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1.
A. Guerrero Gómez N. González Jaramillo J.A. Castro Pérez 《Revista espa?ola de anestesiología y reanimación》2019,66(1):10-17
Introduction
The fast track / ultra-fast-track protocols are techniques used to optimise the patient care process and a quick recovery after cardiac surgery. They are one of the mainstays of efficient practice. With their use, the length of hospital and intensive care unit (ICU) stays are reduced, with a direct impact on costs and the quality of the health service.Objective
To compare the length of stay in the ICU, length of hospital stay, and post-operative mortality in ultra-fast-track extubated (uFTE) patients and those with conventional extubation (CE) after cardiac surgery.Methods
Longitudinal, analytical, retrospective study was conducted, with the period between the time of surgery and discharge being included as the study period.Results
A total of 396 patients older than 18 years who required cardiac surgery were included, of whom 207 patients had (uFTE) and 189 had CE. Although the groups were not comparable due to the statistical differences found, when performing the multivariate adjustment, uFTE maintained its statistical independence and was associated with lower cardiovascular morbidity, such as myocardial ischaemia (95% CI: 0.37-0.86; P = .01) and lower post-surgical vasopressor requirement (95% CI: 0.18-0.49; P < .01). No significant differences were found in the length of hospital stay, ICU stay, or post-operative mortality in the ICU.Conclusion
Implementing the uFTE strategy, decreases cardiovascular morbidity and vasopressor requirement. The change to uFTE should be accompanied by changes in models and practices in patient recovery to standardised protocols. This study shows that uFTE did not reduce the length of ICU stay, hospital stay, or mortality. 相似文献2.
Esparza-Gordillo Jorge; Goicoechea de Jorge Elena; Buil Alfonso; Berges Luis Carreras; Lopez-Trascasa Margarita; Sanchez-Corral Pilar; Rodriguez de Cordoba Santiago 《Human molecular genetics》2005,14(8):1107
Some MCP SNP and aHUS-associated MCP mutation 相似文献
3.
4.
Sergi Sastre Francisco Maculé Sandra Lasurt Josep-María Segur Lluis Lozano Montse Nuñez Santiago Suso 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2007,17(4):393-397
Five patients with idiopathic transient osteoporosis were examined. Bone scanning and MRI was helpful in the diagnosis to differentiate of necrosis and all patients recovered completely with conservative and symptomatic treatment. There was no history of trauma in all patients. MRI was realized previously in all cases to confirm the diagnosis and after the resolution of symptomathology. 相似文献
5.
Robotic-assisted heller myotomy versus laparoscopic heller myotomy for the treatment of esophageal achalasia: multicenter study 总被引:3,自引:0,他引:3
Santiago Horgan M.D. Carlos Galvani M.D. Maria V. Gorodner M.D. Pablo Omelanczuck M.D. Fernando Elli M.D. Federico Moser M.D. Luis Durand M.D. Miguel Caracoche M.D. Jorge Nefa M.D. Sergio Bustos M.D. Phillip Donahue M.D. Pedro Ferraina M.D. 《Journal of gastrointestinal surgery》2005,9(8):1020-1030
Laparoscopic Heller myotomy (LHM) has become the standard treatment option for achalasia. The incidence of esophageal perforation
reported is about 5%–10%. Robotically assisted Heller myotomy (RAHM) is emerging as a safe alternative to LHM. Data comparing
the two approaches are scant. The aim of this study was to compare RAHM with LHM in terms of efficacy and safety for treatment
of achalasia. A total of 121 patients underwent surgical treatment of achalasia at three institutions. A retrospective review
of prospectively collected perioperative data was performed. Patients were divided into two groups: group A (RAHM), 59 patients,
and group B (LHM), 62 patients. All the operations were completed using minimally invasive techniques. There were 63 women
and 58 men, with a mean age of 45 ±19 years (14–82 years). Fifty-one percent of patients in group A and 95% of patients in
group B reported weight loss. Duration of symptoms was equal for both groups. Dysphagia was the main complaint in both groups
(P = NS). There was no difference in preoperative endoscopic treatment in both groups (44% versus 27%, P = NS). Operative
time was significantly shorter for LHM in the first half of the experience (141 ± 49 versus 122 ± 44 minutes, P < .05). However,
in the last 30 cases there was no difference in operative time between the groups (P = NS). Intraoperative complications (esophageal
perforation) were more frequent in group B (16% versus 0%). The incidence of postoperative heartburn did not differ by group.
There were no deaths. At 18 and 22 months, 92% and 90% of patients had relief of their dysphagia. This study suggests that
RAHM is safer than LHM, because it decreases the incidence of esophageal perforation to 0%, even in patients who had previous
treatment. At short-term follow-up, relief of dysphagia was equally achieved in both groups.
Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18,
2005 (oral presentation).
This study was supported in part by a grant provided by Intuitive Surgical, Inc. and Ethicon Endo-Surgery, Inc. 相似文献
6.
Abstract Caries experience and enamel fluorosis prevalence in 8-year-old children belonging to different socio-economic classes were determined in two Chilean twin cities that are served by optimally fluoridated community water from the same waterworks facility. Low socio-economic status (LSES) children had a higher mean dm ft and DMFT indices (P<0.001) than high socioeconomic status (HSES) children. Prevalence of enamel fluorosis in the permanent teeth of LSES children was 0.79, significantly higher (X2= 9.0; P<0.003) than the value 0.59 found in HSES children. The proportion of Dean's scores 2. 3, 4 and 5 in first molars, mandibular and maxillary incisors in LSES children was higher than in HSES children (P<0.001). Differences in prevalence and seventy of enamel fluorosis between both groups are tentatively attributed lo a different pattern of tap water and tea consumption at pre-school ages. Suggestions are advanced to minimize the undesirable prevalence and severity of enamel fluorosis. 相似文献
7.
Controlled study of meso-2,3-dimercaptosuccinic acid for the management of childhood lead intoxication. 总被引:7,自引:0,他引:7
J H Graziano N J Lolacono T Moulton M E Mitchell V Slavkovich C Zarate 《The Journal of pediatrics》1992,120(1):133-139
We examined the efficacy and safety of meso-2,3-dimercaptosuccinic acid (DMSA) in children with markedly elevated blood lead (BPb) concentrations. Among 19 children with BPb concentrations of 50 to 69 micrograms/dl (2.41 to 3.33 mumol/L) who received a 5-day inpatient oral course of DMSA (1050 mg/m2 per day), the mean BPb concentration decreased by 61%; in four who received calcium disodium ethylenediaminetetraacetic acid (CaNa2EDTA) (1000 mg/m2 per day intravenously), it decreased by 45% (p less than 0.0007). Urinary lead excretion was comparable in both groups. Treatment with DMSA was more effective than treatment with CaNa2EDTA in restoring metabolic activity to the heme pathway and was well tolerated even among nine patients who received concomitant iron supplementation and two who had homozygous deficiency of glucose-6-phosphate dehydrogenase. On discharge, these 19 children received either no chelation therapy or DMSA, 350 or 700 mg/m2 per day for 14 days on an outpatient basis. After 14 days the mean BPb values for the no-chelation, low-DMSA, and high-DMSA groups were 73%, 66%, and 50% of the pretreatment values, respectively. We conclude that a 5-day oral course of DMSA is effective in the treatment of children with severe lead poisoning. In addition, on an outpatient basis the administration of DMSA, 700 mg/m2 per day, is capable of delaying the typical rebound in BPb values and should ultimately reduce the need for repeated hospitalizations. 相似文献
8.
María de Oña Navarro Santiago Melón Susana Méndez Beatriz Iglesias Ana Palacio María J. Bernardo José L. Rodriguez-Lambert Ernesto Gómez 《Transplant international》2002,15(11):570-573
Ganciclovir (GCV) prophylaxis or pre-emptive therapy significantly reduce the rate of cytomegalovirus (CMV) disease and viremia, but increase the potential for emergence of ganciclovir-resistant CMV strains. The inhibitor concentration at 50% (IC(50)) of GCV from 156 CMV isolates from 59 renal or heart transplant recipients was calculated by means of a rapid phenotypic susceptibility assay. Twenty-seven strains were from 14 patients undergoing GCV therapy. The IC(50) was higher in patients under the prophylaxis regimen. One CMV strain, from a heart transplant recipient, became GCV-resistant after 1 month of therapy (IC(50)=13.7 micromol/l). These data, together with clinical and virological markers, suggested that a switch to foscarnet was necessary, and good evolution was observed. Thus, assay of CMV susceptibility to GCV could be helpful in clinical management. 相似文献
9.
10.
Ilham Bettahi David Pozo Carmen Osuna Russel J. Reiter Dario Acuña-Castroviejo Juan M. Guerrero 《Journal of pineal research》1996,20(4):205-210
Abstract: In this report, rat hypothalamic nitric oxide synthase (NOS) activity is shown to be partially inhibited by physiological concentrations of the pineal hormone melatonin. In vitro studies demonstrate that 1 nM melatonin, which approximates the physiological concentration of the hormone at night, significantly inhibited NOS activity. In vivo studies show that administering melatonin or collecting the hypothalamus from animals at night, when endogenous melatonin levels are elevated, results in a significant decrease of NOS activity. Results also show that calmodulin may be involved in this process since its presence in the incubation medium prevents the inhibitory effect of melatonin on NOS activity. 相似文献