Short-term Results of Liver Transplantation With Octogenarian Donors.

BACKGROUND: There are increasingly more patients awaiting liver transplantation while the number of donors has remained stable. It has been proven that grafts from donors older than 60 years have comparable results with those from younger donors. It is unclear whether this is so with donors older than 80 years old. MATERIAL AND METHODS: This was a retrospective study of all adult liver transplantations at our institution between March 2011 and December 2015. We compared 1-, 3-, 6-, and 12-month graft survival rates from donors <80 years and ≥80 years. We also compared postoperative complications: infections, acute kidney injury, need for readmission in the intensive care unit, length of stay, mechanical ventilation, and specific graft complications. We considered differences in each age group regarding the presence of hepatitis C virus (HCV). RESULTS: Of 177 recipients, 38 received grafts from octogenarian donors (21.5%). Survival rates were very similar in the groups (97%, 93%, 91%, and 87% for donors <80 years and 95%, 92%, 87%, and 76% for donors ≥80 years). Although for younger grafts, 1-year survival rates were slightly lower for HCV+ patients (80% vs 89%; log-rank 0.205), this difference does not exist for elderly donors. The incidence of postoperative complications was similar in both groups. CONCLUSIONS: Livers from octogenarian donors are acceptable for liver transplantation provided that thorough assessment and selection is made by avoiding other known poor prognosis factors. The presence of HCV did not affect survival rates.

Effects of the Hypnotic Agent on Primary Graft Dysfunction After Liver Transplantation.

BACKGROUND: Morbidity and mortality rates in orthotopic liver transplantation have decreased in the past few years. Risk factors related to severe postoperative complications, such as primary graft dysfunction, still need to be analyzed. We evaluated the influence of the hypnotic agent used during anesthesia on primary graft dysfunction. METHODS: We performed a retrospective analysis of 419 consecutive patients who received a liver transplant between 2005 and 2013 in a single center. We analyzed the incidence of primary graft dysfunction (defined as alanine aminotransferase or aspartate aminotransferase levels higher than 1500 IU/L on the first 3 days after surgery) and if the hypnotic agent was associated with this event. RESULTS: The incidence of primary graft dysfunction was 42.2% (114 patients), similar in both groups (propofol group, 89 patients, 43.2% and sevoflurane group, 25 patients, 39.1%). In the multivariate analysis, we did not find any relationship between the hypnotic agent (propofol or sevoflurane) and early graft dysfunction. CONCLUSIONS: In our patients, we found no differences in the incidence of liver graft dysfunction according to the hypnotic used during transplantation. We can suggest that both drugs (sevoflurane and propofol) are equally safe in orthotopic liver transplantation.

Guía rápida de fármacos en soporte vital avanzado / No disponible

Durante las últimas reuniones de la American Heart Association (AHA) y el European Resuscitation Council(ERC), la tendencia es la de minimizar tanto las maniobrasen soporte vital avanzado (SVA), como el uso de fármacos. Por ello, cada vez más, se van simplificando el número o tipo de fármacos que se usan en reanimación cardiopulmonar (RCP). A pesar de ello, la premura de su utilización hace necesario que conozcamos las dosis exactas, el modo y el momento en que deben administrarse. Por todo esto, se elaboró una guía rápida de uso de estos fármacos usados en RCP adecuada para la utilización que se podría hacer en el Servicio de Urgencias de Atención Primaria (SUAP),en la que se muestran las posibles vías de administración, la dosis para un individuo adulto, así como algunas precauciones que deben tenerse en cuenta en su utilización (AU)

The tendency during the last meetings of the American Heart Association (AHA) and European Resuscitation Council(ERC) has been to minimize both maneuvers in advanced cardiac life support (ACLS) as well as the use of drugs. Thus, the number or type of drugs used in cardiopulmonary resuscitation(CPR) is being increasingly reduced. In spite of it, the urgency of their use makes it necessary for us to know the exact doses to administer, method and moment. Therefore, a rapid guide to the use of these drugs in CPR has been elaborated, that is adapted to its use in the Primary Care Emergency Service. This guide demonstrates the possible administration routes, dose for an adult individual as well as some precautions to bear in mind during its use (AU)

Adenoma hepático en relación con la toma de anticonceptivos orales / Hepatic adenoma related to taking oral contraceptives

No disponible

[Descriptive epidemiology of suicide in Spain (1906-1990)]. / Epidemiología descriptiva del suicidio en España (1906-1990).

INTRODUCTION: In Spain, suicide as a cause of death is increasing in different age groups in both sexes. The aim of the present work is to characterize the phenomenon of suicide. MATERIALS AND METHODS: A retrospective descriptive epidemiological study was carried out. Data periodically published by the National Institute of Statistics (INE) on the statistical Incidence of Suicides in Spain (1906-1990) were analyzed, processed and tabulated. RESULTS: Suicide increases with age and this increase is more pronounced as from 40 years of age. The ratio between sexes is 3:1 in favour of men, although with a tendency to decrease. The most important causes of suicide are: physical suffering (27%), psychopathy (18%) and Daily Activities (DA) (17.5%). The method most used is hanging, which has been the case of 37% of the suicides committed in Spain during the study period (1906-1990). CONCLUSIONS: The risk factors associated with suicide are age, male sex, and physical and mental suffering.