When a patient undergoes surgery liver under temporary vascular exclusion, resection, vascular reconstruction or transplantation, surgeons are forced to partially obstruct blood flow during the operation. This process, which occurs in organ ischemia followed by restoration of circulation (reperfusion) is extremely damaging to the tissue, which produces cellular damage associated with inflammation and oxidative stress, which may be irreversible.

“This is a very complex because of the ischemia-reperfusion affects, in general, to determine all surgeries, often, the success or failure of a procedure. That is why we started our studies to find a way to prevent injury in this case the liver, “said Dr. Virginia Fernández, academic at the Institute of Biomedical Sciences, Faculty of Medicine of the U. de Chile.

Just in the last contest Regular Fondecyt Dr. Fernandez was awarded a project to investigate the utility of providing a combination of iron and thyroid hormone (triiodothyronine or T3) to rats prior to performing liver surgery, with the objective organ preconditioning before ischemia-reperfusion. “Currently, the only strategy used in clinical preacondicionante the liver is to submit a brief period of ischemia prior to major surgery. However, because it raises the risks of surgery in patients with promising results have not always this strategy is still controversial, “said Dr. Fernandez.

The researcher, together with a team consisting of doctors Luis Videla, Gladys Tapia, Patricia Varela Pamela Romanque and has developed a line of research in this area through which is inquiring into various treatment options for liver preconditioning with no side effects severe. This could not have used T3, polyunsaturated fatty acids omega-3, iron and combinations. The results of the investigations have resulted in important publications that reflect the molecular mechanisms that explain how this preconditioning occurs.

“The important thing is to use low doses of the agent preacondicionante to avoid toxicity or side effects and also carry out the treatment for periods of time as limited as possible. In my last Fondecyt, I’m reporting now, concluded the description of the mechanisms T3-induced liver preconditioning through a transcription factor can be modulated, called NF-kappaB. Also, with my team determined that the administration of polyunsaturated fatty acids omega-3 to rats prior to ischemia-reperfusion liver, the organ preconditioning induced damage to the surgery. These compounds have anti-inflammatory properties that can protect various tissues, as long as they are offered in appropriate doses, and that when administered in excess can trigger cell damage, academic detailing.

The role of iron
In addition, Dr. Fernandez, in collaboration with his colleague Susan Puntarulo of the University of Buenos Aires, considered the involvement of iron in hepatic protection against ischemia-reperfusion when administered before surgery. Again using an animal model concluded that iron is capable of preconditioning the liver against damage. “Giving the hormone T3, as well as omega-3 fatty acids and iron during different periods, allowing the liver to prepare and defend against the insult to which it is subjected during surgery involving ischemia-reperfusion. Combining some of these treatments could be useful, especially because it allows lower doses and collateral damage, for example, potential cardiac effects of T3 in some patients or iron toxicity when used at high doses, “he says.

For this reason, the newly awarded the academic Fondecyt examine the hepatoprotective response potentiation when the iron is combined with T3. For this study the effect of this treatment group over another liver transcription factor, the Nrf2, which has already been described in studies of Dr. Luis Videla. It is clear from this analysis it is activated by moderate oxidative stress induced by T3 producing an antioxidant response earlier. “We will investigate the response of Nrf2 and NF-kappaB in front of the administration of iron and T3, so to preacondicionante find a strategy that has a potential application in the clinic,” he says.

These individuals tend to show excessive concern, convinced that they have serious defects, but in reality these are minimums, obsessed with a perfect body to the point that constantly consulted the plastic surgeon. In these cases, the surgeon should refuse and refer the patient to a psychologist or psychiatrist for treatment.

But instead, we observed that women often seem donated to one another, operating with the same ease with going to the hairdresser. Therefore, behind the obsession with improving the physical appearance dissatisfaction often hide other, emotional imbalances, the fantasy of unhappiness or lack of success because of some physical trait disharmonious.

Characteristics of people with this disease:

They tend to be timid, anxious, impressionable social, sensitive to rejection vulnerable. Are likely to suffer from depression and anxiety and feelings of inferiority, having a distorted body image.

Knife Addiction: How does it manifest body dysmorphic disorder?

- There are people looking at surgery to fix all their “dramas” in different areas of your life, which would be the same as searching removed a problem in the body that actually is in the mind.

- But in some cases, what can happen is to develop a compulsion. If so, there comes a time when the person wants to operate beyond what is beneficial.

The price of being “more beautiful”

There are people whose claims are at a level of idealization impossible to be translated into reality. Often seek to modify a default and then obsessed with other faults are minimal, subtle and unnecessary change. These individuals were often referred to as “addicted to the scalpel.”

These individuals repeatedly enter the operating room for the plastic surgeon will do a touch up here and there, and always left with the feeling that something more must be corrected. It is important to evaluate these types of personalities in order to see if they suffer from Body Dysmorphic Disorder or Dysmorphophobia. The term comes from Greek and means “ugly” and is part of the obsessive-compulsive disorders, being something of a disorder of perception.

The chances of a successful spinal treatment depend heavily on the stages of such kind of back pain on the body. At present there is a good range of types of spinal surgery across the world but one need to select the best spinal surgery treatment for getting better and faster improvement even after the surgery.

In order to get rid of problem of back pain completely forever, the patients look often look for the best back surgery options for themselves and their loved ones for effective treatment with no side effects on the body. These days for curing the spinal problems, plenty of surgeons are making the use of the laser spine surgery for magnificent and magical results on the conditions of the patients.

These sorts of laser surgery are very effective even for the patients of any stage who are suffering form the back problems. The team of surgeons which performs the surgeries like this is very important and they should be highly skilled and trained in order to deliver the successful surgery on the patients.

Addiction to cosmetic surgery: In search of the perfect image

The belief is that most common people who are operating a complex with age. While it is true that aging is bad press, statistics say that 32 percent of the interventions were performed in people over 50 years or more. 64 percent of cosmetic surgery occur in individuals between 21 and 50 years, with very low incidence in children under 21. Within these values, 20 percent are male. Therefore, these figures show the remarkable increase in the number of cosmetic surgeries.

Surgeries for “taste” or necessity?

There is nothing wrong to seek surgery to correct a defect very evident, that maybe the person is distressing for some time, socando confidence in itself. This kind of surgery will relieve the subject and provide a better quality of life. The obsession with aesthetics in search of a face or a perfect body deserves to resort to a psychologist instead of going to a plastic surgeon. For example, a person may have had a procedure in which aesthetically’m very happy, and yet, look for a new operation in another part of his body due to the good results obtained previously. This need not be addicted to the scalpel.

Rhinoplasty

They are normal bruising and swelling in the nose, eyelids and surrounding areas after plastic surgery. 3 or 4 weeks during inflammation remain, so do not worry if the contour of your eye turns black. Do not self medicate, ask your doctor for a cream-inflammatory. You can also apply ice with chamomile gauze over your eyes every 15 minutes during the first 48 hours.

Although it is annoying and uncomfortable, sleep sitting. Thus you can keep your head and chest high. Nor try to turn her head sideways. During the first weeks can not wear contacts or glasses.

During this time, avoid going outside when the day is very sunny. Wear a hat or cap letting the sun hit him in the face and not exposed to heat. This can cause nosebleeds. Talk as little as possible and try not to laugh or mourn. Nor blow your nose and open mouth to sneeze.

During the first 48 hours eat soft foods and cold. Chew gentle, non-alcoholic drinks. And remember, if you notice any unusual reaction, see your doctor.

The work, coordinated by Michel Suter, Hospital Chablais (Aigle-Monthey, Lausanne, Switzerland), compared the case of 492 patients with morbid obesity (body mass index-BMI-was greater than 40) with 133 individuals superobese (BMI greater than 50). All of them had undergone bariatric surgery, specifically gastric bypass and laparoscopic Roux.

Among other variables, researchers evaluated the amount of weight loss, improved quality of life and the impact of the intervention on other diseases or conditions suffered by participants.

The results of their work showed that morbidly obese individuals were able to reduce their weight by 34.7% at 18 months of invtervention. Six years later, this group had achieved average losses of 30.1% of body weight.

For their part, patients had lost weight superobese to two and a half to a maximum of 37.3%, after six years, the weight loss amounted to 30.7%.

Similar results

Although the losses were slightly higher among individuals superobese, the average body mass index in this group remained significantly higher than the rest because of its higher initial overweight.

“Between 85 and 90% of morbidly obese individuals were able to reach a BMI below 35, while less than 50% of superobese succeeded. Of these, 25% remained in the range of morbid obesity, “write the researchers.

Despite these differences, researchers found that the development of diseases associated with obesity, such as changes in cholesterol or glucose metabolism was similar in both groups.

Improvements in quality of life of patients after surgery was similar among participants, although some had greatly reduced their level of obesity.

“The lower residual weight or BMI is not the only important thing. Other aspects of the outcome of bariatric surgery must be evaluated to draw meaningful conclusions on the effectiveness of the operation,” the researchers comment in their work.

Nevertheless, these authors note that, to ratify the results of their work should be carried out further research, because in his work only took into account a particular surgical technique.

In an article accompanying this work in the medical journal, the surgical specialist of the University of Wisconsin (USA), Jon Gould, agrees with the authors noted that bariatric surgery is “more than a weight loss operation” .

“The community of scholars should emphasize changes in the health and quality of life that are achieved with these operations,” he concludes.

The operation, in the experimental stage, creates a narrow channel that slows the movement of food to move from the top to the bottom of the stomach. That, according to doctors, helping patients feel full more quickly and allows them to eat less.

Doctors say preliminary results of 200 patients in the U.S. and another 100 in Europe look promising.

After about 18 months, obese Europeans had lost about 45% of their body weight on average, said Dr. Gregg Nishi, a surgeon at Cedars-Sinai Medical Center in Los Angeles. Nishi American and European studies discussed during a conference in Chicago this week for specialists in digestive diseases.

The procedure is performed only on studies for now. Manufacturers of the device used in the operation intends to request federal approval if the investigation is continuing according to plan.

Nishi said the two studies continue. And so far the results are slightly better than typical results with conventional operations to reduce obesity.

Risks include the perforation of the esophagus, which can cause death. Nishi said that this occurred with a patient in another center. Besides, he said, there have been no serious complications.

Liliana Gomez, administrative coordinator at Cedars-Sinai, was among the first Americans to be subjected to surgery for obese like that.

She proposed conventional surgery, which included cuts on her stomach, until he learned that doctors at the hospital studied the new technique.

Since its operation in August, Gomez has lost about 18 kilos (40 pounds).

Doctors do not know yet what is the probability that the bones of patients enough to impair fracture in the years after the operation, but one of the first attempts to determine duplicate operations suggests that risk and that patients are more likely to fracture a hand or foot.

The Mayo Clinic findings are surprising and carry out more research to determine whether this link is real, but as bariatric surgery flourishes and even the teens in their formative years of trying bone, experts say it is urgent to discover the long term side effects and how to counter them.

The mere consumption of calcium supplements may not be enough.

”These procedures are being sold as a panacea, ”warned last week Dr. Silverberg Shonni Joy Columbia University at the annual meeting of the Endocrine Society, where the relationship between fat and bone was the central theme. ”It is important to find the answers to these questions,”he said.

Here’s the irony: In fact, it seems that obesity protects against osteoporosis, the weakening of the bones, possibly the only positive thing that any doctor would say the excess fat.

Begin”better than most of us,”she said in bone metabolism at the Mayo Clinic, Dr. Jackie Clowes. So the big question is whether we really end up with weaker bones or simply going through a transition period in which their bones adapt to their new body size.

Some 15 million people in America are considered extremely obese, with overweight by 45 kilograms (100 pounds) or more.

Diet alone is not sufficient antidote against diabetes and other health problems, so that surgery is becoming the preferred treatment, since the clips on the stomach called gastric bypass to other less invasive methods. Patients tend to lose 15% to 25% of their original weight and improves the diabetes.

Over one million 200 thousand U.S. patients have undergone surgery in the last decade and only 220 thousand last year, according to the American Society for Metabolic & Bariatric Surgery.

The single-port laparoscopic method, or single port, reduces surgical insult, since it reduces to a single inlet and outlet boarding place for surgeons. The navel is the perfect opening to introduce optical scalpel without need for additional incisions in the abdomen.

“Additional benefits of this technique over traditional laparoscopic surgery are a potential decreased postoperative pain, less trauma to the abdominal wall and a better cosmetic result, besides being able to avoid possible complications associated with additional trocars, such as bleeding wall the bleeding vessel damage or epigastric hernia, “says Morales Conde.

The intervention was resolved in just 140 minutes, although the section of the tumor specimen and the anastomosis of the colon were performed intracorporeally. Another aspect that contributed to the completion of this surgery has been instrumental flexible traction used for boarding. In this sense, Laparoscopic Surgery Unit is involved in a technology development project with several international companies to create different knives that can help improve surgery in the future.