Revista clínica española
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Revista clínica española · Apr 1995
[The liver transplant program of the Hospital General Universitario Gregorio Marañón: an analysis of the first 100 patients].
During a 3-year period between 1990 and 1993, 100 patients received orthotopic liver transplantation at the "Gregorio Marañón" University General Hospital. The mean age of the patients was relatively high (46.9 +/- 10 years), with an important number of cirrhotic patients (91%). The rate of primary liver failure was relatively low (4.5% of transplantations) although 12 cases with more than 55 years were included in the present series. ⋯ Postoperative complications of the graft were vascular in 9 cases, biliary in 17 cases, and acute rejection (cellular) in 70 patients, although only 50 of these patients required treatment with steroid boluses. Infections were diagnosed in 60 cases with 80% of major infections, 6 of them caused by Aspergillus fumigatus that were lethal in all the cases. Postoperative survival was 82%, 72%, 69% and 69% at 1 month, 6 months, 1 year and 2 years respectively.
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Revista clínica española · Mar 1995
Case Reports[The adult respiratory stress syndrome and septic shock associated with tuberculosis].
The increase in the incidence of tuberculosis infection in the last few years has caused a recurrence of atypical clinical forms, as well as the development of associations and uncommon complications during the clinical course, which include the adult respiratory distress syndrome (ARDS) and septic shock. Three patients with ARDS are here reported; two patients had findings of septic shock and negative serology to human immunodeficiency virus and the only etiological agent documented was M. tuberculosis. ⋯ None of the patients survived the episode. Tuberculosis, particularly the disseminated forms, should be considered as possible etiology in high risk patients with septic shock, ARDS or both.
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Revista clínica española · Feb 1995
Clinical Trial[Airway continuous positive pressure in acute respiratory failure caused by Pneumocystis carinii pneumonia].
To evaluate the efficiency of continuous positive airway pressure through a face mask in acute respiratory insufficiency (ARI) secondary to Pneumocystis carinii pneumonia. ⋯ These results confirm that CPAP through a face mask is an effective means to improve oxygenation in patients with Pneumocystis carinii pneumonia who develop hypoxemic respiratory insufficiency. Its early introduction in hospital protocols can help improving the prognosis in certain patients with severe PCP and avoid their admission to ICU, which would be thus preserved for those patients requiring mechanical ventilation.
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Revista clínica española · Jan 1995
Case Reports[Catastrophic antiphospholipid syndrome. Presentation of a case].
The case of a 35 years old female patient is here reported. Her previous medical records included repeated miscarriages and ischaemic ulcers in the right leg. ⋯ She was successfully managed with plasmapheresis, high dose prednisone, and anticoagulants. The clinical picture was considered to be a catastrophic antiphospholipid syndrome.