Medicina intensiva
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To analyze if the levels of von Willebrand factor (FvW) are higher in patients with ischemic heart disease than in healthy subjects and evaluate the relationship of these levels with clinical recurrence and coronary interventionism. ⋯ FvW levels reflect an endothelial alteration in patients with ischemic heart disease. The increase of the levels after coronary interventionism could be due to the endothelial aggression itself of the intervention. It was not possible to demonstrate higher levels of FvW in patients with symptoms in the three month follow-up.
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A near-miss event is defined as an event that could have resulted in an injury, fatality, or property damage if it had not been prevented. Analysis of near-miss events could be an efficient method in the study of adverse events. ⋯ However, up to now, this method has been slow to develop. We present two clinical cases that help to understand the usefulness of the near-miss reporting system.
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Cerebrovascular accident in young adults is not rare and the most common causes are: cardiac embolism, arterial dissection and migraine. The unknown etiology, in spite of extensive studies, is described in the literature in about one third of patients under 45 years of age. The mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) may occur with symptoms that simulate a stroke. ⋯ We describe the case of an 18-year old patient who was admitted to the Intensive Care Unit due to a sudden picture of blindness. The ophthalmologic study was normal and the neuroimaging studies showed infarction in both occipital lobules. We explain the different clinical features, diagnostic, therapeutic and prognostic methods of the disease.