Rev Invest Clin
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Historical Article
[From temples and sanctuaries to hospitals; 6,000 years of history].
To find out when and where the hospitals began, its history and evolution. ⋯ The sick man has been looking for the healing of his ailments, and few places made him feel protected as the hospital does. The birth, growing and evolution of such institutions had been slow and steady until the end of the second millennium aD.
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Two cases of cryptococcal meningitis and increased intracranial pressure in patients with acquired immunodeficiency are described. Both patients presented high intracranial pressure that persisted despite optimal antifungal treatment (amphotericin B, 5-flucytosine initially, and fluconazole posteriorly). The elevated intracranial pressure produced headache, seizures, and reduced visual and auditory acuity. ⋯ After one year of follow-up, one patient died due to progression of his disease, while the other is still alive and without evidence of neurological disease. Intracranial hypertension is a frequent clinical manifestation of cryptococcal meningitis in patients with acquired immunodeficiency syndrome (AIDS) that requires adequate diagnosis and management. Treatment should be directed towards the reduction of intracranial pressure though repeated lumbar punctures and, in some cases, with lumboperitoneal or ventricular-peritoneal shunts.
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To validate the population pharmacokinetic parameters of chloramphenicol in pediatric patients with sepsis and malnutrition (PPSM) using a bayesian forecasting program. ⋯ These data indicate that chloramphenicol pharmacokinetics in PPSM can be predicted with minimal bias and good precision using a bayesian forecasting program, allowing a better control of the chloramphenicol serum concentrations. In addition, the limited number of samples required by the bayesian method may represent an important economical benefit for the patient.
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To assess the fresh-frozen plasma (FFP) transfusion indications in a Mexican hospital. ⋯ 78 patients with 292 FFP units transfused were analyzed: in 20 patients the indication was clotting support, 16 with CI < 1.5 and four with CI > 1.6, one with blood loss and one with surgical procedure; hypoalbuminemia in 10; hypovolemia in eight; unidentified reason in 33 and others in seven patients. Eleven units (3.76%) were considered properly transfused whereas 281 (96.23%) were inadequately indicated.