Clinics
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Review Comparative Study
Noninvasive mechanical ventilation in the treatment of acute cardiogenic pulmonary edema.
Current literature was searched by using the MEDLINE database to find consistent evidence regarding the use of noninvasive mechanical ventilation in patients with acute cardiogenic pulmonary edema. 18 studies demonstrating that noninvasive ventilation applied by continuous positive airway pressure (CPAP) or bilevel positive airway pressure (bilevel-PAP) is safe, and that the two approaches have similar effects and are effective in preventing endotracheal intubation in patients with respiratory distress of cardiac origin, were found. The results support the concept that positive intrathoracic positive pressure must be seen as a nonpharmacological form of treatment of acute pulmonary edema rather than only a supportive measure.
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To evaluate the perinatal results for neonates with congenital diaphragmatic hernia diagnosed prenatally. ⋯ Perinatal mortality was very high in prenatally diagnosed cases of congenital diaphragmatic hernia. Earlier perinatal deaths are associated with the presence of other structural defects or chromosomal abnormalities. In cases of isolated congenital diaphragmatic hernia, mortality is related to the presence of herniated liver, right-sided lesion, and major mediastinal shift.
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Letter Case Reports
Infected hepatic hematoma after renal extracorporeal shock wave lithotripsy.
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To compare the evolution of standard base excess and serum lactate level between surviving and non surviving patients with severe sepsis and septic shock resuscitated with early goal-directed therapy. ⋯ Although evolutive standard base excess and serum lactate level are still outcome markers in severe sepsis and septic shock patients resuscitated with early goal-directed therapy, other studies must be performed to clarify if hemodynamic interventions based on standard base excess and serum lactate level could be reliable to improve clinical outcomes in severe sepsis and septic shock patients.
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Release of the neuronal protein S-100B into the circulation has been suggested as a specific indication of neuronal damage. The hypothesis that S-100B is a useful and cost-effective screening tool for the management of minor head injuries was tested. ⋯ Protein S-100B had a very high sensitivity and negative predictive value and could have an important role in ruling out the need for cranial computed tomography scan after minor head injury. This appears to be of substantial clinical relevance, particularly in countries where trauma incidence is high and medical resources are limited, such as in Brazil.