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Rincon C.A.D.,Hospital Universitario Of La Samaritana
Revista Colombiana de Gastroenterologia | Year: 2011

Obesity is considered to be the epidemic of the 21st century. Until now there are no known medical or pharmacological methods to manage obesity in ways that control it and signifi cantly reduce the comorbidities associated with it. Bariatric surgery has become the best alternative for management of obesity. Management of patients undergoing bariatric surgery requires referral centers with multidisciplinary medical groups committed to choice and long term follow-up of these patients. Bariatric surgery continues to be the gold standard for surgical management of morbid obesity. © 2011 Asociaciones Colombianas de Gastroenterología, Endoscopia digestiva, Coloproctología y Hepatología.

Luna-Duran A.M.,Anestesiologa | Gonzalez-Serrano G.,Hospital Universitario Of La Samaritana | Echeverry P.,Anestesiologa del Institute Ortopedia Infantil Roosevelt
Revista Colombiana de Anestesiologia | Year: 2015

We present a clinical case report of a child with scimitar syndrome and a review of the literature in order to describe the main surgical and anesthetic implications of these patients. Child, 4. months old, weight 4700. g, diagnosed with pneumonia and left lobar emphysema requiring mechanical intubation and ICU care. The associated diagnoses are failed extubation, severe pulmonary hypertension and scimitar syndrome confirmed with echocardiography. He was scheduled for pulmonary lobectomy. His mother signed an informed consent authorization for anesthesia and surgery. The child entered surgery, intravenous anesthetic induction was performed and a central venous catheter, an arterial line, urinary catheter and pre-and post-ductal pulse oximeters were inserted. He required vasopressor support with dopamine and transfusion of red blood cells. No adverse events during surgery. At the end of the surgery he was carried back to pediatric ICU and intubated with a chest tube. Extubation was successfully performed two days later with favorable progress. Scimitar syndrome is characterized by an anomalous right pulmonary venous return associated with congenital heart disease and pulmonary malformations. It has a low prevalence in the population but a very high perioperative morbidity and mortality, especially in children. With this report we present the main standards and practices for anesthetic management, monitoring and hemodynamic goals with these patients. © 2015 Sociedad Colombiana de Anestesiología y Reanimación.

Although there is no doubt of the benefi t of cardiac resynchronization therapy, the increased use of this technique allows to see the diffi culties in the positioning of electrodes, particularly of the left electrode. We describe the case of a man with an indication of cardiac resynchronization therapy in whom due to anatomical abnormalities of the left venous vessels and contraindication for the use of the right subclavian region, the right femoral route was successfully used. This allows us to show the femoral route as a practical and safe alternative for the implantation of cardiac resynchronization devices.

Cortes J.A.,National University of Colombia | Leal A.L.,National University of Colombia | Montanez A.M.,National University of Colombia | Buitrago G.,National University of Colombia | And 2 more authors.
Brazilian Journal of Infectious Diseases | Year: 2013

Objective: The aim of this study was to describe the most frequently found bacterial microorganisms in bloodstream isolates taken from patients in intensive care units in Colombia and their resistance profiles. Methods: This was a multicentre descriptive observational study that was carried out between January 2001 and June 2008 with laboratory data from 33 participating hospitals in a surveillance network. Results: The most frequently found microorganisms were coagulase-negative Staphylococci 39.6%, Staphylococcus aureus 12.3%, Klebsiella pneumoniae 8.2%, Escherichia coli 5.7%, Acinetobacter baumannii, 4.0% and Pseudomonas aeruginosa 3.8%. Coagulase-negative Staphylococci registered greater than 70% oxacillin resistance rate. S. aureus presented a change in its multiresistance profile during the years of follow-up. There was a trend towards a lower resistance rate among E. coli and K. pneumoniae isolates during the study period while A. baumannii carbapenem resistance rate exceeded 50%. Discussion: There has been a change in the frequency of species being isolated with a higher frequency of enterobacteriaceae compared to Gram-positive microorganisms, in general with a high resistance rate. © 2013 Elsevier Editora Ltda.

Gonzalez Cardenas V.H.,Hospital Universitario Of La Samaritana
Revista Colombiana de Anestesiologia | Year: 2012

Objective: To establish the prevalence of neonatal respiratory depression in patients exposed to intrathecal fentanyl during Cesarean section. Methods: Cross-sectional Analytical Observational Retrospective Study conducted at the Mother and Child Clinic of the Saludcoop Corporation in patients undergoing C-section who received intrathecal fentanyl for regional anesthesia in 2007 and 2008. Primary endpoints: low APGAR score (APGAR<7) and severe APGAR (APGAR<4). Results: 2165 records of C-sections and intrathecal fentanyl with a mean dose of 19.21mcg (SD=0.206mcg). Prevalence of low APGAR at 1, 5 and 10 minutes was 1.77% (SD=0.63%), 0.11% (SD 0.163%), and 0%, respectively. The latter two values were different from the 1-minute value (ANOVA Scheffé Test, p=0.031) and there was no difference between them (minutes 5 and 10) (ANOVA p=0.861). Severely diminished APGAR results were, 0.059% (SD 0.058) 1 minute after birth and 0% at 5 and 10 minutes. There were no statistically significant differences between the three severely diminished values (ANOVA p=0.861). Conclusions: The prevalence of respiratory depression measured with the APGAR test at birth is low; severely compromised APGAR shows a trend towards 0 in the different minutes of assessment. However, the reliability of the diagnostic tool (APGAR) is questionable, considering discrepancies when the analysis is done with a far more sensitive diagnostic tool (Silverman test). The importance of this study relates only to the assessment of prevalence and its use as a source of a research hypothesis, and not as an association or prediction study. © 2011 Sociedad Colombiana de Anestesiología y Reanimación.

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