ABSTRACT
Una de las complicaciones más temidas de la colecistectomía es la lesión de la vía biliar principal. Si ésta es advertida, el cirujano debe ser capaz de reparar tal lesión para evitar secuelas posteriores. En el 75%de los casos la lesión es inadvertida y condiciona, a corto o largo plazo, una estenosis benigna que plantea problemas serios de diagnóstico y tratamiento. Su frecuencia es de aproximadamente 0,2%en la colecistectomía convencional, y en la colecistectomía laparoscópica se ha comunicado una frecuencia de 2%. Existen varios factores que inciden en su producción y que pueden ser prevenibles, si se conocen. El pronóstico depende del criterio para escoger el procedimiento de reparación y de la habilidad para realizarlo. Sin embargo, el factor más importante es el estado funcional del hígado
Subject(s)
Cholecystectomy/adverse effects , Common Bile Duct/injuries , Iatrogenic Disease/etiology , Iatrogenic Disease/surgeryABSTRACT
Estamos enfermos de muchos errores y de otras tantas culpas; pero nuestro peor delito se llama abandono de la infancia, descuido de la fuente de vida. Muchas de las cosas que necesitamos pueden esperar. El niño no. El está haciendo ahora mismo sus huesos, creando su sangre y ensayando sus sentidos. A él no se le puede responder "mañana". El se llama "ahora". (Gabriela Mistral)
Subject(s)
Iatrogenic Disease/etiology , Neonatology/trends , Perinatology/trendsABSTRACT
A major cause for failure of krypton red laser photocoagulation in patients with exudative age-related macular degeneration has been the development of recurrent choroidal neovascularization adjacent to the previously treated areas. After reviewing the possible causes of recurrences, it is apparent that a certain number are iatrogenic, ie, induced by krypton red laser causing disruption and damage to the pigment epithelium-Bruch's membrane-choroidal complex. We describe three separate episodes in two patients of iatrogenic recurrent choroidal neovascularization after krypton red laser photocoagulation.
Subject(s)
Choroid/blood supply , Iatrogenic Disease/etiology , Light Coagulation/adverse effects , Neovascularization, Pathologic/etiology , Aged , Female , Fluorescein Angiography , Fundus Oculi , Humans , Laser Therapy , Macula Lutea/anatomy & histology , Recurrence , Visual AcuityABSTRACT
During antirejection treatment with antithymocyte globulin (ATG), a 48-year-old male kidney graft recipient was erroneously given 30 mg/kg ATG on day 5 of the treatment course. Clinically, the patient presented with abdominal pain, profuse diarrhea, and fever. Initially, the platelet count dropped to 94 x 10(3)/microliters and showed a further decrease to 65 x 10(3)/microliters 2 days thereafter. Plasmapheresis carried out about 12 h after the end of ATG infusion resulted in a decrease in serum levels of total rabbit immunoglobulin as well as the antibody fraction reactive with human T lymphocytes. Within 10 days after the discontinuation of ATG treatment, the relative and absolute number of the T-cell subpopulations, which had disappeared from the circulation at the time of antirejection therapy, returned to normal values. In addition, at this time both platelet and lymphocyte counts were again found to be in the normal range. Kidney function had recovered from the rejection crisis such that the patient could be discharged 26 days posttransplantation.
Subject(s)
Antilymphocyte Serum/adverse effects , Iatrogenic Disease/etiology , Kidney Transplantation , T-Lymphocytes/immunology , Antilymphocyte Serum/administration & dosage , Diarrhea/etiology , Fever/etiology , Humans , Iatrogenic Disease/blood , Iatrogenic Disease/therapy , Leukopenia/etiology , Male , Middle Aged , Pain/etiology , Plasmapheresis , Thrombocytopenia/etiologyABSTRACT
As the computerization of patient care becomes more widespread, hospitals are likely to experience increasing liability for computer-related patient injuries. With physicians' exclusive responsibility for the quality of care giving way to one that, for inpatients, is shared with the hospital, this increased computerization complicates the determination of liability for patient injuries. However, potential liability can be minimized if hospitals control the use of new computerized equipment, such as through the privileging process, manager equipment wisely, and train personnel in its proper use.
Subject(s)
Decision Making, Computer-Assisted , Equipment Safety , Financial Management/methods , Hospital Information Systems/legislation & jurisprudence , Iatrogenic Disease/etiology , Malpractice/legislation & jurisprudence , Risk Management/methods , Humans , Software/standards , United States , United States Food and Drug AdministrationSubject(s)
Catheterization/adverse effects , Iatrogenic Disease/etiology , Ureter/surgery , Animals , Dilatation/adverse effects , Humans , SwineABSTRACT
Increasing experience with the diagnosis of retinal pigment epithelial (RPE) tears has led to expanded recognition and understanding of this clinical entity. The authors report 18 RPE tears followed for an average of 28 months; 16 were associated with age-related macular degeneration and 2 with presumed ocular histoplasmosis syndrome. Retinal pigment epithelial dehiscences fell into four categories: nine spontaneous tears associated with choroidal neovascularization, one tear associated with an RPE detachment without choroidal neovascularization, four iatrogenic tears occurring at krypton treatment of choroidal neovascularization, and four iatrogenic tears developing weeks to months after laser treatment of choroidal neovascularization. Eight patients had a final visual acuity of 20/100 or better, four were 20/200, and six were 20/400 or worse. Photocoagulation, particularly with the use of krypton red laser, may be modified on the basis of possible RPE tear formation. Heightened awareness of the possibility of inducing pigment epithelial rips should improve diagnosis and management of these cases.
Subject(s)
Pigment Epithelium of Eye , Adult , Aged , Aged, 80 and over , Choroid/blood supply , Eye Diseases/complications , Eye Diseases/pathology , Eye Diseases/physiopathology , Female , Fluorescein Angiography , Humans , Iatrogenic Disease/etiology , Laser Therapy/adverse effects , Male , Middle Aged , Neovascularization, Pathologic/surgery , Pigment Epithelium of Eye/injuries , Prognosis , Visual AcuitySubject(s)
Adenoma, Islet Cell/chemically induced , Adenoma, Islet Cell/complications , Glucagon/adverse effects , Glucagonoma/chemically induced , Iatrogenic Disease/etiology , Insulinoma/complications , Pancreatic Neoplasms/complications , Skin Diseases/etiology , Amino Acids/blood , Female , Glucagon/blood , Glucagon/therapeutic use , Humans , Hypoglycemia/drug therapy , Hypoglycemia/etiology , Middle Aged , Pancreatic Neoplasms/chemically induced , Skin Diseases/pathology , SyndromeSubject(s)
Esophageal Perforation/etiology , Iatrogenic Disease/etiology , Aged , Biopsy/adverse effects , Drainage/adverse effects , Esophageal Perforation/mortality , Esophageal Perforation/surgery , Esophagoscopy/adverse effects , Humans , Iatrogenic Disease/mortality , Iatrogenic Disease/surgery , Male , Middle Aged , Prognosis , Radiography , Vagotomy/adverse effects , Wounds and Injuries/complicationsABSTRACT
Three cases of iatrogenic compartment syndrome of the upper extremity are reported. Each was the result of the use of hypertonic saline solution in the administration of intravenous regional anesthesia. Two patients were left with residual problems after resolution of the compartment syndrome despite early surgical intervention in one of these cases. This mechanism may explain other previously reported occurrences of severe swelling in an extremity after intravenous regional anesthesia.
Subject(s)
Anesthesia, Conduction/adverse effects , Compartment Syndromes/etiology , Saline Solution, Hypertonic/adverse effects , Sodium Chloride/adverse effects , Adult , Arm , Female , Humans , Iatrogenic Disease/etiology , Middle AgedABSTRACT
Three to 15% of the whole population of patients with small cell lung carcinoma are long-term survivors. In a view of preventing iatrogenic sequellae and obtaining a better definition of therapeutic indications, the prognostic factors in this population will be defined.
