Cir Cir
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The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. ⋯ As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.
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Randomized Controlled Trial
Immediate feeding tolerance in patients with mild acute biliary pancreatitis.
La pancreatitis aguda leve es una inflamación local del páncreas sin complicaciones locales ni falla orgánica. Su manejo consiste en tres elementos básicos: hidratación, analgesia y ayuno. La realimentación se inicia cuando el paciente no tiene dolor y refiere apetito, pero el momento exacto para iniciarla no está previamente documentado. ⋯ Immediate oral feeding is well tolerated and secure in patients with mild acute biliary pancreatitis.
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Infection with the SARS-CoV-2 virus and the development of all manifestations of COVID-19, predisposes to arterial and venous thromboembolic disease. The coagulation system can be activated by various viruses, including SARS-CoV-2. ⋯ Treatment is aimed at the prevention, early detection and timely interventions of all coagulation disorders generated by COVID-19. The recommended anticoagulant is low molecular weight heparin, taking into account creatinine clearance, and if major invasive procedures will be performed, unfractionated heparin is a safe option.
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In late December 2019, COVID-19, a new emerging disease, quickly spread in Wuhan, China. The WHO formally declared it a pandemic and a health emergency on March 11th, 2020. ⋯ The time to take leadership in healthcare where the national health system together with academic societies, universities and private initiative join forces to combat the pandemic has arrived. It is convenient to form collaboration groups of experts in the different specialties that through innovation in health and education, with evidence-based medicine, efficiency of operational costs and tools such as telemedicine, allow us to return to daily surgical procedures, reestablishing the surgery services as soon as possible.