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Moliner Velázquez S, Palau Martí C, Tatay J, Hernández Laforet J, Ferrer Gómez C. PERCUTANEOUS TRACHEOTOMY IN ICU: OUR EXPERIENCE IN 2020-2021 (COVID-19 PANDEMIC). J Cardiothorac Vasc Anesth 2022. [DOI: 10.1053/j.jvca.2022.09.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Rubio-Haro R, Quesada-Carrascosa M, Hernández-Laforet J, Ferrer Gómez C, De Andrés J. Diagnostic-therapeutic algorithm for thrombotic microangiopathy. A report of two cases. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:179-182. [PMID: 35283062 DOI: 10.1016/j.redare.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 11/30/2020] [Indexed: 06/14/2023]
Abstract
Thrombotic microangiopathies (TMA) are a group of clinical syndromes associated with haemolytic anaemia, thrombocytopenia and organ dysfunction, mainly renal or neurological. They are associated with significant morbidity and mortality, so early diagnosis and treatment are essential. In this article we report two cases of TMA; a patient with thrombotic thrombocytopenic purpura (TTP) and a patient with atypical haemolytic uraemic syndrome (aHUS).
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Affiliation(s)
- R Rubio-Haro
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, Spain.
| | - M Quesada-Carrascosa
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, Spain
| | - J Hernández-Laforet
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, Spain
| | - C Ferrer Gómez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, Spain
| | - J De Andrés
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, Spain; Unidad de Anestesia-Departamento de Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, Spain
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Peña Borras JJ, Pajares Moncho A, Puig J, Mateo Rodríguez E, López Forte C, Peña Pérez L, Moreno Pachón J, Gabaldón Conejos T, Pérez Artacho J, Ferrer Gómez C, Férez Martí A, López Cantero M, de Andrés Ibáñez J. Tranexamic acid in cardiac surgery: Are low doses enough? Rev Esp Anestesiol Reanim (Engl Ed) 2021; 68:576-583. [PMID: 34857506 DOI: 10.1016/j.redare.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 02/09/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Tranexamic acid is used to prevent hyperfibrinolysis and reduce postoperative bleeding and blood transfusions in on-pump cardiac surgery. We evaluate the efficacy of low or high dose tranexamic acid in a prospective cohort study conducted in Valencia. MATERIALS AND METHODS A total of 427 patients were recruited between January 2019 and January 2020, 207 in the Hospital General Universitario (low dose [LD]) and 220 in the Hospital Universitario y Politécnico La Fe (high dose [HD] and intermediate dose [ID]). We recorded the presence of hyperfibrinolysis on rotational thromboelastometry, intra- and postoperative administration of blood products, chest tube output within the first 12 h, and incidence of convulsions. Univariate and multivariate comparisons were performed. Univariate analysis of all categories was performed after propensity score matching between LD and HD and between LD and ID. RESULTS There were no statistically significant differences in: appearance of hyperfibrinolysis, administration of blood products, postoperative chest tube output within the first 12 h, or occurrence of convulsions. Group LD received less fibrinogen than group HD (P = .014) and ID (P = .040) but more fresh frozen plasma than group ID (P = .0002). CONCLUSIONS Administration of low-dose tranexamic acid is as effective as higher doses in hyperfibrinolysis prophylaxis and the prevention of postoperative bleeding in cardiac surgery.
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Affiliation(s)
- J J Peña Borras
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - A Pajares Moncho
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - J Puig
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Departamento de Cirugía, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain.
| | - E Mateo Rodríguez
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - C López Forte
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - L Peña Pérez
- Centre for Haematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden
| | - J Moreno Pachón
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - T Gabaldón Conejos
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - J Pérez Artacho
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Ferrer Gómez
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - A Férez Martí
- Servicio de Análisis Clínicos, Hospital General Universitario de Valencia, Valencia, Spain
| | - M López Cantero
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - J de Andrés Ibáñez
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, Spain; Departamento de Cirugía, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain
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Ferrer Gómez C, Solís Albamonte P, Delgado Navarro C, Salvador García C, Tormo Palop N, Andrés Ibáñez JA. Analysis of Candida auris candidemia cases in an Intensive Care Unit of a tertiary hospital. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 68:431-436. [PMID: 34538766 DOI: 10.1016/j.redare.2020.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 10/09/2020] [Indexed: 06/13/2023]
Abstract
UNLABELLED Candida auris is a multi-resistant emerging fungus. OBJECTIVES To analyze the relationship between colonization by C. auris and the appearance of invasive candidiasis. Description of the sample of colonized patients, risk factors for colonization and/or infection, and calculation of mortality rates. METHODOLOGY Longitudinal observational study in an anesthesia intensive care unit in 2018. RESULTS 2130 patients were admitted. Surveillance studies were positive in 124 patients; 118 cases involved skin colonization and 52 were pharyngeal. Patients with a positive blood culture were identified. A statistically significant association was found between pharyngeal colonization and the appearance of a positive blood culture. There were significant differences between patients with a high Candida Score as a risk factor for candidemia. In total, 67% of pharyngeal carriers negativized at 1 month compared to 21% of cutaneous carriers, who negativized after 3-4 months. Of the patients with positive blood cultures, 70% of non-survivors received only monotherapy, although this difference was not statistically significant due to the small sample size. CONCLUSIONS The incidence of C. auris, a multi-resistant pathogen that is difficult to diagnose, treat and eradicate, is steadily increasing among critically ill patients. Its status as an emerging threat to global health calls for the urgent implementation of early in-hospital detection systems.
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Affiliation(s)
- C Ferrer Gómez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital General Universitario de Valencia, Valencia, Spain
| | - P Solís Albamonte
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital General Universitario de Valencia, Valencia, Spain.
| | - C Delgado Navarro
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital General Universitario de Valencia, Valencia, Spain
| | - C Salvador García
- Servicio de Microbiología, Hospital General Universitario de Valencia, Valencia, Spain
| | - N Tormo Palop
- Servicio de Microbiología, Hospital General Universitario de Valencia, Valencia, Spain
| | - J A Andrés Ibáñez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital General Universitario de Valencia, Valencia, Spain
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Peña Borras JJ, Pajares Moncho A, Puig J, Mateo Rodríguez E, López Forte C, Peña Pérez L, Moreno Pachón J, Gabaldón Conejos T, Pérez Artacho J, Ferrer Gómez C, Férez Martí A, López Cantero M, de Andrés Ibáñez J. Tranexamic acid in cardiac surgery: Are low doses enough? Rev Esp Anestesiol Reanim (Engl Ed) 2021; 68:S0034-9356(21)00105-5. [PMID: 34538453 DOI: 10.1016/j.redar.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/04/2020] [Accepted: 02/09/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Tranexamic acid is used to prevent hyperfibrinolysis and reduce postoperative bleeding and blood transfusions in on-pump cardiac surgery. We evaluate the efficacy of low or high dose tranexamic acid in a prospective cohort study conducted in Valencia. MATERIALS AND METHODS A total of 427 patients were recruited between January 2019 and January 2020, 207 in the Hospital General Universitario (low dose [LD]) and 220 in the Hospital Universitario y Politécnico La Fe (high dose [HD] and intermediate dose [ID]). We recorded the presence of hyperfibrinolysis on rotational thromboelastometry, intra- and postoperative administration of blood products, chest tube output within the first 12h, and incidence of convulsions. Univariate and multivariate comparisons were performed. Univariate analysis of all categories was performed after propensity score matching between LD and HD and between LD and ID. RESULTS There were no statistically significant differences in: appearance of hyperfibrinolysis, administration of blood products, postoperative chest tube output within the first 12h, or occurrence of convulsions. Group LD received less fibrinogen than group HD (P=.014) and ID (P=.040) but more fresh frozen plasma than group ID (P=.0002). CONCLUSIONS Administration of low-dose tranexamic acid is as effective as higher doses in hyperfibrinolysis prophylaxis and the prevention of postoperative bleeding in cardiac surgery.
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Affiliation(s)
- J J Peña Borras
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - A Pajares Moncho
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - J Puig
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España; Departamento de Cirugía, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, España.
| | - E Mateo Rodríguez
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - C López Forte
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - L Peña Pérez
- Centre for Haematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Suecia
| | - J Moreno Pachón
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - T Gabaldón Conejos
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - J Pérez Artacho
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - C Ferrer Gómez
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - A Férez Martí
- Servicio de Análisis Clínicos, Hospital General Universitario de Valencia, Valencia, España
| | - M López Cantero
- Servicio de Anestesiología y Reanimación, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - J de Andrés Ibáñez
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, Valencia, España; Departamento de Cirugía, Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, España
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Rubio-Haro R, Quesada-Carrascosa M, Hernández-Laforet J, Ferrer Gómez C, De Andrés J. Diagnostic-therapeutic algorithm for thrombotic microangiopathy. A report of two cases. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 69:S0034-9356(21)00016-5. [PMID: 34148684 DOI: 10.1016/j.redar.2020.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
Thrombotic microangiopathies (TMA) are a group of clinical syndromes associated with haemolytic anaemia, thrombocytopenia and organ dysfunction, mainly renal or neurological. They are associated with significant morbidity and mortality, so early diagnosis and treatment are essential. In this article we report two cases of TMA; a patient with thrombotic thrombocytopenic purpura (TTP) and a patient with atypical haemolytic uraemic syndrome (aHUS).
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Affiliation(s)
- R Rubio-Haro
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, España.
| | - M Quesada-Carrascosa
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, España
| | - J Hernández-Laforet
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, España
| | - C Ferrer Gómez
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, España
| | - J De Andrés
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Universitario, Valencia, España; Unidad de Anestesia-Departamento de Cirugía, Facultad de Medicina, Universidad de Valencia, Valencia, España
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Sanz Herrero F, Puchades Gimeno F, Ortega García P, Ferrer Gómez C, Ocete Mochón MD, García Deltoro M. Methylprednisolone added to tocilizumab reduces mortality in SARS-CoV-2 pneumonia: An observational study. J Intern Med 2021; 289:259-263. [PMID: 32603493 PMCID: PMC7361229 DOI: 10.1111/joim.13145] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022]
Affiliation(s)
- F Sanz Herrero
- From the, Pulmonology Department, Consorci Hospital General Universitari, València, Spain
| | - F Puchades Gimeno
- Internal Medicine Department, Consorci Hospital General Universitari, València, Spain
| | - P Ortega García
- Hospital Pharmacy Department, Consorci Hospital General Universitari, València, Spain
| | - C Ferrer Gómez
- Anesthesiology Department and Intensive Care Unit, Consorci Hospital General Universitari, València, Spain
| | - M D Ocete Mochón
- Microbiology Department, Consorci Hospital General Universitari, València, Spain
| | - M García Deltoro
- Infectious Diseases Department, Consorci Hospital General Universitari, València, Spain
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López G, Ayala SM, Efron AM, Gómez CF, Lucero NE. A serological and bacteriological survey of dogs to detect Brucella infection in Lomas de Zamora, Buenos Aires province. Rev Argent Microbiol 2009; 41:97-101. [PMID: 19623899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Canine brucellosis caused by Brucella canis is a disease of the reproductive tract that may cause miscarriage in females, infection of the sexual organs in males and infertility in both sexes. The prevalence of brucellosis in dogs is unknown and little has been done to control the disease, except in certain breeds and some commercial dog kennels. In the course of a free neuter program in Lomas de Zamora, Buenos Aires province, prevalence of antibodies to Brucella sp., bacteriological isolation and clinical observations were performed. Of 224 dogs studied, 33 (14.7%) were found positive for the rapid slide agglutination test (RSAT), 24 (10.7%) of which were confirmed by IELISA. Of the 33 RSAT positive, 17 (51.5%) blood cultures were done, and B. canis were isolated from 2 cases. Since infected dogs have been shown to remain bacteremic for prolonged periods, our results also suggest a risk of human infections in this area.
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Affiliation(s)
- G López
- Zoonosis Center, Municipalidad de Lomas de Zamora, 12 de octubre 1060, (1828) Banfield, Provincia de Buenos Aires, Argentina
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Ferrer Gómez C, Torregrosa Martínez JC, Sanchís Mínguez C, Gimeno Campos MJ. [Severe methemoglobinemia due to aniline intoxication]. Rev Esp Anestesiol Reanim 2008; 55:53-55. [PMID: 18333391 DOI: 10.1016/s0034-9356(08)70502-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Ferrer Gómez C, Puig Bitrià R, Boada Pie S, Recasens Urbez J, Rull Bartomeu M. [Oral analgesia versus posterior tibial nerve block for postoperative pain in ambulatory open hallux valgus surgery: a randomized clinical trial]. Rev Esp Anestesiol Reanim 2006; 53:220-5. [PMID: 16711497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
INTRODUCTION This trial assessed the safety and efficacy of a continuous posterior tibial nerve block in the ankle provided in the patient's home by elastomeric pump infusion of 0.375% ropivacaine after ambulatory hallux valgus surgery. MATERIAL AND METHODS Patients were randomized to 2 groups of 20 each to receive either the conventional oral analgesia prescribed by our team after outpatient surgery (metamizole 575 mg/6 h p.o.) or perineural analgesia with a continuous infusion of 5 mL x h(-1) of 0.375% ropivacaine in the posterior tibial nerve. Surgery was performed under hyperbaric spinal anesthesia with mepivacaine and an injection of 0.25% bupivacaine into the joint. Both groups also received 50 mg/8 h p.o. of tramadol as rescue analgesia. Assessment during visits by the home care team 12, 24, and 48 hours after surgery included the following variables: pain on a visual analog scale (VAS, 0-10), sleep quality, need for rescue analgesia, acceptance of the technique, side effects and adverse events. Descriptive statistics were calculated and comparisons were performed with the Mann-Whitney U test; sleep quality and need for rescue analgesia were compared by applying the chi2 statistic with a test of linear trend. RESULTS The perineural analgesia group had significantly lower VAS scores at 4, 12, and 24 hours and less need for rescue analgesia. No differences in sleep quality were found (P0.07). The incidence of side effects did not differ, and there were no readmissions. The patients expressed a high level of acceptance of the technique. CONCLUSION Continuous perineural analgesia in the home setting was found to be effective and safe in our patients.
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Affiliation(s)
- C Ferrer Gómez
- Servicio de Anestesiología y Reanimación, Hospital Universitari Joan XXIII, Tarragona.
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Ortez de Landázuri PJ, Boada Pie S, Ferrer Gómez C, Puig Bitria R, Sánchez Herrero A, Rull Bartomeu M. [Spontaneous kinking of an epidural catheter]. Rev Esp Anestesiol Reanim 2005; 52:121-2. [PMID: 15765999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Ferrer Gómez C, Saludes Serra J, Pelegrí Grau D, Padrol A, Rull Bartomeu M. [Syringomyelia discovered after epidural infusion]. Rev Esp Anestesiol Reanim 2005; 52:60-1. [PMID: 15747712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Recasens Urbez J, Ferrer Gómez C, Puig Bitria R, Jubera Ortiz de Landázuri P, Boada Pie S, Rull Bartomeu M. [Convulsions induced by ropivacaine after brachial plexus block]. Rev Esp Anestesiol Reanim 2004; 51:553-5. [PMID: 15620167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Ropivacaine is a local anesthetic frequently used to provide regional blocks because its toxicity threshold is favorable and it is highly selective for sensory nerve fibers. Few reports of adverse events and complications related to use of ropivacaine have been published. We report 2 cases of central nervous system toxicity. Each occurred after a brachial plexus block with 0.75% ropivacaine, one performed by an axillary approach and one by an infraclavicular approach with nerve stimulation.
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Affiliation(s)
- J Recasens Urbez
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari Joan XXIII, Tarragona.
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Ferrer Gómez C, Puig Bitria R, Jubera Ortiz de Landázuri P, Ferrer Gómez C, Recasens Urbez J, Boada Pie S, Rull Bartomeu M. [Two cases of erythroposia related to brachial plexus blocks]. Rev Esp Anestesiol Reanim 2004; 51:350-1. [PMID: 15303538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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16
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Fernández García S, Prieto Alvarez P, Ferrer Gómez C, Bella Romera S, Játiva Porcar R, Cuenca Peña J. [Post-surgical chylothorax after bilateral cervical lymph node excision]. Rev Esp Anestesiol Reanim 2002; 49:279-80. [PMID: 12216514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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17
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Ferrer Gómez C, Silla Aleixandre I, Vicente Guillén R, Barrio Mataix J, Rodríguez Argente G, Montero Benzo R. [Persistent left superior vena cava: an infrequent localization of the central venous catheter]. Rev Esp Anestesiol Reanim 2001; 48:97-9. [PMID: 11257961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Ferrer Gómez C, Saludes Serra J, Tello Galindo I, Gómez Montemayor E, Bella Romera S, Cuenca Peña J. [0.2% ropivacaine vs. 0.1% ropivacaine plus fentanyl in obstetric epidural analgesia]. Rev Esp Anestesiol Reanim 2000; 47:332-6. [PMID: 11103113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To compare the analgesic efficacy of epidural administration of 0.2% ropivacaine alone to that of 0.1% ropivacaine plus 0.0002% fentanyl during childbirth. PATIENTS AND METHODS We performed a prospective, randomized single-blind study of 84 women in labor (aged 16 to 40 y, ASA I-II, weight over 110 kg, height over 150 cm, gestational age 37 to 42 weeks). The women were randomly assigned to two groups: group I consisted of 42 patients who received an initial bolus of 10 ml of ropivacaine 0.2% followed by continuous perfusion of ropivacaine 0.2% at a rate of 6 to 10 ml/h; group II was composed of 42 women who received an initial bolus of ropivacaine 0.2% with 50 micrograms of fentanyl followed by continuous infusion of ropivacaine 0.1% and fentanyl 2 micrograms/ml at a rate of 6 to 10 ml/h. Data recorded were parity and type of delivery, blood pressure, heart rate (HR), time to onset of pain relief, motor blockade on a modified Bromage scale, pain on a visual analog scale (VAS) and fetal HR, Apgar score and arterial and venous pH of umbilical blood. RESULTS We found no significant differences in demographic or hemodynamic data in mothers or fetuses, in type of delivery or motor block, although the latter tended to be slightly lower in group II. In group II, the total anesthetic dose used was significantly lower (p = 0.003); time until onset of pain relief was significantly shorter (p = 0.044); and VAS scores were significantly lower at 15 min (p = 0.005), 30 min (p = 0.029), 60 min (p = 0.017) and 90 min (p = 0.002). The number of top-up boluses needed for deliveries involving instruments was significantly greater in group II (p = 0.37). CONCLUSION The protocol of ropivacaine 0.1% with 2 micrograms/ml of fentanyl provides satisfactory analgesia throughout labor, allowing lower doses of local anesthetic to be used, with shorter onset of pain relief and reduced motor blockade; however the analgesia provided is insufficient for deliveries assisted by instruments.
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Affiliation(s)
- C Ferrer Gómez
- Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitari Sant Joan, Reus, Tarragona
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Ferrer Gómez C, Climent Durán M, Giner Almaraz S, Silvestre Quílez S, Giménez Navarro P. [The prevalence of antibodies to the rubella virus in pregnant women at a health center]. Aten Primaria 1999; 23:429-33. [PMID: 10363396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVE To know the prevalence of antibodies against rubella in pregnant women of a health centre. DESIGN Cross-sectional descriptive study, for 4 years. SETTING Llíria health centre. Zone 9. Area 5. Valencia. PATIENTS Random sample of 405 pregnant women (15-45 years) of 3500 women in fertile age, extracted from the obstetrics unity. MEASUREMENTS AND RESULTS We collected the following variable: age of the mother in the last gestation, number of previous gestations (including abortions), determination of antibodies against rubella, degree of schooling and occupation index. The results show a prevalence of antibodies against rubella of the 95.2% (CI 95% 93.1-97.3). We find meaningful differences between the antibodies protective titles and the age (p < 0.0005) and instruction level (p = 0.0263), so when the women are elder and they have a instruction level better the antibodies protective titles are bigger. We don't find meaningful differences with the mother occupational level (p = 0.0945), either with the number of previous gestations (p = 0.2947). The prevalence of antibodies against rubella, according to groups of age in the pregnant women population, varies from 81.8% (CI 95% 59.7-94.8) in the group of 15 to 19 years, until a 100% (CI 95% 66.4-100) in the group of 40-44 years. The relationship between the number of gestations and the lack immunization against rubella is for the first pregnancy 52.6%, second pregnancy 36.8%, several pregnancy 10.5%. CONCLUSIONS The prevalence of antibodies against rubella in pregnant women is 95%, similar to other published studies. This prevalence increases with the age what suggests the primary paper of the wild virus in the maintenance of the rate of prevalence. It should be to incise more in the immunization after the labour, overcoat, in those pregnant women with less schooling, so corroborate our results. It is necessary to take the adequate measures so that 47.4% of the total of seronegative women (with more than one pregnancy), don't escape to the controls of the sanitary system.
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Ferrer Gómez C, Sánchez Sánchez J, Tello Galindo I, Masip Serra R, Rull Bartomeu M. [Formation of a curl in a central venous catheter after catheterization of the basilic vein]. Rev Esp Anestesiol Reanim 1999; 46:178-9. [PMID: 10365620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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Abstract
The association of repeated sinus-bronchial-pulmonary infection and male infertility is well known in the literature in conditions such as cystic fibrosis, immotile cilia syndrome and Young's syndrome. Outside the context of these clinical entities, however, the association is unusual. We report the case of a 36-year-old man with sinusitis, bronchiectasis and sterility due to Sertoli-cell-only syndrome, an association that has not been described to date. Testicular biopsy showed absence of spermatogones and other germ cells, and non specific alterations were found in nasal cilia axonemes, in the presence of DNA branches. A sweat test was negative. Given that recent studies have shown an increase in the prevalence os Sertoli-cell-only syndrome, other cases might be described and this association may correspond to a specific entity.
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Antón Crespo V, Hinojosa del Val J, Aparisi Quereda L, Primo Vera J, Molés Marco JR, Fernández Chinchilla J, Ferrer Gómez C. [Chronic calcifying pancreatitis and chronic renal failure]. Rev Esp Enferm Dig 1994; 85:141-3. [PMID: 8186017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We report a case of chronic calcifying pancreatitis and exocrine pancreatic deficiency in a patient with chronic renal failure under hemodialysis. We analyze the possible relationship between these two entities with special reference to the role of secondary hyperparathyroidism and extraosseous or metastatic calcification.
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Escudero Torrella J, Láinez Andrés JM, Morera Guitart J, Ferrer Gómez C, Lluch Bellod V, Sancho Rieger J. [Reintervention in gliomas: the necessity of nuclear magnetic resonance]. Arch Neurobiol (Madr) 1990; 53:129-33. [PMID: 2241470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The reoperation of patients with recurrence of cerebral glioma is a technique offering survival with a good quality of life. The accepted criteria are a Karnofski index until reoperation greater than or equal to 70, young age, and a favourable histologic grade of tumor. NMR offers better sensitivity than other neuroimaging techniques for the detection of tumoral extension, local and at a distance, and allows a good tumoral resection. We report a patient with recurrence of a cerebral astrocytoma grade II with the criteria for reoperation, but when we performed NMR a dissemination of the tumor to the posterior fossa was seen, and reoperation was consequently counter-indicated. We discuss the mechanism of the extension of cerebral gliomas, the value of neuroimaging techniques and the role of reoperation in this context. We consider it necessary to perform NMR prior to reoperation in this special group of patients with a cerebral glioma recurrence.
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