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Analyzes this definition of suicide: a behavior that seeks to find a solution to an existential problem by making an attempt on the life of the subject. Theoretical implications and the relationship between suicide and mental illness are discussed. Reprint of first chapter of book entitled "Suicides." (CC)

Copyright of Revista Chilena de Cirugia is the property of Sociedad de Cirujanos de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hepatocellular carcinoma (HCC) is a major problem in cirrhotic patients. Liver resection has been established as an effective treatment in patients with well-preserved liver function. The goal of this study is to describe the perioperative results and survival rates after liver resection in patients with HCC. Patients and Methods: Retrospective study including patients with HCC who underwent liver resection as definitive treatment between January 2000 and August 2013. Clinical and surgical data were assessed; survival analysis was also performed using Kaplan-Meier curves and Log-rank test. Results: Twenty-five liver resections were performed during the study period, 7 cases in patients with no history of cirrhosis. Most cases were treated by minor resections, including bi-segmentectomies, mono-segmentectomies and non-anatomic resections. In 5 patients a right extended hepatectomy was performed. Intra and postoperative complications were registered in one and 8 cases, respectively. Four patients developed postoperative liver dysfunction and one case developed liver insufficiency. There was no perioperative mortality. The 3 and 5 years disease-free survival rate was 48% and 30%, respectively. Additionally, the 3 and 5 years overall survival rate was 65% and 51%, respectively. Conclusions: The present data confirm the feasibility and safety of liver resections in well-selected patients with HCC. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Ventral hernias are defects of the anterior abdominal wall, the laparoscopic repair has shown some advantages compared to open repair. Aim: To evaluate perioperative outcomes of the laparoscopic ventral hernia repair and to describe risk factors associated to recurrence. Methods: Non-concurrent prospective cohort study, clinical data of all patients who underwent laparoscopic ventral hernia repair between June 2006 and May 2013 were reviewed. Univariate analyses were performed using chi-square for categorical variables and U Mann-Whitney test for continuous variables. Multivariate analysis was performed using a logistic regression model. Results: 127 patients underwent laparoscopic ventral hernia, 52% female, age of 58.1 ± 1.2 years old. Mean Body Mass Index (BMI) was 31 ± 0.5 kg/m2 and 67.7% were incisional hernias. Median operative time was 80 minutes (ranging from 30-350) and the median defect size was 6 cm (ranging from 2-20). Conversion to open surgery was necessary in 4 cases (3.9%). Median of hospital stay was 2 days (ranging from 1-15). Recurrence rate was 14.2% and the median to recurrence was 9 months. Recurrence rate was associated positively to defect size > 10 cm (p = 0.002), previous recurrence (p = 0.029) and operative time > 90 minutes (p = 0.017) in the univariate analyses. However, it was only associated to the first two in the multivariate analysis (OR 3.906; IC 1.734-13.058 y OR 5.93; IC 1.546-22.976, respectively). Conclusions: Laparoscopic repair of ventral hernia is a safe procedure with acceptable perioperative complication rates. Defect size and previous recurrence are associated to a higher recurrence rate. [ABSTRACT FROM AUTHOR]

Oxidative stress has been associated with mechanisms of EH (essential hypertension). The aim of the present study was to test the hypothesis that the antioxidant properties of vitamins C and E are associated with a decrease in BP (blood pressure) in patients with EH. A randomized double-blind placebo-controlled clinical trial was conducted in 110 men with grade 1 EH (35–60 years of age without obesity, dyslipidaemia and diabetes mellitus, non-smokers, not undergoing vigorous physical exercise, without the use of any medication and/or high consumption of fruit and vegetables). Participants were randomly assigned to receive either vitamins C+E [vitamin C (1 g/day) plus vitamin E (400 international units/day)] or placebo for 8 weeks. Measurements included 24 h ambulatory BP and blood analysis of oxidative-stress-related parameters in erythrocytes (GSH/GSSH ratio, antioxidant enzymes and malondialdehyde) and plasma [FRAP (ferric reducing ability of plasma)], and levels of 8-isoprostane, vitamins C and E were measured at baseline and after treatment. Following administration of vitamins C+E, patients with EH had significantly lower systolic BP, diastolic BP and mean arterial BP and higher erythrocyte and serum antioxidant capacity compared with either placebo-treated patients with EH or the patients with EH at baseline prior to treatment. BP correlated positively with plasma 8-isoprostane levels and negatively with plasma FRAP levels in the vitamins C+E- and placebo-treated groups. In conclusion, the present study supports the view that oxidative stress is involved in the pathogenesis of EH, and that enhancement of antioxidant status by supplementation with vitamins C and E in patients with EH is associated with lower BP. This suggests intervention with antioxidants as an adjunct therapy for hypertension. [ABSTRACT FROM AUTHOR]

Abstract  Oxidative stress may play a role in the pathogenic mechanism of essential hypertension. Lipid peroxidation can alter the cellular structure of membrane-bound enzymes by changing the membrane phospholipids fatty acids composition. We investigated the relationship between (Na + K)-ATPase activity, lipid peroxidation, and erythrocyte fatty acid composition in essential hypertension. The study included 40 essential hypertensive and 49 healthy normotensive men (ages 35–60 years). Exclusion criteria were obesity, dyslipidemia, diabetes mellitus, smoking, and any current medication. Patients underwent 24-h ambulatory blood pressure monitoring and blood sampling. Lipid peroxidation was measured in the plasma and erythrocytes as 8-isoprostane or malondialdehyde (MDA), respectively. Antioxidant capacity was measured as ferric reducing ability of plasma (FRAP) in the plasma and as reduced/oxidized glutathione (GSH/GSSG ratio) in erythrocytes. (Na + K)-ATPase activity and fatty acids were determined in erythrocyte membranes. Hypertensives had higher levels of plasma 8-isoprostane, erythrocyte MDA, and relative percentage of saturated membrane fatty acids, but lower plasma FRAP levels, erythrocyte GSH/GSSG ratio, (Na + K)-ATPase activity and relative percentage of unsaturated membrane fatty acids, compared with normotensives. Day-time systolic and diastolic blood pressures correlated positively with lipid peroxidation parameters, but negatively with (Na + K)-ATPase activity. These findings suggest that the modulation of (Na + K)-ATPase activity may be associated with changes in the fatty acid composition induced by oxidative stress and provide evidence of a role for this enzyme in the pathophysiology of essential hypertension. [ABSTRACT FROM AUTHOR]

The article presents a paper focused on theoretical pluralism and sociology that was presented during an international symposium in Paris, France in June 2003. It talks about the distinction between the concept of sociology as a discipline and the status it shares with philosophy and history. Clausewitz's book "On War," which focuses on the capability of war to create a science devoted to its rational exploration, is discussed. The article also talks about the bonds between sociology and ideology.

Background: Endoscopic submucosal dissection (ESD) is a minimally invasive procedure that allows curative treatment of early gastric cancer (EGC) in selected patients., Aim: To report our initial experience with ESD., Material and Methods: Analysis of prospective data from 16 patients aged 61 to 84 years, who underwent ESD between December 2011 and June 2014. Tumor type, operative time, hospitalization length, oncologic outcomes, complications and short-term follow up were registered., Results: En-block resection was achieved in all cases. The median operative time was 135 min (range: 50-320 min). Specimens' median size was 3.5 cm (range: 3-10). All the resections were R0. In 14 patients ESD was considered curative. In two patients, ESD was considered potentially non-curative due to the presence pathological risk factors for lymph-node metastases in the biopsy specimen. Both patients underwent laparoscopic gastrectomy with lymph-node dissection. There was one case of gastric wall perforation that was repaired by laparoscopic suture. There was no mortality. The median follow-up time was 15 months (range: 2-30 months)., Conclusions: ESD is a feasible and safe procedure in our institution with good results in this initial experience.

Background: Computed tomography (CT) is currently the exam of choice for bowel obstruction. The test reports the etiology, site and grade of obstruction, and the presence of bowel ischemia, affecting the surgical decision. We undertook this study to determine the diagnostic accuracy of CT for bowel ischemia and the probability of surgery depending on signs of bowel ischemia and grade of bowel obstruction observed in CT in patients with adhesive small bowel obstruction., Methods: We carried out a retrospective study including patients from 2007-2010 admitted due to adhesive bowel obstruction and with intravenous contrast-enhanced abdominopelvic CT at admission. Tomographic signs of bowel ischemia were established and diagnostic accuracy was calculated. We also determined the probability of surgery depending on tomographic grade of obstruction and signs of bowel ischemia by subgroup analysis., Results: This was a cohort of 164 patients with a mean age of 60.4 ± 20 years; 87% had previous abdominal surgery and 86 patients required surgery (52%). In regard to tomographic signs of bowel ischemia, sensitivity was 72.5%, specificity 97.5%, positive predictive value 90%, negative predictive value 91%, positive likelihood ratio 29.9, and negative likelihood ratio 0.28. Tomographic signs of bowel ischemia simultaneously with high-grade obstruction presented an 83% probability of surgery; high-grade obstruction alone presented a 57% probability and in absence of both signs was 36%., Conclusions: There is good diagnostic accuracy for tomographic signs of bowel ischemia and its definitive presence. Tomographic signs of bowel ischemia simultaneously with high-grade bowel obstruction significantly increase the probability of surgery.

Background: Preservation solutions are critical for organ transplantation. In liver transplant (LT), the solution developed by the University Of Wisconsin (UW) is the gold-standard to perfuse deceased brain death donor (DBD) grafts. Histidine-Tryptophan-Ketoglutarate (HTK), formerly a cardioplegic infusion, has been also used in solid organ transplantation., Aim: To compare the outcomes of LT in our center using either HTK or UW solution., Patients and Methods: Retrospective study including 93 LT DBD liver grafts in 89 patients transplanted between March 1994 and July 2010. Forty-eight grafts were preserved with UW and 45 with HTK. Donor and recipient demographics, total infused volume, cold ischemia time, post-reperfusion biopsy, liver function tests, incidence of biliary complications, acute rejection and 12-month graft and patient survival were assessed. Preservation solution costs per liver graft were also recorded., Results: Donor and recipient demographics were similar. When comparing UW and HTK, no differences were observed in cold ischemia time (9.6 ± 3 and 8.7 ± 2 h respectively, p = 0.23), biliary complications, the incidence of acute rejection, primary or delayed graft dysfunction. Histology on post-reperfusion biopsies revealed no differences between groups. The infused volume was significantly higher with HTK than with UW (9 (5-16) and 6 (3-11) l, p < 0.001). The cost per procurement was remarkably lower using HTK., Conclusions: Perfusion of DBD liver grafts with HTK is clinically equivalent to UW, with a significant cost reduction.