Manejo y resultados de pacientes con diverticulitis aguda: experiencia de cinco años en el Hospital San Vicente Fundación / Management and results of patients with acute diverticulitis. Five year-experience at the San Vicente Fundación Hospital

Introducción. Los datos epidemiológicos de la diverticulitis en Colombia son limitados. El objetivo de este artículo fue caracterizar una población que ingresó con diverticulitis aguda al Hospital Universitario San Vicente Fundación, un centro de referencia de la ciudad de Medellín, Colombia, para analizar la presentación y comportamiento de la enfermedad en la población local, con estadísticas propias y desenlaces de la enfermedad en los últimos años. Métodos. Estudio observacional retrospectivo, descriptivo, entre enero de 2015 y diciembre de 2019. Se hizo un estudio exploratorio uni-, bi- y multivariado de factores de riesgo para fallo en el tratamiento y la mortalidad. Resultados. Se incluyeron 103 pacientes. Se presentó principalmente en mujeres y la edad promedio fue de 65 años. La diverticulitis Hinchey Ia fue la más frecuente (41,7 %) y el manejo médico fue exitoso en todos los casos, mientras que en las tipo III y IV, todos se manejaron de forma quirúrgica, con tasas de éxito entre el 50 y el 64 %. La presencia de signos de irritación peritoneal al examen físico, el recuento de leucocitos y la PCR, el ingreso a la Unidad de Cuidados Intensivos y la mortalidad aumentaron de forma directamente proporcional con el estadio de Hinchey. Conclusiones. Existe una relación directamente proporcional entre la clasificación de Hinchey y los signos de respuesta inflamatoria clínicos y paraclínicos, la necesidad de manejo quirúrgico, la estancia en la Unidad de Cuidados Intensivos y la mortalidad.

Introduction. Epidemiological data on diverticulitis in Colombia are limited. The objective of this article was to characterize a population that was admitted with acute diverticulitis to the San Vicente Fundación University Hospital, a reference center in the city of Medellín, Colombia, to analyze the presentation and behavior of the disease in the local population, with its own statistics, and outcomes of the disease in recent years. Methods. Retrospective descriptive observational study between January 2015 and December 2019. An exploratory uni-, bi- and multivariate study of risk factors for treatment failure and mortality was performed. Results. A total of 103 patients were included. The most frequent Hinchey classification was Ia (41.7%). It occurs mainly in women, mean age 65 years. Hinchey Ia diverticulitis is the most frequent and medical management is successful in 100% of cases; while in III and IV, 100% were managed surgically with success rates between 50 and 64%. The presence of peritoneal signs on physical examination, leukocyte count and CRP, ICU admission and mortality increased directly proportional with Hinchey stage. Conclusions. There is a directly proportional relationship between Hinchey staging with clinical and paraclinical signs of inflammatory response, need for surgical management, ICU stay and mortality.

Power from Geothermal Resources as a Co-product of the Oil and Gas Industry: A Review.

The increase in the global demand for energy and fossil fuel dependency is hindering efforts to reduce greenhouse gas (GHG) emissions. Geothermal resources supplement this increase in energy demand with reduced emissions because of their availability, base-load production profile, and climatic independence. Despite these advantages, the development of geothermal energy is limited because of different reasons such as subsurface exploration risk and high upfront capital cost for drilling and facility construction. However, similarities in infrastructure and operations between the oil and gas industry and the geothermal industry can optimize expense and development when exploiting geothermal resources. Thus, in this review, we present recent advances and applications of geothermal power systems in the oil and gas industry starting from the fundamentals and basic principles of geothermal energy and the organic Rankine cycle (ORC). These applications include the use of geothermal resources via abandoned wells, active wells, and paired thermal enhanced oil recovery processes with injection for fluid heating and energy production. Abandoned wells are alternatives that reduce costs in geothermal energy-use projects. The use of geothermal resources via active wells allows the valorization of a resource, such as the production of water, which is considered a byproduct of production activities in an oilfield. The use of thermally enhanced oil recovery processes enhances the energy conditions of fluids produced in the field, improving geothermal systems with fluids at higher temperatures. Finally, an overview is presented of the challenges and opportunities of geothermal energy in the oil industry where the requirement to improve the usage of technologies, such as the ORCs, with the working fluids used in the cycles, is highlighted. Furthermore, the importance of environmental studies and use of novel tools, such as nanotechnology, to improve the efficiency of geothermal energy usage is highlighted.