ABSTRACT
Meconium aspiration syndrome causes respiratory failure after birth and in vivo monitoring of pulmonary edema is difficult. The objective of the present study was to assess hemodynamic changes and edema measured by transcardiopulmonary thermodilution in low weight newborn piglets. Additionally, the effect of early administration of sildenafil (2 mg/kg vo, 30 min after meconium aspiration) on this critical parameter was determined in the meconium aspiration syndrome model. Thirty-eight mechanically ventilated anesthetized male piglets (Sus scrofa domestica) aged 12 to 72 h (1660 ± 192 g) received diluted fresh human meconium in the airway in order to evoke pulmonary hypertension (PHT). Extravascular lung water was measured in vivo with a PiCCO monitor and ex vivo by the gravimetric method, resulting in an overestimate of 3.5 ± 2.3 mL compared to the first measurement. A significant PHT of 15 Torr above basal pressure was observed, similar to that of severely affected humans, leading to an increase in ventilatory support. The vascular permeability index increased 57 percent, suggesting altered alveolocapillary membrane permeability. Histology revealed tissue vessel congestion and nonspecific chemical pneumonitis. A group of animals received sildenafil, which prevented the development of PHT and lung edema, as evaluated by in vivo monitoring. In summary, the transcardiopulmonary thermodilution method is a reliable tool for monitoring critical newborn changes, offering the opportunity to experimentally explore putative therapeutics in vivo. Sildenafil could be employed to prevent PHT and edema if used in the first stages of development of the disease.
Subject(s)
Animals , Humans , Infant, Newborn , Male , Extravascular Lung Water/drug effects , Hypertension, Pulmonary/prevention & control , Meconium Aspiration Syndrome/drug therapy , Piperazines/administration & dosage , Sulfones/administration & dosage , Vasodilator Agents/therapeutic use , Animals, Newborn , Disease Models, Animal , Lung/drug effects , Lung/pathology , Meconium Aspiration Syndrome/pathology , Purines/administration & dosage , Sus scrofa , Time Factors , Thermodilution/methodsABSTRACT
Se presenta una caso clínico de linfoma primario del sistema nervioso central (LPSNC) en una paciente con infección por virus de la inmunodeficiencia humana (VIH) en estadio sida. En este caso particular se destaca la confirmación por histopatología mediante intervención neuroquirúrgica de una lesión ocupante de espacio (LOE), lo que permitió instalar tratamiento oncoespecífico y terapia antirretroviral, lográndose buena evolución clínica. El obejtivo de la presente comunicación es realizar una revisión y actualización bibliográfica del LPSNC en pacintes con VIH destacando principalmente el aporte de los métodos diagnósticos y terapéuticos.
Subject(s)
Humans , Adult , Female , Case-Control Studies , Central Nervous System , Lymphoma, AIDS-RelatedABSTRACT
clínica, la radiología y la anatomía patológica en forma similar a la EMH
Subject(s)
Infant, Newborn , Humans , Fetal Organ Maturity , Hyaline Membrane DiseaseABSTRACT
La angiodisplasia de colon se ha reportado como una afeccion frecuente y causa de sangrados gastrointestinales inexplicados. Nuestro interes es exponer los elementos diagnosticos angiograficos y anatomopatologicos, a traves de 2 casos. Debe senalarse que el diagnostico se hace casi exclusivamente a traves de la arteriografia mesenterica y su confirmacion anatomo-patologica exige tecnicas especiales y sobre todo una coordinacion entre el Cirujano, Radiologo y Anatomopatologico para el manejo correcto de la pieza anatomica