Claudio Gómez

Metabolic Syndrome and Perioperative Complications During Elective Surgery Using General Anesthesia

Introduction: Metabolic Syndrome (MS) is a cluster of alterations associated to high risk of cardiovascular diseases and diabetes mellitus. Although Metabolic Syndrome is a public health issue, little has been studied about its impact in the anesthetic‐surgical scene. Aims: To analyze the correlation level between MS and perioperative complications, in patients under programmed surgery with general anesthesia technique in Cartagena, Colombia. Materials and methods: A case control study was designed, where 300 patients were enrolled: 150 cases and 150 controls. Socio‐demographic, hemodynamics and respiratory variables, as well as surgical complications (hypotension, hypertension, hypoxemia, bleeding, moderated‐severe pain and post chirurgical nausea‐vomiting) were registered. Fishers exact test and X2, where appropriated were employed to compare categorical data. A logistic regression model was applied to calculate correlation between variables. Results: Surgical complications were more frequent in cases group (P<.001). Differences in age and ASA physical status were also found (P<.05). MS was correlated to perioperative complications (OR: 3.31; P<.05). ASA III physical status was another risk factor to post chirurgical complications development (OR: 4.01; P<.05). None mortality case was reported. Conclusions: In a comparison with healthy population, Metabolic Syndrome represented a risk factor to perioperative complications development. According to results, further prevention and approach guidelines in order to reduce perioperative complications associated to Metabolic Syndrome. Introducción: El síndrome metabólico es un conjunto de alteraciones asociadas a un alto riesgo de enfermedades cardiovasculares. Aunque representa un problema de salud pública, poco se conoce de su impacto en situaciones como la anestésica‐quirúrgica. Objetivo: Analizar la correlación entre síndrome metabólico y complicaciones perioperatorias en pacientes de cirugía programada con anestesia general en Cartagena, Colombia. Material y métodos: Se diseñó un estudio de casos y controles, con 300 pacientes: 150 casos y 150 controles. Se registraron variables sociodemográficas, hemodinámicas, respiratorias, complicaciones perioperatorias (hipotensión, hipertensión, hipoxemia, sangrado, dolor moderado‐severo y náuseas o vómitos postoperatorios). Se emplearon la prueba exacta de Fisher o la de la &khgr;2, según fuera apropiado, para la comparación de grupos. Se aplicó un modelo de regresión logística univariable, para estimar el grado de correlación entre las variables. Resultados: Las complicaciones perioperatorias fueron más frecuentes en el grupo de casos (p < 0,001). Hubo diferencias significativas en edad y estado físico según la Asociación Americana de Anestesiólogos (ASA) (p < 0,05). El síndrome metabólico se correlacionó con complicaciones perioperatorias (odds ratio [OR] = 3,31). El estado físico ASA III fue factor de riesgo de complicaciones postoperatorias (OR = 4,01). Conclusiones: El síndrome metabólico es un factor de riesgo de complicaciones perioperatorias. El estudio indica que hay que implementar estrategias de intervención sanitarias con vistas a la prevención y el manejo del síndrome metabólico en el ámbito quirúrgico, lo que conlleva reducción de las complicaciones perioperatorias asociadas.

Síndrome metabólico y complicaciones perioperatorias durante cirugías programadas con anestesia general

Introduction: Metabolic Syndrome (MS) is a cluster of alterations associated to high risk of cardiovascular diseases and diabetes mellitus. Although Metabolic Syndrome is a public health issue, little has been studied about its impact in the anesthetic-surgical scene. Aims: To analyze the correlation level between MS and perioperative complications, in patients under programmed surgery with general anesthesia technique in Cartagena, Colombia. Materials and methods: A case control study was designed, where 300 patients were enrolled: 150 cases and 150 controls. Socio-demographic, hemodynamics and respiratory variables, as well as surgical complications (hypotension, hypertension, hypoxemia, bleeding, moderated-severe pain and post chirurgical nausea-vomiting) were registered. Fisher’s exact test and X2, where appropriated were employed to compare categorical data. A logistic regression model was applied to calculate correlation between variables. Results: Surgical complications were more frequent in cases group (P<.001). Differences in age and ASA physical status were also found (P<.05). MS was correlated to perioperative complications (OR: 3.31; P<.05). ASA III physical status was another risk factor to post chirurgical complications development (OR: 4.01; P<.05). None mortality case was reported. Conclusions: In a comparison with healthy population, Metabolic Syndrome represented a risk factor to perioperative complications development. According to results, further prevention and approach guidelines in order to reduce perioperative complications associated to Metabolic Syndrome.

Molecular characterization of the cry gene profile of bacillus thuringiensis isolated from a Caribbean region of Colombia

In order to characterize native strains of Bacillus thuringiensis of the Colombian Caribbean with toxic effect against insect vectors, 28 samples of bacteria identified as B. thuringiensis were isolated from different soils and muds around the city of Valledupar. Using a biological test, five isolates of B. thuringiensis showed toxic effect against larvae of Aedes aegypti. PCR methods were used to detect cry1, cry2, cry4B, cry10 and cyt1 genes. Cry1 and cry2 genes were detected in 35.7% and 32.1% of the 28 isolates analyzed, respectively. Surprisingly, reduced lengths of cry4B gene segments were detected in 28.6% of B. thuringiensis samples. The presence of cry10 or cyt1 was not detected in any of the 28 samples of B. thuringiensis, despite the high sensitivity of the assays used. The results show that B. thuringiensis samples from the Colombian Caribbean have atypical characteristics compared to those of Latin America and elsewhere in the world, which is consistent with the idea that the geographic origin of B. thuringiensis samples is associated with their biological and genetic characteristics.