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Search Results: 1 - 10 of 200624 matches for " P.; Bordejé "
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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
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.
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.
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
Hybrid Fuzzy Controller Based Frequency Regulation in Restructured Power System  [PDF]
P. Anitha, P. Subburaj
Circuits and Systems (CS) , 2016, DOI: 10.4236/cs.2016.76065
Abstract: This paper discusses the implementation of Load Frequency Control (LFC) in restructured power system using Hybrid Fuzzy controller. The formulation of LFC in open energy market is much more challenging; hence it needs an intelligent controller to adapt the changes imposed by the dynamics of restructured bilateral contracts. Fuzzy Logic Control deals well with uncertainty and indistinctness while Particle Swarm Optimization (PSO) is a well-known optimization tool. Abovementioned techniques are combined and called as Hybrid Fuzzy to improve the dynamic performance of the system. Frequency control of restructured system has been achieved by automatic Membership Function (MF) tuned fuzzy logic controller. The parameters defining membership function has been tuned and updated from time to time using Particle Swarm Optimization (PSO). The robustness of the proposed hybrid fuzzy controller has been compared with conventional fuzzy logic controller using performance measures like overshoot and settling time following a step load perturbation. The motivation for using membership function tuning using PSO is to show the behavior of the controller for a wide range of system parameters and load changes. Error based analysis with parametric uncertainties and load changes is tested on a two-area restructured power system.
Integral Performance Criteria Based Analysis of Load Frequency Control in Bilateral Based Market  [PDF]
P. Anitha, P. Subburaj
Circuits and Systems (CS) , 2016, DOI: 10.4236/cs.2016.76086
Abstract: Performance index based analysis is made to examine and highlight the effective application of Particle Swarm Optimization (PSO) to optimize the Proportional Integral gains for Load Frequency Control (LFC) in a restructured power system that operates under Bilateral based policy scheme. Various Integral Performance Criteria measures are taken as fitness function in PSO and are compared using overshoot, settling time and frequency and tie-line power deviation following a step load perturbation (SLP). The motivation for using different fitness technique in PSO is to show the behavior of the controller for a wide range of system parameters and load changes. Error based analysis with parametric uncertainties and load changes are tested on a two-area restructured power system. The results of the proposed PSO based controller show the better performance compared to the classical Ziegler-Nichols (Z-N) tuned PI andFuzzy Rule based PI controller.
Projection of the Semi-Axes of the Ellipse of Intersection  [PDF]
P. P. Klein
Applied Mathematics (AM) , 2017, DOI: 10.4236/am.2017.89097
Abstract:
It is well known that the line of intersection of an ellipsoid and a plane is an ellipse (see for instance [1]). In this note the semi-axes of the ellipse of intersection will be projected from 3d space onto a 2d plane. It is shown that the projected semi-axes agree with results of a method used by Bektas [2] and also with results obtained by Schrantz [3].
太古宙绿岩带金矿区域预测准则
д.в.Pундцвист
黄金科学技术 , 1991,
Abstract:
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