Browsing by Author "Letelier, LM"

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    Critical appraisal: Enteral nutrition is better than parenteral nutrition for patients with acute pancreatitis.
    (SOC MEDICA SANTIAGO, 2005) Manriquez, JJ; Letelier, LM
    Objective: To compare the safety and clinical outcomes of enteral and parenteral nutrition in patients with acute pancreatitis. Data sources: Medline, Embase, Cochrane controlled trials register, and citation review of relevant primary and review articles. Study selection: Randomized controlled studies that compared enteral nutrition with parenteral nutrition in patients with acute pancreatitis. From 117 articles screened, six were identified as randomized controlled trials and were included for data extraction. Data extraction: Six studies with 263 participants were analyzed. Descriptive and outcome data were extracted. Main outcome measures were infections, complications other than infections, operative interventions, length of hospital stay, and mortality. The metaanalysis was performed with the random effects model. Data synthesis: Enteral nutrition was associated with a significantly lower incidence of infections (relative risk 0.45; 95% confidence interval 0.26 to 0.78, P = 0.004), reduced surgical interventions to control pancreatitis (0.48, 0.22 to 1.0, P = 0.05), and a reduced length of hospital stay (mean reduction 2.9 days, 1.6 days to 4.3 days, P < 0.001). There were no significant differences in mortality (relative risk 0.66, 0.32 to 1.37, P = 0.3) or non-infectious complications (0.61, 0.31 to 1.22, P = 0.16) between the two groups of patients. Conclusions: Enteral nutrition should be the preferred route of nutritional support inpatients with acute pancreatitis.
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    CT angiography as the diagnostic and decision making method used for surgical indication in pulmonary hypertension due to chronic thromboembolism. Report of one case
    (SOC MEDICA SANTIAGO, 2005) Claro, JC; Baudrand, R; Baeza, C; Letelier, LM
    Pulmonary hypertension due to chronic pulmonary thromboembolisin is frequently underdiagnosed and has a very poor prognosis if untreated. When the presence of central pulmonary artery thrombus is confirmed, thromboendarterectomy is the treatment of choice, with very good results. We report a 28 years old male with two previous episodes of deep venous thrombosis (DVT) who was admitted due to 8 months of progressive shortness of breath and a syncope. He underwent a CT pulmonary angiogram and an echocardiogram. Severe pulmonary hypertension was confirmed, secondary to a chronic pulmonary thromboembolisin with an overlapped acute component. He received systemic thrombolysis with partial thrombus disappearance, Therefore a pulmonary thromboendarterectomy was performed and an inferior vena cava filter was placed. The patient was discharged with marked improvement in his functional capacity.