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Cirugía retroperitoneal laparoscópica: Experiencia del Hospital Universitario La Paz
Aguilera Bazán,A.; Pérez Utrilla,M.; Martín,M.; Pintado Otero,R.; Cisneros Ledo,J.; Pe?a Barthel,J. de la;
Archivos Espa?oles de Urología (Ed. impresa) , 2008, DOI: 10.4321/S0004-06142008000600009
Abstract: objectives: with the popularisation of laparoscopic radical prostatectomy, the above technique has once again taken on an important role in the work of urology departments. our extensive experience in laparoscopy means that we are performing increasingly more interventions using this approach. in the context of minimally invasive surgical procedures, this is probably bringing clearer benefits to retroperitoneal surgery than to prostatic surgery. in this article, we describe our series over nearly 4 years. methods: the period analysed covers june 2004 to march 2008, during which time 288 retroperitoneal operations were performed (184 nephrectomies, 113 other procedures). in the majority of cases, the route of approach was transperitoneal. results: the mean hospital stay was 3.6 days for the nephrectomies and 3 days for the other procedures. the transfusion rate for the nephrectomies was 5% and there was a conversion rate of in 2%. in the other types of surgery, the transfusion rate was 6% and there were no conversions. conclusions: the expansion of laparoscopy in urology has to be accompanied good patient selection and the progressive acquiring of experience on the part of the surgeon. certain interventions should only be tackled in cases where there is extensive experience.
La Relación del Hombre con su Primer(a) Hijo(a) Durante los Primeros Seis Meses de Vida: Experiencia Vincular del Padre Men's Relationship With Their First Child During the First Six Months of Life: Father's Bonding Experience  [cached]
Nicolás Suárez-Delucchi,Pablo Herrera
Psykhe (Santiago) , 2010,
Abstract: Se presentan los principales resultados de una investigación acerca de la experiencia de hombres en relación al vínculo con su primer(a) hijo(a) durante sus primeros 6 meses de vida. Se utilizó un dise o descriptivo-analítico relacional con metodología cualitativa, recolectando los datos mediante entrevistas individuales semiestructuradas a 14 padres, las que se analizaron a través de la grounded theory. Los resultados se agruparon en torno al fenómeno Experiencia de Conocerse Mutuamente, que implica el cuidado del padre al hijo(a), la confianza del hijo(a) hacia el padre y el afecto mutuo. Se discute la importancia de los factores que surgieron como intervinientes en la experiencia vincular gratificante: (a) cambios en la identidad, (b) relación con la madre y (c) tiempo-presencia disponible. The main findings of a study that explored the experience of bonding among men with their first child during the first six months of life are reported. This study was conducted using qualitative methodology within a descriptive-analytical design. Data was collected using semi-structured interviews with 14 fathers, which were analyzed using grounded theory. The results were organized around elements of the father's Experience of Getting to Know Each Other, including: the father's care of the child, the child's confidence in the father, and mutual affection. The relevance of the following emerging intervening factors for a rewarding bonding experience is discussed: (a) identity changes, (b) relationship with the mother, and (c) available time-presence.
Integración monetaria: la experiencia durante los primeros a os del euro  [cached]
Fernando Ossa Scaglia
Análisis Económico , 2009,
Abstract: En este trabajo se analiza el proceso que se tradujo en la unificación monetaria en la Unión Europea y la experiencia de los primeros a os del euro. En primer término se discute el efecto que ha tenido el euro en la integración comercial y financiera de los países miembros. Luego se analiza la política monetaria y fiscal en la unión monetaria. Se argumenta que el Banco Central Europeo (BCE) ha sido exitoso en establecer la credibilidad de su política monetaria basada en una meta de inflación. Respecto a la política fiscal, se concluye que el debilitamiento del control del sesgo potencial hacia el gasto fiscal deficitario en el área monetaria podría constituirse en una amenaza para la credibilidad del BCE. También se analizan las funciones internacionales de una moneda y cuál ha sido la evolución del euro como dinero internacional en el uso privado y oficial.
La Relación del Hombre con su Primer(a) Hijo(a) Durante los Primeros Seis Meses de Vida: Experiencia Vincular del Padre
Suárez-Delucchi,Nicolás; Herrera,Pablo;
Psykhe (Santiago) , 2010, DOI: 10.4067/S0718-22282010000200009
Abstract: the main findings of a study that explored the experience of bonding among men with their first child during the first six months of life are reported. this study was conducted using qualitative methodology within a descriptive-analytical design. data was collected using semi-structured interviews with 14 fathers, which were analyzed using grounded theory. the results were organized around elements of the father's experience of getting to know each other, including: the father's care of the child, the child's confidence in the father, and mutual affection. the relevance of the following emerging intervening factors for a rewarding bonding experience is discussed: (a) identity changes, (b) relationship with the mother, and (c) available time-presence.
Hemorragia retroperitoneal espontánea: nuestra experiencia en los últimos 10 a?os
Gimeno Argente,V.; Bosquet Sanz,M.; Ramírez Backhaus,M.; Trassierra Villa,M.; Arlandis Guzmán,S.; Jiménez Cruz,J.F.;
Actas Urológicas Espa?olas , 2007, DOI: 10.4321/S0210-48062007000500012
Abstract: introduction and objectives: etiology, clinical features, diagnostic methods and treatment of spontaneous retroperitoneal hemorrhage were analyzed. methods: we report 27 cases with diagnosis of spontaneous retroperitoneal hemorrhage treated in our hospital between january 1996 and december 2005. the imaging techniques were abdominal ultrasonography, abdominal ct scan and mri. results: the most common cause of retroperitoneal hemorrhage was renal angiomyolipoma rupture in 7 patients. continuous flank or abdominal pain were the primary symptoms. abdominal ultrasonography showed hematoma in 81.8% patients, but the actual etiologic diagnosis was ascertained in only 40.9% of them. retroperitoneal hemorrhage was demonstrated by means of abdominal ct scan in all cases and bleeding origin was established in 92.6% of cases. ten patients underwent urgent surgery while conservative treatment was attempted in the remaining 17. conclusions: in our experience, in cases of spontaneous retroperitoneal hemorrhage, ct scan is the best imaging method to establish the diagnosis and the management of such entity although it will need to be individualized for every case because it depends on the hemodinamic situation and etiologic diagnosis.
Sangramientos más frecuentes en los primeros 30 meses de vida de los hemofílicos Most frequent bleeding disorders in hemophiliacs in the first 30 months of life  [cached]
Martha Sagarra Veranes
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2004,
Abstract: La edad pediátrica del hemofílico constituye uno de los períodos más importantes en su vida, pues permite, en cierta medida, predecir la evolución de la enfermedad. En esta edad comienzan los sangramientos y las primeras hemartrosis. En el presente estudio, de 65 enfermos evaluados, 55 (84,6 %) presentaron estas manifestaciones en los primeros 30 meses de edad. Los hematomas aparecieron más precozmente generalmente antes del a o, pero el sangramiento articular o muscular ocurrió cuando el ni o empezó a caminar The pediatric age of the hemophiliac is one of the most important periods in his life, since it allows, in a certain way, to predict the evolution of the disease. Bleedings and the first hemarthroses began at this age. In the present study, of 65 evaluated patients, 55 (84.6 %) had these manifestations in the first 30 months of life. The hematomas appeared generally earlier before the first year of life, but the articular or muscular bleeding ocurred when the child began to walk
Nefrectomía radical laparoscópica retroperitoneal: experiencia inicial con 50 casos
Silva Quintela,R.; Siqueira,F.; Marelli de Carvalho,G.; Miranda Salim,M.; Lopes Abelha,Jr D.; Eduardo Távora,J.;
Actas Urológicas Espa?olas , 2008, DOI: 10.4321/S0210-48062008000400006
Abstract: purpose: laparoscopic radical nephrectomy is preferentially performed by transperitoneal approach. despite offering advantages the direct retroperitoneal laparoscopic approach has not found uniform acceptance due to small working space in the retroperitoneum. retroperitoneoscopy is our preferred approach for performing radical nephrectomy for localized renal tumors. we present our technique and our experience with the first 50 retroperitoneoscopic radical nephrectomies and compare the results with other series. matherials and methods: 50 patients underwent retroperitoneoscopic radical nephrectomy for renal tumors ct1/ct2 between march 2004 to march 2007. a four ports retroperitoneal laparoscopic nephrectomy technique is performed with the patient in the full flank position. an artisanal balloon is used to create the retroperitoneal working space. the specimen is extracted intact by an extraperitoneal iliac incision. follow up data were retrospectively reviewed. results: mean tumor size was 5,3 cm (3 to 13 cm), surgical time was 150 min (90 to 300 min), and blood loss was 130 ml (40-1000 ml). average hospital stay was 2,2 days (1-11 days). complications occurred in 6 (12%) patients. two patients (4%) presented major complications and one of then require open conversion. four patients (8%) presented minor complications. there were two later recurrences. one local and port site recurrence in a pt3an0m0 renal cancer and one systemic metastases in a pt3n0m0 urothelial cancer occurred. both cases presented inadequately extraction. conclusion: retroperitoneoscopy is a feasible, effective and safe alternative for the treatment of localized renal tumors. retroperitoneoscopy should be avoided in advanced and large size renal tumors.
Supervivencia en pacientes con tuberculosis infectados por VIH. Estudio de los fallecimientos en los primeros nueve meses  [cached]
Falqués Casanovas Meritxell,Langohr Klaus,Gómez Melis Guadalupe,García de Olalla Rizo Patricia
Revista Espa?ola de Salud Pública , 1999,
Abstract: FUNDAMENTO: En las personas con tuberculosis infectadas por el VIH, se ha observado una elevada letalidad durante las primeras semanas desde el inicio de la terapia antituberculosa. En el presente estudio se analiza la supervivencia de las mismas en el marco de un estudio de cohortes retrospectivo. MéTODOS: Se incluyeron 1.135 individuos que correspondían a aquellos por el VIH mayores de quince a os y residentes en Barcelona, registrados por el Programa de Prevención y Control de la Tuberculosis de Barcelona y que fueron diagnosticados entre 1988 y 1993. Las variables analizadas fueron edad, sexo, antecedentes de prisión, distrito municipal, grupo de riesgo, porcentaje de linfocitos T CD4+, prueba de la tuberculina, diagnóstico de sida (según criterio CDC-1987), patrón radiológico, bacteriología y localización anatómica de la tuberculosis. Se utilizó el método semiparamétrico de Cox, las curvas de Kaplan-Meier y la prueba de log-rank. RESULTADOS: La probabilidad de supervivencia a los nueve meses fue del 77%, con amplias variaciones en los diversos subgrupos. Las únicas variables significativas en el modelo multivariado de Cox fueron sida, porcentaje de linfocitos T CD4+ y su interacción. El riesgo de morir para un individuo sin SIDA y porcentaje de linfocitos T CD4+ inferior o igual al 14% fue 7.69 veces mayor que el riesgo de morir para un individuo sin SIDA y porcentaje de linfocitos T CD4+ superior al 14%. CONCLUSIONES: La supervivencia en las personas con tuberculosis infectadas por VIH es muy variable. Las que fallecieron a corto plazo fueron las diagnosticadas de sida al iniciar el tratamiento antituberculoso y que, además, tenían un porcentaje de linfocitos T CD4+ inferior o igual al 14%.
Una experiencia de terapia grupal con ni os abandonados y huérfanos en una aldea infantil  [cached]
Rosa María Normand
Revista de Psicología , 1987,
Abstract: El presente artículo tiene como objetivo relatar los primeros ocho meses de una experiencia de terapia grupal que tendrá una duración total de 15 meses, en una aldea infantil que pertenece a la Fundación por los Ni os del Perú. La técnica terapéutica aplicada se emplea en el Bearverbrook Guidance Center de la ciudad de Boston en EE.UU. de Norteamérica. El marco de referencia de esta posición es integracionista, incluyéndose autores como Anna Freud, Joseph Sandler, D.W. Winnicott, John Bowlby y Virginia Axline. Se trata de una primera experiencia, aún no concluída, pero que pensamos puede ser relatada por los importantes cambios observados en los ni os tratados. Presentaremos un segundo artículo al finalizar los 15 meses del tratamiento.
Lumboscopia: Experiencia con la técnica en Berazategui. Primeros 600 casos
Santinelli,Flavio; Mias,Fernando; Manduley,Alejandro;
Archivos Espa?oles de Urología (Ed. impresa) , 2007, DOI: 10.4321/S0004-06142007000300008
Abstract: objectives: to show the lumboscopy technique developed in our department, our case series and its results. methods: from august 15th 1997 to date 606 patients were operated on by means of the lumboscopy technique. 152 nephrectomies, 18 partial nephrectomies, 103 pyeloplasties, 5 adrenalectomies, 89 pyelolithotomies, 153 ureterolithotomies, 44 renal cyst unroofing and other 42 procedures were performed. results: we perform the retroperitoneal access in the inferior lumbar triangle, with digital blunt dissection only and direct pneumatic dissection with a high flow insufflator, without balloon or balloon trocar dissection. we describe the development of the working space with perirenal fat flaps, as well as the various types of pathology operated and our complications. conclusions: the working space in lumboscopy must be created by the surgeon beyond using a balloon or direct digital dissection technique. the technique we describe is easy and reproducible, creating an adequate surgical space and requires the anatomical knowledge to be able to identify landmarks.
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