Revista médica de Chile
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Revista médica de Chile · Apr 1991
Case Reports[Aseptic meningitis following spinal anesthesia. Report of a case].
Aseptic meningitis after lumbar puncture and spinal anesthesia is a rare but serious complication, whose acute onset and clinical symptoms mimic septic meningitis. A 33 year old woman presented this complication 5 h after an uneventful cesarean section under subarachnoid blockade. ⋯ The clinical picture, differential diagnosis and value of early lumbar puncture are discussed. The successful use of midazolam to treat psychomotor agitation in this patient is also reported.
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Revista médica de Chile · Dec 1990
Case Reports[The value of cerebral biopsy in patients with AIDS and extensive cerebral lesions].
We performed cerebral biopsy in 4 patients with AIDS and evidence of expanding intracerebral lesions. Three patients had cerebral toxoplasmosis and the fourth had Chagas encephalitis. No patient developed complications. We feel that cerebral biopsy is warranted and safe in patients with AIDS and intracerebral lesions of uncertain origin.
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We report 6 patients with Munchausen syndrome, a fictitious disorder with physical symptoms. There were 4 females and 2 males, the age ranged from 21 to 29 years. ⋯ Two patients were ill enough to be at risk of death. An early diagnosis may help prevent unnecessary or risky procedures in these patients.
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Revista médica de Chile · Oct 1990
Review[The admission and discharge criteria of a unit for critical patients].
Admission and discharge criteria for patients in an intensive care unit are controversial, especially in view of the fact that some patients derive no benefit from intensive care therapy while depriving others from a potential benefit. The general characteristics of patients in need of intensive care are discussed. Irreversibility of the underlying condition, the quality of "terminal patient" and other factors that may contraindicate admission to an intensive care unit are analyzed. Discharge criteria for patients not expected to derive further benefit from a prolonged stay in the unit are outlined.
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Revista médica de Chile · Jun 1990
[Prolonged hospitalization in the intensive care unit: a worthless effort?].
Hospitalization of a patient in critical care unit for over a month is exceptional and often raises the question of an irreversible disease process. From 2715 consecutive patients admitted to an intensive care unit in the last 4 years we identified 20 patients remaining in the unit for over a month. ⋯ None of the complications developing or the therapeutic procedures used in the first 3 weeks predicted the outcome. In contrast, the presence of respiratory failure, septic shock, requirement of ventilation or parenteral nutrition at day 30 was highly associated with mortality.