Papers by cesar segundo flores padilla
Clinical Obstetrics & Gynecology, 2017
Maternal sepsis is now a leading cause of direct maternal death during pregnancy. This review add... more Maternal sepsis is now a leading cause of direct maternal death during pregnancy. This review addresses the latest advances in the identification and management of critically ill parturients. Specifically, this review will focus on the vulnerability of pregnant women to sepsis, the utility of early warning criteria in the identification of the septic parturient, emphasize the immediate antibiotic management of suspected sepsis, and elaborate upon the latest understanding in the ventilatory management of parturients with sepsis.
Journal of Clinical Anesthesia, 2016
To review the clinical and basic science literature regarding Zika viral illness and highlight re... more To review the clinical and basic science literature regarding Zika viral illness and highlight relevant findings for obstetric anesthesiologists. This review provides a global review of Zika viral illness, transmission patterns, pathophysiology of disease, and anesthetic management of the parturient with Zika viral illness and associated comorbidities. Systematic review. Large academic hospital. None. None. None. None. With the rapid spread of Zika virus and expected increase of spread in the summer of 2016, this review provides anesthesiologists with current recommendations, physiologic alterations, and anesthetic considerations in regard to the parturient with Zika viral illness and associated diseases.
Revista Perspectivas, May 1, 2014
PURPOSE To determine the role of computed tomography (CT) in evaluating common and rare life thre... more PURPOSE To determine the role of computed tomography (CT) in evaluating common and rare life threatening complications associated with the implantation of a Heartmate II LVAD (Left Ventricular Assist Device). METHOD AND MATERIALS A retrospective analysis was performed on 90 patients (mean age 54.8 years, 72 males, 18 females) who were recipients of a Heartmate II LVAD spanning a four year period of time (1/2007-12/2010). Complications were classified into categories of infection (driveline infection, abscess), hematoma, pericardial effusion, incisional hernia, associated hemorrhagic or ischemic events, and device malfunction (driveline transection, pump thrombosis, malpositioned cannula). The patient’s medical record and imaging were reviewed to classify each complication chronologically. The CT images of patients with driveline infections were reviewed for the location and size of the infiltrative change. Statistical analyses including odd’s ratios, and correlation coefficients wer...
Pain Medicine, 2015
Objective. To determine perioperative treatments and events associated with Hospital Consumer Ass... more Objective. To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey responses. Design. Retrospective analysis. Setting. Single tertiary care, academic, urban, level-1 trauma center. Participants. Final cohort represents 2,758 consecutive surgical inpatients meeting criteria for evaluation by HCAHPS. Exposures. Responses to four HCAHPS questions were compared against 19 perioperative treatments and events. Measures. Positive and negative responses to HCAHPS questions.
SSRN Electronic Journal, 2012
We measure the effects of debt dilution on sovereign default risk and show how these effects can ... more We measure the effects of debt dilution on sovereign default risk and show how these effects can be mitigated with debt contracts promising borrowing-contingent payments. First, we calibrate a baseline modelà la Eaton and Gersovitz (1981) to match features of the data. In this model, bonds' values can be diluted. Second, we present a model in which sovereign bonds contain a covenant promising that after each time the government borrows it pays to the holder of each bond issued in previous periods the difference between the bond market price that would have been observed absent current-period borrowing and the observed market price. This covenant eliminates debt dilution by making the value of each bond independent from future borrowing decisions. We quantify the effects of dilution by comparing the simulations of the model with and without borrowing-contingent payments. We find that dilution accounts for 84% of the default risk in the baseline economy. Similar default risk reductions can be obtained with borrowing-contingent payments that depend only on the bond market price. Using borrowing-contingent payments is welfare enhancing because it reduces the frequency of default episodes. JEL classification: F34, F41.
Journal of public health dentistry, Jan 3, 2017
Although dental decay is preventable, it remains the most common pediatric chronic disease. We de... more Although dental decay is preventable, it remains the most common pediatric chronic disease. We describe a public health approach to implementing a scalable and sustainable school-based oral health program for low-income urban children. The Los Angeles Trust for Children's Health, a nonprofit affiliated with the Los Angeles Unified School District, applied a public health model and developed a broad-based community-coalition to a) establish a District Oral Health Nurse position to coordinate oral health services, and b) implement a universal school-based oral health screening and fluoride varnishing program, with referral to a dental home. Key informant interviews and focus groups informed program development. Parent surveys assessed preventative oral health behaviors and access to oral health services. Results from screening exams, program costs and rates of reimbursement were recorded. From 2012 to 2015, six elementary schools and three dental provider groups participated. Four...
Academic pediatrics, Jan 27, 2017
Because children with medical complexity (CMC) display very different health trajectories, needs,... more Because children with medical complexity (CMC) display very different health trajectories, needs, and resource utilization than other children, it is unclear how well traditional conceptions of population health apply to CMC. We sought to identify key health outcome domains for CMC as a step toward determining core health metrics for this distinct population of children. We conducted and analyzed interviews with 23 diverse national experts on CMC to better understand population health for CMC. Interviewees included child and family advocates, health and social service providers, and research, health systems, and policy leaders. We performed thematic content analyses to identify emergent themes regarding population health for CMC. Overall, interviewees conveyed that defining and measuring population health for CMC is an achievable, worthwhile goal. Qualitative themes from interviews included: 1) CMC share unifying characteristics that could serve as the basis for population health ou...
A & A case reports, Jan 30, 2016
Parturients may present with evidence of acute heart failure or respiratory distress during the p... more Parturients may present with evidence of acute heart failure or respiratory distress during the peripartum period. This case report documents utilization of "stand-by" extracorporeal membrane oxygenation (ECMO) for a 40-year-old woman with a history of severe left ventricular dysfunction who presented for elective dilation and evacuation of triplets at 20 weeks' gestation. The patient's medical history was significant for hypertension, diabetes mellitus, methamphetamine use (acute/chronic), and cardiac-respiratory arrest before her previous emergent cesarean delivery. The patient underwent general anesthesia with the placement of peripheral venous and arterial cannulas for "stand-by" ECMO. The patient remained stable throughout the procedure, and "stand-by" ECMO was not initiated; the patient was discharged 5 days' postprocedure. The use of "stand-by" ECMO in the parturient with severe cardiopulmonary dysfunction is still in its in...
A & A Case Reports, 2016
Peripartum cardiomyopathy is a rare form of heart failure with significant perioperative implicat... more Peripartum cardiomyopathy is a rare form of heart failure with significant perioperative implications. In this case report, we describe a 34-year-old gravida 5, parity 3, patient who was admitted for an elective cesarean delivery. During the delivery, the patient developed sudden cardiac arrest and was emergently intubated in the operating room. An emergent transesophageal echocardiogram revealed a left ventricular ejection fraction of 10% with global biventricular hypokinesis. Urgent multidisciplinary consultations led to the rapid implementation of the Impella™ 2.5 for ventricular support. The patient recovered ventricular function within 4 days and recovered to baseline function.
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Papers by cesar segundo flores padilla