Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 26
Filter
1.
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 37(3): 29-35, dic. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1100090

ABSTRACT

De entre las emergencias pediátricas, la apendicitis aguda es la patología más frecuente, siendo importante observar su comportamiento en nuestro medio y por variables como la edad y diagnósticos diferenciales. Objetivo: determinar las características de los pacientes menores de 16 años ingresados al Servicio de Cirugía Pediátrica del Hospital José Ca-rrasco con diagnóstico de apendicitis aguda entre enero 2012 y diciembre 2016.Métodos: estudio descriptivo basado en las historias clínicas de niños in-gresados a emergencia con dolor abdominal en el período enero 2012 a diciembre 2016 y diagnosticados de apendicitis. Los datos fueron analiza-dos y tabulados en Excel. Se tomaron en cuenta consideraciones éticas.Resultados: se analizaron 614 niños con dolor abdominal; 334 fueron diagnosticados de apendicitis aguda (246 niños) y peritonitis apendicular (88 niños), corresponden al sexo masculino 54.19%. La media de edad fue 9.9 años; la leucocitosis fue el hallazgo de laboratorio más frecuente encontrado en 82.93%. El estudio ecográfico resultó positivo para apendi-citis en 55.69%. Todos recibieron tratamiento laparoscópico por el mismo equipo quirúrgico, las complicaciones se presentaron en el 8.69%.Conclusiones: la apendicitis aguda es la principal causa de cirugía de emergencia en pacientes pediátricos, afecta más al género masculino, en-tre 6 y 11 años de edad (media 9.9 años), es requiere un diagnóstico y tratamiento inmediato para evitar complicaciones; el tratamiento laparos-cópico es un procedimiento seguro.(AU)


Among pediatric emergencies, acute appendicitis is the most frequent pathology, it is important to observe their behavior in our environment and variables such as age and differential diagnoses should be taken into account.Objective: to determine the characteristics of patients under 16 admitted to the Pediatric Surgery Service of the José Carrasco Hospital with a diagnosis of acute appendicitis between January 2012 and December 2016.Methods: It is a descriptive study based on the medical records of children admitted to the emergency department with abdominal pain in the period January 2012 to December 2016 and diagnosed with appendicitis. The data was analyzed and tabulated in the Excel program. All ethical considerations were taken into account.Results: 614 children with abdominal pain were analyzed; 334 were diagnosed with acute appendicitis (246 children) and appendicular peritonitis (88 children), 54.19% correspond to the male sex. The average age was 9.9 years; the leukocytosis was the most frequent laboratory finding in 82.93%. The ultrasound study was positive for appendicitis in 55.69%. All received laparoscopic treatment by the same surgical team, complications occurred in 8.69%.Conclusions: acute appendicitis is the main cause of emergency surgery in pediatric patients, it affects more to the male gender, between 6 and 11 years of age (average 9.9 years), immediate diagnosis and treatment is required to avoid complications; laparoscopic treatment is a safe procedure.(AU)


Subject(s)
Humans , Male , Female , Child , Appendicitis/complications , Appendicitis/diagnosis , Peritonitis/prevention & control
2.
Rev. habanera cienc. méd ; 17(1): 91-102, ene.-feb. 2018. ilus
Article in Spanish | LILACS (Americas), CUMED | ID: biblio-901802

ABSTRACT

Introducción: La peritonitis postoperatoria es una de las complicaciones más frecuentes que se presenta tras procederes laparoscópicos. Objetivo: Caracterizar la evolución de los pacientes complicados con peritonitis después de un proceder laparoscópico. Material y método: Se realizó un estudio observacional descriptivo de los pacientes con peritonitis ingresados en la terapia intensiva, del Centro Nacional de Cirugía de Mínimo Acceso, desde septiembre de 2010 hasta diciembre de 2015. Se analizaron algunas variables demográficas, procederes laparoscópicos que se complicaron con este diagnóstico, complicaciones clínicas, antibioticoterapia utilizada, tipo de nutrición y la escala de evaluación fisiológica APACHE II como predictor de pronóstico. La información se obtuvo de las historias clínicas. Las variables cualitativas se resumieron utilizando frecuencias absolutas y porcentajes. Para las cuantitativas se utilizó la media y la desviación estándar. Resultados: Se complicaron con peritonitis 26 de 298 pacientes ingresados en el período (8,7 ), la edad media fue de 60 años, predominó el sexo femenino (57,7 por ciento). Se complicaron más con este diagnóstico los pacientes perforados postcolonoscopia (50 por ciento). El disbalance hidroelectrolítico (73,1 por ciento) fue la complicación asociada más frecuente. Se usó precozmente la nutrición enteral en 57,7 por ciento y los antibióticos más utilizados fueron ceftriaxone, amikacina y metronidazol. Predominó la evolución favorable a pesar que el score APACHE II se mantuvo en valores elevados. Conclusiones: Las perforaciones intestinales después de una colonoscopía tienen un alto riesgo de sufrir peritonitis secundaria, pero si se realiza un diagnóstico y tratamiento precoz su evolución es favorable(AU)


Introduction: Endoscopic dilatation is the first therapeutic option to eliminate benign esophageal stenosis and improve the symptoms and the quality of life of those patients who suffer from it. Objective:To describe the results of endoscopic dilatation in patients with benign esophageal stenosis treated in the National Center for Endoscopic Surgery from January 2015 to December 2016. Material and Methods:A case series longitudinal observational study was conducted in 59 patients with benign esophageal stenosis. Dilatations were done with Savary-Gilliard bougie and balloons. Results:The mean age was 52,5 years, and the condition predominated in 37 male patients (62,7 percent). Post-surgical, peptic, and caustic were the most frequent etiologies with 25, 14, and 6 cases, respectively. Short stenosis predominated in 51 cases. Bougies were used in 48 patients for a total of 149 dilatations, corresponding to a mean of 3,1 dilatations/ patients. Correction of the stenosis was made in 1-3 sessions in 47 percent of patients; 11 cases were dilated with balloon, corresponding to a mean of 1- 3 dilatations/ patients. Four patients from the group that were dilated with Savary-Gilliard bougies showed refractoriness. A perforation, and two bleedings occurred. After the dilatations, dysphagia improved or disappeared in 93,2 percent of patients. Conclusions:Endoscopic therapy through dilatation of benign esophageal stenosis indicated to be a good alternative method in achieving corrections in a few dilatation sessions, with a low number of complications, and an improvement of the dysphagia(AU)


Subject(s)
Humans , Male , Female , Peritonitis/surgery , Peritonitis/diagnosis , Peritonitis/prevention & control , Early Diagnosis , Clinical Evolution/methods , Epidemiology, Descriptive , Laparoscopy/methods , Critical Care/methods , Observational Study
4.
REME rev. min. enferm ; 21: [1-7], 2017. tab
Article in English, Portuguese | LILACS (Americas), BDENF | ID: biblio-907933

ABSTRACT

Objetivo: analisar a taxa das peritonites no Serviço de Diálise Peritoneal de um Hospital-Escola e conhecer o perfil dos pacientes do programa de diálise peritoneal. Metodologia: estudo observacional, descritivo, retrospectivo, de natureza quantitativa, realizado no serviço de diálise no interior de São Paulo de janeiro a dezembro de 2015. RESULTADOS: dos 39 pacientes em diálise peritoneal, 51,3% eram do sexo masculino, 64,1% não idosos, 51,3% procediam de outros municípios, 69,2% aposentados, 66,7% estavam em diálise peritoneal ambulatorial contínua, 43,6% estavam em tratamento de um a dois anos e 79,5% não estavam na lista de transplante, sendo 41% em virtude de início recente na terapia. Dos 20 pacientes que apresentaram peritonite, 50% tiveram dois episódios no ano, 20% causados por Staphylococcus aureus. Em 90% o antibiótico foi administrado por via endovenosa, 95% tiveram associação de antibióticos, sendo os mais comuns ceftazidima, vancomicina e cefalotina. Dos 90% dos pacientes que saíram da terapia, 65% eram do sexo feminino, 55% moravam no município da instituição de tratamento, 70% eram aposentados e 65% estavam em diálise peritoneal ambulatorial contínua, com média de idade de 56 anos (DP=14,6 anos) e média de 1,7 ano de tratamento. A taxa de peritonite em diálise peritoneal ambulatorial contínua e diálise peritoneal automatizada foi de 2,79% e em diálise peritoneal intermitente 13,33%. CONCLUSÃO: a maioria dos pacientes que teve peritonite eram mulheres. A média de peritonites foi maior entre as pessoas com menos idade e menos tempo de tratamento e 90% dos pacientes saíram da terapia.


Objective: analyze peritonitis rates in the Peritoneal Dialysis Service of a university hospital and identify the profile of patients attending the peritoneal dialysis program. Methods: This observational, retrospective, and descriptive study with a quantitative approach was conducted at adialysis service in the interior of São Paulo, Brazil, from January to December 2015. Results: Of the 39 patients on peritoneal dialysis, 51.3% were men;64.1% were non-elderly patients; 51.3% were from towns other than where the service was located; 69.2% were retired; 66.7% were in continuous ambulatory peritoneal dialysis; the duration of treatment of 43.6% ranged from one to two years; 79.5% were not on the transplant waiting list;and 41% had recently started therapy. Of the 20 patients presenting peritonitis, 50% had two episodes and 20% of the episodes were causedby Staphylococcus aureus. The antibiotic was administered intravenously in 90% of the patients; antibiotics were associated with ceftazidime, vancomycin or cephalothin (the most common ones) in 95%. Among those who dropped out of therapy (90%): 65% were women, 55% lived in thesame town as the health facility; 70% were retired; 65% were undergoing continuous ambulatory peritoneal dialysis, and were aged 56 years old onaverage, while treatment duration was 1.7 years on average. The peritonitis rate among those on continuous ambulatory peritoneal dialysis andautomated peritoneal dialysis was 2.79%, while 13.33% were on intermittent peritoneal dialysis. Conclusion: Most patients with peritonitis werewomen, lived in the same town as the facility, were retired and underwent continuous ambulatory peritoneal dialysis, and treatment duration was1.7 years on average, and 90% of the patients dropped out of therapy.


Objetivo: analizar la tasa de peritonitis en el servicio de diálisis peritoneal de un hospital escuela; conocer el perfil de los pacientes del programa dediálisis peritoneal. Metodología: Estudio observacional, descriptivo, retrospectivo, cuantitativo realizado en el servicio de diálisis de un hospital delinterior del estado de São Paulo, entre enero y diciembre de 2015. Resultados: De los 39 pacientes en diálisis peritoneal, 51,3% eran varones, 64,1% noancianos, 51,3% venían de otros municipios, 69,2% jubilados, 66,7% en diálisis peritoneal continua ambulatoria, 43,6% en tratamiento entre uno y dosaños,79,5% no estaban en la lista de trasplantes y, entre ellos, 41% habían reiniciado recientemente el tratamiento. De los 20 paciente que presentaron peritonitis, 50% tuvieron dos episodios en el año, 20% causado por Staphylococcus aureus. En 90%, el antibiótico se administró vía venosa, 95%tuvieron asociación de antibióticos, siendo los más comunes ceftazidima, vancomicina y cefalotina, y 90% de los pacientes interrumpieron la terapia,65% eran mujeres, 55% vivían en el municipio de la institución de tratamiento, 70% eran jubilados y 65% estaban en CAPD con promedio de 56 añosde edad y 1,7 años de tratamiento. La tasa de peritonitis en diálisis peritoneal continua ambulatoria y diálisis peritoneal automatizada fue de 2,79%y en diálisis peritoneal intermitente 13,33%. Conclusión: Entre los pacientes con peritonitis, la mayoría eran mujeres, el promedio de peritonitis fuemayor entre las personas más jóvenes y con menos tiempo de tratamiento y 90% de los pacientes interrumpieron el tratamiento.


Subject(s)
Humans , Male , Female , Peritoneal Dialysis , Peritonitis/diagnosis , Peritonitis/epidemiology , Peritonitis/prevention & control , Renal Insufficiency, Chronic/complications , Socioeconomic Factors
6.
Acta cir. bras ; 30(8): 568-573, Aug. 2015. tab, ilus
Article in English | LILACS (Americas) | ID: lil-757992

ABSTRACT

PURPOSE: To evaluate the effects of copaiba oil as a prophylactic and/or therapeutic substance on survival of rats subjected to cecal ligation and puncture, describing histopathological and oxidative stress findings.METHODS:Forty rats (Ratus norvegicus) were distributed into five study groups (N=8): Sham group (ShG): normal standard animals; Sepse group (SepG): submitted a cecal ligation and puncture (CLP); Pre group (PreG): administered copaiba oil once daily by subcutaneous injection for five days before carrying out CLP; Post CLP group (PostG): administered copaiba oil once daily by subcutaneous injection from the first day of CLP until death by sepsis; and Pre/Post group (Pre/PostG): administered copaiba oil once daily by subcutaneous injection for five days before carrying out CLP and from the first day of CLP until de death by sepsis. After the death of the animals, blood was collected for assessment of oxidative stress and histological analysis were performed. The Kaplan-Meier curves of surviving time were realized.RESULTS: Survival analysis demonstrated that animals treated with copaiba oil prior to the execution of the CLP (PreG and Pre/Post groups) had longer survival compared to the sepsis group (p<0.0001) whereas animals receiving copaiba only after the completion of CLP (PostG) showed no statistically significant difference compared to the sepsis group. However, when comparing the two groups in which was administered copaiba previously (PreG and Pre/PostG groups), there was no statistical significance between the groups (p=0.4672). There was no statistical difference between histopathological findings or the levels of oxidative stress.CONCLUSION: Prophylactic subcutaneous administration of copaiba increases survival of rats subjected to severe sepsis by cecal ligation and puncture.


Subject(s)
Animals , Male , Fabaceae/chemistry , Peritonitis/drug therapy , Plant Oils/therapeutic use , Sepsis/drug therapy , Cecum/surgery , Disease Models, Animal , Feces , Injections, Subcutaneous , Ligation , Malondialdehyde/blood , Oxidative Stress/drug effects , Punctures , Peritonitis/etiology , Peritonitis/prevention & control , Plant Oils/pharmacology , Post-Exposure Prophylaxis/methods , Random Allocation , Rats, Wistar , Reproducibility of Results , Survival Analysis , Sepsis/prevention & control , Time Factors , Treatment Outcome
7.
Rev. cuba. pediatr ; 85(4): 448-454, oct.-dic. 2013.
Article in Spanish | LILACS (Americas) | ID: lil-697507

ABSTRACT

Introducción: la diálisis peritoneal es la mejor alternativa terapéutica para los niños con enfermedad renal crónica terminal, y en las modalidades de diálisis peritoneal ambulatoria ha permitido el tratamiento fuera del hospital, lo que proporciona un mejor estilo y calidad de vida. No es un método exento de riesgos. Las complicaciones infecciosas relacionadas a la diálisis peritoneal son la causa más importante de morbilidad y es la peritonitis su principal complicación. Objetivo: determinar retrospectivamente la frecuencia y las características de complicaciones infecciosas relacionadas al proceder dialítico. Métodos: nuestro hospital es referente como unidad de diálisis pediátrica del país, así que recibe la mayoría de los niños con enfermedad renal crónica terminal de Cuba. Se revisaron los expedientes clínicos de niños con enfermedad renal crónica terminal en programa de diálisis peritoneal ambulatoria en el Hospital Pediátrico de Centro Habana durante el período 2008-2011. Resultados: se estudiaron 12 pacientes con un promedio de edad de 11 años, 58 por ciento del sexo femenino. Se documentaron 24 episodios infecciosos. Las complicaciones encontradas fueron infección del sitio de salida del catéter, con 62,5 por ciento, peritonitis 33,3 por ciento e infección del túnel submucoso 4,2 por ciento. Predominaron cultivos positivos a bacterias grampositivas (66,7 por ciento). Las bacterias más comunes fueron: Staphylococcus coagulasa positivo (48 por ciento) y Staphylococcus coagulasa negativo (22 por ciento). Otros gérmenes identificados fueron E. coli, Enterobacter spp. y Candida spp., con 8,3 por ciento respectivamente. Conclusiones: la infección del sitio de salida del catéter fue la complicación infecciosa más frecuente en nuestra serie. Las bacterias grampositivas son los gérmenes más comunes que causan infección del sitio de salida y peritonitis en pacientes en diálisis peritoneal ambulatoria


Introduction: peritoneal analysis is the best therapeutic alternative for children suffering terminal chronic renal disease and it has allowed, in the ambulatory peritoneal dialysis variant, providing out of hospital treatment to improve life style and quality. It is not risk-free method since the peritoneal dialysis-related infectious complications are the most important cause of morbidity, being peritonitis the main one. Objective: to retrospectively determine the frequency and the characteristics of dialysis-related infectious complications. Methods: our hospital is a point of reference in the country as pediatric dialysis unit where most of children with terminal chronic renal disease in Cuba are referred to. The medical histories of children with this type of disease, who were included in the ambulatory peritoneal dialysis program of Centro Habana pediatric hospital for the 2008-2011 period, were checked over. Results: twelve patients aged 11 years as average were studied. Fifty eight percent were girls. Twenty four infectious events were documented. The most frequent complications were infection at the outlet site of the catheter (62.5 percent), peritonitis (33.3 percent) and submucous tunnel infection (4.2 percent). Positive cultures to Grampositive bacteria (66.7 percent) were predominant. The most common bacteria were positive Staphylococcus coagulase (48 percent) and negative Staphylococcus coagulase (22 percent). Other germs were E E. coli, Enterobacter spp. and Candida spp, with 8.3 percent, respectively. Conclusions: the most frequent complication was infection at the outlet site of the catheter in our sample. The most common germs were Grampositive bacteria that cause this type of infection and peritonitis in patients under ambulatory peritoneal dialysis treatment


Subject(s)
Humans , Male , Female , Child , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Catheter-Related Infections/prevention & control , Catheter-Related Infections/transmission , Renal Insufficiency, Chronic/drug therapy , Peritonitis/complications , Peritonitis/prevention & control , Case Reports
8.
Rev. Méd. Clín. Condes ; 21(5): 757-763, sept. 2010. ilus, tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-999302

ABSTRACT

Cirrosis hepática es una enfermedad prevalente en el mundo. Su diagnóstico y tratamiento debe ser dominio de todo médico general e internista. En los últimos años han ocurrido notables avances en el diagnóstico, fisiopatología, tratamiento y en la identificación de factores pronósticos de cirrosis y de sus complicaciones mayores. Particular atención ha existido en desarrollar medidas preventivas de sus complicaciones como por ejemplo: hemorragia por várices esofágicas, peritonitis bacteriana espontánea, síndrome hepatorrenal. Estas medidas preventivas han influido de forma muy favorable en el pronóstico de los pacientes cirróticos. En este artículo se discuten las diversas estrategias preventivas que han demostrado su efectividad en cirrosis hepática


Liver cirrhosis is a prevalent disease around the world. Its diagnosis and treatment must be in the knowledge of every general physicians and internist.Over the last years, there have been notorious advances in the diagnosis, pathophysiology, treatment and the identification of prognosis factors for cirrhosis major complications.There has been particular attention to the development of preventive measures for its complications, such as variceal bleeding, spontaneous bacterial peritonitis, hepatorenal syndrome. These preventive measures have had a favorable influence on the prognosis of cirrhotic patients. This article discusses several preventive strategies that have proven its effectiveness in hepatic cirrhosis


Subject(s)
Humans , Peritonitis/prevention & control , Hepatorenal Syndrome/prevention & control , Esophageal and Gastric Varices/prevention & control , Liver Cirrhosis/complications , Peritonitis/microbiology , Prognosis , Severity of Illness Index , Ascitic Fluid/microbiology , Esophageal and Gastric Varices/complications , Esophageal and Gastric Varices/etiology , Adrenergic beta-Antagonists/administration & dosage , Gastrointestinal Hemorrhage/ethnology , Gastrointestinal Hemorrhage/prevention & control , Liver Cirrhosis/therapy , Anti-Bacterial Agents/administration & dosage
9.
Gastroenterol. latinoam ; 21(2): 234-236, abr.-jun. 2010. tab
Article in English | LILACS (Americas) | ID: lil-570014

ABSTRACT

In summary the carbon tetrachloride/phenobarbital of cirrhosis in rats mimics human cirrhosis very closely, with development of ascites and SBP. This model shows us that bacterial overgrowth occurs as cirrhosis progresses and that bacterial translocation from the gut to extra-intestinal sites is part of the early pathogenesis of SBP. SID with norfloxacin dramatically reduced translocation and SBP at the expense of grampositive overgrowth and infection with gram-positives and colonization with strange gram negatives. SID with TMP-SMZ actually delayed development of ascites and prolonged survival.


Subject(s)
Animals , Rats , Ascites/microbiology , Liver Cirrhosis, Experimental/complications , Peritonitis/microbiology , Bacterial Translocation/physiology , Antibiotic Prophylaxis , Ascites/prevention & control , Carbon Tetrachloride Poisoning , Liver Cirrhosis, Experimental/chemically induced , Liver Cirrhosis, Experimental/microbiology , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Bacterial Physiological Phenomena , Norfloxacin/therapeutic use , Peritonitis/prevention & control , Bacterial Translocation
10.
GEN ; 64(2): 120-123, jun. 2010. ilus, tab
Article in Spanish | LILACS (Americas) | ID: lil-664482

ABSTRACT

Reportamos un caso de apendicitis epiploica, así como revisión de la literatura. Se trata de un paciente masculino de 38 años, que ingresa por presentar dolor en fosa iliaca izquierda de aparición brusca , de severidad creciente , distensión y malestar, sin leucocitosis Al examen físico el abdomen esta distendido y muy doloroso a la palpación, a predominio de flanco y fosa iliaca izquierda. Trae ecosonograma abdominal que reporta esteatosis hepática y aglomeración de asas en fosa iliaca izquierda. La colonoscopía solo muestra hemorroides, el dolor abdominal persiste y hay signos de peritonismo. Es intervenido quirúrgicamente con los siguientes hallazgos apéndice epiploica gangrenosa; colon sigmoide con adherencia a pared lateral del abdomen con apéndice epiploica necrosada; realizan resección de apéndice epiploica y apendicetomía. Lo más relevante de este caso, es lo poco frecuente y en el cual sus síntomas se confunden con patologías comunes tales como la apendicitis y la diverticulitis. Sin embargo el manejo de imágenes y su característico aspecto en las misma, juega un papel determinante en el adecuado y efectivo diagnostico lo que hace de su reconocimiento un factor importante...


We report a case of epiploic appendicitis, as well as the review of the literature. This is a 38 year old male patient who was admitted due to left iliac fossa pain of sudden onset; of increasing severity, bloating and discomfort, without leukocytosis. At physical examination the abdomen is distended and very tender, with predominance in left iliac flank. He brought abdominal ultrasonography which shows hepatic steatosis and loops agglomeration in left iliac fossa. Colonoscopy shows hemorrhoids, persistent abdominal pain and there are signs of peritonitis. The patient underwent surgery with the following findings: gangrenous epiploic appendix, sigmoid colon with adherence to lateral abdominal wall with necrotic epiploic appendix; they performed the resection of the epiploic appendix and appendectomy. What is special about this case is how rare it is and that his symptoms are mistaken with common pathologies, such as appendicitis and diverticulosis. However, the imaging management and the epiploic appendix characteristic appearance in these images, play a determining role in the effective and appropriate diagnosis; which makes, its recognition an important factor...


Subject(s)
Humans , Male , Adult , Appendicitis/surgery , Appendicitis/diagnosis , Endosonography/methods , Peritonitis/surgery , Peritonitis/prevention & control , Gastroenterology
11.
Asunciòn; IPS/UCA; 00002009. 73 p. (Peritonitis aguda operados en el servicio de cirugìa general HCIPS Enero 2006-Diciembre 2008).
Monography in Spanish | LILACS (Americas), BDNPAR | ID: biblio-1018673

ABSTRACT

La peritonitis es un proceso inflamatorio de la membrana peritoneal, uno de los problemas infecciosos màs serios en la cirugìa general.


Subject(s)
Peritonitis/surgery , Peritonitis/complications , Peritonitis/diagnosis , Peritonitis/prevention & control , Paraguay
13.
Arq. gastroenterol ; 42(4): 256-262, out.-dez. 2005. tab
Article in English | LILACS (Americas) | ID: lil-420001

ABSTRACT

RACIONAL: Devido ao prognóstico sombrio que a peritonite bacteriana espontânea acarreta aos pacientes com doença crônica parenquimatosa de fígado, a prevenção desta condição é fundamental.OBJETIVO: Comparar a eficácia da sulfametoxazol/trimetoprima versus norfloxacino para a prevenção de peritonite bacteriana espontânea em pacientes com cirrose e ascite. PACIENTES E MÉTODOS: Cinqüenta e sete pacientes com cirrose e ascite foram avaliados entre março de 1999 e março de 2001. Todos haviam apresentado um episódio prévio de peritonite bacteriana espontânea ou tinham proteína do líquido de ascite <1 g/dL e/ou bilirrubinas séricas > 2,5 mg dL. Os pacientes foram randomizados para receber sulfametoxazol/trimetoprima 800/160 mg por dia, 5 dias por semana, ou norfloxacino 400 mg diariamente. O período médio de acompanhamento foi de 163 dias para o grupo norfloxacino, 182 dias para o grupo sulfametoxazol/trimetoprima. Na análise estatística foi considerado um nível de significância de 5%. RESULTADOS: De acordo com os critérios de inclusão, 32 pacientes (56%) foram tratados com o norfloxacino e 25 (44%) com a sulfametoxazol/trimetoprima. A peritonite bacteriana espontânea ocorreu em três pacientes tratados com o norfloxacino (9,4%), comparado com quatro tratados com a sulfametoxazol/trimetoprima (16%). Infecções extra-peritoniais ocorreram em 10 pacientes recebendo o norfloxacino (31,3%) e em 6 recebendo a sulfametoxazol/trimetoprima (24,0%). Ocorreram sete óbitos entre os pacientes que receberam o norfloxacino (21,9%) e cinco entre os que receberam a sulfametoxazol/trimetoprima (20,0%). No que tange aos efeitos colaterais das medicações, estes só foram observados no grupo da sulfametoxazol/trimetoprima. CONCLUSÃO: A despeito do número de pacientes e do tempo de acompanhamento, a sulfametoxazol/trimetoprima e o norfloxacino foram igualmente efetivas na profilaxia da peritonite bacteriana espontânea, sugerindo que a primeira seja uma opção viável.


Subject(s)
Female , Humans , Male , Anti-Infective Agents/therapeutic use , Ascites/complications , Bacterial Infections/prevention & control , Liver Cirrhosis/complications , Norfloxacin/therapeutic use , Peritonitis/prevention & control , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use , Bacterial Infections/etiology , Follow-Up Studies , Peritonitis/etiology , Treatment Outcome
14.
Acta cir. bras ; 20(6): 473-477, nov.-dez. 2005. ilus, tab
Article in Portuguese | LILACS (Americas) | ID: lil-417064

ABSTRACT

OBJETIVO: O estudo foi desenvolvido para avaliar os efeitos do autotransplante esplênico na proteção contra sepse abdominal em ratos Wistar jovens e adultos. MÉTODOS: Foram utilizados 54 ratos Wistar jovens e adultos (90 e 180 dias respectivamente) sendo distribuídos em 3 grupos: Grupo Sham, onde os animais eram submetidos a laparotomia com manipulação de alças apenas (n=6 animais jovens adultos), Grupo Esplenectomia, no qual os animais eram submetidos a esplenectomia total (n=10 animais jovens e adultos) e Grupo Auto-implante, onde os animais eram submetidos a esplenectomia total e um terço do baço era implantado em uma bolsa no retroperitônio (n=10 animais jovens e adultos). Após três meses os animais eram submetidos a nova laparotomia com ligadura e perfuração do ceco para estimular a sepse abdominal e acompanhados até o momento do óbito para estabelecimento de uma curva de mortalidade. RESULTADOS: Houve recuperação do baço implantado em todos os animais. Não houve diferença significativa entre o tempo de óbito entre os grupos. Os animais jovens aparentemente tiveram uma melhor resposta embora não estatisticamente significativa. CONCLUSÃO: Este estudo demonstrou que o auto-implante de baço no retroperitônio não provê proteção efetiva contra sepse abdominal em comparação aos ratos esplenectomizados.


Subject(s)
Animals , Rats , Spleen/transplantation , Retroperitoneal Space/surgery , Peritonitis/prevention & control , Splenectomy , Age Factors , Feces/microbiology , Rats, Wistar , Time Factors , Transplantation, Autologous
15.
Rev. chil. infectol ; 22(1): 63-74, mar. 2005. tab
Article in Spanish | LILACS (Americas) | ID: lil-417245

ABSTRACT

Las infecciones en pacientes afectados por cirrosis hepática son frecuentes, recurrentes y de pronóstico desfavorable. Su génesis está facilitada por defectos adquiridos y progresivos de la inmunidad innata y del sistema retículo-endotelial, siendo agravados por el consumo de alcohol. Estas infecciones son habitualmente bacterianas o virales y tienen habitualmente una presentación clínica estereotipada, aunque en ocasiones el diagnóstico puede ser difícil. Las neumonías, infecciones del tracto urinario, bacteriemias y peritonitis bacteriana espontánea (PBE) abarcan más del 90% de los casos; esta última exige de una alta sospecha clínica y de un protocolo de diagnóstico estandarizado. Las medidas preventivas son importantes en el manejo de estos pacientes e incluyen quimioprofilaxis contra la PBE en casos seleccionados, vacunas contra infecciones neumocóccicas e influenza en general, y hepatitis A y B en pacientes susceptibles. Debido a que la seroconversión con estas vacunas es deficiente, la inmunización activa debiera ser aplicada tan precozmente como sea posible, antes que se establezca un deterioro clínico.


Subject(s)
Humans , Bacterial Infections/etiology , Liver Cirrhosis/complications , Antibiotic Prophylaxis , Bacteremia/diagnosis , Bacteremia/etiology , Bacteremia/prevention & control , Bacterial Infections/diagnosis , Bacterial Infections/prevention & control , Liver Cirrhosis/immunology , Peritonitis/diagnosis , Peritonitis/etiology , Peritonitis/prevention & control , Pneumonia/diagnosis , Pneumonia/etiology , Pneumonia/prevention & control , Urinary Tract Infections/diagnosis , Urinary Tract Infections/etiology , Urinary Tract Infections/prevention & control
16.
Rev. bras. colo-proctol ; 21(1): 33-41, jan.-mar. 2001. tab
Article in Portuguese | LILACS (Americas) | ID: lil-295604

ABSTRACT

A infecçäo intra-abdominal generalizada é das mais temíveis complicaçöes pós-operatórias em coloproctologia. Antes do reconhecimento precoce dessas complicaçöes e da agressiva terapêutica cirúrgica, 90 por cento dos pacientes morriam de "sepse". Nas primeiras décadas desse século, a taxa de morte por causa das peritonites generalizadas graves caiu para 40-50 por cento, fato creditado, exclusivamente, ao procedimento cirúrgico. O advento aos mais potentes antimicrobianos, nas décadas seguintes, näo foi suficiente para continuar diminuindo a incidência da morte. O perfil muda, no entanto a partir do início dos anos 80, com novas técnicas e táticas operatórias, com os novos conhecimentos sobre a fisiopatologia das infecçöes localizadas e de suas repercussöes sistêmicas graves e dos suportes de terapia intensiva. A identificaçäo dos ciclos de eventos de etiologia variada, que culmina com a síndrome da reaçäo inflamatória sistêmica tem sido fator decisivo na orientaçäo da terapêutica, apontando para o mais precoce diagnóstico e a mais agressiva abordagem, cujo intuito é impedir a cascata das reaçöes inflamatórias que quando excessiva provoca, de forma irreversível, danos teciduais e a falência orgânica múltipla


Subject(s)
Humans , Colorectal Surgery/adverse effects , Peritoneum/pathology , Peritonitis/physiopathology , Peritonitis/prevention & control
17.
In. Fernandes, Antonio Tadeu; Fernandes, Maria Olívia Vaz; Ribeiro Filho, Nelson; Graziano, Kazuko Uchikawa; Cavalcante, Nilton José Fernandes; Lacerda, Rúbia Aparecida. Infecçäo hospitalar e suas interfaces na área da saúde. Säo Paulo, Atheneu, 2000. p.740-5, tab, graf.
Monography in Portuguese | LILACS (Americas), SES-SP | ID: lil-268060
18.
Rev. ciênc. méd., (Campinas) ; 8(2): 63-7, maio-ago. 1999.
Article in Portuguese | LILACS (Americas) | ID: lil-267189

ABSTRACT

Com o objetivo de alertar todos os profissionais da Area da Saúde sobre os riscos do uso inadequado de talco em luvas cirúrgicas, säo apresentadas as formas de lubrificaçäo das luvas, sua evoluçäo histórica na medicina e as complicaçöes de algumas formulaçöes de talco. A síndrome da peritonite granulomatosa, complicaçäo freqüente, foi descrita, assim como as medidas necessárias que devem ser adotadas para preveni-las. Concluiu-se que esses conhecimentos poderäo diminuir a freqüência de complicaçöes advindas do mau uso de talco e contribuir para o diagnóstico das mesmas, evitando reintervençöes cirúrgicas desnecessárias.


Subject(s)
Granuloma, Foreign-Body/etiology , Granuloma, Foreign-Body/prevention & control , Gloves, Surgical/history , Peritonitis/etiology , Peritonitis/prevention & control , Talc/adverse effects
19.
ABCD arq. bras. cir. dig ; 13(1/2): 3-6, jan.-jun. 1998. ilus, tab
Article in English | LILACS (Americas) | ID: lil-259964

ABSTRACT

A peritonite bacteriana permanece como causa significante de mortalidade e morbidade no paciente cirurgico. O objetivo desta investigacao foi analisar a influencia do fermentado de Zymomonas mobilis, como fator modulador na reducao da mortalidade associada a sepse intraperitoneal...


Subject(s)
Animals , Mice , Antibiosis , Peritonitis/therapy , Zymomonas/metabolism , Peritonitis/prevention & control
20.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 1998; 8 (5): 211-213
in English | IMEMR (Eastern Mediterranean) | ID: emr-115421

ABSTRACT

Typhoid peritonitis is the most common type of peritonitis in the Bahawalpur area. Previously surgical management was haphazard and depended upon the choice of surgeon with high mortality and morbidity. The introduction of a new scoring system has not only helped the registrars and junior consultants in maintaining a uniform treatment policy but also decreased the mortality and morbidity to a considerable extent


Subject(s)
Humans , Intestinal Perforation/prevention & control , Peritonitis/surgery , Peritonitis/prevention & control , Peritonitis/etiology , Intestinal Perforation/surgery
SELECTION OF CITATIONS
SEARCH DETAIL