This review considers secondary prevention of ictus based on the use of oral anticoagulant drugs. For this, we analyze separately the secondary preventive aspects of the two most frequent ischemic aetiologies: cardioembolic and atherothrombotic infarcts.

Administration, Oral↗

PubMedDate not supplied

[Esophagectomy for esophageal cancer excluding cardial involvement. Analysis of 40 cases].

This is a study of esophageal resection for cancer of the esophagus in 40 patients, 34 of which were diagnosed as squamous carcinoma and 6 as adenocarcinoma excluding the cardias, tumor localization includes cervical esophagus in one case and all the rest in the thoracic esophagus, 2 in the proximal third, 25 in the middle third and 12 in the distal third. With regard to surgical approach, 11 were treated with total esophagectomy (7 Akiyama, 4 transhiatal resection) and of the 29 treated, of subtotal esophagectomy, 24 were according to the Lewis technique and 5 through a left-sided thoracotomy. Reconstruction was done with stomach in 33 cases six with colon and one with jejunum. Complications were detected in 52.5% the patients with pleuro-pulmonary being the most frequent, anastomotic dehiscence occurred in 5 cases (4 of which were chose manually). The operative mortality rate was 5% and the actuarial survival at 5 years was at 28.4%.

Adenocarcinoma↗

PubMedDate not supplied

[Should patients with acute cerebrovascular disorders be admitted to the intensive care units?].

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Acute Disease↗

PubMedDate not supplied

Liver transplantation with a twenty-four hour delay and an initial low dose of cyclosporine.

BACKGROUND/AIMS: Cyclosporine A based immunosuppression protocols have improved the results of liver transplantation. However, there is no general agreement concerning the most appropriate initial dose of cyclosporine or the precise moment we should start its administration. MATERIALS AND METHODS: Two cyclosporine A administration procedures in liver transplantation were analyzed by means of a prospective study using 91 consecutive patients and dividing them into two groups: Group A: 50 consecutive transplants in which cyclosporine was started since the surgery at 4 mg/kg/day, and Group B: the following 41 consecutive transplants in which cyclosporine was started 24 hours after transplantation at 2 mg/kg/day. RESULTS: Cyclosporine levels were higher in Group A in the first month (without significant differences). There were differences in the need for hemodialysis (14% vs 0%, p < 0.01), in the length of time (h) on mechanical ventilation (147.5 +/- 36 vs 48.7 +/- 15.7, p < 0.05) and in the time (d) spent in intensive care (10.5 +/- 1.6 vs 6.5 +/- 0.8, p < 0.05). There were no differences in the incidence of acute rejection, arterial blood pressure, septic and neurological complications, or in the actuarial survival rate for patients and grafts at 36 months. CONCLUSIONS: Delayed administration of cyclosporine simplifies the treatment of patients in the first 24 hours, it has several beneficial features and does not appear to be associated with a high acute rejection rate. On the basis of these results, our group has adopted delayed and low-dosage cyclosporine procedure.

Creatinine↗