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Search Results: 1 - 10 of 240974 matches for " Jorge Villegas C "
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Mortalidad tras un a o de protocolización en el manejo del paciente quemado Effects of standarization of burn patient treatment on mortality
JORGE VILLEGAS C,ESTEBAN TORRES E,CéSAR PEDREROS P,PAULINA SINGH O
Revista Chilena de Cirugía , 2010,
Abstract: Introducción: En el 2005 el Servicio de Quemados del HUAP inició un proceso de modernización. Durante el primer a o se intervino en el protocolo terapéutico médico y quirúrgico. Se analizarán la mortalidad observada en este período. Materiales y Métodos: Se analizaron los pacientes admitidos en Cuidados Intermedios e Intensivos de nuestra unidad desde el Io de marzo de 2005 a Io de marzo de 2006. Se realizó aseo quirúrgico precoz, según protocolo, previa reanimación estandarizada con Ringer Lactato usando la fórmula de Parkland, 4 cc/kg/% SCT (superficie corporal total). Todos los casos fueron monitorizados, guiados por diuresis y con algoritmo para decidir inicio de drogas vasoactivas o monitorización invasiva. Resultados: Ingresan 88 pacientes, 58% trasladados de otros centros. Edad promedio 43 ± 18,9 a os; hombres 65%, mujeres 35%; superficie corporal quemada 30 ± 21%, profunda 12,5 ± 17%. Se administró en promedio 9.122 ± 6.930 ce durante las primeras 24 hrs. Primer aseo se realizó a las 48 hrs (1 hr -15 días), Ia escarectomía a los 4,2 días (3 hrs - 15 días), Ia cobertura a los 3,8 días (3 hrs - 19 días), 1er autoinjerto a los 18 días (4 - 26 días). Tiempos operatorios promedio en las 3 primeras cirugías inferiores a 87 min. Mortalidad absoluta disminuyó a 19%. Mortalidad global 37%. Conclusiones: Luego del primer a o del proceso de modernización, con reanimación estandarizada, equipos quirúrgicos proporcionales a la SCT quemada con disminución de los tiempos quirúrgicos, asociado a un manejo multidisciplinario, se logró una disminución de la mortalidad global. Background: In 2006, the burn unit of an emergency public hospital in Chile standardized its medical and surgical treatment protocols. Aim: To analyze the evolution of mortality among patients admitted to the unit after the standardization process. Material and Methods: Patients admitted to the unit between March 2005 and March 2006, were analyzed. An early surgical debridement was performed, according to the guide-lines, after a standardized reanimation with Lactate Ringer using Parkland formula (4 ml/kg/% burn surface área). All patients were monitored. An algorithm was used to decide the indication of vasoactive drugs or invasive monitorization. Results: Eighty eight patients aged 43 ± 19 years (65% males) were admitted. The estimated percentage body burned was 30 ± 21%, deep in 12.5 ± 17%. A mean of 9.122 ± 6.930 mi of fluid were administered in the first 24 hours. The first surgical debridement was performed at 48 hours (range 1 to 15 days). The first escharotomy was performed at 4.2 da
Injuria inhalatoria en pacientes quemados: Revisión
PEDREROS P,CESAR; LONGTON B,CRISTOBAL; WHITTLE V,SANDRA; VILLEGAS C,JORGE;
Revista chilena de enfermedades respiratorias , 2007, DOI: 10.4067/S0717-73482007000200006
Abstract: every year almost three thousand people get burned in chile. in this group, about 40% of the critical burned patients also suffer inhalation injury. this number is expected to grow bigger among the adult population in the next few years. inhalation injury significantly increases mortality in burned patients. the prevalence, pathophysiology, clinical characteristics, treatment, and prognosis of this pathology have not been incorporated in the undergraduate curses of chilean medical schools. therefore, this subject is pooly known by most of our physicians. because this disease will be included in the explicit warranties health plan of the public health care system in chile, we decide to write this review about this pathological condition
El GES promueve la equidad en el tratamiento del gran quemado de la tercera edad
Albornoz G,Claudia R; Villegas C,Jorge; Bravo Y,Iside; Pe?a M,Verónica;
Revista médica de Chile , 2011, DOI: 10.4067/S0034-98872011001100011
Abstract: background: the guidelines for the treatment of severely burned patients, ineluded in the explicit guarantees in health care (ges), accept having a garces' index over 70, among others, as an inclusion criterion. this criterion allows elderly patients with small total burn surface area (tbsa) to have access to ges. aim: to analyze if a universal access to ges for this group of patients is justified. material and methods: revision of medical records of adult patients admitted to a burn service. causative agent, tbsa, associated illnesses and outcome were compared between 218 subjects aged 65 years or more and 720 subjects aged less than 65 years. results: older subjects had smaller tbsa, a lower prevalence of inhalation injury and more associated diseases. their lethality was three times greater than that of younger subjects and their risk of dying. when adjusting for tbsa, presence of inhalation injury and associated diseases was 11 times greater. conclusions: the inclusion of older people with lower tbsa in the explicit guarantees in health is fully justified, considering the lethality of burns in this age group.
Injuria inhalatoria en pacientes quemados: Revisión Inhalation injury in burned patient: A review
CESAR PEDREROS P,CRISTOBAL LONGTON B,SANDRA WHITTLE V,JORGE VILLEGAS C
Revista Chilena de Enfermedades Respiratorias , 2007,
Abstract: Cada a o casi tres mil personas sufren quemaduras en Chile. En la población adulta se estima que este número se incrementará en los próximos a os. En este grupo, cerca del 40% de las quemaduras graves se asocian a injuria inhalatoria. la injuria inhalatoria aumenta significativamente la mortalidad en los pacientes quemados. la prevalencia, fisiopatologia, cuadro clínico, manejo y pronóstico de esta patología no han sido incorporados en los estudios de pregrado de las escuelas de medicina y son temas desconocidos para la mayoría de los médicos. En el contexto de la próxima incorporación de este tipo de dolencias en el plan de garantías explícitas en la salud chilena hemos realizado una actualización del tema Every year almost three thousand people get burned in Chile. In this group, about 40% of the critical burned patients also suffer inhalation injury. This number is expected to grow bigger among the adult population in the next few years. Inhalation injury significantly increases mortality in burned patients. The prevalence, pathophysiology, clinical characteristics, treatment, and prognosis of this pathology have not been incorporated in the undergraduate curses of Chilean medical schools. Therefore, this subject is pooly known by most of our physicians. Because this disease will be included in the explicit warranties health plan of the public health care system in Chile, we decide to write this review about this pathological condition
Génesis de suelos en el valle del río de las Vueltas, provincia Santa Cruz, Patagonia Soil genesis in Río de las Vueltas Valley, Santa Cruz Province, Patagonia
Daniela C. Villegas,Fernando X. Pereyra,Jorge. A. Irisarri,José A. Ferrer
Revista de la Asociación Geológica Argentina , 2004,
Abstract: Se han estudiado los factores de formación de los suelos "material originario" y "relieve", en un sector del oeste de la provincia de Santa Cruz (Patagonia Austral). El área de estudio se localiza en el valle del río de las Vueltas, entre la laguna del Desierto y el lago Viedma (49°S y 49°30'S y a los 73°O). Se ha observado una estrecha relación entre la variabilidad de los suelos y los fuertes gradientes bioclimáticos y geomorfológicos de la región. Los suelos fueron estudiados según una transecta NO-SE. El sector occidental, incluido en la Cordillera Andina Patagónica y su piedemonte, se caracteriza por fuertes pendientes debidas al proceso glaciario; materiales originarios de origen coluvial, glaciar y glacifluvial, así como tefras volcánicas; regímenes de humedad de los suelos údico y xérico y vegetación de bosque de Nothofagus. El área oriental posee un paisaje ondulado de origen glacifluvial y fluvial y extensas planicies estructurales con geoformas eólicas sobreimpuestas, el régimen de humedad de los suelos de tipo arídico, y la vegetación de estepas herbáceo-arbustiva. Ambos sectores presentan diferentes asociaciones de suelos según los rasgos del paisaje y los materiales parentales. El sector occidental se caracteriza por la secuencia: Distrudeptes, Udivitrandes/Hapludandes y Haploxeroles, mientras que el sector oriental está dominado por Haplargides, Torriortenes y Haplocalcides. En el área occidental se reconocieron rasgos de podosolización, principalmente en la porción noroeste, donde los suelos poseen horizontes Bs y E y fuerte desaturación entre otras características. Por otro lado, en la parte suroriental, la presencia de carbonato de calcio, valores básicos de pH y alta saturación con bases son las características más frecuentes. Factors of soils formation, parent material, and relief in western part of Santa Cruz province (southermost Patagonia) were studied in río de las Vueltas valley beetween Laguna del Desierto and Lago Viedma (49°S-49°30′S y a 73° W). There is great soil variability related to a strong north-west-south-east bioclimatic and geomorphic gradient. Soils were studied in a NW-SE transect, where three different sectors could be distinguished. The western area, including the Patagonian Andean Cordillera and piedmont is characterised by strong landscape variations due to glacial processes, colluvial, glacial, cineritc and glacifluvial parent materials, a udic-xeric regime and Nothofagus woodlands. The landscape of the eastern area is mainly of glacial-fluvioglacial, fluvial origin, with aeolian landforms, an arid regime, gr
El GES promueve la equidad en el tratamiento del gran quemado de la tercera edad Analysis of the explicit guarantees of health inclusion criteria for elderly burned patients
Claudia R Albornoz G,Jorge Villegas C,Iside Bravo Y,Verónica Pe?a M
Revista médica de Chile , 2011,
Abstract: Background: The guidelines for the treatment of severely burned patients, ineluded in the explicit guarantees in health care (GES), accept having a Garces' index over 70, among others, as an inclusion criterion. This criterion allows elderly patients with small total burn surface area (TBSA) to have access to GES. Aim: To analyze if a universal access to GES for this group of patients is justified. Material and Methods: Revision of medical records of adult patients admitted to a burn service. Causative agent, TBSA, associated illnesses and outcome were compared between 218 subjects aged 65 years or more and 720 subjects aged less than 65 years. Results: Older subjects had smaller TBSA, a lower prevalence of inhalation injury and more associated diseases. Their lethality was three times greater than that of younger subjects and their risk of dying. When adjusting for TBSA, presence of inhalation injury and associated diseases was 11 times greater. Conclusions: The inclusion of older people with lower TBSA in the explicit guarantees in health is fully justified, considering the lethality of burns in this age group.
La quemadura eléctrica por alto voltaje es un factor predictor de mortalidad en pacientes "grandes quemados"
MANGELSDORFF G,GüNTHER; GARCíA-HUIDOBRO D,M. ANGéLICA; ATENAS M,OMAR; WHITTLE V,SANDRA; VILLEGAS C,JORGE;
Revista médica de Chile , 2011, DOI: 10.4067/S0034-98872011000200006
Abstract: background: electrical burns are associated with complications and may aggravate burned patients. aim: to evaluate the effect of electrical burns in mortality and length of stay in a critical care unit for burn patients. material and methods: retrospective analysis of medical records of 182 patients aged 15 to 90 years, admitted to an intensive care unit for burn patients. the length of stay and mortality of 14 patients that suffered electric burns was compared with the features of 168 patients with other type of burns. results: patients with electrical burns were younger, had a lower percentage of total body surface burnt and had a lower frequency of inhalatory injuries than their counterparts with other type of burns. mortality rate among patients with electric or other types of burns was similar (three and 49 patients, respectively). intensive care unit stay was also similar. a multivariate analysis showed that high voltage electric burns were an independent risk factor for death with an odds ratio of 12 (95% confidence intervals 1.8-79.4). conclusions: high voltage electric burns are an independent risk factor for death among burn patients.
A Digital System for Managing HL7/CDA Electronic Medical Records Stored in iButtons®  [PDF]
Edgar Lugo, Roberto Mu?oz, Carla C. Vilachá, ángel Villegas, José Pacheco, Ricardo Villegas
E-Health Telecommunication Systems and Networks (ETSN) , 2014, DOI: 10.4236/etsn.2014.33004
Abstract: The goal of this research was to develop a digital system that could allow managing electronic medical records (EMRs) codified under specifications of the Health Level 7/Clinical Document Architecture (HL7/CDA) international standard, and saving them in a portable digital storage device called iButton?. To this end, an USB-based hardware interface for reading and storing EMRs in iButtons was designed and implemented. In addition, a software application for invoking read/write operations on stored EMRs and showing their content on a graphical user interface was also developed, following the Extreme Programming (XP) software development methodology and using Visual Basic .NET as programming language. Tests conducted on the hardware interface showed that it was able to recognize any iButton type, reading and writing data on them as well. Moreover, the system helped in creating empty EMRs in conformance with the HL7/CDA standard, adding and viewing information, and updating it in the iButton. This system offers an easy way for managing and visualizing medical records codified in HL7/CDA, and allows patients to take their updated medical history with them everywhere.
Mortalidad tras un a?o de protocolización en el manejo del paciente quemado
VILLEGAS C,JORGE; TORRES E,ESTEBAN; PEDREROS P,CéSAR; SINGH O,PAULINA; LONGTON B,CRISTóBAL; CARLOS SAID,JUAN; GARCíA P,GABRIEL; BRAVO Y,ISIDE; WHITTLE V,SANDRA; DEICHLER V,FERNANDA;
Revista chilena de cirugía , 2010, DOI: 10.4067/S0718-40262010000200009
Abstract: background: in 2006, the burn unit of an emergency public hospital in chile standardized its medical and surgical treatment protocols. aim: to analyze the evolution of mortality among patients admitted to the unit after the standardization process. material and methods: patients admitted to the unit between march 2005 and march 2006, were analyzed. an early surgical debridement was performed, according to the guide-lines, after a standardized reanimation with lactate ringer using parkland formula (4 ml/kg/% burn surface área). all patients were monitored. an algorithm was used to decide the indication of vasoactive drugs or invasive monitorization. results: eighty eight patients aged 43 ± 19 years (65% males) were admitted. the estimated percentage body burned was 30 ± 21%, deep in 12.5 ± 17%. a mean of 9.122 ± 6.930 mi of fluid were administered in the first 24 hours. the first surgical debridement was performed at 48 hours (range 1 to 15 days). the first escharotomy was performed at 4.2 days (range 3 hours -15 days), the first covering at 3.8 days (range 3 hours-19 days) the first auto graft at 18 days (range 4-26 days). operative times in the first three surgical procedures were less than 87 min. global mortality was 37%. conclusions: the standardized treatment of burns resulted in an absolute reduction of mortality.
Influencia del uso de una técnica menos invasiva que disminuye la aparición de complicaciones de la safenectomía en la cirugía de revascularización miocárdica
Ramírez,José L; Franco,Gloria; Olaya,Carlos; Ramírez,Alejandro; Jaramillo,Juan C; Villegas,Alberto; Durán,Marco A; Montoya,Mario; González,Gustavo; Montoya,Juan D; Zapata,Jorge A; Rendón,Juan C; Colorado,Alexánder; Villa,Virginia;
Revista Colombiana de Cardiología , 2007,
Abstract: background: the internal saphenous vein, despite all its limitations, remains the most used duct for myocardial revascularization. however, the complications regarding the extraction of the vein are a big problem in terms of morbidity, length of hospital stay and costs. material and methods: we present a controlled clinical assay, evaluating a less invasive technique for obtaining the saphenous vein in comparison with the standard technique previously used in our institution. for this purpose, we took 200 patients who underwent surgery and 400 patients in the control group. results: in hospital saphenectomy infection rate was 0.5% compared to 4% in the control group, resulting a rr=0.125 value with a confidence interval of 95% of 0.016 – 0.916 significantly smaller in the study group: the rra value was 3.5% and the nnt was 28 which means that with this technique one case of infection is avoided in every 28 patients who undergo surgery. furthermore, we found that patients who underwent surgery have significant less hospital stay than those in the control group. mean stay was 7.39 ± 5.8 days for the intervened group and 8.64 ± 8.55 days in the control group. conclusions: we can conclude that the less invasive saphenectomy technique is safe, easy to learn and offers a great advantage in regard to the morbidity associated to the surgical wound of the legs in coronary artery bypass surgery.
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