[Organ and tissue donation and transplantation: three health care centers' attitude]. / Actitud hacia la donación y el trasplante de órganos y tejidos de tres instituciones de salud.

OBJECTIVE: To assess the knowledge and attitude towards organ donation within health professionals in different institutions of Nuevo Leon. METHODS: A prospective, open, observational, descriptive study of parallel groups, through application of a survey formulated by the Hospital Universitario (HU) "Dr. José Eleuterio González". We applied 208 surveys in the HU (n = 100) and other institutions like IMSS, ISSTE (n = 108). RESULTS: From all the participants, 86% had a positive attitude towards organ donation, associated to a higher education, and information regarding organ donation received by other health professionals. Though having a positive attitude toward organ donation, 14% of health professionals don't support it due to being afraid of not receiving medical assistance, knowing their status of donators, religious reasons, and fear of organ trafficking. CONCLUSIONS: Our study shows that, even within the health professionals, there is a need for information regarding organ donation. A well-instructed health professional shows a higher interest in organ donation; this could have a positive impact in the attitude of the population toward organ donation, as well as in the obtainment of organs inside the medical institutions.

5-Year management and outcomes of penetrating neck injury in a trauma center. Penetrating neck injury.

BACKGROUND: Penetrating neck injuries represent 5-10% of all traumatic injuries, these bring with them a high rate of morbidity and mortality due to vital structures that could be injured in this area. The aim of this study was to determine the epidemiological and clinical characteristics of penetrating neck injuries. METHODS: This was a retrospective, unicentric and descriptive study that included all patients who underwent neck exploration surgery. RESULTS: A total of 70 neck exploration cases were reviewed, 34 (49%) didn't had any injury. Thirty (43%) had at least one hard sign, 42 (60%) patients showed at least one soft sign. Statistical analysis showed only surgical time (252±199.5 vs. 155±76.4; p=0.020) and transfusions (1.87±3 vs. 0.4±0.856; p=0.013) were statistically significant. We report a mortality of 2 (3%) patients. CONCLUSIONS: Our prevalence of neck surgical exploration without vascular injury was slightly higher (49% vs. 40%) than literature. We highlight the importance of not performing neck explorations in all patients who present a penetrating injury. We did not obtain differences between groups for hard signs and soft signs. We were not able to identify whether or not there would be an injury based on clinical characteristics. Imaging studies should be performed to avoid unnecessary neck explorations; however, depending on the clinical scenario some surgery cannot be avoided.

Complications and treatment to liver wound by gunshot. A retrospective approach.

INTRODUCCIÓN: Un trauma penetrante puede dañar una variedad de órganos. Dado que el hígado es un órgano sólido inelástico, no tiene la tolerancia al estiramiento necesaria para hacer frente a una herida por proyectil de arma de fuego (GSW). MÉTODOS: Este fue un estudio retrospectivo, observacional y descriptivo de 53 registros clínicos de pacientes ingresados en el Departamento de Cirugía por trauma hepático (LT) por un GSW. RESULTADOS: Del total de historias clínicas analizadas, el 89% de los pacientes presentaron una lesión asociada con LT. La lesión orgánica asociada más frecuente fue la torácica, específicamente la lesión pulmonar, en el 58%. El predictor más importante de mortalidad fue una estancia en la unidad de cuidados intensivos (UCI), que aumentó el riesgo unas 21 veces. CONCLUSIÓN: Una estadía en la UCI, seguida de la presencia de fracturas, fue el predictor más importante de mortalidad. Se necesitan nuevas medidas de pronóstico para contrarrestar las variables que ha creado el aumento de GSW, además de disminuir el tiempo de espera desde el evento traumático hasta el tratamiento relevante. INTRODUCTION: A penetrating trauma can damage a variety of organs. Since the liver is an inelastic solid organ, it does not have the necessary stretch tolerance to cope with a gunshot wound (GSW). METHODS: This was a retrospective, observational, and descriptive study of 53 clinical records of patients admitted to the Department of Surgery for liver trauma (LT) by a GSW. RESULTS: Of the total clinical records analyzed, 89% of the patients presented a lesion associated with LT. The most common associated organic lesion was thoracic, specifically lung injury, in 58%. The most important predictor of mortality was a stay in the intensive care unit (ICU), which increased the risk about 21 times. CONCLUSION: A stay in the ICU, followed by the presence of fractures, was the most important predictor of mortality. New prognostic measures are needed to counteract the variables that the increase in GSWs has created, in addition to decreasing the waiting time from the traumatic event to relevant treatment.

Prognosis of mortality and evolution in pancreatoduodenal trauma in patients with wound by projectile of firearm.

BACKGROUND: The wounds caused by the firearm projectile are published to date in a public health problem in the world. As an example, we mentioned the injuries caused by firearms are the first cause of death in the age group between 1 to 19 years in the United States, as in Mexico. OBJECTIVE: Analysis of the prognostic factors of mortality and evaluation of the evolution in patients with TPD due to abdominal HPPAF. METHOD: Retrospective, observational, descriptive study. Helped by 49 clinical files of patients who were admitted to the department of surgery of the University Hospital José Eleuterio González, between 2011 to 2015 and whose diagnosis was due to pancreatic trauma (TP), duodenal trauma (TD) or pancreatoduodenal trauma (TPD) by wounds caused by the firearm projectile. RESULTS: During a collection period of 5 years, a total of 49 clinical records applicable to the study were obtained according to the inclusion criteria, of which 36 (73%) suffered only from TD, 37 (75%) from TP and 24 (49%) about TPD. Significant differences were obtained for mortality associated with TD and TPD, but not for TP. The most affected organ as a lesion associated with a TPD was the liver, followed by thoracic structures and the stomach. The most significant risk factor for mortality was a prolonged stay in the intensive care unit. CONCLUSIONS: Data obtained are consistent with those consulted, providing new reproducible statistics for future studies regarding the increasing violence in our country and around the world.

ANTECEDENTES: Las heridas por proyectil de arma de fuego constituyen un problema de salud pública en el mundo. Como ejemplo mencionamos que este tipo de lesiones son la primera causa de muerte en el grupo de edad de 1 a 19 años en los EE.UU., al igual que en México. OBJETIVO: Análisis de los factores pronósticos de mortalidad y evaluación de la evolución en pacientes con TPD por HPPAF abdominal. MÉTODO: Estudio retrospectivo, observacional y descriptivo, realizado con 49 expedientes clínicos de pacientes que fueron admitidos en el departamento de cirugía del Hospital Universitario José Eleuterio González entre los años 2011 y 2015, cuyo diagnostico fue herida por proyectil de arma de fuego con trauma pancreático (TP), duodenal (TD) o pancreatoduodenal (TPD). RESULTADOS: Durante un periodo de recolección de 5 años se obtuvieron 49 expedientes clínicos aplicables al estudio según los criterios de inclusión, de los cuales 36 pacientes (73%) sufrieron únicamente TD, 37 (75%) TP y 24 (49%) TPD. Se obtuvieron diferencias significativas para la mortalidad asociada a TD y TPD, pero no para TP. El órgano más afectado como lesión asociada a un TPD fue el hígado, seguido de las estructuras torácicas y el estómago. El factor de riesgo para mortalidad más significativo fue una estancia prolongada en la unidad de cuidados intensivos. CONCLUSIONES: Los datos conseguidos concuerdan con los consultados, otorgando nueva estadística reproducible para futuros estudios respecto a la violencia creciente en nuestro país y alrededor del mundo.