RESUMEN
Cytoprotective effects on the liver of somatostatin (ST) and octreotide (OT) have been previously described in normothermic ischemia-reperfusion models. The purpose of this study was an enzymatic and morphological assessment of hepatic cytoprotective effects during extended cold storage. Rat livers were washed in situ via the portal vein with University of Wisconsin solution (UW) UW+ST, or UW+OT. After 24 or 48 hours of cold ischemia time (CIT), livers were reperfused for 2 hours via the portal vein with oxygenated KHB at 37 degrees C using a nonrecirculating ex situ isolated perfusion system. Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatinine kinase (CK) were assessed in the perfusate during ex situ isolated reperfusion. After a 24-hour cold ischemia time (CIT) ALT, LDH, and CK levels were significantly lower (P < .05) in the UW+ST and the UW+OT livers than the UW livers. After 48-hour CIT, AST, ALT, LDH, and CK levels were significantly lower (P < .05) in the UW+ST and the UW+OT livers than the UW livers. Histopathological examination revealed mild differences after 24-hour CIT but an evidently less ischemically damage organ after 48-hour CIT. With the limitations of an in vitro model, ST and OT showed enzymatic and morphological effects during extended liver preservation.
Asunto(s)
Hígado/citología , Octreótido/farmacología , Preservación de Órganos/métodos , Somatostatina/farmacología , Animales , Hígado/efectos de los fármacos , Hígado/fisiología , Pruebas de Función Hepática , Vena Porta/fisiología , RatasRESUMEN
Measurements of electrical impedance were performed to assess ischemic damage in the rabbit liver during long-term preservation with University of Wisconsin (UW) or histidine-tryptophan-ketoglutarate (HTK) solution. The impedance was measured at a frequency of 200 Hz after in situ perfusion and after cold storage for 24 and 48 hours in UW or HTK solution (six livers per group). Z(200 Hz) was significantly higher (P < .01) after 48 compared with 24 hours of cold storage with both protection solutions without significant differences between the livers preserved with both solutions. Electrical impedance was observed to be a sensitive indicator of liver damage during long-term protection, showing similar preservation quality for both preservation solutions.
Asunto(s)
Hígado/fisiología , Animales , Impedancia Eléctrica , Hepatectomía/métodos , Modelos Animales , Preservación de Órganos , Soluciones Preservantes de Órganos , Conejos , Recolección de Tejidos y Órganos/métodosRESUMEN
Renal paratransplant hernia constitutes an unusual variant of internal hernia caused by entrapment of bowel through a defect in the peritoneum covering the transplanted kidney. Only three cases have been previously reported. We present three new cases of renal paratransplant hernia. Abdominal pain and vomiting were the main symptoms. Clinical diagnosis of bowel obstruction and paratransplant hernia was reached using abdominal CT scan. All patients underwent an emergency surgical procedure, and one patient needed resection of necrotic bowel. The three patients survived owing to early surgical intervention, and they were discharged asymptomatic. Paratransplant hernia represented 1.1% of our series of transplant patients. Early diagnosis and surgical treatment are esential in transplant patients with bowel obstruction to avoid high morbidity and mortality rates.
Asunto(s)
Dolor Abdominal/diagnóstico , Hernia/etiología , Trasplante de Riñón/efectos adversos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnósticoRESUMEN
OBJECTIVES: The aim of this study was to quantify the frequency of nosocomial infection in the general surgery service of a tertiary-care hospital and to identify associated risk factors. METHODS: A prospective, longitudinal, descriptive and analytical study was made from January 1995 to December 1998 of a clinical cohort of 2794 patients who underwent a surgical procedure with a post-surgery stay of more than 48 h. The criteria for infection were those defined by the Center for Disease Control and Prevention (CDC) of the USA. RESULTS: The most frequent nosocomial infection was surgical infection (SI), with a global cumulative incidence (CI) of 7.7%, ranging from 3.4% for clean surgery to 23.7% for dirty surgery. The next most frequent were urinary tract infection (UTI) and bacteremia (1.5%) and nosocomial pneumonia (NP) (0.5%). The global CI of SI decreased from 11.7% in 1995 to 4% in 1998. An ASA classification higher than 2 multiplied the risk of SI by 1.76; with respect to UTI multiplied the risk by 2.13; the risk of NP by 5.93 and multiplied the risk of B by 4.72. CONCLUSIONS: The most frequent nosocomial infection was surgical infection. An ASA higher than 2, the stay prior to surgery; the number of days with a urinary catheter, with a central venous catheter and with mechanical ventilation; as well as the improvement in the use of antimicrobial prophylaxis, were all factors that influenced the frequency of nosocomial infection.
Asunto(s)
Infección Hospitalaria/epidemiología , Servicio de Cirugía en Hospital , Infección de la Herida Quirúrgica/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/epidemiología , Niño , Preescolar , Femenino , Unidades Hospitalarias , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Neumonía/epidemiología , Estudios Prospectivos , Factores de Riesgo , Infecciones Urinarias/epidemiologíaRESUMEN
Septic arthritis is a relatively common disease, but reports of septic arthritis caused by fungi are still rare and it is often associated with predisposing factors that reduce cellular immunity (alcoholism, cancer, endogenous or exogenous hypercortisolism, intravenous drug abuse). Articular conditions caused by Scedosporium apiospermum are uncommon. Here we report the case of a 32-year-old immunocompetent male with septic arthritis caused by S. apiospermum and review 12 other cases.
Asunto(s)
Artritis Infecciosa/microbiología , Micetoma/microbiología , Scedosporium/aislamiento & purificación , Adulto , Antifúngicos/uso terapéutico , Artritis Infecciosa/tratamiento farmacológico , Humanos , Inmunocompetencia , Itraconazol/uso terapéutico , Masculino , Pruebas de Sensibilidad Microbiana , Micetoma/tratamiento farmacológico , Scedosporium/efectos de los fármacosRESUMEN
OBJECTIVE: Total gastrectomy for advanced gastric cancer is frequently combined with extended lymphadenectomy. This technique is easier when resection of distal pancreas and/or spleen is performed. We have tried to evaluate whether the resection of both structures and total gastrectomy in patients with advanced gastric cancer actually improve survival rates. PATIENTS: From 1991 to 1999, 140 patients with advanced gastric cancer underwent total gastrectomy at the General Hospital of Albacete: 43 with simple total gastrectomy, 57 with total gastrectomy plus splenectomy and 40 with total gastrectomy plus distal pancreaticosplenectomy. Univariate and multivariate analysis were conducted in order to evaluate different prognostic factors and survival curves among the groups. RESULTS: Survival rates of the three groups were compared for each factor, being only significant variables the degree of tumor infiltration in the gastric wall, the size of the tumor, the staging and the type of lymphatic infiltration. Neither splenectomy nor distal pancreaticosplenectomy improved the survival compared to simple total gastrectomy. Morbimortality rates increased with more aggressive surgical procedures, but differences were not significant. CONCLUSIONS: Resection of distal pancreas and/or spleen plus total gastrectomy for advanced gastric cancer is associated to a greater number of isolated lymph nodes, but do not improve the survival of patients.
Asunto(s)
Gastrectomía/métodos , Pancreatectomía/métodos , Esplenectomía/métodos , Neoplasias Gástricas/cirugía , Anciano , Análisis de Varianza , Femenino , Gastrectomía/mortalidad , Humanos , Escisión del Ganglio Linfático/mortalidad , Masculino , Persona de Mediana Edad , Pancreatectomía/mortalidad , Esplenectomía/mortalidad , Neoplasias Gástricas/mortalidad , Tasa de SupervivenciaAsunto(s)
Apendicectomía , Apendicitis/cirugía , Cálculos/complicaciones , Enfermedades del Ciego/complicaciones , Divertículo/complicaciones , Adulto , Cálculos/diagnóstico , Enfermedades del Ciego/diagnóstico , Divertículo/diagnóstico , Humanos , Hallazgos Incidentales , Periodo Intraoperatorio , MasculinoAsunto(s)
Apendicectomía/efectos adversos , Apendicitis/cirugía , Colecistitis/etiología , Enfermedad Aguda , Niño , Femenino , HumanosAsunto(s)
Enfisema/inducido químicamente , Enfisema/patología , Alucinógenos/efectos adversos , Enfisema Mediastínico/inducido químicamente , Enfisema Mediastínico/patología , N-Metil-3,4-metilenodioxianfetamina/efectos adversos , Enfermedades del Cuello del Útero/inducido químicamente , Enfermedades del Cuello del Útero/patología , Adulto , Femenino , Humanos , Tomografía Computarizada por Rayos XAsunto(s)
Enfermedades Óseas/diagnóstico , Equinococosis Hepática/diagnóstico , Equinococosis/diagnóstico , Enfermedades Musculares/diagnóstico , Enfermedades Óseas/cirugía , Terapia Combinada , Equinococosis/cirugía , Equinococosis Hepática/cirugía , Humanos , Masculino , Mebendazol/administración & dosificación , Persona de Mediana Edad , Enfermedades Musculares/cirugía , Cuidados PosoperatoriosAsunto(s)
Pólipos Intestinales/complicaciones , Intususcepción/etiología , Neoplasias del Yeyuno/complicaciones , Dolor Abdominal/etiología , Adulto , Urgencias Médicas , Femenino , Humanos , Pólipos Intestinales/cirugía , Intususcepción/diagnóstico por imagen , Intususcepción/cirugía , Neoplasias del Yeyuno/cirugía , RadiografíaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Niño , Apendicectomía/efectos adversos , Apendicitis/cirugía , Colecistitis/etiología , Enfermedad AgudaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Apendicectomía , Apendicitis/cirugía , Cálculos/complicaciones , Enfermedades del Ciego/complicaciones , Divertículo/complicaciones , Cálculos/diagnóstico , Enfermedades del Ciego/diagnóstico , Divertículo/diagnóstico , Hallazgos Incidentales , Periodo IntraoperatorioRESUMEN
No disponible