Browsing by Author "Downey, Patricio"

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    Resolution of early stage diabetic nephropathy in an obese diabetic patient after gastric bypass
    (2006) Perez, Gustavo; Devaud, Nicolas; Escalona, Alex; Downey, Patricio
    Epidemiological studies have proven that obesity is a significant risk factor for type 2 diabetes. Long-term progression of diabetes leads to various microvascular complications, of which diabetic nephropathy has become of increasing importance, and is the main cause of end-stage renal failure in occidental countries, Microalbuminuria is the first marker of incipient diabetic nephropathy, an early stage glomerulopathy which can progress to renal failure and which historically has been treated with angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists. We report a severely obese diabetic patient on treatment for diabetic nephropathy with ACE-inhibitors and poor results, which resolved after Roux-en-Y gastric bypass.
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    Síndrome cardiopulmonar por Hantavirus: Utilidad de la monitorización con el sistema PiCCO
    (2003) Romero Patino; Carlos Miguel; Andresen Hernández, Max Alfonso; Díaz Patiño, Orlando; Tomicic, Vinko; Baraona Reyes, Fernando Exequiel; Mercado Flores, Marcelo Esteban; Pérez C., Carlos; Downey, Patricio; Dougnac Labatut, Alberto
    We report a 68 years old man, farmer from the metropolitan region, admitted with a Hantavirus Cardiopulmonary Syndrome. The diagnosis was made using serologic test and was later confirmed by the Public Health Institute. He evolved to an early multiple organ failure, requiring high concentrations of oxygen and invasive ventilatory assistance, vasopressor drugs and renal replacement therapy. Swan Ganz and PiCCO were used simultaneously for hemodynamic monitoring. Treatment consisted in global support therapy, antimicrobial therapy and systemic corticosteroids. Intrathoracic blood volume was a more reliable parameter than pulmonary capillary wedge pressure for the assessment of preload. As expected in situations of increased vascular permeability, there was an increase in extravascular lung water. There was a good correlation between extravascular lung water and oxygenation parameters (PaO2/FiO2 and oxygenation index). PiCCO system may become a helpful tool in the management of patients with Hantavirus Cardiopulmonary Syndrome