Citrato de fentanyl a diferentes dosis en su capacidad protectora ante los cambios hemodinámicos posterior a la intubación orotraqueal en pacientes de cirugía abdominal, en Hospital Nacional de Santiago de María, año 2015

La presente investigación surge como respuesta a la necesidad de comparar diferentes dosis de citrato de fentanyl en su capacidad protectora de los cambios en la presión arterial sistólica, diastólica, media, frecuencia cardíaca y saturación de oxígeno posterior a la intubación orotraqueal. Esto insistió a formular el Tema: Citrato de fentanyl a diferentes dosis en su capacidad protectora ante los cambios hemodinámicos posterior a la intubación orotraqueal en pacientes de cirugía abdominal, en hospital nacional de Santiago de María, año 2015. Por ello se elaboró el Objetivo: Comparar citrato de fentanyl a diferentes dosis en su capacidad protectora ante los cambios hemodinámicos posterior a la intubación orotraqueal. Se construyó la Metodología base de estudio: La investigación es de tipo ensayo clínico controlado, ya que evaluamos experimentalmente el fentanil a diferentes dosis y se controlaron las variables. La selección de los pacientes se realizó mediante la determinación de criterios de inclusión. Los instrumentos que se utilizaron para la obtención de la información son la guía de observación, en la cual se llevó un control y monitoreo continuo de los signos vitales de los pacientes que formaron parte de la investigación. Asimismo se obtuvieron los Resultados que fueron procesados por medio del sistema SPSS versión 19, determinando si tenían una distribución normal mediante Shapiro-Wilk dependiendo de esto se le aplicaron pruebas estadísticas de T-Student, U de Mann Whitney, determinando que el fentanyl a dosis de 4 mcg/kg proporciona una mayor estabilidad en los cambios hemodinámicos que se dan posterior a la intubación orotraqueal.

Emerging pathogens in the central nervous system: a cerebral abscess by Streptococcus porcinus

Brain abscesses can cause an incapacitating neurological deicit in up to 50% of patients, thus the reduction of these sequelae becomes the main goal of its timely and speciic surgical and medical treatment. With technological advances in bacteriological identiication and diagnostic imaging, the clinical suspicion can be conirmed, and the speciic etiological agent can be identiied in a larger number of cases. New pathogens have emerged through this process, such as Streptococcus porcinus, in which the ability to affect the central nervous system has not been documented. A clinical case is presented of a brain abscess in an immunocompetent patient, and its favorable response to surgical drainage t hrough a skull burr h ole and nee dle aspiration with antibiotic therapy (ceftriaxone, metronidazole and vancomycin) is discussed.

Formación de adherencias peritoneales comparando el uso de lactato de Ringer y solución salina al 0.9 a 37 grados Celsius en la cavidad abdominal de ratas wistar

Después de una laparotomía del 70 al 95de pacientes tienen algún grado de adherencias, las que se manifestarán dependiendo de su consistencia y ubicación con cuadros clínicos de obstrucción intestinal agudos o crónicos, dolor abdominal crónico de casa no bien definido, dispareunias, infertilidad. El tratar la causa y el lavado de cavidad peritoneal son puntales principales en el tratamiento de la inflamación peritoneal desencadenante de la formación de adherencias. Para el lavado los cristaloides son los más indicados y de ellos la solución salñina y el lactato de Ringer los más usados. El objetivo fue conocer la capacidad para disminuir la formación de adherencias intraabdominales con el uso de lactato de ringer en comparación con la solución salina al contacto con el peritoneo, en ausencia de patología abdominal, en ratas Wistar. Para esto se realizó un estudio experimental clínico controlado aleatorizado en ratas wistar de laboratorio, formando dos grupos de 38 especímenes en cada uno, que cumplan los criterios de inclusión y exclusión, a las cuales les introdujo 5cc, de lactato de ringer y el otro grupo 5cc de solución salina al 0.9a 37 grados Celsius en la cavidad abdominal por punción con aguja Verres. A las 6 semanas se sacrificó a los animales y se realizó una valoración de las adherencias con clasificación macroscópica y estudio microscópico. De 75 casos, 35 del grupo de Lactato de Ringer y 36 del grupo de Solución salina, solamente 3 (8,10) ratas del grupo de Lactato de Ringer y 3 (7,89) del grupo de Solución Salina presentaron adherencias intraperitoneales. RR: 0,97 (0,18-5,15)

Prevalence of General and Abdominal Obesity in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study

Background: Pediatric obesity is one of the predisposing risk factors for many non-communicable diseases. Objectives: The purpose of this study was to estimate the national prevalence of general and abdominal obesity among Iranian children and adolescents. Patients and Methods: This cross-sectional nation-wide study was performed in 30 provinces in Iran among 14880 school students aged 6 – 18 years, selected by multistage random cluster sampling. The World Health Organization growth curve was used to categorize Body Mass Index (BMI). Obesity was defined as BMI equal to or higher than the age- and gender-specific 95th percentile; abdominal obesity was considered as waist-to-height ratio of more than 0.5. Results: Data of 13486 out of 14880 invited students were complete (response rate of 90.6%). They consisted of 6543 girls and 75.6% urban residents, and had a mean age of 12.45 (95% CI: 12.40 - 12.51) years. The prevalence rate of general and abdominal obesity was 11.89% (13.58% of boys vs. 10.15% of girls) and 19.12% (20.41% of boys vs. 17.79% of girls), respectively. The highest frequency of obesity was found in the middle school students (13.87% general and 20.84% abdominal obesity). The highest prevalence of general obesity was found in Boushehr (19%) followed by Guilan and Mazandaran (18.3%, 18.3%), while the lowest prevalence was observed in Hormozgan (2.6%). The highest frequency of abdominal obesity was found in Mazandaran (30.2%), Ardabil (29.2%) and Tehran (27.9%). Provinces such as Sistan-Baloochestan (8.4%), Hormozagan (7.4%), and Kerman (11.4%) had the lowest prevalence of abdominal obesity. The Southern and South Eastern provinces had the lowest prevalence of general obesity (2.6% and 5.6%) and abdominal obesity (7.4% and 8.8%). Moreover, the highest prevalence of obesity was found in North and North West Iran by maximum frequency of 18.3% general obesity and 30.2% of abdominal obesity. Conclusions: The results showed a high prevalence of general and abdominal obesity among boys living in the Northern provinces of Iran. The present study provides insights that policy makers should consider action-oriented interventions for prevention and control of childhood obesity at national and sub-national level.

Study of new physiological characteristics as protein receptors (RP55) of light, color, heat, motion, smell, electric, vibration and position located in head, body and abdominal, found in mosquito larvae.

The main objective of the research is to demonstrate new physiological characteristics receptors in the presence of mosquito larvae. 100 larvae of different species were collected and studied for a week in periods of 8-24 hrs. Larvae stages I, II, III and IV have photo-thermo receptors of light and heat housed in the body is divided into head, thorax and abdomen, perceive hot or cold environments, and have fibers in chest or hairs lining your body or abdomen, and a pair of antennae on the head. Stages II and III are more developed than the initial stages. They are attracted by the dark green at the bottom, a pair of eyes that perceive light and color. Have receptors proteins (RP55) that capture motion at a speed the slightest movement of waves in the water. Its nose is not well developed but have chemoreceptors. They adapt to changes in pH in alkaline media, are sensitive to chemical, thermal and mechanical changes nociceptors have electroreceptors or galvanoreceptores sensitive to electrical stimuli, have mechanoreceptors that are sensitive to touch, pain, pressure, gravity, sound. They have a GPS position that seems the guides. It is precisely in the fibers, mushrooms or bristles are recipients along with the micro villi in head, thorax and abdomen.
RESUMEN El objetivo principal de la investigación es demostrar nuevas características fisiológicas como la presencia de receptores en las larvas de mosquitos. Se recolectaron 100 larvas de diferentes especies y se estudiaron por una semana en periodos de 8 a 24 hrs. Las larvas de los estadios I,II,III y IV tienen foto-termo receptores de luz y calor alojados en el cuerpo que se divide en cabeza, tórax y abdomen, perciben ambientes fríos o calientes, así como tienen fibras en tórax o pelos que recubren su cuerpo, y un par de antenas en la cabeza. Los estadios II y III son más desarrollados que las etapas iniciales. Tienen receptores proteicos RP55. Les atrae el color verde oscuro en el fondo, un par de ojos que perciben la luz y color con fotoreceptores. Tienen receptores RP55 de movimiento que captan a una velocidad el más mínimo movimiento de ondas en el agua. Su olfato no está muy desarrollado pero tienen quimioreceptores. Se adaptan a cambios de pH en medios alcalinos, tienen nociceptores sensibles a cambios químicos, térmicos y mecánicos, tienen galvanoreceptores o electroreceptores sensibles a estímulos eléctricos, tienen mecanoreceptores que son sensibles al tacto, dolor, presión gravedad, sonido. Tienen un GPS de posición que pareciera las orienta.

Determinación de la frecuencia de infección en el sitio operatorio en pacientes intervenidos quirúrgicamente de cirugía abdominal de emergencia en el Hospital Vicente Corral Moscoso julio-enero 2006-2007

Se realizó un estudio transversal; en un universo de 180 pacientes. Los datos se obtuvieron por entrevista y se analizaron con el software Epi-Info. Resultados La prevalencia de de infección del sitio de la herida quirúrgica fue del 10.6. La asociación con el sobrepeso proporcionó una p= 0.93, razón de prevalencia (PR) 0.96, (IC 950.4-2.3); con la evolución del cuadro clínico mayor a 12 horas p=0.11, PR 2.9 (IC 950.7-12.1); con patología clínica coexistente p=0.006, PR 3.1 (IC 951.3-7.3); con más de 60minutos de exposición al acto quirúrgico se infectaron el 12.3de pacientes. En los hombres la prevalencia fue del 10.3(IC 953.9-16.7), en las mujeres del 10.8(IC 954.5-17.1); en los pacientes mayores a 64 años fue del 5.3(IC 950-15) y en los menores a 64 del 11.2(IC 956.3-16.1). Conclusión: la prevalencia de infección del sitio de la herida quirúrgica fue del 10.6. Se encontró asociación significativa con la patología clínica asociada, con la herida contaminada y sucia y con el acto quirúrgico mayor a 60 minutos de exposición

A Randomized Double-Blind Placebo-Controlled Trial of Lactobacillus reuteri for Chronic Functional Abdominal Pain in Children

Background: Functional abdominal pain (FAP) is one of the most common diseases, and large percentages of children suffer from it. Objectives: The purpose of the study was to evaluate the effect of Lactobacillus reuteri in treatment of children with functional abdominal pain. Patients and Methods: This study was a randomized double-blind placebo-controlled trial. Children aged 4 to 16 years with chronic functional abdominal pain (based on Rome III criteria) were enrolled in the study. They were randomly divided into two groups, one receiving probiotic and the other placebo. Results: Forty children received probiotic and forty others placebo. There were no significant differences in age, weight, sex, location of pain, associated symptoms, frequency and intensity of pain between the groups. The severity and frequency of abdominal pain in the first month compared to baseline was significantly less and at the end of the second month, there was no significant difference between both groups compared to the end of the first month. Conclusions: This study showed that the severity of pain was significantly reduced in both groups. There was no significant difference in pain scores between them. The effect of probiotic and placebo can probably be attributed to psychological effect of the drugs.

Validación del ECOFAST en trauma abdominal. Hospital Vicente Corral. Cuenca 2007

Con un diseño descriptivo y una muestra propositiva se incluyeron, desde el 1 de abril de 2006 hasta el 30 de marzo de 2007, cincuenta y cinco pacientes con diagnóstico de trauma abdominal que acudieron a la emergencia del Hospital Vicente Corral a quienes se realizó ECOFAST. De estos cuarenta y tres entraron al quirófano para laparotomía; y doce permanecieron en observación con evaluación favorable y fueron dados de alta. El análisis, considerando como prueba de oro la presencia de líquido libre en cavidad tras laparotomía, se basó en la sensibilidad, especificidad y razón de verosimilitud positiva y negativa. La sensibilidad fue del 81.82 por ciento (IC95 por ciento: 61.14 a 96.49 por ciento), la especificidad del 90 por ciento (IC 95 por ciento: 66.41 a 100 por ciento), la razón de verosimilitud positiva 8.18 (IC 95 por ciento: 2.40 a - 11.6 por ciento) y la razón de verosimilitud negativa del 4.95 (IC95 por ciento: 2.28 a 21.63). El trauma contuso predominó en esta revisión en un 58.1 por ciento y la mayoría de veces causado por accidentes automovilísticos. En el análisis de los resultados encontramos un promedio de edad de 33 más menos 16.8 años. El ECOFAST es un método diagnóstico confiable en la predicción de lesiones intraabdominales en pacientes con trauma abdominal que requieren laparotomía

Threshold values of sagittal abdominal diameter for the detection of cardio-metabolic risk factors in Northeastern Mexico: a cross-sectional study

Background: The use of sagittal abdominal diameter (SAD) has been proposed for screening cardio-metabolic risk factors; however, its accuracy can be influenced by the choice of thresholds values. Aim: To determine the SAD threshold values for cardio-metabolic risk factors in Mexican adults; to assess whether parallel and serial SAD testing can improve waist circumference (WC) sensitivity and specificity; and to analyze the effect of considering SAD along with WC and body mass index (BMI) in detecting cardio-metabolic risk. Methods: This cross-sectional study was conducted during 2012-2014 in Northeast Mexico (n = 269). Data on anthropometric, clinical, and biochemical measurements were collected. Sex-adjusted receiver-operating characteristic curves (ROC) were obtained using hypertension, dysglycemia, dyslipidemia and insulin resistance as individual outcomes and metabolic syndrome as a composite outcome. Age-adjusted odds ratios and 95% confidence intervals (CI) were estimated using logistic regression. Results: The threshold value for SAD with acceptable combination of sensitivity and specificity was 24.6 cm in men and 22.5 cm in women. Parallel SAD testing improved WC sensitivity and serial testing improved WC specificity. The co-occurrence of high WC/high SAD increased the risk for insulin resistance by 2.4-fold (95% CI: 1.1-5.3), high BMI/high SAD by 4.3-fold (95% CI: 1.7-11.9) and SAD alone by 2.2-fold (95% CI: 1.2.-4.2). Conclusions: The use of SAD together with traditional obesity indices such as WC and BMI has advantages over using either of these indices alone. SAD may be a powerful screening tool for interventions for high-risk individuals.

Ejercicios adecuados de resistencia abdominal: una herramienta para la prevención contra lumbalgias

El propósito de este artículo fue el de analizar la técnica tradicional de los ejercicios abdominales, con el fin de dar recomendaciones alternativas que garanticen una buena ejecución sin riesgos. Además, presenta algunas recomendaciones que ayudarán a prescribir ejercicio abdominal para la salud.

Aproximación a la exploración ecográfica abdominal en primates de la especie Saguinus leucopus

Bogotá (Colombia): Universidad de La Salle. Facultad de Ciencias Agropecuarias. Programa de Medicina Veterinaria

Desenlaces en pacientes embarazadas con patología quirúrgica abdominal 2011-2014

Estudio transversal realizado entre 2011 y 2014 en la Clínica de la Mujer con el fin de describir el comportamiento de la salud el binomio madre hijo en gestantes que requirieron manejo quirúrgico de patologías quirúrgicas abdominales no ginecobstétricas.

FAST-E en Pacientes con Trauma Abdominal Cerrado Estable, en un Departamento de Urgencias en Colombia

El impacto que ha generado el trauma en Colombia a lo largo de la historia, nos ha obligado a mejorar y adaptar diferentes tipos de sistemas de atención en trauma, basados en los lineamientos internacionales, los cuales buscan evitar el significativo aumento en las tasas de mortalidad y discapacidad que se obtienen de este, especialmente en los servicios de Emergencias en los cuales se reciben el 100% de estos pacientes con traumatismo múltiple o politraumatismo. Dentro de este grupo de pacientes hay un subgrupo que son las pacientes con trauma de abdomen que cursan con estabilidad hemodinámica y además son clasificados de bajo riesgo, ya sea por índices de trauma o por otros métodos como la medición sérica de lactato, los cuales tienen un papel poco despreciable al momento de ver mortalidad y discapacidad por trauma, ya sea penetrante o cerrado; en este trabajo específicamente nos centramos en las personas que consultan al servicio de Emergencias con trauma cerrado de abdomen los cuales son considerados de bajo riesgo, siendo este subgrupo de pacientes uno de los más difíciles de abordar y enfocar al momento de la valoración inicial, ya que se debe tener la seguridad de que no hay lesiones que comprometen la vida y por consiguiente estos pacientes puedan ser dados de alta.

CO2-EVAR: An innovative approach to Automated Carbon Dioxide Angiography during Endovascular Abdominal Aortic Aneurysm repair

Objectives CO2-EVAR was proposed for treatment of AAA especially in patients with CKD. Issues regarding standardization, such as visualization of lowest renal artery (LoRA) and quality image in angiographies performed from pigtail or introducer-sheath, are still unsolved. Aim of the study was to analyze different steps of CO2-EVAR to create an operative protocol to standardize the procedure. Methods Patients undergoing CO2-EVAR were prospectively enrolled in 5 European centers (2018-2021). CO2-EVAR was performed using an automated injector. LoRA visualization and image quality (1-4) were analyzed and compared at different procedure steps: preoperative CO2-angiography from Pigtail/Introducer-sheath (1st Step), angiographies from Pigtail at 0%,50%,100% main body (MB) deployment (2nd Step), contralateral hypogastric artery (CHA) visualization with CO2 injection from femoral Introducer-sheath (3rd Step) and completion angiogram from Pigtail/Introducer-sheath (4th Step). Intra-/postoperative adverse events were evaluated. Results Sixty-five patients undergoing CO2-EVAR were enrolled, 55/65(84.5%) male, median age 75(11.5) years. Median ICM was 20(54)cc; 19/65(29.2%) procedures were performed with 0-iodine. 1st Step: median image quality was significantly higher with CO2 injected from femoral introducer [Pigtail2(3)vs.3(3)Introducer,p=.008]. 2nd Step: LoRA was more frequently detected at 50% (93%vs.73.2%, p=.002) and 100% (94.1%vs.78.4%, p=.01) of MB deployment compared with first angiography from Pigtail; image quality was significantly higher at 50% [3(3)vs.2(3),p=<.001] and 100% [4(3) vs.2(3),p=.001] of MB deployment. CHA was detected in 93% cases (3rd Step). Mean image quality was significantly higher when final angiogram (4th Step) was performed from introducer (Pigtail2.6±1.1vs.3.1±0.9Introducer,p=<.001). Rates of intra-/postoperative adverse events (pain,vomit,diarrhea) were 7.7% and 12.5%. Conclusions Preimplant CO2-angiography should be performed from Introducer-sheath. MB steric bulk during its deployment should be used to improve image quality and LoRA visualization with CO2. CHA can be satisfactorily visualized with CO2. Completion CO2-angiogram should be performed from femoral Introducer-sheath. This operative protocol allows to perform CO2-EVAR with minimal ICM and low rate of mild complications.

Development of a hydrogel construct to prevent endoleaks occurrence following endovascular abdominal aortic aneurysm repair

Abdominal aortic aneurysm is the pathological dilation of the abdominal tract of the aorta and, if left untreated, could undergo rupture with a mortality rate of up to 90%. EVAR is the most common method for AAA treatment consisting in the internal coverage of the aorta with a metallic stent to isolate the aneurysmatic segment from the systemic circulation. Although EVAR technical success rate is high, reinterventions are common. Among the causes of reinterventions typeII endoleaks are the most frequent and consist in retrograde blood flow into the aneurysmal sac from collateral aortic branches. Continued perfusion of the aneurysm sac may lead to aneurysm rupture, therefore AAA sac embolization is performed using metallic coils. However, the presence of artifacts caused by the presence of metallic coils is a limitation because they are radiopaque and can hamper the endoleak during imaging follow-up. This study is aimed at developing a biocompatible hydrogel that could be injected into the aneurysmal sac and may allow a selective intraprocedural sac embolization to reduce post procedural typeII endoleak and eventual AAA rupture. P(BT75BSI25) was synthesized by polycondensation and its biocompatibility tested to assess whether the polymers had no toxic effects. HUVEC cell line was used to mimic the environment in which the polymer would be in contact with, PBS was used as a positive control and MTT assay was performed to evaluate cellular viability after being in contact with the hydrogel. MTT assay showed no significant difference between PBS and P(BT75BSI25), thus the polymer is biocompatible, as confirmed by the analysis of apoptosis by flow cytometry. An aromatic copolymer was obtained via polycondensation and was found to be biocompatible in contact with endothelial cells. This suggests that the hydrogel could be potentially used in the clinical setting for the treatment of type II endoleak after EVAR.