[Hepatic abscess: series of 107 cases and literature review]. / Absceso hepático: serie de 107 casos y revisión de la literatura.

UNLABELLED: Liver abscess is a rare disease with high morbidity and mortality. OBJECTIVE AND METHOD: Description of liver abscess cases attended in the Universidad de Chile Clinical Hospital between 2000 and 2007 and review of the literature on the topic. RESULTS: For 107 cases reviewed, mean age was 59 years. Most common symptoms were fever and abdominal pain with an average duration of 19 days. COMORBIDITY: twenty five percent of patients had Diabetes Mellitus type 2, seven percent were immunosuppressed patients and 24% had undergone invasive procedures. Not achieved identify the origin in most cases. The most requested image test was abdominal CT. In 49/75 (65.3%) the abscess culture allowed to establish the etiology. Bacteremia was present in 17/68 (25%) of cases. Most cases were treated with two or more antibiotics and percutaneous drainage. CONCLUSION: Clinical manifestations and resolution of liver abscess in this series are consistent with those described in the literature.

Absceso hepático: serie de 107 casos y revisión de la literatura / Hepatic abscess: series of 107 cases and literature review

Liver abscess is a rare disease with high morbidity and mortality. Objective and Method: Description of liver abscess cases attended in the Universidad de Chile Clinical Hospital between 2000 and 2007 and review of the literature on the topic. Results: For 107 cases reviewed, mean age was 59 years. Most common symptoms were fever and abdominal pain with an average duration of 19 days. Comorbidity: twenty five percent of patients had Diabetes Mellitus type 2, seven percent were immunosuppressed patients and 24 percent had undergone invasive procedures. Not achieved identify the origin in most cases. The most requested image test was abdominal CT. In 49/75 (65.3 percent) the abscess culture allowed to establish the etiology. Bacteremia was present in 17/68 (25 percent) of cases. Most cases were treated with two or more antibiotics and percutaneous drainage. Conclusion: Clinical manifestations and resolution of liver abscess in this series are consistent with those described in the literature.

El absceso hepático es una patología infrecuente con alta morbimortalidad. Objetivo y método: Describir los casos de absceso hepático en el Hospital Clínico de la Universidad de Chile entre los años 2000 y 2007 y revisión de la literatura respecto del tema. Resultados: En 107 casos revisados, la edad promedio fue 59 años. Los síntomas más frecuentes fueron fiebre y dolor abdominal con una duración promedio de 19 días. El 25 por ciento de los casos presentaba como co-morbilidad diabetes mellitus tipo 2, un 7 por ciento era inmuno suprimido y 24 por ciento había sido sometido a procedimiento invasor previo. No se logró identificar el origen en la mayoría de los casos. El estudio de imagen más solicitado fue la TC de abdomen. En 49/75 (65,3 por ciento) se estableció la etiología mediante el cultivo del absceso. Se constató bacteriemia en 17/68 (25 por ciento) pacientes. La mayoría de los casos se trataron con dos o más antimicrobianos y drenaje percutáneo. Conclusión: Las características de los casos de absceso hepático encontradas en este estudio concuerdan con lo descrito en la literatura médica.

Epidemiología de la hipertensión en hemodiálisis crónica / Prevalence of hypertension among patients on chronic hemodialysis

Background: Hypertension is a common and important cardiovascular risk factor in patients on chronic hemodialysis. Aim: To report the prevalence and characteristics of hypertension among patients on chronic hemodialysis. Patients and methods: Cross sectional study of 313 patients (192 male, aged 57 ñ 18 years) dialyzed in 7 representative centers in Santiago, Chile. Results: Patients were on hemodialysis for a mean of 68 ñ 53 months and 67 (21 percent) were diabetic. 230 (74 percent) were hypertensive and 223 of these (97 percent) had predialysis hypertension. A multivariate analysis showed that hypertension was associated with increased weight gain between dialysis, failure to achieve the postdialysis dry weight, increasing age and the presence of diabetes. Among hypertensive patients, 61 percent were receiving antihypertensive medications, compared with 27 percent of patients with normal blood pressure. Conclusions: High blood pressure is highly prevalent among patients on chronic hemodialysis and is associated to hypervolemia, age and the presence of diabetes

Hemodialysis-associated cardiac arrhythmias: a lower risk with bicarbonate?

The role of hemodialysis (HD) as an arrhythmogenic event has recently been emphasized. We studied 18 patients by Holter monitoring, comparing the arrhythmogenic effect of acetate dialysis (AHD) and bicarbonate dialysis (BHD). The frequency of ventricular arrhythmias was 93 +/- 66/h in AHD and 32 +/- 26/h in BHD (p less than 0.005). According to the classification of Lown and Graboys, classes III and IV were more often to be found in AHD than in BHD and no patient on BHD was in class IVB and class V. Five patients affected with ischemic heart disease had more frequent and dangerous ventricular arrhythmias than the others; a significant difference between buffers was recorded in all cases but 1. Intradialytic changes in body weight, hematocrit, osmolarity, ionized calcium and potassium during AHD and BHD were similar. The two methods only differed in the quickness and degree of correction of acidosis, and this was related to a significant difference in intraerythrocytic potassium at the end of the session. The quicker and more regular correction of acidosis with BHD and the consequent difference in ionic flows between the intra- and extracellular spaces, as demonstrated by changes in intraerythrocytic potassium at the end of the session, could account for the seemingly less arrhythmogenic effect of BHD.