RESUMO
Shy-Grager syndrome presents as a combination of parkinsonism and autonomic failure (orthostatic hypotesion, anhidrosis, pupillary failure, loss of bladder and bowel sphincter function and iris atrophy). This article introduce to the automatic diagnosis
Assuntos
Humanos , Síndrome de Shy-Drager/fisiopatologiaRESUMO
We report a 50 years old woman admitted to the hospital due to progressive dysphagia and disarthria of there weeks duration. On admission a right hemiparesis was noted. CSF examination showed a protein of 9 mg/dl and no cells. A brain CAT scan showed rounded bilateral subcortical frontoparietal hypodense zones peripheral contrast material enhancement. Pseudobulbar palsies and hemiparesis worsened and the patient required nasoenteral feeding. She was discharged after four months, with severe dissabilities, with the diagnosis of Balo concentric, a progressive demyelinating disease
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Esclerose Cerebral Difusa de Schilder/diagnóstico , Escleroderma Sistêmico/diagnóstico , Disartria/complicações , Tomografia Computadorizada por Raios X/métodos , Transtornos de Deglutição/complicaçõesRESUMO
Wernicke encephalopathy, due to the depletion of thiamine, can be a complication of chronic hemodialysis. We report a 43 years old diabetic male in chronic hemodialysis, who two weeks after an infra-condyleal amputation of his left leg, was admited to the hospital due to an episode of vomiting and abdominal pain lasting 5 days, where confusion and ocular motor signs appeared. Parenteral thiamine administration was started and the confusional state abated. Dialysis can be a predisposing factor for Wernicke encaphalopathy and this diagnosis must be considered in confuse patients
Assuntos
Humanos , Masculino , Adulto , Encefalopatia de Wernicke/etiologia , Diálise Renal/efeitos adversos , Tiamina/administração & dosagem , Deficiência de Tiamina/complicações , Diabetes Mellitus/complicações , Hipertensão/complicaçõesRESUMO
Se realiza un estudio prospectivo consecutivo de validación del Acute Physiologic and Chronic health Evaluation (APACHE) II en 42 pacientes admitidos a la Unidad de Cuidados Intermedios (UCIM) del Servicio de Medicina del Hospital "Dr. Gustavo Fricke", durante 2 meses. La muestra consta de 23 hombres y 19 mujeres, con una edad promedio de 63,4 +/- 12,8 años; derivados preferentemente desde las salas del Servicio de Medicina (74%), con compromiso de más de un sistema, hospitalización previa promedio de 9,3 días y estadía intraunidad promedio cercana a los 7 días. La mortalidad general alcanzó al 26,2%. El promedio APACHE II para los sobrevivientes (31) y para los fallecidos (11) fue de 11,3 +/- 4,7 y 22,9 +/- 4,9, respectivamente (p < 0,0001). Se encontró una correlación directa y positiva entre el índice APACHE II y la mortalidad. No hubo pacientes con APACHE > = 23 que sobrevivieran. La infección intra UCIM (IUU) se observó en 11 casos (26,2%), se presentó en pacientes con índice APACHE II significativamente mayor, no alteró la mortalidad esperada, pero sí se encontró en pacientes con estadías más prolongadas