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Biomedical subjects

M Andresen

Publications and source records attributed to M Andresen.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Improving the editing of medical journals and the World Association of Medical Editors (WAME)].

Medical journal editing is a task with many facets. The role of the editors includes organizing and evaluating a peer-review system as a main tool for their decision making in selecting manuscripts to be published. The International Congress on Biomedical Peer Review and Global Communications was held in September, 1997, in Prague, Czech Republic, organized by JAMA, the BMJ and Project HOPE, and sponsored by several other organizations. A meeting of the World Association of Medical Editors took place during this Congress and its institutional objectives and membership were discussed and enlarged, based on the previous foundation Conference held in Bellagio, Italy, in March 1995. The main goals of this Association: "To facilitate worldwide cooperation and communication among editors of peer-reviewed medical journals; to improve editorial standards, to promote professionalism in medical editing through education, self-criticism and self-regulation; and to encourage research on the principles and practices of medical editing" were accomplished in a warm and friendly atmosphere, with over 300 participants from 46 countries and every continent. Revista Médica de Chile was represented in these meetings by its former and present Editors. An analysis of the meetings by the editorial team will lead to changes intended to improve the editorial process in our journal.

Peer Review↗
PubMed1996

[Prolonged inhalation of nitric oxide in adult respiratory distress syndrome in a case].

Inhalation therapy with nitric oxide has been suggested as beneficial in the adult respiratory distress syndrome, however there are few reports of its prolonged use. We report a patient with a chronic lymphocytic leukemia that developed an adult respiratory distress syndrome with severe hypoxemia, refractory to conventional therapeutic measures, during the course of a septic shock. The patient received nitric oxide (19 ppm) improving arterial oxygen saturation and allowing the reduction of FiO2 to 40%. The patient died five days later due to a multiple organ failure.

Aged↗
PubMed1996

[Inhibition of the nitric oxide pathway in refractory septic shock].

AIM: To assess the acute effects of methylene blue infusion, an inhibitor of nitric oxide synthesis, on hemodynamic parameters in patients with refractory septic shock. PATIENTS AND METHODS: Fourteen patients admitted to intensive care units with septic shock of diverse etiologies and unable to maintain median arterial pressures over 60 mm Hg with the use of at least 2 vasoactive drugs, were studied. All received a 1 mg/kg bolus of methylene blue Hemodynamic parameters were measured before and 30, 60, 120 and 180 min after the bolus. RESULTS: Systolic and diastolic blood pressure and systemic vascular resistance increased in all patients. There were no significant changes in cardiac output, oxygen consumption or extraction. CONCLUSIONS: Methylene blue has an acute pressor effect in patients with septic shock.

Adult↗
PubMed1996

[Patients with acute adult respiratory distress syndrome: effects of inhaled nitric oxide on gas exchange and hemodynamics].

BACKGROUND: Adult respiratory distress syndrome is highly prevalent in intensive care units and has a high mortality. Lately, nitric oxide has been used as adjuvant therapy. AIM: To study the effects of nitric oxide inhalation in patients with adult respiratory distress syndrome. PATIENTS AND METHODS: Twelve patients with adult respiratory distress syndrome, were subjected to nitric oxide inhalation at a concentration of 10 parts per million, during 30 minutes. RESULTS: At the end of the nitric oxide inhalation period, there was an improvement of PaO2/FIO2 ratio from 89 +/- 32 to 111 +/- 43 mm Hg and a 16% reduction of lung shunting (Qs/Qt). CONCLUSIONS: Nitric oxide inhalation at a concentration of 10 parts per million improved arterial oxygenation and reduced pulmonary shunting in patients with adult respiratory distress syndrome.

Administration, Inhalation↗
PubMed1995

[Vital prognosis in severe acute hepatic failure. Value of the quantitative indexes of evaluation].

The aim of this study was to assess the predictive value for mortality of admission and daily APACHE II score, mortality due to multiple organ failure and the Organ Failure Score in patients with acute hepatic failure. We retrospectively studied 15 such patients admitted to an intensive care unit. Thirteen patients died (87%) and their admission APACHE II score was 22 +/- 7.5 compared to 21 +/- 8.5 in survivors. Daily APACHE II score, mortality due to multiple organ failure and multiple organ failure score had a 100% sensitivity to predict mortality and a 69.2, 76.9 and 76.9% specificity respectively. The predictive accuracies of multiple organ failure and multiple organ failure score were 80% and significantly better than the accuracy of admission APACHE II score (53%). We conclude that these prognostic scores can be useful in the assessment of patients with acute hepatic failure.

APACHE↗
PubMed1994

[Multiple organ failure syndrome in fulminant hepatic failure].

BACKGROUND: in fulminant hepatic failure, different organs systems become involved and a multiple systems organic failure may ensure. AIM: to perform a retrospective analysis of patients with fulminant hepatic failure admitted to UC Hospital Intensive Care Unit. PATIENTS AND METHODS: the charts of fourteen patients (8 male) were analyzed. Multiple systems organic failure was defined as the presence of 2 or more organic dysfunctions. The evolution and mortality of these patients was analyzed. RESULTS: patient's ages ranged from 30 to 74 years. The etiology of hepatic failure was B hepatitis in 4, non A non B hepatitis in 5, acute fatty liver of pregnancy in 3 and use of halothane and HIN in 2. ICU stay ranged from 1 to 44 days and 2 patients survived (one with drug induced liver failure and one with acute fatty live of pregnancy). Mean prothrombin time was 19 +/- 9.5%, total bilirrubin was 24 +/- 8.9 mg/dl and 12 patients reached grade IV encephalopathy. Mean admission APACHE II score was 21.5 +/- 6. Twelve patients developed multiple systems organic failure, that appeared 1.5 days after or was already present at ICU admission; it lasted a mean of 2.5 days and all these 12 patients died. Neurologic involvement occurred in 13 patients, renal in 10, cardiovascular in 9, respiratory in 5 and hematological involvement in 1. CONCLUSIONS: multiple systems organic failure is frequent in fulminant hepatic failure and is associated with a high mortality.

Adult↗
PubMed1993

[Mortality in an intensive care unit: predictive value of APACHE II severity score versus maximum APACHE].

Patients admitted to intensive care units (ICU) experience constant changes in their general condition. Therefore, the determination of Apache score within the first 24 hours of admission may not be a reliable index of severity. The aim of this study was to measure daily Apache scores in ICU patients, and to determine if the maximum score (Maximum Apache) attained during hospitalization had a better prognostic value than that of admission. We measured daily Apache scores to 314 patients admitted to Hospital Clínico UC ICU. Mean admission score was 17.5 +/- 9.3 (range: 1-47) and mean maximum score was 18.6 +/- 9.7 (range: 1-47), p < 0.001. Mortality during ICU stay was 17.2%, and 8.6% during hospitalization after ICU discharge. Only 78.3% of patients attained their maximum apache score during the first 24 hours of admission, whereas 21.7% attained it during the rest of ICU hospitalization. Excluding subjects with less than one day of ICU stay, 33% of patients attained maximum Apache score after 24 hours of ICU admission. Statistical analysis showed that maximum Apache score was a better predictor of mortality than that of admission.

Adolescent↗
PubMed1991

[Sublingual captopril versus nifedipine in the treatment of hypertensive crisis].

The currently accepted drug of choice for treatment of hypertensive crisis is sublingual nifedipine. We compared the effects of sublingual captopril (25 mg) to those of nifedipine (10 mg) in 54 patients with this complication who came to the emergency room. Five min after administration of captopril, blood pressure decreased from 197.5 +/- 32.7/118.3 +/- 8.2 to 156 +/- 27.2/95.8 +/- 12.9 mmHg and heart rate decreased from 87.9 +/- 15.1 to 74.7 +/- 10.9 (p < 0.05). Blood pressure in the nifedipine group decreased from 198 +/- 27.3/120 +/- 9.8 to 147.7 +/- 17.8/86 +/- 17.9 (p < 0.05), while no change was observed in heart rate. Delayed measurements showed lower diastolic pressures at 60 and 75 min and lower systolic pressure at 120 min in the nifedipine group (p < 0.054). Few and not significantly different side effects were observed with both drugs. Thus, sublingual captopril is useful for treatment of hypertensive crisis.

Administration, Sublingual↗
PubMed1990

[Syncope: recurrence and prognosis during 2 years].

We followed up 143 patients that had been admitted to intensive care units of a general hospital with syncope. 127 patients (89%) remained in follow up for a mean of 24 months (range 3 to 54 months). There were 70 men and 57 women and the mean age was 71.5 years. Recurrences were observed in 21 patients (17%) and were similar for patients whose syncope had a cardiovascular origin (10%), non cardiovascular origin (25%) or an undetermined cause (18%). Mortality from cardiac or vascular causes was 20% in the cardiovascular origin group, and 5 and 4.2% in the other groups, respectively (p less than 0.005). Recurrence did not influence mortality. A history of hypertension, cerebrovascular accidents and ventricular arrhythmias was associated to higher mortality risk (p less than 0.05).

Adult↗
PubMed1989

Intrahepatic cholestasis of pregnancy in twin pregnancies.

To clarify whether the increase in estrogen levels occurring during twin pregnancies (TP) is associated with a greater risk of developing intrahepatic cholestasis of pregnancy (ICP), we followed up 62 consecutive patients with TP and compared them with single pregnancies delivered in our hospital during 1 year. The prevalence of ICP was significantly higher in twin than in single pregnancies (20.9% versus 4.7%, respectively; P less than 0.001). Urinary estriol excretion was also significantly higher in twin compared to single pregnancies, although no quantitative differences were detected in TP with or without ICP. In multiparous patients with a proband TP affected by ICP, the disease recurred only in further TP, emphasizing the important role that estrogens seem to play in the pathogenesis of ICP. In contrast, in multiparous patients with a proband single pregnancy affected by ICP, the disease occurred in 70.5% of their other single pregnancies, suggesting the presence of a metabolic predisposition in these cases. However, in both groups of multiparous women a notable number of single pregnancies were not affected by the disease, supporting the postulate that the pathogenesis of ICP is multifactorial and that some as yet unidentified environmental factor needs to be present in order to develop the disease and also to modulate its expressivity.

Alanine Transaminase↗
PubMed1989

[Paroxysmal nocturnal hemoglobinuria presenting as acute renal failure].

We report a patient who developed acute renal failure at the first severe hemolytic crisis associated to paroxysmal nocturnal hemoglobinuria. The associated histologic findings on electron microscopy and immunofluorescence are discussed as an insight to possible pathogenic mechanisms.

Acute Kidney Injury↗
PubMed1989

[Severity evaluation system: APACHE II, SAPS. National experience in a unit of medical intensive therapy].

We evaluated 2 new prognostic indices, APACHE II and SAPS, in 533 consecutive patients admitted to a general hospital clinical care unit. Mortality was 19.5% (13.1% in the ICU). Among non-survivors 80% had a greater than = 20 APACHE II score and 77% a greater than = 13 SAPS score. Only 2% of patients with APACHE score less than 10 or SAPS less than 7 died. A good correlation with previously used indices (APACHE I and TISS) was 0.6. Utilization of these prognostic indices allows comparison of reports from different centers, evaluation of early and long term prognosis and a help in making cost-benefit decisions.

Chile↗
PubMed1989

[Syncope: general characteristics and its relation to age].

We retrospectively analyzed the clinical data of 146 patients admitted to a general hospital with the diagnosis of syncope. A definite or highly likely cause was identified in 91 patients (62%). These were of cardiovascular origin in 78%: conduction defects (31), sinus node disease (9), obstructive causes (8), ventricular arrhythmia (8), ischemia (5) and miscellaneous (14). A non cardiovascular origin was present in 22% of patients: intoxication (7), hysteria (5), hypoxemia (3), vasovagal (2), gastrointestinal bleeding (2) and 2 others. The final diagnosis in patients with a known cause was established by the history and physical examination in 16, the ECG in 42, Holter 9, ECG monitoring in ICU 8 and echocardiogram 6. No difference in the distribution of causes was present between patients below or above 65 years of age. In hospital mortality was 2%.

Adult↗