Gac Med Mex
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Subarachnoid hemorrhage constitutes approximately 10% of cases of cerebrovascular disease and its incidence ranges between 11 and 28 cases/100,000/year. More than 80% of cases are secondary to rupture of cerebral aneurysm; however, in 5 to 16% of patients with subarachnoid hemorrhage it is not possible to find a cause (subarachnoid hemorrhage with negative angiography). This group of patients represents a dilemma for the correct diagnosis, treatment and prognosis; there is no consensus on the criteria to repeat the angiography after the first negative study. ⋯ Our observations suggest that the overall prognosis for these patients is very good (86%). The risk of another hemorrhage after discharge from the hospital is small. Our results are compared with those in other published series.
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Comment Letter Historical Article
[Medical and surgical books printed in New Spain ...].
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The aminoglycosides are broad-spectrum antibiotics especially effective against many strains of gramnegative bacteria. Since streptomycin was used for tuberculosis treatment, the toxic side effects of such antibiotics were identified. The kidney and the inner ear are affected. ⋯ During the last fifty years, risk factors for aminoglycoside-induced-ototoxicity have been identified, including a genetically transmitted hypersensitivity to the ototoxic effect. Although several strategies to prevent the damage have been proposed, today it is not rare that patients suffer permanent loss of hearing and loss of balance due to aminoglycoside toxicity. This review gives a brief background of aminoglycoside ototoxicity, some strategies to prevent it, and the therapeutic use of the vestibulo-toxic effect.