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Introduction. One of the congenital anomalies that pediatric surgeons constantly face is esophageal atresia. The results of its treatment in the 21st century, which is even carried out through minimally invasive surgery, have nothing to do with the anguish experienced after its recognition as a disease in 1670 by Durston. Methods. A historical review and analysis of the information available in the databases was performed to establish the evolution of the surgical correction of esophageal atresia over time to the present. Results. Since the end of the 19th century, when the era of surgery began, surgeons faced the uncertainties of a disease that was yet to be understood, making multiple unsuccesful efforts, with high mortality in each procedure proposed for its resolution. After five decades of failed attempts, the resilience of the surgeons of the time, together with progress in anesthetic resources, pediatric and nursing care, instruments and infection control, finally allowed the goal of achieving survival after such a complex procedure was possible. Conclusions. This article aims to recognize the milestones that marked advances in surgery for the correction of esophageal atresia at the global, Latin American and national levels. [ABSTRACT FROM AUTHOR]

Thoracic surgery is associated with severe acute and chronic pain; therefore, postoperative pain management is crucial for the success of the surgery. There are factors that can trigger greater pain in this procedure, and the anesthetic management and analgesic techniques used can help to better control moderate to severe pain. This review aims to conduct updated bibliographic research on the use of medications and various techniques used in multimodal analgesia in thoracic surgery, such as paravertebral block, epidural block, erector spinae plane block (ESP), or serratus anterior block, as well as intravenous or oral drugs that can improve analgesia. A systematic review of the literature was performed using the PubMed, Embase, and Scopus databases from January 2010 to January 2024, with the keywords «analgesia», «thoracic surgery», «postoperative pain», «nerve block». Studies in English and Spanish that discussed anesthesia techniques applied during thoracic surgery procedures were included. As a result, 27 articles were selected according to their importance and level of impact. In conclusion, multimodal analgesia is the tool we should utilize. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción. Una de las anomalías congénitas a las que permanentemente se enfrenta el cirujano pediatra es la atresia de esófago. Los resultados de su tratamiento en el siglo XXI, el cual incluso se realiza a través de cirugía mínimamente invasiva, nada tienen que ver con las angustias vividas a partir de su reconocimiento como enfermedad en 1670 por Durston. Métodos. Se realizó una revisión histórica y el análisis de la información disponible en las bases de datos, con el fin de establecer la evolución de la corrección quirúrgica de la atresia esofágica a través del tiempo hasta la actualidad. Resultados. Desde finales del siglo XIX, cuando empezó la era de la cirugía, los cirujanos se enfrentaron a las incertidumbres de una enfermedad que estaba por comprenderse, realizando múltiples esfuerzos infructuosos, con alta mortalidad en cada procedimiento que se proponía para su resolución. Luego de cinco décadas de intentos fallidos, la resiliencia de los cirujanos de la época, junto con el progreso en cuanto a recursos anestésicos, cuidados pediátricos y de enfermería, instrumental y control de las infecciones, permitió que por fin el objetivo de alcanzar la supervivencia después de un procedimiento tan complejo fuera posible. Conclusiones. Este artículo pretende reconocer los hitos que marcaron los avances en la cirugía para la corrección de la atresia de esófago en el ámbito mundial, latinoamericano y nacional.

Resumen: La circulación extracorpórea (CEC) es un componente esencial de la cirugía cardíaca dado que permite mantener soporte vital durante el paro cardíaco inducido necesario para realizar las intervenciones cardioquirúrgicas. Sin embargo, la CEC presenta efectos adversos a nivel local y sistémico debido a que sus componentes producen alteraciones a nivel de la macro y microcirculación, potencialmente llevando a una hipoperfusión. La técnica de perfusión dirigida por objetivos (GDP, por sus siglas en inglés), busca personalizar el manejo hemodinámico según metas predefinidas, optimizando de tal modo la oxigenación y perfusión tisular durante la CEC. Esto implica una monitorización constante de parámetros claves, con la finalidad de realizar cambios en tiempo real de las estrategias de perfusión. Durante los últimos 10 años, se han explorado los beneficios del uso de GDP y, visualizado su superioridad en relación al enfoque tradicional. El objetivo de este artículo es describir la práctica GDP en la monitorización durante la CEC. Nos enfocaremos en las variables ya existentes monitorizadas bajo el concepto de GDP, aplicándolas y manipulándolas para optimizar la perfusión tisular en tiempo real. Abstract: Extracorporeal circulation (ECC) is an essential component of cardiac surgery since it allows life support to be maintained during the induced cardiac arrest necessary to perform cardiosurgical interventions. However, CPB presents adverse effects at a local and systemic level because its components produce alterations at the macro- and microcirculation levels, potentially leading to hypoperfusion. The goal-directed perfusion (GDP) technique seeks to personalize hemodynamic management according to predefined goals, thereby optimizing tissue oxygenation and perfusion during CPB. This implies constant monitoring of key parameters, to make real-time changes to perfusion strategies. Over the past 10 years, the benefits of using GDP have been explored and its superiority over the traditional approach visualized. The objective of this article is to describe GDP practice in monitoring during CPB. We will focus on the existing variables monitored under the GDP concept, applying and manipulating them to optimize tissue perfusion in real-time.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: Describir las características clínico-demográficas de sujetos internados luego de una intervención quirúrgica que recibieron asistencia kinésica (AK) en sala de cirugía general de un hospital público de Ciudad Autónoma de Buenos Aires (CABA). El objetivo secundario es describir el uso de dispositivos de oxigenoterapia, el desarrollo de complicaciones pulmonares postoperatorias (CPP) y el tiempo transcurrido hasta la AK. Materiales y métodos: Se incluyeron datos de fichas kinésicas de sujetos que se sometieron a una cirugía abdominal, torácica o pélvica y que recibieron AK entre enero de 2019 y diciembre de 2022. Se registraron datos demográficos y clínicos, motivo de consulta kinésica, desarrollo de CPP, cantidad de días de AK y uso de de oxigenoterapia. Resultados: Se incluyeron 151 fichas kinésicas. Del total, 15 sujetos (9,9 %) desarrollaron CPP. En este grupo, la mediana de días transcurridos entre la cirugía y el comienzo de la AK fue de 8 días (RIQ 4-16), mientras que para los sujetos que no desarrollaron complicaciones fue de 4 días (RIQ 2-7). Un total de 57 sujetos (37,5 %) requirieron oxigenoterapia, de los cuales 3 requirieron ventilación mecánica invasiva y 1 no invasiva. Conclusión: Se describieron las características clínico-demográficas de sujetos postquirúrgicos internados en sala de cirugía general de un hospital general de agudos de la CABA. Aquellos sujetos con CPP recibieron más días de AK y requirieron oxígeno suplementario durante un período más extenso. Los sujetos que no desarrollaron CPP recibieron AK en una etapa más temprana, en comparación con los que desarrollaron complicaciones.

Fundamento: en las últimas seis décadas han existido avances significativos en la supervivencia de los pacientes y en los resultados funcionales tras una cirugía de reemplazo de válvulas cardíacas. Objetivo: identificar factores predictivos de supervivencia relacionados con el síndrome de bajo gasto cardíaco, en pacientes con cirugía cardíaca valvular, atendidos en el Centro de Cirugía Cardiovascular y Cardiología, Hospital Provincial Clínico Quirúrgico Docente Saturnino Lora Torres, en Santiago de Cuba, entre enero 2019 y diciembre 2021. Métodos: se realizó un estudio analítico de casos y controles en pacientes que tuvieron síndrome de bajo gasto cardíaco en el período posoperatorio, luego de recibir cirugía valvular cardíaca en el centro y período de tiempo antes declarados. Se trabajó con una muestra de 168 pacientes, divididos en dos grupos: uno con 56 casos de síndrome de bajo gasto cardíaco y 112 controles, que no presentaron esta entidad. Resultados: 34,5 % de los pacientes tenían edad ≥ 65 años; el antecedente de diabetes mellitus y de fibrilación auricular mostraron asociación con la aparición de bajo gasto cardíaco. La cirugía de emergencia (en 45,2 % de los pacientes); sangramiento, tiempo de circulación extracorpórea, función sistólica del ventrículo izquierdo y excursión sistólica del plano anular tricúspideo alterados, además de la presencia de hipertensión pulmonar, evidenciaron asociación. Conclusiones: la edad > 65 años, disfunción de ambos ventrículos deprimida, el antecedente de fibrilación auricular y el tiempo de circulación extracorpórea mayor de 90 minutos, son capaces de predecir la aparición de bajo gasto cardíaco y la supervivencia.

Introduction: The reported incidence of cardiac trauma is low and its degree of resolution is variable depending on the cause, the mechanism of injury, the place where it occurs and the characteristics of the health care system. Their incidence has currently increased due to the increase in traffic accidents and violence, with a predominance of penetrating trauma associated with stab wounds and firearms. Cardiac trauma is accompanied by a high degree of lethality. Clinical case. A 35-year-old female patient, evaluated in the emergency room for penetrating thoracic trauma caused by stab wound. She underwent emergency intervention due to left pleural effusion, but without hemodynamic improvement. She was reevaluated and pericardial effusion with cardiac tamponade caused by cardiac injury was detected. She was treated surgically with satisfactory Results: Results: The clinical manifestations generally described in penetrating cardiac trauma are severe and fatal, but in some cases and due to the characteristics of the injury caused, the patient's hemodynamics may not be so compromised. To consolidate the clinical diagnosis, several complementary studies can be performed, with FAST ultrasound being one of the most recommended due to its high sensitivity and specificity. Surgical treatment is still the most indicated, depending on the technological progress of the hospital and the hemodynamic stability of the patient. Conclusions. Knowledge of penetrating cardiac trauma is of great importance, not only for the emergency department physician but also for the general practitioner. A quick and accurate diagnosis, together with adequate management can be decisive in saving the patient's life. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Paulista de Enfermagem is the property of Universidade Federal de Sao Paulo, Escola Paulista de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The survival of patients with Marfan syndrome and aortic root involvement has increased over the past decades due to the introduction of valve-sparing aortic root replacement techniques. Objective: To identify and characterize the short- and long-term outcomes of patients with Marfan syndrome managed with aortic root replacement with aortic valve reimplantation (Tirone David procedure). Materials and method: A case series of patients diagnosed with Marfan syndrome who underwent the surgical procedure between 2002 and 2020. Kaplan-Meier curves were created to evaluate aortic reintervention-free time and survival. Results: 18 patients were included, the average age was 29 years; disease progression was identified in 35.3%, determined by reintervention in five patients, three patients had type B aortic dissection, two had severe aortic insufficiency and five had chronic thoracic or abdominal aneurysms. There were three deaths, not directly related to disease progression. Conclusions: In patients with Marfan syndrome and aortic root disease, aortic root replacement with aortic valve reimplantation is the ideal technique due to its results in results in avoiding the need for reintervention and improving survival and quality of life. However, surgery does not resolve distal aortic involvement, which is the main factor in disease progression. [ABSTRACT FROM AUTHOR]

Background: Cardiopulmonary bypass generates an exacerbated response that may lead to sepsis Objective: To describe the association between procalcitonin levels and sepsis diagnosis in cardiovascular surgery subjects with cardiopulmonary bypass. Material and methods: A case-series study was conducted in 142 patients. Serum procalcitonin levels were measured at 24 hours and at 72 hours after surgery using a point of care testing based on quantitative immunochromatographic method. To assess association between procalcitonin levels and sepsis status, we calculated area under the curve (AUC) and sensitivity, specificity, and predictive values for the best cut-off point. Results: From 142 patients studied, 7 developed sepsis after surgery (4.9%). For 24-hours procalcitonin levels AUC was 0.921 and best cut-off point was 3.8 ng/mL (sensitivity 0.857 and specificity 0.904). In the case of 72-hours procalcitonin levels, we observed a value of 0.868 for AUC and best cut-off point was 8.4 ng/mL (sensitivity 0.86 and specificity 0.97). Conclusions: Procalcitonin levels at 24 and 72 hours after cardiovascular surgery with cardiopulmonary bypass are associated with sepsis presence at cut-off points of 3.8 and 8.4 ng/mL respectively. [ABSTRACT FROM AUTHOR]

Objective: To evaluate effectivity of thymectomy as an alternative treatment of MG in our center, between 2007 and 2019 and to know how it has impacted in life quality and pharmacological management. Material and Method: cohort study patients treated with thymectomy by Thoracic Surgical team from Gustavo Fricke Hospital between 2007 and 2019. The study variables were medical treatment and anticholinesterases doses before and after the thymectomy, and life quality measured through MG-QOL15 survey. Standard deviation measures and statistics comparisons were used for the analysis of these variables, considering statistically significant a p < 0.05. Results: total of 20 patients, mainly young women, thymectomy through a Trans-sternal approach. Anticholinesterase doses, showed a statistically significant decrease from 5.05 to 3.06 before and after thymectomy (p < 0.05). Discussion: It has been demonstrated that thymectomy plays an important role on the management of MG, giving a mastery against medical exclusive treatment, The American Foundation for Myasthenia Gravis recommends the use of MG-QOL15 survey as an important tool to evaluate life quality. There is a limited amount of national literature related to this topic. Conclusion: Thymectomy is a life quality changing procedure for MG patients and it helps to significantly reduce the drug doses used. [ABSTRACT FROM AUTHOR]

Fundamento: el traumatismo torácico es un cuadro clínico complejo que puede comprometer la vida del paciente. Por ello es de interés su estudio y análisis.Objetivo: caracterizar los pacientes con traumatismo torácico en el servicio de Cirugía General.Métodos: estudio descriptivo, prospectivo, de serie de casos, que incluyó a pacientes que ingresaron con el diagnóstico de traumatismo torácico, en el servicio de Cirugía General del Hospital General Universitario Dr. Gustavo Aldereguía Lima, de Cienfuegos, en el período enero/2019 a diciembre/2020. Las variables analizadas fueron: edad, sexo, comorbilidades, exámenes imagenológicos, agente causal, lesión torácica, tipo de tratamiento, tipo de traumatismo torácico y estado al egreso.Resultados: el trauma de tórax fue más frecuente en el sexo masculino, a partir de la cuarta década de vida en pacientes sanos. El examen imagenológico más usado fue la radiografía simple de tórax; y el agente causal predominante, la herida por arma blanca. Las lesiones torácicas más frecuentes resultaron el enfisema subcutáneo y el hemoneumotorax, así como la pleurostomía fue el tipo de tratamiento más usado. Predominó el traumatismo torácico aislado, siendo las lesiones abdominales las más asociadas. La mayoría de los pacientes egresaron vivos.Conclusión: el trauma torácico constituye una patología altamente desafiante, por lo complejas que pueden llegar a ser las lesiones derivadas de él; se presenta con mayor frecuencia en hombres sanos. Cuando se asocia a otras lesiones aumenta la mortalidad.

Objective: To determine the possible clinical and echocardiographic predictors associated with the onset of low cardiac output syndrome. Materials and methods: An analytical case--control study was conducted in patients with postoperative low cardiac output syndrome treated at Centro de Cardiología y Cirugía Cardiovascular of Hospital Provincial Docente Saturnino Lora in Santiago de Cuba from January 2019 to December 2021. Both study groups were part of the same population of patients who underwent a cardiovascular surgery but differed in the fact that, at admission, some suffered from postoperative low cardiac output syndrome and others did not. The dependent variable was the presence of low cardiac output and the independent variables were clinical, hemodynamic and echocardiographic factors. Results: In the series, patients under 65 years of age prevailed in both case and control groups (51.2 % and 73.5 %, respectively). Atrial fibrillation, right ventricular systolic function and perioperative bleeding (p = 0.008) were statistically significant (p < 0.05). Most patients (102 [91.10 %; p = 0.047]) showed a left ventricular ejection fraction (LVEF) > 50 % and a large number of patients (76 [45.24 %; p ≤ 0.05; OR: 2.14]) had undergone emergency surgeries. A logistic regression analysis determined that the clinical and echocardiographic variables, such as age over 65 years, depressed right ventricular function, extracorporeal circulation ≥ 90 minutes and elevated pulmonary artery systolic pressure, had a statistically significant association. The area under the curve (AUC) showed that variables including age, extracorporeal circulation time and perioperative bleeding had predictive capability. Conclusions: It was observed that some clinical and echocardiographic elements, such as age, atrial fibrillation, depressed right ventricular systolic function and emergency surgery, were associated as predictors of low cardiac output syndrome. [ABSTRACT FROM AUTHOR]

Introduction: pulmonary thromboendarterectomy is the treatment of choice and the only potentially curative option for chronic thromboembolic pulmonary arterial hypertension. Objective: To integrate the information available in the scientific literature on nurse involvement in pulmonary thromboendarterectomy. Method: integrative review for which a search of primary articles was carried out in databases such as: CUIDEN, SAGE, Springer, Scholar, Scopus, Taylor and Francis, PubMed, ScienceDirect and LILACS. Search strategies were defined in both English and Spanish, no period was established, a database was built with the information obtained and this was integrated in a narrative way. Results: 8 articles were included, 5 of them were topics reviews. Nurse plays a critical role, participating in the different intervention phases within the surgical context, promoting the patient’s hemodynamic evolution; skillfully detecting problems related to cardiac output, severe changes in pulmonary pressure, ventilatory needs applied to the patient and hydroelectrolytic management; it also dominates the complications that are the cornerstone derived from the procedure. Conclusions: The nurse plays in the processes of understanding the diagnosis, preoperative, intraoperative and postoperative phase; However, there are limitations in the production of knowledge in this event of interest from nursing. [ABSTRACT FROM AUTHOR]

Introducción. La lobectomía pulmonar es uno de los procedimientos más frecuentes en la cirugía torácica en Colombia y a nivel mundial. El objetivo de este estudio fue proporcionar información sobre el comportamiento clínico de los individuos sometidos a este tipo de cirugías. Métodos. Estudio observacional retrospectivo en un Hospital Universitario de Cali, Colombia, que incluyó todos los pacientes sometidos a lobectomía pulmonar, por causas benignas o malignas, entre los años 2010 y 2020. La información se extrajo del registro institucional de cirugía de tórax, obteniendo datos demográficos, clínicos y patológicos. Resultados. Se evaluaron los registros clínicos de 207 individuos. El 55,5 % eran mujeres, la edad promedio fue 58 años y el 41 % tuvieron antecedente de tabaquismo. En el 51,6 % de los casos se diagnosticaron neoplasias, de las cuales el 47,8 % eran primarias de pulmón, siendo el adenocarcinoma el subtipo más común. Las enfermedades benignas no tumorales representaron el 48,3 % de los casos y la causa más frecuente fueron las infecciones, dentro de las que se incluyeron 17 casos de tuberculosis pulmonar. La técnica más frecuente fue la cirugía toracoscópica video asistida (82,6 %). Presentaron un porcentaje de reintervención del 5,8 %, 10,6 % de complicaciones severas y una mortalidad hospitalaria del 4,3 %. Conclusión. La población evaluada muestra una carga alta de comorbilidades y riesgo operatorio elevado; de forma consecuente, al compararla con otras series internacionales, se encontró un porcentaje mayor de complicaciones perioperatorias y mortalidad.

Objective: to evaluate the religious-spiritual coping in patients in the preoperative period of cardiac surgery. Method: cross-sectional, analytical study, in which 62 patients hospitalized in the preoperative period of cardiac surgery, between September and December 2020, in two reference hospitals in cardiac surgery in northeastern Brazil, were evaluated. Results: the patients showed a high use of religious-spiritual coping, with predominance for the positive. The main factors used for positive religious-spiritual coping were Positive position towards God and Distancing through God/Religion/Spirituality. Conclusion: nurses can consider and invest in interventions that favor positive coping, aiming to reflect better patient experience in the face of important stressors, such as cardiac surgery. [ABSTRACT FROM AUTHOR]

Background: chest trauma is a complex clinical picture that can compromise the patient's life. Therefore, its study and analysis is of interest. Objective: to characterize patients with chest trauma in the General Surgery service. Methods: descriptive, prospective, case series study which included patients admitted with a diagnosis of chest trauma, in the General Surgery Service at the Dr. Gustavo Aldereguía Lima General University Hospital, Cienfuegos, from January 2019 to December2020. The analyzed variables were: age, sex, comorbidities, imaging tests, causal agent, chest injury, type of treatment, type of chest trauma, and discharge status. Results: chest trauma was more frequent in males, from the fourth decade of life in healthy patients. The most used imaging test was the simple chest X-ray; and the predominant causal agent, the stab wound. The most frequent chest injuries were subcutaneous emphysema and hemopneumothorax, and pleurostomy was the most used type of treatment. Isolated chest trauma prevailed, with abdominal injuries being the most associated. Most of the patients were discharged alive. Conclusion: thoracic trauma constitutes a highly challenging pathology, due to how complex the injuries derived from it can become; It occurs more frequently in healthy men. When associated with other injuries, mortality increases. [ABSTRACT FROM AUTHOR]

Introducción: La cirugía torácica representa una de las causas de ingreso más frecuentes en la unidad de cuidados intensivos. Objetivo: Describir las variables edad, sexo, diagnóstico preoperatorio, técnica quirúrgica empleada, analgesia, complicaciones y evolución de los pacientes sometidos a cirugía torácica, en una unidad de cuidados intensivos. Métodos: Se realizó un estudio de corte transversal de 42 pacientes de cirugía torácica, ingresados en una unidad de cuidados intensivos. Se estudiaron las variables edad, sexo, diagnóstico, técnica quirúrgica empleada, analgesia, complicaciones y evolución, con las cuales se realizó un análisis de frecuencias. Resultados: El grupo etario predominante fue el de mayores de 60 años (42,9 %). El sexo representativo fue el masculino (78,5 %). El diagnóstico más frecuente para cirugía torácica fue el cáncer de pulmón (47,6 %). La técnica más empleada fue la lobectomía (28,6 %). La dipirona fue la analgesia más utilizada (35,7 %). La mayoría de los pacientes no presentó complicaciones (83,3 %). Prevalecieron los pacientes egresados vivos (97,6 %) sobre los fallecidos (2,4 %). Conclusiones: El cáncer de pulmón representó la causa más frecuente de cirugía torácica en ambos sexos, en consecuencia, la toracotomía con lobectomía fue la técnica más empleada. Este tipo de intervención siempre implica alteraciones funcionales que pueden ser inaparentes y controlables; el manejo postoperatorio en la unidad de cuidados intensivos de estos pacientes determinará en gran medida su evolución.

Background: Thoracic great vessel injuries in thoracic trauma (TTGVI) are a heterogeneous group of injuries with high morbimortality that constituting 0.3-10% of the findings in thoracic trauma (TT). Aim: To describe characteristics, treatments and variables associated with mortality in hospitalized patients with TTGVI. Methods: Observational-analytical study. Period January-1981 and December-2020. Review of prospective TT protocols and clinical records. TTGVI were classified according to American Association for the Surgery of Trauma (AAST), trauma severity index were calculated: Injury Severity Score (ISS), Revised Trauma Score Triage (RTS-T) and Trauma Injury Severity Score (TRISS). Univariate and multivariate analysis was performed with calculation of Odds Ratio (OR) for variables associated with mortality. SPSS25® was used, with U Mann Whitney and chi-squared tests, as appropriate. Results: From a total of 4.577 TT in the period, 97 (2.1%) met the inclusion criteria. Males: 81 (91.8%), mean age: 32.3 ± 14.8 years. Penetrating TT: 65 (67.0%). Axillary-subclavian artery lesions in 39 (40.2%) and thoracic aorta in 31 (32.0%) were more frequent. AAST 5-6: 39 (40.2%). Invasive treatment: 87 (89.7%), of these, in 20 (20.6%) endovascular repair, 14 (14.4%) of thoracic aorta. Open surgery in 67 (69.1%). Mortality in 13 (13.4%), shock on admission was independently associated with mortality (OR 6.34) and ISS = 25 (OR 6.03). Conclusion: In our series, TTGVI were more frequent in axillary-subclavian vessels and thoracic aorta. Treatment was mainly invasive, with open surgery being the most frequent. Variables associated with mortality were identified. [ABSTRACT FROM AUTHOR]

Aim: To present two cases of thoracic trauma with great vessel injury (TTGVI) surgeries where extracorporeal circulation (ECC) was employed. Materials and Method: Two TTGVI cases are presented and ECC during surgery was used in both. Results: Case 1; 31-year-old man with TTGVI due to an intracavitary foreign body (pleural tube) in the left pulmonary artery trunk, which entered through lung parenchyma. An open surgery was performed to remove the foreign body with pulmonary tractotomy using ECC as support. Case 2; 21-year-old man with blunt TTGVI and aortic injury at sinotubular junction. An open surgery with ascending aorta prosthesis replacement was performed, using ECC as support. Discussion: The use of ECC as support is an alternative to replace cardiac and/or pulmonary function during exceptional TTGVI reparation surgeries. Conclusion: The use of circulation assist techniques as support during TTGVI repair surgery occurs in highly selected cases, being an alternative to face very complex injuries. [ABSTRACT FROM AUTHOR]

Background: The treatment of choice for Pulmonary Hydatid Cys (PHC) is surgical resection. There is currently controversy about the superiority of surgery with capitonage (SC) versus surgery without it (SWC). Aim: To compare the results of conservative surgery with capitonnage and versus surgery without capitonnage using Propensity Score Matching (PSM). Materials and Method: A retrospective analytical study was carried out with patients with PHC treated surgically at the Guillermo Grant Benavente Hospital, Concepción, Chile, between January-1995 and December-2018. A PSM was performed with a 1:1 ratio. Results: Conservative surgery was done in 165 cases, 101 SC and 64 SWC. After matching, 53 SC and 53 SWC operated patients were obtained. No significant differences were observed in the presence of persistent air leak (9.4% vs11.3%, SC vs SWC respectively, p 0.75), empyema (3.8% vs 0%, p 0.49), days with pleurotomy (9.1 ± 8.9 vs 10.1 ± 10.7, p 0.39), nor days of postoperative stay (10.4 ± 9.0 vs 11.7 ± 11.9, p 0.22). Conclusion: The SWC demonstrated comparable results to the SC technique in the conservative surgical treatment of PHC. [ABSTRACT FROM AUTHOR]

Introduction: During cardiac surgery postoperative care, physical, psychological, and social problems arise, affecting the patient's self-care agency, which brings with it the need for a caregiver during recovery. Objective: To determine the relationship between primary caregivers' burden level and the self-care agency of cardiac surgical patients. Materials and Methods: A descriptive, cross-sectional, analytical, and correlational design was used. Patients (n=86) and caregivers (n=86) attending a cardiac surgery program from a high complexity medical center in Cúcuta, Colombia, participated and were selected using non-probability quota sampling. Self-care Agency Scale (SAS) and Zarit Burden Interview were used in the study. Results: Among the caregivers with severe burden, 83.33% cared for patients with low self-care agency. In the mild-burden caregivers' group, 63% of the patients had middle self-care agency. Most patients (71.01%) of caregivers with no burden had middle self-care agency, but 20.29% exhibited high self-care agency. Discussion: the capacity for self-care agency reduces the level of caregiver burden, when the patient manages to adapt to the activities that contribute to care, the level of dependency decreases. Conclusion: The research demonstrated the relationship between these two variables. Patients and caregivers must be addressed to achieve self-care empowerment. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se presenta una observación clínica de contusión grave de tórax con la producción de un neumotórax bilateral a tensión, tratado con toracotomía bilateral.

Se presentan 40 heridas penetrantes de t´orax de la ´práctica civil.

Se hacen consideraciones sobre la fisiopatología y la terapéutica el enfisema ampolloso en base al estudio de una serie de veintiséis pacientes.

Introduction: the results of surgical procedures in cardiac surgery depend, to a great extent, on the quality of post-operative care. The complexity of the evolution of these patients requires attention from specialized personnel and a differentiated support structure. Objectives: to characterize patients in the postoperative period of cardiac surgery and to describe the main postoperative complications. Methods: we conducted a cross-sectional descriptive study of cases operated and received in the postoperative period of cardiac surgery at the Hospital Provincial Universitario Cardiocentro “Ernesto Guevara” during 2018. Results: 161 cardiac surgery patients were received in the postoperative period; 70.8% were male and most of them were between 45 and 54 years old (32.3%); valve surgery was performed on 49.1%; 16.1% of the total patients were ventilated for more than 48 hours and many were complicated by nosocomial pneumonia (11.8%) and there was a very low frequency of post-operative strokes. Conclusions: the behavior of most of the variables studied in the postoperative period was adequate and patients with invasive mechanical ventilation for more than 48 hours, as well as nosocomial pneumonia, presented high levels in the postoperative period for this type of surgery.

Presentado en sesión 14 de agosto de 1963

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Presentado en sesión de 31 de agosto de 1949

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Presentado en sesión de 28 de mayo de 1952