Reducing major lower extremity amputations after the introduction of a multidisciplinary team for the diabetic foot.

We analyzed the incidence of lower extremity amputations (LEAs) in the 3rd Health Care Area of Madrid before and after the March 2008 introduction of a multidisciplinary team for managing diabetic foot disease. We compared the amputation rates in people with and without diabetes during 2 periods: before (2001-2007) and after (2008-2011) the introduction of a Multidisciplinary Diabetic Foot Unit (MDFU). We also analyzed the trend of the amputation rates by joinpoint regression analysis and measured the annual percentage change (APC).

[Laparoscopic adrenalectomy. Lateral transabdominal tecnique "step by step" and analysis of 41 consecutive patients].

Since the initial report in 1992, laparoscopic adrenalectomy has proved substantial advantages over the conventional procedure in terms of decreased postoperative pain and hospital stay, allowing earlier return to normal activity. The technical details are in permanent evolution and the most widely accepted laparoscopic surgery for the adrenal gland is the transabdominal lateral approach. We hereby describe step by step the way we perform the lateral approach after 41 consecutive cases.