3 research outputs found

    Microcirugia en quemados: artículo de revisión

    Get PDF
    Burn injuries are an underappreciated trauma that can affect anyone, anytime, anywhere. Severe burns elicit a complex pattern of responses that can last for years after the initial injury. The WHO estimates that 11 million burn injuries of all kinds occur annually worldwide, 180,000 of which are fatal. Microsurgery is a type of surgery that requires a surgical microscope in most cases, in order to develop an adequate anastomosis of blood vessels. Methodology: A systematic review was carried out through various databases from January 2012 to May 2022; The search and selection of articles was carried out in journals indexed in English and Spanish. Results: To meet the need of the recipient site or the burn injury, a microsurgical free flap is used, which includes a multitude of flaps. Among the main causes that require an early transfer of free tissue we find injuries caused by high voltage electrical injuries. The selection of the free flap depends on the usual parameters established by the recipient site. Conclusions: This review offers updated and detailed information on free tissue transfer, how it is subclassified, risk factors for burns, and the main causes of early and late transfer.Antecedentes: Las lesiones por quemaduras son un trauma subestimado que puede afectar a cualquier persona, en cualquier momento y en cualquier lugar. Las quemaduras graves provocan un patrón complejo de respuestas que pueden durar varios años después de la lesión inicial. La OMS estima que en todo el mundo se producen anualmente 11 millones de lesiones por quemaduras de todo tipo, 180.000 de las cuales son mortales. La microcirugía, es un tipo de cirugía del cual se precisa un microscopio quirúrgico en la mayoría de los casos, con el fin de desarrollar una adecuada anastomosis de vasos sanguíneos. Metodología: Se realizó una revisión sistemática a través de diversas bases de datos de enero de 2012 a mayo de 2022; la búsqueda y selección de artículos fue llevada a cabo en revistas indexadas en idioma inglés y español. Resultados: Para satisfacer la necesidad del sitio receptor o la lesión por la quemadura se utiliza colgajo libre microquirúrgico, la cual incluye una multitud de colgajos. Dentro de las principales causas que requieren una transferencia temprana de tejido libre encontramos las lesiones ocasionadas por lesiones eléctricas de alto voltaje. La selección del colgajo libre depende de los parámetros habituales establecidos por el sitio receptor. Conclusiones: La presente revisión ofrece información actualizada y detallada de la transferencia de tejido libre, como se subclasifica, factores de riesgo de las quemaduras y las principales causas de una transferencia temprana y tardía

    Endocarditis bacteriana: características epidemiológicas

    Get PDF
    Background: Infective endocarditis is an infection of the endothelium of the heart. In the era of interventional cardiology and radiology, infective endocarditis due to Staphylococcus aureus is becoming more relevant. Methodology: A sistematic review was carried out through various databases from January 2016 to July 2022; The search and selection of articles was carried out in journals indexed in English and Spanish. Results: The etiology is variable, among the most frequent agents we can highlight those caused by viridans streptococci, Streptococcus gallolyticus, Staphylococcus aureus, coagulase-negative staphylococci, Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella and enterococci. In developed countries, the incidence of endocarditis ranges between 2.6 and 7 cases per 100,000 inhabitants per year. The median age of patients with endocarditis is 58 years. Conclusions: This review offers updated and detailed information on the main risk factors for bacterial endocarditis that are known to date, as well as reporting on the main bacteria involved in this pathology and which are the most frequent in both the outpatient population. as in the hospital.Antecedentes: La endocarditis infecciosa, es una infección del endotelio del corazón. En la era de la cardiología y radiología intervencionista, la endocarditis infecciosa por Staphylococcus aureus está cobrando mayor relevancia. Metodología: Se realizó una revisión sistematica a través de diversas bases de datos de Enero de 2016 a Julio de 2022; la búsqueda y selección de artículos fue llevada a cabo en revistas indexadas en idioma inglés y español. Resultados: La etiología es variable, dentro de los agentes más frecuentes podemos destacar los causados por estreptococos viridans, Streptococcus gallolyticus, Staphylococcus aureus, estafilococos coagulasa negativos, Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella y enterococos. En los países desarrollados, la incidencia de endocarditis oscila entre 2,6 y 7 casos por 100.000 habitantes al año. La mediana de edad de los pacientes con endocarditis es de 58 años. Conclusiones: La presente revisión ofrece información actualizada y detallada sobre los principales factores de riesgo de la endocarditis bacteriana que se conocen hasta la fecha, al igual que informar sobre las principales bacterias implicadas en esta patología y cuáles son los más frecuentes tanto en la población extrahospitalaria como en la intrahospitalaria

    Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

    Full text link
    Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis
    corecore