zygomatic arch of a young female patient who presented facial asymmetry and progressive limitation in mouth opening, treated by resective surgical procedure and discusses the clinical, radiological and histological features of this pathology along with its treatment. © Under License of Creative Commons Attribution 3.0 License.

Chico A.,Hospital Santa | Tundidor D.,Hospital Santa | Jordana L.,Hospital Santa | Saigi I.,Hospital Santa | And 3 more authors.
Journal of Diabetes Science and Technology | Year: 2014

The aim was to evaluate changes in insulin requirements from onset of continuous subcutaneous insulin infusion (CSII) until glucose optimization in type 1 diabetes and to determine patient characteristics to be considered when CSII is implemented. We retrospectively analyzed 74 type 1 diabetic patients over a follow-up of 5 months after starting CSII. Patients without a decrease in HbA1c levels at the end of follow-up were excluded. We compared total daily doses (TDD), basal/bolus distribution, basal diurnal/nocturnal proportion, number of basal segments, and HbA1c levels in relation to sex, age, body mass index (BMI), diabetes duration, and indication for CSII. At follow-up, HbA1c decreased by 0.75%, TDD decreased by 18%, basal rate was 60% of TDD, and diurnal basal rate was 60% of total basal rate. Insulin requirements were higher in males and in obese patients. Female patients and patients with longer diabetes duration showed a higher percentage of basal insulin. The number of basal segments was 4.9 ± 2.9. Basal requirements were higher in the second half of the nocturnal period. The dawn phenomenon was more relevant in men. Improvements in glycemic control were more marked in younger patients, in patients with higher HbA1c, in patients using more basal segments, and in patients initiating CSII for glucose control before pregnancy. Sex, diabetes duration, and BMI should be considered when initiating CSII. Our findings may help clinicians in clinical decision making regarding CSII therapy. © 2014 Diabetes Technology Society.

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