Medicina intensiva
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This article reviews the utility and applicability of available systems in order to calculate general and quality costs in clinical services settings. ⋯ The effort to implement systems focused to analyze general and quality costs will result in a benefit of those participating in the healthcare system: citizens, professionals, managers, and "financials" since that which is only a legitimate demand today will be a inexcuseable commitment of the healthcare professionals from the society tomorrow.
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The purpose of this presentation is to report three adult patients with aortoenteric fistula whose initial presentation was abdominal pain and digestive bleeding. We stress the low incidence of this disease as a cause of digestive bleeding, its high mortality and the need of high clinical suspicion for its diagnosis. We discuss the different sites of the aortoenteric fistulas, probable physiopathological mechanisms that generate them and their elevated association with the presence of vascular prostheses.
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Comparative Study
[Prognostic estimation in critical patients. Validation of a new and very simple system of prognostic estimation of survival in an intensive care unit].
To make the validation of a new system of prognostic estimation of survival in critical patients (EPEC) seen in a multidisciplinar Intensive care unit (ICU). ⋯ In spite of its ease of application and calculation and of incorporating delay of admission in ICU as a variable, EPEC does not offer any predictive advantage on MPM II 0 or SAPS II, and its predictions adapt to reality worse.
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Comparative Study
[Discrepancies between clinical and pathological diagnosis in a polyvalent intensive care service].
Analyze the frequency and spectrum of the most relevant diseases found in the necropsic study. Assess the association between stay in Intensive Care Unit (ICU) less than 24 hours and rate of diagnostic errors. ⋯ Autopsy continues to be a useful tool to assess quality of clinical diagnosis. The diagnostic errors with therapeutic repercussion are bacterial infections and cardiovascular disease. Patients with a stay less than 24 hours have a higher rate of type I diagnostic errors.