Endofuga tipo IB, complicación tardía de prótesis endovascular / Type IB endoleak: a late complication of endovascular prosthetic repair

Objetivo: describir las endofugas como complicación tardía de las prótesis por reparación endovascular de aneurisma de aorta abdominal, a través del reporte de caso presentado en el Hospital Universitario del Quindío San Juan de Dios Colombia. Diseño del estudio: reporte de caso. Presentación: hombre de 77 años, con antecedente de implante de endoprótesis en la aorta abdominal infrarrenal y en las arterias iliacas derecha e izquierda. Siete años después ingresó al servicio de urgencias por hipotensión, diaforesis y dolor abdominal de inicio súbito. Se realizó intervención quirúrgica de urgencia evidenciando ruptura de aneurisma y endofuga tipo IB a nivel de la endoprotesis de aorta abdominal. Conclusión: la reparación endovascular, técnica de gran importancia para el manejo del aneurisma de aorta abdominal (AAA), tiene el riesgo de complicación por exclusión incompleta de flujo sanguíneo al saco aneurismático, con tasas de reintervención por complicación de 30% y conversión a manejo quirúrgico de 5%, aumentando la mortalidad.

Objective: to describe endoleaks as a late complication of endovascular prosthetic repair (EVAR) of abdominal aorta aneurysm (AAA), through a case report presented at Hospital Universitario del Quindío San Juan de Dios Colombia. Study Design: case report. Case presentation: a 77-year-old man with past medical history of undergoing an EVAR of the left and right common iliac arteries for infra-renal AAA. Seven years later he was admitted to the emergency department with a sudden episode of hypotension, diaphoresis and abdominal pain. He underwent an emergency surgical intervention evidencing an AAA sac rupture secondary to a type IB peri-prosthetic endoleak. Conclusion: EVAR, a very important procedure for the management of AAA has the disadvantage of post-procedural complications due to failure to completely exclude blood flow perfusing the aneurysm sac, requiring a re-intervention in 30% and the need for open surgery in 5% associated with increased mortality rates.

Perioperative Care for Pediatric Patients With Penetrating Brain Injury: A Review.

Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury. PBI was one of the exclusion criteria in the second edition of guidelines for the acute medical management of severe TBI in infants, children, and adolescents that was published in 2012 (it is referred to as "pediatric guidelines" in this review). Many reviews of TBI do not differentiate between the mechanisms of injury. We present an overview of PBI, its presenting features, epidemiology, and causes as well as an analysis of case series and the conclusions that may be drawn from those and other studies. More clinical trials specific to penetrating head injuries in children, focusing mainly on pathophysiology and management, are needed. The term PBI is specific to penetrating injury only, whereas TBI, a more inclusive term, describes mainly, but not only, blunt injury.

Participatory ergonomics among female cashiers from a department store.

The objective of this paper was to control ergonomic risks among female cashiers working in a department store belonging to the retail market. This study was conducted between May and November 2010. Participatory ergonomics was applied through knowing and understanding how the company works, establishing the work team (Ergo group), training the team in ergonomics-related topics, and making decisions and interventions. The sample was composed of 71 participants--mostly female cashiers--, and all of them have a musculoskeletal compromise, declaring pain or discomfort mainly in the neck, lower back, right wrist and shoulders. Among others, following problems were found: postural overload, repetitive work, manual load handling, mental fatigue, environmental discomfort, variable work schedules, extended working days, and absence of breaks. In the intervention, the main implemented changes were the redesign of workstation, complete change of chairs and keyboards, and the implementation of a rotation system, as well breaks for compensatory exercises. After that, an evident improvement of found problems was observed, therefore it can be concluded that participatory ergonomics is an attractive methodology, appropriate and efficient for solving and controlling ergonomic risks and problems.

Ergonomía participativa en cajeras de una gran tienda / Participatory ergonomics among female cashiers from a department store

El objetivo de este trabajo fue controlar los riesgos disergonómicos en cajeras de una tienda de una gran empresa del sector del retail, usando ergonomía participativa, a través del conocimiento y entendimiento del sistema de la empresa, constitución del grupo de trabajo (grupo Ergo), capacitación del grupo en temas relacionados con la ergonomía, toma de decisiones e intervenciones. La muestra estuvo compuesta de 71 participantes –en su mayoría cajeras–, las cuales en el 100 por ciento tenían compromiso músculo-esquelético, y manifestaban dolor o molestia principalmente en cuello, región lumbar, muñeca derecha y hombros. Se encontró sobrecarga postural, trabajo repetitivo, manejo manual de cargas, carga mental, disconfort ambiental, variabilidad en los horarios, jornadas prolongadas, ausencia de pausas, entre otros trastornos. En la intervención los principales cambios implementados fueron el rediseño de la estación de caja, la renovación de sillas y teclados e implementación de un sistema de rotación, así como la realización de pausas con ejercicios compensatorios. Luego de la intervención se observó una notoria mejoría de las problemáticas encontradas, concluyéndose que la ergonomía participativa es una metodología atractiva, adecuada y eficaz en la solución y control de los riesgos y problemas ergonómicos.

The objective of this paper was to control ergonomic risks among female cashiers working in a department store belonging to the retail market. Participatory ergonomics was applied through knowing and understanding how the company works, establishing the work team (Ergo group), training the team in ergonomics-related topics, andmaking decisions and interventions. The sample was composed of 71 participants –mostly female cashiers–, and all of them have a musculoskeletal compromise, declaring pain or discomfort mainly in the neck, lower back, right wrist and shoulders. Among others, following problems were found: postural overload, repetitive work, manual load handling, mental fatigue, environmental discomfort, variable work schedules, extended working days, and absence of breaks. In the intervention, the main implemented changes were theredesign of workstation, complete change of chairs and keyboards, and the implementation of a rotation system, as well breaks for compensatory exercises. After that, an evident improvement of found problems was observed, therefore it can be concluded that participatoryergonomics is an attractive methodology, appropriate and efficientfor solving and controlling ergonomic risks and problems.