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Biomedical subjects

A Bertrán

Publications and source records attributed to A Bertrán.

17 recordsLinked to original sources

[Logistic model for predicting the prognosis in patients with intra-abdominal infection based on the APACHE II index].

BACKGROUND: The APACHE II method has been widely used to classify patients according to disease severity. The high mortality and the lack of reliable prognostic parameters justify the study and application of indexes of severity (IS) and prognostic indexes (PI) in patients with intraabdominal sepsis. METHODS: A prospective study is presented concerning 100 patients with intraabdominal sepsis in whom a prognostic index derived from the APACHE II method by means of a logistic regression model was applied. In this model the APACHE II score is used as the only independent variable with the aim of predicting the outcome (mortality or survival) at the time of hospital admission. RESULTS: The predictive values obtained, with a 70% probability of mortality taken as the cut-off point, were: sensitivity 100%, specificity 87.7% and total predictive capacity 91%. CONCLUSIONS: It was concluded that the logistic prediction model of prognosis shows a high correlation with patient outcome and the application of the APACHE II score is useful in patients with intraabdominal infection.

Abdomen↗

[Failure of a cyclophosphamide-dexamethasone combination in paraquat poisoning].

A 37-year-old female deliberately ingested a 20% solution of paraquat in water. One hour later gastric lavage was carried out and bentonite was administered. Five hours later cyclophosphamide (5 mg/kg/day) and dexamethasone (24 mg/day) were started and a continuous intestinal lavage was carried out; four hours later, hemodialysis was begun. After 36 hours, features of renal and respiratory failure developed, with a rapid progress to respiratory distress. The patient died 94 hours after the ingestion of the poison. Despite early therapy with dexamethasone and cyclophosphamide, this patient's evolution does not support the presumed effectiveness of this drug association for paraquat poisoning.

Adult↗

Acute thallium poisoning: an evaluation of different forms of treatment.

Hemodialysis, forced potassium diuresis, chelating agents per os, and Dithiocarb given intravenously during short periods of time were used for the treatment of acute thallium poisoning (ingestion of 750 mg of thallium sulfate), and the effectiveness of these different therapeutic procedures was analyzed. Chelating agents per os (Prussian blue, Dithiocarb, and Dithiozone) were ineffective in our patient, since fecal excretion of thallium was very low and unmodified by them. Forced potassium diuresis and hemodialysis were very useful therapeutic measures, especially in the first 12 days following ingestion. Dithiocarb perfusion seems to be the most effective method for enhancing urinary thallium excretion. This method might be most useful in the treatment of thallium poisoning if its deleterious effects could be eliminated.

Acute Disease↗

[Oliguric and non-oliguric renal failure in high risk patient in intensive care units (author's transl)].

Oliguric and non-oliguric acute renal failure was studied in a group of 28 high risk patients in an intensive care unit. Of these, 15 (53.5%) presented oliguric and 13 (46.4%) non oliguric acute renal failure. Causal agents of the renal failure were postoperative in 14 cases, mainly peritonitis; medical in 10 and posttraumatic in 4. Oliguric renal failure was most commonly medical, while non-oliguric renal failure was predominantly postoperative in origin (p less than 0.05). Results of urinalysis indicative of renal failure were similar in both groups: NAO, osmolarity, FeNa, BUN o/p and creatinine o/p, as were degree and course of renal failure, and the appearance of complications and indications for dialysis. There was no significant difference in mortality rate between oliguric (93%) and non-oliguric (85%) patients; total mortality was 89%. The results of this study clearly show that non-oliguric acute renal failure carries the same poor prognosis in high risk patients in intensive care units as do the oliguric forms of the entity.

Acute Kidney Injury↗

Metabolic acidosis and coma due to an overdose of nalidixic acid.

A case of severe metabolic acidosis and coma after taking 28 g of nalidixic acid is described. After administration of 600 mEq of sodium bicarbonate the patient developed a respiratory alkalosis with secondary tetany. She recovered her state of consciousness nine hours later and the acid-base disturbance resolved after sixty hours.

Acidosis↗

Acute renal failure in a patient treated by continuous povidone-iodine mediastinal irrigation.

Polyvinylpyrrolidone-iodine (PI) is a widely used antiseptic agent, safe and effective, in the treatment and prophylaxis of wound sepsis. By continuous irrigation it is frequently used to treat suppurative mediastinitis after median sternotomy. We describe a 63 year old woman with a suppurative mediastinitis, treated with continuous PI irrigation who developed an acute oliguric renal failure. The withdrawal of PI was followed by a complete improvement of renal function. Herein we present our case and a review of the literature about the systemic toxicity of PI.

Acute Kidney Injury↗