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F Turégano Fuentes

Publications and source records attributed to F Turégano Fuentes.

15 recordsLinked to original sources
PubMed2005

Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings.

BACKGROUND: At 07:39 am on March 11th, 2004, ten terrorist bomb explosions occurred almost simultaneously in four commuter trains in Madrid, Spain, killing instantly 177 people and injuring >2,000. There were 14 subsequent in-hospital deaths, bringing the definite death toll to 191 victims. This article describes the organization of the clinical management and patterns of injuries in casualties who were taken to the closest hospital, with emphasis on the critical patient population. RESULTS: There were 312 patients taken to that center, and 91 were hospitalized, 89 of them (28.5%) for >24 hrs. Sixty-two patients only had superficial bruises or emotional shock, but the remaining 250 patients had more severe lesions. The data on 243 of the latter form the basis of this report. Tympanic perforation occurred in 41% of 243 victims with moderate-to-severe trauma, chest injuries in 40%, shrapnel wounds in 36%, fractures in 18%, first- or second-degree burns in 18%, eye lesions in 18%, head trauma in 12%, and abdominal injuries in 5%. Between 8:00 am and 5:00 pm, 34 surgical interventions were performed on 32 victims. Twenty-nine casualties (12% of the total or 32.5% of those hospitalized) were deemed in critical condition, and two of them died within minutes of arrival. The other 27 survived to be admitted to intensive care units, and three of them died, bringing the critical mortality rate to 17.2% (5/29). The mean Injury Severity Score and Acute Physiology and Chronic Health Evaluation II scores of critical patients were 34 and 23, respectively. Among these critical patients, soft-tissue and musculoskeletal injuries predominated in 85% of cases, ear blast injury was identified in 67%, and blast lung injury was present in 63% (17 cases). Fifty-two percent suffered head trauma. CONCLUSIONS: There was probably an overtriage to the closest hospital, and the time of the blasts proved crucial for the adequacy of the medical and surgical response. The number of blast lung injuries seen is probably the largest reported by a single institution, and the critical mortality rate was reasonably low.

Blast Injuries↗
PubMed1996

[Acute obstruction of the colon secondary to biliary lithiasis].

Gallstone ileus is an unusual cause of mechanical obstruction of the gastrointestinal tract; but obstruction of the colon by a gallstone is an even more rare event, and there are few references in the literature. We describe the cases of two elderly women who were admitted to the Emergency Service with a mechanical obstruction of the colon and air in the biliary tract. A barium-enema examination showed the presence of a foreign body in the sigmoid colon; this was found to be a gallstone in a subsequent colonoscopy in one of the patients; a precise preoperative diagnosis was not possible in the other. In both cases the obstruction was caused by a gallstone impacted in the sigmoid colon and a cholecystocolonic fistula was evident in a postoperative barium enema examination. Correction of the obstruction is the main objective of initial treatment. The repair of the fistula can be performed at the same time or at a later date.

Aged↗
PubMed1995

[Idiopathic granulomatous appendicitis or Crohn's disease confined to the appendix?].

Crohn's disease limited to the appendix is uncommon. When Crohn's disease affects the appendix it typically has a longer clinical course than most cases of acute appendicitis. The diagnosis is histological. Appendiceal Crohn's disease has a benign course after surgery, and that's why some authors believe that it could be a different entity which should be better addressed to as "Idiopathic Granulomatosus Appendicitis". We present three new cases of Crohn's disease limited to the appendix.

Adolescent↗
PubMed1993

[Incarcerated giant hiatal hernia].

A massive incarcerated hiatal hernia is a frequent finding in elderly people. The aim of this report has been to review from 1987 to 1992 the clinical aspects, therapeutic options and results of surgical treatment in a series of twenty-eight patients (23 females and 5 males) with a large incarcerated hiatal hernia. Age averaged 66 +/- 10 years; thirteen patients (46.5%) had a sliding type of hernia, 8 (28.5%) a mixed one, and 7 (25%) a paraesophageal hernia. In 9 patients (32%) there was a chronic volvulus of the incarcerated stomach. Twenty-seven patients underwent elective repair; one patient developed a perforated gastric ulcer into the pericardial sac with pneumopericardium and died before surgery. The surgical technique included reduction of the hernia, closure of the hiatus and an antireflux procedure (Nissen 25, Toupet 1 and Dor 1). There was no mortality and the morbidity (18%) was not directly related to the surgical procedure. In our series there were no cases of acute volvulus requiring emergency surgery. Our results suggest that surgical correction of massively incarcerated hiatal hernias is well tolerated in the elderly, it relieves symptoms, and avoids potential serious complications.

Adult↗
PubMed1989

[Papillary-cystic carcinoma of the pancreas: an infrequent tumor with favorable prognosis].

Two cases are presented of papillary-cystic carcinoma of the pancreas diagnosed and treated in the II General Surgery Service of the Gregorio Marañón General Hospital of Madrid (Spain) over the last six years. Both occurred in young women who presented with pain and abdominal mass. The tumors were large and were located on the tail of the pancreas. One was treated by local resection and the other by distal pancreatectomy. Both women are free of disease after a follow-up period of 6 years and 10 months, respectively. This is a very infrequent tumor, about 100 cases having been described up until the present, and it has a very favorable prognosis. Its clinical, diagnostic, pathologic, therapeutic and prognostic features are analyzed.

Adult↗
PubMed1989

Hemangiopericytoma of the spleen.

Hemangiopericytomas are rare vascular tumors, most frequently found in the muscles of the lower extremities. A parenchymatous origin is extremely uncommon. We present here what we believe is the first case ever reported of an hemangiopericytoma of the spleen.

Adult↗
PubMedDate not supplied

[Low gastrointestinal bleeding due to ectopic varices as a result of adhesions].

Portal hypertension frequently causes the appearance of porto-systemic shunts, such as esophageal varices and also, but with much less frequency, other atypical shunts known as ectopic varices. Despite their infrequency/rarity, ectopic varices can cause serious gastrointestinal bleeding. Intraabdominal adhesions, especially post-operative ones, promote their appearance. The therapeutic management of ectopic varices is initially the same as that for esophageal varices but surgical treatment is usually necessary as a diagnostic and therapeutic procedure.

Aged↗
PubMedDate not supplied

[The seeding of porcine endothelial cells on a polytetrafluoroethylene (PTFE) substrate. An experimental study].

The endotely of the vascular wall represents a natural antithrombogenic layer in intimal contact with the bloody flow. The waited success of the artificial prosthesis as replacers of minor vessels was not reached. Basically, its poor results were caused by the lake of endothelialization on the prothesical material. A cellular lap on the prosthesis, previously to the implant, could be a good resolution to this problem. If we studied the possibility to obtain a stable, endothelial monolayer "in vitro" before to the "in vivo" implant of the vascular prosthesis. We studied the role of fibronectin as a mediator between the substract and the endothelial cell. Changes on fibronectin when it is added on the culture medium were also analyzed. Although fibronectin has some positive effects as a biologic "glue" previously to the implant to the prosthesis, our results show that after the implant, fibronectin could cause a toxic effect on the adherence and survival of the endothelial cells.

Animals↗