Revista médica de Chile
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Revista médica de Chile · Jun 1999
Review[Effect of catecholamines on splanchnic perfusion in sepsis].
Splanchnic ischemia is frequent in sepsis and septic shock and is related to impairment in intestinal permeability, derangement in mucosal barrier functions and translocation of proinflammatory mediators. These changes can contribute to the pathogenesis of multiple organ failure. ⋯ On the other hand, epinephrine further impairs splanchnic perfusion. In view of the contradictory effects of different vasoactive drugs, gastric tonometry must be measured during their use, to find the optimal drug combination that optimizes splanchnic blood flow.
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The art of medicine was formed in Greece in close relationship to culture and philosophy. During the Christian era, it was projected through the Corpus Hippocraticus, in several ethical and philosophical documents such as The Oath of Medical Science, Medical Law, Decency, Precepts, Antique Medicine, Airs and Aphorisms, Waters and places. The central idea of Hippocratic philosophy is the principle of wholeness, summarized by Plato in the sentence "The certain knowledge of nature is solely possible from medicine and only when it is correctly approached as a whole". ⋯ The Hippocratic logic is probabilistic and temporal and rejects the principles of noncontradiction, of identity and therefore the abstract determinism of contemporary science. The present force of the oath is explained because its ethics and epistemology are matters of medicine that understands the real world of the ill, trying to avoid suffering and injustice. Only Hippocrates can defend each ill as a whole with the wisdom of its philosophy.
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Revista médica de Chile · Mar 1999
Historical Article[The first Chilean journal of psychiatry, neurology and forensic medicine].
This historical review refers to the first Chilean Journal of Psychiatry, Neurology and Forensic Medicine, that was published for the first time in July 1917, and allows to get acquainted of the knowledge level of those times. The publication was in charge of physicians from "Casa de Orates", the Clinic of Nervous and Mental diseases and the Chair of Forensic Medicine. ⋯ More than half of papers were of psychiatric topics, reviewing a disease or updating treatments. Analysis of psychiatric themes showed a special interest for problems related to hospital management and mental health.
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Revista médica de Chile · Feb 1999
Review[Ventilatory support in patients with acute disease of the central nervous system].
Patients with severe head injury are prone to pulmonary complications that result in hypoxemia or hypercarbia, which could worsen their neurological condition. A rational ventilatory approach requires a good knowledge of respiratory and neurological pathophysiology. ⋯ The use of low or moderate positive and expiratory pressure levels apparently improves oxygenation without worsening intracranial pressure. Ventilatory management should be closely monitored and adjusted to hemodynamic, respiratory and neurological status to achieve a good outcome.
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Revista médica de Chile · Feb 1999
[Congenital defects of antithrombin III and proteins C and S during pregnancy].
We report 10 patients with congenital deficiencies of the natural anticoagulant proteins S, C and antithrombin III. Thirteen of a total of 30 pregnancies were managed at the perinatal branch of our department. We discuss the mechanism of action of these proteins and their role in thrombotic events. We analyze the most frequent thrombotic complications and we discuss the general guidelines for the investigation of a patient with a suspected congenital thrombophilia with special regard to its management during pregnancy, delivery and perinatal outcome.