RESUMEN
OBJECTIVE: To examine the effects of pretreatment with statins at high doses (40 mg of rosuvastatin or 80 mg of any other statin) and low to moderate doses (<40 mg of rosuvastatin or <80 mg of any other statin) on ischemic stroke (IS) severity in clinical practice. METHODS: Observational study of IS admissions to our stroke unit over a 3-year period (2008-2010). Mild stroke severity was defined as NIH Stroke Scale score ≤5 on admission. Multivariable regression models and matched propensity score analyses were used to quantify the association of statin pretreatment at high and low to moderate doses with mild stroke severity. RESULTS: Of the 969 IS patients, 23% were taking low to moderate doses and 4.1% were taking high doses of statins prior to the stroke. Statins were associated with lower NIHSS scores on admission (median [interquartile range] 4 [9] for nonstatin patients, 4 [9] for low to moderate doses of statins, and 2 [4] for high doses of statins; p = 0.010). After multivariable adjustment, pretreatment with statins was associated with a higher probability of mild stroke severity in the unmatched analysis (odds ratio [OR] = 1.637, 95% confidence interval [CI] 1.156-2.319 for the low to moderate doses and OR = 3.297, 95% CI 1.480-7.345 for the high doses of statins) as well as in the propensity score matched analysis (OR = 2.023, 95% CI 1.248-3.281 for the low to moderate doses and OR = 3.502, 95% CI 1.477-8.300 for the high doses of statins). CONCLUSION: Pretreatment with statins is associated with lower stroke severity, at high as well as at low to moderate doses.
Asunto(s)
Isquemia Encefálica/diagnóstico , Isquemia Encefálica/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/epidemiología , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Accidente Cerebrovascular/epidemiología , Resultado del TratamientoRESUMEN
Focal Nodular Hyperplasia (FNH) and Hepatic Adenoma (HA) are a benign tumors of the liver. The association with the use of oral contraception in women in middle age has been mentioned. This benign liver tumors are relatively rare lesions and are usually unrelated to subjective symptoms. They are increasingly being diagnosed as a result of the widespread use of ultrasound, computed tomography and magnetic resonance in the evaluation of patients with non-specific abdominal symptoms.
Asunto(s)
Adenoma de Células Hepáticas/fisiopatología , Hiperplasia Nodular Focal/fisiopatología , Neoplasias Hepáticas/fisiopatología , Adenoma de Células Hepáticas/diagnóstico , Anticonceptivos Orales/efectos adversos , Femenino , Hiperplasia Nodular Focal/diagnóstico , Hiperplasia Nodular Focal/patología , Humanos , Hígado/diagnóstico por imagen , Hígado/patología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Radiografía , Factores de Riesgo , UltrasonografíaRESUMEN
OBJECTIVE: To determine advantages and disadvantages of manual vs mechanical sutures in colon surgery. MATERIAL AND METHODS: A retrospective study of clinical files of 84 colon surgery patients was conducted, to establish morbidity and mortality of these patients with special emphasis in length of surgical procedure and type of suture used during procedure (either manual or mechanical). RESULTS: Of 84 patients included in this study, manual suture was used in 70 (group 1) and mechanical suture in 14 (group 2). Most common preoperative diagnosis was diverticular disease in 22 cases (26.2%), 20 for group with manual suture, and two for group with mechanical suture. Most common surgical procedure was colectomy with ileoproctoanastomosis in group 1 and lower anterior resection with coloproctoanastomosis in group 2. Five cases presented complications (2.85%) with manual suture, while only one case presented complications in group 2 (7.14%). Main complications were dehiscence in group 1 and stenosis in group 2. DISCUSSION: There were no significant differences between both types of suture in terms of time of surgical procedure; there were no statistical differences for both techniques in terms of morbidity and mortality. However, there is shorter time of recovery in patients in whom mechanical suture was used with less tissue edema due to manipulation and less disability period.