Revista médica de Chile
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Revista médica de Chile · Feb 2012
Case Reports[Type B lactic acidosis associated with marginal lymphoma of the spleen: report of one case].
Lactic acidosis in the absence of hypoxia or tissue hypoperfusion (type B) is very rare and is associated with the use of some drugs or malignancy. We report a 79-year-old woman, with a marginal non-Hodgkin's lymphoma of the spleen that was subjected to a splenectomy one year ago. She presented with unexplained tachypnea associated with pancytopenia and elevation of IgM to 10 times over the higher normal limit. ⋯ She was treated with sodium bicarbonate and steroids without obtaining a reduction in lactate levels. Twelve days after admission, a single dose of Rituximab quickly normalized lactate concentrations and platelet count. After the fourth dose of Rituximab, pancytopenia disappeared and IgM fell to 25% of its baseline concentration.
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Revista médica de Chile · Feb 2012
[Assessment of arterial damage by noninvasive peripheral arterial tonometry in non-diabetic hemodialysis patients].
Hemodialysis patients (HD) display high rates of cardiac disease and mortality. The cardiovascular morbidity and mortality of HD patients is attributable in a significant proportion to endothelial dysfunction, arterial stiffness, and vascular calcifications. ⋯ Noninvasive assessment of peripheral vascular function may be useful for the identification of patients at risk for late cardiac events.
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Revista médica de Chile · Feb 2012
Case Reports[Prolonged hypothermia in refractory intracranial hypertension. Report of one case].
The use of hypothermia after cardiac arrest caused by ventricular fibrillation is a standard clinical practice, however its use for neuroprotection has been extended to other conditions. We report a 23-year-old male with intracranial hypertension secondary to a parenchymal hematoma associated to acute hydrocephalus. An arterial malformation was found and embolized. ⋯ After 12 hours of hypothermia, intracranial pressure was controlled. After 13 days of hypothermia a definitive control of intracranial pressure was achieved. The patient was discharged 40 days after admission, remains with a mild hemiparesia and is reassuming his university studies.
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Revista médica de Chile · Jan 2012
[Glycemic control in diabetic patients hospitalized in a non-critical care hospital setting].
During hospitalization, hyper and hypoglycemia impairs the prognosis of diabetic patients. Strict glycemic control improves survival in intensive care units. There is no evidence to support it for patients in non-critical wards. ⋯ Two of three diabetic patients admitted to our non-critical medical ward have a non-optimal glycemic control. Appearance of hypoglycemia is associated with a longer hospital stay.
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Revista médica de Chile · Jan 2012
[Basic cardiopulmonary resuscitation: knowledge, practical skills and effectiveness of maneuvers of general physicians].
General physicians should be adequately trained to deliver effective resuscitation during ventricular fibrillation (VF). ⋯ Despite an elevated degree of knowledge about key aspects of CPR, this group of Chilean physicians displayed suboptimal practical skills while performing CPR in a simulated scenario, specially delivering effective chest compressions and promptly asking for and using the defibrillator.