RESUMEN
Metformin is a hypoglycemic agent used as the first line for the treatment of non-insulin dependent Diabetes Mellitus. While it is a generally safe drug, it has an infrequent adverse reaction called lactic acidosis. We report a 49 year-old patient with non-insulin-requiring type 2diabetes who developed an acute kidney failure injury along with severe metabolic acidosis secondary to pneumonia during treatment.
La metformina es un agente hipoglucemiante que se ocupa de primera línea para el tratamiento de la Diabetes Mellitus no insulino dependiente. Si bien es un medicamento bien tolerado, tiene una reacción adversa bastante infrecuente que es la acidosis láctica. Reportamos el caso de una paciente de 49 años insulino no dependiente que desarrolló una injuria renal aguda junto con acidosis metabólica severa secundaria a una neumonía en tratamiento.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Acidosis Láctica/inducido químicamente , Acidosis Láctica/terapia , Lesión Renal Aguda/inducido químicamente , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/efectos adversos , Metformina/efectos adversosRESUMEN
Respiratory physiotherapy, including the management of invasive mechanical ventilation (MV) and noninvasive mechanical ventilation (NIV), is a key supportive intervention for critically ill patients. MV has potential for inducing ventilator-induced lung injury (VILI) as well as long-term complications related to prolonged bed rest, such as post-intensive care syndrome and intensive care unit acquired weakness. Physical and respiratory therapy, developed by the critical care team, in a timely manner, has been shown to prevent these complications. In this pathway, real-time bedside monitoring of changes in pulmonary aeration and alveolar gas distribution associated with postural positioning, respiratory physiotherapy techniques and changes in MV strategies can be crucial in guiding these procedures, providing safe therapy and prevention of potential harm to the patient. Along this path, electrical impedance tomography (EIT) has emerged as a new key non-invasive bedside strategy free of radiation, to allow visualization of lung recruitment. This review article presents the main and potential applications of EIT in relation to physiotherapy techniques in the ICU setting.
Asunto(s)
Enfermedad Crítica , Impedancia Eléctrica , Modalidades de Fisioterapia , Respiración Artificial , Tomografía , Humanos , Tomografía/métodos , Respiración Artificial/métodos , Terapia Respiratoria/métodos , Cuidados Críticos/métodos , Lesión Pulmonar Inducida por Ventilación Mecánica/prevención & control , Lesión Pulmonar Inducida por Ventilación Mecánica/etiología , Ventilación no Invasiva/métodosRESUMEN
Resumen Chile ha tenido un incremento sostenido de población inmigrante, pero poco se conoce sobre su impacto en el sistema escolar. Por medio de metodologías mixtas, se recolectó información acerca de las percepciones y prejuicios que estudiantes y profesores, de comunas de la Región Metropolitana de Chile, poseen respecto de la inmigración y la multiculturalidad. Este artículo caracteriza aspectos asociados al prejuicio existente hacia los inmigrantes en el sistema escolar, tanto a nivel explícito como implícito, corroborando la hipótesis de contacto propuesta por la psicología social, y brindando orientaciones tendientes a potenciar la inclusión de la diversidad cultural en el sistema educacional, tanto a nivel de contexto, de políticas como de prácticas pedagógicas.
Abstract Chile has had a steady increase in the immigrant population, but little is known about its impact on the school system. Through mixed methodologies, information was collected about the perceptions and prejudices that students and teachers, from the metropolitan district of Chile, possess regarding immigration and multiculturalism. This article characterizes aspects associated to the existing prejudice towards immigrants in the school system, both explicitly and implicitly, verifying the contact hypothesis proposed by social psychology; And providing guidance aimed at promoting the inclusion of cultural diversity in the educational system, both at the level of context, policies and pedagogical practices.