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El cáncer de vesícula biliar es una enfermedad poco frecuente en el mundo y altamente letal. Objetivo: caracterizar histopatológicamente el cáncer de vesícula biliar en el Hospital Clínico Quirúrgico Docente "Joaquín Albarrán" de La Habana-Cuba, en el periodo 2010 al 2019. Método: se realizó un estudio retrospectivo, descriptivo y observacional, en el cual se revisaron los registros de biopsias y necropsias para identificar los casos con diagnóstico histológico de cáncer de vesícula biliar, se revisaron además tejidos fijados en parafina del archivo. Resultados: fueron diagnosticados 10 casos de cáncer de vesícula, 9 femenino y 1 masculino, todos mayores de 60 años. Histológicamente la variedad predominante fue el adenocarcinoma moderadamente diferenciado, siendo 2 de ellos mucoproductores, de los cuales 1 infiltrante y con permeación linfática. Conclusión: el cáncer de vesícula biliar es una enfermedad con muy baja frecuencia y su diagnóstico, continua siendo un hecho incidental, es decir, que el diagnóstico se establece en el examen histopatológico luego de la colecistectomía o en la necropsia. La variedad más frecuente es el adenocarcinoma moderadamente diferenciado.

Gallbladder cancer is a rare and highly lethal disease in the world. Objective: To characterize histopathologically gallbladder cancer at the "Joaquín Albarrán" Clinical Teaching Surgical Hospital of Havana-Cuba, in the period 2010 to 2019. Methods: A retrospective, descriptive and observational study was conducted, in which biopsy and necropsy records were reviewed to identify cases with a histological diagnosis of gallbladder cancer. Paraffin-embedded tissues from the archive were also reviewed. Results: Ten cases of gallbladder cancer were diagnosed, nine female and one male, all over 60 years old. Histologically the predominant variety was moderately differentiated adenocarcinoma, being 2 of them mucoproducers, of which 1 was infiltrating and with lymphatic permeation. Conclusion: Gallbladder cancer is a very low frequency disease and its diagnosis continues to be an incidental fact, that is, the diagnosis is established in the histopathological examination after cholecystectomy or in the necropsy. The most frequent variety is moderately differentiated adenocarcinoma.

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RESUMEN Según las evidencias científicas actuales, la administración de un tratamiento simple y económico con propiedades antifibrinolíticas, como el ácido tranexámico pudiera reducir la pérdida sanguínea luego de un trauma y disminuir el riesgo asociado a transfusiones sanguíneas. El ácido tranexámico es un derivado sintético de la lisina con una actividad antifibrinolítica pura. Su mecanismo de acción se basa en la unión al enlace de la lisina del plasminógeno, lo que bloquea la unión de la fibrina al complejo activador del plasminógeno-plasmina.Ante tal evidencia, esta revisión se propone describir los resultados del empleo del ácido tranexámico según la evidencia disponible. Para ello se realizó una búsqueda en bases de datos como PubMed, SciELO y ClinicalKeys(AU)

ABSTRACT According to the present scientific evidence, the administration of a simple economic treatment with anti-fibrinolytic properties such as the tranexamic acid can reduce the blood loss after trauma, and decrease the risk associated to blood transfusions. Tranexamic acid is a synthetic derivative of lysine with pure anti-fibrinolytic activity. Its mechanism of action is based on the joining to the plasminogen lysine bond, which blocks the binding of fibrin to the activating complex of plasminogen-plasmin. This review was aimed at describing the results of the use of tranexamic acid based on available evidence. To this end, a literature search was made in PubMed, SciELO and Clinical Keys databases(AU)

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PURPOSE: To determine whether there is an increased risk to the corneal endothelium when mitomycin C (MMC) is administered after photorefractive keratectomy (PRK). DESIGN: Prospective, randomized, double-blind, placebo-controlled crossover trial. METHODS: Corneal endothelium was analyzed preoperatively and postoperatively in 18 eyes of nine patients who were administered either MMC- or balanced salt solution (BSS)-supplemented PRK at Codet Aris Vision, Tijuana, Mexico. After laser ablation, one eye was randomly assigned to intraoperative topical MMC 0.02% treatment for 30 seconds, and the fellow eye (the control eye) was treated in a standard fashion with topical BSS. Preoperative pachymetry and endothelial cell count were performed and compared with postoperative measurements after one month and three months. Main outcome measure studied was endothelial cell loss. RESULTS: There was no significant difference in the preoperative endothelial cell count between the 2 groups: MMC group 2835 +/- 395, control group 2779 +/- 492, P = .62. In the control group, at one month and three months the difference in the endothelial cell count was not statistically significant (P = .27, P = .14, respectively). However, in the MMC group the endothelial cell loss was statistically significant: at one month 14.7 +/- 5.1%, and at three months 18.2 +/- 9.0% (P = .0006, P = .002, respectively). CONCLUSIONS: The use of intraoperative topical MMC 0.02% for 30 seconds after PRK may affect the endothelial cell count.

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PURPOSE: To assess the outcome of simultaneous implantable contact lens (ICL) removal and cataract extraction with pseudophakic intraocular lens (IOL) implantation. SETTING: CODET Aris Vision Institute, Tijuana, Mexico. METHODS: This retrospective noncomparative interventional case series evaluated 14 eyes of 12 patients with ICL implantations who developed a cataract and simultaneously had ICL removal and cataract extraction with IOL implantation. The follow-up time was at least 6 months (range 6 to 24 months). Visual acuity (logMAR), manifest refraction, intraocular pressure, and adverse events were recorded. RESULTS: Of the 12 patients (14 eyes), 10 patients (12 eyes) had ICL surgery to correct high myopia and 2 patients (2 eyes), to correct hyperopia. The mean uncorrected visual acuity after ICL implantation (before cataract development), before cataract surgery, and after cataract surgery were 0.48 +/- 0.32, 0.83 +/- 0.34, and 0.40 +/- 0.27, respectively. The mean best corrected visual acuity (BCVA) before ICL implantation, after ICL implantation, and after cataract surgery were 0.31 +/- 0.21, 0.28 +/- 0.19, and 0.27 +/- 0.21, respectively. The mean final manifest spherical equivalent was 0.30 diopters (D) +/- 1.07 (SD) (range +2.38 to 2.0 D). Ten eyes (71.4%) were within +/-1.0 D of the calculated target. One eye had a tear in the posterior capsule with vitreous loss during cataract surgery. No other intraoperative, perioperative, or postoperative complications were observed. No loss of BCVA was recorded at the last postoperative visit. CONCLUSIONS: Lens opacities and cataract formation are a potential complication of ICL surgery. The removal of the ICL and the cataract with IOL implantation was found to be safe, with predictable refractive results.

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