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Biomedical subjects

F González Hermoso

Publications and source records attributed to F González Hermoso.

At least 19 recordsLinked to original sources
PubMed2001

[Medical errors or deviations in daily health care practice].

There is since 1991 an increasing preoccupation in the English medical literature on adverse events and it has caused that the Institute of Medicine (IOM) has written in 1998 a report that has driven the American Government to make some national plans to find a solution to the problem and to create a committee which deal with the Quality of Health Care in America with the participation of outstanding figures of the policy, sanitary administration, and medical scientific societies. There are deviations between 3.7 and 45.8 in hospital stay. They have Mortality between 4.9 and 5.6. From those between, a 51% and a 54% can be avoided. Only a 27% can be considered as negligence. Deviations happen only a few times because of an isolated personal human factor, but they are associated with many different ocassional and underlying reasons. The analysis of those reasons is essential to understand and to help preventing repetition of that facts. Adverse events does not in many cases mean a training failure but an error in the way that a physician act at a certain moment. The cognitive psychology tries to explain the way that memory behaves, reasoning, and human performance. Adverse events could be not so often, if all the efforts could be driven in direction of prevention, and not in direction of legal punishment. The industry have a lot of experience in applying norms, which could be adapted to any sanitary system, as it is shown in civil aviation industry. All the sanitary personnel should collaborate and this is fundamental to know the facts and the circumstances. However it requires confidentiality and absence of retaliation. It is a fact that there are deviations and its importance requires a cultural change to transform a traditionally defensive attitude into a collaborating conduct in order to improve the quality of the attendance.

Humans↗
PubMed1994

[Volvulus of the transverse colon: a rare cause of intestinal obstruction].

Volvulus of the transverse colon is rare, given its short and fixed mesentery and the normal fixation of the hepatic and splenic flexures of the colon. The case reported herein brings the total of reported cases to 72. Various predisposing factors have been identified, most notably congenital abnormalities, physiologic disturbances and mechanical obstruction; in our case these three factors were present. The possible role of colonoscopy in diagnosis and/or therapy is unclear. In our patient, colonoscopy proved to be of no use for diagnosis or treatment.

Adult↗
PubMed1993

[Comparison of prosthetic materials for abdominal wall reconstruction. Experimental study].

To repair large abdominal deficiencies, either congenital of acquired, occasionally serious problems show up where obtaining the ideal material is concerned, in those cases where autological tissue in the right size can not be found. In this sense materials like silver, steel and tantalium darning have been used, as well as many other synthetic tissues and non porous materials like silastic. During this same period, prosthesis of reabsorbing materials have been developed and used. We present a experimental work in which we compare four prosthesic materials as there are Marlex, Silastic, polyglycolic acid and lyodura, from the clinical, biological and histopathological point of view, distinguishing the ideal material in definite pathologies.

Abdominal Muscles↗
PubMed1992

[Acute perforated sigmoid diverticulitis in childhood].

Colonic diverticulosis is a pathology of high incidence in normal population during the last decades of life. About 2-5 per 100 of patients admitted because of this disease are below 40 years old, and in this group of patients diverticulitis tends to be very aggressive with a high number of complications. We report a clinical case of acute perforation of sigmoid colon due to diverticulitis in a ten year old child who was treated surgically by means of resection of the sigma and primary end-to-end anastomosis. We did not find in the literature consulted any cases of this illness under twenty years of age.

Acute Disease↗
PubMed1989

[Pancreatoduodenal traumatism. Apropos of 18 cases].

We present our experience on pancreato-duodenal trauma surgically treated; we have studied the etiopathogenesis of the lesions and the severity of the condition, which is related to their anatomical relationships and to the difficulties of the early diagnosis. We emphasize the value of non invasive diagnostic methods, particularly immediate ultrasonography, CAT and exceptionally RECP. Abdominocentesis with peritoneal lavage and the insertion of a catheter through a minimal jejunostomy, for the nutritional support of the patient and to prevent complications merits special mention.

Adolescent↗
PubMed1989

[Spontaneous perforation of the esophagus: Boerhaave's syndrome. Analysis of a case].

We describe a case of spontaneous perforation of the esophagus (PEE) that was satisfactorily treated by thoracotomy, primary closure and reinforcement of the suture with a gastric fundal patch (Thal plasty). Emphasis is placed on the need to establish an early diagnosis and the essential points of treatment to obtain a favorable outcome.

Aged↗
PubMed1989

[Hemorrhagic recurrence after operations of azygoportal disconnection].

One of the main drawbacks attributed to azygoportal disconnection operations in the surgical treatment of bleeding esophageal varices is recurrence of hemorrhage. The present paper reviews the results obtained as regards hemorrhage recurrence in 4,975 patients who underwent azygoportal disconnection in 41 series published in the western literature in recent years. An analysis is also made of the factors that, according to different authors, could be related to the failure of these procedures to prevent eventual variceal hemorrhage.

Azygos Vein↗
PubMed1989

[Colonic lesion caused by acute pancreatitis. Use of minimal catheter jejunostomy. Apropos of 6 cases].

Colonic affectation in the context of acute pancreatitis is undoubtedly a rare complication to judge from the number of cases reported in the literature, but its appearance is increasing, perhaps because it is receiving more attention. The "infrequent" complications of so-called acute pancreatitis range from massive necrosis of the colon to fistula of the transverse colon, colonic stricture as a chronic manifestation and finally, colonic varices as a sign of segmental portal hypertension due to involvement of the mesenteric portal axis. A retrospective study was made of 6 cases treated in our General and Digestive Surgery Department and the literature on this etiopathogenic situation was reviewed to study the clinical manifestations, diagnosis and treatment of these uncommon complications. We propose minimal catheter jejunostomy as a technique for the prevention and treatment of possible complications, with epidural analgesia of these patients.

Acute Disease↗
PubMed1989

[Spiegel's hernia. Apropos of 10 cases].

We present our recent experience in the last ten cases of Spiegel's hernia, studying its form of presentation and clinical manifestations. We studied emergency cases because they presented intestinal obstruction and were handled as a surgical emergency. We remark the noninvasive diagnostic methods, mainly echography. The surgical treatment for repair of the hernial defect and the material used was the same in every case. The morbi-mortality of the series was null and there was no recurrence in the period in which we studied and followed-up the series.

Adult↗
PubMed1989

[Complete section of the choledochus caused by non-penetrating trauma of the abdomen. Use of minimal catheter jejunostomy].

A case is presented of complete section of the choledochus as the sole lesion in closed abdominal trauma. A study is made of the difficulties of an early diagnosis of this pathology, as well as techniques for intraoperative localization and repair. Emphasis is placed on the use of peritoneal lavage as a preoperative diagnostic method and Tc99m HIDA scintigraphy of the biliary tract. The surgical technique is reviewed, assuming that the most physiological and anatomic procedure is end-to-end choledochoduodenostomy using reabsorbable sutures. We recommend the use of minimal transcatheter jejunostomy (YMC) as a method for immediate replacement of bile juice and inhibition of secretion, as well as the possibility of postoperative physiological nutrition using this approach.

Adult↗
PubMed1987

Intercostal pedicled flap in esophageal atresia.

Since 1974 we have used an intercostal pedicled flap (IPF) between the esophageal anastomosis and the sutured trachea in a single case of recurrent tracheoesophageal fistula (TEF) and in four cases of primary repair of esophageal atresia (EA) and TEF in which the distance between both ends was greater than 2.5 cm and with a certain degree of tension in the anastomotic line. Furthermore, in the last two cases reported in this article, we have been able to use the IFP in an extrapleural approach in a way not previously reported. The short-term and long-term follow-ups have been excellent without any complications relating to the esophagus itself or to the pedicle flap of intercostal muscle. The method is considered particularly useful in recurrent fistulas.

Esophageal Atresia↗