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Biomedical subjects

J A Pino Capote

Publications and source records attributed to J A Pino Capote.

11 recordsLinked to original sources

[Routine preoperative screening of asymptomatic patients: beliefs and attitudes of anesthesiologists in the Canary Islands, Spain].

OBJECTIVES: To identify factors that explain anesthesiologists' inappropriate use of preoperative tests in asymptomatic patients scheduled for elective surgery. MATERIAL AND METHODS: A validated questionnaire was sent to anesthesiologists at university hospitals in the Canary Islands. Information about preoperative testing patterns and reasons for selecting tests was gathered. RESULTS: The questionnaire was self-administered by 66 anesthesiologists (68% of the total). Scientific knowledge was not the reason why most respondents ordered preoperative tests in asymptomatic individuals. That was the opinion of 95% of anesthesiologists for chest x-rays, 82% for electrocardiograms, and 68% for laboratory tests. Clinical history and a medical examination gave sufficient information for selecting patients in need of specific tests in the opinion of 77.19% of the respondents. Half did not agree that routine electrocardiograms and laboratory tests should be abandoned. The justification for these tests was coverage of medical malpractice liability for 68.42%. Most considered that the need to order preoperative tests in asymptomatic patients increased after age 40. CONCLUSIONS: Although anesthesiologists admit that their request for preoperative tests in asymptomatic individuals is not supported by scientific evidence, the quest for safety and legal protection from the consequences of potential adverse consequences of providing anesthesia affects the selection of preoperative tests for asymptomatic patients.

Adolescent↗

[Embolism at the iliac bifurcation secondary to an atrial myxoma].

A 73-year-old woman presented a clinical picture of bilateral acute ischemia of the lower limbs. After embolectomy, transthoracic echocardiography revealed left atrial tumor. The picture was complicated by the onset of compartment syndrome in the lower extremities requiring decompressive fasciotomy. The excised atrial tumor proved to be a cardiac myxoma. Atrial myxoma, the most common benign cardiac tumor, leads to systemic, cardiac and embolic sequelae. Transthoracic echocardiography is the main diagnostic technique available, proving more useful than transesophageal echocardiography for small tumors. Such techniques can also be used during surgery, particularly in cases where preoperative assessment has left doubts about tumor location. We also argue in favor of early use of transesophageal echocardiography when peripheral arterial embolism is the diagnosis, in order to locate a cardiac focus as the cause of the clinical picture.

Aged↗