Hidrops fetal no inmune por parvovirus: manejo mediante transfusión intrauterina

Fetal hydrops is the abnormal accumulation of fluid in at least 2 fetal compartments. Its origin can be immune or non-immune. Parvovirus B19 is responsible for a significant part of non-immune hydrops cases. The fetal prognosis is poor with high mortality. We present a clinical case of a pregnant woman with a fetus affected by non-immune hydrops secondary to severe anemia after infection with parvovirus B19, managed by intrauterine transfusion.El Hidrops fetal es la acumulación anormal de líquido en al menos 2 compartimientos fetales. Su origen puede ser inmune o no inmune. El parvovirus B19 es responsable de una parte importante de los casos de hidrops no inmune. El pronóstico fetal ante esta entidad, es malo, y presenta alta mortalidad. Se presentar un caso clínico de una gestante con un feto afectado por hidrops no inmune secundario a anemia severa, causada por infección fetal por parvovirus B19, manejado mediante transfusión sanguínea fetal intrauterina

Módulo de adquisición para prueba de esfuerzo cardiovascular (MAPEC)

Uno de los procedimientos diagnósticos de Cardiopatía Isquémica es el electrocardiograma de esfuerzo, mejor conocido como Prueba de Esfuerzo Cardiovascular. La Prueba de Esfuerzo Cardiovascular evalúa alteraciones funcionales de la circulación coronaria independientes de los cambios anatómicos del vaso coronario. Así, el ejerc:cio realizado por un individuo durante la prueba debe ser lo más cercano al máximo de su capacidad. Una de las formas con las que a través de la Prueba de Esfuerzo Cardiovascular se estima el nivel máximo de ejercicio es por medio del cálculo del consumo máximo de oxígeno, el cual guarda una estrecha relación lineal con la frecuencia cardiaca máxima alcanzada y es independiente del nivel de entrenamiento físico del paciente. Teniendo en cuenta esto, El Módulo de Adquisición para Prueba de esfuerzo Cardiovascular, MAPEC, optimiza la adquisición del electrocardiograma de esfuerzo y además la toma directa del registro de la concentración de oxígeno para la estimación del consumo de oxígeno durante la realización del ejercicio. El Módulo de Adquisición para Prueba de Esfuerzo permite la adquisición, procesamiento y visualización del electrocardiograma de esfuerzo de doce derivaciones y del consumo máximo de oxígeno, brindando al médico una herramienta eficiente y eficaz para estimar la prevalencia de la cardiopatía lsquémica

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Pasados y presente. Estudios para el profesor Ricardo García Cárcel

Ricardo García Cárcel (Requena, 1948) estudió Historia en Valencia bajo el magisterio de Joan Reglà, con quien formó parte del primer profesorado de historia moderna en la Universidad Autónoma de Barcelona. En esta universidad, desde hace prácticamente cincuenta años, ha desarrollado una extraordinaria labor docente y de investigación marcada por un sagaz instinto histórico, que le ha convertido en pionero de casi todo lo que ha estudiado: las Germanías, la historia de la Cataluña moderna, la Inquisición, las culturas del Siglo de Oro, la Leyenda Negra, Felipe II, Felipe V, Austrias y Borbones, la guerra de la Independencia, la historia cultural, los mitos de la historia de España... Muy pocos tienen su capacidad para reflexionar, ordenar, analizar, conceptualizar y proponer una visión amplia y llena de matices sobre el pasado y las interpretaciones historiográficas. A su laboriosidad inimitable se añade una dedicación sin límites en el asesoramiento de alumnos e investigadores e impulsando revistas, dosieres, seminarios o publicaciones colectivas. Una mínima correspondencia a su generosidad lo constituye este volumen a manera de ineludible agradecimiento