[New device and technique to measure intra-abdominal pressure].

Introduction: sequential measurement of intra-abdominal pressure is of paramount importance for an early detection and appropriate therapeutic management of intra-abdominal hypertension and abdominal compartment syndrome.

Objective: to validate a device and technique developed to measure intra-abdominal pressure (an innovation of the Foley urinary catheter named intra-abdominal pressure catheter).

Methods: three different sets of measurements where done to test the intra-abdominal pressure catheter device: I.

[Cosyntropin test in severe active tuberculosis].

Background: Frequency of adrenal insufficiency in patients with tuberculosis varies from 0 to 58%; however, all published series excluded severely ill patients. Our objective was to investigate adrenal insufficiency with the low-dose cosyntropin test in patients with severe active tuberculosis.

Method: From two large university affiliated hospitals, 18 patients with tuberculosis and criteria of sepsis or severe sepsis according to SCCM/ACCP criteria, defined by the present authors as severe active tuberculosis, participated in the study.

[Hyperglycemia in critically ill patients: clinical implications for treatment].

Hyperglycemia is frequent during critical illness and is perceived by the clinician as part of the systemic metabolic response to stress. Of all patients with "stress hyperglycemia" only one third are known to have diabetes mellitus. Previous studies reported that patients presenting hyperglycemia during acute illness have an increased risk for nosocomial infections.

[Effects of different positive end expiratory pressure levels on resting energy expenditure measured by indirect calorimeter in patients with pressure-controlled ventilation].

Objective: To identify variations during measurements of resting energy expenditure (REE), oxygen consumption (VO2) and CO2 production (VCO2) by indirect calorimetry (IC) in patients with pressure-controlled ventilation and different levels of positive end expiratory pressure (PEEP).

Design: Prospective and comparative study.

Setting: Intensive care unit (ICU) of a university-affiliated hospital.

[Orbit decompression surgery in patients with exophthalmos caused by Graves-Basedow disease].

Objective: To evaluate in a prospective trial two surgical technique routinely used for orbital decompression in Graves' disease ophthalmopathy.

Patients And Methods: Patients with Graves' disease exophthalmus (greater than 22 mm) that was euthyroid for at least six months after treatment were admitted to the study and randomly assigned to two groups, twenty six orbits in 17 patients were surgically decompressed with the Walsh and Ogura technique (group I) and 18 orbits in 18 patients were decompressed with Kennedy's surgical approach (group II).

Results: Both surgical techniques were equally effective in reducing the exophthalmus (p < 0.

[Acute fatty liver of pregnancy complicated by pancreatitis].

A woman with acute fatty liver of pregnancy developed fulminant hepatic failure after delivery, a time when spontaneous recovery was expected. Pancreatitis and multiple organ failure was documented and intensive treatment in a critical care unit was needed to support organ function. She underwent plasmapheresis due to extreme hyperbilirubinemia and coma.

Pentoxifylline and oxygen consumption in severe sepsis--a preliminary report.

Objective: To demonstrate that pentoxifylline (PTX) and not placebo improves oxygen consumption (VO2) in critically ill patients with severe sepsis.

Setting: Multidisciplinary intensive care unit in a university affiliated hospital.

Design: A randomized, double blinded clinical trial comparing 300 mg of PTX administered in a 120 min iv infusion with an identically looking placebo.

[Comparative treatment of acute optic neuritis with "boluses" of intravenous methylprednisolone or oral prednisone].

Sixteen patients with acute optic neuritis were studied, and randomized into two groups of treatment. Group I was assigned to in hospital treatment with intravenous methylprednisolone 500 mg Q8 hours for 10 doses, followed by oral prednisone for two weeks and tapering doses thereafter. Group II was treated with oral prednisone one mg per kilogram of body weight for two weeks followed by tapering doses.

[The diagnosis of Cushing's disease by the nocturnal dexamethasone administration test].

Prospective study performed at the General Hospital, National Medical Center, XXI Century, Endocrinology Ward, Mexico-City, to compare the diagnostic sensitivity in Cushing's disease of the oral high doses (8 mg) dexametazone suppression test in single doses with nocturnal administration (DXM-N) and the classic doses of two days (DXM-C). Fourteen patients with hypercortisolism were studied; on thirteen the hypophyseal origin was surgical confirmed. Sensitivity of high doses of oral dexametazone test was proved by using serial samples of serum cortisol; the Fisher test was used for analysis of the suppression of serum cortisol after the test was done.

[The somatostatin analog SMA (201-995) as adjuvant treatment in patients with external fistulae of the digestive system].

Six patients with gastrointestinal fistulae treated with a potent inhibitor of gastrointestinal hormones, the somatostatin analogue SMS 201-995 are reported. All patients had severe intraabdominal diseases and underwent a mean of 3.5 surgery procedures during their hospital stay.

[Effect of a synthetic somatostatin analogue with delayed action (SMS 201-995) on the biliary expenditure in a patient with an external biliary tract fistula].

The effect of treatment with a long acting analogue of somatostatin (SMS 201-995) administered by subcutaneous route 165 micrograms every eight hours in a patient with a external biliary fistula is reported. There was a significant reduction of the daily fistula output during treatment when compared with the basal periods (p = 0.04), with an average decrease of 270 ml/day during the first period of treatment and 357 ml/day when the drug was administered the second time (p = 0.

[Primary hypothyroidism associated with a chiasmatic syndrome simulating a prolactinoma].

Three cases of primary hypothyroidism with optic chiasm compression due to pituitary hyperplasia are reported. Patients consulted for amenorrhea, galactorrhea and visual disturbances. The study of these patients disclosed a chiasm syndrome, persistent hyperprolactinemia, decreased thyroxine and triiodothyronine associated with elevated thyrotropin stimulating hormone in blood.