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Objective: to assess the safety and efficacy of laparoscopy in the treatment of symptomatic cholelithiasis in patients with Child´s Class A and Class B cirrhosis. Study design: descriptive and retrospective study. Patients: we studied 14 patients (mean age 60 yrs) with Child´s Class A and Class B hepatic cirrhosis who underwent laparoscopic cholecystectomy. We analyzed the occurrence of intraoperative and postoperative complications. Results: eight patients were women (57.14%) and 6 were men (42.85%). Eight of the 14 patients presented with Child's Class B cirrhosis and 6 patients with Class A. Cholecystectomy was programmed for all patients. The average duration of surgery was 77 min. Intraoperative complications occurred in 2 patients (14.28%) in the form of liver bed bleeding. Postoperative complications were observed in 3 patients (21.42%), 2 presented with ascites which led to a worsening of Child's Class in one of them, and the third patient presented with angina-like symptoms (acute, sharp pain in the chest irradiating to the back). Mean length of hospital stay was 3 days. No postoperative morbidity or mortality occurred, and there were no conversions. Conclusions: LC (laparoscopic cholecystectomy) is a safe and effective alternative for the treatment of symptomatic cholelithiasis in patients with well-compensated Child's Class A and Class B cirrhosis. Postoperative morbi-mortality is low, bleeding is unimportant, and both duration of surgical procedure and hospital stay are short.Objetivo: evaluar la seguridad y eficacia del uso de la laparoscopia en pacientes cirróticos en estadio A y B de Child-Pugh con colelitiasis sintomática. Diseño del estudio: estudio descriptivo, retrospectivo. Pacientes: catorce pacientes con una edad media de 60 años diagnosticados de cirrosis hepática en estadios A y B que se les practicó colecistectomía laparoscópica. Se estudia la aparición de complicaciones intraoperatorias y postoperatorias tras la intervención Resultados: ocho (57,14%) casos eran mujeres y 6 ( 42,85%) varones. De los 14 pacientes, 8 presentaban un estadio Child-Pugh B y 6 un Child-Pugh A. Todos los pacientes se intervienen de colelitiasis de forma programada. El tiempo operatorio medio fue de 77 min. Dos (14,28%) de los pacientes presentaron complicaciones intraoperatorias, sangrado del lecho quirúrgico. Tres (21,42%) pacientes presentaron complicaciones postoperatorias: dos (14,28%) presentaron ascitis con empeoramiento del Child-Pugh en uno de ellos y el otro presentó un cuadro anginoso. La estancia media de estos pacientes es de 3 días. No hubo ninguna muerte tras la intervención y no hubo ninguna reconversión. Conclusiones: la CL es una alternativa segura y efectiva en el tratamiento de colelitiasis sintomáticas en pacientes con cirrosis en estadio A y B compensada. Ofrece una baja morbimortalidad postoperatoria con una escasa pérdida de sangre, un tiempo operatorio corto y una reducida estancia hospitalaria.

Chronic pain causes disability and loss of health worldwide. Yet, a mechanistic explanation for it is still missing. Frequently, neural phenomena, and among them, Central Sensitization (CS), is presented as causing chronic pain. This narrative review explores the evidence substantiating the relationship between CS and chronic pain: four expert researchers were divided in two independent teams that reviewed the available evidence. Three criteria were established for a study to demonstrate a causal relationship: (1) confirm presence of CS, (2) study chronic pain, and (3) test sufficiency or necessity of CS over chronic pain symptoms. No study met those criteria, failing to demonstrate that CS can cause chronic pain. Also, no evidence reporting the occurrence of CS in humans was found. Worryingly, pain assessments are often confounded with CS measures in the literature, omitting that the latter is a neurophysiological and not a perceptual phenomenon. Future research should avoid this misconception to directly interrogate what is the causal contribution of CS to chronic pain to better comprehend this problematic condition., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Abundance of microplastics in coastal sediments is considered an emerging pollution problem worldwide. In Mexico, studies focused on microplastics in coastal sediments are little. In this study, we analyzed the textural characteristics and investigated the abundance of microplastics in the Tecolutla beach sediments, SW Gulf of Mexico. The extraction of microplastics in sediments was done by density separation. Microplastics were identified by stereomicroscope and scanning electron microscopy, and were classified based on their morphology, color, length, texture, and abundance. Among 181 microplastics, fiber type is predominant (number of microplastics n = 166; 92%) and followed by film (n = 12; 6%) and fragment (n = 3; 2%) types. The most abundant color of microplastics is black (n = 81; 45%) and second dominant color is blue (n = 65; 36%); most of them are fiber type. Based on the textural characteristics of sediments, it was observed that microplastics were derived from the fluvial contribution of the Tecolutla River and were deposited in the coastal environment by ocean currents. This study revealed that the abundance of microplastics was high in fine-grained sediments and was directly proportional to skewness. The results of this study can act as a reference for understanding the abundance of microplastics in the Gulf of Mexico coastal sediments., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

A two-stage bioreactor operated under anoxic denitrifying conditions was evaluated for desulfurization of synthetic biogas laden with H 2 S concentrations between 2500 and 10,000 ppm v . H 2 S removal efficiencies higher than 95% were achieved for H 2 S loads ranging from 16.2 to 51.9 gS m liquid -3 h -1 . Average H 2 S oxidation performance (fraction of S-SO 4 2- produced per gram of S-H 2 S absorbed) ranged between 8.2 ± 1.2 and 18.7 ± 5.3% under continuous liquid operation. Nitrogen mass balance showed that only 2-6% of the N-NO 3 - consumed was directed to biomass growth and the rest was directed to denitrification. Significant changes in the bacterial community composition did not hinder the H 2 S removal efficiency. The bioreactor configuration proposed avoided clogging issues due to elemental sulfur accumulation as commonly occurs in packed bed bioreactors devoted to H 2 S-rich biogas desulfurization., Competing Interests: Declaration of competing interest No conflict of interest exists in the submission of this manuscript., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This review focuses on the laparoscopic approach to gastrointestinal emergencies and its more recent indications. Laparoscopic surgery has a specific place in elective procedures, but that does not apply in emergency situations. In specific emergencies, there is a huge range of indications and different techniques to apply, and not all of them are equally settle. We consider that the most controversial points in minimally invasive procedures are indications in emergency situations due to technical difficulties. Some pathologies, such as oesophageal emergencies, obstruction due to colon cancer, abdominal hernias or incarcerated postsurgical hernias, are nearly always resolved by conventional surgery, that is, an open approach due to limited intraabdominal cavity space or due to the vulnerability of the bowel. These technical problems have been solved in many diseases, such as for perforated peptic ulcer or acute appendectomy for which a laparoscopic approach has become a well-known and globally supported procedure. On the other hand, endoscopic procedures have acquired further indications, relegating surgical solutions to a second place; this happens in cholangitis or pancreatic abscess drainage. This endoluminal approach avoids the need for laparoscopic development in these diseases. Nevertheless, new instruments and new technologies could extend the laparoscopic approach to a broader array of potentials procedures. There remains, however, a long way to go.

Objective: To investigate the incidence, time of appearance, treatment, and evolution of tumors appearing in liver transplant recipients at our hospital., Material and Methods: We undertook a retrospective analysis of our series of liver transplants between 1990 and 2005. Patients who died during the immediate postoperative period were excluded., Results: Of the 515 patients, 25 died during the immediate postoperative period and therefore had no occasion to develop neoplasms. Of the remaining 490, 32 developed cancers (6.5%). The average age was 55.4 +/- 7.17 years. The reasons for transplant were alcoholic cirrhosis (n = 15), hepatitis C virus (2), hepatitis B virus (n = 1), alcoholic and viral cirrhosis (n = 7), primary biliary cirrhosis (n = 1), and cryptogenic cirrhosis (n = 1). Four patients developed multiple neoplasms. Most of the tumors were cutaneous: nine basal cell and six squamous cell carcinomas. Other locations were the lung, urothelium, stomach, thyroid, and brain. Eight patients presented metastasis at the time of diagnosis. The average tumor-free period was 3.36 years. Nine patients died as a result of the tumor., Discussion: Patients with a liver transplant have a high risk of developing cancers as a result of the immunosuppression treatment, which is lifelong. Nevertheless, other factors can be involved, such as infection by cytomegalovirus or the original diagnosis leading to transplantation. The risk for developing cancers is significantly greater than in the general population, with a higher tendency to recurrence and later development of second neoplasms.

Objective: To assess the safety and efficacy of laparoscopy in the treatment of symptomatic cholelithiasis in patients with Child's Class A and Class B cirrhosis., Study Design: Descriptive and retrospective study., Patients: We studied 14 patients (mean age 60 yrs) with Child's Class A and Class B hepatic cirrhosis who underwent laparoscopic cholecystectomy. We analyzed the occurrence of intraoperative and postoperative complications., Results: Eight patients were women (57.14%) and 6 were men (42.85%). Eight of the 14 patients presented with Child's Class B cirrhosis and 6 patients with Class A. Cholecystectomy was programmed for all patients. The average duration of surgery was 77 min. Intraoperative complications occurred in 2 patients (14.28%) in the form of liver bed bleeding. Postoperative complications were observed in 3 patients (21.42%), 2 presented with ascites which led to a worsening of Child's Class in one of them, and the third patient presented with angina-like symptoms (acute, sharp pain in the chest irradiating to the back). Mean length of hospital stay was 3 days. No postoperative morbidity or mortality occurred, and there were no conversions., Conclusions: LC (laparoscopic cholecystectomy) is a safe and effective alternative for the treatment of symptomatic cholelithiasis in patients with well-compensated Child's Class A and Class B cirrhosis. Postoperative morbi-mortality is low, bleeding is unimportant, and both duration of surgical procedure and hospital stay are short.