Medicina
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Hyperglycemia is a frequent complication in patients admitted to the hospital, and it is associated with increased morbidity, mortality and length of stay. The mechanisms that cause these complications are not clear, but multiple physiological processes are affected with increased glucose levels. ⋯ In this article we review observational and prospective studies regarding hyperglycemia in the hospital. We also describe options for glucose control, and recommendations for the transition of glucose management to the ambulatory setting.
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New options have been developed for the prevention and treatment of acute ischemic stroke in the last 20 years, such as carotid endarterectomy and intravenous thrombolysis with tissue plasminogen activator. Scientific evidence has supported their use in developed countries, while there is an evident delay in their use among emerging countries. ⋯ Decompressive craniectomy seems to be an effective and safe approach for rapidly lowering intracranial pressure. Although randomized trials are lacking, there is enough evidence to support this surgical procedure in appropriately selected patients.