Cir Cir
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Review
[Massive transfusion and trauma patient management: pathophysiological approach to treatment].
Bleeding that requires massive blood transfusion is one of the main causes of cardiac arrest and death in the operating room. Its mortality varies widely between 15 and 54%, and it is strongly related to multiple factors such as acidosis, hypothermia and hypocoagulation. ⋯ A well-established response plan is needed by the surgical team and the blood bank in order to quickly facilitate blood products to the patient. Measures to avoid hypothermia and availability of rapid infusion systems are also necessary.
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At the beginning of the second trimester of 2009 there was an influenza A (H1N1) outbreak. The aim of this study is to describe the clinical presentation and mortality of the severe form of pneumonia in patients with human influenza A H1N1. ⋯ Pneumonia virus of human influenza A (H1N1) is associated with high morbidity and mortality. According to our results, it is recommended to make an early diagnosis and to initiate a treatment regimen based on treatment bundles designed to optimize oxygenation, reduce viral load and modulate inflammation.
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The femoral hernia, the least common of all groin hernias, is seen most frequently in females. The main techniques for repair are femoral, inguinal and extraperitoneal Cheatle-Henry techniques. With laparoscopic surgery, total extraperitoneal technique is done with a patch to cover the femoral ring. We undertook this study to present the experience with the Cheatle-Henry operation for treatment of femoral hernia. ⋯ Cheatle-Henry operation is a safe and secure technique to operate on femoral hernia, which is the least common of all groin hernias.
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Rectus sheath hematoma in the vast number of cases is due to an inferior epigastric artery tear occasionally due to trauma (not considered serious) or alterations in coagulation or use of anticoagulant therapy. It is an unlikely and difficult to diagnose pathology. ⋯ Rectus sheath hematoma is a diagnosis to consider in a previously asymptomatic patient who presents with clinical features of acute pain and appearance of increase of volume in the abdominal wall involving the rectus muscles.
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over time, a significant number of definitions and concepts on quality of care have been identified. This study focuses on quality of care from the perspective of medical patients. ⋯ acknowledgment of the concept of quality of health care provides a starting point to determine the source of errors, malpractice and professional responsibility in order to resolve and prevent them. Conamed offers alternative means for conflict resolution related to physician-patient relationship by means of conciliation and arbitration, favoring patient and family, as well as the medical profession.