Revista médica de Chile
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Revista médica de Chile · Apr 1991
Randomized Controlled Trial Meta Analysis Clinical Trial[Premature rupture of membranes at preterm. Meta-analysis of the effect of steroids on the prevention of respiratory distress syndrome].
The use of steroids in premature rupture of the membranes is controversial. We used meta-analysis of published results to evaluate the effect of steroid treatment to prevent fetal respiratory distress syndrome associated to premature rupture of the membranes and found that a 30% reduction in the rate of this complication was observed in patients receiving steroids. ⋯ However, infectious complication of the mother increased (mean relative risk 1.68, 95% Cl 1.16-2.44) but not those of the neonate. These results support the use of steroids in order to prevent fetal respiratory distress syndrome in pregnant women with premature rupture of membranes.
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A 17-year-old patient with long-standing poorly controlled type I diabetes mellitus developed bilateral transient edema of the optic disc with minimal visual impairment. Evaluation with fluoresceins angiography revealed the typical pattern of diabetic papillopathy with disc swelling and peripapillary capillary dilatation. Complete resolution occurred within 6 months, with no specific therapy other than improvement of metabolic control with insulin therapy. Early diagnosis of this complication is required to avoid ocular damage.
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Revista médica de Chile · Apr 1991
Comparative Study[Sublingual captopril versus nifedipine in the treatment of hypertensive crisis].
The currently accepted drug of choice for treatment of hypertensive crisis is sublingual nifedipine. We compared the effects of sublingual captopril (25 mg) to those of nifedipine (10 mg) in 54 patients with this complication who came to the emergency room. Five min after administration of captopril, blood pressure decreased from 197.5 +/- 32.7/118.3 +/- 8.2 to 156 +/- 27.2/95.8 +/- 12.9 mmHg and heart rate decreased from 87.9 +/- 15.1 to 74.7 +/- 10.9 (p < 0.05). ⋯ Delayed measurements showed lower diastolic pressures at 60 and 75 min and lower systolic pressure at 120 min in the nifedipine group (p < 0.054). Few and not significantly different side effects were observed with both drugs. Thus, sublingual captopril is useful for treatment of hypertensive crisis.
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Revista médica de Chile · Apr 1991
Case Reports[Aseptic meningitis following spinal anesthesia. Report of a case].
Aseptic meningitis after lumbar puncture and spinal anesthesia is a rare but serious complication, whose acute onset and clinical symptoms mimic septic meningitis. A 33 year old woman presented this complication 5 h after an uneventful cesarean section under subarachnoid blockade. ⋯ The clinical picture, differential diagnosis and value of early lumbar puncture are discussed. The successful use of midazolam to treat psychomotor agitation in this patient is also reported.