Medicina intensiva
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Editorial Comment
[Increasing the number of valid lungs for transplantation: a necessity].
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Clinical Trial
[Efficacy and safety of non-permanent transvenous pacemaker implantation in an intensive care unit].
To analyze the clinical indications for use, morbidity and mortality associated with a non-permanent transvenous pacemaker. ⋯ Predictfurors of complications were restlessness, cardiovascular risk factors, and insertion through the jugular or subclavian vein. Complications prolonged ICU stay and were not related to the professionals involved.
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We analyzed short, medium and long-term mortality in transplant recipients who received lungs from donors aged 55 years or more. ⋯ The final decision to accept a lung graft should be based on individual evaluation of each donor and recipient. However, given the lack of lung donors, donors aged 55 years or more should be considered for lung transplantation.
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To analyze mortality and resource consumption in patients with long stays in pediatric intensive care units (PICUs). ⋯ Critical children with prolonged stay in the PICU show important morbidity and mortality, and an important consumption of healthcare resources. The adoption of specific measures permitting early identification of patients at risk of prolonged stay is needed in order to adapt therapeutic measures and available resources, and to improve treatment efficiency.
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Lyell's syndrome or toxic epidermal necrolysis (TEN) is an extremely rare and dangerous severe skin disorder characterized by a high proportion of cutaneous lesions leading to necrosis and subsequent shedding of the epidermis over large areas of skin after an idiosyncratic reaction triggered by a drug. The patients who suffer it pathophysiologically have similar complications to those seen in major burns. TEN traditionally has been treated with immunomodulators such as glucocorticoids, intravenous gammaglobulin, cyclophosphamide, thalidomide or plasmapheresis. ⋯ Cyclosporin A has been tested as a single immunomodulator in patients with TEN since the end of the 90 s in a limited number series. The results have improved in regards to survival compared with studies with other drugs. We report three consecutive cases of toxic epidermal necrolysis treated with cyclosporin A in this article.