Revista médica de Chile
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Revista médica de Chile · May 2015
Review[Non-celiac gluten sensitivity: Another condition that responds to gluten].
Remission of gastrointestinal and general symptoms after gluten withdrawal has been described in some non-celiac individuals for nearly 30 years. Only recently, efforts have been made to define this entity, now referred to as "non-celiac gluten sensitivity". It includes patients that clinically respond to gluten free diet without exhibiting allergic or autoimmune features to explain such response. ⋯ Genetic and immune factors, changes in intestinal microbiota and non-gluten components present in wheat grains are main factors postulated in the pathogenesis of this condition. To date, there are no specific biomarkers for non-celiac gluten sensitivity and diagnosis is reached by excluding other causes of disease. A trial with gluten-free diet and subsequent gluten challenge is the methodology most frequently used to confirm diagnosis.
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Lack of adherence with medications is the main cause of antihypertensive treatment failure. ⋯ Only half of hypertensive patients comply with their antihypertensive therapy.
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Suicide is a complex phenomenon that has accompanied human beings throughout history. Its strong association with mental disorders led to its medicalization and psychiatrists became the physicians in charge of diagnosing and treating patients at risk of suicide. This article discusses the potential limitations that psychiatrists may face when diagnosing suicide risk and providing optimal care. ⋯ We propose that although diagnosing and adequately treating patients at risk of suicide would be the psychiatrist's responsibility, the act of suicide itself is personal and non-transferable. Considering the latter as part of the medical team's responsibilities would turn working with patients with mental disorders into a fearless act. Finally, suicide should be considered to be part of the natural history of the evolution of many mental disorders and, thus, should constitute a specific topic when training specialists.
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Revista médica de Chile · Apr 2015
Case Reports[Intracranial sinus venous thrombosis in ulcerative colitis. Report of one case].
Intracranial sinus venous thrombosis (ICSVT) is a rare complication of ulcerative colitis that affects from 1.7 to 7.5% of patients. We report a 22 year-old male with ulcerative colitis in treatment with mesalazine and prednisone presenting with headache and speech disturbances. ⋯ Anticoagulation with heparin was started which was changed to oral anticoagulation with warfarin. The patient was discharged ten days after admission.