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Nosocomial infections are frequent complications after abdominal surgery. Most abdominal procedures are clean-contaminated, contaminated, or even dirty procedures, since plenty of microorganisms are able to enter the gastrointestinal and the genitourinary tracts. Nosocomial infections are associated with morbidity and mortality and reduce patients'quality of life after surgery. Moreover, they prolong hospital stay and altogether represent an economic burden for health services. Despite different guidelines endorsed by scientific societies describing recommendations for preventing and treating nosocomial infections, they still represent a challenge for healthcare staff. The aim of this book is to revise the actual evidence on the different aspects of nosocomial infections after abdominal surgery.

Documento del año 2019 en eltema Medicina - Medicina interna, Nota: 100,, Materia: 2019-2020, Idioma: Español, Resumen: ¿Cómo se comporta la presión intrabdominal en los pacientes postquirúrgicos y su papel en el diagnóstico precoz de complicaciones en los servicios de Cuidados Intensivos del Hospital Universitario Camilo Cienfuegos de Sancti Spíritus, desde el 1 de enero del 2017 hasta el 1 de diciembre del 2018? La peritonitis secundaria es una patología con alto índice de morbimortalidad en nuestro centro. Se realizó un estudio observacional analítico prospectivo de cohorte longitudinal con el objetivo de determinar la relación existente entre los valores de la presión intrabdominal (PIA) y la aparición de complicaciones en pacientes que ingresaron en la UCI del Hospital “Camilo Cienfuegos” de Sancti Spíritus entre enero de 2017 hasta octubre de 2018. La muestra estuvo conformada por 73 pacientes operados con 18 o más años de edad. El 24.66% de los pacientes tenía 70 o más años, de ellos el 63.01% eran masculinos y el 58.06% fue operado por tumor abdominal, el 79.45% fue operado de urgencia y del total el 61.64% tenía una PIA grado I. El 38.35% necesitó relaparotomía de ellos el 20.84% con PIA grado II. El 52,05% no presentó complicaciones mientras que de todos los casos reintervenidos el 54.79% falleció. Por lo que podemos llegar a la conclusión que valores elevados de la PIA, especialmente con valores superiores al grado II, se relacionan con la aparición de complicaciones, la necesidad de relaparotomía y aumento de la mortalidad en los reintervenidos.

This book covers the management of surgical diseases'through the eyes'of a clinician by providing an evidence-based approach to specific clinical dilemmas. The chapters take the reader through a step-by-step'decision-making'approach to commonly encountered, but difficult to manage, situations where the editors share their rationale behind the process. Emphasis is placed on the use of tables and algorithms to simplify understanding. They aim to empower the readers with the ability to manage complex abdominal surgery scenarios in a streamlined manner, thus improving the care and outcome of patients.Key Features Targets specific, difficult to manage scenarios Provides expert opinion/advice on how to tackle tricky situations Covers both benign and malignant cases Examines surgical dilemmas through illustrations

Over two decades an abundance of knowledge has been accumulated focus­ ing on the understanding of the molecular and cellular pathomechanisms of stressful conditions like systemic inflammation and sepsis. We have learned that there is a clear correlation between the magnitude of the inciting traumatic event and the degree of inflammatory dysbalance. The immunoinflammatory disintegration comprises a simultaneous col­ lapse of the otherwise very smoothly balanced pro- and antiinflammatory vectors of cytokine regulation. Most recently, we understood that it is predominantly the dysregulation of antiinflammatory mediators that plays a pivotal role for the phenomenon of trauma-induced depression or paralysis of cell-mediated immune responses. The substantial intellectual and logistic investments of numerous investi­ gators towards understanding the biology of sepsis inevitably lead us towards a rewarding status in terms of reaching spheres of clinical relevance. From the evolutionary collection of a multitude of ex-vivo and in-vivo immuno­ mechanistic parameters, some were found to represent most significant bio­ logical markers to support the clinician to characterize better the severity of inflammatory illness and to predict outcome. Chapter one of this book, authored by G. Grass and E.A.M. Neugebauer, analyses elegantly our current knowledge on the assessment of the immuno­ logical status in terms of risk and prognosis of sepsis.