Revista médica de Chile
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Revista médica de Chile · May 2007
Multicenter Study[Prevalence of severe sepsis in intensive care units. A national multicentric study].
Severe sepsis (SS) is the leading cause of death in the Intensive Care Units (ICU). ⋯ SS is highly prevalent in Chilean ICUs and represents the leading diagnosis at admission. SS as cause of hospitalization, APACHE II and SOFA scores were independent predictors of mortality.
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Revista médica de Chile · Apr 2007
Editorial[Honesty and good faith: two cornerstones in the ethics of biomedical publications].
The editors of medical journals should take the steps necessary to assure its readers that the contents of their publications are based in true data, that they are original and fulfill the ethical rules of biomedical and clinical research, including its reporting. This editors role has become increasingly difficult since the pressure to publish scientific papers is progressively stimulated by the role that those papers play in curricula vitae when the authors apply for university positions, academic promotions, research grants and for their personal prestige. As a consequence, increasing instances of misconduct in scientific publications are detected. ⋯ The editors should denounce the situation in a forthcoming issue of the journal. Universities should enforce the teaching of ethical rules that govern the report of scientific information. Revista Médica de Chile follows recommendations given by the International Committee of Medical Journal Editors, the World Association of Medical Editors and other groups, but honesty and good faith in all the actors involved in the process of biomedical publications (authors, reviewers, editors) remain the cornerstones of scientific good behavior.
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Revista médica de Chile · Apr 2007
Review[Predictive value of history and physical examination for the diagnosis of community-acquired pneumonia in adults: a literature review].
Distinguishing pneumonia from other causes of respiratory illnesses, such as bronchitis, influenza and upper respiratory tract infections, has important therapeutic and prognostic implications. This decision is usually made by clinical assessment alone or by performing a chest x-ray. The reference standard for diagnosing pneumonia is chest radiography, but many physicians rely on history and physical examination to diagnose or exclude this disease. ⋯ Prediction rules have been recommended to guide the order of diagnostic tests, to maximize their clinical utility. Thus, some studies have shown that the absence of any vital sign abnormalities or any abnormalities on chest auscultation substantially reduces the likelihood of pneumonia to a point where further diagnostic evaluation may be unnecessary. This article reviews the literature on the appropriate use of the history and physical examination in diagnose community-acquired pneumonia.
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Revista médica de Chile · Mar 2007
[Mechanical ventilatory parameters guided by the low flow pressure-volume curve in patients with acute lung injury/acute respiratory distress syndrome].
Mechanical ventilation may contribute to lung injury and then enhance systemic inflammation. Optimal ventilatory parameters such as tidal volume (VT) and positive end expiratory pressure (PEEP) can be determined using different methods. Low flow pressure volume (P/V-LF) curve is a useful tool to assess the respiratory system mechanics and set ventilatory parameters. ⋯ P/V-LF curves information allowed us to adjust ventilatory parameters and optimize gas exchange without detrimental effects on oxygen delivery in mechanically ventilated ALI/ARDS patients.
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Revista médica de Chile · Mar 2007
Case Reports[Hypocalcemic cardiomyopathy secondary to hypoparathyroidism after a thyroidectomy: report of one case].
Calcium plays a central role in ventricular function. We report a 37 year-old woman with chronic hypoparathyroidism and hypocalcemia secondary to a thyroidectomy performed when she was 18 years old, as treatment for a Graves Basedow's disease. ⋯ Calcium supplementation in addition to diuretics, captopril and digoxin were followed by rapid clinical improvement. Follow up until 18 months showed persistent left ventricular dilatation and systolic dysfunction, with improvement of all the other echocardiographic findings.