Revista médica de Chile
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Revista médica de Chile · Jun 1998
[Inferior vena cava filters. Indications and results in 111 patients].
Anticoagulation is the treatment of choice for deep vein thrombosis and pulmonary embolism. Occasionally this treatment is contraindicated or fails to prevent pulmonary embolism. In these patients, inferior cava vein interruption is indicated and filter insertion is the procedure commonly performed. ⋯ Inferior cava vein filter insertion is a safe measure to prevent pulmonary embolism and its consequences.
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The case of a pregnant patient who had a massive intracraneal haemorrhage at 18 weeks of gestation is presented. Patient's neurological damage evolved to brain death, but the fetus continued in good condition. The decision of withdrawing life support or to continue supporting the mother's life to allow fetal development aroused difficult ethical questions, both to relatives and professionals. ⋯ The conclusion was that the continuation of life support treatments was not an ethical obligation. Withdrawing life support to allow fetal death in this case means foregoing an experimental treatment and to respect family's autonomy and the right of the patient's death with dignity. Similar cases need to be discussed with a multidisciplinary analysis in their own particularity.
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Bioethics arose in a delicate social and political moment in the United States of America. With time, it has become a social and perhaps political movement. Its scope is wider and different than that of medical ethics. ⋯ The emphasis in the principle of autonomy that some specialists in bioethics pose, even over the principle of beneficence, is determined, according to our judgment, by inherent factors of the North American culture. We believe that medical ethics should be distinguished even though not separated from bioethics. Physicians should go back to the Hippocratic oath as the fundamental guide for their professional activity.
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Revista médica de Chile · Nov 1997
[Diabetic neuropathy: thermal sensation and metabolic control in non-insulin-dependent diabetics].
The early detection of peripheral neuropathy in diabetics is important since it is the main risk factor for lower limb trophic lesions in diabetics. ⋯ In this group of diabetics, there is a relationship between the severity of distal polyneuropathy and the metabolic control, assessed with glycosylated hemoglobin levels.
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Revista médica de Chile · Sep 1997
Randomized Controlled Trial Clinical Trial[Nocturnal hypoxemia after abdominal surgery: associated factors and usefulness of oxygen therapy].
Postoperative nocturnal hypoxemia (PONH) is a main factor in the genesis of respiratory, cardiac and neurologic complications after surgery. ⋯ PONH is a common event in patients older than 40 years scheduled for open or laparoscopic abdominal surgery, and develops more frequently in those with preoperative nocturnal hypoxemia and greater ventilatory impairment. PONH can be prevented, most of the time, with oxygen administration.