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F López Soriano

Publications and source records attributed to F López Soriano.

At least 19 recordsLinked to original sources
PubMed1993

[Nutritional parameters and morbimortality in clinical hospitalization].

The prevalence of malnutrition in patients admitted to hospital in the region of Northwest Murcia and its repercussion on the morbidity rate and length of admission are studied. A protocol of nutritional evaluation according to the computer programme EDECAN-MED was applied, and the corresponding statistical treatment of data and results was done. We find that anthropometric data lack predictive value and that deterioration in the values for albumin, basal energy expenditure and nutritional prognostic index are associated with increased morbidity/mortality and prolongation of the length of hospital stay. The most valuable predictive datum of the length of hospital stay was the nutritional prognostic index, in spite of it being an index of surgical risk.

Adolescent↗
PubMedDate not supplied

[Assessment of nutritional status at hospital admission: identification of patients with risk for malnutrition].

Various studies of prevalence in our hospitals have detected large percentages of under-nourished patients in both medical and surgical wards. These groups of patients are not detected in clinical practice and are therefore untreated, leading to nutritional deterioration. The present paper studies the prevalence of the risk of malnutrition, using the Cardona risk assessment sheet as modified by Mager, in 134 patients between the 3rd and 5th day after admission to hospital. A chi-squared test was applied to allow comparison of quantitative and qualitative variables. We found 56.70% of patients risked under-nourishment (60% in medical wards and 50% in surgical wards). The variables which showed the best correlation with the risk of malnutrition were albumen (p < 0.01), weight loss (p < 0.001) and age (p < 0.005). The Hospital's Clinical Nutrition Committee must define the standard to be achieved regarding nutritional risk in order to ensure the quality offered to our patients in this regard.

Adolescent↗
PubMedDate not supplied

[Impact of hospitalization on patients with nutrition status evaluation at admission].

Malnutrition (MN) continues to be an unacknowledged and underestimated problem in hospitals. It affects patients, by increasing complications, mean hospital stay (HS) and health-related risks. Such MN tends to be aggravated by hospitalization. Our purpose was to analyze the influence of hospitalization on the nutritional status of the patients studied. The following data were collected from 134 patients previously assessed for malnutrition risk between the 3rd and 5th day after admission: 1) during admission: type of diet, no of days with an absolute diet, use of protein supplements and artificial nutrients, onset of large-scale and small-scale complications, duration of HS, no of subsequent admissions and death; and 2) on discharge: serum albumin (SA) g/dl, total lymphocytes (TL)/ml. A statistical analysis was carried out using the chi 2 test, a Correlation test and ANOVA for a significance level of p < 0.05. It was possible to review 71.64% of the case histories and 61.45% were assessed. The following findings were reached: 1) the patients with weight loss on admission (WLA) had lower SA figures on discharge (p < 0.01) and a higher mortality rate (p < 0.001). 2) Absolute diet during HS led to a lengthening of admission time (p < 0.001). 3) Those patients with a severe risk of MN were the same ones who only received nutritional support (p < 0.001). 4) Patients who were re-admitted presented a worse nutritional status on discharge (p < 0.001). 5) An increase of 3.7 days in the HS in medical cases and 7.9 days more in surgical services, for those patients at risk of MN. 1. Low SA, TL and WLA figures are prognostic factors for hospital death. 2. Nutritional support was only used at severe levels of MN risk, so the HS was longer in these cases. 3. Patients with MN should be detected on arrival in order to avoid inherent health risks during hospitalization.

Hospitalization↗
PubMedDate not supplied

[Future development of heart valve surgery. New prostheses and access routes].

Valvular surgery has evolved in the last year with the development of new valvular prostheses and new minimally invasive implanting techniques. We discuss the advantages of the new mechanical aortic prostheses of superior hemodynamic characteristics, which avoid the need to widen the valvular ring in many cases. At the same-time, we emphasize on the use of new biological aortic prostheses, with minimal transvalvular gradient and less incidence of calcification. The advantages and disadvantages of the different minimally invasive techniques are analyzed without reaching yet a definite conclusion on their application.

Forecasting↗
PubMedDate not supplied

[The development of an informational logic support for aiding diagnosis and treatment. The Edecan-Med program. I. The assessment of nutritional status].

We present the elaboration of an informatic program (Informatic Logic Support [SLI]) as a clinical help in diagnosis and treatment, for use by compatible computers PC. In this first part dedicated to artificial nutrition, we explain the scientific support, the capture of anthropometric and biochemical data, the processing, the results and the conclusions delivered by the computer that inform us about all the calculated nutritional parameters the type of malnutrition, the surgical risk of morbimortality (nutritional prognostic), and the caloric needs.

Anthropometry↗
PubMedDate not supplied

[Cardiovascular response to orotracheal intubation using midazolam or etomidate in anesthesia induction].

By means of the present study, we compare the variations in the cardiovascular response to the orotracheal intubation while using midazolam or etomidate during the anesthetic induction. For this purpose, we studied 2 groups of 10 patients each one which were premedicated with fentanyl and atropine, and succinylcholine as muscle relaxant. We took the data at a basal state, 10 minutes after premedication and 0, 1, 2, 3, 4, 5 and 10 minutes after the intubation handling. As hemodynamic data we registered heart rate, systolic and diastolic blood pressure and the rate product (PRP). In both groups, the peak response occurred two minutes after intubation in all the studied parameters. Systolic and diastolic blood pressure as well as PRP were significantly lower with midazolam. We conclude that midazolam and etomidate do not prevent the cardiovascular response to the intubation handling, although midazolam smooths pressure response.

Anesthesia, General↗
PubMedDate not supplied

[Myocardial revascularization. The evolution of 100 cases].

The postoperative course of 100 pts. that underwent aorto-coronary bypass surgery was studied at the Instituto Nacional de Cardiología "Ignacio Chávez": 84 were men and 16 women between 37 and 74 years. 56 had previous history of myocardial infarction, while in 16 of them occurred within 30 days of the surgical procedure. 88 had symptomatic angina and 8 were in cardiac failure. The coronariography showed trivascular lesions in 73% and 8 pts. had stenosis of the left main coronary artery. Two pts. had 5 coronary grafts, 4 had 17, 3 had 37, two 35 and one 9 pts. All anterior descending coronary arteries were grafted. 61 of them and the 8 main left damaged were grafted with internal mammary artery Afert surgery; 15 pts had AMI, 4 profuse bleeding, one cardiac failure and shock. CPK enzyme levels of 500 were found in the majority of the pts with AMI with 81.2 positive predictive value and negative of 97.6. Three pts died, two at the OR with cardiac failure one of them had ventricular rupture, and the last at the ICU also with cardiac failure. We emphasize that CPK values of 500 UI or more in the postoperative course may be diagnostic of AMI.

Adult↗
PubMedDate not supplied

[Tetralogy of Fallot with abnormal coronary arteries].

Between 1980 and 1989 nine patients with Tetralogy of Fallot with abnormal coronary artery underwent surgical treatment. In all but one, the abnormal coronary artery was identified at surgery. Seven (group I) had the anterior descending coronary artery arising from the right coronary artery; one (group II) with had the right coronary artery arising from the left coronary artery and finally, the only case of the group III had left coronary artery arising from the main pulmonary artery. Systemic-pulmonary anastomosis was done in two cases of the Group I, in one due to severe hypoplasia of the pulmonary ring and main pulmonary artery and in the other due to the anomaly of the coronary artery. In the case of the Group II the right coronary artery was accidentally cut and the patient developed right ventricular infarction and died. All surviving are in NYHA functional class I. Nowadays, the preoperative evaluation of Tetralogy of Fallot, can be done by echocardiography despite the possibility of its association with abnormal coronary artery. In special cases aortography or arterial coronarography should be considered.

Anastomosis, Surgical↗
PubMedDate not supplied

[Mixed benzodiazepine poisoning and reversal with flumazenil (Ro 15-1788)].

A case of 17 year old female with acute benzodiazepines (800 mg of bentazepan and 400 mg de chlordiazepoxide) and tricyclic antidepressants (500 mg of imipramine) self poisoning is reported. Initial examination showed comatous patient (Glasgow coma scale 7, sedation scale 4) and a critical respiratory failure with a suspicious of pulmonary aspiration of gastric contents. Supportive measures were started and flumazenil administered intravenous (0.1 mg/min) until a total dose of 1.2 mg; 15 minutes later neurological state was absolutely normal. We conclude that flumazenil is a selective and useful benzodiazepine antagonist in the treatment of acute benzodiazepine poisoning.

Adolescent↗
PubMedDate not supplied

[Coronary revascularization in the geriatric patient].

In order to determine the current status of coronary revascularization in the elderly, we studied 102 patients aged 65 to 77 years (mean 68 years) who had surgery at the Instituto Nacional de Cardiología "Ignacio Chávez". Seventy eight (76.4%) were male and 24 (23.5%) female. The coronary risk factors were cigarette smoking, systemic arterial hypertension and familiar history of coronary heart disease. Fifty five patients (54%) had myocardial infarction prior to surgery and in 29 (28.4%) the time between the ischemic event and surgery was less than one year. Ninety Patients (88.2%) presented with unstable and 12 (11.7%) with stable angina. Ejection fraction was less than 40% en 32 patients (31%). Coronary angiograms showed one vessel disease in 5 cases (4.9%), two vessel involvement in 29 (28.4%), three vessel lesions in 56 (55.8%) and left main coronary artery in 12 (11.7%). The patients underwent a mean of 2.1 bypasses (range 1 to 4). Perioperative mortality was 10.7%. Actuarial survival and angina pectoris relapse were 80 and 24% respectively at 6 years follow-up. We conclude that old age does not rule-out surgery for coronary heart disease.

Aged↗
PubMedDate not supplied

[Immediate and long-term results of aortic valvulotomy in aortic valve stenosis].

Between April 1962 and December 1982 we performed valvulotomies on 68 patients to correct valvular aortic stenosis (VAoS). Forty-one were men and 27 women whose ages ranged from 20 months to 47 years (mean = 11.9 +/- 6.4 years). In 95% of cases VAoS was congenital. All patients underwent clinical preoperative evaluation with chest roentgenogram and electrocardiogram (ECG). Catheterization was done on 89.7%. Symptoms varied from none to syncope and stress angina. Symptoms bore no relation to the systolic aortic gradient, which oscillated between 31 and 200 mm Hg. There was a significant postoperative improvement in symptoms and less notable improvement in chest X-rays and ECG. Follow-up was from 1 to 22 years (mean = 7.12 +/- 4.43 years). Thirty-nine patients were followed for 5 or more years with serial clinical, radiological and electrocardiographic control. Fifty percent underwent postoperative catheterization. Seventeen patients continued with residual aortic regurgitation (AoR). Fourteen patients were again operated. A new valvulotomy was performed on 2 and valve replacement was done on the rest. Perioperative mortality was 2.9% and long-term survival 88% with 84.6% of the patients asymptomatic or in functional class I of the NYHA. Survival curves were plotted and the literature reviewed. The conclusion was that although this surgery constitutes a low risk, it should be considered palliative in the majority of the cases.

Adolescent↗
PubMedDate not supplied

[Implantation of mitral valve prosthesis with continuos suture].

The results obtained in 20 patients with the use of continue suture technic for prosthetic implantation of the mitral valve were compared to those observed in other 20 patients in which the prothesis were implanted with isolated suture technic. With the first one the aortic clamp time was reduced in average about 50 minutes; the extracorporeal circulation time also diminished in the same proportion. One patient died in each group, meaning a 5% of hospital mortality. The going after time in the first group was 2.5 years and in none was found prosthetic dysfunction or perivalvular lickage. We conclude that prosthetic implantation technic for mitral valve with continue suture, offers the following advantages: a) Important reduction of the transoperative myocardial ischemia. b) Reduction also, of the hole estracorporeal circulation time. c) Minor possibilities of periprosthetic lickage. d) Minor risk of valvular thrombosis in the suture line.

Adolescent↗