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( Erick Rendon ),( Perla Colunga ),( Miguel Angel Flores ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
We report the case of a young man with systemic leptospirosis and intra-alveolar hemorrhage. A 19-year-old man presented with severe sepsis and a few hours later he developed respiratory failure. Leptospirosis was suspected because of conjuntival suffusion. Refractary septic shock requiring three vasopressors was present and intra- alveolar hemorrhage produced severe acute respiratory distress syndrome (ARDS). A pulmonary artery catheter (PAC) was placed and cor pulmonale developed. Methylprednisolone (MP) was initiated at 1 g/day for fi ve days. Forty-hours after the fi rst dose, ventilatory and multiorganic failure improved. No randomized trials have been performed to prove corticosteroid effi cacy. We consider that even for patients with a risk of high mortality, corticosteroid use should be considered. To our knowledge, this is the fi rst case reporting acute cor pulmonale secondary to ARDS caused by leptospirosis.
( Hector Raul Ibarra Sifuentes ),( Carlos Javier Rodriguez Alvarez ),( Erick Joel Rendon Ramirez ),( Perla Rocio Colunga Pedraza ),( Iris Jazmin Colunga Pedraza ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The Glasgow-Blatchford scale has been used to classify patients into low or high risk and the need for medical or endoscopic treatment Methods: A cross-sectional study, which retrospectively Blatchford scale is calculated for patients with nVUGIB, requiring blood transfusion, to determine the likelihood of blood transfusion, using Pearson correlation applying SPSS Statistics 18; in a period beginning from January 1, 2009 to December 31, 2013 Results: 42 patients with diagnosis of nVUGIB were studied, of which 26 patients (61.9%) required blood transfusion. By sex the highest percentage was 65% for men (17 men and 9 women). 95.3% of the patients had a Blatchford scored greater than 0 and 61.9% required blood transfusion. A Pearson correlation index of 0.815 was found. Conclusions: The Pearson correlation showed a positive relationship between the variables, finding that the Blatchford scale was useful in determining which patients required blood transfusion when a cutoff 3 was used.