Browsing by Author "Hernández, E"

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    Factors increasing the mortality rate for patients with ruptured abdominal aortic aneurysms
    (2001) Alonso-Pérez, M; Segura, RJ; Sánchez, J; Sicard, G; Barreiro, A; García, M; Díaz, P; Barral, X; Cairols, MA; Hernández, E; Moreira, A; Bonamigo, TP; Llagostera, S; Matas, M; Allegue, N; Krämer, AH; Mertens, R; Coruña, A
    The objective of this report was to analyze the current surgical results of operative treatment in patients suffering ruptured AAA (abdominal aortic aneurysms) and to define those independent predictive factors for mortality. During a period of 2 years, from January 1996 to December 1997, 144 patients operated on for ruptured AAA in 10 hospitals were included in a multicenter retrospective study. Among the collected variables concerning each patient, those with potential relation to surgical mortality were studied: gender, age, diabetes, hypertension, cardiopathy, pulmonary obstructive disease, preoperative renal dysfunction, symptomatic cerebrovascular disease, peripheral vascular disease, hematocrit on admission, preoperative hypotension < 80 mmHg, loss of consciousness, cardiac arrest, aortic aneurysm location (infrarenal versus non-infrarenal), iliac involvement, aneurysm size, type of rupture, left renal vein ligature, ligature of a patent inferior mesenteric artery, place of aortic cross-clamping, type of grafting, exclusion of both hypogastric arteries, venous technical complications, associated surgery, use of cell saver, intraoperative blood loss, and postoperative complications (renal failure, sepsis, coagulopathy, cardiac complications, pulmonary complications, colon ischemia, prosthetic graft complications, and need for reoperation). Those variables with statistical significance in the univariate analysis were introduced into a multivariate logistic regression model to determine the independent predictors of death. From our results we concluded that surgery for ruptured abdominal aortic aneurysms continues to have an excessively high mortality rate. Even though some preoperative variables could be identified as predictors of mortality, an absolute mortality risk has not yet been determined and the decision to negate surgery should be individualized rather than taken on that basis only. Early diagnosis and treatment of symptomatic aneurysms would improve mortality figures and selective screening should be contemplated.
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    Temporal and spatial variation in the distribution of epineustonic competent larvae of Concholepas concholepas along the central coast of Chile
    (2002) Poulin, E; Palma, AT; Leiva, G; Hernández, E; Martínez, P; Navarrete, SA; Castilla, JC
    The abundance of competent epineustonic larvae of the gastropod Concholepas concholepas (Gastropoda: Muricidae) in nearshore waters at 2 sites along the central coast of Chile was examined through monthly plankton tows from July 1999 to June 2000, Larvae were found in plankton collections from July 1999 to February 2000 with maximum abundance in September and October. Settlement in artificial collectors deployed onshore on the lower intertidal zone showed the same unimodal pattern with a settlement peak during October and November. Variation in larval distribution among sampling dates was related to the occurrence of north-south winds. We found that C, concholepas larvae were more abundant closer to shore after moderate southerly wind periods than on calm days, probably because of the shoreward advection of the upper sea surface layer. While sampling during a strong coastal upwelling event (produced by strong southwesterly winds), C. concholepas larvae were only found in the upwelled waters between the front and the coast. This unusual pattern contrasts with what would be expected for typical epineustonic larvae, suggesting the existence of a mechanism of transport or retention by which C. concholepas larvae stay near coastal settling areas, thus avoiding offshore dispersion.