Mostrando recursos 1 - 20 de 19.034

  1. Colpocleisis de Le Fort. Modificación de la técnica quirúrgica en un caso de fallo temprano de la cirugía

    Álvarez Díaz, Mirtha María; Montalvo Fernández, Javier; Chala Galindo, Juan Manuel
    La colpocleisis de Le Fort es ideal en pacientes con co-morbilidades que desaconsejen cirugías prolongadas y complejas. En una paciente con prolapso total de órganos pélvicos (POP-Q estadio IV) y tras una cirugía con la técnica clásica que falló, condicionada en gran parte por sus múltiples patologías nos planteamos una modificación de la técnica quirúrgica. Se logró una corrección completa y duradera del prolapso. A los 10 meses de la cirugía la paciente se mantiene asintomática, y con adecuada calidad de vida.

  2. La cirugía de recuperación rápida en las artroplastias de rodilla y cadera. Una actualización

    Molko, S.; Combalia Aleu, Andrés
    Fast-track surgery, or enhanced recovery, has appeared in the last 20 years or so as a combination of the optimisation of clinical protocols and organisational processes, pursuing the reduction in surgical stress with the aim of reducing peri-operative comorbidities, convalescence time, and functional recovery, resulting in a reduction in admission time. After a review of the European literature available on this subject, this article attempts to present an update. It highlights its interest and origins, basically being set out as a response to the question: ‘Why is this patient in Hospital today?’ It also attempts to summarise the essence of such...

  3. Técnica de recuperación acelerada (fast-track) aplicada a cirugía protésica primaria de rodilla y cadera. Análisis de costos y complicaciones

    Wilches, C.; Sulbaran Sierra, José David; Fernández, J.E.; Gisbert Margarit, Josep Mª; Bausili, J. M.; Pelfort López, X.
    Purpose To determine the cost reduction and complication rates of using an enhanced recovery pathway (Fast-track) when compared to traditional recovery in primary total hip replacement (THR) and total knee replacement (TKR), as well as to determine if there were significant differences in complication rates. Material and methods Retrospective review of 100 primary total arthroplasties using the Fast-track recovery system and another 100 using conventional recovery. Gender, Charlston comorbidity index, ASA score, length of stay and early complications were measured, as well in-hospital complications and those in the first six months, re-admissions and transfusion rates. The total and daily cost of stay was...

  4. Un nuevo concepto para un antiguo dolor: «carpalgia», dolor en la muñeca

    Maizo Alemán, L.
    Objetivo Se pretende proponer a la comunidad científica de cirugía ortopédica, traumatología y médica en general el uso de un nuevo término para describir semiológicamente el dolor musculoesquelético de muñeca. Hallazgos Es frecuente en el campo médico el uso términos de raíces grecolatinas. El resultado obtenido se expresa en el neologismo «carpalgia», definiéndose así como el dolor musculoesquelético de la región de la muñeca. Conclusiones El uso de otros términos relacionados con dolor musculoesquelético al nivel del hombro (omalgia), rodilla (gonalgia), metatarso (metatarsalgia), columna vertebral (cervicalgia, dorsalgia, lumbalgia) o la cadera (coxalgia) han demostrado su importancia mediante su aplicabilidad en distintas publicaciones médicas de los...

  5. Cirugía estética y responsabilidad civil:: análisis sistemático de una compleja jurisprudencia

    Gómez Rufián, Luis
    The object of the present research is to lay out the jurisprudence about plastic surgery in the matter of its legal nature and its appropriate rules of lability. Specifically, it studies, though a detailed jurisprudential analysis, ordered chronologically, the causes, condition and consequences of the progressive transformation of the medical duty in plastic surgery with a result type (resemble to a limited period of work contract and ruled with a system of objetive liability) to a means type (resemble to a service lease contract and ruled with a system of subjective liability in which lex artis and patient information have...

  6. Transfusión de hematíes y supervivencia a largo plazo en la cirugía cardíaca no complicada

    Riera Sagrera, María; Ibáñez, J.; Molina, M.; Amézaga, Rocío; Colomar, A.; Carrillo López, A.; Campillo-Artero, C.; Sáez de Ibarra Sánchez, José I.; Bonnín Gubianas, Oriol
    Objective. A study was made to explore the possible association between the perioperative transfusion of 1 - 2 red blood cell units and in-hospital morbidity, 30-day mortality, and long-term survival in patients undergoing heart surgery. Design. A prospective observational study was carried out. Setting. The ICU of a university hospital. Patients. All patients over 17 years of age that underwent heart surgery and were admitted to the ICU between November 2002 and December 2009 were included. Those patients who did not (n = 703) and those who did (n = 959) receive the perioperative transfusion of 1 - 2 red blood cell units...

  7. Demanda futura de procedimientos intervencionistas en cardiopatía estructural. ¿Es sensato realizar TAVI solo en centros con cirugía cardiaca? Respuesta

    Morís de la Tassa, César; Pascual, Isaac; Avanzas, Pablo

  8. Demanda futura de procedimientos intervencionistas en cardiopatía estructural. ¿Es sensato realizar TAVI solo en centros con cirugía cardiaca?

    Lozano, Iñigo; Rondán, Juan; Vegas, José M.; Segovia, Eduardo

  9. Impresión tridimensional de modelos cardiacos: aplicaciones en el campo de la educación médica, la cirugía cardiaca y el intervencionismo estructural

    Valverde, I.
    In recent years, three-dimensional (3D) printed models have been incorporated into cardiology because of their potential usefulness in enhancing understanding of congenital heart disease, surgical planning, and simulation of structural percutaneous interventions. This review provides an introduction to 3D printing technology and identifies the elements needed to construct a 3D model: the types of imaging modalities that can be used, their minimum quality requirements, and the kinds of 3D printers available. The review also assesses the usefulness of 3D printed models in medical education, specialist physician training, and patient communication. We also review the most recent applications of 3D models...

  10. Biomarcadores cardiacos en el síndrome de bajo gasto cardiaco en el posoperatorio de cirugía de cardiopatías congénitas en niños

    Pérez Navero, Juan Luis; Torre Aguilar, M.J. de la; Ibarra de la Rosa, Ignacio; Gil Campos, Mercedes; Gómez Guzmán, E.; Merino Cejas, Carlos; Muñoz Villanueva, María del Carmen; Llorente Cantarero, F.J.
    Introduction and objectives To assess the predictive value of atrial natriuretic peptide, β-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I) as indicators of low cardiac output syndrome in children with congenital heart disease undergoing cardiopulmonary bypass (CPB). Methods After corrective surgery for congenital heart disease under CPB, 117 children (aged 10 days to 180 months) were enrolled in a prospective observational pilot study during a 2-year period. The patients were classified according to whether they developed low cardiac output syndrome. Biomarker levels were measured at 2, 12, 24, and 48 hours post-CPB. The clinical data and outcome variables were...

  11. Spontaneous Coronary Artery Dissection: A Rare Cause of Cardiogenic Shock in Young Women

    Domínguez Pace, María Paz
    La disección coronaria espontánea (DCE) es una causa infrecuente de SCA. Se presenta en mujeres jóvenes, en ocasiones con elevación del segmento ST y se asocia con displasia fibromuscular (DFM)1-2,3,5. Puede manifestarse como disección con rotura intimal o como hematoma intramural. En general,  resuelven espontáneamente con buen pronóstico a largo plazo,1,2,4,5 pero en ocasiones la evolución es más compleja como los casos que presentaremos a continuación.   Caso 1: Mujer de 46 años, sin factores de riesgo. Consultó por angor de 3 horas de duración asociado a síntomas vagales. ECG sin cambios isquémicos, troponinaus 281 ng/L(VN < 14 ng/L) y...

  12. Utilización de segmentos intestinales animales para el entrenamiento en cirugía urológica

    Tobía González, Sebastián Gregorio; Rodríguez, D.
    Este trabajo se enmarca en el proyecto de extensión universitaria de la Cátedra de Urología para urólogos en formación y en el proyecto pedagógico de habilidades y destrezas para ayudantes alumnos de la Cátedra de Anatomía C. El objetivo es lograr el desarrollo de métodos alternativos de aprendizaje quirúrgico en la utilización de segmentos intestinales reproduciendo técnicas quirúrgicas urológicas.

  13. Ocular residual astigmatism’s effect on high myopic astigmatism LASIK surgery

    Teus, Miguel Ángel; Arruabarrena, Carolina; Hernández Verdejo, José Luis; Cañones Zafra, Rafael; Mikropoulos, Dimitrios G.
    Purpose: To analyze the effect of ocular residual astigmatism (ORA) on the effectiveness of LASIK for treating high myopic astigmatism. Methods: This is an observational, cross-sectional study. We studied 116 consecutive myopic eyes with −3 diopters (D) or more of astigmatism that underwent LASIK surgery. The magnitude of uncorrected residual refractive astigmatism 3 months postoperatively was measured. Results: The mean preoperative cylinder was −4.0±0.83 D (range, −7.5 to −3 D) and the mean preoperative ORA was 0.82±0.5 D. The mean residual refractive cylinder 3 months postoperatively was −0.78±0.83 D (range, −3 to 0 D). No correlation was found between ORA and the...

  14. Retinopatía por descompresión después de cirugía intraocular

    Arévalo, J.F.; Mendoza, A.J.; Fernández, C.F.; Yépez, Juan Bautista; Krivoy, D.; Millán, F.A.
    Objective: To report 10 instances of decompression retinopathy (DCR) developing after intraocular surgery. Methods: This was a case series of 9 patients (10 eyes). Decompression retinopathy occurred after trabeculectomy (4 eyes), phacomulsification (3 eyes), Ahmed valve placement (1 eye), silicone oil removal (1 eye) and vitrectomy (1 eye). Fundus evaluation and fluorescein angiography were performed in all instances. Results: Superficial, subhyaloidal, and deep retinal hemorrhages were noted in the posterior pole and peripheral retina; some of these had a white center. Nine (90%) of 10 eyes had a previous diagnosis of glaucoma, 6 having primary open-angle glaucoma, 2 neovascular glaucoma...

  15. Guías y miniplacas personalizadas: un protocolo guiado para cirugía ortognática

    Brunso, Joan; Prol, Carlos; Franco, María; Carlos Villafranca, Félix de; Carmelo Martín, Jesús; Andoni Santamaría, Joseba
    Introduction. Technological advances in preoperative planning and 3D printing allow custom-made biomedical devices to be synthesised using a completely digital workflow. The aim of this paper is to present and critically evaluate a new Orthognathic Positioning System (OPS) for Orthognathic Surgery. The OPS used bone-supported guides and a custom mini-plate to allow maxillary fragment positioning and fixation without the need for an inter-maxillary occlusal splint. Materials and methods. A prospective observational study was conducted on 10 cases of bimaxillary surgery using an inverse planning protocol. The guide and the custom-made mini-plate were designed using CAD-CAM software and synthesised by laser from...

  16. Aplicaciones del colgajo sural medial en cirugía reconstructiva de cavidad oral y orofaringe

    Zubillaga, Ignacio; Redondo, Marta; Sánchez, Gregorio
    Objective. To present a clinical series of medial sural artery perforator flaps, including a review of its applications, characteristics, and related complications. Material and methods. A retrospective study was conducted on 25 patients who underwent oral cavity and oropharynx reconstruction with medial sural artery perforator flap from 2010 to 2013 in the Oral and Maxillofacial Surgery Department of the 12 de Octubre University Hospital (Madrid, Spain). Results. The ages ranged from 18 to 82 years (mean 56.6), with 14 males and 11 females. Of the 25 harvested flaps, 15 were from the left lower limb and 10 from the right. The mean pedicle...

  17. Sistemas de ayuda a la decisión clínica en enfermedades de diagnóstico complejo

    Monsalve Torra, Ana
    El trabajo de investigación presentado en esta tesis doctoral aborda el uso de algoritmos de inteligencia artificial y su aplicación en los sistemas de ayuda para la toma de decisiones en enfermedades de diagnóstico complejo. La dificultad en la gestión clínica de dichas enfermedades requiere un trabajo en conjunto (área de salud e ingeniería informática) y un intercambio de conocimientos, experiencias e información que permita obtener mejores resultados en el proceso de atención de los enfermos. La creación de sistemas que contribuyan en la toma de decisiones tiene como propósito mejorar la calidad de los procesos médico-asistenciales en la predicción...

  18. Edema macular quístico pseudofáquico: Detección mediante «optical coherence tomography»

    Torrón Fernández-Blanco, Clemencia; Ruíz Moreno, Oscar; Ferrer Novella, Eugenio; Sánchez Cano, Ana; Honrubia López, Francisco M.
    Objetivo: Detectar la incidencia de edema macular quístico (EMQ) tras cirugía de catarata tanto clínico como subclínico, mediante «ocular coherence tomography» (OCT) y comparar dicha incidencia entre un grupo de pacientes diabéticos y otro de no diabéticos. Material y métodos: Estudio prospectivo de 260 ojos intervenidos de forma consecutiva de catarata mediante facoemulsificación con implante de lente intraocular acrílica, desde septiembre de 2004 a marzo de 2005. Grupo A: 208 ojos de pacientes no diabéticos, grupo B: 42 ojos de pacientes diabéticos, grupo C: 10 ojos de pacientes diabéticos con edema macular y que recibieron triamcinolona intravítrea (TAIV) al finalizar...

  19. Visión binocular tras cirugía refractiva en pacientes hipermétropes

    Gómez de Liaño, R.; Piedrahita Alonso, Elena; Arias Puente, Alfonso
    Purpose: To evaluate the changes in binocular vision and ocular motility in hyperopic patients undergoing refractive surgery. Methods: Prospective study of 31 consecutive patients who underwent bilateral refractive surgery for hyperopia between May 1999 and February 2002. The examination included best-corrected visual acuity, cycloplegic refraction, ocular motility, fusion at distance, stereopsis and fusional amplitudes, before and at one month, 3 months, 6 months, one year after surgery and annually thereafter. Results: After refractive surgery, there were changes in visual acuity, residual hyperopic refractive errors, and anisometropic changes that influenced the oculomotor status. The most frequent sensory modifications were suppression at...

  20. Uso del hexafluoruro de azufre en la cirugía filtrante del glaucoma

    Abreu Reyes, José Agustín

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