A case of intestinal obstruction with sigmoid colon volvulus in a 14-weeks pregnant woman is presented. This is a rare complication of difficult diagnosis; and the case reported was due to an internal hernia. Some aspects of pathophysiology and diagnosis are discussed.

Injury and stress influence the immune system, and interactions between inflammatory mediators play a crucial role in controlling the immune response. Immunomodulation hyperinflammatory try improve early phase of trauma or shock. A review of clinical studies and immune mechanisms of nutritional support perioperative immunopotentiators supplements such as arginine, omega-3 and ribonucleic acid (RNA), which can counteract the alterations of the inflammatory response, the immune system function is performed intestinal barrier, effectively and early. We conclude that the only strategy available to the clinician is immunonutrition, which should be strongly considered as a rational advantage to modulate not only the immune and inflammatory response, but also all host defense mechanisms.

A case of intestinal obstruction with sigmoid colon volvulus in a 14-weeks pregnant woman is presented. This is a rare complication of difficult diagnosis; and the case reported was due to an internal hernia. Some aspects of pathophysiology and diagnosis are discussed.

Injury and stress influence the immune system, and interactions between inflammatory mediators play a crucial role in controlling the immune response. Immunomodulation hyperinflammatory try improve early phase of trauma or shock. A review of clinical studies and immune mechanisms of nutritional support perioperative immunopotentiators supplements such as arginine, omega-3 and ribonucleic acid (RNA), which can counteract the alterations of the inflammatory response, the immune system function is performed intestinal barrier, effectively and early. We conclude that the only strategy available to the clinician is immunonutrition, which should be strongly considered as a rational advantage to modulate not only the immune and inflammatory response, but also all host defense mechanisms.

RESUMEN El estrés y la injuria influyen sobre el sistema inmune, y las interacciones entre los mediadores de la inflamación juegan un rol crucial en el control de la respuesta inmune. La inmunomodulación intenta mejorar la fase hiperinflamatoria temprana del trauma o choque. Se realiza una revisión de los estudios clínicos y mecanismos inmunes del apoyo nutricional perioperatorio de suplementos inmunopotenciadores, como arginina, ácidos grasos omega-3 y ácido ribonucleico (ARN), los cuales pueden contrarrestar las alteraciones de la respuesta inflamatoria, el sistema inmune y función de barrera intestinal, en forma efectiva y temprana. Se concluye que la única estrategia disponible para el clínico es la inmunonutrición, que debería ser fuertemente considerada como una ventaja racional para modular no sólo la respuesta inmune e inflamatoria, sino también todos los mecanismos...

Introducción: No se cuenta con estudios de las modificaciones de la onda de velocidad de flujodel tronco de la arteria pulmonar por el uso de corticoides. Objetivos: Evaluar el efecto del usode corticoides prenatales sobre la medida del índice Doppler tiempo de aceleración/tiempode eyección sistólico (TA/TE) en el flujo del tronco de la arteria pulmonar fetal en el embarazopretérmino, y correlacionar una posible variación en el índice TA/TE con la inducción de madurezpulmonar fetal. Diseño: Estudio descriptivo, prospectivo y longitudinal. Institución: HospitalRegional Honorio Delgado, Arequipa, Perú. Participantes: Fetos pretérmino. Intervenciones:Evaluación ultrasonográfica obstétrica con biometría fetal y medición del flujo sanguíneoen el tronco de la arteria pulmonar fetal, usando el Doppler pulsado, antes y después de laadministración de corticoides para maduraci...

Evaluation of the second stage of labor is still subjective. Translabial intrapartum ultrasound is an objective evaluation tool of progression of the various stages of childbirth. Objectives: To determine the usefulness of translabial intrapartum ultrasound study in determining duration of the second stage of labor. Design: Observational, prospective and relationship study. Setting: Honorio Delgado Regional Hospital, Arequipa, Peru. Participants: Women in the second stage of labor. Interventions: From April through July 2012 53 patients in second stage of labor and who delivered vaginally underwent translabial ultrasound assessment of variety of position, direction, and angle of progression of the cephalic descent and its relation with duration of the second stage. Main outcome measures: Relation of cephalic descent and duration of the second stage. Results: There was a significant stati...

Introducción: No se cuenta con estudios de las modificaciones de la onda de velocidad de flujodel tronco de la arteria pulmonar por el uso de corticoides. Objetivos: Evaluar el efecto del usode corticoides prenatales sobre la medida del índice Doppler tiempo de aceleración/tiempode eyección sistólico (TA/TE) en el flujo del tronco de la arteria pulmonar fetal en el embarazopretérmino, y correlacionar una posible variación en el índice TA/TE con la inducción de madurezpulmonar fetal. Diseño: Estudio descriptivo, prospectivo y longitudinal. Institución: HospitalRegional Honorio Delgado, Arequipa, Perú. Participantes: Fetos pretérmino. Intervenciones:Evaluación ultrasonográfica obstétrica con biometría fetal y medición del flujo sanguíneoen el tronco de la arteria pulmonar fetal, usando el Doppler pulsado, antes y después de laadministración de corticoides para maduraci...

Evaluation of the second stage of labor is still subjective. Translabial intrapartum ultrasound is an objective evaluation tool of progression of the various stages of childbirth. Objectives: To determine the usefulness of translabial intrapartum ultrasound study in determining duration of the second stage of labor. Design: Observational, prospective and relationship study. Setting: Honorio Delgado Regional Hospital, Arequipa, Peru. Participants: Women in the second stage of labor. Interventions: From April through July 2012 53 patients in second stage of labor and who delivered vaginally underwent translabial ultrasound assessment of variety of position, direction, and angle of progression of the cephalic descent and its relation with duration of the second stage. Main outcome measures: Relation of cephalic descent and duration of the second stage. Results: There was a significant stati...