Search

Objetivo Analizar la relacion de la situacion inmunologica preoperatoria tras fractura subcapital de cadera con las complicaciones postoperatorias. Material y metodo Estudio prospectivo aleatorio de 94 pacientes (81 mujeres) con fractura subcapital de cadera Garden IV (edad media: 82,9 anos (± 7,48), maximo: 100, minimo: 64 anos). Al ingreso se determino en sangre venosa periferica: formula leucocitaria, inmunoglobulinas (IgG, IgA, IgM e IgE), CD19, CD3, CD4, CD8, niveles de transferrina, alfa-2-macroglobulina, ceruloplasmina, proteina transportadora de retinol, prealbumina, albumina, proteinas totales, colesterol total y trigliceridos. Se estudiaron las complicaciones postoperatorias. En la estadistica se realizo analisis de la varianza y Chi cuadrado. Resultados Se detectaron 12 casos de infeccion de la herida quirurgica, 27 casos de infeccion de orina, 3 casos de neumonia y una infeccion periprotesica. Los pacientes con infeccion postoperatoria presentaron en el preoperatorio menores niveles de IgM (infeccion de orina y neumonia), de IgA (neumonia) y de IgE (infeccion de la herida), menor numero de CD4 y CD8/mm 3 (infeccion de orina y neumonia) y un menor porcentaje de CD19 (infeccion de herida). La albumina, la prealbumina, el colesterol total, los trigliceridos y la transferrina disminuyeron significativamente con la edad. Conclusiones La IgM, la IgA, la IgE, el porcentaje de CD19 y el numero de CD4 y CD8 podrian servir como indicadores de un mayor riesgo de desarrollar infecciones durante el postoperatorio de una fractura subcapital de cadera.

Purpose To analyze the relationship between a patient's immunological status prior to arthroplasty secondary to a femoral neck fracture and postoperative complications. Materials and methods Prospective randomized study of 94 patients (81 of which female) with a Garden IV femoral neck fracture (mean age: 82.9 years (± 7.48), range: 100-64). On admission, the following parameters were evaluated in the patients’ peripheral venous blood: differential leukocyte count; inmunoglobulin (IgG, IgA, IgM and IgE); percentage of CD19, CD3, CD4 and CD8; transferrin levels; alfa-2-macroglobulin; ceruloplasmin; retinol transport protein; prealbumin; albumin; total proteins; total cholesterol and triglycerides. Postoperative complications were studied. Statistics: Variance and chi square analysis. Results There were twelve cases of surgical wound infection, 27 of urinary infection, 3 cases of pneumonia and one periprosthetic infection. Patients with a postoperative infection had lower preop levels of IgM (urinary infection and pneumonia), IgA (pneumonia) and IgE (wound infection), as well as a lower count of CD4 and CD8 per cubic mm (urinary infection and pneumonia) and a lower percentage of CD19 (wound infection). Albumin, prealbumin, total cholesterol, triglycerides and transferrin decreased significantly with age. Conclusions The IgM, IgA, IgE, the CD19 percentage and CD4 and CD8 counts could be used indicators of a higher risk of developing infections after surgery for a femoral neck fracture.

A case of solitary neurofibroma located in the mid-portion of the esophagus in a 61-year-old woman is reported. She was operated with the diagnosis of benign tumor of the esophagus (leiomyoma). The microscopic examination of the tumor tissue found nervous cells. The immunohistochemistry analysis confirmed neurofibroma.

The authors present a case report of a cholecystostomized high surgical-risk patient with gallstones in gallbladder and biliary duct treated with continuous monoctanoin infusion through a Pezzer's tube. They analyze the biological characters of such substance as solvent agent, its management and the results of treatment.

Resumen La hidatidosis pulmonar en general supone el 22% de los casos tratados en un Servicio de Cirugia General; y de dicho 22%, el 4,9% corresponde a la hidatidosis infantil. Se lleva a cabo un estudio clinico y diagnostico de la enfermedad. Se establece una clasificacion anatomo-pa-tologica de los quistes y se hace un estudio comparativo con el adulto. Se exponen los diferentes tipos de terapeuticas empleadas desde 1952 para tratar la enfermedad hidatidica. La morbilidad post-operatoria es del 4,7% y la mortalidad del 0,9%, guardando estas una relacion con el tipo anatomopatologico del quiste.

The objective of this study is to evaluate the response of the subpopulations of lymphocytes and IGs to the administration of total parenteral nutrition for 7 days in 26 patients suffering from malnutrition, 12 of whom had digestive neoplasia and 14 non-neoplastic gastrointestinal disorders. Following the total parenteral nutrition, a significant increase in the percentage of T-helper lymphocytes was noted, and an improvement in the OKT4/OKT8 quotient, as well as in the IgA and the C4 fraction of the complement. The existence of neoplastic conditions did not have a significant effect on the variations in the parameters studied. The presence of lipids in the parenteral nutrition diet did not affect the subpopulations of lymphocytes.

A primary Echinococcus of the upper mediastinum revealed itself as a cervical mass in an 18-year-old asymptomatic patient. Chest x-ray films and a thyroid scan led to the diagnosis of benign mediastinal tumor or cyst Through a cervical approach a cystectomy was performed. The pericystic membrane was left “in situ”. The result of this simple operation was excellent. This, according to our view of literature, is the 22nd case of this condition published.

The use of nasoenteral feeding tubes has increased in recent years. However, the rigid wire used to stiffen the tube during insertion can produce complications. To prevent the perforation of the enteral or respiratory tract, the wire introducer should not be advanced beyond the nasopharynx, and the placement of the tube should be systematically verified with X-rays.