Biomedical subjects

Monica Rivera

Publications and source records attributed to Monica Rivera.

3 recordsLinked to original sources

PubMed2006

Natural history of patients hospitalized for management of cirrhotic ascites.

BACKGROUND & AIMS: Since the International Ascites Club published the diagnostic criteria of refractory ascites (RA) and hepatorenal syndrome (HRS), there have been few studies assessing the natural history of ascites. The aims of this study were to define the natural history of cirrhotic ascites and to identify prognostic factors for dilutional hyponatremia (DH), RA, HRS, and survival. METHODS: Two hundred sixty-three consecutive cirrhotic patients were followed for 40.9 +/- 2.6 months after their first significant ascites. RESULTS: During follow-up 74 (28.1%) patients developed DH, 30 (11.4%) RA (diuretic-resistant in 2 cases and diuretic-intractable because of the development of diuretic-induced complications in 28 cases), and 20 (7.6%) HRS (type 1, 7; type 2, 13). The 5-year probability of DH, RA, and HRS development was 37.1%, 11.4%, and 11.4%, respectively. The probability of survival at 1 and 5 years was 85% and 56.5%, respectively. The independent predictors for survival were baseline age, baseline Child-Pugh score, and DH development. The 1-year probability of survival after developing DH, RA, and type 2 HRS was 25.6%, 31.6%, and 38.5%, respectively. In contrast, the mean survival was only 7 +/- 2 days in those patients developing type 1 HRS. CONCLUSIONS: (1) The survival of cirrhotic patients with first episode of ascites is relatively high, and it is mainly influenced by age and Child-Pugh score at the time of ascites decompensation, as well as by DH development. (2) The probability of RA and HRS development is relatively low, but they are associated with a poor prognosis.

Ascites↗

PubMed2006

Update on brow and forehead lifting.

PURPOSE OF REVIEW: The purpose of this review is to provide the latest findings in the constantly changing field of brow and forehead lifting. Significant articles published in the last 24 months are reviewed and discussed based on the personal experience of the senior author (F.P.). RECENT FINDINGS: Important anatomical findings have been made over the last few years which will have an impact on plastic surgery of the upper third of the face, with new ligamentous structures of the forehead and more precise landmarks of the supraorbital neurovascular bundle being described. The short-term efficacy of a new device for periosteal fixation has been evaluated and new data have been collated about the time required for forehead periosteal readhesion. SUMMARY: In the last few years there have been important anatomical findings which will allow the development of more detailed and safe techniques for forehead lift surgery. New absorbable materials are available that allow efficient mechanical fixation of the soft tissues. The senior author of this review has extensive personal experience involving more than 400 cases. In addition to commenting on recent articles, we detail the methods we have used over the last 8 years, especially regarding the fixation technique.

Cadaver↗

PubMed2004

Natural history of decompensated hepatitis C virus-related cirrhosis. A study of 200 patients.

BACKGROUND/AIMS: Since few data are available concerning the clinical course of decompensated hepatitis C virus (HCV)-related cirrhosis, the aim of the present study was to define the natural long-term course after the first hepatic decompensation. METHODS: Cohort of 200 consecutive patients with HCV-related cirrhosis, and without known hepatocellular carcinoma (HCC), hospitalized for the first hepatic decompensation. RESULTS: Ascites was the most frequent first decompensation (48%), followed by portal hypertensive gastrointestinal bleeding (PHGB) (32.5%), severe bacterial infection (BI) (14.5%) and hepatic encephalopathy (HE) (5%). During follow-up (34+/-2 months) there were 519 readmissions, HCC developed in 33 (16.5%) patients, and death occurred in 85 patients (42.5%). The probability of survival after diagnosis of decompensated cirrhosis was 81.8 and 50.8% at 1 and 5 years, respectively. HE and/or ascites as the first hepatic decompensation, baseline Child-Pugh score, age, and presence of more than one decompensation during follow-up were independently correlated with survival. CONCLUSIONS: Once decompensated HCV-related cirrhosis was established, patients showed not only a very high frequency of readmissions, but also developed decompensations different from the initial one. These results contribute to defining the natural course and prognosis of decompensated HCV-related cirrhosis.

Adult↗