Revista médica de Chile
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Revista médica de Chile · Mar 2011
Review[Vasoplegic syndrome and its treatment with vasopressin during cardiac surgery with cardiopulmonary bypass].
Cardiac surgery with cardiopulmonary bypass is associated with systemic inflammatory response. In some cases this clinical condition is characterized by severe hypotension due to low systemic vascular resistance during and after cardiopulmonary bypass. A few of these cases do not respond to volume or catecholamines. ⋯ Supplementary vasopressin improves blood pressure and might be considered as an alternative treatment. Several reports have shown benefits when used alone or in combination with catecholamines. However, further studies are necessary to find the most appropriate use of the drug for vasoplegic syndrome.
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Revista médica de Chile · Mar 2011
Review[Mechanical ventilation in patients with acute brain injury].
In about 20% of patients admitted to an Intensive Care Unit (ICU) the indication of mechanical ventilation (MV) is a neurological disease. These patients have a prolonged MV stay and high mortality. The appropriate use of MV in patients with acute brain injury (ABI) is critical considering that MV by itself is able to induce or worsen an underlying lung injury. ⋯ Its use should be limited to the emergency management of intracranial hypertension, while the underlying cause is being treated. Non-conventional ventilatory modes as prone position ventilation, high-frequency oscillatory ventilation and extracorporeal C02 removal can be used in patients with ABI. All of them have specific risks and should be employed cautiously This paper reviews upper airway management and MV in patients with acute brain injury.
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Efficient drugs against Chagas' disease must have an effect on the amastigote forms or intracellular reproduction elements of Trypanosoma cruzi (T. cruzi). Trypomastigote and epimastigote forms derive from the former and their response to medications is less marked. The only drugs used in humans are nifurtimox (NF) and benznidazole (BNZ). ⋯ Approximately 30% of patients will experience secondary effects. Children have a better tolerance to the drugs. Congenital or acquired acute, intermediate and chronic cases should be treated.
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Revista médica de Chile · Sep 2010
Review[Review on periodontal disease and metabolic control of diabetes mellitus].
There may be an interaction between periodontal disease and some systemic diseases such as diabetes mellitus. The objective of this review was to verify, by means of a review of clinical trials, if there is a positive association between periodontal disease and the glycemic control of type 2 diabetes mellitus (DM-2) patients. ⋯ It was concluded that periodontal disease may influence the metabolic control of DM-2. Additional studies with larger sample sizes and longer follow up are necessary for a better clarification of this issue.
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Revista médica de Chile · Apr 2010
Review[Current management strategies for pulmonary hypertension in surgical patients].
Pulmonary hypertension is a clinical condition with a low prevalence, but carries high morbidity and mortality. Important advances in the understanding of this disease and in its therapy have occurred. A particular scenario is pulmonary hypertension in patients undergoing non-cardiac as well as cardiac surgery. The aim of this review is to present information that may allow diagnostic and therapeutic approaches of this clinical condition in patients undergoing surgery.