RESUMO
INTRODUCTION: the current literature relates the return to driving with multiple variables. For various reasons, the current data on the time to return to driving after a total hip arthroplasty (THA) are diverse and even contradictory. We have proposed the objective of determining the time required to drive a manual gear vehicle again in a group of patients who underwent primary THA through a posterolateral approach with focus on manual gear cars. MATERIAL AND METHODS: we have studied the functional results of 112 patients who underwent primary THA between January 2019 and January 2020 in a high level in Cadiz, Andalusia, Spain. RESULTS: the median return to driving was three weeks (IQR 2-4). We have identified that 89.3% of the patients were able to drive again before the sixth week after surgery and in 92% of the cases they did so feeling even safer than before the THA. CONCLUSION: we consider that after the sixth week of an THA it is safe to resume driving a vehicle.
INTRODUCCIÓN: la literatura actual relaciona el regreso a la conducción vehicular con múltiples variables. Sin embargo, los datos actuales sobre el tiempo de regreso a la conducción luego de una artroplastía total de cadera (ATC) son diversos e incluso contradictorios. Por lo tanto, nos hemos planteado el objetivo de determinar el tiempo requerido para volver a conducir en un grupo de pacientes sometidos a una ATC primaria mediante un abordaje posterolateral, centrándonos específicamente en vehículos de marcha manual. MATERIAL Y MÉTODOS: hemos estudiado los resultados clínico-funcionales de 112 pacientes sometidos a una ATC primaria entre Enero de 2019 y Enero de 2020 en un hospital de alta complejidad en Cádiz, Andalucía, España. RESULTADOS: la mediana del tiempo de regreso a la conducción fue de tres semanas (RIC 2-4). Hemos identificado que 89.3% de los pacientes pudo volver a conducir antes de la sexta semana posterior a la cirugía. Además, en 92% de los casos, los pacientes se sintieron aún más seguros al conducir después de la ATC que antes de la intervención. CONCLUSIÓN: consideramos que a la sexta semana de una ATC es seguro reanudar la conducción de un vehículo.
Assuntos
Artroplastia de Quadril , Condução de Veículo , Humanos , Artroplastia de Quadril/métodosRESUMO
Right ventricular failure after heart transplantation has been well documented as a major determinant of patient outcome. In 50 patients undergoing orthotopic heart transplantation, nine male patients with an average age of 41 years had in the immediate postoperative period a syndrome that consisted of low cardiac index, high right atrial and pulmonary artery pressures, and high pulmonary vascular resistance. The preoperative data showed: right atrial pressure, 9 +/- 6 mm Hg; pulmonary pressure, 38 +/- 10 mm Hg; cardiac index, 1.6 +/- 0.4 L/min/m2; pulmonary vascular resistance, 466 +/- 91 dynes/sec/cm-5; pulmonary wedge pressure, 15 +/- 6 mm Hg; and systemic vascular resistance, 2089 +/- 290 dynes/sec/cm-5. The immediate postoperative data revealed: right atrial pressure, 17 +/- 5; pulmonary artery pressure, 32 +/- 8; cardiac index, 2.2 +/- 0.7; pulmonary vascular resistance, 421 +/- 368; pulmonary wedge pressure, 15 +/- 6; systemic vascular resistance 1318 +/- 263. All of these patients were receiving inotropic and vasodilator drugs with no improvement after volume challenge. Prostacyclin was started, and the dose increased from 0.5 to 5.0 ng/kg/min, until an increase in cardiac index and a reduction in pulmonary resistance were achieved. The final profile was right atrial pressure, 12 +/- 5; pulmonary artery pressure, 24 +/- 6; cardiac index, 3.7 +/- 1.2; pulmonary vascular resistance, 122 +/- 42; pulmonary wedge pressure, 14 +/- 4; systemic vascular resistance, 870 +/- 263. The use of prostacyclin enabled the weaning of other drugs within a 48-hour period with no side effects and no worsening of the hemodynamic conditions after discontinuation of prostacyclin.
Assuntos
Epoprostenol/uso terapêutico , Transplante de Coração , Hipertensão Pulmonar/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Adulto , Débito Cardíaco/efeitos dos fármacos , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Função Ventricular Direita/efeitos dos fármacosRESUMO
Serum amylase was studied in twenty seven patients submitted to cardiac operation. The ages ranged between 16 and 74 (mean 55) years; twenty one (78) were male and six (22%) female. Myocardial revascularization was carried on in 17 patients, mitral valve replacement in four patients, aortic valve replacement in two patients, plastic surgery of the aortic valve in two patients, plastic surgery of the mitral valve in one patient. Blalock Taussig anastomosis was carried on in one patient. The serum amylase was determined in samples obtained before operations, 24 hours and 48 hours postoperatively. Seven (26%) patients showed postoperative elevation of seric amylase in the absence of clinical signs of pancreatitis. Thus, postoperative elevation of seric amylase after cardiac surgery may occur in the absence of pancreatitis and may be due to other factors associated with the patient, with the operative procedure, with drugs used and with surgical complications.
Assuntos
Amilases/sangue , Procedimentos Cirúrgicos Cardíacos , Complicações Pós-Operatórias , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
1. Seven patients submitted to myocardial revascularization surgery with cardiopulmonary bypass were studied. Blood samples were obtained immediately before and 24 h after surgery. The parameters studied were the production of platelet activating factor (PAF-acether) and superoxide anion, cellular beta-glucuronidase activity as well as polymorphonuclear cell (PMN) and platelet counts. 2. Twenty-four h after surgery, there was a 54% decrease in platelet number (P less than 0.005), a 121% increase in PMN number (P less than 0.005), a 353% increase in PAF-acether (P less than 0.01), a 211% increase in superoxide anion (O2-) and a 104% increase in beta-glucuronidase (P less than 0.05) levels when compared with the pre-surgery levels. 3. The present results indicate that PMN are more reactive after surgery with cardiopulmonary bypass.
Assuntos
Ponte Cardiopulmonar , Glucuronidase/sangue , Revascularização Miocárdica , Neutrófilos/fisiologia , Fator de Ativação de Plaquetas/biossíntese , Superóxidos/sangue , Contagem de Células Sanguíneas , Humanos , Pessoa de Meia-Idade , Contagem de PlaquetasRESUMO
Seven patients submitted to myocardial revascularization surgery with cardiopulmonary bypass were studied. Blood samples were obtained immediately before and 24 h after surgery. The parameters studied were the production of platelet activating factor (PAF-acether) and superoxide anion, cellular beta-glucuronidase activity as well as polymorphonuclear cell(PMN) and platelet count. Twenty-four h after surgery, there was a 54% decrease in platelet number (P<0.005), a 121% increase in PMN number (P<0.005), a 353% increase in PAF-acether (P<0.01), a 211% increase in superoxide anion (O2-) and a 104% increase in beta-glucuronidase (P<0.05) levels when compared with the pre-surgery levels. The present results indicate that PMN are more reactive after surgery with cardiopulmonary bypass
Assuntos
Pessoa de Meia-Idade , Humanos , Ponte Cardiopulmonar , Fator de Ativação de Plaquetas/biossíntese , Glucuronidase/sangue , Revascularização Miocárdica , Neutrófilos/fisiologia , Superóxidos/sangue , Contagem de Células Sanguíneas , Contagem de PlaquetasRESUMO
Tecem-se comentários gerais sobre a evoluçäo pós-operatória de pacientes submetidos à cirurgia cardiovascular, enfatizando principalmente aspectos da fisiopatologia, diagnóstico e tratamento das alteraçöes cardiovasculares e respiratórias observadas neste período