PubMed Health⌕ Search

Biomedical subjects

J Marchena Gómez

Publications and source records attributed to J Marchena Gómez.

At least 19 recordsLinked to original sources
PubMed2000

[Prognostic factors of mortality in elderly patients in the emergency department].

BACKGROUND: Increasing attention has been given to the elderly patients in emergency departments. However, prevalence and predictive factors of mortality in geriatric patients in emergency rooms have not been stablished. This study was conducted to analyse predictive factors associated with mortality in patients aged more than 75 years-old. METHODS: Descriptive transversal study. Data from 1003 patients aged over 75 years were recorded: biographic data, past medical history, functional capacity, acute vs chronic diseases, discharge diagnosis, emergency room stay, mortality and their causes. Bivariant and multivariant (logistic regression) analysis were performed in an attempt to establish mortality associated factors. Prevalence odds ratio (OR) and 95% confidence intervals were estimated. RESULTS: 45 patients died (4.7% IC 95%: 3.2 a 5.7). In bivariant analysis age (p = 0.008), previous heart failure (p = 0.008) or renal failure (p = 0.05), functional disability (p < 0.001), mental disorders (p < 0.001), acute diseases (p = 0.01), and the following entities: politraumatism, sepsis, respiratory failure, pneumonia, ileus, acute abdomen, and coronary artery diseases, were associated with mortality. In multivariant analysis were detected as independent prognostic factors: circulatory disorders, coronary artery diseases, sepsis, respiratory failure, and functional disability. CONCLUSIONS: Over 75 years-old patients mortality in emergency departments is more frequently associated with diagnosis of coronary heart disease, respiratory failure, sepsis and functional disability.

Aged↗
PubMed1997

Anastomotic stricture with the EEA-Stapler after colorectal anastomosis.

OBJECTIVE: Analysis of colorectal anastomosis stricture incidence after anterior resection of the rectum performed with the EEA-Stapler. To find out if differences existed in stricture incidence considering factors such, as age, neoplasia, postoperative radiotherapy, tumor stage and anastomic level. DESIGN: Longitudinal descriptive study. PATIENTS AND METHOD: 67 patients who underwent rectal anterior resection using the EEA-Stapler were evaluated. Data from sex, age, indication for operation, postoperative radiotherapy, tumor staging and anastomic level were recorded and compared with presence of stricture anastomosis. Stenosis was evaluated and graded as follows: grade O, no stenosis; grade I, no symptoms, X-ray or endoscopic finding; grade II, symptoms, the patients require ballon catheter dilation; and grade III, invalidant symptoms, the patients require surgery. RESULTS: Twelve patients (20%) were recorded as grade II and 3 patients (5%) as grade III. There were no statistically significant differences between prevalence of stricture and sex, age, neoplasic or non-neoplasic conditions, previous radiotherapy, level of anastomosis, and tumor stage. CONCLUSION: Stenosis after colorectal anastomosis with stapler devices must not be considered as an uncommon complication. In 20% of patients it may be a serious state that may require repeated catheter balloon dilations or surgery. Such condition is not dependent on diverse factors studied.

Adult↗
PubMed1995

[Colorectal cancer in the context of multiple primary malignant neoplasms].

INTRODUCTION: The finding of more than one carcinoma throughout the life of a patient is not unusual. In fact, the occurrence of multiple primary cancers has been well documented. However, the features, implications and prognosis of colorectal cancers associated to other malignancies, have been less well documented. PATIENTS AND METHOD: We report 29 patients with multiple primary neoplasms in which at least one of them was a colorectal cancer. Number, extension and localization of colonic neoplasm, and time interval between diagnosis of both neoplasms, and mortality and survival rate were retrospectively analyzed. Follow-up ranged from 1 to 360 months. RESULTS: Twenty three patients had two cancers, and six more than three neoplasms. Colorectal cancer was primary in 8 patients, metachronous in 14 patients and synchronous in 5 patients. Breast (7 cases), prostate (5 cases), endometrium (3 patients) and stomach (3 cases), were the other malignancies most frequently detected. Overall, 13 of the 27 patients (49%) died during the follow-up period after the recognition of the colorectal cancer. Two patients were lost to follow-up. Mantel-Haenszel test did not show significative differences in survival between patients with two or more neoplasms. There were no differences in survival depending upon the timing of diagnosis of the colorectal tumor. CONCLUSIONS: These data suggest that colorectal cancer may share etiologic factors with hormone-dependent neoplasms (breast, prostate) and gastric cancer. In patients with primary multiple neoplasms, the number of neoplasms detected and the interval time between both diagnosis are not prognostic factors when one of the malignancies in colorectal cancer.

Adult↗
PubMed1992

[Enterolithiasis].

The term enterolithiasis refers to concretions formed within the gastrointestinal tract. Conditions causing stasis predispose formation of enteroliths, which may be either radiopaque or radiolucent. Thus, a wide spectrum of intestinal disorders are associated with enterolithiasis including intestinal diverticulum, Crohn's ileitis, intestinal tuberculosis, radiation enteritis and strictures after surgery. The authors report one patient with intestinal obstruction as a complication of enterolithiasis and diagnosed previously as gallstone ileus. The pathogenesis and management concerning this entity are also discussed.

Aged↗
PubMed1990

[Torsion of an ectopic spleen as a cause of acute abdomen].

A case of torsion of an ectopic spleen is presented. Diagnosis was obtained by echography, CAT and arteriography. We review the cases reported in literature and discuss the diagnostic and therapeutic problems raised by this rare condition as the cause of acute abdomen as well as for the differential diagnosis of abdominal masses.

Abdomen, Acute↗
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↗