Browsing by Author "Regueira, Tomas"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    INTESTINAL PERFORATION SECONDARY TO BLUNT INGUINAL TRAUMA IN A SOCCER PLAYER: A CASE REPORT
    (ELSEVIER SCIENCE INC, 2012) Vucetich, Nevenka; Andresen, Max; Hasbun, Pablo; Regueira, Tomas; Ibanez, Luis; Gonzalez, Alejandro
    Background: Intestinal perforation caused by blunt trauma to an inguinal hernia is a very uncommon event. Case Report: We present the case of a 55-year old man who suffered trauma to the inguinal area while playing soccer and later developed intense abdominal pain with no categorical signs of peritoneal irritation. Computed tomography scan at arrival showed a right inguinal hernia, with partial protrusion of the ileum, inflammatory changes of the mesenteric fat tissue inside the hernial sac, and free intraperitoneal fluid. Several hours later he developed hypotension and fever. An emergency laparotomy was performed, revealing ileum perforation with peritonitis. Intestinal perforation was repaired without intestinal resection. After surgery, the patient developed severe septic shock with multiple organ failure. He recovered without sequelae and was discharged 3 weeks later. Conclusion: This case emphasizes the potential clinical complications associated with this condition. (C) 2012 Elsevier Inc.
  • Thumbnail Image
    Item
    Intra-abdominal hypertension: Incidence and association with organ dysfunction during early septic shock
    (W B SAUNDERS CO-ELSEVIER INC, 2008) Regueira, Tomas; Bruhn, Alejandro; Hasbun, Pablo; Aguirre, Marcia; Romero, Carlos; Llanos, Osvaldo; Castro, Ricardo; Bugedo, Guillermo; Hernandez, Glenn
    Purpose: The objective of this article is to study the cumulative incidence of intra-abdominal hypertension (IAH) in septic shock (SS) patients during the first 72 hours of intensive care unit (ICU) admission and to determine if the presence and severity of IAH are associated with sepsis morbidity and mortality.
  • Thumbnail Image
    Item
    Mini bronchoalveolar lavage in patients with severe respiratory failure
    (SOC MEDICA SANTIAGO, 2011) Andresen, Max; Mercado, Marcelo; Zapata, Marcelo; Bustamante, Andrea; Regueira, Tomas
    Background: To recognize the etiological agent responsible for severe acute respiratory failure (ARF) in patients in mechanical ventilation (MV) is important to determine their treatment and prognosis, and to avoid the excessive use of antibiotics. Mini bronchoalveolar lavage (mini BAL) is a blind, non bronschoscopic procedure, used to obtain samples from the lower respiratory tract from patients on mechanical ventilation (MV). Aim: To assess the feasibility, complications and preliminary results of mini BAL among patients with severe ARF on MV Material and Methods: Prospective study in 17 patients with acute lung injury (ALI) or acute respiratory distess syndrome (ARDS) on MV and with negative conventional microbiological studies. Mini BAL was performed using standardized protocols. Hemodynamic and respiratory parameters where measured before and after the procedure. Samples obtained were sent to quantitative cultures. Results: At baseline: APACHE II score of 22 +/- 6,7, P(a)O(2)/F(i)O(2) ratio was 176.6 +/- 48.6 and the oxygenation index was 9.74 +/- 3.78. All procedures were performed by an ICU resident. Thirty five percent of the procedures had positive cultures and no complications related to the procedures were reported. The procedure lasted an average of 12 minutes and the instilled and rescued volume were 60 ml and 19.6 ml, respectively There were no significant differences between hemodynamic and respiratory variables before and after the procedure. Conclusions: Mini BAL is a safe, fast and easy technique for obtaining samples from the inferior airway in patients with ALI or ARDS on MV (Rev Med Chile 2011; 139: 1292-1297).
  • No Thumbnail Available
    Item
    Vitamin E Blocks Connexin Hemichannels and Prevents Deleterious Effects of Glucocorticoid Treatment on Skeletal Muscles
    (2020) Balboa, Elisa; Saavedra, Fujiko; Cea, Luis A.; Ramirez, Valeria; Escamilla, Rosalba; Vargas, Anibal A.; Regueira, Tomas; Saez, Juan C.
    Glucocorticoids are frequently used as anti-inflammatory and immunosuppressive agents. However, high doses and/or prolonged use induce undesired secondary effects such as muscular atrophy. Recently, de novo expression of connexin43 and connexin45 hemichannels (Cx43 HCs and Cx45 HCs, respectively) has been proposed to play a critical role in the mechanism underlying myofiber atrophy induced by dexamethasone (Dex: a synthetic glucocorticoid), but their involvement in specific muscle changes promoted by Dex remains poorly understood. Moreover, treatments that could prevent the undesired effects of glucocorticoids on skeletal muscles remain unknown. In the present work, a 7-day Dex treatment in adult mice was found to induce weight loss and skeletal muscle changes including expression of functional Cx43/Cx45 HCs, elevated atrogin immunoreactivity, atrophy, oxidative stress and mitochondrial dysfunction. All these undesired effects were absent in muscles of mice simultaneously treated with Dex and vitamin E (VitE). Moreover, VitE was found to rapidly inhibit the activity of Cx HCs in freshly isolated myofibers of Dex treated mice. Exposure to alkaline pH induced free radical generation only in HeLa cells expressing Cx43 or Cx45 where Ca2+ was present in the extracellular milieu, response that was prevented by VitE. Besides, VitE and two other anti-oxidant compounds, Tempol and Resveratrol, were found to inhibit Cx43 HCs in HeLa cells transfectants. Thus, we propose that in addition to their intrinsic anti-oxidant potency, some antioxidants could be used to reduce expression and/or opening of Cx HCs and consequently reduce the undesired effect of glucocorticoids on skeletal muscles.