Revista médica de Chile
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Revista médica de Chile · Sep 2019
Case Reports[Continuous intra arterial nimodipine for vasospasm secondary to subarachnoid hemorrhage. Report of one case].
We report a 39-year-old male with an aneurysmal subarachnoid hemorrhage without hydrocephalus, in whom a right choroidal aneurysm was early excluded by endovascular coil insertion. Intracranial pressure (PIC) and cerebral oxygenation (PtiO2) sensors for neuromonitoring were installed due to a persistent comatose state. From the 3rd day, neuromonitoring became altered. ⋯ Finally, the infusion was stopped at day 15 without significant complication. We conclude that intra-arterial nimodipine continuous infusion in refractory VE can be useful and safe in selected patients. Multimodal neuromonitoring is essential.
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Revista médica de Chile · Sep 2019
[Spirituality in medicine. An analysis of Christina Puchalki's writings].
The relationship between spirituality and medicine is present from the very origins of Medicine. Its relevance has been rediscovered during the past decades. Numerous publications report positive health results when spiritual needs of patients are addressed. ⋯ Our analysis shows that Puchalski's arguments are ultimately grounded on an ethics of virtue and a realist anthropology, more than in mere positive effects or in patient's wishes. Indeed, Puchaslki's anthropological conception recognized human dignity as an intrinsic value that must be always acknowledged, especially in the context of disease, where questions about the meaning of life, suffering, connection and transcendence inevitable arise. We conclude that Puchalski's ethical arguments are solid and suggest the challenge of including the spiritual dimension in the formation of health care professionals.
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Revista médica de Chile · Sep 2019
[Use of sodium-glucose cotrasporter 2 inhibitors in type 2 diabetics. Experience in 77 patients].
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a new pharmacological alternative for the treatment of diabetes. ⋯ The effects observed in this study are comparable and of similar magnitude to randomized studies of SGLT2i reported in the international literature.
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Revista médica de Chile · Sep 2019
[Prion induced spongiform encephalopathy of Creutzfeldt-Jakob disease].
The infectious protein or prion (PrPSC) is a transmissible and replicable polypeptide, which arises from an abnormal folding of the PrP protein, by unknown mechanisms and without changes in the primary sequence of its amino acids. Its new spatial disposition arises from the substitution of its alpha helices by beta bands, which increase its structural stability, avoiding its complete proteolysis, resulting in a residual accumulation of prions. These prions induce the misfolding of normal PrP protein, generating their exponential increase, leading to a disturbance of neuronal homeostasis which results in the development of the fatal spongiform encephalopathy of the Creutzfeldt-Jakob disease (CJD). ⋯ The Classical form of CJD produced by MM1 prion occurs in 70% of the cases. The Cerebellar form originated by the VV2 prion occurs in 15% of cases, the form with Kuru plates, associated with the prion MV2 occurs in 5%, and the Vacuolar, related to the MM2 prion occurs in 4%. CJD is always characterized by behavioral, motor, cognitive, and vision alterations and by findings in magnetic resonance imaging, electroencephalogram and cerebrospinal fluid that define each clinical and neuropathological form.
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Revista médica de Chile · Sep 2019
[Surgical complications in cirrhotic patients. Analysis of 102 cases].
Cirrhotic patients have an increased surgical risk due to potential intra and postoperative complications. ⋯ In these patients, surgical complications were common, although with low mortality.