3 research outputs found
Post-surgical complications in patients undergoing radical cystectomy according to the patient’s nutritional status
Introducción: La cistectomía radical es el tratamiento de elección para los tumores vesicales musculo-invasivos presentando una gran morbilidad y una considerable tasa de mortalidad. Un factor importante a tener en cuenta es el estado nutricional del paciente ya que puede impactar de forma negativa en la evolución clínica de los pacientes. Material y métodos: Realizamos un estudio retrospectivo de las cistectomías realizadas entre 2012 y 2015 en el servicio de Urología de HU Son Espases y se evalúa la aparición de complicaciones postoperatorias según el estado nutricional calórico calculado a través del IMC, el estado nutricional proteico calculado a través de la albúmina postoperatoria inmediata y el estado nutricional inmunológico a través de los linfocitos totales. Resultados: Presentaron alguna complicación el 42% de los pacientes. Un 21% presentaron únicamente una complicación Clavien II y un 21% presentaron una complicación mayor a Clavien III o más de una complicación. Se encontraron diferencias estadísticamente significativas según el estado nutricional proteico (Normal-leve vs moderado-grave) en la fuga de la anastomosis uretero-ileal. No se encontraron diferencias en el resto de variables. Conclusiones: La mayoría de pacientes sometidos a cistectomía radical con derivación urinaria tipo intestinal presentan algún estado de malnutrición proteica postoperatoria. En nuestra serie, el estado nutricional proteico del paciente presenta una relación con la aparición de fuga de la anastomosis uretero-ileal.Radical cystectomy is the election treatment for muscle-invasive bladder tumors presenting a high morbidity and significant mortality rate. An important factor to consider is the nutritional status of the patient because it can negatively impact the clinical course of patients. Methods: We perfomed a retrospective study of radical cystectomies with intestinal conduct between 2012 and 2015 in the department of Urology in HU Espases and we evaluated the postoperative complications according to the caloric nutritional status calculated by BMI, protein nutritional status calculated by the immediate postoperative albumin and the inmunological nutritional status by total account of lymphocites. Results: Developed complications the 42% of patients. 21% had only one complication Clavien II and 21% had one complication Clavien III or more than one complication. We found statistically significant differences with the protein nutritional status (mild Normal-vs moderate to severe) in the escape of the ureter-ileal anastomosis. No differences in the other variables were found. Conclusions: Most patients undergoing radical cystectomy with intestinal conduct type have a postoperative state of protein malnutrition. In our series, the protein nutritional status of the patient has a relationship with the occurrence of leakage from the ureter-ileal anastomosis
Recommended from our members
Vascular Reactivity Profile of Novel KCa 3.1-Selective Positive-Gating Modulators in the Coronary Vascular Bed.
Opening of intermediate-conductance calcium-activated potassium channels (KC a 3.1) produces membrane hyperpolarization in the vascular endothelium. Here, we studied the ability of two new KC a 3.1-selective positive-gating modulators, SKA-111 and SKA-121, to (1) evoke porcine endothelial cell KC a 3.1 membrane hyperpolarization, (2) induce endothelium-dependent and, particularly, endothelium-derived hyperpolarization (EDH)-type relaxation in porcine coronary arteries (PCA) and (3) influence coronary artery tone in isolated rat hearts. In whole-cell patch-clamp experiments on endothelial cells of PCA (PCAEC), KC a currents evoked by bradykinin (BK) were potentiated ≈7-fold by either SKA-111 or SKA-121 (both at 1 μM) and were blocked by a KC a 3.1 blocker, TRAM-34. In membrane potential measurements, SKA-111 and SKA-121 augmented bradykinin-induced hyperpolarization. Isometric tension measurements in large- and small-calibre PCA showed that SKA-111 and SKA-121 potentiated endothelium-dependent relaxation with intact NO synthesis and EDH-type relaxation to BK by ≈2-fold. Potentiation of the BK response was prevented by KC a 3.1 inhibition. In Langendorff-perfused rat hearts, SKA-111 potentiated coronary vasodilation elicited by BK. In conclusion, our data show that positive-gating modulation of KC a 3.1 channels improves BK-induced membrane hyperpolarization and endothelium-dependent relaxation in small and large PCA as well as in the coronary circulation of rats. Positive-gating modulators of KC a 3.1 could be therapeutically useful to improve coronary blood flow and counteract impaired coronary endothelial dysfunction in cardiovascular disease