Predictive capacity of risk indices in pulmonary resections

Pulmonary and cardiac complications are known to be the most frequent causes of morbidity and mortality after thoracic surgery. We attempted to correlate the relationship between the complications with preoperatively cardiac, pulmonary and cardiopulmonary risk indices in patients undergoing pulmonary resections. Complicatiosn in 15 consecutive patients with high cardiac (GoldmanÝs index); pulmonary (TorringtonÝs index) or cardiopulmonary (exercise capacity less than 3 METS) risk indices were compared with 31 consecutive patients without that risk factores. Nineteen complications developed in 15 patients in the high risk group and 4 complications occurred in 31 patients in the low risk group (p<0.0001). Death occurred in 8 patients in the high risk group, there were no deaths in the low risk group. Causes of death were: Pneumonia 4; Contralateral bronchial obstruction 1; Cardiac death 1; Pulmonary Embolism 1 and Sepsis 1 patient. Patients assigned to Goldman cardiac index = 3 or 4; Torrington pulmonary index = 3 and maximal exercise capacity tower than 3 METS correlated well with high morbidity and mortality. Using together the three indices, sensitivity was similar but specificity was better: all the patients who eventually died postoperatively had been preoperatively assigned to the high risk group. Our findings suggest that outcome and severity of complications after resective pulmonary surgery correlate with high risk cardiac, pulmonary and/or cardiopulmonary predictive indices.

Correlacion entre los clearance de amilasa y de creatinina en las pancreatitis agudas y otras patologias. / Correlation of the clearance of amylase and creatinine in acute pancreatitis and other pathologies

Del estudio de 151 pacientes, entre los cuales se contaron 30 normales, 19 pancreatitis agudas y 102 con diversas patologias, ha podido confirmarse el valor diagnostico del ACCR en las pancreatitis en el 89,4%. La prolongada elevacion del ACCR coincidio con pancreatitis graves, e incluso su ascenso en el curso de la enfermedad indico un nuevo brote evolutivo de necrosis.Se comprueba la no confiabilidad absoluta en presencia de clearance de creatinina anormal y se efectuan consideraciones sobre el presunto mecanismo de elevacion del ACCR teniendo en cuenta el analisis de los resultados obtenidos en el grupo de pacientes con insuficiencia renal, hemorragias digestivas, colecistitis agudas, litiasis vesicular y sindrome coledociano

Utilidad de la povidona iodada en la antisepsia colonica intraoperatoria. / Utility of povidone-iodine in intraoperative colonic antisepsis

La PVP-I ha demostrado, actuando durante solo 10 minutos, notable accion germicida tanto in vitro como in vivo en el colon de perros. In vitro se observo una reduccion bacteriana de 93,34%. En el colon de perros la reduccion alcanzo a 77,28% para los germenes aerobios y a 95% para los anaerobios. En ninguna oportunidad se observaron efectos locales o generales indeseables. Los resultados obtenidos permiten considerar a la PVP-I como muy util para la preparacion inmediata en cirugia colonica, tanto urgente como electiva