Browsing by Author "Jarufe Cassis, Nicolás"

Now showing 1 - 20 of 64
  • No Thumbnail Available
    Item
    805 Complications of Gastrointestinal Endoscopy in 85,391 Procedures
    (Mosby-Elsevier, 2012) Espino Espino, Alberto Antonio; García Astorquiza, Ximena Andrea; Mac Namara, Macarena; Richter Roca, Hugo Michael; Pimentel Muller, Fernando; Biel Morales, Francisco Javier; Robles García, Camila Fernanda; Callejas, Matías F.; Sharp Pittet, Allan Carlos; Donoso, Andrés; Candia Balboa, Roberto Andrés; González Donoso, Robinson; Jarufe Cassis, Nicolás; Arrese, Marco; Álvarez Lobos, Manuel; Padilla Pérez, Oslando
    Background: Complications are inherent to GI endoscopy (GIE) and do not necessarily imply endoscopist's negligence. They may occur even using highest standards of practice. Objectives: To analyze the frequency and severity of complications occurring within 30 days after of the GIE at a single university hospital in Chile. Methods: We reviewed the records about patients who underwent GIE from January 2001 through May 2011. Results: A total of 85,391 GIE were evaluated. Procedures: 46,928 (55%) esophagogastroduodenoscopy (EGD); 27,993 (32.8%) diagnostic colonoscopies; 1427 (1.7%) polypectomies; and other procedures (hemostasis, variceal band ligation (VBL), foreign-body removal, dilation, stents, PEG, ERCP, EUS and double balloon endoscopy) 9043 (10.5%). A total of 299 complications were associated with GIE (59 % female, mean age 63 years, range 5 - 99). The overall complications rate was 0.35% (cardiopulmonary (CP) 0.1%, bleeding 0.07%, perforation 0.06%, infection 0.04%, pancreatitis 0.03% and other). The overall complication rate was higher in therapeutic procedures (TP) vs diagnostic procedures (DP) (2.7% v/s 0.16%, p<0.0001). The percentage of severe complications was higher in TP vs DP (52.3% vs 28.4%, p<0.0001). The overall complication rate for EGD was 0.14% (CP 0.07%, perforation 0.017%, bleeding 0.019%); diagnostic colonoscopy, 0.27% (CP 0.1%, perforation 0.06%, bleeding 0.02%); and polypectomy, 1.8% (CP 0.14%, perforation 0.28%, bleeding 0.98%). A total of 15 deaths occurred (overall rate 0.018%, 83% in TP). The overall mortality rate was higher in TP vs DP (0.2% v/s 0.003%, p<0.0001). The mortality rate for PEG was 0.7%; VBL 0.4%; ERCP 0.2%; diagnostic colonoscopy 0.004%; EGD 0.004%; and polypectomy 0%. Conclusions: GIE is associated with complications and mortality. The severity and risk of complications are higher in therapeutic procedures. These risks should be clearly explained to patients and their family before the procedure.
  • No Thumbnail Available
    Item
    A large liver tumour
    (2010) Gabrielli Nervi, Mauricio; Figueroa, Eduardo; Ibáñez Anrique, Luis; Jarufe Cassis, Nicolás
  • Thumbnail Image
    Item
    Accuracy of the BAR score in the prediction of survival after liver transplantation
    (2019) Martinez Castillo, Jorge Arturo; Pacheco, Sergio; Bachler, J.; Jarufe Cassis, Nicolás; Briceño, Eduardo; Guerra Castro, Juan Francisco; Benitez, Carlos; Wolff, Rodrigo; Barrera Martínez, Francisco José; Arrese Jiménez, Marco
  • Thumbnail Image
    Item
    Allowing New Opportunities in Advanced Laparoscopy Training Using a Full High-Definition Training Box
    (2016) Achurra Tirado, Pablo; Lagos, Antonia; Ávila, Rubén; Tejos, Rodrigo; Buckel, Erwin; Alvarado, Juan; Boza, Camilo; Jarufe Cassis, Nicolás; Varas, Julián
  • Thumbnail Image
    Item
    Amylase Level in Drains After Pancreatoduodenectomy as a Predictor of Clinically Significant Pancreatic Fistula
    (2014) Ceroni Villanelo, Marco; Galindo, J.; Guerra Castro, Juan Francisco; Salinas, J.; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás
  • Thumbnail Image
    Item
    Anatomic hepatectomy as a definitive treatment for hepatolithiasis: a cohort study
    (2012) Jarufe Cassis, Nicolás; Figueroa, Eduardo; Muñoz Castro, César; Moisan Paravic, Fabricio Robertino; Varas Cohen, Julián; Valbuena Mora, José Rafael; Bambs S., Claudia; Martínez Castillo, Jorge; Pimentel Müller, Fernando
  • Thumbnail Image
    Item
    Arteria hepática izquierda de arteria gastroduodenal. Un desafío técnico durante cirugía de Whipple. Caso clínico
    (2015) Avila, R.; Vander, G.; Navia, A.; Altamirano, A.; Guerra Castro, Juan Francisco; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás
  • Thumbnail Image
    Item
    Avances en la cirugía de tumores del páncreas exocrino en niños
    (2013) Pattillo Silva, Juan Carlos; Jarufe Cassis, Nicolás
  • Thumbnail Image
    Item
    Brazilian consensus on incidental gallbladder carcinoma
    (2020) Coimbra F. J. F.; Torres, O. J. M.; Alikhanov, R.; Agarwal, A.; Pessaux, P.; Fernandes, E. S. M.; Quireze Junior, C.; Araujo, R. L. C.; Godoy, A. L.; Jarufe Cassis, Nicolás; Waechter, F. L.; de RESENDE, A. P.; Boff, M. F.; Coelho, G. R.; de REZENDE, M. B.; Linhares, M. M.; Belotto, M.; Moraes Junior, J. M. A.; Amaral, P. C. G.; Pinto, R. D.; Genzini, T.; Lima, A. S.; Ribeiro, H. S. C.; Ramos, E. J.; Anghinoni, M.; Pereira, L. L.; Enne, M.; Sampaio, A.; Montagnini, A. L.; Diniz, A.; de JESUS, V. H. F.; Sirohi, B.; Shrikhande, V.; Peixoto, R. D.; Kalil, A. N.; Smith, M.; Herman, P.
  • Thumbnail Image
    Item
    Comparison of oncological outcomes after open and laparoscopic re-resection of incidental gallbladder cancer
    (2020) Vega P., Eduardo; De Aretxabala, X; Qiao, W; Newhook, TE; Okuno, M; Castillo, E; Sanhueza García, Marcel Paolo; Diaz, C; Cavada, G; Jarufe Cassis, Nicolás; Muñoz, C; Rencoret, G; Vivanco, M; Joechle, K; Tzeng, CWD; Vauthey, JN; Viñuela Fawaz, Eduardo Andrés; Conrad, C
  • Thumbnail Image
    Item
    Complicaciones neurológicas en pacientes adultos sometidos a trasplante hepático ortotópico. Experiencia de un centro universitario
    (2008) Mellado T., Patricio; Peredo Orellana, Pilar Andrea; Valenzuela Mangini, Raúl Francisco; Arrese Jiménez, Marco; Pérez Ayuso, Rosa María; Domínguez, Pilar; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás; Martínez Castillo, Jorge
    Background: Orthotopic liver transplantation (OLT) is the treatment of choice for multiple acute and chronic end-stage liver diseases as well as for selected cases of liver malignancy and liver-site metabolic disorders. Neurological impairment is a major source of morbidity and mortality following OLT. Aim: To describe the incidence and the type of neurological complications occurring in the post-operative period of OLT in patients transplanted in our hospital. Material and methods: Between March 1994 and August 2007, 76 adult patients underwent OLT. Data on incidence, time of onset, and outcome of central nervous system (CNS) complications have been obtained from our program data base and patient charts. Results: Twenty three patients (30.3%) had CNS complications following OLT. The leading complications were immunosuppressive drug-related neurological impairment in nine patients (39.1%), peripheral nerve damage in five patients (21.7%), central pontine myelinolysis in four patients (17.4%), cerebrovascular disease in three (13%) and CNS infection in three (13%). Most CNS events (90%) occurred in the first 2 weeks after OLT. Five patients with neurological complications died (22%). Conclusions: CNS complications occurred in almost one fifth of the population studied, and they had a poor outcome, as previously reported
  • Thumbnail Image
    Item
    Consensus, Dilemmas, and Challenges in Living Donor Liver Transplantation in Latin America
    (2016) Salvalaggio, P.; Neto, J.; Alves, J.; Fonseca, E.; De Albuquerque, L.; Andraus, W.; Massarollo, P.; Garcia, V.; Maurette, R.; Jarufe Cassis, Nicolás; Pacheco, L.; Rusca, L.; Osorio, V.; Matamoros, M.; Varela, G.; Ruf, A.
  • No Thumbnail Available
    Item
    Current situation of pediatric liver transplantation in Chile : Inequities associated with the MELD/PELD prioritization system
    (2020) Diaz Piga, Luis Antonio; López, M.; Sin, P.; Wolff, R.; Buckel, Erwin; Pattillo Silva, Juan Carlos; Jarufe Cassis, Nicolás; Martínez Castillo, Jorge; Guerra, Juan Francisco; Gana Ansaldo, Juan Cristóbal; González, G.; Muñoz, M. P.; Uribe, M.; Ananias, Á.; Bezama, I.; Zañartu, N.; Innocenti, F.; Elgueta S.
  • Thumbnail Image
    Item
    Definiciones y conceptos en hepatolitiasis
    (2013) Jarufe Cassis, Nicolás; Muñoz C., César; Martínez Castillo, Jorge; Guerra Castro, Juan Francisco; Pimentel Muller, Fernando
  • Thumbnail Image
    Item
    Dexmedetomidine ameliorates gut lactate production and impairment of exogenous lactate clearance in an endotoxic sheep model
    (2015) Hernández P., Glenn; Tapia, Pablo; Bruhn, Alejandro; Soto, Dagoberto; Alegría, Leyla; Jarufe Cassis, Nicolás; Menchaca, Rodrigo; Meissner, Arturo; Vives, María Ignacia; Ospina Tascón, Gustavo A.; Luengo, Cecilia; Bakker, Jan
  • Thumbnail Image
    Item
    Diarrea poscolecistectomía : ¿un problema frecuente?
    (2017) Manríquez, Erik; Tejos, Rodrigo; Rojas, Alejandro; Pimentel, Eduardo; Vega, Tomás; Achurra Tirado, Pablo; Avila, Rubén; Jarufe Cassis, Nicolás; Crovari Eulufi, Fernando; Arrese Jiménez, Marco; Martínez, Jorge
  • Thumbnail Image
    Item
    Disminución de la presión venosa central : efecto sobre el gasto cardíaco
    (2017) Concha P., Mario; Mertz K., Veronica; Cortínez Fernández, Luis Ignacio; Jarufe Cassis, Nicolás; Martínez, Jorge; Guerra, Juan Francisco; Carmona B., Javiera
  • Thumbnail Image
    Item
    Early and severe impairment of lactate clearance in endotoxic shock is not related to liver hypoperfusion: preliminary report
    (2014) Tapia, Pablo; Soto, Dagoberto; Bruhn, Alejandro; Regueira Heskia, Tomás; Jarufe Cassis, Nicolás; Alegría, Leyla; Bachler, J. P.; Leon, F.; Vicuña, C.; Hernández P., Glenn
  • Thumbnail Image
    Item
    Effectiveness of Learning Advanced Laparoscopic Skills in a Brief Intensive Laparoscopy Training Program
    (2015) Castillo, Richard; Buckel, Erwin; Leon, Felipe; Varas, Julián; Alvarado, Juan; Achurra Tirado, Pablo; Aggarwal, Rajesh; Jarufe Cassis, Nicolás; Boza, Camilo
  • Thumbnail Image
    Item
    Effects of dexmedetomidine and esmolol on systemic hemodynamics and exogenous lactate clearance in early experimental septic shock
    (2016) Hernández P., Glenn; Tapia, Pablo; Alegría, Leyla; Soto, Dagoberto; Jarufe Cassis, Nicolás; Achurra Tirado, Pablo; Rebolledo, Rolando; Bruhn, Alejandro; Castro, Ricardo; Kattan Tala, Eduardo José; Bakker, Jan; Luengo, Cecilia; Gomez, Jussara; Ospina Tascón, Gustavo
    Abstract Background Persistent hyperlactatemia during septic shock is multifactorial. Hypoperfusion-related anaerobic production and adrenergic-driven aerobic generation together with impaired lactate clearance have been implicated. An excessive adrenergic response could contribute to persistent hyperlactatemia and adrenergic modulation might be beneficial. We assessed the effects of dexmedetomidine and esmolol on hemodynamics, lactate generation, and exogenous lactate clearance during endotoxin-induced septic shock. Methods Eighteen anesthetized and mechanically ventilated sheep were subjected to a multimodal hemodynamic/perfusion assessment including hepatic and portal vein catheterizations, total hepatic blood flow, and muscle microdialysis. After monitoring, all received a bolus and continuous infusion of endotoxin. After 1 h they were volume resuscitated, and then randomized to endotoxin-control, endotoxin-dexmedetomidine (sequential doses of 0.5 and 1.0 μg/k/h) or endotoxin-esmolol (titrated to decrease basal heart rate by 20 %) groups. Samples were taken at four time points, and exogenous lactate clearance using an intravenous administration of sodium L-lactate (1 mmol/kg) was performed at the end of the experiments. Results Dexmedetomidine and esmolol were hemodynamically well tolerated. The dexmedetomidine group exhibited lower epinephrine levels, but no difference in muscle lactate. Despite progressive hypotension in all groups, both dexmedetomidine and esmolol were associated with lower arterial and portal vein lactate levels. Exogenous lactate clearance was significantly higher in the dexmedetomidine and esmolol groups. Conclusions Dexmedetomidine and esmolol were associated with lower arterial and portal lactate levels, and less impairment of exogenous lactate clearance in a model of septic shock. The use of dexmedetomidine and esmolol appears to be associated with beneficial effects on gut lactate generation and lactate clearance and exhibits no negative impact on systemic hemodynamics.Abstract Background Persistent hyperlactatemia during septic shock is multifactorial. Hypoperfusion-related anaerobic production and adrenergic-driven aerobic generation together with impaired lactate clearance have been implicated. An excessive adrenergic response could contribute to persistent hyperlactatemia and adrenergic modulation might be beneficial. We assessed the effects of dexmedetomidine and esmolol on hemodynamics, lactate generation, and exogenous lactate clearance during endotoxin-induced septic shock. Methods Eighteen anesthetized and mechanically ventilated sheep were subjected to a multimodal hemodynamic/perfusion assessment including hepatic and portal vein catheterizations, total hepatic blood flow, and muscle microdialysis. After monitoring, all received a bolus and continuous infusion of endotoxin. After 1 h they were volume resuscitated, and then randomized to endotoxin-control, endotoxin-dexmedetomidine (sequential doses of 0.5 and 1.0 μg/k/h) or endotoxin-esmolol (titrated to decrease basal heart rate by 20 %) groups. Samples were taken at four time points, and exogenous lactate clearance using an intravenous administration of sodium L-lactate (1 mmol/kg) was performed at the end of the experiments. Results Dexmedetomidine and esmolol were hemodynamically well tolerated. The dexmedetomidine group exhibited lower epinephrine levels, but no difference in muscle lactate. Despite progressive hypotension in all groups, both dexmedetomidine and esmolol were associated with lower arterial and portal vein lactate levels. Exogenous lactate clearance was significantly higher in the dexmedetomidine and esmolol groups. Conclusions Dexmedetomidine and esmolol were associated with lower arterial and portal lactate levels, and less impairment of exogenous lactate clearance in a model of septic shock. The use of dexmedetomidine and esmolol appears to be associated with beneficial effects on gut lactate generation and lactate clearance and exhibits no negative impact on systemic hemodynamics.