Revista médica de Chile
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Revista médica de Chile · Mar 2020
Case Reports[Combined use of left ventricular assist devices in cardiogenic shock. Report of one case].
We report a 55-year-old woman with a history of hypothyroidism and type 2 diabetes mellitus who consulted at the emergency room because of intermittent oppressive chest discomfort. At admission, electrocardiogram showed a complete atrioventricular block. A transthoracic echocardiogram disclosed severe left ventricular dysfunction. ⋯ Despite successful primary angioplasty, she persisted with refractory shock and progressive hypoxemia. A concomitant connection to the extracorporeal membrane oxygenation system (ECMO) was decided. The support of both devices allowed the stabilization of the patient and the improvement of perfusion parameters.
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Primary cardiac tumors have a low incidence, and their presentation form and clinical course are not well known. ⋯ Most PCTs in this group of patients were benign neoplasms and the most common tumors were myxomas. The main diagnostic method is echocardiography and the prognosis of surgical treatment is excellent when the tumors are benign. (Rev Med Chile 2020; 148: 327-335).
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Revista médica de Chile · Mar 2020
Case Reports[Hypophosphatemia induced by carboxymaltose iron and imatinib. Report of two cases].
Hypophosphatemia is a relatively frequent and a potentially serious adverse drug effect. Clinically it is characterized by bone pain and muscle weakness. There are several mechanisms by which a drug can induce hypophosphatemia and they can be classified according to whether or not they are mediated by an excess of Fibroblast Growth Factor 23 (FGF23). ⋯ He developed symptomatic hypophosphatemia due to non FGF23-mediated hyperphosphaturia. As treatment with imatinib could not be interrupted, hypophosphatemia and its symptoms resolved with oral phosphate intake. These cases illustrate the importance of recognizing and treating drug-induced hypophosphatemia in a timely manner, and thus avoid the morbidity associated with this entity.
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Revista médica de Chile · Mar 2020
[Variceal and non-variceal upper gastrointestinal bleeding. Analysis of 249 hospitalized patients].
Upper gastrointestinal bleeding (UGIB) is one of the main reasons of hospitalization due to gastrointestinal causes. Reported mortality rates range from 5 to 12%. ⋯ Hospital mortality of UGIB remains high, especially in variceal UGIB. Elevated creatinine levels on admission, the need of transfusion of red blood cells and variceal etiology are risk factors for mortality.
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Revista médica de Chile · Mar 2020
[A proposal of the Chilean Academy of Medicine to improve organ procurement and transplantation in Chile].
The Chilean Academy of Medicine designated a group of specialists to evaluate the practice and to propose reforms for organ donation and transplantation, due to the general insufficiencies at the national level with these procedures. In the last six years the mean number of organ transplants in Chile was 340 cases per year while effective cadaveric donors ranged between 6 and 10 per million inhabitants. These averages remained stable during this period and are among the lowest in the region. ⋯ The committee proposes several measures for improvement. These are a systematic and obligatory report of potential organ donors by all emergency and critical care centers, frequent evaluation of results, empowering of health authorities to correct insufficiencies in organ procurement, education programs for primary, secondary, technical and university students to improve their knowledge about the social significance and solidarity required for transplantation policies and specialized updated training of all health professionals involved. Organ donation and transplantation must be based on clear and fair ethical considerations in order to be accepted by the general public.