G. García de Casasola

Ecocardiografía clínica básica en Medicina Interna

Focused cardiac ultrasound is a noninvasive technique which can be performed by the internist. It is capable of providing useful, rapid and accurate information about the structure and function of the heart. It can be used to complement anamnesis and physical examination at the bedside. Clinicians may be able to determine left and right ventricular diameter and function, detect the presence of significant pericardial effusion, identify important valvular defects and estimate the central venous pressure by measuring the diameter and collapsibility of inferior vena cava with good accuracy after a short training period. The aim of focused cardiac ultrasound is not to perform a complete echocardiogram but using previous mentioned data, it is possible to expedite diagnosis and optimize the management of patients with cardiovascular diseases.

Si fiebre, ¿hemocultivos?

A 78-year-old man was referred from his residency where he lives to the emergency division due to general deterioration and frequent falls in the last week. His personal history is remarkable for arterial hypertension and diabetes. Two weeks before he needed a vesical catheterism that was traumatic and profilactic ciprofloxacin was prescribed. On physical exploration he appears disoriented, blood pressure is 9/40 mm Hg, cardiac rythm 120 beats per minute, temperature 37,3 °C and 24 respirations per minute. He appears to have pain on his upper left abdomen cuadrant. When the nurse gets a peripheral vein she asks, ¿should I obtain hemocultures?

Pegylated interferon induced interstitial pneumonitis in a patient with hepatitis C infection

Pegylated interferon and ribavirin is the treatment of choice in patients with chronic hepatitis C infection. The most common side effects of interferon therapy are flu-like symptoms and psy chiatric disorders. Pneumonitis is a less frequent complication as sociated with non-negligible mortality. We herein report a case of interferon associated pneumonitis in a patient with non-severe clinical symptoms and a normal chest radiography. Physicians should be aware of this entity during the differential diagnosis of respiratory symptoms in patients receiving treatment with interfer on due to its high morbimortality and good resolution and out come after drug withdrawal.