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J Figueras Felip

Publications and source records attributed to J Figueras Felip.

8 recordsLinked to original sources

Early onset of organ failure is the best predictor of mortality in acute pancreatitis.

BACKGROUND: APACHE II is a multifactorial scoring system for predicting severity in acute pancreatitis (AP). Organ failure (OF) has been correlated with mortality in AP. OBJECTIVE: To evaluate the usefulness of APACHE II as an early predictor of severity in AP, its correlation with OF, and the relevance of an early establishment of OF during the course of AP. PATIENTS AND METHODS: From January 1999 to November 2001, 447 consecutive cases of AP were studied. APACHE II scores and Atlanta criteria were used for defining severity and OF. RESULTS: Twenty-five percent of patients had severe acute pancreatitis (SAP). APACHE II at 24 h after admission showed a sensitivity, specificity, and positive and negative predictive value of 52, 77, 46, and 84%, respectively, for predicting severity. Mortality for SAP was 20.5%. Seventy percent of patients who developed OF did so within the first 24 hours of admission, and their mortality was 52%. Mortality was statistically significant (p< 0.01) if OF was established within the first 24 hours after admission. CONCLUSIONS: APACHE II is not reliable for predicting outcome within the first 24 hours after admission and should therefore be used together with other methods. OF mostly develops within the first days after admission, if ever. The time of onset of OF is the most accurate and reliable method for predicting death risk in AP.

APACHE↗

[Transcultural adaptation of the Liver Disease Quality of Life instrument (LDQOL 1.0) for its use in the Spanish population].

Instruments of health-related quality of life (HRQOL) help us to interpret the results of treatments and health interventions. In Spain there is no HRQOL instrument specifically designed for use in patients with liver disease or to measure the effect of interventions such as liver transplantation. The Liver Disease Quality of Life (LDQOL 1.0) questionnaire is an American instrument developed for use in these patients. The aim of this study was to produce an appropriate version of this questionnaire for use in Spain. Cultural adaptation was performed in 3 phases: a) modification for use in Spain of a Hispanic version of this questionnaire supplied by the original authors; b) back-translation to English of a new version of the questionnaire and comparison with the original version in English, and c) a pilot test in a small sample of patients. In the first phase consisting of revision of the Hispanic version, the changes were mainly linguistic due to cultural and idiomatic differences. The validated Spanish version of the SF-36 was directly incorporated and items that could be of interest to local investigators were added. Few changes were made in the second phase of the process: changes involved an item on the appearance of feces and another item on taking naps. In the final phase, various changes suggested by the patients were introduced. Before applying the new version of the LDQOL 1.0 in clinical studies in Spain, its psychometric properties (its reliability, validity and sensitivity to change) must be verified in a subsequent validation study.

Cross-Cultural Comparison↗

[Results of cephalic pancreaticoduodenectomy in patients with chronic pancreatitis].

OBJECTIVE: To analyse the results obtained after cephalic pancreatoduodenectomy in patients with severe chronic pancreatitis. DESIGN: Retrospective study of indications and results of the intervention.Patients. The inclusion criteria were severe anatomic alteration of the head of the pancreas associated with refractory pain. Pancreatoduodenectomy was performed in 19 patients. RESULTS: Four patients had postoperative morbidity, and the mean hospital stay was 15 days. One patient died in the postoperative period. The pain evolution after surgery was: total control in 72% and satisfactory control in the remaining patients. During follow-up, de novo diabetes was detected in two patients, difficulty in maintaining weight in one patient, and de novo steatorrhea in four patients. CONCLUSIONS: Cephalic pancreatoduodenectomy is a good therapeutic alternative for the treatment of patients with chronic pancreatitis, refractory pain, and severe involvement of the pancreas head. Pain control is excellent and sequelae, such as diabetes or steatorrhea, are easily amenable to medical treatment.

Adult↗

[Primary peritonitis. Study of four cases (author's transl)].

Four cases of primary peritonitis in the adult, with favourable evolution, are presented. This is a rare condition which still involves a not unappreaciable mortality rate. The treatment was surgical in three cases, in one case a paracentesis was performed and antibiotics were administered. The treatment included an exploratory laparotomy, smear with Gram stain and culture of the pus, washing of the peritoneal cavity with isotonic saline solution, appendectomy, closing of the abdominal cavity without drainage and parenteral antibiotic therapy. Exclusive medical treatment carries a greater risk of complications and should be reserved for those patients in very precarious general condition.

Adult↗