RESUMEN
OBJECTIVE: The aim of this work was to identify clinical data indicative of the number of hyperbaric oxygen therapy HBO2 sessions that should be prescribed for adjuvant treatment of tissue injuries of differing severity. PATIENTS: A total of 1730 cases of patients treated with HBO2 using an open protocol (without a predetermined number of sessions) was examined in this study. METHOD: A retrospective study involving charts review was conducted. Severity had been previously determined for the treatment of acute (fasciitis, myositis, gangrene, contaminated/infected perineal or lower extremity traumatic injuries) or chronic (osteomyelitis, pressure sore, diabetic or ischemic ulcer) injuries. Only patients that met or exceeded the supposed effective minimal treatment doses (5 sessions for acute, 10 sessions for chronic injuries) were included in the present study. RESULTS: The data analysis included 1506 cases. These consisted of 1014 patients with acute injuries, who required 11 to 18 sessions (depending on injury severity), and 492 patients with chronic injuries, who required a greater (p < 0.001) number of sessions (approximately 30/patient, independent of injury severity). Global mortality was 79/1506 patients. CONCLUSION: These results seem to support the initial indication of 15 HBO2 sessions for the treatment acute injuries, and 30 for treatment of chronic injuries. Prospective studies may better determine the number of sessions for the treatment of different types of injuries.
Asunto(s)
Oxigenoterapia Hiperbárica/estadística & datos numéricos , Heridas y Lesiones/terapia , Enfermedad Aguda , Adulto , Distribución de Chi-Cuadrado , Enfermedad Crónica , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Estadísticas no Paramétricas , Índices de Gravedad del Trauma , Heridas y Lesiones/clasificación , Heridas y Lesiones/mortalidadRESUMEN
Case report on right branch block, acute pulmonary oedema and enteritis caused by electric shock in a boy. The invasive hemodynamic study showed primary pulmonary hypertension, cardiogenic shock, and acute respiratory failure. The outcome was good, with total and progressive recovery of all lesions. The literature review revealed the rarity of pulmonary oedema and enteritis after an electric shock. The invasive haemodynamic data suggest physiopathological explanations for findings in the case and indicate therapeutic measures for similar situations.
Asunto(s)
Humanos , Masculino , Niño , Edema Pulmonar , Bloqueo de Rama , Traumatismos por Electricidad , Edema Pulmonar , Bloqueo de Rama , Traumatismos por Electricidad , Electrocardiografía , Consumo de Oxígeno , HemodinámicaRESUMEN
Case report on right branch block, acute pulmonary oedema and enteritis caused by electric shock in a boy. The invasive hemodynamic study showed primary pulmonary hypertension, cardiogenic shock, and acute respiratory failure. The outcome was good, with total and progressive recovery of all lesions. The literature review revealed the rarity of pulmonary oedema and enteritis after an electric shock. The invasive haemodynamic data suggest physiopathological explanations for findings in the case and indicate therapeutic measures for similar situations.
Asunto(s)
Bloqueo de Rama/etiología , Traumatismos por Electricidad/complicaciones , Edema Pulmonar/etiología , Bloqueo de Rama/fisiopatología , Niño , Traumatismos por Electricidad/fisiopatología , Electrocardiografía , Hemodinámica , Humanos , Masculino , Consumo de Oxígeno , Edema Pulmonar/fisiopatologíaRESUMEN
Light and electron microscopy study of fourteen liver biopsies in typhoid fever disclosed a mild hepatitis in which there is marked reticulo-endothelial hyperplasia, with many lymphoid cells in the hepatic sinusoids. The hepatic cell lesion was non specific, manifested by reticulum endoplasmic dilatation, mitochondrial alteration and biliary canaliculus injury. Such findings were particularly evident in the jaundiced patients. Jaundice was, in our series, a more frequent complication of acute typhoid fever than commonly reported. Usually it is of short duration and the serum bilirubin was not markedly elevated. However, there were instances when the jaundice was so accentuated as to lead the clinician to a first diagnosis of virus hepatitis or leptospirosis. The pathogenesis of the intrahepatic cholestasis in typhoid fever is still obscure, but apparently it is, as has been described in other infectious diseases, due to an injury of the bile secretory apparatus brought out by the bacillary endotoxin.