Correction to: Massive Hemothorax Due to Intrathoracic Herniation of the Gastric Remnant After Roux-en-Y Gastric Bypass with Concurrent Hiatal Hernia Repair

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Efecto del tratamiento preoperatorio con estatinas sobre los resultados de la cirugía coronaria

IntroducciónEl uso de estatinas se asocia a una reducción de accidentes coronarios en prevención primaria y secundaria y después de angioplastia primaria.ObjetivoInvestigar si el empleo de estatinas en pacientes sometidos a cirugía de revascularización coronaria (CRC) se asocia a beneficio clínico.MétodosSe incluyeron 102 pacientes consecutivos con enfermedad coronaria para CRC electiva y aislada. En el momento de la inclusión se registró el tratamiento preoperatorio y las variables clínicas basales. En el seguimiento se registró la aparición de muerte de origen cardíaco e infarto agudo de miocardio (IAM) en los primeros 30 días.ResultadosRecibían estatinas 61 pacientes (60%) frente a 41 (40%) que no las recibían. No se encontraron diferencias significativas entre ambas poblaciones respecto a las características basales. A los 30 días se produjo una muerte cardíaca (1,6%) en el grupo que recibió estatinas, frente a cinco (12,2%) en el grupo que no las recibían (p=0,02), el IAM ocurrió en cuatro (6,6%) frente a 8 (19,5%) (p=0,04) y el resultado compuesto de muerte cardíaca o IAM ocurrió en cinco (8,2%) frente a 10 (24,4%) (p=0,02). En un modelo multivariado, el tratamiento preoperatorio con estatinas se mantuvo como un factor independiente de predicción (p=0,01; odds ratio [OR]: 3,6) de la aparición de muerte de causa cardíaca o IAM durante los primeros 30 días después de la intervención.ConclusiónEl tratamiento previo con estatinas se asocia de forma significativa e independiente a un menor riesgo de IAM o muerte de origen cardíaco en pacientes sometidos a CRC.IntroductionStatin treatment diminishes adverse cardiac events both in primary and secondary prevention and also after percutaneous coronary intervention.ObjectiveTo study if preoperative statin treatment is associated with any clinical advantage after coronary artery surgery.MethodsWe enrolled 102 consecutive patients with coronary artery disease, scheduled for elective coronary artery surgery. Combined procedures were excluded. Preoperative treatment and the clinical baseline characteristics were recorded in all patients at inclusion. Cardiac death and acute myocardial infarction (AMI) were recorded during the first 30 days.ResultsSixty one patients (60%) were on preoperative statin treatment vs. 41 (40%) who were not. There were no differences at baseline level between both groups. There was one cardiac death at 30 days (1.6%) in the statin-treatment group vs. five deaths (12.2%) in the nostatin group (p=0.02). Acute myocardial infarction presented in four (6.6%) vs. eight (19.5%) (p=0.04). The primary combined cardiac endpoint made of cardiac death or AMI occurred in five (8.2%) vs. 10 (24.4%) (p=0.02). In a multivariate model, preoperative statin treatment remained an independent predictor (p=0.01; odds ratio [OR] 3.6) of cardiac death or AMI during the first 30 days after surgery.ConclusionPreoperative statin-treatment was significative and independently associated with less risk of AMI or cardiath death in patients who underwent coronary artery bypass grafting

Resultados clínicos y flebográficos del tratamiento trombolítico con urokinasa por vía locoregional en 102 casos de trombosis venosa profunda /Norberto Cassinello Martínez ; directores Pascual Parrilla Paricio, Pablo Ramírez Romero.

Tesis-Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 431.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-1229

Circulating TNF-α and its soluble receptors during experimental acute pancreatitis

Clinical and experimental studies have shown increased concentrations of TNF-α and its soluble receptors in serum of patients with acute pancreatitis. In this work, we have investigated the time-course of TNF-α and its soluble receptors during taurocholate-induced acute pancreatitis. In addition, since TNF-α itself could mediate the shedding of its receptors, we have assessed the effect of inhibiting TNF-α production on the release of soluble TNF-α receptors in experimental acute pancreatitis. Our results indicate that soluble receptors are released in the early stages of the disease and this increase is concomitant with the release of TNF-α, which is mainly bound to specific proteins. The increased concentrations of its receptors strongly suggest that they could be these binding proteins. Inhibition of TNF-α generation with pentoxifylline abrogated the shedding of sTNF-αR1, but had no effect on sTNF-αR2. This finding suggests that the shedding of sTNF-αR1 is induced by TNF-α itself, but in the case of sTNF-αR2, the shedding appears to be induced by another mechanism. © 2003 Elsevier Ltd. All rights reserved.This work was supported by grants GV01-137 from Generalitat Valenciana, 1FD1997-1616 from Ministerio de Ciencia y Tecnologı́a and 01/0949 FIS form Ministerio de Sanidad y Consumo; S. Granell was supported by a grant from IDIBAPSPeer Reviewe