Gac Med Mex
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Randomized Controlled Trial Clinical Trial
[Prevention of hypoxic-ischemic encephalopathy with high-dose, early phenobarbital therapy].
To assess usefulness of high-dose early phenobarbital therapy for prevention of hypoxic-ischemic encephalopathy (HIE) secondary to perinatal asphyxia (PNA). ⋯ There was no significant difference in the overall frequency of HIE, nor in the incidence of seizures or stage II of HIE in both groups. According to these results and even though there were no side effects, we think phenobarbital is not useful for these purposes. Long-term follow-up of the treated infants is justified, since phenobarbital might have a beneficial effect on neuro-behavioral development.
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Historical Article
[The Dr. Manuel Gea General Hospital: past, present, and future].
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[Morbility at the Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, 1995-2001].
Hospital statistics are very important as tools that help to define research objectives and design health programs. ⋯ This study is not a population study, but it helps to increase knowledge of the main causes of hospitalization at one of the most important neurologic institutions in the world, which provides care for thinsured population throughout Mexico. These findings facilitate analysis and decision-making to undertake specifications to improve the quality of neurologic medical attention.
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Arginine-vasopressin (VP), also known as the antidiuretic hormone, is essential for water homeostasis. Its synthesis and liberation depends on regulation of osmotic, hypovolemic, hormonal, and nonosmotic stimuli. ⋯ Shock state with refractory vasodilation seen in sepsis, systemic inflammatory response, hypovolemia, cardiac arrest, polytrauma, etc., is characterized by an initial phase of liberation and increased levels of VP followed by a second phase characterized by inappropriately low levels of this hormone that are associated with refractoriness to management with volume, inotropics, and vasopressors. It has been demonstrated in clinical and experimental studies that exogenous VP treatment under this condition increases systemic vascular resistance, perfusion pressure, and oxygen supply to peripheral tissues, which makes it possible to decrease and to suspend vasopressors and also to increase survival.