Revista médica de Chile
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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.
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Revista médica de Chile · May 1990
Review Case Reports[Lymphomatoid granulomatosis: a clinical case].
A 49 year old woman with a fluctuating painful ophthalmoplegia and a history of polyarthralgia is reported. On examination, additional findings included a maxillary subcutaneous infiltration, sphenoidal sinusitis and pulmonary nodes. Lung and sinus biopsy demonstrated findings compatible with lymphomatoid granulomatosis. The patient was treated with prednisone and cyclophosphamide, with good response of neurological and dermatological findings.
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Revista médica de Chile · Mar 1990
Case Reports[Acute post-partum infarct of the myocardium secondary to a spontaneous dissection of the coronary artery].
A 38 year-old woman had an anterolateral wall myocardial infarction and acute left ventricular failure 11 days after a cesarean section. Coronary angiography performed 14 days later because of recurrent angina disclosed dissection of the left main coronary artery. She subsequently underwent aorto coronary bypass surgery uneventfully. Spontaneous coronary artery dissection is a rare entity that mainly affects women in peripartum periods and presents a high mortality rate.
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Revista médica de Chile · Mar 1990
Case Reports[Use of a specific DNA probe to confirm sickle cell anemia in a caucasian woman].
A specific DNA probe containing part of the structural B-globulin gene was used to confirm the diagnosis of sickle cell anemia in a caucasian woman. The patient's genomic DNA was digested with the restriction endonuclease Dde I, fractioned by agarose electrophoresis and Southern blotting. Molecular hybridization was performed with the DNA probe prepared by chemical labelling with photobiotin. ⋯ Upon digestion with Dde I, the DNA of an individual with the normal genotype containing the enzyme recognition sequence at the site of sickle cell mutation, resulted in 2 fragments of 201 and 175 bp. The pedigree of the patient's caucasian family was studied by Hb electrophoresis. Four out of 7 brothers carried the sickle cell trait.