RESUMO
El estudio CRASH-2 es un ensayo clínico pragmático que busca evaluar la eficacia de un antifibrinolítico de bajo costoy ampliamente disponible para la prevención de mortalidad y sangrado en pacientes con trauma. En este artículo presentamos algunos conceptos relacionados a la magnitud del problema y la necesidad de investigación en trauma en el contexto peruano. Asimismo se discute las bases teóricas y practicas del ensayo CRASH-2 así como la experiencia peruana hasta el momento.
CRASH-2 is a pragmatic clinical trial which evaluates the efficacy of a widely available, low cost antifibrinolytic for the prevention of mortality and bleeding in patients with trauma. In this article we present some issues related to the magnitude of the problem as well as the need for research in trauma relevant to the Peruvian context. The rationale for the CRASH-2 trial and the Peruvian experience up to date are also discussed.
Assuntos
Humanos , Acidentes de Trânsito , Antifibrinolíticos , Ensaios Clínicos como Assunto , Ácido TranexâmicoRESUMO
The abdominal oblito that can be formed in an involuntary way after making an invasive procedure abdominal constitutes a serious problem that is not very analyzed in the medical literature. The purpose in the presentation of this case of intestinal obstruction by oblito is to aid the support of the concept that all has not still been said about the ways of presentation of the abdominal oblito. Also to insist in the importance of the prevention and the inform of the personnel of the surgical room. The daily chore confirms that this topic is a taboo issue and that it generates dilemmas in diverse planes which magnitude is as enough as to be discussed.
Assuntos
Humanos , Feminino , Obstrução Intestinal/cirurgiaRESUMO
We describe the surgical management of a patient who had gallbladder stones and hemmolytic anemia by spherocytosis. On this patient we perfomed cholecystectomy and splenectomy by laparoscopic approach without any complications and a succesfully post operative period.
Assuntos
Humanos , Feminino , Adolescente , Esplenectomia , Laparoscopia , Colecistectomia LaparoscópicaRESUMO
Philosophic medical and legal principles are stated introducing the name oblito, explaining its linguistic root. The definition of foreing body accidentally forgotten during an operation and with no therapeutic value, is proposed. The characteristics of the foreing body left in the abdomen during surgery from the nosographic and nosologic point of view, give this process an individuality, that allows to speak about its clinics. The symptomatology is clear and connected to the clinical forms analyzed. Diagnosis is reached specially by radiology. In order to complete the oblito's pathological similitude with other abdominal processes, it is necessary to point out that it has a regulated prophilaxis, in nearly every surgical center.
Assuntos
Abdome , Corpos EstranhosRESUMO
Se estudian 33 pacientes operados por patología de urgencia del colon izquierdo con indicación de operación a lo Hartmann. Las más frecuentes fueron por vólvulo del colon sigmoide (11), lesiones por arma de fuego (10), iatrogénico (3), cáncer (2), heridas punzopenetrantes (2), traumatismo no penetrante (1), y otros (3). Se hacen consideraciones en relación a la técnica a lo Hartmann: en el primer tiempo operatorio y las posibilidades de restauración del tránsito en el segundo, mostrándonos partidarios de la anastomosis terminolateral, como la más segura cuando existe un muñón distal difícil. Consideremos que la colectomía segmentaria a lo Hartmann, es una técnica que ofrece una solución inmediata con un aceptable margen de seguridad en la compleja y grave patología de urgencia del colon izquierdo