Surgical Infection Reduction Program of the Observatory of Surgical Infection (PRIQ-O): Delphi prioritization and consensus document on recommendations for the prevention of surgical site infection.

Surgical site infection is the most frequent and avoidable complication of surgery, but clinical guidelines for its prevention are insufficiently followed. We present the results of a Delphi consensus carried out by a panel of experts from 17 Scientific Societies with a critical review of the scientific evidence and international guidelines, to select the measures with the highest degree of evidence and facilitate their implementation. Forty measures were reviewed and 53 recommendations were issued.

A simple score to predict early severe infections in patients with newly diagnosed multiple myeloma.

Infections remain a common complication in patients with multiple myeloma (MM) and are associated with morbidity and mortality. A risk score to predict the probability of early severe infection could help to identify the patients that would benefit from preventive measures. We undertook a post hoc analysis of infections in four clinical trials from the Spanish Myeloma Group, involving a total of 1347 patients (847 transplant candidates).

The Effect of Hospital Discharge with Empiric Noninvasive Ventilation on Mortality in Hospitalized Patients with Obesity Hypoventilation Syndrome. An Individual Patient Data Meta-Analysis.

Hospitalized patients with acute-on-chronic hypercapnic respiratory failure due to obesity hypoventilation syndrome (OHS) have increased short-term mortality. It is unknown whether prescribing empiric positive airway pressure (PAP) at the time of hospital discharge reduces mortality compared with waiting for an outpatient evaluation (i.e.

SEOM clinical guideline for the diagnosis and treatment of gastric cancer (GC) and gastroesophageal junction adenocarcinoma (GEJA) (2019).

Gastric cancer (GC) is the fifth most common cancer worldwide with a varied geographic distribution and an aggressive behavior. In Spain, it represents the sixth cause of cancer death. In Western countries, the incidence is decreasing slightly, with an increase in gastroesophageal junction adenocarcinoma (GEJA), a different entity that we separate specifically in the guideline.

Radiology of acute pancreatitis today: the Atlanta classification and the current role of imaging in its diagnosis and treatment.

Acute pancreatitis is common and requires multidisciplinary management. The revised Atlanta classification, published in 2012, defines the terminology necessary to enable specialists from different backgrounds to discuss the morphological and clinical types of acute pancreatitis. Radiologists' role depends fundamentally on computed tomography (CT), which makes it possible to classify the morphology of this disease and to predict its clinical severity by applying imaging severity indices.

Evaluation of the CRUSADE Risk Score for Predicting Major Bleeding in Patients with Concomitant Kidney Dysfunction and Acute Coronary Syndromes.

Background: Kidney dysfunction (KD) has been associated with increased risk for major bleeding (MB) in patients with acute coronary syndromes (ACS) and may be in part related to an underuse of evidence-based therapies. Our aim was to assess the predictive ability of the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) risk score in patients with concomitant ACS and chronic kidney disease.

Methods: We conducted a retrospective analysis of a prospective registry including 1,587 ACS patients.

First month prednisone dose predicts prednisone burden during the following 11 months: an observational study from the RELES cohort.

Aim: To study the influence of prednisone dose during the first month after systemic lupus erythematosus (SLE) diagnosis (prednisone-1) on glucocorticoid burden during the subsequent 11 months (prednisone-2-12).

Methods: 223 patients from the Registro Español de Lupus Eritematoso Sistémico inception cohort were studied. The cumulative dose of prednisone-1 and prednisone-2-12 were calculated and recoded into a four-level categorical variable: no prednisone, low dose (up to 7.

Patterns of drug therapy in newly diagnosed Spanish patients with systemic lupus erythematosus.

Objectives: This is the first Spanish multicentric inception lupus cohort, formed by SLE patients attending Spanish Internal Medicine Services since January 2009. We aimed to analyse drug therapy during the first year of follow-up according to disease severity.

Methods: 223 patients who had at least one year of follow-up were enrolled upon diagnosis of SLE.

[Current treatment of primary immune thrombocytopenia].

Primary immune thrombocytopenia, also termed immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by premature platelet destruction and impaired platelet production. Traditional treatment of ITP has predominantly consisted of immune suppression and/or modulation. However, the understanding of the immune mediated impairment of platelet production has led to the development of new treatments that target the thrombopoietin receptor, promoting formation of megakaryocytes and increasing platelet counts.

[Is sutureless hernia repair a safe option for treating abdominal wall hernias? A prospective study with a synthetic tissue adhesive (n-hexyl-alpha-cyanoacrylate)].

Introduction: The use of tissue adhesives can be an alternative to suture fixation of the mesh, but experience in their use is very limited.

Material And Methods: A prospective descriptive study was conducted on a group of 35 patients with inguinal hernias repaired by sutureless hernioplasty (20 by open and 15 by endoscopic), the prosthesis was fixed with a synthetic adhesive (n-hexyl-α-cyanoacrylate). This group was compared with another 35 patients for hernia repair with fixation sutures.

[Direct embolization of stomal varices in portal hypertension after the treatment of liver metastases].

We present the case of a man with a history of colorectal carcinoma and metastatic liver involvement who developed portal hypertension and recurrent bleeding from stomal varices after treatment with intra-arterial oxaliplatin and radioembolization with yttrium-90 microspheres. The definitive treatment for the bleeding episodes was embolization of the varices with coils using a direct percutaneous approach.

Adult intussusception - 14 case reports and their outcomes.

Aims: To analyze diagnostic and therapeutic options depending on the clinical symptoms, location, and lesions associated with intussusception, together with their follow-up and complications.

Patients And Methods: Patients admitted to the Morales Meseguer General University Hospital (Murcia) between January 1995 and January 2009, and diagnosed with intestinal invagination. Data related to demographic and clinical features, complementary explorations, presumptive diagnosis, treatment, follow-up, and complications were collected.

[General surgeons and varicose vein surgery].

Chronic venous insufficiency is a highly prevalent condition, with significant health and economic repercussions. Although important therapeutic developments have been introduced in recent years, the majority are dealt with by general surgeons in national health hospitals. These surgeons do not have the required and continuous training, and continue to perform classic surgery techniques.

[Treatment of non-midline ventral hernia: experience in an abdominal wall unit and literature review].

Introduction: Lateral ventral hernia is an interesting surgical problem. However, few data are available on this entity.

Objective: To review current knowledge of lateral ventral hernia and present our experience of this entity in a multidisciplinary abdominal wall unit.

[Adrenal incidentalomas. A disease on the increase].

Introduction: Adrenal incidentalomas are unsuspected, clinically silent adrenal lesions discovered incidentally by imaging tests performed a priori for problems unrelated to the adrenal glands. The aim of this study was to present a series of incidentalomas and review the diagnostic process and treatment techniques.

Patients And Method: Of a series of 63 patients studied and/or treated for adrenal disease, there were 34 patients with adrenal incidentalomas.

[Risk factors in experimenting with and consumption of tobacco by 12-14 year-old school students. Attitudes to tobacco in pressure groups].

Introduction: Tobacco is the first addictive substance that adolescents and school-children have contact with. The presence of family members and friends as smokers in their environment is related to tobacco experimentation.

Objectives: To describe experimentation and consumption of tobacco in secondary school students (ESO); to identify the attitudes related to smoking; and to study the relationship between smoking by family members, friends and teachers and students' own experimentation and consumption.

[Utility of frozen section in the surgical treatment of thyroid nodules].

Objective: To present our experience of the use of frozen section (FS) in the operative management of thyroid nodules and determine the utility of this procedure when deciding the extent of thyroidectomy.

Patients And Method: We performed a prospective and comparative study. The FS of patients who underwent surgery for thyroid nodules between 1995 and 2002 were evaluated.

[Traumatic Spigelian hernia. Elective extraperitoneal laparoscopic repair].

Traumatic Spigelian hernia is rare. These hernias are usually treated in the same admission through open surgery. We present a case of Spigelian hernia in a high anatomical location following injury, with a cutaneous lesion and preperitoneal hematoma.

[Laparoscopic repair of secondary lumbar hernias: open vs. laparoscopic surgery. A prospective, nonrandomized study].

Introduction: Lumbar hernia is an uncommon defect of the posterior abdominal wall and its surgical treatment remains controversial. The aim of the present study was to evaluate the utility of laparoscopy versus open surgery.

Patients And Method: We performed a prospective, nonrandomized study of 16 patients with secondary lumbar hernias who underwent surgery between January 1997 and January 2003.

Clinical pathway for the treatment of primary spontaneous pneumothorax in a general surgery department.

Primary spontaneous pneumothorax is a common abnormality for which there is a variety of treatments. This study presents the results of a year's evaluation of a clinical pathway (CP). A series of 34 patients treated during 1 year before CP development was analyzed to identify the weak points.

Sensitivity of urinary antigen test in relation to clinical severity in a large outbreak of Legionella pneumonia in Spain.

Presented here are the results of Legionella urinary antigen testing correlated with patient characteristics and severity of pneumonia (Fine score) in 295 patients diagnosed with Legionella pneumonia in connection with a large outbreak in Murcia, Spain. Overall, the sensitivity of the urinary antigen test was 47.7% (141/295).