Revista médica de Chile
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Revista médica de Chile · Dec 2001
Review[Febrile neutropenia in the child with cancer. Current concepts about risk assessment and selective management].
The risk for invasive bacterial infection (IBI) in cancer pediatric patients with febrile neutropenia, is variable. Clinicians worldwide are increasingly considering selective strategies for children at low risk for IBI, including shortened antimicrobial course, early hospital discharge, oral antimicrobial treatment, and management as outpatients. These strategies would significantly benefit these children and health care systems. ⋯ During 1996-1997 we identified risk factors of IBI in a group of 447 febrile neutropenic episodes. During 1999-2000 we validated these risk factors in a prospective study that included 263 febrile neutropenic episodes. A model of risk prediction was developed and is currently being evaluated for the selection of low risk patients who are treated as inpatients for 24 hours, followed by outpatient treatment.
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Revista médica de Chile · Oct 2001
[The six minute walking test elicits lung hyperinflation in patients with severe chronic obstructive lung disease].
Exercise tolerance in patients with COPD is highly variable and poorly related to airways obstruction assessed by FEV1. These patients develop dynamic hyperinflation (DH) during an incremental exercise test which can be evaluated through a reduction in inspiratory capacity (IC). ⋯ Our results demonstrate that a moderate exercise such as the walking test induces DH and hypoxemia in patients with COPD and FL and stresses the importance of assessing DH by measuring IC in these patients.
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Revista médica de Chile · Oct 2001
Case Reports[Massive pericardial effusion and cardiac tamponade as the presentation form of hypothyroidism].
We report a 43 years old female, admitted due to fatigability, asthenia and diffuse abdominal pain. On admission, obesity, slowness of thinking, bradycardia, distention of jugular veins and ascites were observed on physical examination. ⋯ A pericardial tap was performed, draining 350 ml. Thyroid hormone substitution was started and after 12 months of follow up, the heart size decreased and a control echocardiogram showed a minimal pericardial effusion.
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Revista médica de Chile · Sep 2001
Comparative Study[Problem based learning in the teaching of physics to medical students. Comparison with traditional teaching].
Problem based learning, integrating basic science with clinical problems, is one of the most recommended forms of teaching for medical schools. ⋯ Physics education, using problem based learning, obtains the same cognitive results but a higher degree of satisfaction than traditional teaching among students.
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Revista médica de Chile · Aug 2001
Review Case Reports[Gemcitabine in the treatment of 4 patients with cholangiocarcinoma].
Cholangiocarcinoma is a biliary tree cancer of unknown etiology, whose symptoms are unspecific and is usually detected in advanced stages. Surgery continues to be the only curative therapy. Median survival in patients with inoperable tumors ranges between 5 and 8 months. ⋯ We report four patients with advanced cholangiocarcinoma, treated with gemcitabine 1000 mg/m2, weekly for 3 weeks every 28 days. There was a stabilization of tumor size and symptoms were alleviated. Toxicity was low and there was a probable prolongation of survival.