Gac Med Mex
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Review Case Reports
Catastrophic antiphospholipid syndrome. Case report and literature review
The present document is the report of a case of a very rare clinical entity, which presents with acute multiorganic failure after a thrombotic storm related to antiphospholipid antibodies, the so-called catastrophic antiphospholipid syndrome, which began as a recurrent picture of mesenteric thrombosis, with a previous history of venous insufficiency and distal ulcers probably associated with an unidentified antiphospholipid; deserving management in intensive care and the consultation by the world expert, Dr. Ricard Cervera who confirmed the diagnosis and recommend treating as such entity, the patient's evolution was satisfactory so far. Final recommendations for diagnosis and current treatment options such as rituximab or eculizumab are made. The present case was added to the international registry that currently houses around 500 cases worldwide (International CAPS Registry).
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Randomized Controlled Trial
[Sitaglitpin phosphate treatment in patients with reactive hypoglycemia secondary to dysinsulinism. Controlled, randomized, double-blind study].
We evaluated the effect of sitagliptin in correction of symptomatic reactive hypoglycemia. ⋯ Sitagliptin improved FISP and reduced post-prandial symptomatology. These results suggest a novel therapeutic option for patients with reactive hypoglycemia related with FISP.
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Case Reports
[Thrombus in transit and submassive pulmonary thromboembolism succesfully treated with tenecteplase].
Right heart thrombus is a slightly detectable condition. In patients presenting with acute pulmonary embolism, the finding of thrombus in transit has been associated with high in-hospital mortality. ⋯ We took the decision to perform fibrinolysis with tenecteplase, presenting significant improvement in the clinical condition, without any complications related to the therapy. Our case demonstrates the effectiveness of thrombolytic therapy in cases of pulmonary embolism and thrombus in transit in right chambers.
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To compare the level of expression of the gene CTSL and its correlation with NKT cells in patients with recent-onset type 1 diabetes (T1D), their siblings, and healthy controls. ⋯ Patients with T1D have lower percentage and absolute number of NKT cells compared to their siblings. NKT cells absolute numbers are correlated with the expression of CTSL in T1D patients.
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Observational Study
[Obesity and its respiratory effects detected through levels of partial pressure of carbon dioxide in the supine position].
Obesity is a disease that is closely associated with deleterious respiratory effects such as the Obesity Hypoventilation Syndrome which conventionally includes awake hypercapnia. There are studies addressing the detection of daytime hypercapnia with the patient either in sitting or standing position. However, there are no studies in obese subjects with a normal daytime PaCO2 in whom the detection of hypercapnia is made in the supine position. It is feasible that the physiopathological changes that occur in obese patients when they adopt the supine position lead to increased PaCO2 levels or hypercapnia. ⋯ We can achieve an early detection of Obesity hipoventilation syndrome in obese patients with a normal daytime PaCO2 by performing the arterial blood gas test in the supine position before these patients develop severe complications.