Archivos de bronconeumología
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Arch. Bronconeumol. · Jan 1999
[Community-acquired pneumonia referred for hospital management. Its epidemiology and the diagnostic and therapeutic approaches].
To determine the epidemiology of community-acquired pneumonia referred to the hospital and to characterize the diagnostic and therapeutic approach adopted by physicians. ⋯ The incidence of community-acquired pneumonia in this population is 3.2 cases per 1,000 inhabitants/year. The population is mainly elderly and comorbidity is common, although mortality is low. We believe common criteria should be adopted for managing community-acquired pneumonia and that empirical treatment should be directed toward germs identified in each setting, based on appropriate etiological investigation.
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The standard, most widely applied way of preserving a lung for transplantation is infusion through the pulmonary artery (PA) of a pulmonaryplegic solution. In this prospective study, we analyzed the initial function of the pulmonary and cardiac graft after biphasic infusion of a solution introduced retrograde through the left auricle and antegrade through the PA. Twenty-six heart and lung grafts (9 unilateral and 17 bilateral) were preserved by cardioplegia and pulmonaryplegia (biphasic) between January 1996 and March 1997. ⋯ No heart transplant patient suffered primary heart failure or left ventricular dilatation. We conclude that biphasic pulmonary preservation achieves satisfactory initial functional viability of the graft. Heart grafts removed simultaneously functioned successfully in the transplanted patient without additional pharmacological or mechanical support.
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Stab wounds are the most common cause of open chest wounds in our setting, with an incidence far higher than either wounds caused by firearms or bull horns. We describe a series of 49 patients, 44 (89.8%) men and 5 (10.2%) women. Mean age was 31 years. ⋯ One patient died as a result of abdominal lesions resulting from stab wounds directly to the abdomen. We are in favor of conservative management. Indications for more aggressive intervention are hypovolemic shock, cardiac tamponade or significant loss of fluid through the thoracic drain.