Resumen El presente artículo recoge las concepciones construidas a través de las caricaturas periodísticas publicadas en medios de comunicación masivos colombianos, y la manera en la que estudiantes universitarios resignifican o apropian dicho producto comunicativo. Luego de revisar los elementos conceptuales acerca de este producto del género periodístico de opinión en el que se definen sus tipos, categorías, usos, recursos gráficos utilizados y el impacto que tienen en la construcción de realidad, se aplicó una encuesta a ciento cincuenta universitarios, con quienes se analizó la forma de lectura de caricaturas para identificar los cambios de comprensión, estado de ánimo y tipo de recibimiento a la información icónica allí consignada, todo ello a través de un instrumento de medición basado en aspectos de la escala de Likert para que los participantes pudieran calificar un grupo de diez caricaturas publicadas. Se buscó comprender la manera en la que el público objeto resignifica o apropia dicho producto periodístico y el impacto que tiene en la forma de leer los acontecimientos. Se concluye que el género periodístico de opinión y la caricatura -como una de sus expresiones- mantiene una relación estrecha con la forma en la que los universitarios entienden su contexto, pero se confirma la brecha existente entre la información y este grupo etario. Se encontró que los jóvenes que consumen caricaturas las utilizan para reafirmar sus convicciones, pero poco para hacer lecturas de realidad disímiles a las propias.

Resumo Este artigo recolhe as concepções construídas através das caricaturas jornalísticas publicadas nos meios de comunicação colombianos e a forma como os estudantes universitários re-significam ou se apropriam desse produto comunicativo. Após revisar os elementos conceituais sobre ese produto do gênero jornalístico de opinião em que são definidos seus tipos, categorias, usos, recursos gráficos utilizados e o impacto que têm na construção da realidade, foi aplicado um instrumento a 150 estudantes universitários, com os quais analisaram a forma de ler cartuns para identificar mudanças na compreensão, humor e tipo de recepção às informações icónicas ali registradas por meio de um instrumento de medida baseado em aspectos da escala Likert para que os participantes pudessem qualificar um grupo de 10 cartuns publicados em diferentes mídias. Procuramos compreender a forma como o público objeto re-significa ou se apropria do referido produto jornalístico e do impacto que ele tem na forma de ler os acontecimentos. Conclui-se que o gênero jornalístico de opinião e caricatura, como uma de suas expressões, mantém estreita relação com a forma como os universitários compreendem seu contexto, mas confirmase a lacuna existente entre a informação e essa faixa etária. Constatou-se que os jovens que assistem desenhos animados os utilizam para reafirmar suas convicções, mas pouco para fazer leituras da realidade diferentes das suas.

Abstract This article collects the conceptions built through the journalistic caricatures published in Colombian mass media, and the way in which university students re-signify or appropriate said communicative product. After reviewing the conceptual elements about this product of the journalistic genre of opinion in which its types, categories, uses, graphic resources used and the impact they have on the construction of reality are defined, an instrument was applied to 150 university students, with whom the study analyzed the way of reading cartoons to identify changes in understanding, mood, and type of reception to the iconic information recorded there through a measurement instrument based on aspects of the Likert scale so that the participants could qualify a group of 10 cartoons published in different media. We sought to understand the way in which the public object re-signifies or appropriates said journalistic product and the impact it has on the way of reading events. It is concluded that the journalistic genre of opinion and caricature, as one of its expressions, maintains a close relationship with the way in which university students understand their context, but the existing gap between information and this age group is confirmed. It was found that young people who watch cartoons use them to reaffirm their convictions but little to make interpretations of reality that are dissimilar to their own.

Abstract The endocannabinoid system (ECS) regulates energy metabolism, has been implicated in the pathogenesis of metabolic diseases and exerts its actions mainly through the type 1 cannabinoid receptor (CB1). Likewise, autophagy is involved in several cellular processes. It is required for the normal development of muscle mass and metabolism, and its deregulation is associated with diseases. It is known that the CB1 regulates signaling pathways that control autophagy, however, it is currently unknown whether the ECS could regulate autophagy in the skeletal muscle of obese mice. This study aimed to investigate the role of the CB1 in regulating autophagy in skeletal muscle. We found concomitant deregulation in the ECS and autophagy markers in high-fat diet-induced obesity. In obese CB1-KO mice, the autophagy-associated protein LC3 II does not accumulate when mTOR and AMPK phosphorylation levels do not change. Acute inhibition of the CB1 with JD-5037 decreased LC3 II protein accumulation and autophagic flux. Our results suggest that the CB1 regulates autophagy in the tibialis anterior skeletal muscle in both lean and obese mice.

ABSTRACT Appendiceal mucinous neoplasms are rare and are classified in low-grade mucinous neoplasm, high-grade mucinous neoplasm and mucinous adenocarcinoma. They are considered precursors of pseudomyxoma peritonei, characterized by the accumulation of mucin within the abdominal cavity. We report three cases of low-grade appendiceal mucinous neoplasm, two men and one woman, who presented with acute abdominal pain. The diagnoses were made preoperatively by computed tomography scan and the tumors were managed through laparoscopic approach (appendectomy, partial resection of the cecum and right colectomy, respectively). The three patients evolved with favorable postoperative outcome without complications. Appendiceal mucinous neoplasms are rare without specific clinical presentation. The laparoscopic approach is a safe and feasible option. The frequency and duration of surveillance in these patients are still controversial.

RESUMEN Las neoplasias mucinosas apendiculares son infrecuentes y se clasifican en neoplasias mucinosas de bajo grado, de alto grado y adenocarcinoma mucinoso. Se consideran precursoras del pseudomixoma peritoneal, caracterizado por la acumulación de mucina dentro de la cavidad abdominal. Informamos tres casos de neoplasia mucinosa apendicular de bajo grado, dos varones y una mujer, que presentaron dolor abdominal agudo, diagnosticados preoperatoriamente mediante tomografía y que fueron manejados con un abordaje laparoscópico (apendicectomía, resección parcial de ciego y colectomía derecha, respectivamente). Los tres casos tuvieron una buena evolución posoperatoria y no hubo complicaciones. Se concluye que las neoplasias mucinosas apendiculares son raras y no tienen una presentación clínica específica. El abordaje laparoscópico es una opción segura y factible. La frecuencia y la duración del seguimiento de estos pacientes es motivo de controversia.

ABSTRACT Objectives. To determine the factors associated with hemoptysis in patients with pulmonary tuberculosis admitted at Dos de Mayo National Hospital. Methods. Analytical study of cases and controls. Patients from the tuberculosis program at Dos de Mayo National Hospital, Lima- Peru, were selected. The cases were patients with pulmonary tuberculosis with hemoptysis, and controls pulmonary tuberculosis without hemoptysis. Epidemiological, clinical and laboratory variables were studied. SPSS 24 software is used. Frequency, central trend and dispersion measurements were determined, as well as odds ratios with their respective confidence intervals at 95%, the value of p<0,05 was considered statistically significant. Results. Tuberculosis hemoptysis account for 5,8% of all patients with pulmonary tuberculosis, 80% occurred in males under 60 years old. 70% of cases had a history of alcoholic habits (OR: 2,5 CI: 1,2-5,5); 24% exposure to biomass burning (OR: 4,9 CI: 1,7-14); 66% had chest pain (OR: 3,3 IC: 1,6-6,7); tomographic alterations were present in 88% of cases (OR: 24,5 IC: 9,2-64,8); however, no variations in the coagulation profile were found. Death from hemoptysis in hospitalized patients with pulmonary tuberculosis was 20,22%. Conclusions. Chronic alcoholism and tomographic evidence of bronchiectasis were associated with hemoptysis in patients hospitalized for pulmonary tuberculosis with positive smear microscopy.

RESUMEN Objetivos. Determinar los factores asociados a hemoptisis en pacientes con tuberculosis pulmonar admitidos al Hospital Nacional Dos de Mayo. Métodos. Estudio analítico de casos y controles. Se seleccionaron pacientes con baciloscopia positiva del programa de tuberculosis del Hospital Nacional Dos de Mayo, Lima - Perú. Los casos fueron pacientes con tuberculosis pulmonar con hemoptisis; y los controles, tuberculosis pulmonar sin hemoptisis. Se estudiaron variables epidemiológicas, clínicas y laboratoriales. Se empleo el software SPSS 24. Se determinaron medidas de frecuencia, medidas de tendencia central y de dispersión, así como los odds ratio con sus respectivos intervalos de confianza al 95%, se consideró estadísticamente significativo el valor de p<0,05. Resultados. La hemoptisis representó el 5,8% del total de pacientes con tuberculosis pulmonar y baciloscopia positiva, el 80% se presentó en varones menores de 60 años. El 70% de casos tuvo antecedente de hábito alcohólico (OR: 2,5 IC: 1,2-5,5); el 24% exposición a quema de biomasa (OR: 4,9 IC: 1,7-14); el 66% presentó dolor torácico (OR: 3,3 IC: 1,6-6,7); las alteraciones tomográficas estuvieron presentes en el 88% de casos (OR: 24,5 IC: 9,2-64,8); no se encontró variaciones en el perfil de coagulación. La mortalidad por hemoptisis en pacientes hospitalizados con tuberculosis pulmonar con baciloscopía positiva fue del 20,22%. Conclusiones. El alcoholismo crónico y la evidencia tomográfica de bronquiectasia estuvieron asociados a hemoptisis en pacientes hospitalizados por tuberculosis pulmonar con baciloscopia positiva.

Infection with Strongyloides stercoralis is a common parasitic infection in tropical and subtropical regions, including the Peruvian Amazon. The clinical manifestations are varied in patients with immunocompromised disease, and the systemic spread of the disease is frequent, compromising different organs and systems. Cutaneous manifestations are infrequent, being described in patients with some degree of immunosuppression. We present the case of an immunocompetent patient who developed a reactive purpura due to chronic Strongyloides stercoralis infection. Thus, skin involvement is possible in immunocompetent patients with systemic exacerbation due to this parasite.

Resumen La infección por Strongyloides stercoralis es una parasitosis frecuente en las regiones tropicales y subtropicales, incluyendo la Amazonía peruana. En pacientes con inmunocompromiso, las manifestaciones clínicas son variadas y es frecuente la diseminación sistémica de la enfermedad, con compromiso de diversos órganos. Las manifestaciones cutáneas son infrecuentes y se describen en pacientes con algún grado de inmunosupresión. Se presenta el caso de un paciente inmunocompetente que desarrolló una púrpura reactiva por una infección por Strongyloides stercoralis crónica. Ante ello, es posible el compromiso cutáneo en pacientes inmunocompetentes con reagudización sistémica por este parásito.

ABSTRACT The study focuses its attention on the formation of experimental skills in Agronomic Engineering students. Its objective was directed to propose a didactic conception for the process of formation of experimental skills of physics in the career of Agronomy of the University of Pinar del Río. Theoretical methods (modeling, systemic-structural, analysis, synthesis, induction and deduction) and empirical methods (survey of physics teachers and document review) were used. The research was descriptive and assumed a mixed approach. The work was taken into account with integrative experimental projects with a systemic, investigative and professional approach that regulates didactic mediation and assigns distinctive and leading roles to professors and students to guarantee the efficiency of the teaching-learning process. The evaluation of experts made allows recommending the proposed conception as a valid option to enhance the efficient development of the process.

RESUMEN El estudio realizado centra su atención en la formación de habilidades experimentales en estudiantes de Ingeniería Agrónoma. Su objetivo estuvo dirigido a proponer una concepción didáctica para el proceso de formación de habilidades experimentales de la Física en la carrera de Agronomía de la Universidad de Pinar del Río. Fueron empleados métodos teóricos (la modelación, el sistémico-estructural, el análisis, la síntesis, la inducción y la deducción) y empíricos (encuesta a profesores de Física y revisión de documentos). La investigación tuvo carácter descriptivo y asumió un enfoque mixto. Se tuvo en cuenta el trabajo con proyectos experimentales integradores con un enfoque sistémico, investigativo y profesional que regula la mediación didáctica y asigna roles distintivos y protagónicos a profesores y estudiantes para garantizar la eficiencia del proceso de enseñanza-aprendizaje. La valoración de expertos realizada permite recomendar la concepción propuesta como una opción válida para potenciar el desarrollo eficiente del proceso.

Introdución: La caries dental es un problema de salud pública y la forma como se ha medido su prevalencia no ha tenido en cuenta las lesiones cariosas sin cavidad. Objetivo: Describir la prevalencia de caries y la relación con factores sociales en adolescentes atendidos en hospitales públicos en el Valle del Cauca. Materiales y métodos: Se realizó un estudio transversal analítico en 305 adolescentes; se registró el índice COP clásico y COP modificado según instrumento clínico suministrado por el Ministerio de Protección Social de Colombia. Los adolescentes auto diligenciaron una encuesta estructurada que incluían variables sociodemográficas y prácticas en salud bucodental. Los estimadores fueron calculados teniendo en cuenta el diseño, utilizando el programa estadístico SPSS® versión 17 y Epi Info 3.5.1. Resultados: Se encontró una prevalencia de caries de 82,3% (caries con o sin cavitación) y una prevalencia de 62,6% (caries con cavitación); con una media de dientes cariados sin cavitación de 1,7 (IC95% 1,4-2,0) y una media de 2,9 (IC95% 2,5-3,3) de dientes cariados con cavitación. La prevalencia más baja se presentó a los 12 y 13 años de edad. Se encontró un COP clásico de 4,6±4,5; el COP modificado fue de 6,3±4,8. En análisis de regresión simple, el tipo de seguridad social y la edad se correlacionaron con el de COP y la historia de caries. Conclusiones: La prevalencia de caries fue mayor a la encontrada en el ENSAB III y IV. Tanto la historia de caries como la prevalencia de caries resultaron asociadas a la edad, la seguridad social, la pertenencia a un grupo poblacional vulnerable.

Introduction: Tooth decay is a public health problem and how has measured its prevalence has not taken account of carious lesions without cavity. Objetive: This study aims to describe the prevalence of tooth de Valle del Cauca. Materials and methods: A cross-sectional study was conducted in 305 adolescents; classic-modified DMF index and caries experience as clinical instrument provided by the Ministry of Social Protection of Colombia was recorded. The auto teens fill out an application structured questionnaire that included demographic variables and practices in oral health. The estimates were calculated taking into account the design, using the statistical program SPSS version 17 and Epi Info 3.5.1. Results: Prevalence 82.3% caries (caries with or without cavitation) and 62.6% prevalence (caries cavitation) was found; with an average of decayed teeth without cavitation of 1.7 (95%CI 1.4-2.0) and a mean of 2.9 (95%CI 2.5-3.3) of decayed teeth with cavitation. The lowest prevalence was presented at 12 and 13 years old. a classic DMF of 4.6±4.5 was found; the modified DFM was 6.3±4.8. In simple regression analysis, the type of social security and age were correlated with DFM and history of caries. Conclusion: The prevalence of caries was higher than that found in the ENSAB III and IV ENSAB. Both the history of caries and caries prevalence were associated with age, social security, membership in a vulnerable population group.

The content of fatty acids and antioxidants in the oil of the seeds of fruit of "aguaymanto" were studied. The extraction of crude oil was carried out by the expeller pressing method with a yield of 18.09%. Fatty acids, tocopherols and sterols by chromatographic methods were quantified. The oil has a high percentage of ω-6 (76.7%) with a degree of unsaturation of 77.1%. The α- tocopherols (70 ppm), β- (1452 ppm), γ- (1469 ppm) and δ- (1445 ppm) are the main species have been separated and quantified by HPLC. Sterols δ-5-avenasterol (17.1%), β-sitosterol (9.7%), stigmasterol (4.9%) and campesterol (4.8%), are the most important species have been separated and quantified by GC. The results obtained confirm that the oil and cake extracted from the seeds of "aguaymanto" could be considerate as a source of natural antioxidants to promote good health and skin care.

Se estudió el contenido de ácidos grasos y antioxidantes en el aceite de las semillas del fruto del "aguaymanto". La extracción del aceite crudo se realizó por el método de prensado por expeller con un rendimiento del 18,09 %. Se cuantificó ácidos grasos, tocoferoles y esteroles por métodos cromatográficos. El aceite presenta un alto porcentaje de ω-6 (76,7 %) con un grado de insaturación de 77,1 %. Los tocoferoles α- (70 ppm), β- (1452 ppm), γ- (1469 ppm) y δ- (1445 ppm) son las principales especies que han sido separadas y cuantificadas por HPLC. Los esteroles δ-5-avenasterol (17,1%), β-sitosterol (9,7%), estigmasterol (4,9%) y campesterol (4,8 %), son las especies más importantes separadas y cuantificadas por CG. Los resultados obtenidos confirman que el aceite y la torta extraídos de las semillas del "aguaymanto" podrían ser considerados como una fuente dietética de antioxidantes naturales para promover una buena salud y cuidado de la piel.

PURPOSE: To evaluate the current model of small bowel resection and intestinal transplantation in pigs. METHODS: Forty two Large White pigs were distributed in five groups: G1(n=6), G2(n=6) and G3(n=6) were submitted to 80%,100% and 100% plus right colon resection respectively and G4(n=7) and G5(n=5) to 100% SBR plus IT without and with immunosuppression based on Tacrolimus and Mycophenolic acid. Evaluation included weight control, clinical status, biochemical analysis and endoscopies for graft biopsies. Follow-up in G1 and 2 was 84 days, while in G3, four and five was ± three weeks. RESULTS: G1 increased weight suggesting adaptation while G2 and 3 loused weight and inadequate adaptation. G4 and 5 died of acute cellular rejection (ACR) and sepses respectively. Overall survival in G1, 2, 3, 4 and 5 at 30 days was 100, 100, 0 and 20 %, respectively. Medium survival in G4 and 5 was 14 and 16 days. CONCLUSIONS: The resection of 80% of small intestine in pigs is not suitable for short bowel syndrome induction. Intestinal transplantation with the proposed immunosuppression protocol was effective in prevent the occurrence of severe acute rejection, but inappropriate to increase recipients survival.

Objective: To compare the prognosis during hospitalization and maximum follow-up of 4 years in patients with myocardial infarction complicated with cardiogenic shock. Method: Prospective observational study practiced in a coronary Care Unit managed by cardiologists. We included patients with myocardial infarction complicated with cardiogenic shock who received early coronary revascularization. Patients were divided into two groups: older than 75 years (group A) and lower (group B), and we compared the evolution during hospitalization and maximum follow-up of 4 years. Primary end point was mortality rate in the maximum follow-up of 4years. Secondary end point was mortality rate during hospitalization. Results: Ninety-seven patients were included, 45% Group A. Patients of Group B were mostly men (81% vs. 57%; P =.014), diabetics (48% vs. 21%; P = 0.006), and smokers (39.6% vs. 5%). Mortality rate during hospitalization was higher in Group A (54.5%) vs. 30.2% in Group B(P = .022). Mortality rate during follow-up (primary variable) was 73% in Group A vs. 38% in Group B (P =.007). Conclusions: Myocardial infarction complicated with cardiogenic shock in elderly patients is an entity with high mortality during hospitalization and continues to worsen during long term follow-up.

Objetivo: Comparar la evolución durante el ingreso y a largo plazo de pacientes con choque cardiogénico de origen isquémico. Método: Estudio observacional prospectivo unicéntrico llevado a cabo en la unidad coronaria de un hospital terciario manejada por cardiólogos. Se incluyen pacientes con choque cardiogénico de origen isquémico que recibieron revascularización coronaria precoz. Dividimos a los pacientes en 2 grupos: mayores de 75 anos (grupo A) y menores (grupo B), y comparamos la evolución durante el ingreso y en un seguimiento máximo de 4 años. El objetivo principal fue estimar la mortalidad a los 4 años. El objetivo secundario se definió como la mortalidad intrahospitalaria. Resultados: Incluimos a 97 pacientes, 44 del grupo A (45%). Los pacientes del grupo B eran con más frecuencia varones (81 vs. 57%, p = 0.014), diabéticos (49 vs. 21%, p: 0.006) y fumadores (39.6 vs. 4.5%, p < 0.05). La mortalidad hospitalaria fue superior en el grupo A (54.5 vs. 30.2%, p = 0.022). El objetivo principal ocurrió en 32 pacientes del grupo A frente a 20 del grupo B (73 vs. 38%, p = 0.007). Conclusión: El choque cardiogénico de origen isquémico en paciente mayores de 75 anos presenta una alta mortalidad durante la estancia hospitalaria y en el seguimiento a largo plazo.

Introducción. El borojó es un fruto tropical cultivado principalmente en el Pacífico colombiano, y se le atribuye un sinnúmero de beneficios para la salud; en la actualidad se están adelantando estudios para obtener más información sobre este fruto y para explotar sus potencialidades agroindustriales. Objetivo. Desarrollar una bebida energizante a partir de borojó en polvo sabor a fresa. Materiales y métodos. Se realizaron análisis bromatológicos y microbiológicos a la pulpa fresca y al borojó en polvo, y se formularon las premezclas variando el porcentaje de borojó en polvo. La aceptación de las formulaciones fue evaluada mediante un perfil de sabor con un panel de expertos, según normas ICONTEC, para seleccionar la formulación final. Muestras de la bebida seleccionada se empacaron en BOPP MET/ PA/LDPE, BOPP/Pigmentado y BOPP/BOPP MET, empaques laminados con barrera al vapor de agua. En tiempo cero, a los 60 y 120 días se realizaron mediciones de actividad acuosa (aw), % de humedad y análisis sensorial a cada muestra, para determinar su estabilidad. Resultados. La premezcla seleccionada contiene un 21.7% de borojó en polvo. El empaque que proporcionó mayor estabilidad de acuerdo con los parámetros fisicoquímicos y sensoriales evaluados fue el BOPP MET/PA/LDPE para la bebida, la cual preservó sus características después de 60 días de empacada.

Introduction. Borojo is a tropical fruit mainly cultivated in the Colombian Pacific, and countless benefts for the human health are attributed to it. At current times, several studies to obtain further information about this fruit, and to exploit its agricultural and industrial uses, are being made. Objective. To develop an energizing beverage from borojo, in a powdered presentation and with strawberry favor. Materials and methods. Chemical and microbiological analyzes were performed to the fresh pulp and to powdered borojo. The pre-mixtures were formulated, varying the powdered borojo percentages. The acceptance of the formulas was evaluated by the use of a favor profile with a panel of experts, according to ICONTEC regulations, to choose the final formulation. Samples of the beverage were packed in BOPP MET/PA/LDPE, BOPP/Pigmented and BOPP/BOPP MET, laminated packaging options with a barrier against vapor. At a zero time period, aqueous activity measurements (aw), % of humidity and the sensory analysis at 60 and 120 days were performed to each sample, in order to establish its stability. Results. The pre-mixture chosen contains 21.7% of powdered borojo. The most stable packaging according to the physical-chemical and sensory parameters was BOPP MET/PA/LDPE, because it preserved its characteristics after 60 days.

Introdução.O borojó é um fruto tropical cultivado principalmente no Pacífico colombiano, e se lhe atribui um inúmero de benefícios para a saúde; na atualidade se estão adiantando estudos para obter mais informação sobre este fruto e para explodir suas potencialidades agroindustriais. Objetivo. Desenvolver uma bebida energizante a partir de borojó em pó sabor a morango. Materiais e métodos. Realizaram-se análises bromatológicos e microbiológicos à polpa fresca e ao borojó em pó, e se formularam as prémisturas variando a percentagem de borojó em pó. A aceitação das formulações foi avaliada mediante um perfil de sabor com um painel de experientes, segundo normas ICONTEC, para selecioná-la formulação final. Mostras da bebida selecionada se embalaram em BOPP MET/PA/LDPE, BOPP/ Pigmentado e BOPP/BOPP MET, empacotamentos laminados com barreira ao vapor de água. Em tempo zero, aos 60 e 120 dias se realizaram medições de atividade aquosa (aw), % de umidade e análise sensorial a cada mostra, para determinar sua estabilidade. Resultados. A pré-mistura selecionada contém um 21.7% de borojó em pó. O empacotamento que proporcionou maior estabilidade de acordo com os parâmetros físico-químicos e sensoriais avaliados foi o BOPP MET/PA/LDPE para a bebida, a qual preservou suas características depois de 60 dias de embalada.

OBJETIVO: Estudar o efeito do alcoolismo no processo de cicatrização intestinal e suas complicações pós-operatórias em ratos. MÉTODOS: Cento e sessenta ratos foram divididos em dois grupos: tratado e controle. O controle recebeu água, enquanto o tratado etanol a 30%. Após 180 dias foram realizadas colotomia, seguida de anastomose. Após os animais foram divididos em quatro subgrupos de 20 ratos para estudo nos seguintes momentos: 4º, 7º, 14º e 21º pós-operatório. Os parâmetros analisados foram: ganho de peso, força de ruptura, hidroxiprolina tecidual, complicações pós-operatórias e estudo histopatológico. RESULTADOS: O ganho de peso foi superior no grupo controle (p<0,05). Após agrupamento dos momentos a força de ruptura foi superior no controle (p<0,05). Não houve diferença quanto à histopatologia e hidroxiprolina. Houve cinco infecções de incisão no grupo tratado, enquanto no controle ocorreram duas (p>0,05). Houve nove fístulas no grupo tratado, enquanto no controle duas (p<0,05). Ocorreram sete mortes no grupo tratado e apenas três no controle (p>0,05). CONCLUSÕES: No grupo tratado ocorreu um processo de subnutrição evidenciado pelo menor ganho de peso. Piora na cicatrização intestinal, indicada pela menor força de ruptura. Ocorreu um maior número de complicações pós-operatórias no grupo tratado.

PURPOSE: To study the effect of alcoholism on intestinal healing and postoperative complications in rats METHODS: One hundred and sixty rats were divided into two groups: control and treated. The control group received water and the treated group 30% ethanol. After 180 days, colotomy with anastomosis were performed. After, the groups were divided into four subgroups: 20 rats for study at the following moments: 4th, 7th, 14th and 21st postoperative. The analyzed parameters were: weight gain, breaking strength, tissue hydroxyproline, postoperative complications and histopathological study RESULTS: Weight gain was greater in the control group (p<0.05). When all the subgroups were clustered, breaking strength was significantly greater in the control (p<0.05). Histopathology and hydroxyproline dosage did not show differences. There were five surgical site infections in the treated group while the control group showed two (p>0.05). Nine fistulas occurred in the treated group whereas the control group two (p<0.05). There were three deaths in the control group and seven in the treated group (p>0.05). CONCLUSIONS: Treated group undergo a malnutrition process that is revealed by lower weight gain. Impaired intestinal healing as indicated by smaller breaking strength. There were a larger number of postoperative complications in the treated animals.

RESUMO Objetivo: Apresentar um modelo de pesquisa e treinamento em transplante multivisceral em suínos. Métodos: Oito porcos da raça Large White (quatro doadores e quatro receptores) foram operados. O transplante multivisceral com estômago, duodeno, pâncreas, fígado e intestino foi realizado a semelhança do transplante em seres humanos com algumas diferenças descritas a seguir. Foram realizadas as anastomoses de veia cava supra-hepática do enxerto com a veia cava do receptor justa diafragmática término-terminal, veia cava infrahepática do enxerto com a veia cava inferior (suprarrenal) do receptor término-terminal e patch da aorta do enxerto com a aorta infrarrenal do receptor término-lateral e reconstrução digestiva. Resultados: Foi possível a realização do transplante multivisceral nos quatro animais. A reperfusão do enxerto multivisceral levou a uma grave síndrome de isquemia-reperfusão, apesar do flush do enxerto. Os animais apresentaram hipotensão com necessidade de drogas vasoativas em altas doses, sendo todos sacrificados com a retirada dessas drogas. Conclusão: Alternativas para minimizar a síndrome de isquemiareperfusão, como o uso de mais de uma droga vasoativa, uso de um terceiro porco apenas para transfusão sanguínea, presença de uma equipe de anestesia na sala de cirurgia e redução do enxerto, serão os próximos passos para possibilitar estudos experimentais.

ABSTRACT Objective: To present a model for research and training in multivisceral transplantation in pigs. Methods: Eight Large White pigs (four donors and four recipients) were operated. The multivisceral transplant with stomach, duodenum, pancreas, liver and intestine was performed similarly to transplantation in humans with a few differences, described below. Anastomoses were performed as follows: end-to-end from the supra-hepatic vena cava of the graft to the recipient juxta diaphragmatic vena cava; end-to-end from the infra-hepatic vena cava of the graft to the inferior (suprarenal) vena cava of the recipient; and end-to-side patch of the aorta of the graft to the infrarenal aorta of the recipient plus digestive reconstruction. Results: The performance of the multivisceral transplantion was possible in all four animals. Reperfusions of the multivisceral graft led to a severe ischemia-reperfusion syndrome, despite flushing of the graft. The animals presented with hypotension and the need for high doses of vasoactive drugs, and all of them were sacrificed after discontinuing these drugs. Conclusion: Some alternatives to minimize the ischemia-reperfusion syndrome, such as the use of another vasoactive drug, use of a third pig merely for blood transfusion, presence of an anesthesia team in the operating room, and reduction of the graft, will be the next steps to enable experimental studies.

CONTEXTO: A correção das hérnias volumosas e dos grandes defeitos da parede abdominal constitui grande desafio da prática cirúrgica, em virtude das dificuldades técnicas e do alto índice de complicações respiratórias e cardiovasculares. OBJETIVOS: Apresentar experiência com a indução do pneumoperitônio progressivo no pré-operatório do tratamento cirúrgico das hérnias volumosas da parede abdominal. MÉTODOS: Estudo retrospectivo de seis pacientes que apresentavam hérnias volumosas da parede abdominal, e que foram operados após a instalação de um pneumoperitônio. O procedimento foi realizado através da colocação de um cateter na cavidade abdominal, na altura do hipocôndrio esquerdo, com insuflação de ar ambiente por período de 10 a 15 dias. RESULTADOS: Dos seis pacientes operados, quatro eram do sexo feminino e dois do masculino. A idade mínima era de 40 e a máxima de 62 anos. A duração da hérnia variou de 5 a 40 anos. Quatro pacientes tinham hérnia incisional, um umbilical e outro inguinal. O tempo médio de pneumoperitônio foi de 11,6 dias. Não houve complicações relacionadas à instalação e manutenção do pneumoperitônio. Todas as hérnias foram corrigidas sem dificuldades técnicas. Utilizou-se a técnica de Lichtenstein para a correção da hérnia inguinal, a transposição peritônio-aponeurótica para uma das hérnias incisionais, sendo as demais corrigidas com uso de tela de polipropileno. Um óbito e uma infecção de parede foram observados no pós-operatório dessas cirurgias. Não houve recidivas registradas até o momento, num período de seguimento de 4 a 36 meses. CONCLUSÃO: O pneumoperitônio progressivo pré-operatório é um procedimento seguro e de fácil execução, pois facilita o procedimento cirúrgico e diminui as complicações respiratórias e cardiovasculares no pós-operatório. É indicado para doentes com hérnias que perderam domicílio na cavidade abdominal.

CONTEXT: Correction of voluminous hernias and large abdominal wall defects is a big challenge in surgical practice due to technical difficulties and the high incidence of respiratory and cardiovascular complications. OBJECTIVES: To present the authors experience with inducing progressive pneumoperitoneum preoperative to surgical treatment of voluminous hernias of the abdominal wall. METHODS: Retrospective study of six patients who presented voluminous hernias of the abdominal wall and were operated after installation of a pneumoperitoneum. The procedure was performed by placing a catheter in the abdominal cavity at the level of the left hypochondrium with ambient air insufflation for 10 to 15 days. RESULTS: Four of the six patients were female and two male. Ages ranged from 42 to 62 years. Hernia duration varied from 5 to 40 years. Four patients had incisional, one umbilical, and one inguinal hernias. Mean pneumoperitoneum time was 11.6 days. There were no complications related to pneumoperitoneum installation and maintenance. All hernias were corrected without technical difficulties. The Lichtenstein technique was used to correct the inguinal hernia, peritoneal aponeurotic transposition for one of the incisional hernias, with the rest corrected using polypropylene mesh. One death and one wall infection were observed post operatively. No recurrences were reported until now, in 4 to 36 months of follow-up. CONCLUSION: Preoperative progressive pneumoperitoneum is a safe and easy executed procedure, which simplifies surgery and reduces post-operative respiratory and cardiovascular complications. It is indicated for patients with hernias that have lost the right of domain in the abdominal cavity.

OBJETIVO: Interposição de um tubo de jejuno entre o colédoco e o duodeno. MÉTODOS: Foram utilizados cinco cães adultos, sem raça definida, de ambos os sexos, com peso médio de 22,3 Kg (18 e 26,5 Kg). Após provocar icterícia obstrutiva pela ligadura do colédoco distal, após uma semana, praticou-se confecção do tubo de jejuno de 2,5 cm de extensão, que foi realizado com um segmento de alça retirado a 15 cm do ângulo de Treitz e a interposição do tubo entre o colédoco e o duodeno. RESULTADOS: Os animais tiveram boa evolução clínica e não apresentaram complicações. Notou-se total integração entre a mucosa da via biliar, do tubo e do duodeno e redução significativa dos valores da bilirrubina total e da fosfatase alcalina após seis semanas, quando comparado com os valores após uma semana de ligadura do colédoco. CONCLUSÃO: O tubo de jejuno interposto entre a via biliar dilatada e o duodeno, apresentou boa integração anatômica e reduziu os níveis de bilirrubina total e fosfatase alcalina dos animais estudados.

PURPOSE: Interposition of a jejunal tube between the common bile duct and duodenum. METHODS: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg), were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. RESULTS: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. CONCLUSION: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.