Envíos recientes

Caracterización de los pacientes con infección tardía del torrente sanguíneo en la Unidad Neonatal del Hospital de San José entre junio de 2014 y mayo de 2015. Serie de casos

Arias, Diana | 2016-12-01

Características de las pacientes con cáncer de ovario en el Hospital de San José, Bogotá D.C., 2009-2013

Mora Padilla, Edmundo | 2016-03-01

Eventos adversos de la CPRE en el Hospital de San José de Bogotá

Peñaloza Ramírez, A. | 2009

Endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred treatment method for hepatobiliary and pancreatic disease. Despite technological progress this technique continues to account for the greatest morbidity and mortality caused by digestive endoscopic procedures. ERCP carries a risk of pancreatitis, perforation, hemorrhage, cholangitis and cardiopulmonary events occurring in upto 10% of patients in referral centers, implying a mortality of up to 1%, not including therapeutic failures or the need for re-intervention. A greater mortality rate has been demonstrated in prospective studies rather than in retrospective studies, but overall, the number of complications described in the literature is much lower than the number of complications that actually occur. A descriptive prospective study was conducted at San José Hospital from April 1, 2006 to April 30, 2007 in patients who underwent an ERCP and had a 1-month follow-up. A total of 381 patients were included; 9 (2.3%) were excluded, and of the remaining 372 there was an overall success in 79.6% of cases, 8.3% had a second intervention, 7.6% developed complications (pancreatitis, perforation, hemorrhage, cholangitis, pain, intolerance to sedatives, and cardiopulmonary events), and 4.3% were failed ERCP studies. The mortality rate of the ERCP procedure was 0.8%. ERCP-related complications were determined at a teaching center, and this suggests the need to implement centers of excellence in order to improve the efficacy of the procedure.

Factores predictivos de mortalidad en la oclusión intestinal por bridas

Domínguez González, Erian Jesús | 2016-09-01

Impact of hypothermia during craniosynostosis repair surgery

González-Cárdenas, Víctor Hugo | 2016-07-01

tIntroduction: Hypothermia is recognized as a risk factor for perioperative complications inpaediatric patients. High surgical risk procedures serve as a model of exposure to that riskfactor. In particular, surgical correction of craniosynostosis serves as a model for measuringthe impact of hypothermia.Objective: To assess hypothermia-related morbidity and mortality in paediatric patientstaken to craniosynostosis correction.Methodology: Historical cohort study of patients taken to craniosynostosis correction andexposed to hypothermia.Results: With prior approval of the Ethics Committee of the institution, 54 records wereincluded in the analysis. No statistically significant differences were found betweenhypothermia and its impact in terms of morbidity and mortality (death, major bleeding,massive haemorrhage massive transfusion, disseminated intravascular coagulation, needfor vasopressor support, mechanical ventilation time and length of stay, including admission to the intensive care unit). A clinically significant increase in bleeding (severe and massive) and severe hypothermia was found (28.6% vs. 40% and 14.3% vs. 40%, respectively). Conclusions: No statistical differences were found in terms of morbidity and mortality with severe hypothermia (and moderate/severe hypothermia).

Morbidity and mortality associated with performing bone marrow aspiration and biopsy

Patiño, Bonell | 2018-02-06

Background: Bone marrow aspiration and biopsy are diagnostic methods in the study of hematological diseases. Complications are rare. Knowing the morbidity and mortality related to the procedure is essential in order to implement preventive behaviors and improvement plans. Objective: To determine the incidence of complications in patients over 18 years who were undergone to bone marrow biopsy and aspiration in a university hospital between October 2013 and May of 2015. Furthermore, frequency, socio-demographic and clinical characteristics were established as well. Materials & methods: Observational, descriptive and retrospective study. The unit of analysis was biopsies and bone marrow aspirations. The information was obtained from the database of outpatient hematology ward, into the program Group of Education and Monitoring of Egress (GESE) of the Hematology Service of Hospital de San José (Bogotá, Colombia), and from medical records. Results: A total of 1252 bone marrow aspirates and biopsies were performed on 914 patients. Seventy-seven complications were reported, which corresponds to 6.15% of all documented procedures. The most frequent complication was: pain (100%), being more affected the women (66%), OR 1,91(IC 1,18-3,11) p=0,003. Regard to pathology diagnosis, 53.2% of biopsies were histologically normal hematopoiesis, followed by 16.8% for chronic myeloproliferative syndromes, which was the diagnosis most commonly associated with bleeding events (40%):OR 8,9 (IC 1,2-66,44) p=0,006, and death (1.3%). Conclusion: Pain was the most frequently reported complication, and among bleeding complications, chronic myeloproliferative disorders were the most common diagnosis. The largest number of complications in women may be related to the anatomical differences between the genders. It is recommended to improve post-procedure analgesia and prospective studies to establish association between complications and diagnosis.

Potential Effect of Colchicine in the Prevention of Acute Respiratory Distress Syndrome (ARDS) In Patients with Covid-19 Infection

Montealegre Gómez, Giovanni | 2020-06

This work presents the theoretical basis for the use of Colchicine in the prevention of Acute Respiratory Distress Syndrome (ARDS) associated with COVID-19 infection. Several reports show that the common final event that increases mortality from COVID-19 infection is ARDS, which occurs due to an unmodulated inflammatory response, which leads to respiratory failure and death. For many years we have used colchicine, anti-inflammatory and antimitotic, for the management of symptoms associated with modeling disease, iatrogenic allogenosis, or Schoenfeld’s syndrome, obtaining control of the inflammatory or autoimmune process that occurred in these patients. Colchicine is an alkaloid extracted from the plant "Genus Colchicum" and works by modulating the inflammatory response in patients with gout, gouty arthritis and familial Mediterranean fever. We observed that a group of patients consuming colchicine, 5 patients, diagnosed with COVID-19 infection and within the age group with the highest risk, presented only minor symptoms and did not develop ARDS. This clinical observation motivates us to describe as an incidental finding the possible prophylactic effect of colchicine in the prevention of acute respiratory distress syndrome (ARDS) in patients with COVID-19 infection. Early detection of patients who may have ARDS and the use of colchicine, a very low-cost drug, in these patients may decrease the mortality associated with COVID-19 infection

Pre-anesthesia evaluation in patients with chronic renal disease (emphasis on cardiovascular risk)

González Cárdenas, Víctor Hugo | 2013

Chronic renal disease is a public health problem worldwide. Several times these patients will undergo surgical procedures related to dialysis or surgeries related to their co-morbidities. The purpose of the pre-anesthesia evaluation is to assess the risk of cardiovascular events and initiate interventions that may influence morbidity and mortality. This article describes the relevant epidemiological data of chronic kidney disease and its cardiovascular risk and provides a guide on clinical assessment, diagnostic tools and strategies to reduce surgical risk. This narrative literature review is based on articles written in both English and Spanish limited to the last 10 years, information from basic textbooks and primary databases (i.e., PUBMED - EMBASE - LILACS), supported by articles referenced in the above-mentioned search.

Stereotactic frame-based guided brain biopsies: experience in a center in Latin America

Ordóñez-Rubiano, Edgar Gerardo | 2018-05-30

Introduction: Stereotactic guided biopsies are chosen for deep-located lesions, as well as for those in eloquent areas, when the risk outweighs the benefit of an open procedure, or when open surgery has no advantage over the suspected histology. Objective: This study aims to describe retrospectively the diagnostic yield and the morbidity and mortality related to a series of stereotactic-guided biopsies in a 6-year period in a single center in Latin America. Materials and methods: 62 medical records of patients who underwent stereotactic-guided brain biopsies were reviewed. The clinical features, the morbidity and mortality associated to the procedures were acquired. Results: The complication rate was 2.7% and the diagnostic yield reached 87%. The most frequent location of the target was frontal and the most frequent diagnosis was glioblastoma. Conclusions: The complication rate and the diagnostic yield in this series were similar to the observed in different series performed with frame-based stereotactic procedures or performed with neuronavigation in the literature.