RESUMO
Calcium regulation is tightly controlled in the body. Multiple causes of hypercalcemia have been studied including primary hyperparathyroidism, hypercalcemia of malignancy, and chronic granulomatous disorders. Among the less studied causes is calcium-alkali syndrome. Here, we discuss a case of hypercalcemia secondary to calcium-alkali syndrome, presenting with hypercalcemia, metabolic alkalosis, and acute kidney injury as a result of ingestion of a large amount of calcium supplements. Hypercalcemia can result in impaired collecting duct system sensitivity to antidiuretic hormone, afferent arteriole constriction, and activation of calcium sensor receptors in multiple tissues. The net effect is an increase in calcium reabsorption with a salt and water diuresis which leads to volume depletion, acute kidney injury, and metabolic alkalosis.
RESUMO
[This corrects the article DOI: 10.1155/2021/5555961.].
RESUMO
Pemphigus vulgaris (PV) is an autoimmune blistering disorder of the skin and mucosal surfaces characterized by acantholysis (loss of adhesion between epidermal cells). Esophageal involvement of PV is an underdiagnosed entity as routine diagnostic endoscopy is not recommended in asymptomatic patients. Dysphagia and odynophagia are common presenting symptoms; however, upper gastrointestinal bleeding (UGIB) associated with esophageal involvement of PV without a history of mucosal blistering is extremely uncommon. We present a case of esophageal involvement of PV associated with active UGIB that was diagnosed on endoscopic evaluation. This case illustrated the importance of early endoscopy to identify the esophageal involvement of PV especially in patients with preexisting disease who present with gastrointestinal symptoms such as dysphagia, odynophagia, and hematemesis. Early recognition of esophageal involvement of PV and initiation of corticosteroid and/or immunosuppressant therapy may improve the outcome of the disease.
RESUMO
Determinar los conocimientos de las enfermeras (os) del programa SAMU sobre la evaluación inicial del paciente politraumatizado por accidente de tránsito. Lima - Perú. 2013. Material y Método: El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población estuvo conformada por 41 enfermeras. La técnica fue la encuesta y el instrumento el cuestionario, que se aplicó previo consentimiento informado. Resultados: Del 100 por ciento (41), 51 por ciento (21) no conoce y 49 por ciento (20) conoce. En la dimensión evaluación primaria 51 por ciento (21) conoce y 49 por ciento (20) no conoce; y en la dimensión evaluación secundaria, 41 por ciento (17) conoce y 59 por ciento (24) no conoce. Conclusiones: Los conocimientos de las enfermeras (os) del programa SAMU sobre la evaluación inicial del paciente poli traumatizado; el mayor porcentaje no conoce los aspectos sobre por el examen físico, la evaluación del sistema respiratorio, la secuencia de la evaluación primaria, complicaciones de la vía aérea, y asegurar buena ventilación; seguido de un porcentaje considerable de enfermeros que conocen sobre la obstrucción de la vía aérea, condiciones para una buena ventilación, asegurar la permeabilidad de la vía aérea, maniobra para control de la columna cervical, complicaciones de la vía aérea, apertura de la vía aérea, evaluación del estado hemodinámico, pulso, control de hemorragias en amputación, y evaluación para determinar traslado...
To determine the knowledge of the nurses of SAMU (Urgency System of Movable Care) about the initial assessment of politraumatized patients by transit accidents. Lima - Peru 2013. Material and Method: The study was applicative, quantitative, descriptive method of transversal cutting. The population consisted of 41 nurses. The technique was the survey, questionnaire the instrument that was applied prior informed consent. Results: Of the 100 per cent (41), the 51 per cent (21) does not know and 49 per cent (20) known. In primary evaluation dimension the 51 per cent (21) know and 49 per cent (20) does not know. In secondary evaluation dimension 41 per cent (17) known and 59 per cent (24) does not know. Conclusions: The knowledge of the nurses of the SAMU program about the initial evaluation of politraumatized patients, the highest percentage of nurses do not know about the aspects about the physical exams, the evaluation of the respiratory system, the sequence of the initial assessment, complications of the respiratory system, and assure good ventilation, followed from a percentage of nurses that know about respiratory obstruction, conditions for good ventilation, assure the permeability of the respiratory system, how to handle and control cervical spinal cord, complications of the respiratory system, assure the mechanical conditions to guaranty a good pass of the air, evaluation of the hemodynamic state, pulse, control bleeding and amputation, and evaluation to determine to move the patients...