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Sepsis de origen abdominal secundaria a perforación estercoral recto-sigmoidea: a propósito de un caso
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Serrano-Lizarazo, Juan Daniel

; Ayala-Gutiérrez, María Camila

; Quintero-Gamboa, Diana Clemencia

; Pinto-Arias, Andrea Juliana

; Serrano-Pastrana, Juan Paulo

Medicas UIS

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aug 2024, Volume 37 N. 2 Pages 121 - 127

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen La perforación estercoral es una ruptura del colon asociada a impactación fecal, rara y letal, con menos de 200 casos reportados globalmente. Predomina en la población geriátrica y se manifiesta principalmente con estreñimiento crónico. El objetivo del artículo es presentar el caso de una mujer adulta intermedia con antecedentes de estreñimiento crónico y enfermedad diverticular, que ingresó a urgencias con una semana de dolor abdominal generalizado, y evolucionó a abdomen en tabla, alteración en la conciencia y taquipnea. Se sospechó sepsis abdominal por lo que se llevó a una laparotomía de emergencia. Esta reveló pelviperitonitis fecal originada por fecaloma sigmoideo con perforación estercoral de 12 cm, manejada con sigmoidectomía, antibioticoterapia de amplio espectro y lavado peritoneal. La paciente evolucionó favorablemente y fue dada de alta. Este desafiante caso, desde el punto de vista quirúrgico y diagnóstico, destaca la complejidad de una patología poco común en un grupo etario atípico.

Abstract Stercoral perforation is a rupture of the colon associated with fecal impaction, rare and lethal, with fewer than 200 cases reported globally. It predominates in the geriatric population and primarily manifests with chronic constipation. The objective of the article is to present the case of a mid-adult woman with a history of chronic constipation and diverticular disease, who was admitted to the emergency room with a one-week history of generalized abdominal pain, progressing to a rigid abdomen, altered consciousness, and tachypnea. Abdominal sepsis was suspected, leading to an emergency laparotomy. This revealed fecal pelvic peritonitis originating from a sigmoid fecaloma with a 12 cm stercoral perforation, managed with sigmoidectomy, broad-spectrum antibiotic therapy, and peritoneal lavage. The patient had a favorable outcome and was discharged. This surgically and diagnostically challenging case highlights the complexity of an uncommon pathology in an atypical age group.

https://doi.org/10.18273/revmed.v37n2-2024010

Comentario a Adrián N. Martín: El lado de los nudos: Punitivismo, burocracias y conciliación penal, Edunpaz, José C. Paz, 2021
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Gulman, Nicolás Pablo

; Luna, Jesica

; Serrano, Camila

Delito y sociedad

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jun 2024, N. 57 elocation e0119

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.14409/dys.2024.57.e0119

Interpretación de Gases Arteriales Sanguíneos: Revisión de tema
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Martin-Arsanios, Daniel Augusto

; Serrano-Giraldo, Julian

; Tíjaro-Merchán, Viviana Andrea

; Perdomo Rodríguez, Laura Sofia

; Delgado-Cañaveral, Maria Camila

; Vargas-Angel, Diana Carolina

; Contreras-Villamizar, Kateir

Revista científica ciencias de la salud

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2024, Volume 6 elocation e6302

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Los gases arteriales son herramientas fundamentales para evaluar objetivamente a pacientes con patologías agudas y crónicas, dado que proporcionan información sobre los índices de oxigenación, ventilación, equilibrio ácido-base y el suministro de oxígeno a nivel celular. Interpretarlos adecuadamente tiene gran importancia clínica, dado que influye en la toma de decisiones permite evaluar la respuesta a intervenciones terapéuticas. Este artículo tiene como objetivo presentar al lector los conceptos básicos de la fisiología del intercambio gaseoso, los trastornos ácido-base más comunes y una interpretación práctica de los gases arteriales. Se utiliza una combinación de ilustraciones gráficas, tablas y algoritmos para facilitar la comprensión y el abordaje clínico de pacientes con alteraciones respiratorias y metabólicas.

ABSTRACT Arterial blood gases are fundamental tools to objectively evaluate patients with acute and chronic pathologies. They provide information on rates of oxygenation, ventilation, acid-base balance, and oxygen supply at the cellular level. Interpreting them properly is of great clinical importance for making timely decisions and allows evaluating the response to therapeutic interventions. This article introduces to the reader to the basic concepts of gas exchange physiology, the most common acid-base disorders, and a practical interpretation of arterial blood gases. A combination of graphic illustrations, tables, and algorithms is used to facilitate the understanding and clinical management of patients with respiratory and metabolic disorders.

https://doi.org/10.53732/rccsalud/2024.e6302

Unveiling a novel memory center in human brain: neurochemical identification of the nucleus incertus, a key pontine locus implicated in stress and neuropathology
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Ávila, Camila de

; Gugula, Anna Trenk, Aleksandra Intorcia, Anthony J. Suazo, Crystal Nolz, Jennifer Plamondon, Julie Khatri, Divyanshi Tallant, Lauren Caron, Alexandre Blasiak, Anna Serrano, Geidy E. Beach, Thomas G. Gundlach, Andrew L. Mastroeni, Diego F.

Biological Research

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2024, Volume 57 elocation 46

Abstract: En | Text: En | PDF: En

Abstract Background The nucleus incertus (NI) was originally described by Streeter in 1903, as a midline region in the floor of the fourth ventricle of the human brain with an ‘unknown’ function. More than a century later, the neuroanatomy of the NI has been described in lower vertebrates, but not in humans. Therefore, we examined the neurochemical anatomy of the human NI using markers, including the neuropeptide, relaxin-3 (RLN3), and began to explore the distribution of the NI-related RLN3 innervation of the hippocampus. Methods Histochemical staining of serial, coronal sections of control human postmortem pons was conducted to reveal the presence of the NI by detection of immunoreactivity (IR) for the neuronal markers, microtubule-associated protein-2 (MAP2), glutamic acid dehydrogenase (GAD)-65/67 and corticotrophin-releasing hormone receptor 1 (CRHR1), and RLN3, which is highly expressed in NI neurons in diverse species. RLN3 and vesicular GABA transporter 1 (vGAT1) mRNA were detected by fluorescent in situ hybridization. Pons sections containing the NI from an AD case were immunostained for phosphorylated-tau, to explore potential relevance to neurodegenerative diseases. Lastly, sections of the human hippocampus were stained to detect RLN3-IR and somatostatin (SST)-IR. Results In the dorsal, anterior-medial region of the human pons, neurons containing RLN3- and MAP2-IR, and RLN3/vGAT1 mRNA-positive neurons were observed in an anatomical pattern consistent with that of the NI in other species. GAD65/67- and CRHR1-immunopositive neurons were also detected within this area. Furthermore, RLN3- and AT8-IR were co-localized within NI neurons of an AD subject. Lastly, RLN3-IR was detected in neurons within the CA1, CA2, CA3 and DG areas of the hippocampus, in the absence of RLN3 mRNA. In the DG, RLN3- and SST-IR were co-localized in a small population of neurons. Conclusions Aspects of the anatomy of the human NI are shared across species, including a population of stress-responsive, RLN3-expressing neurons and a RLN3 innervation of the hippocampus. Accumulation of phosphorylated-tau in the NI suggests its possible involvement in AD pathology. Further characterization of the neurochemistry of the human NI will increase our understanding of its functional role in health and disease.

https://doi.org/10.1186/s40659-024-00523-z

Los Servicios de Salud Públicos de la Región Metropolitana (RM) cuentan con 9 camas psiquiátricas de corta estadía por 100.000 habitantes mayores de 18 años, insuficiente para la necesidad actual
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González, Alfonso Díaz, Camila Mena, Cristián Valenzuela, Cristián Cooper, Antonia Inostroza, Patricio Coloma, Benjamín Serrano, María José Gil, Francisco

Revista médica de Chile

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aug 2023, Volume 151 N. 8 Pages 1078 - 1087

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: The Public Health Services at the Metropolitan Region (MR) of Chile have nine acute psychiatric beds per 100,000 inhabitants, under international recommendations. Aim: The present study will evaluate the resolution capacity of the main MR Psychiatric Emergency Room (PER), which may help assess the impact of the availability of acute beds in the MR. Material and Methods: A retrospective observational study of electronic patient records for all adult patients attending PER of the Psychiatric Institute "Dr. José Horwitz B." between 2017 and 2020 was analyzed. Crude and adjusted Incidence Rate Ratios were obtained for the indication of hospitalization, admissions, and those rejected due to lack of acute psychiatric beds. Results: 90,464 attendances were evaluated on 41,541 patients, and hospitalization was indicated for 12.5% of them. Admissions were carried out in 59.5%, and 35.9% did not occur due to a lack of acute psychiatric beds. When comparing the adjusted Incidence Rates, only a higher hospitalization rate was observed for users from regions (IRR = 1,267; 95% CI: 1,11-1,44; p-value < 0.001) and during the first half of 2020 (IRR = 1.49; CI95%: 1.35-1.65; p-value < 0.001). Conclusions: The demand for psychiatric hospitalizations and the low availability of acute psychiatric beds in the MR probably have unsuspected consequences. The solution requires multilevel planning among all the actors involved.

RESUMEN Introducción: Los Servicios de Salud Públicos de la Región Metropolitana (RM) cuentan con 9 camas psiquiátricas de corta estadía por 100.000 habitantes adultos, por debajo de las recomendaciones internacionales. Objetivo: El presente estudio evaluará la capacidad de resolución del principal Servicio de Urgencias Psiquiátricas de la RM lo que puede ser de utilidad para evaluar el impacto de la disponibilidad de camas de corta estadía en la RM. Materiales y Método: Se realizó un estudio observacional retrospectivo de todas las atenciones realizadas en el Servicio de Urgencias del Instituto Psiquiátrico "Dr. José Horwitz B." entre los años 2017 y 2020 y las indicaciones de hospitalización y su resolución. Se obtuvieron Razones de Tasas de Incidencia crudas y ajustadas para la indicación de hospitalización, las efectuadas y aquellas rechazadas por falta de vacantes. Resultados: Se realizaron 90.464 atenciones a 41.541 usuarios y se indicó la hospitalización al 12,5% de ellas. La hospitalización se efectúa en el 59,5% de las atenciones y 35,9% no se pueden realizar por falta de vacantes. Al comparar las Tasas de Incidencia ajustadas se observó solamente una mayor tasa de hospitalización efectuada para los usuarios de regiones (IRR = 1,27; IC95%: 1,11-1,44; valor-p < 0,001) y durante el primer semestre de 2020 (IRR = 1,49; IC95%: 1,35-1,65; valor-p < 0,001). Conclusiones: La evidente demanda por las hospitalizaciones psiquiátricas y la baja disponibilidad de camas de corta estadía en la Región Metropolitana probablemente tiene consecuencias insospechadas. Su abordaje es un desafío que requiere de una planificación multinivel entre todos los actores involucrados.

https://doi.org/10.4067/s0034-98872023000801078

Metabolic studies and calculi analysis in urinary lithiasis, how to stop recurrence?
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Barco-Castillo, Catalina Uribe, Camila Bohórquez, Angela Trujillo, Carlos Gustavo Serrano, Adolfo

Urología Colombiana

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mar 2023, Volume 32 N. 1 Pages 15 - 22

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen La litiasis urinaria es la consulta urológica más frecuente para la sala de emergencias debido al cólico renoureteral. Las complicaciones incluyen hematuria, anuria debido a la obstrucción bilateral o unilateral en el riñón solitario y la sepsis. La recurrencia ocurre en hasta el 50% de los pacientes después de 5 años desde el primer episodio, y aquellos pacientes requieren estudios metabólicos y análisis del cálculo. El manejo farmacológico y las modificaciones dietéticas evitarán nuevos episodios. Nuestro objetivo es describir cada trastorno metabólico asociado con su respectivo tipo de cálculo y su manejo basado en la prevención de la recurrencia de la litiasis urinaria.

Abstract Urinary lithiasis is the most frequent urological consultation to the emergency room due to renoureteral colic. Complications include hematuria, anuria due to bilateral or unilateral obstruction in solitary kidney, and sepsis. Recurrence occurs in up to 50% of patients after 5 years from the first episode, and those will need metabolic studies and calculi analysis. Pharmacological management and dietary measures will prevent new episodes. We aim to describe each metabolic disorder associated with its respective type of calculi, and its management based on prevention of recurrence of urinary lithiasis.

https://doi.org/10.24875/ruc.22000003

Diseño y validación de una herramienta para la predicción de desenlaces adversos en pacientes con obstrucción intestinal por bridas: La escala HALVIC
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Quiroga-Centeno, Andrea Carolina Pinilla-Chávez, María Camila Chaparro-Zaraza, Diego Fernando Hoyos-Rizo, Katherine Pinilla-Merchán, Pedro Felipe Serrano-Pastrana, Juan Paulo Gómez-Ochoa, Sergio Alejandro

Revista Colombiana de Cirugía

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mar 2023, Volume 38 N. 1 Pages 84 - 100

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción. La obstrucción intestinal por bridas representa una causa común de consulta a los servicios de urgencias, pero hay poca claridad sobre qué pacientes tienen mayor riesgo de desarrollar complicaciones. El objetivo de este estudio fue diseñar y validar una escala de predicción de riesgo de desenlaces adversos en pacientes con obstrucción intestinal por bridas. Métodos. Estudio de cohorte retrospectivo realizado a partir de la base de datos MIMIC-IV. Se incluyeron pacientes adultos admitidos al servicio de urgencias entre 2008 y 2019, con diagnóstico de obstrucción intestinal por bridas. El desenlace principal fue el compuesto de resección intestinal, ingreso a unidad de cuidados intensivos y mortalidad por cualquier causa. Se diseñó una escala de predicción de riesgo asignando un puntaje a cada variable. Resultados. Se incluyeron 513 pacientes, 63,7 % hombres. El desenlace compuesto se presentó en el 25,7 % de los casos. La edad, historia de insuficiencia cardiaca y enfermedad arterial periférica, nivel de hemoglobina, recuento de leucocitos e INR constituyeron el mejor modelo de predicción de estos desenlaces (AUC 0,75). A partir de este modelo, se creó la escala simplificada HALVIC, clasificando el riesgo del desenlace compuesto en bajo (0-2 puntos), medio (3-4 puntos) y alto (5-7 puntos). Conclusión. La escala HALVIC es una herramienta de predicción simple y fácilmente aplicable. Puede identificar de manera precisa los pacientes con obstrucción intestinal por bridas con alto riesgo de complicaciones, permitiendo el ajuste individualizado de las estrategias de manejo para mejorar los desenlaces.

Abstract Introduction. Adhesive Small Bowel Obstruction (ASBO) represents a common cause of consultation to the emergency department. Currently there is little clarity about which patients with ASBO are at increased risk of developing complications, potentially benefiting from early surgical management. The present study aims to design and validate a risk prediction scale for adverse outcomes in patients with ASBO. Methods. Retrospective cohort study performed from the MIMIC-IV database between 2008 and 2019. Adult patients admitted to the emergency department with a diagnosis of ASBO were included. The primary outcome was the composite of bowel resection, intensive care unit admission, and all-cause mortality. A risk prediction scale was designed by assigning a score to each variable according to the measure of association obtained in the logistic regression model. All analyses were performed in R statistical software (version 3.5.3). Results. Five-hundred-thirteen patients were included (men 63.7%, median age: 61 years). Composite outcome was present in 25.7% of cases. Age, history of heart failure and peripheral arterial disease, hemoglobin level, leukocyte count, and INR were the best predictors of these outcomes (AUC 0.75). Based on this model, the simplified HALVIC scale was created, classifying the risk of the composite outcome as low (0-2 points), medium (3-4 points) and high (5-7 points). Conclusion. The HALVIC scale is presented as a simple and easily applicable predictive tool in the clinical setting, which can accurately identify patients with ASBO at high risk of complications, allowing the surgeon to adjust management strategies individually and potentially improving the outcomes of these patients.

https://doi.org/10.30944/20117582.2288

O que mudou entre os períodos de pico e de platô durante a primeira onda do SARS-CoV-2? Estudo multicêntrico português em unidades de cuidados intensivos SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV-2 SARS-CoV- SARS-CoV
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Pereira, Rui Antunes

; Sousa, Marta

; Cidade, José Pedro

; Melo, Luís

; Lopes, Diogo

; Ventura, Sara

; Aragão, Irene

; Lima Neto, Raul Miguel de Freitas

; Molinos, Elena

; Marques, Ana

; Cardoso, Nelson

; Marino, Flávio

; Monteiro, Filipa Brás

; Oliveira, Ana Pinho

; Silva, Rogério C

; Real, André Miguel Neto

; Banheiro, Bruno Sarmento

; Reis, Renato

; Adão-Serrano, Maria

; Cracium, Ana

; Valadas, Ana

; Ribeiro, João Miguel

; Póvoa, Pedro

; Tapadinhas, Camila

; Mendes, Vítor

; Coelho, Luís

; Maia, Raquel

; Freitas, Paulo Telles

; Ferreira, Isabel Amorim

; Ramires, Tiago

; Val-Flores, Luís Silva

; Cascão, Mariana

; Alves, Rita

; Rodeia, Simão C

; Barrigoto, Cleide

; Cardiga, Rosa

; Silva, Maria João Ferreira da

; Vale, Bruno

; Fonseca, Tatiana

; Rios, Ana Lúcia

; Camões, João

; Pérez, Danay

; Cabral, Susana

; Ribeiro, Maria Inês

; Mendes, João João Gouveia, João Fernandes, Susana Mendes

Revista Brasileira de Terapia Intensiva

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dec 2022, Volume 34 N. 4 Pages 433 - 442

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Analisar e comparar as características de pacientes críticos com a COVID-19, a abordagem clínica e os resultados entre os períodos de pico e de platô na primeira onda pandêmica em Portugal. Métodos: Este foi um estudo de coorte multicêntrico ambispectivo, que incluiu pacientes consecutivos com a forma grave da COVID-19 entre março e agosto de 2020 de 16 unidades de terapia intensiva portuguesas. Definiram-se as semanas 10 - 16 e 17 - 34 como os períodos de pico e platô. Resultados: Incluíram-se 541 pacientes adultos com mediana de idade de 65 [57 - 74] anos, a maioria do sexo masculino (71,2%). Não houve diferenças significativas na mediana de idade (p = 0,3), no Simplified Acute Physiology Score II (40 versus 39; p = 0,8), na pressão parcial de oxigênio/fração inspirada de oxigênio (139 versus 136; p = 0,6), na terapia com antibióticos na admissão (57% versus 64%; p = 0,2) ou na mortalidade aos 28 dias (24,4% versus 22,8%; p = 0,7) entre o período de pico e platô. Durante o período de pico, os pacientes tiveram menos comorbidades (1 [0 - 3] versus 2 [0 - 5]; p = 0,002); fizeram mais uso de vasopressores (47% versus 36%; p < 0,001) e ventilação mecânica invasiva na admissão (58,1% versus 49,2%; p < 0,001), e tiveram mais prescrição de hidroxicloroquina (59% versus 10%; p < 0,001), lopinavir/ritonavir (41% versus 10%; p < 0,001) e posição prona (45% versus 36%; p = 0,04). Entretanto, durante o platô, observou-se maior uso de cânulas nasais de alto fluxo (5% versus 16%; p < 0,001) na admissão, remdesivir (0,3% versus 15%; p < 0,001) e corticosteroides (29% versus 52%; p < 0,001), além de menor tempo de internação na unidade de terapia intensiva (12 versus 8 dias; p < 0,001). Conclusão: Houve mudanças significativas nas comorbidades dos pacientes, nos tratamentos da unidade de terapia intensiva e no tempo de internação entre os períodos de pico e platô na primeira onda da COVID-19. Objetivo COVID19, COVID19 COVID 19, 19 Portugal Métodos ambispectivo COVID-1 202 1 portuguesas Definiramse Definiram se 3 Resultados Incluíramse Incluíram 54 6 57 [5 74 anos 71,2%. 712 71,2% . 71 (71,2%) 0,3, 03 0,3 , 0 0,3) 40 (4 39 0,8, 08 0,8 0,8) oxigêniofração fração 139 (13 136 0,6, 06 0,6 0,6) 57% (57 64% 64 0,2 02 24,4% 244 24 4 (24,4 22,8% 228 22 0,7 07 7 ( [ 5 5] 0,002 0002 002 0,002) 47% 47 (47 36% 36 0,001 0001 001 58,1% 581 58 (58,1 49,2% 492 49 0,001, 59% 59 (59 10% lopinavirritonavir lopinavir ritonavir 41% 41 (41 45% 45 (45 0,04. 004 0,04 04 0,04) Entretanto observouse observou 5% (5 16% 0,3% (0,3 15% 15 29% 29 (29 52% 52 12 0,001. Conclusão COVID19. 19. COVID1 COVID- 20 71,2 (71,2% 0, 13 24,4 (24, 22,8 0,00 000 00 58,1 (58, 49,2 0,0 (0, (2 71, (71,2 24, (24 22, 58, (58 49, (0 (71, (71 (7

ABSTRACT Objective: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal. Methods: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined. Results: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau. Conclusion: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave. Objective COVID19 COVID 19 COVID-1 characteristics Portugal Methods 202 1 units respectively 34 defined Results fortyone forty one 6 57 [5 74 years 71.2%, 712 71.2% , 71 (71.2%) included 0.3, 03 0.3 0 3 0.3) 40 (4 39 0.8, 08 0.8 8 0.8) pressurefraction pressure fraction 139 (13 136 0.6, 06 0.6 0.6) 57% (57 64% 64 0.2 02 admission 28day day 28 24.4% 244 24 4 (24.4 22.8% 228 22 0.7 07 7 period ( [ 5 5] 0.002 0002 002 47% 47 (47 36% 36 0.001 0001 001 58.1 581 58 (58. 49.2% 492 49 45% 45 (45 0.04, 004 0.04 04 0.04) 59% 59 (59 10% lopinavirritonavir lopinavir ritonavir 41% 41 (41 prescriptions However highflow high flow 5% (5 16% 0.3% (0.3 15% 15 29% 29 (29 52 52% 12 Conclusion COVID1 COVID- 20 71.2 (71.2% 0. 13 24.4 (24. 22.8 0.00 000 00 58. (58 49.2 0.0 (0. (2 71. (71.2 24. (24 22. 49. (0 (71. (71 (7

https://doi.org/10.5935/0103-507x.20210037-pt

Reparación de lesión vascular accidental de grandes vasos por laparoscopia en ocho pasos
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Sanabria-Serrano, Daniel Eduardo Díaz-Girón, Maria Camila Fernández-Gualdrón, Maria Camila Melenje-Ramos, Adriana Rodríguez-Castillo, Juliana Lucía

Revista Colombiana de Obstetricia y Ginecología

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jun 2022, Volume 73 N. 2 Pages 223 - 224

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.18597/rcog.3905

10.

Infección temprana de la malla quirúrgica en herniorrafia incisional. Incidencia, factores de riesgo y desenlaces en más de 60.000 pacientes
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Quiroga-Centeno, Andrea Carolina

; Hoyos-Rizo, Katherine

; Chaparro-Zaraza, Andrés Felipe

; Pinilla-Merchán, Pedro Felipe

; Chávez, María Camila Pinilla

; Serrano-Pastrana, Juan Paulo

; Ochoa, Sergio Alejandro Gómez

Revista Colombiana de Cirugía

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apr 2022, Volume 37 N. 2 Pages 194 - 205

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción. La infección de la malla en cirugía de reparación de hernias de pared abdominal es un desenlace pobre, asociado a un incremento en el riesgo de complicaciones. El objetivo del presente estudio fue analizar la incidencia, los factores asociados y desenlaces en pacientes llevados a herniorrafia incisional con malla con posterior diagnóstico de infección temprana. Métodos. Estudio de cohorte retrospectiva. Se utilizaron los datos de egresos hospitalarios de la National Inpatient Sample (NIS) de los Estados Unidos de América para identificar a todos los pacientes adultos llevados a herniorrafia incisional durante los años 2010 a 2015. Se utilizaron modelos de regresión logística bivariada y multivariada para evaluar los factores de riesgo en infección temprana de la malla, y finalmente, modelos de regresión logística y lineal, según el tipo de variable dependiente, de tipo stepwise forward para evaluar la asociación entre el diagnóstico de infección de malla y los desenlaces adversos. Resultados. En total se incluyeron 63.925 pacientes. La incidencia de infección temprana de la malla fue de 0,59 %, encontrando como factores asociados: comorbilidades (obesidad, desnutrición proteico calórica, anemia carencial y depresión), factores clínico-quirúrgicos (adherencias peritoneales, resección intestinal, cirugía laparoscópica y complicaciones no infecciosas de la herida) y administrativos o asistenciales. Conclusiones. La infección temprana, aunque infrecuente, se asocia con un aumento significativo en el riesgo de complicaciones. La optimización prequirúrgica con base en los factores de riesgo para este desenlace nefasto es un elemento clave para la reducción de la incidencia y mitigación del impacto de la infección en los pacientes con herniorrafía incisional con malla.

Abstract Introduction. Mesh infection in abdominal wall hernia repair surgery has poor outcome, associated with an increased risk of complications. The objective of this study was to analyze the incidence, associated factors, and outcomes in patients undergoing incisional herniorrhaphy with mesh and subsequent diagnosis of early infection. Methods. Retrospective cohort study. Hospital discharge data from the National Inpatient Sample (NIS) of the United States of America were used to identify all adult patients undergoing incisional herniorrhaphy during the years 2010 to 2015. Bivariate and multivariate logistic regression models were used to evaluate risk factors in early mesh infection, and finally, logistic and linear regression models, according to the type of dependent variable, of the stepwise forward type to evaluate the association between the diagnosis of mesh infection and adverse outcomes. Results. A total of 63,925 patients were included. The incidence of early infection of the mesh was 0.59%, finding as associated factors: comorbidities (obesity, protein-caloric malnutrition, deficiency anemia and depression), clinical-surgical factors (peritoneal adhesions, intestinal resection, laparoscopic surgery and surgical site complications) and administrative or healthcare. Conclusions. Early infection, although rare, is associated with a significantly increased risk of complications. Pre-surgical optimization based on risk factors for this poor outcome is a key element in reducing the incidence and mitigating the impact of infection in patients with mesh incisional herniorrhaphy.

https://doi.org/10.30944/20117582.1119

11.

El modelo GAM (Gestión Autónoma de la Medicación) como generador de autonomía en salud mental
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Avarca, Camila Aleixo de Campos

; Serrano-Miguel, Mercedes

; Vicentin, Maria Cristina Gonçalves

; Martínez-Hernáez, Ángel

Interface - Comunicação, Saúde, Educação

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2022, Volume 26 elocation e210506

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Neste texto apresentamos o conceito de autonomia aplicado ao campo da saúde mental. Para isso tomaremos como referencial uma experiência denominada “Guia para a gestão autônoma de medicamentos” (GAM) e sua implantação em dois contextos geográficos: Brasil e Espanha. A estratégia GAM propõe uma compreensão da autonomia afastando-se de uma visão individualista para se aproximar de uma perspectiva social e coletiva. Neste artigo iremos evidenciar os possíveis deslocamentos e tensões presentes, bem como os possíveis efeitos da autonomização que sua implementação produziu no contexto do cuidado em saúde mental. Assim, na experiência brasileira, observamos como esse deslocamento se produz a partir desse lugar do poder-saber, típico da experiência do profissional, enquanto a experiência espanhola mostra como a adaptação da ferramenta decorre da implicação necessária dos profissionais, usuários, familiares e rede social em um processo conjunto de trabalho e cuidado coletivo.

In this article we present the concept of autonomy applied to the field of mental health drawing on experiences of the implementation of the “Autonomous Medication Management Guide” in two different contexts: Brazil and Spain. Autonomous medication management proposes an understanding of autonomy that moves away from an individualistic view towards a social and collective perspective. This article highlights potential shifts and tensions and the possible effects of “autonomization” in the context of mental health care. In the Brazilian experience, we observed how this shift is produced from the place of power-knowledge typical of professional practice, while the Spanish experience shows how the adaptation of the tool derives from the necessary involvement of professionals, service users, families and social networks through a joint process of collective working and care.

En este texto presentamos una aproximación al concepto de autonomía aplicado al campo de la salud mental tomando como marco la “Guía para la gestión autónoma de la medicación” (GAM) y su despliegue en Brasil y España. La estrategia GAM plantea una comprensión de la autonomía alejada de una visión individualista para aproximarse a una perspectiva social y colectiva. En este artículo vamos a evidenciar los posibles desplazamientos y las tensiones generadas, así como los efectos de autonomización que conlleva su implementación en salud mental. En la experiencia brasileña, se observa ese desplazamiento desde el lugar del saber-poder, propio de los profesionales, mientras la experiencia española muestra cómo la adaptación de la herramienta parte de la necesaria implicación de los profesionales, de los usuarios/as, sus familias y su red social en un proceso conjunto de trabajo y cuidado colectivo.

https://doi.org/10.1590/interface.210506

12.

El modelo GAM (Gestión Autónoma de la Medicación) como generador de autonomía en salud mental
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Avarca, Camila Aleixo de Campos

; Serrano-Miguel, Mercedes

; Vicentin, Maria Cristina Gonçalves

; Martínez-Hernáez, Ángel

Interface - Comunicação, Saúde, Educação

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2022, Volume 26 elocation e210506

Abstract: Es Pt En | Text: Es Pt En | PDF: Es | PDF: Pt | PDF: En

https://doi.org/10.1590/interface.210506

13.

‘Nicanor y la Violeta’: Un análisis crítico del uso del artículo definido ante nombres propios masculinos y femeninos
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Aliaga Rovira, Leonardo Avilés Retamal, Patricia Román Montes de Oca, Domingo Serrano Insunza, María José Colicheo Cabrera, Camila Soto Cáceres, Francisco

Logos (La Serena)

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dec 2020, Volume 30 N. 2 Pages 224 - 235

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: This article studies the structure “definite article + proper noun anthroponym” and its distribution of use in cases of female and male anthroponyms. It is assumed that this structure is more frequent when the anthroponym is female (“la Violeta” and not “el Nicanor”). Since the presence of the article is expletive before proper nouns and, on the contrary, the use of this determinant or another is required, in specific syntactic positions, before common nouns, the appearance of the definite article preceding the feminine anthroponym could be a mark of social prejudice towards woman. To corroborate this hypothesis, the phenomenon studied was tracked in chilean written press texts, in order to analysing its appearance and frequency of use in cases of feminine and masculine anthroponyms.

Resumen: En este artículo se estudia la estructura “artículo definido + nombre propio antropónimo” y su distribución de uso en casos de antropónimos femeninos y masculinos. Se parte del supuesto de que esta estructura es más frecuente cuando el antropónimo es femenino (“la Violeta” y no “el Nicanor”). Al ser expletiva la presencia del artículo ante los sustantivos propios y, por el contrario, ser requerido su uso o el de otro determinante, en posiciones sintácticas específicas, ante los sustantivos comunes, la aparición del artículo definido precediendo al antropónimo femenino podría ser una marca del prejuicio social hacia la mujer. Para corroborar esta hipótesis, se realizó un rastreo del fenómeno estudiado en textos de prensa escrita chilena, con el objetivo de analizar su aparición y frecuencia de uso en los casos de antropónimo femenino y masculino.

https://doi.org/10.15443/rl3018

14.

Occurrence of recently diagnosed atrial fibrillation in the immediate postoperative period of myocardial revascularization surgery. Although common, a devalued complication
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Pereira, Marcel de Paula

; Lima, Eduardo Gomes

; Garzillo, Cibele Larrosa

; Barbosa, Camila Talita Machado

; Sampaio, Leon Pablo Cartaxo

; Darrieux, Francisco Carlos da Costa

; Serrano Jr, Carlos Vicente

Revista da Associação Médica Brasileira

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nov 2020, Volume 66 N. 11 Pages 1473 - 1475

Abstract: En | Text: En | PDF: En

SUMMARY Atrial fibrillation (AF) is the most common arrhythmia in the postoperative period of cardiac surgery, with a prevalence between 15-40% after coronary artery bypass surgery (CABG). Several strategies have been tested for the prevention and management of AF postoperatively. Previous studies and analysis of records have shown higher rates of hospitalization and clinical outcomes associated with this entity, including increased mortality in the short- and long-term. This perspective reviews the topic, and offers recommendations for the management of this arrhythmia in the postoperative period of CABG, with a special focus on anticoagulation strategies.

https://doi.org/10.1590/1806-9282.66.11.1473 375 downloads

15.

Recomendaciones para el uso de la hormona de crecimiento humana recombinante en pacientes pediátricos de talla baja en Colombia
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Pinzón Serrano, Estefanía López, Vladimir González Toro-Ramos, Martin Oliver, Jesús Argente Garzón, Liliana Barrero Duarte, Fredy Mendivelso González, Nancy Yomayusa Salazar, Camila Céspedes Escobar, Oscar Ventura, Paola Duran Patiño, Angélica González Rodríguez, Sandra Roa Linares, Juan Llano Rivera, Juan López Saldarriaga, Johana Correa Espejo, Jennyfer Monroy VelásquezRodríguez, Ana Gaviria, Natalia Mejía Ramírez, Claudia Heredia Izquierdo, Adriana Lema Zuccardi, María Urueña Ochoa, Nayive Gil Barrera, Carolina Rojas Campos, Diana Bareño Hernández, Mónica Fernández Zapata, Liliana Mejía Ronderos, Catalina Forero Flechas, Paola Pedraza Rhoades, Audrey Matallana Mosquera, Mario Angulo Cárdenas, María Suarez Villa, Alvaro Arango Pereira, Marcela Fama Osorio, Samantha Muñoz Espitia, Martha Páez Miranda, Ángelo López Rodríguez, Johanna Vargas Amaya, Diego Ruíz Gaona, Luis Laverde Torres, Giovana Manrique Tobón, Andrea Castro Acosta, Dora Romero Gutiérrez, Ana Castillo Gómez, Olga Gómez Padilla, Eduardo Low Peña, Juan Acevedo

Revista Colombiana de Nefrología

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jun 2020, Volume 7 N. 1 Pages 149 - 177

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract In Colombia there are no guidelines for diagnosis and management of patients with short stature and for the use of recombinant human growth hormone, mainly caused by the diversity of training centers in pediatric endocrinology. In response to this situation, the Asociación Colegio Colombiana de Endocrinología Pediátrica leds the first colombian short stature expert committee in order to standardize the use of human recombinant growth hormone. This work had the participation and endorsement of a consortium of clinical experts representing the Sociedad Colombiana de Pediatría, Secretaría Distrital de Salud de Bogotá- Subred Integrada de Servicios de Salud Suroccidente, Fundación Universitaria Sanitas, Universidad de los Andes and some public and private health institutions in the country, in addition to the participation of methodological experts from the Instituto Global de Excelencia Clínica Keralty. By reviewing the literature and with the best available evidence, we proposed to unify definitions, a diagnostic algorithm, biochemical and dynamic tests with their reference parameters, a description of the considerations about growth hormone use among the indications approved by regulatory agency for medications and food in Colombia and finally a proposal for an informed consent and a medication fact sheet available for parents and patients.

https://doi.org/10.22265/acnef.7.1.375

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