Revista médica de Chile
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Revista médica de Chile · Apr 2011
Case Reports[Rhabdomyolysis and acute renal failure after cocaine overdose: report of one case].
Rhabdomyolysis caused by cocaine abuse is multifactorial, involving tissue ischemia secondary to vasoconstriction and cellular damage caused by the drug. Renal failure may or may be not associated to rhabdomyolysis. ⋯ In spite of a vigorous hydration and alkalization, he developed acute renal failure. Renal function recovered after several weeks of dialysis.
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Revista médica de Chile · Mar 2011
Review[Vasoplegic syndrome and its treatment with vasopressin during cardiac surgery with cardiopulmonary bypass].
Cardiac surgery with cardiopulmonary bypass is associated with systemic inflammatory response. In some cases this clinical condition is characterized by severe hypotension due to low systemic vascular resistance during and after cardiopulmonary bypass. A few of these cases do not respond to volume or catecholamines. ⋯ Supplementary vasopressin improves blood pressure and might be considered as an alternative treatment. Several reports have shown benefits when used alone or in combination with catecholamines. However, further studies are necessary to find the most appropriate use of the drug for vasoplegic syndrome.
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Revista médica de Chile · Mar 2011
Review[Mechanical ventilation in patients with acute brain injury].
In about 20% of patients admitted to an Intensive Care Unit (ICU) the indication of mechanical ventilation (MV) is a neurological disease. These patients have a prolonged MV stay and high mortality. The appropriate use of MV in patients with acute brain injury (ABI) is critical considering that MV by itself is able to induce or worsen an underlying lung injury. ⋯ Its use should be limited to the emergency management of intracranial hypertension, while the underlying cause is being treated. Non-conventional ventilatory modes as prone position ventilation, high-frequency oscillatory ventilation and extracorporeal C02 removal can be used in patients with ABI. All of them have specific risks and should be employed cautiously This paper reviews upper airway management and MV in patients with acute brain injury.
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Efficient drugs against Chagas' disease must have an effect on the amastigote forms or intracellular reproduction elements of Trypanosoma cruzi (T. cruzi). Trypomastigote and epimastigote forms derive from the former and their response to medications is less marked. The only drugs used in humans are nifurtimox (NF) and benznidazole (BNZ). ⋯ Approximately 30% of patients will experience secondary effects. Children have a better tolerance to the drugs. Congenital or acquired acute, intermediate and chronic cases should be treated.
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There is a higher prevalence of eating disorders (ED) among adolescent females. These are less common in men and there are clinical differences between genders. ⋯ There was a delay in diagnosis of ED in men. The high prevalence of AN found in this group is characteristic of patients recently diagnosed with ED. Overweight could be a precipitating factor. Nearly two thirds of male ED patients had a psychiatric comorbidity. This high prevalence may suggest a susceptibility to develop ED in males.