[Characteristics of Hospitalized Adults with Severe Hyponatremia: A Comparison of Patients with Severe and Very Severe Hyponatremia in Terms of Etiology, Symptoms, Treatment Response, and Mortality].

Unlabelled: Hyponatremia is the most common hydroelectrolyte disorder in hospitalized patients. It is unclear whether there are differences between severe hyponatremia (<125 mEq/L) and very severe hyponatremia (<115 mEq/L) in terms of etiology, response to therapy, and mortality.

Aim: Describe the etiology, symptoms, response to treatment and mortality of hospitalized adults with severe and very severe hyponatremia.

[Geographic sectorization of hospitalized patients to health care teams. Impact on teamwork and patient satisfaction].

Historically, the wards of hospitals were divided by services such as medicine, surgery and traumatology, among others. To optimize the use of beds, undifferentiated medical surgical services were implemented in different hospitals in the country. This work organization had consequences in several areas, such as teamwork, the sense of belonging, the quality of teaching and travel times, among other factors.

[The importance of timely and safe care. Report of one case].

We report a 32-year-old woman with chronic kidney disease on hemodialysis undergoing a nephrectomy for left xanthogranulomatous pyelonephritis with a coralliform calculus and septic shock. Her clinical evolution was torpid, subfebrile, with persistent elevation of inflammatory parameters and with the finding of intra-abdominal collections interpreted as post-surgical. Finally faced with microbiological evidence of infection of the collections, the patient was operated and tended to improve.

[Low molecular weight heparin-induced hyperkalemia and hyponatremia. Report of one case].

Low molecular weight heparin-induced hyperkalemia is not an uncommon side effect. The development of hyponatremia is well described although it is less common. We report a 72-year-old woman with lumbar metastases who developed hyponatremia and hyperkalemia on the tenth day of hospitalization.

[Removal of an infected gastric cyanoacrylate plug. Report of one case].

In patients with actively bleeding gastric varices, the treatment of choice is the endoscopic use of sclerosing agents such as cyanoacrylate. We report a 69-year-old man who, after being treated with cyanoacrylate, suffered from recurrent febrile episodes. After an extensive study and broad-spectrum antibiotic treatment, discarding other presumably infectious focus, the superinfection of the cyanoacrylate plug was suspected, and its surgical removal was decided.

[Deterioration of vital signs as predictors of major medical emergencies in hospitalized patients].

Background: Medical emergencies (ME) in hospitalized patients (cardiac and respiratory arrest, suffocation, asphyxia, seizures, unconsciousness) are associated with high morbidity and mortality. Most of these patients have signs of physiological deterioration prior to the appearance of the emergency. Early detection of warning signs by rapid response teams (RRT) may provide an opportunity for the prevention of major adverse events.

[Risk of falls among patients admitted to a medical-surgical ward. Analysis of 376 medical records].

Background: Detecting patients at risk of falls during hospital stay is of utmost importance to implement preventive measures.

Aim: To determine the frequency of patients with a high risk of falls admitted to a medical-surgical ward. To assess the preventive measures implemented.

[Human herpes virus 6 infection in an inmunocompetent patient with carbamazepine-induced DRESS syndrome].

DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is an adverse life-threatening drug reaction characterized by a polymorphous rash associated with fever, lymphadenopathy and multiorgan involvement with eosinophilia. We present the case of an immunocompetent man with DRESS syndrome secondary to carbamazepine, that developed concomitantly meningoencephalitis caused by human herpes virus 6 (HHV-6), and a review of literature. The pathogenic role of HHV-6 in DRESS syndrome remains controversial.

[Erythema nodosum: Analysis of 91 hospitalized patients].

Background: Erythema Nodosum (EN) is an acute nodular erythematous cutaneous eruption. It is presumed to be a hypersensitivity reaction and it may be idiopathic, or occur in association with diverse diseases and medications.

Aim: To identify the main etiologies of EN among patients admitted to a medicine service of a clinical hospital.

[Hemolysis, serositis and exanthema induced by Mycoplasma pneumoniae infection. Report of one case].

Mycoplasma infections have extrapulmonary manifestations that may be associated with respiratory symptoms and may have skin, heart, gastrointestinal, rheumatologic, neurologic, hematologic involvement. Cold agglutinin mediated autoimmune hemolytic anemia is the most common hematological manifestation. We report a 27-year-old woman infected with Mycoplasma pneumoniae, who presented respiratory involvement with pneumonia, exanthema, serositis and acute hemolytic anemia that required transfusion.

[The discharge process].

Discharge is one of the most important processes that hospitalized patients must endure. This process is complex, requires coordination among several professionals and transfers an overwhelming amount of information to patients. Often, it is limited to the writing of the discharge summary, with a primary emphasis on the drug list.

[Hospital case management].

Due to demographic changes, rising health expenditures, and the reimbursement mechanisms of insurers in the past 30 years, physicians and nurses have had to change the way services are delivered. Concepts such as cost effectiveness and patient safety have also led to the emergence of case management. Case management, usually led by nurses, is responsible for early recognition of patients at high risk for prolonged hospitalization, readmission, a high level of consumption of healthcare resources, and mobilizing strategies to discharge patients as soon as possible in a safe manner with appropriate medical follow-up.

[Hospital medicine in Chile].

After 15 years of development of Hospital Medicine in Chile, there are several benefits of this discipline. Among others, a reduction in the length of hospital stay, readmissions, costs, and improved medical teaching of students, residents and fellows have been observed. However, in South América there are only isolated groups dedicated to Hospital Medicine in Chile, Argentina and Brazil, with a rather slow growth.

Thromboprophylaxis in major knee and hip replacement surgery: a review.

Patients undergoing total knee and total hip replacement (THR/TKR) surgery are at high risk of venous thromboembolism (VTE), and routine thromboprophylaxis is recommended after these procedures. However, current thromboprophylaxis may require daily injections, careful anticoagulation monitoring, and dietary restrictions, which can lead to poor patient compliance and suboptimal outcomes. Therefore, there is an unmet need for simpler medication options.

[Pneumonia caused by Streptococcus pyogenes. Report of one case].

We report a 58-year-old female presenting with fever and vomiting. The initial laboratory examination disclosed two blood cultures that were positive for Streptococcus Pyogenes. An abdominal CAT scan showed a right basal pneumonia.

[Pseudotumor cerebri secondary to Behçet disease. Report of one case].

The classical manifestations of Behçet disease are mouth ana genital ulcers, cutaneous lesions ana ocular involvement. The central nervous system is affected in 5 to 59% of the cases, usually in the form of meningoencephalitis or sinus venous thrombosis. We report a 17-year-old femóle presenting with a two weeks history of progressive headache, nausea and blurred vision.

[Hospital medicine].

Hospital medicine was created over 10 years ago aiming to provide an integral care to hospitalized patients. Hospital specialists are physicians mainly devoted to the global care of hospitalized patients. Their professional functions include patient care, teaching, clinical research and managing activities.

[Thrombotic thrombocytopenic purpura: experience in 18 cases and literature review].

Background: Thrombotic thrombocytopenic purpura (TTP) is characterized by anemia, thrombocytopenia, neurological and renal involvement of variable severity and it has a dismal prognosis. Platelet-derived von Willebrand Factor-cleaving metalloprotease ADAMTS-13 activity may orient the diagnosis, but normal levels do not discard it. The most effective therapy thus known is plasmapheresis.

[Cat-scratch disease. Review of eight adult patients hospitalized for fever or adenopathy].

Background: Cat-scratch disease is common among children. Among adults the disease is less often considered in the differential diagnosis of enlarged lymph nodes and fever.

Aim: To report the clinical and laboratory features of eight patients with cat-scratch disease.

[Malignant neuroleptic syndrome and polyserositis associated to clozapine use: report of one case].

Malignant neuroleptic syndrome is a complication of antipsychotic medication use. Clozapine use is also associated with polyserositis and eosinophilia. We report a 17 years old female treated with clozapine, valproic acid, lithium carbonate and lorazepam that consulted in the emergency room for confusion, lethargy, catatonia, rigidity, myalgya and fever.