Revista Clínica Escuela de Medicina UCR-HSJD, Volumen 2, Número 2

URI permanente para esta colecciónhttps://hdl.handle.net/10669/14693

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    EVOLUCIÓN CLÍNICA DE LOS PACIENTES CON DIABETES MELLITUS SOMETIDOS A ANGIOPLASTÍA CORONARIA CON IMPLANTACIÓN DE STENT DE ENERO A DICIEMBRE DEL 2009 EN EL HOSPITAL SAN JUAN DE DIOS
    (2011-04-01 00:00:00) Monge Ortega, Patricia; Arauz Chavarría, Jorge
    Background: Percutaneous coronary angioplasty(PTCA) with stent placement is both safe and effective interventional treatment for ischemicheart disease. This disease has a high prevalenceand impact in the morbidity and mortality in the general population. The purpose of this study is to describe the outcomes obtained with PTCA/stent terapy at the San Juan de Dios Hospital during the period between January 2009 and December 2009. Methodology: A descriptive, retrospective and observational study was performed by collecting information from medical files of 268 patient streated with PTCA during the study period. Ananalysis of the outcomes was performed on those patients that met inclusion criteria. Results: We included 88 diabetic patients (62 males and 26 females). 18,3% of the patients haddyslipidemia, 49,8% were smokers and 87,5%had hypertension. In relation with previous procedures, 12,5% of the patients had one previous angioplasty and 2,3% had bypasssurgery. On average there were 1,4 ± 0,6 vessel streated, with a minimum of 1 vessel and amaximum of 3 vessels. On average there were 1,7 ± 1,0 stents perpatient, with a minimum of one and a maximumof five stents. The number of stents per treatedvessel was 1,3. Medicated stents were used in 89,4% of the cases. Succesful PTCA accountedfor 96,6% of the individuals (85 cases), and only6 patients (6,8%) had procedure related complications. Major cardiovascular events after PTCA ocurredun 23 patients (26,1%). Twentythree patients(26,1%) had major cardiovascular events after PTCA, and 39,1% of these, required another PTCA. There were two patients who were tratedfor two different lesions (9,33%) and 4,5% of the patients had reestenosis. A 3,4% (3 cases) dieafter the procedure due to cardiovascular causes (two cases because of cardiogenic shock and onecase because of advanced coronary arterydisease). The first two died during the firstmonth after the procedure and the other one die done year after the angioplastic procedure. Conclusion: Diabetic patients had higher risk ofthrombosis, restenosis, reintervention and overallmortality on both groups of stents.
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    DOLOR ABDOMINAL Y VÓMITOS EN UNA MUJER JOVEN.
    (2011-04-01 00:00:00) Vargas Solís, Sussy; Duarte Sancho, Paolo C.
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    HISTORIA DE LA REANIMACIÓN DEL PACIENTE QUEMADO
    (2011-04-01 00:00:00) Navarro Coto, José Francisco; Granados Quesada, Ronny; Jiménez Pereira, Eliécer
    Since it was proven in 1863 that fluid loss wasthe cause of death in burnt patients, a number offormulas and therapeutic options have beenestablished with the aim of improving thepatients’ survival. The Parkland ́s formula andthe use of Ringer’s lactate have been the twomethods with the best results. The use of colloidsand hypertonic solutions as well as gelatins havebeen analyzed however, there hasn’t been animprovement in the patient’s survival on thecontrary, the adverse effects have beendocumented in various revisions and clinicaltrials.  
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    MASCULINO 58 AÑOS, DIABÉTICO E HIPERTENSO CON CUADRO SUBAGUDO DE CERVICALGIA, PARESTESIAS Y DEBILIDAD EN MIEMBROS SUPERIORES QUE EVOLUCIONA A TETRAPARESIA ESPÁSTICA
    (2011-04-01 00:00:00) Ávila Sánchez, Diego; Barguil Meza, Ibrahim
    A 58 years old male, with history of diabetesmellitus and hypertension whom presented to ourhospital with subacute neck pain and paresthesias of upper limbs, complicated later with cervicalcord syndrome. There was evidence of C6-C7 vertebral osteomyelitis and cervical instability.Debridement was performed, along with stabilization and repair of the cervical spine. Blood andbone cultures were negative and empirical therapy with parenteral vancomycin (4-week course) was started, followed by oral ciprofloxacin (4-weeks course). Clinical evolution was satisfactory.