Fuego quirúrgico: un incidente prevenible / Surgical fire: an avoidable incident

Introduction: surgical fire requires the presence of three components, known as the "fire triad": a fuel, an ignition source and an oxidizer. Clinical case: we report a patient who, during an ambulatory surgery, suffered a facial burn from a fire. The use of an electrosurgical unit and supplementary oxygen through nasal cannula were important factors in this case. We describe how and why fire start, which are the high-risk surgeries and the strategies to reduce the risk of fire in surgical patients.

Introducción: el fuego quirúrgico requiere tres elementos para que se produzca, conocidos como "triada de fuego": un combustible, una fuente de ignición y un oxidante. Caso clínico: presentamos el caso de una paciente que sufrió una quemadura facial por fuego durante una cirugía ambulatoria, en la que fueron factores importantes el uso de una unidad electroquirúrgica y la administración de oxígeno a través de una cánula nasal. Describimos cómo y por qué se puede producir fuego, cuáles son las cirugías de alto riesgo y las estrategias para reducir el riesgo de fuego en pacientes quirúrgicos.

Tratamiento del hígado graso no alcohólico: ¿qué sabemos?: [revisión] / Treatment of non-alcoholic fatty liver disease: what do we know?: [review]

Non-alcoholic fatty liver disease (NAFLD) is now recognized as one the most common liver diseases worldwide and is emerging as a frequent cause of liver-related mortality thus representing a significant health burden around the world. NAFLD is a clinical-pathological disease that has become more relevant in the recent years, resulting in a vast corpus of scientific information. Major clinical issues in management of patients with NAFLD are recognition of subjects at risk of progression towards chronic liver disease including cirrhosis as well as medical treatment of the condition with both pharmacological and non-pharmacological strategies. This article reviews currently available evidence about NAFLD management.

El hígado graso no alcohólico (HGNA) es considerada en la actualidad como una de las enfermedades hepáticas más comunes a nivel mundial y emerge como una causa frecuente de mortalidad asociada a enfermedades hepáticas, así como un significativo impacto en los costos de salud alrededor del mundo. El HGNA es una entidad clínico-patológica que ha cobrado relevancia en los últimos años, dando origen a gran cantidad de información científica. Los aspectos clínicos más importantes del manejo de pacientes con HGNA son el reconocimiento de sujetos en riesgo de progresar a formas de enfermedad hepática más avanzadas, incluyendo la cirrosis así como el tratamiento medico de esta condición con medidas farmacológicas y no-farmacológicas. El presente articulo revisa la evidencia disponible acerca de los conceptos actuales sobre el manejo del hígado graso no alcohólico.

Hígado graso no alcohólico: una entidad relevante para el endocrinólogo / The relevance of non-alcoholic fatty liver for endocrinologists

Non-alcoholic fatty liver disease (NAFLD) is emerging as a leading cause of chronic liver disease worldwide. Although its pathophysiology is not completely understood, insulin resistance has been identified as a central event involved in both pathogenesis and progression of the disease. Due to its asymptomatic nature and its benign evolution in the majority of cases, awareness about the possibilityof progression of NAFLD among non-hepatologists is limited. Different studies indicate that non-alcoholic steatohepatitis, the inflammatory form of NAFLD, can progress to more advanced stages of chronic liver disease including cirrhosis in up to 25 percent of cases in a decade. Furthermore, recent data show that NAFLD is an important risk factor for developing cardiovascular events and diabetes. This article briefly reviews current concepts on NAFLD. As endocrinologists frequently face patients with insulin resistance, the identification of patients with NAFLD and the assessment of prognosis acquires significant clinical relevance.