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Search Results: 1 - 10 of 556661 matches for " MARTíN; MORA M "
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Urinary catheter-related infection in critically ill patients
L Lorente, C Henry, M Martín, M Mora
Critical Care , 2005, DOI: 10.1186/cc3075
Abstract: It is a prospective study performed during 30 months of the patients admitted to a 24-bed medical–surgical ICU of a 650-bed university hospital. Urinary cultures were taken on admission and twice weekly. UCRI were diagnosed according to CDC criteria. UCRI were classified based on the onset moment as early onset and late onset: early onset were those developed during the first 4 days of the ICU stay; and late onset were those developed 5 days after ICU admission. The statistical analysis was performed using the SPSS 11.0 program. Continuous variables are reported as means and standard deviation, and categoric variables as percentages.A total of 1582 patients were admitted, 953 males (60.24%). The mean age was 57.91 ± 18.83 years (median 63 years, interquartile range 44–73 years). The mean APACHE II score was 13.95 ± 8.93 (median 14, interquartile range 10–19). Admission diagnoses were: 737 (46.59%) heart surgery, 189 cardiological (11.95%), 196 neurologic (12.29%), 185 trauma (11.69%), 120 respiratory (7.59%), 104 digestive (6.57%) and 51 intoxication (3.22%). Mortality rate was 14.79% (234 patients). A total of 1392 patients (87.99%) needed a urinary catheter, during 12,556 days. Of the 1392 patients, 72 (5.17%) developed 75 UCRI (late onset in 54 cases and early onset in 21 cases). All UCRI were caused by only a microorganism. The incidence density was 5.97 UCRI/1000 urinary catheter-days. The microorganisms responsible for UCRI were the following: Escherichia coli (16), Pseudomonas aeruginosa (seven), Morganella morganii (four), Klebsiella (four), Citrobacter (five), Proteus mirabilis (three), Enterococcus faecalis (eight), coagulase-negative staphylococci (seven), MSSA (two), Candida albicans (12) and other fungi (seven).In our series, most UCRI had a late onset, were caused by only a microorganism and were mainly due to E. coli and C. albicans.
Trust matters in cooperative agreements but does the nature of the partner also matter?
ángeles Montoro-Sánchez,Eva M Mora-Valentín,Luis á Guerras-Martín
Academia : Revista Latinoamericana de Administración , 2010,
Abstract: El objetivo de este trabajo consiste en analizar el papel que la confianza tiene en los acuerdos de cooperación entre empresas. Se evidencia que la confianza afecta a tales acuerdos de manera distinta, dependiendo de la naturaleza del socio (empresa u organismo de investigación) y en función de la etapa de evolución del acuerdo. Una observación detallada de los diferentes componentes de la confianza (inicial o durante la vida del acuerdo) y de los diferentes contextos (al principio del acuerdo o durante el proceso de implantación) sugiere que la confianza tiene una influencia distinta en el éxito de las alianzas. Los resultados empíricos muestran que la confianza influye en el éxito de la relación, como en otros estudios previos. Sin embargo, cuando tenemos en cuenta la naturaleza del socio, los niveles medios de confianza y de éxito varían, al igual que varía el grado de influencia de la confianza en el éxito.
Arterial catheter-related infection of 2,949 catheters
Leonardo Lorente, Ruth Santacreu, María M Martín, Alejandro Jiménez, María L Mora
Critical Care , 2006, DOI: 10.1186/cc4930
Abstract: We performed a prospective observational study of all consecutive patients admitted to the 24 bed medical and surgical intensive care unit of a 650 bed university hospital during three years (1 May 2000 to 30 April 2003).A total of 2,018 patients was admitted to the intensive care unit during the study period. The number of arterial catheters, the number of days of arterial catheterization, the number of CRLIs and the number of CRBSIs were as follows: total, 2,949, 17,057, 20 and 10; radial, 2,088, 12,007, 9 and 3; brachial, 112, 649, 0 and 0; dorsalis pedis, 131, 754, 0 and 0; and femoral, 618, 3,647, 11 and 7. The CRLI incidence was significantly higher for femoral access (3.02/1,000 catheter-days) than for radial access (0.75/1,000 catheter-days) (odds ratio, 1.5; 95% confidence interval, 1.10–2.13; P = 0.01). The CRBSI incidence was significantly higher for femoral access (1.92/1,000 catheter-days) than for radial access (0.25/1,000 catheter-days) (odds ratio, 1.9; 95% confidence interval, 1.15–3.41; P = 0.009).Our results suggest that a femoral site increases the risk of arterial catheter-related infection.Arterial catheterization is a frequent procedure in intensive care units (ICUs). In the European Prevalence of Infection in Intensive Care study, for example, 44% of critically ill patients underwent arterial catheterization [1]. Arterial catheters are used when frequent arterial blood sampling or continual monitoring of systemic arterial pressure is considered necessary.Intravascular catheters may cause different complications, including infection. The interest in catheter-related infection research lies in the attributable mortality [2-5] and the attributable costs [6-9] it represents.In a previous study developed by our team [10], we analyzed catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) of 1,231 arterial catheters (radial, brachial, dorsalis pedis and femoral) and 1,608 central venous catheters (subclavian, jug
Central venous catheter-related infection in a prospective and observational study of 2,595 catheters
Leonardo Lorente, Christophe Henry, María M Martín, Alejandro Jiménez, María L Mora
Critical Care , 2005, DOI: 10.1186/cc3824
Abstract: This is a prospective and observational study, conducted in a 24-bed medical surgical intensive care unit of a 650-bed university hospital. All consecutive patients admitted to the ICU during 3 years (1 May 2000 and 30 April 2003) were included.The study included 2,018 patients. The number of CVCs and days of catheterization duration were: global, 2,595 and 18,999; subclavian, 917 and 8,239; jugular, 1,390 and 8,361; femoral, 288 and 2,399. CRLI incidence density was statistically higher for femoral than for jugular (15.83 versus 7.65, p < 0.001) and subclavian (15.83 versus 1.57, p < 0.001) accesses, and higher for jugular than for subclavian access (7.65 versus 1.57, p < 0.001). CRBSI incidence density was statistically higher for femoral than for jugular (8.34 versus 2.99, p = 0.002) and subclavian (8.34 versus 0.97, p < 0.001) accesses, and higher for jugular than for subclavian access (2.99 versus 0.97, p = 0.005).Our results suggest that the order for punction, to minimize the CVC-related infection risk, should be subclavian (first order), jugular (second order) and femoral vein (third order).Central venous catheters (CVCs) are commonly used in critically ill patients for the administration of fluids, medications, blood products and parenteral nutrition, for the insertion of a transvenous pacing electrode and to monitor hemodynamic status. The use of catheters is habitual in critically ill patients; in the EPIC study, 78% of critically ill patients had some form of CVC inserted [1].Central venous catheterization may cause different complications, including infection, haemorrhage and thrombosis. Interest in catheter-related infection lies in the mortality [2-5] and the costs [6-9] it represents.In a previous study [10], our team analyzed catheter-related local infection (CRLI) and catheter-related bloodstream infection (CRBSI) resulting from the use of CVCs; these were reported for each site of CVC placement. The incidence density of CRLI in femoral or jugular
Hernia de Amyand: presentación de un caso y revisión de la literatura Amyand hernia: Report of one case
MARTíN NICOLA S,GUILLERMO MORA M,RODNEY STOCK,RODRIGO VALLEJOS C
Revista Chilena de Cirugía , 2007,
Abstract: La presencia de apendicitis aguda en una hernia inguinal es un hecho infrecuente, con un 0,13% de los casos. Esta rara condición se conoce como Hernia de Amyand. La forma de presentación habitual es la de una hernia inguinal complicada. Es por este motivo que el diagnóstico preoperatorio de apendicitis aguda requiere de una alta sospecha clínica, realizándose mayoritariamente durante la cirugía. El estudio de imágenes, en particular la Tomografía Axial Computada, ha sido utilizado para plantear este diagnóstico. El tratamiento recomendado es la apendicectomía y la reparación primaria de la hernia en el mismo tiempo operatorio. No se debe utilizar prótesis por el riesgo de infección y fístula del mu ón apendicular. Debido a lo excepcional de esta patología, presentamos el caso de un hombre de 75 a os que se manifestó como una hernia inguinal complicada y cuyo diagnóstico de apendicitis se realizó en pabellón luego de abrir el saco The presence of an acute appendicitis in an incarcerated inguinal hernia, termed Amyand's hernia, is an uncommon and rare condition estimated to be found in approximately 0.13% of adult inguinal hernia repairs. The usual clinical presentation is as a complicated inguinal hernia; this is why the preoperative diagnosis of acute appendicitis requires a high clinical suspicion, even though the diagnosis of Amyand's hernia is done mainly during surgery. Computed tomography is a good diagnostic method. The treatment is surgical, and consists of an appendectomy with primary repair of the hernia. Synthetic mesh should not be used in the repair of contaminated abdominal wall defects, because the prosthetic material can increase the inflammatory response and result in wound infection and a possible appendiceal stump fistula. We report a 75 years old man who presented with a complicated inguinal hernia, in whom the diagnosis of acute appendicitis was made during surgery after opening the hernia sac
Prevalencia de fibrilación auricular y factores relacionados en una población del centro de Madrid
Candel,F. J.; Matesanz,M.; Cogolludo,F.; Candel,I.; Mora,C.; Bescos,T.; Martín,M.; Vila i Costa,I.;
Anales de Medicina Interna , 2004, DOI: 10.4321/S0212-71992004001000003
Abstract: introduction: atrial fibrillation is the most common arrhythmia on clinical practice and an important risk factor for ictus. the aim of this study was to know the prevalence of this arrythmia in a central district of madrid. material and methods: a retrospective study was done analysing medical records of 13.945 patients belonging to a primary care centre of madrid. time of study: recruitment of data from september 2000 to may 2001; analysis of data: from september 2001 to may 2002. results: we obtained a total of 425 atrial fibrillations, 348 non-valvular and 77 valvular. global prevalence of atrial fibrillation in patients over 40 years in our area was 2.52%. (2.47% male, 2.55% female). risk factors for atrial fibrillation more frequently found in non-valvular were high blood preassure (hbp), diabetes, ischaemic heart disease and left ventricular dysfunction. among valvulars we found hbp, left atrial size over 45 mm and left ventricular dysfunction. conclusions: atrial fibrillation shows a prevalence and distribution in the studied area similar to that found in other european countries.
Acoustic signal detection through the cross-correlation method in experiments with different signal to noise ratio and reverberation conditions
S. Adrián-Martínez,M. Ardid,M. Bou-Cabo,I. Felis,C. Llorens,J. A. Martínez-Mora,M. Salda?a
Physics , 2015,
Abstract: The study and application of signal detection techniques based on cross-correlation method for acoustic transient signals in noisy and reverberant environments are presented. These techniques are shown to provide high signal to noise ratio, good signal discernment from very close echoes and accurate detection of signal arrival time. The proposed methodology has been tested on real data collected in environments and conditions where its benefits can be shown. This work focuses on the acoustic detection applied to tasks of positioning in underwater structures and calibration such those as ANTARES and KM3NeT deep-sea neutrino telescopes, as well as, in particle detection through acoustic events for the COUPP/PICO detectors. Moreover, a method for obtaining the real amplitude of the signal in time (voltage) by using cross correlation has been developed and tested and is described in this work.
Accidental catheter removal in critically ill patients: a prospective and observational study
Leonardo Lorente, María S Huidobro, María M Martín, Alejandro Jiménez, María L Mora
Critical Care , 2004, DOI: 10.1186/cc2874
Abstract: This was a prospective and observational study, conducted in a 24-bed medical/surgical ICU in a university hospital. We included all consecutive patients admitted to the ICU over 18 months (1 May 2000 to 31 October 2001). The incidences of ACR for all types of catheters (both per 100 catheters and per 100 catheter-days) were determined.A total of 988 patients were included. There were no significant differences in ACR incidence between the four central venous access sites (peripheral, jugular, subclavian and femoral) or between the four arterial access sites (radial, femoral, pedal and humeral). However, the incidence of ACR was higher for arterial than for central venous catheters (1.12/100 catheter-days versus 2.02/100 catheter-days; P < 0.001). The incidences of ACR/100 nonvascular catheter-days were as follows: endotracheal tube 0.79; nasogastric tube 4.48; urinary catheter 0.32; thoracic drain 0.56; abdominal drain 0.67; and intraventricular brain drain 0.66.We found ACR incidences for central venous catheter, arterial catheter, endotracheal tube, nasogastric tube and urinary catheter that are similar to those reported in previous studies. We could not find studies that analyzed the ACR for thoracic, abdominal, intraventricular brain and cardiac surgical drains, but we believe that our rates are acceptable. To minimize ACR, it is necessary to monitor its incidence carefully and to implement preventive measures. In our view, according to establish quality standards, findings should be reported as ACR incidence per 100 catheters and per 100 catheter-days, for all types of catheters.Use of catheters in critically ill patients is routine. In the European Prevalence of Infection in Intensive Care (EPIC) study [1], the following catheters were required in the management of critically ill patients: urinary catheter (75%), central venous catheter (64%), orotracheal tube (62%), arterial catheter (44%) and thoracic drain (14%). Use of catheters carries risks for complica
Parasitosis intestinales y factores higiénicos sanitarios asociados en individuos de localidades rurales del estado Sucre
Mora,L; Segura,M; Martínez,I; Figuera,L; Salazar,S; Fermín,I; González,B;
Kasmera , 2009,
Abstract: the present study was carried out to determination the frequency intestinal parasitisms and its associated sanitary hygienic factors in the rural localities orinoco la pe?a, quebrada seca and san juan river. a total of 562 feces samples were analyzed, by different coproparasitological methods: microscopic evaluation in 0.85% physiological saline solution and lugol, ritchie, as well as the zielh-neelsen stainin. the highest frequencies of intestinal parasites was found in orinoco la pe?a and quebrada seca. blastocystis hominis (44.9%, 21.82%, 33.74%) and giardia duodenalis (20.41%, 9.7%, 19.02%) were most commonly observed. the frequency of helminths varied depending on the studied community, but observing more frequently ascaris lumbricoides, trichuris trichiura and ancylostomids. when evaluating the sanitary and hygienic factors associated to parasitosis we found a relationship between feces excretion (x2: 23,85***; p<0,001), water treatment (x2: 34,00***; p<0,001), and hygienic habits with presence of protozoans in individuals from quebrada seca, as well as with the presence of garbage disposal services (x2: 5,17*; p<0,05 ), presence of helminths were associated with the water source (x2: 13,97***; p<0,001) and hygienic habits. in orinoco la pe?a and san juan river water treatment (x2: 11,56*; p<0,05; and x2: 21,5 **; p<0,01 ) was associate to presence of protozoans. the high frequencies of parasites indicates that the sanitary conditions and hygienic habits were favorable factors for the infection and infestation of parasites, combined to the environmental factors and deficiency health of services characteristic of these rural communities. sanitary intervention from governmental authorities is necessary to improve environmental reparation and preventive sanitary education.
Fiebre de origen desconocido como presentación inicial de dos casos de carcinoma epidermoide de cérvix
Molina Garrido,M. J.; Mora Rufete,A.; Guillén Ponce,C.; Martínez y Sevila,C.; Carrato,A.;
Anales de Medicina Interna , 2006, DOI: 10.4321/S0212-71992006000800009
Abstract: we present the case of two women with fuo as first manifestation of a cervical carcinoma. in both cases, wide spectrum antibiotic treatment (and tuberculostatic medication in the first woman) were not useful to stop fever. autoimmune diseases tests were normal. just image thecniques let us detect a suspicious lesion (specially, abdomino-pelvic magnetic resonance) and biopsy gave the definitive diagnosis. a radical surgery caused the fever resolution. these are two cases of cervical cancer as cause of fever of unknown origin and, at the moment, we have not found another cases in the literature. we should consider this kind of tumor as a possible origin of fever.
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