Revista médica de Chile
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Revista médica de Chile · May 2006
[Partial or total replacement of the aortic arch. Experience in 23 patients].
Surgery of the aortic arch is a very complex procedure since it requires protective strategies for the brain, heart and rest of the body. ⋯ There is a learning curve, where more extensive operations, particularly those done as emergency or for dissections, had an increased operative risk.
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Among critically ill patients, several physio-pathological processes such as global and local hypo-perfusion, hypoxia, endothelial injury and acidosis have been associated with the production and release of large amounts of reactive oxygen species (ROS) in a non regulated fashion. Although in physiologic conditions ROS influence intracellular processes and participate in the defense against infectious organism, in critically ill conditions they are associated with potential oxidative damage over cellular structures and with persistent activation of the inflammatory response. Mechanisms associated with oxidative damage are activation of the macrophage-monocyte system and neutrophils, ischemia-reperfusion events and intracellular ROS production. ⋯ Several studies show that in critically ill patients increase levels of ROS or reduction of antioxidant levels are related to disease severity. In animal models of critical diseases, antioxidant therapy has shown to reduce mortality. Nevertheless, there are few studies in humans that only show improvements in hemodynamic variables, reduction in inflammatory mediators levels, decreases in oxidized compounds and that suggest a lower incidence of multiple organ failure.
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Revista médica de Chile · May 2006
Case Reports[Recurrent left atrial myxoma. Report of a case in a 2 year-old boy].
Primary cardiac tumors are uncommon in pediatric patients. We report a two year-old boy, who presented a recurrent left atrial myxoma. He was referred for cardiologic evaluation because of cardiomegaly on a chest X-ray. ⋯ The tumor was uneventfully removed and the pathological examination confirmed a myxoma. He remained asymptomatic and during a follow up echocardiography two years later, a recurrent tumor was noted. He was successfully operated again, remaining free of a new recurrence after 3 years of follow up.
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Revista médica de Chile · Apr 2006
Case Reports[Antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis associated to the use of propylthiouracil. Report of four cases].
Antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis is an uncommon complication of the use of propylthiouracil. When it occurs, it affects multiple organs as any systemic vasculitis. ⋯ In three patients, a skin biopsy confirmed the diagnosis. The condition subsided when propylthiouracil was discontinued, but one female patient required the use of prednisone.
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Revista médica de Chile · Apr 2006
[The absence of brainstem reflexes does not predict short term mortality in anoxic ischemic coma].
Anoxic-ischemic coma has a poor outcome with a high rate of mortality and morbidity. Therefore, clinical predictors of prognosis are needed for therapeutic decision-making. ⋯ Thirty day survival in this group of patients was 29% and the absence of brainstem reflexes was not a predictor of mortality.