ABSTRACT
INTRODUCTION: Venous thrombosis is a serious surgical complication that frequently results in loss of kidney graft. CASE PRESENTATION: We report the case of a female patient recipient of a decease kidney transplant that in the tenth postoperative presented with hematuria, graft pain and oliguria. Ultrasound examination was suggestive of venous thrombosis with abnormal doppler waveform pattern and reversal of diastolic flow. She underwent emergency surgical intervention after 2h of diagnosis. The vein thrombus was removed by perfusing the renal graft artery with 1000ml of Euro-Collins solution. The patient evolves with recovery of renal function after 1 week of the procedure DISCUSSION: Similar reports of graft rescue in the vein thrombosis are scarce and that the time of diagnosis to intervention is a determining factor. CONCLUSION: Rapid diagnosis of exactly 2h combined with the early re-operation may be successful in preserving renal graft in cases of venous thrombosis.
ABSTRACT
Evaluar, en pacientes con Diabetes Mellitus (DM) tipo 2, la asociación entre el grado de conocimiento acerca de hipoglicemias, con el número de éstas, la mayor prevalencia de hipoglicemia severa y el tratamiento antidiabético usado. Pacientes y Método: Estudio transversal. Se aplicó encuesta de conocimiento acerca de hipoglicemia (5 preguntas de alternativa) a pacientes adultos hospitalizados en un periodo de cuatro meses; se registró el número de hipoglicemias reportadas por los pacientes en los últimos 12 meses; y el tipo de tratamiento utilizado para la DM en este periodo. Resultados: 71 pacientes; 34 mujeres, media de 65 años de edad. El promedio de respuestas correctas fue de 2,42. Los pacientes que refirieron haber recibido alguna vez educación, tuvieron más respuestas correctas (p=0.0004); tendencia a menor número de hipoglicemias durante el último año (p=0,191) y mayor presencia de hipoglicemia severas (p=0,158). No hubo correlación significativa entre el número de hipoglicemias reportadas y el número de respuestas correctas (r= 0.0088 de Spearman). En relación al tipo de tratamiento hipoglicemiante, no se observaron diferencias significativas entre haber recibido educación y el número de hipoglicemia referidas (p=0,771), así como tampoco con la presencia de hipoglicemias severas (p=0,347). Discusión: Destaca el escaso conocimiento acerca de la hipoglicemia en este grupo de pacientes. Aquellos con más conocimientos reportaron menos hipoglicemias; probablemente porque las sabenprevenir. Destaca el mayor número de hipoglicemias severas en pacientes con más conocimiento, tal vez por mayor reporte. La educación sigue siendo un pilar fundamental en el manejo de pacientes con DM...
Assess, in patients with Diabetes Mellitus (DM) type 2, the association between the knowledge about hypoglicemia and the number of episodes of them, the highest prevalence of severe hypoglycemia, and antidiabetic treatment. Methods: Cross-sectional study. A survey of hypoglycemia (5 questions of alternatives)were provided to hospitalized patients during a period of four months; the number of episodes the patients reported were registered for 12 months, as was the type of treatment used during this period. Results: 71 patients; 34 women, mean age 65 years. The average number of correct answers was 2.42. Patients who had received some kind of education about hypoglycemia had more correct answers (p =0.0004); they trended to fewer episodes during the preceding year (p = 0.191) and more episodes of severe hypoglycemia (p=0.158). There isnt a statistically significant association between the number of episodes of hypoglycemia and the number of correct answers (Spearman r=0.0088). Regarding the type of hypoglycemic treatment, there are no significant differences between having received education and the reported number of episodes of hypoglycemia (p=0.771), nor with the presence of severe hypoglycemia (p=0.347). Conclusions: Its worth noting the limited knowledge about hypoglycemia in this patient group. Those with more knowledge reported less episodes of hypoglycemia, most likely because they know how to prevent the episodes from occurring. The greater number of incidents of severe hypoglycemia in patients with more knowledge may be due to better recognition of the severity and reporting it. Education remains a mainstay in the management of patients with DM...
