Revista médica de Chile
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Revista médica de Chile · May 2015
Review[Causes and management of severe acute liver damage during pregnancy].
Abnormalities in liver function tests appear in 3% of pregnancies. Severe acute liver damage can be an exclusive condition of pregnancy (dependent or independent of pre-eclampsia) or a concomitant disease. HELLP syndrome and acute fatty liver of pregnancy are the most severe liver diseases associated with pregnancy. ⋯ It has a high mortality and patients should be transplanted. Fulminant hepatic failure caused by acetaminophen overdose can be managed with n-acetyl cysteine. Because of the high fetal mortality rate, the gestational age at diagnosis is crucial.
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Revista médica de Chile · May 2015
Review[Non-celiac gluten sensitivity: Another condition that responds to gluten].
Remission of gastrointestinal and general symptoms after gluten withdrawal has been described in some non-celiac individuals for nearly 30 years. Only recently, efforts have been made to define this entity, now referred to as "non-celiac gluten sensitivity". It includes patients that clinically respond to gluten free diet without exhibiting allergic or autoimmune features to explain such response. ⋯ Genetic and immune factors, changes in intestinal microbiota and non-gluten components present in wheat grains are main factors postulated in the pathogenesis of this condition. To date, there are no specific biomarkers for non-celiac gluten sensitivity and diagnosis is reached by excluding other causes of disease. A trial with gluten-free diet and subsequent gluten challenge is the methodology most frequently used to confirm diagnosis.
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Revista médica de Chile · May 2015
[Clinical predictors of bacteremia in immunocompetent adult patients hospitalized for community-acquired pneumonia].
The clinical usefulness of blood cultures in the management of patients hospitalized with community-acquired pneumonia (CAP) is controversial. ⋯ Blood cultures do not contribute significantly to the initial management of patients hospitalized for community-acquired pneumonia. The main clinical predictors of bacteremia were antibiotic use, hypotension, renal dysfunction and systemic inflammation.
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Revista médica de Chile · May 2015
[The cost of polypharmacy in patients with type 2 diabetes mellitus].
Polypharmacy or the concomitant use of three or more medications, may increase the complexity of health care and its costs. ⋯ Medications represent less than 50% of total expenses of diabetic patients with polypharmacy.