El síndrome de desmielinización osmótica (SDO) es una complicación neurológica que se produce por la corrección rápida de la hiponatremia. Se presenta el caso de una mujer de 79 años con hiporexia y constipación de 4 semanas de evolución. Al ingreso estaba deshidratada y con escala de Glasgow 14 puntos.  Los exámenes mostraron Na 121 mEq/l, creatinina 5,86 mg/dl, pH: 7,24; pCO2: 8,2 mm Hg, HCO3: 6,8 mmol/l. Se le indicó ClNa 0,9% 120 ml/h y bicarbonato de sodio al 8,4% 21 ampollas de 20 ml en 24 h. A las 24 horas la creatinina estaba en 3,6 mg/dl y el sodio sérico 144 mEq/l. Debido a la persistencia de la alteración del sensorio, se realizó una resonancia magnética de encéfalo que mostró lesiones mesencefálicas características de síndrome de desmielinización osmótica. Fue dada de alta con terapia física. Se concluye que el uso de bicarbonato de sodio para la corr...

Objective: To determine whether an educational intervention strategy would improve the frequency of medical prescriptions for adequate thromboprophylaxis in a medicine service. Methods: Quasi-experimental study, in which in the pre-intervention phase the frequencies of indication of appropriate thromboprophylaxis by physicians from the medicine service were obtained. An 8-week educational intervention was carried out with this same group of doctors. In the post-intervention phase, the frequency of adequate thromboprophylaxis was measured at 2 and 4 months after the intervention. Results: The educational intervention was implemented in 112 resident physicians in medicine specialties. All prescriptions were made by the first-year resident physicians and endorsed by their supervising physician. Prior to the intervention, 47 (44.35%) adequate prescriptions were obtained, 13 (12.26%) suboptim...