Estadísticas

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      "titulo" => "Técnica del colgajo romboidal en el tratamiento del sinus pilonidal crónico. Nuestra experiencia en 20 casos"
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          "autoresLista" => "M Romero Simó, E Marcote Valdivieso, G Manzanet Andrés, A Torner Pardo, M Canales López"
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    "titulo" => "Modificaciones del intercambio gaseoso y del shunt pulmonar en un modelo experimental de hemorragia aguda"
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        "titulo" => "Factors predictive of complications in patients with perforated gastroduodenal ulcer"
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        "resumen" => "<span class="elsevierStyleBold">Introducci&#243;n&#46;</span> La hemorragia constituye un hecho relativamente frecuente en el &#225;mbito quir&#250;rgico&#46; El conocimiento de la fisiopatolog&#237;a del shock hemorr&#225;gico permite la correcta toma de decisiones terap&#233;uticas&#46; El objetivo del estudio es analizar las modificaciones en el shunt pulmonar &#40;Qs&#47;Qt&#41; y el intercambio gaseoso que la hemorragia induce en un modelo experimental canino&#46; <span class="elsevierStyleBold">Material y m&#233;todos&#46;</span> Dieciocho perros anestesiados y monitorizados sometidos a hemorragia gradual seg&#250;n la clasificaci&#243;n de shock hemorr&#225;gico del Colegio Americano de Cirujanos&#44; en los siguientes estadios&#58; B &#40;basal&#41;&#44; I &#40;15&#37;&#41;&#44; Ib &#40;20&#37;&#41;&#44; II &#40;25&#37;&#41;&#44; IIb &#40;30&#37;&#41; y III &#40;35&#37; de la volemia perdida&#41;&#46; Registro de los valores hemodin&#225;micos y de las gasometr&#237;as arteriales y venosas durante cada uno de los estadios&#46; <br/> <span class="elsevierStyleBold">Resultados&#46;</span> La hemorragia indujo un descenso de las presiones de llenado card&#237;aco y del gasto card&#237;aco&#46; El descenso del gasto card&#237;aco se asoci&#243; a un descenso significativo del Qs&#47;Qt desde el estadio I &#40;p &#60; 0&#44;05&#41;&#46; No se presentaron modificaciones significativas de la PaO2&#44; ni de la diferencia alveolo-arterial de O2 &#40;DA-a O2&#41; a pesar de descensos significativos de la PvO2&#46; Se observ&#243; un progresivo incremento de las diferencias arteriovenosas de PCO2 &#40;Da-v PCO2&#41;&#44; expresi&#243;n de la isquemia tisular&#46; <br/> <span class="elsevierStyleBold">Conclusiones&#46;</span> El descenso del gasto card&#237;aco durante la hemorragia induce un descenso concomitante del Qs&#47;Qt&#59; este descenso del shunt pulmonar permite mantener la PaO2 a pesar de descensos de la PvO2&#46; El mecanismo responsable ser&#237;a una potenciaci&#243;n de la vasoconstricci&#243;n pulmonar hip&#243;xica durante el descenso del gasto card&#237;aco"
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        "resumen" => "<span class="elsevierStyleBold">Objectives&#46;</span> To determine the predictive factors of mortality and morbidity in patients undergoing surgery for perforated gastroduodenal ulcer&#46; <br/> <span class="elsevierStyleBold">Patients and methods&#46;</span> A retrospective study was carried out of 131 consecutive patients treated surgically for perforated gastroduodenal ulcer&#46; The parameters assessed were patient age and sex&#44; the interval between initial onset and surgery&#44; additional risk factors&#44; surgical technique&#44; leukocyte count&#44; blood glucose level&#44; urea&#44; hemoglobin&#44; duration of surgery&#44; presence of pneumoperitoneum&#44; intraoperative hypotension and degree of peritonitis&#46; <br/> <span class="elsevierStyleBold">Results&#46;</span> The rate of morbidity in this series was 20&#37; and the mortality&#44; 13&#37;&#46; The factor identified as significant predictors of morbidity and mortality were&#58; age&#44; sex&#44; associated risk factors&#44; an interval of more than 24 hours&#44; preoperative blood glucose and urea levels&#44; a leukocyte count of less than 10&#44;000 cells&#44; absence of pneumoperitoneum&#44; intraoperative hypotension and the presence of purulent peritonitis&#46; This system made it possible to identify 23 of the 27 patients who developed complications&#46; <br/> <span class="elsevierStyleBold">Conclusions&#46;</span>&#46; In female patients over 70 years of age with associated medical diseases&#44; an interval of more than 24 hours&#44; blood glucose level over 150&#44; urea level over 35&#44; leukocyte count under 10&#44;000&#44; intraoperative hypotension and the presence of purulent peritonitis&#44; the therapy of choice would probably be laparoscopic suture of the ulcer together with lavage and drainage of the abdominal cavity"
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