Tratamiento de la hernia inguinal bilateral con malla autoadhesiva en régimen de cirugía ambulatoria. ¿Un nuevo estándar? / Bilateral inguinal hernia repair with self-gripping mess in Day Surgery setting: a new standard?

Introducción: El empleo de mallas confeccionadas con materiales parcialmente reabsorbibles y un diseño que permite que se fijen al tejido sin suturas se plantea como estándar terapéutico en la hernioplastia inguinal bilateral, disminuyendo los tiempos quirúrgicos y mejorando el dolor y la recuperación postoperatoria y, por tanto, favoreciendo la ambulatorización del proceso. Material y métodos: Estudio retrospectivo a través de la historia clínica electrónica (IANUS) de 58 pacientes intervenidos en nuestro servicio en el periodo comprendido entre enero de 2011 y marzo de 2013. Resultados: Se han intervenido en la unidad de cirugía mayor ambulatoria (UCMA) 34 pacientes (58,6 %) y 24 (41,4 %) en régimen de cirugía de tarde. De los pacientes intervenidos en UCMA, solo 3 (8,8 %) precisaron ingreso. De los operados de tarde, 14 (58 %) tuvieron más de una pernocta. Sufrieron dolor agudo intenso 8 pacientes, 4 intervenidos en programa de cirugía ambulatoria y 4 en cirugía de tarde. Presentaron hematomas postoperatorios 8 pacientes, la mayoría intervenidos en cirugía de tarde, estado físico ASA III y tratados con antiagregantes o anticoagulantes. Conclusiones: La hernioplastia inguinal bilateral con malla autoadhesiva en UCMA es un procedimiento ambulatorizable casi al 100 %. Puede plantearse como nuevo estándar en el tratamiento ambulatorio de las hernias inguinales bilaterales (AU)

Introduction: The use of meshes made with partially absorbable materials and a design that allows the tissue to be fixed without sutures, is considered as a therapeutic standard in the bilateral inguinal hernia repair, decreasing surgery time and improving the pain and the postoperative recovery, and for that, helping the ambulatorization of the process. Material and methods: A retrospective study using the electronic medical record (IANUS) of 58 patients operated in our Service in the period between January 2011 and March 2013. Results: The patients are males in 95 % of the cases. 58.6 % underwent surgery in our outpatient surgery unit, 8.8 % needed to be admitted to hospital 41.4 % were operated in the regime of evening surgery, having to sleep overnight 58 %. 8 patients suffered severe acute pain, 4 were operated in ambulatory surgery and 4 in evening surgery. 8 patients had postoperative haematomas, the majority had been operated the evening before, were ASA III and treated with antiplatelet drugs or anticoagulants. Conclusion: The bilateral inguinal hernia repair with self-gripping mesh in our outpatient surgery unit is a day-case episode nearly 100 %. It can be considered as a new standard in the outpatient treatment of the bilateral inguinal hernias (AU)

Macroamilasemia en pediatría / Macroamylasemia in paediatrics

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Filariasis ocular por Loa loa. ¿Parasitosis tropical emergente en Europa? / Ocular filariasis due to Loa-loa. An emerging tropical parasitosis in Europe?

No disponible

Implantación de receta XXI en el Centro de Salud de Benahadux (Almería) / Introduction of XXI rrescription in the Benahadux Health Centre (Almería, Spain)

No disponible

[Nutritional risk in patients with pulmonary tuberculosis: the patient's or the health services' problem?]. / Riesgo nutricional en pacientes con tuberculosis pulmonar: cuestión del paciente o de los servicios de salud?

OBJECTIVE: To determine nutritional risk factors in a population of patients with pulmonary tuberculosis (PT). MATERIAL AND METHODS: During 1997, one-hundred and eighty-five patients with PT were chosen at random from two health institutions in Monterrey, Nuevo León, México. Variables analyzed were: anthropometric measures, socioeconomic status, utilization of the nutrition clinic, access to foodstuffs, adverse reactions to drugs, and disease attributable to malnutrition. Statistical analysis consisted of descriptive, bivariate, and multivariate logistic regression, in addition to prevalence ratios and 95% confidence intervals. RESULTS: The mean age was 42.4 +/- 19.9 years. The mean body mass index was 19.8 +/- 3.2; 57% of patients presented malnutrition; 26% of them were referred to the nutrition clinic, 24.3% of whom actually attended it. Multivariate analysis showed that adverse reactions of tuberculosis drugs were risk factors for malnutrition, independent of age, gender, education, occupation, year of diagnosis and access to foodstuffs, disease attributable, and utilization of the nutrition clinic. (chi 2 = 10.58; p = 0.051, R2 = 0.42). CONCLUSIONS: Nutritional risk in patients with pulmonary tuberculosis is both a patient and a health services issue. The high prevalence of malnutrition, the low utilization rate of nutritional services, and the effect of adverse reactions to therapeutic drugs, justify the need to focus attention on this particular group of patients.

Thixotropic behavior of a microcrystalline cellulose-sodium carboxymethylcellulose gel.

An extensive study has been made of the thixotropic behavior of a microcrystalline cellulose-sodium carboxymethylcellulose gel (2% weight) and of its modification due to physical factors such as agitation time, duration of storage at rest, and temperature. An empirical function, giving thixotropic area variation rate as a function of agitation time, was obtained and found to be practically independent of storage time.