Revista médica de Chile
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Revista médica de Chile · Aug 2008
Multicenter Study[Characteristics and factors associated with mortality in patients receiving mechanical ventilation: first Chilean multicenter study].
The outcome of mechanically ventilated patients can be influenced by factors such as the indication of mechanical ventilation (MV) and ventilator parameters. ⋯ Conditions present at the onset of MV and ventilator management were similar to those reported in the literature. Magnitude of multiorgan dysfunction and high plateau pressures are the most important factors associated with mortality.
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The scope of clinical bioethics must be broadened to a social bioethics that tackles institutional and public health ethical problems and those related to the health system reform. The superficial application of the four bioethical principles is not enough to face these problems and assure a complete respect of individual rights. ⋯ We propose to incorporate these social issues to the academic bioethical discussion and to develop a bioethics with complementary principles that can be used to solve cases and in decision making. We should use the means incorporated in our legislation such as Assistance Ethics Committees, Research Ethics Committees and the National Bioethics Commission, to pursue our objectives).
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We report a 64 year-old male, living in a rural area, with a history of a thyroid nodule subjected to a fine needle aspiration 18 years ago. He consulted this time for a goiter associated to dyspnoea and dysphagia. A chest X-ray and a neck CAT scan showed a calcified nodule in the superior mediastinum of thyroidal origin, that displaced airways and blood vessels and a small thyroid nodule of uncertain origin. ⋯ The patient was operated, performing a subtotal thyroidectomy A calcified nodule measuring 8 x 6 x 6 cm and another nodule measuring 10 mm were found during the surgical exploration. The pathological examination of the surgical piece disclosed a calcified hydatic cyst and a focal nodular hyperplasia. The patient remains asymptomatic seven months after surgery.
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Revista médica de Chile · Jul 2008
Case Reports[McKittrick- Wheelock syndrome: report of one case].
Villous colorectal adenomas are common tumors that normally provoke scarce symptomatology. We report a 59 year-old female that was admitted with severe dehydration due to severe diarrhea lasting 10 days and vomiting in the last 48 hours. ⋯ In this patient, the fluid and electrolyte hypersecretion of the rectal villous adenoma provoked a depletion syndrome with serious hydroelectrolytic alterations, acute renal failure and hypovolemic shock. This syndrome was first described by McKittrick and Wheelock in 1954.