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J R Santana

Publications and source records attributed to J R Santana.

6 recordsLinked to original sources
PubMed2004

Assessment of pulmonary function in patients before and after laparoscopic and open esophagogastric surgery.

BACKGROUND: Laparoscopy is a technique used in various surgical procedures. Few studies in the literature compare stress between laparoscopic and open surgery used for esophagogastric surgical procedures. Pulmonary function is known to be significantly affected in open surgeries, increasing postoperative morbidity and mortality. The current study aimed to assess pulmonary function in patients before and after open and laparoscopic esophagogastric surgery. METHODS: For this study, 75 patients were divided into two groups: 50 patients undergoing laparoscopy and 25 patients undergoing open surgery. The following parameters were determined by spirometry before and after surgery: forced expiratory volume in the first second (FEV(1)), forced vital capacity (FVC), and forced expiratory flow in the midexpiratory phase (FEF(25-75%)). RESULTS: A decrease in FEV(1,) FVC, and FEF((25-75%)) was observed in the two groups on postoperative days 2, 3, and 4, as compared with the preoperative period. Likewise, FEV(1) and FVC showed a significant reduction on postoperative days 2, 3, and 4 in the patients who underwent to open surgery, but only on the day 2 in those who underwent to laparoscopic surgery. A significant decrease in FEF((25-75%)) was observed only on postoperative day 2 in the group that underwent open surgery. Significant differences in FEV(1) between the groups were observed on postoperative days 2, 3, and 4. No significant difference in FVC was noted between the groups, and a difference in FEF((25-75%)) was observed only on postoperative day 4. CONCLUSIONS: Postoperative pulmonary dysfunction was more important for the patients undergoing open surgery than for those undergoing laparoscopic surgery.

Digestive System Surgical Procedures↗
PubMed1995

Accuracy of emergency physician data collection in automobile collisions.

OBJECTIVE: Triage decisions must be based on accurate information with a valid understanding of injury patterns and their sources. Only a data base that includes both medical and collision factors can best provide the breadth of information required to achieve this goal. In the study reported here we assessed the accuracy of automobile collision data collected by emergency physicians compared with Police Accident Reports. DESIGN: Prospective study in which emergency medicine attending physicians completed questionnaires placed near the entrance to the trauma rooms in the emergency department. MATERIALS AND METHODS: During a two-month period the emergency medicine attending physicians obtained data concerning vehicle collision factors for all automobile collisions resulting in major trauma to patients over 18 years of age who were triaged to the Emergency Department at Stanford University Hospital, a level-I trauma center. These data were then compared by one of the investigators with the data contained in Police Accident Reports, which were available for 50 of the 64 patients who met the study eligibility criteria. MEASUREMENTS AND MAIN RESULTS: For each automobile collision, the attending physician was asked to collect the following data: direction of impact; extrication required; ejection; type and use of restraints; deployment of an airbag; type of vehicle; reported severity (minor, moderate, or major) of impact; presence and degree of steering wheel deformation; presence and degree of intrusion into occupant compartment; estimated speed and collision type (i.e., vehicle to vehicle, to fixed object, etc.) Nearly three-fourths (74%) of all cases had at least one discrepancy when compared with the Police Accident Reports, while 46% of these had multiple discrepancies. CONCLUSIONS: When data obtained by emergency physicians are compared with the information in Police Accident Reports, there are notable differences on several collision factors. Triage decisions must be based on accurate information with a valid understanding of injury patterns and their sources. Only a data base that includes both medical and collision factors can best provide the breadth of information required to achieve this goal.

Accidents, Traffic↗
PubMedDate not supplied

[Preoperative nutritional assessment: a 1-year experience].

A study was made of 443 surgical patients using a standard protocol for nutritional evaluation based on anthropometrical, analytical and immunological tests. The main criteria used for considering the presence of malnutrition was a weight loss of 10% and/or seric albumin level of less than 3.5 g/dl., by which method four nutritional groups were established. The average age of the sample was 56 +/- 15 years and 35% of patients had neoplasias, 9.25% of patients were classified as belonging to Group A (weight loss and low albumin levels), 10.15% as group B (low albumin levels), 14.44% as group C (weight loss), and 66.16% as group D (normal), so that the global malnutrition percentage was 33.84%. The Body Mass Index (BMI) and Ideal Weight Percentage (% IWP) were of similar importance, and there was a significant alteration in the Triceps Skin Fold (% TSF) and Muscular Area Percentage of the arm (% MAP) when malnutrition was in evidence. In the study of the Delayed Hypersensitivity Skin Tests (DSST) 21.4% showed anergia, 15.8% hypoergia and 62.8% were reactive, with a reduction in reactivity in the case of malnutrition. This was the parameter that most affected the albumen level.

Adult↗
PubMedDate not supplied

[Variability of anthropometric parameters].

Presentation of a comparative study of four ideal weight tables applied to the same population, in order to evaluate the differences or similarities between the same. Significant differences (p<0.001) were found between the four tables studied (WHO, USA, Barcelona, Tenerife) when classifying a patient into one of the three groups defined (malnutrition, normal and obese). The maximum differences found were between the Barcelona and Tenerife tables, which classified 13,7% and 24.05% respectively as cases of malnutrition and 35.9% and 16.89% respectively as obese.

Adult↗
PubMedDate not supplied

[Incidence of malnutrition in a surgery department].

Presentation of a description of the initial results obtained in nutritional evaluation of patients admitted for elective surgery during a 6-month period. A total of 212 patients were studied, recording malnutrition in 25%. This was severe in half of the cases. As a result of the malnutrition, a significant reduction was observed in the number of positive responses to the Multitest and the total count of lymphocytes.

Adult↗