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Search Results: 1 - 10 of 208410 matches for " L. Bordejé "
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Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Severe acute pancreatitis
Bordejé Laguna,L.; Lorencio Cárdenas,C.; Acosta Escribano,J.;
Nutrición Hospitalaria , 2011,
Abstract: severe acute pancreatitis (sap) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. in the last decade, nutritional support has become a key element in the treatment of sap. thus, specialized nutrition is indicated from admission, with enteral nutrition being preferred to parenteral nutrition. enteral nutrition should be initiated early using infusion through the jejunum beyond the ligament of treitz to minimize pancreatic stress. there are no specific studies that establish the type of diet to be used but experts recommend the use of polymeric diets. parenteral nutrition, without a specific formula, is indicated in patients with sap who are intolerant to enteral nutrition or when the clinical signs of pancreatitis are exacerbated or aggravated by enteral nutrition. even so, a minimal level of enteral infusion should be maintained to preserve the trophic effect of the intestinal mucosa. in the last few years, several studies of the administration of immunomodulatory diets in patients with sap have been carried out to demonstrate their effects on the course of the disease. however, there are few clear recommendations on the prognostic benefits of pharmaconutrient enriched diets in these patients. there is substantial scientific evidence suggesting that the only clear indication for pharmaconutrition in patients with sap is parenteral glutamine administration, which is recommended by all clinical guidelines with distinct grades of evidence.
Cirugía cardíaca en pacientes de edad avanzada Cardiac surgery in elderly patients
S. Just,T.M. Tomasa,P. Marcos,L. Bordejé
Medicina Intensiva , 2008,
Abstract: Objetivo. Comparar la morbilidad y la mortalidad de los pacientes de cirugía cardíaca de acuerdo a la edad inferior o superior a 75 a os. Dise o. Estudio descriptivo retrospectivo. Pacientes. Dos mil cuatrocientos setenta pacientes consecutivos ingresados en el postoperatorio inmediato tras cirugía cardíaca en nuestra Unidad de Medicina Intensiva entre noviembre de 2000 y diciembre de 2005. De ellos, 1.983 eran menores de 75 a os y 497 mayores de 75 a os. Se han incluido todos los pacientes con cirugía, tanto programada como urgente y emergente. Principales variables de interés. Factores de riesgo cardiovascular (diabetes mellitus, hipertensión arterial y dislipidemia), European System for Cardiac Operative Risk Evaluation (EuroSCORE) y EuroSCORE logístico, estancia, mortalidad, complicaciones durante la estancia en la Unidad de Cuidados Intensivos (UCI). Resultados. La mortalidad hospitalaria de los pacientes mayores de 74 a os fue significativamente superior (9,2% frente a 4,3%, p < 0,05). La morbilidad de los pacientes mayores de 74 también fue superior (EuroSCORE 8,2 ± 2,7 frente a 4,9 ± 3,3, p < 0,001). Tanto la estancia en la UCI como la estancia hospitalaria fueron significativamente superiores en los pacientes mayores de 74 a os. Conclusiones. En nuestra serie tanto la morbilidad como la mortalidad de los mayores de 74 es superior, lo que conlleva peores resultados en la cirugía cardíaca de estos pacientes. Objective. To compare morbidity and mortality of cardiac surgery patients according to age below or above 75 years. Design. Descriptive retrospective study. Patients. A total of 2,470 consecutive patients admitted to our Intensive Medicine Unit between November 2000 and December 2005 who were in the immediate postoperative period after cardiac surgery. Of these patients, 1,983 were younger than 75 years and 497 were older than 75 years. Main variables of interest. Cardiovascular risk factors (diabetes mellitus, arterial hypertension and dyslipidemia), EuroSCORE (European System for Cardiac Operative Risk Evaluation) and logistic EuroSCORE, length of stay, mortality, complications during Intensive Care Unit (ICU) stay. Results. In-hospital mortality of patients older than 74 years was significantly higher (9.2% versus 4.2%, p < 0.05). The morbidity of patients over 74 years of age was also significantly higher (EuroSCORE 8.2 ± 2.7 versus 4.9 ± 3.3, p < 0.001). Both ICU stay and hospital stay were significantly higher in those over 74 years of age. Conclusions. In our series both morbidity and mortality were higher in those older than 74 years
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Severe acute pancreatitis Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico: Actualización. Consenso SEMICYUC-SENPE: Pancreatitis aguda grave
L. Bordejé Laguna,C. Lorencio Cárdenas,J. Acosta Escribano
Nutrición Hospitalaria , 2011,
Abstract: Severe acute pancreatitis (SAP) causes local and systemic complications leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of SAP. Thus, specialized nutrition is indicated from admission, with enteral nutrition being preferred to parenteral nutrition. Enteral nutrition should be initiated early using infusion through the jejunum beyond the ligament of Treitz to minimize pancreatic stress. There are no specific studies that establish the type of diet to be used but experts recommend the use of polymeric diets. Parenteral nutrition, without a specific formula, is indicated in patients with SAP who are intolerant to enteral nutrition or when the clinical signs of pancreatitis are exacerbated or aggravated by enteral nutrition. Even so, a minimal level of enteral infusion should be maintained to preserve the trophic effect of the intestinal mucosa. In the last few years, several studies of the administration of immunomodulatory diets in patients with SAP have been carried out to demonstrate their effects on the course of the disease. However, there are few clear recommendations on the prognostic benefits of pharmaconutrient enriched diets in these patients. There is substantial scientific evidence suggesting that the only clear indication for pharmaconutrition in patients with SAP is parenteral glutamine administration, which is recommended by all clinical guidelines with distinct grades of evidence. La pancreatitis aguda grave es una patología que cursa con complicaciones locales y sistémicas que condicionan una situación de estrés altamente catabólica, hipermetabólica e hiperdinámica con marcada morbimortalidad. En la última década, el soporte nutricional se ha convertido en uno de los puntos clave en el tratamiento de la pancreatitis aguda grave. Así, hay indicación de nutrición especializada desde el ingreso, siendo de elección la nutrición enteral sobre la nutrición parenteral administrada de forma precoz más allá del ligamento de treitz, para provocar el mínimo estímulo pancreático. No hay estudios específicos que nos aclaren cuál es el tipo de dieta a administrar, pero los expertos recomiendan la utilización de dietas poliméricas. La nutrición parenteral, sin una fórmula concreta, quedaría indicada en los pacientes con pancreatitis aguda grave que presentan intolerancia a la nutrición enteral o cuando se agravan los signos clínicos de pancreatitis al administrar la dieta enteral. Aun así, se recomienda mantener
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Gastrointestinal surgery
Sánchez álvarez,C.; Zabarte Martínez de Aguirre,M.; Bordejé Laguna,L.;
Nutrición Hospitalaria , 2011,
Abstract: gastrointestinal surgery and critical illness place tremendous stress on the body, resulting in a series of metabolic changes that may lead to severe malnutrition, which in turn can increase postsurgical complications and morbidity and mortality and prolong the hospital length of stay. in these patients, parenteral nutrition is the most widely used form of nutritional support, but administration of enteral nutrition early in the postoperative period is effective and well tolerated, reducing infectious complications, improving wound healing and reducing length of hospital stay. calorie-protein requirements do not differ from those in other critically-ill patients and depend on the patient's underlying process and degree of metabolic stress. in patients intolerant to enteral nutrition, especially if the intolerance is due to increased gastric residual volume, prokinetic agents can be used to optimize calorie intake. when proximal sutures are used, tubes allowing early jejunal feeding should be used. pharmaconutrition is indicated in these patients, who benefit from enteral administration of arginine, omega 3 and rna, as well as parenteral glutamine supplementation. parenteral nutrition should be started in patients with absolute contraindication for use of the gastrointestinal tract or as complementary nutrition if adequate energy intake is not achieved through the enteral route.
Guidelines for specialized nutritional and metabolic support in the critically-ill patient: Update. Consensus SEMICYUC-SENPE: Gastrointestinal surgery Recomendaciones para el soporte nutricional y metabólico especializado del paciente crítico: Actualización. Consenso SEMICYUC-SENPE: Cirugía del aparato digestivo
C. Sánchez álvarez,M. Zabarte Martínez de Aguirre,L. Bordejé Laguna
Nutrición Hospitalaria , 2011,
Abstract: Gastrointestinal surgery and critical illness place tremendous stress on the body, resulting in a series of metabolic changes that may lead to severe malnutrition, which in turn can increase postsurgical complications and morbidity and mortality and prolong the hospital length of stay. In these patients, parenteral nutrition is the most widely used form of nutritional support, but administration of enteral nutrition early in the postoperative period is effective and well tolerated, reducing infectious complications, improving wound healing and reducing length of hospital stay. Calorie-protein requirements do not differ from those in other critically-ill patients and depend on the patient's underlying process and degree of metabolic stress. In patients intolerant to enteral nutrition, especially if the intolerance is due to increased gastric residual volume, prokinetic agents can be used to optimize calorie intake. When proximal sutures are used, tubes allowing early jejunal feeding should be used. Pharmaconutrition is indicated in these patients, who benefit from enteral administration of arginine, omega 3 and RNA, as well as parenteral glutamine supplementation. Parenteral nutrition should be started in patients with absolute contraindication for use of the gastrointestinal tract or as complementary nutrition if adequate energy intake is not achieved through the enteral route. El estrés de la cirugía gastrointestinal y la enfermedad crítica representan una gran agresión sobre el organismo, lo que ocasiona una serie de cambios metabólicos que pueden conducir a una situación de desnutrición grave, con aumento de las complicaciones posquirúrgicas, mayor morbimortalidad y prolongación de la estancia hospitalaria. En estos enfermos la nutrición parenteral es la más utilizada, pero se ha visto que la nutrición enteral administrada de forma precoz en el postoperatorio es efectiva y bien tolerada, con disminución de las complicaciones infecciosas, mejoría de la cicatrización de las heridas y menor estancia hospitalaria. Las necesidades caloricoproteicas no difieren de las de otros pacientes críticos, y dependerán de la patología basal del paciente y de su grado de estrés metabólico. En caso de intolerancia a la nutrición enteral, en especial si se debe al aumento del residuo gástrico, se deben utilizar procinéticos para optimizar el aporte calórico. En caso de suturas proximales se debe recurrir a la colocación de sondas que permitan la nutrición en yeyuno de forma precoz. La farmaconutrición tiene efectos beneficiosos en este t ipo de enfermos, con indicación
Cirugía cardíaca en pacientes de edad avanzada
Just,S.; Tomasa,T.M.; Marcos,P.; Bordejé,L.; Torrabadella,P.; Moltó,H.P.; Moreno,J.A.; Castro,M.A.;
Medicina Intensiva , 2008,
Abstract: objective. to compare morbidity and mortality of cardiac surgery patients according to age below or above 75 years. design. descriptive retrospective study. patients. a total of 2,470 consecutive patients admitted to our intensive medicine unit between november 2000 and december 2005 who were in the immediate postoperative period after cardiac surgery. of these patients, 1,983 were younger than 75 years and 497 were older than 75 years. main variables of interest. cardiovascular risk factors (diabetes mellitus, arterial hypertension and dyslipidemia), euroscore (european system for cardiac operative risk evaluation) and logistic euroscore, length of stay, mortality, complications during intensive care unit (icu) stay. results. in-hospital mortality of patients older than 74 years was significantly higher (9.2% versus 4.2%, p < 0.05). the morbidity of patients over 74 years of age was also significantly higher (euroscore 8.2 ± 2.7 versus 4.9 ± 3.3, p < 0.001). both icu stay and hospital stay were significantly higher in those over 74 years of age. conclusions. in our series both morbidity and mortality were higher in those older than 74 years of age group, which entails worse results in cardiac surgery of these patients. keywords: cardiac surgery, sternotomy, cardiopulmonary bypass, mortality, postoperative care, elderly.
Computing Reachable Sets as Capture-Viability Kernels in Reverse Time  [PDF]
No?l Bonneuil
Applied Mathematics (AM) , 2012, DOI: 10.4236/am.2012.311219
Abstract: The set SF(x0;T) of states y reachable from a given state x0 at time T under a set-valued dynamic x’(t)∈F(x (t)) and under constraints x(t)∈K where K is a closed set, is also the capture-viability kernel of x0 at T in reverse time of the target {x0} while remaining in K. In dimension up to three, Saint-Pierre’s viability algorithm is well-adapted; for higher dimensions, Bonneuil’s viability algorithm is better suited. It is used on a large-dimensional example.
Three Dimensional Evolution of SN 1987A in a Self-Gravitating Disk  [PDF]
L. Zaninetti
International Journal of Astronomy and Astrophysics (IJAA) , 2013, DOI: 10.4236/ijaa.2013.32010
Abstract:

The introduction of an exponential or power law gradient in the interstellar medium (ISM) allows to produce an asymmetric evolution of the supernova remnant (SNR) when the framework of the thin layer approximation is adopted. Unfortunately both the exponential and power law gradients for the ISM do not have a well defined physical meaning. The physics conversely is well represented by an isothermal self-gravitating disk of particles whose velocity is everywhere Maxwellian. We derived a law of motion in the framework of the thin layer approximation with a control parameter of the swept mass. The photon’s losses, which are often neglected in the thin layer approximation, are modeled trough velocity dependence. The developed framework is applied to SNR 1987A and the three observed rings are simulated.

The Luminosity Function of Galaxies as Modeled by a Left Truncated Beta Distribution  [PDF]
L. Zaninetti
International Journal of Astronomy and Astrophysics (IJAA) , 2014, DOI: 10.4236/ijaa.2014.41013
Abstract: A first new luminosity function of galaxies can be built starting from a left truncated beta probability density function, which is characterized by four parameters. In the astrophysical conversion, the number of parameters increases by one, due to the addition of the overall density of galaxies. A second new galaxy luminosity function is built starting from a left truncated beta probability for the mass of galaxies once a simple nonlinear relationship between mass and luminosity is assumed; in this case the number of parameters is six because the overall density of galaxies and a parameter that regulates mass and luminosity are added. The two new galaxy luminosity functions with finite boundaries were tested on the Sloan Digital Sky Survey (SDSS) in five different bands; the results produce a better fit than the Schechter luminosity function in two of the five bands considered. A modified Schechter luminosity function with four parameters has been also analyzed.
On the Dark Matter’s Halo Theoretical Description  [PDF]
L. M. L. M. Chechin
Journal of Modern Physics (JMP) , 2012, DOI: 10.4236/jmp.2012.35052
Abstract: We argued that the standard field scalar potential couldn’t be widely used for getting the adequate galaxies’ curve lines and determining the profiles of dark matter their halo. For discovering the global properties of scalar fields that can describe the observable characteristics of dark matter on the cosmological space and time scales, we propose the simplest form of central symmetric potential celestial-mechanical type, i.e. U(φ) = –μ/φ. It was shown that this potential allows get rather satisfactorily dark matter profiles and rotational curves lines for dwarf galaxies. The good agreement with some previous results, based on the N-body simulation method, was pointed out. A new possibility of dwarf galaxies’ masses estimation was given, also.
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