Browsing by Author "Mellado T., Patricio"

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    Características de la enfermedad cerebrovascular en un Servicio de Cuidados Intermedios Neurológicos, en Chile. Análisis de 459 pacientes consecutivos
    (2005) Mellado T., Patricio; Court L, J.; Godoy F, J.; Mery C, V.; Barnett T, C.; Andresen H, M.; Huete L, I.; Tevah C, J.; Tomicic F, V.; Romero P, C.; Fadic R, R.; Soza M, M.A.; Valenzuela M, R.; Tapia I, J.
    Stroke is the second cause of mortality and the first cause of morbidity in Chile and worldwide. Nowadays there is a major interest in introducing new therapies applying evidence based medicine for these patients. Aim: To describe the clinical profile of patients attended after a stroke, to determine stroke subtypes and their risk factors. Material and methods: Retrospective review of clinical records of 459 patients (mean age 65±48 years, 238 female) that were admitted to our unit during a period of 37 months. Results: Sixty three percent of patients had an ischemic stroke, 14% had an hemorrhagic stroke, 15% had a transient ischemic attack, 2% had a cerebral venous thrombosis and 6% a subarachnoidal hemorrhage. The global mortality was 1%. Seventy percent of patients had a history of high blood pressure. Conclusions: The most common type of stroke is ischemic and high blood pressure is the main risk factor (Rev Méd Chile 2005; 133: 1274-84).
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    Complicaciones neurológicas en pacientes adultos sometidos a trasplante hepático ortotópico. Experiencia de un centro universitario
    (2008) Mellado T., Patricio; Peredo Orellana, Pilar Andrea; Valenzuela Mangini, Raúl Francisco; Arrese Jiménez, Marco; Pérez Ayuso, Rosa María; Domínguez, Pilar; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás; Martínez Castillo, Jorge
    Background: Orthotopic liver transplantation (OLT) is the treatment of choice for multiple acute and chronic end-stage liver diseases as well as for selected cases of liver malignancy and liver-site metabolic disorders. Neurological impairment is a major source of morbidity and mortality following OLT. Aim: To describe the incidence and the type of neurological complications occurring in the post-operative period of OLT in patients transplanted in our hospital. Material and methods: Between March 1994 and August 2007, 76 adult patients underwent OLT. Data on incidence, time of onset, and outcome of central nervous system (CNS) complications have been obtained from our program data base and patient charts. Results: Twenty three patients (30.3%) had CNS complications following OLT. The leading complications were immunosuppressive drug-related neurological impairment in nine patients (39.1%), peripheral nerve damage in five patients (21.7%), central pontine myelinolysis in four patients (17.4%), cerebrovascular disease in three (13%) and CNS infection in three (13%). Most CNS events (90%) occurred in the first 2 weeks after OLT. Five patients with neurological complications died (22%). Conclusions: CNS complications occurred in almost one fifth of the population studied, and they had a poor outcome, as previously reported
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    Determinación y jerarquización de signos clínicos para diagnóstico temprano de xantomatosis cerebrotendinosa
    (2018) Vega, Javier; Solervicens R., Paulina; Maiz Gurruchaga, Manuel Alberto; Preiss Contreras, Yudith Gabriela; Mellado T., Patricio; Santos Martín, José Luis
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    Experiencia preliminar del tratamiento con dexmedetomidina del estado confusional e hiperadrenergia en la unidad de cuidados intensivos.
    (2002) Romero Patino, Carlos Miguel; Bugedo Tarraza, Guillermo; Bruhn, Alejandro; Mellado T., Patricio; Hernández P., Glenn; Castillo Fuenzalida, Luis Benito
    Delirium (confusion) is an acute, reversible and fluctuating compromise of awareness and cognitive function, a state that can increase morbidity and mortality. We describe four patients with delirium associated with agitation and hyperadrenergic states refractory to haloperidol but responsive to dexmedetomidine.
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    Hipotermia intravascular inducida en el manejo de la hipertensión intracraneana en insuficiencia hepática aguda. Caso clínico
    (2009) Castillo Fuenzalida, Luis Benito; Pérez Ríos, Cristián; Ruiz B., C.; Bugedo Tarraza, Guillermo; Hernández P., Glenn; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Pérez Ayuso, Rosa María; Mellado T., Patricio; Domínguez, P.
    Acute liver failure has a mortality rate in excess of 80%. Most deaths are attributed to brain edema with intracranial hypertension and herniation of structures, where ammonium plays a major role in its generation. We report an 18 year-old female with a fulminant hepatic failure caused by virus A infection. The patient developed a profound sopor and required mechanical ventilation. A CT scan showed the presence of brain edema and intracranial hypertension. A Raudemic® catheter was inserted to measure intracranial pressure and brain temperature. Intracranial hypertension became refractory and intravascular hypothermia was started, reducing brain temperature to 33oC. Seventy two hours later, a liver transplantation was performed. After testing graft perfusion, rewarming was started, completing 122 hours of hypothermia at 33oC. The patient was discharged in good conditions after 69 days of hospitalization (Rev Méd Chile 2009; 137: 801-6).
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    Neural lesions in obstetrics : a diagnostic tree
    (2022) Lacassie Quiroga, Héctor; Mellado T., Patricio; Cruz, Juan Pablo
    Letter to the editor.
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    Risk factors of early adverse drug reactions with phenytoin: A prospective inpatient cohort
    (2017) Uribe San Martín, Reinaldo; Ciampi, Ethel; Uslar, Wilhelm; Villagra, Silvana; Plaza Plaza, José Cristián; Godoy F., Jaime; Mellado T., Patricio
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    Sarcoid-like granulomatous myositis-associated hypercalcemia. An infrequent case to consider
    (2021) Uslar N., Thomas; Olmos Borzone, Roberto Ignacio; Godoy Santín, Jaime; Mellado T., Patricio; González Vicente, Gilberto
    PTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13.4 mg/dl) following a trip to the Caribbean. The evaluation showed a suppressed PTH, 25-hydroxy vitamin D of 7.5 ng/ml, 18F-FDG PET/CT showed markedly increased uptake in intercostal, back, shoulder, buttock and thigh muscles and a deltoid biopsy confirmed extensive granulomatous myositis. He was prescribed glucocorticoids which resulted in normalized plasma calcium levels and complete recovery from tetraparesis. Sarcoid-like granulomatous myositis should be incorporated into the differential diagnosis of PTH-independent hypercalcemia, especially in the absence of clinical features of sarcoidosis and with special emphasis on the use of 18F-FDG PET/CT to ensure a correct approach.
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    Síndrome anti-GQ1b : Descripción de cuatro pacientes y revisión de la literatura
    (2013) Uribe San Martín, Reinaldo; Suárez, F.; Sandoval, Patricio; Mellado T., Patricio
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    Síndrome del creciente temporal. Reporte de un caso y revisión de la literatura
    (2004) Mery C, V.; Mellado T., Patricio; Valenzuela Mangini, Raúl; Luco Franzoy, Cristián; Huete Lira, Isidro
    The temporal crescent syndrome or half-moon syndrome is a rare mono ocular retrochiasmatic visual field defect that can be correlated to a lesion along the contralateral parieto-occipital sulcus. This field defect may be missed in automated perimetry. We report a 45 years old man, consulting for sudden loss of the peripheral temporal field in his right eye. The magnetic resonance imaging and the spectroscopy studies confirmed an ischemic lesion on the left anterior occipital cortex. Control imaging studies six months later did not show changes in the lesion (Rev Méd Chile 2004; 132: 1523-6).
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    Strain auricular izquierdo y biomarcadores cardíacos como predictores de accidente cerebrovascular en pacientes con fibrilación auricular de reciente comienzo
    (2017) Potthoff, Marcelo; Gabrielli, Luigi; Huete, Isidro; Mezzano, Diego; Lavandero, Sergio; Sanchez, Ximena; Mellado T., Patricio; Villarroel del Pino, Luis A.; Corbalán Herreros, Ramón
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    Trombolisis mecánica de tronco basilar con Solitaire FR® : caso clínico
    (2013) Tevah Castillo, José Carlos; Mellado, Felipe; Marín, Arnaldo; Mellado T., Patricio; Fava Peirano, Mario
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    Trombosis de seno venoso secundaria a traumatismo encéfalo craneano : caso clínico
    (2013) Suárez, F.; Mellado T., Patricio; Godoy F., Jaime
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    Varicella-Zoster Virus Meningitis and Encephalitis: An Understated Cause of Central Nervous System Infections
    (2020) Alvarez, J. C.; Alvarez Lavin, Jorge E.; Ticono, J.; Mellado T., Patricio; Miranda Vera, Héctor David; Ferrés, Marcela; Forero, J.; Alvarez, C.
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    Xantomatosis cerebrotendínea: Una causa de aumento de volumen bilateral del tendón de Aquiles. Caso clínico
    (2009) Filippi Nussbaum, Jorge Luis; Irarrázaval, Sebastián; Preredo O., Pilar; Mellado T., Patricio
    Cerebrotendinous xanthomatosis is an inherited autosomal recessive disease caused by a mutation in the gene for the sterol 27-hydroxylase enzyme, which determines the accumulation of plasmatic cholestanol in various tissues. The natural history of this disease is characterized by chronic diarrhea beginning in childhood, cataract in youth, tendinous xanthomas in adulthood and later progressive neurological dysfunction manifested as dementia, psychiatric disorders, cerebellar, pyramidal or extrapyramidal signs or seizures. We report a 39 year-old male with a history of diarrhea during childhood and bilateral cataracts requiring surgery at 20 years of age, who evolves later with psychiatric disorders and bilateral increased volume in Achilles tendons. High levels of plasmatic cholestanol and magnetic resonance imaging confirmed the diagnosis of this disease.