Transfusión autóloga diferida en cirugía primaria de prótesis total de cadera

Se analizan los resultados obtenidos mediante transfusión autóloga diferida (TAD) en 50 pacientes intervenidos de prótesis total primaria de cadera. Las extracciones de sangre se realizaron con una semana de intervalo, transcurriendo al menos 72 horas entre la última extracción y la intervención. El total de unidades extraídas para TAD ha sido 100, transfundiéndose 77, lo que supuso el 91% de la sangre transfundida a estos pacientes. 8 pacientes precisaron la transfusión de 1 unidad de sangre homóloga. No se produjeron reacciones adversas ni durante la extracción ni tras la transfusión y los pacientes recuperaron sus cifras normales de hemoglobina y hematocrito al cabo de 1 mes de la intervención. La TAD es un procedimiento sencillo y eficaz de reposición de sangre en cirugía programada de cadera.The results of deferred autologous blood transfusion in 50 patients who underwent total hip replacement are analyzed. Patients donated blood in weekly bases, last donation 72 hours before surgery. A total of 100 units were obtained by this method and 77 of them were used, wich means 91% of the blood transfused to these patients. Eight patients were transfused with homologue blood. No adverse reactions could be observed either in relation with the autodonation of blood or the autotransfusion. One month after surgery, all patients showed hemoglobin and hematocrit whitin normal limits. Autologous transfusion is a simple and efficacious procedure of blood replacement in primary hip arthroplasty

Luminescence Sensors Applied to Water Analysis of Organic Pollutants—An Update

The development of chemical sensors for environmental analysis based on fluorescence, phosphorescence and chemiluminescence signals continues to be a dynamic topic within the sensor field. This review covers the fundamentals of this type of sensors, and an update on recent works devoted to quantifying organic pollutants in environmental waters, focusing on advances since about 2005. Among the wide variety of these contaminants, special attention has been paid polycyclic aromatic hydrocarbons, pesticides, explosives and emerging organic pollutants. The potential of coupling optical sensors with multivariate calibration methods in order to improve the selectivity is also discussed

Physiological changes during pregnancy and gestational diabetes

La diabetes gestacional es una enfermedad endocrino-metabólica que aparece o se diagnostica por primera vez durante el embarazo y que se caracteriza por un estado de intolerancia a la glucosa, provocado en parte por los cambios metabólicos y hormonales que acontecen durante el embarazo. Actualmente, es la enfermedad más frecuente asociada a la gestación. La importancia del estudio de esta patología radica en las potenciales complicaciones sobre la salud materna y/o fetal, así como en su impacto socio-económico. En este trabajo se revisarán los principales aspectos relacionados con la diabetes gestacional, tales como su prevalencia, factores de riesgo, diagnóstico y las principales estrategias de tratamiento. Con independencia de los criterios diagnósticos empleados, la intervención precoz es fundamental para reducir las complicaciones materno-fetales derivadas de la elevación de la glucemia. El profesional de enfermería es una figura clave dentro del proceso educativo y en la atención a la mujer con diabetes gestacional, cuyo principal objetivo deberá ser conseguir un adecuado control glucémico mediante la adquisición de hábitos de vida saludables y/o terapia farmacológica, reduciendo de esta manera las complicaciones asociadas a la enfermedad.Gestational diabetes is a metabolic disease that appears or is diagnosed for the first time during pregnancy and is characterized by a state of glucose intolerance, caused by the hormonal and metabolic changes that occur during pregnancy. Is currently the most frequent disease associated with pregnancy. The importance of its study lies in the potential maternal or fetal health complications, as well as its socio-economic impact. In this work the main aspects related to gestational diabetes, such as its prevalence, risk factors, diagnosis and the main treatment strategies will be revised. Regardless of the diagnostic criteria used, early intervention is critical to reduce fetal complications arising from the elevation of blood sugar. Professional nursing is a key figure within the educational process and in the attention to women with gestational diabetes, whose main objective should be to get a proper glycemic control through the acquisition of healthy lifestyle habits or drug therapy, thus reducing the complications associated with the disease.Grado en Enfermerí

Association between socioeconomic status and survival after a first episode of myocardial infarction

Background: A low socioeconomic status is associated with higher overall mortality rates. Aim: To assess the effect of socioeconomic inequalities on survival of patients hospitalized with a first myocardial infarction. Material and Methods: Analysis of hospital discharge and mortality databases of the Ministry of Health. Patients aged over 15 years discharged between 2002 and 2011 with a first myocardial infarction (code I-21, ICD-10) were identified. Their survival was verified with the mortality registry. Survival from 0 to 28 and from 29 to 365 days was analyzed. Socioeconomic status was determined using the type of health insurance, stratified as public insurance (low and medium status) and private insurance (high status). Prais-Winsten trend (P-W) and Cox survival analyses were done. Results: We analyzed 59,557 patients (69% males). Sixty three percent were of low socioeconomic status, 19% medium and 18% high. Between 2002 and 2011 the increase in survival was higher among patients of low socioeconomic status, mainly in women (P-W coefficients 0.58:0.31-0.86 in men and 1.12:0.84-1.41 in women for 0-28 days survival and 0.24:0.09-0.39 in men and 0.48:0.37-0.60 in women for 29-365 days survival, respectively). However, age and year of hospitalization adjusted analysis showed a higher mortality risk among patients of low socioeconomic status at 0-28 days ( HR 1.67:1.53-1.83 for men and 1.49:1.34-1.66 for women) and at 29-365 days (HR 2.30: 1.75-2.71 for men and 1.90:1.56-1.85 for women). Conclusions: Survival after a myocardial infarction improved in the last decade especially in patients of low socioeconomic status. However, subjects of this stratum continue to have a higher mortality.Fondo concursable para el apoyo a la investigación, Insituto de Salud Poblacional - Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile

Color doppler ultrasound assessment of activity in keloids

BACKGROUND The assessment of activity in keloids may be critical for defining their management. There is a lack of clinical scorings designed for the evaluation of keloids and biopsies may be contraindicated. OBJECTIVE To assess the sonographic activity of keloids in comparison with clinical scoring. MATERIALS AND METHODS A retrospective study of the clinical and color Doppler ultrasound (CDU) images of patients medically derived to CDU with the diagnosis of keloid was performed. Activity was evaluated clinically (modified Seattle Scar Scale) and CDU. Keloids were considered active when CDU detected vascularity within the lesion. Statistical analysis was performed (Wilcoxon-Mann-Whitney, Student t-test, and interobserver agreement). RESULTS Thirty-five patients with 42 keloids were evaluated. Color Doppler ultrasound provided the diameters, including depth, and vascularity. On CDU, 76% were active and 24% inactive. Clinically, Observer 1 found 55% and Observer 2 found 88% of active keloids. Interobserver agreement between clinical observers was moderate (k = 0.42). Subclinical fistulous tracts, involvement of the hypodermis, muscle, and calcifications were also found on CDU. CONCLUSION Color Doppler ultrasound can support the assessment of activity in keloids. Clinical evaluation alone can underestimate the activity in keloids. Relevant anatomical and subclinical features can be detected by CDU

Engineering application of exergy analysis: Gas recovery system in steel industry

International Conference on Efficiency, Cost, Optimization, Simulation, and Environmental Impact of Energy Systems, ECOS 2010 (23. 2010. Lausanne