ABSTRACT
No disponible
Subject(s)
Humans , Male , Child , Flushing/etiology , Hyperhidrosis/etiology , Neuroblastoma/surgery , Horner Syndrome/etiology , Skin/blood supply , Exercise , Thorax , Upper Extremity/pathology , Neurophysiology , Face/innervation , Face/pathologySubject(s)
Autonomic Nervous System Diseases/diagnosis , Flushing/diagnosis , Hypohidrosis/diagnosis , Autonomic Nervous System Diseases/diagnostic imaging , Autonomic Nervous System Diseases/etiology , Autonomic Nervous System Diseases/physiopathology , Child , Flushing/diagnostic imaging , Flushing/etiology , Flushing/physiopathology , Humans , Hypohidrosis/diagnostic imaging , Hypohidrosis/etiology , Hypohidrosis/physiopathology , Magnetic Resonance Imaging , Male , Mediastinal Neoplasms/pathology , Mediastinal Neoplasms/therapy , Neuroblastoma/pathology , Neuroblastoma/therapyABSTRACT
La anafilaxia perioperatoria es un cuadro clínico que puede amenazar la vida del paciente, producido por fármacos o sustancias usados durante la anestesia. Después de una anafilaxia debe realizarse un estudio alergológico para identificar el agente responsable y prevenir recurrencias. La incidencia global se estima de 1 entre 10.000-20.000 anestesias. Los agentes más frecuentemente implicados son los bloqueantes neuromusculares, látex y antibióticos. El diagnóstico inicial es clínico y en el tratamiento es esencial la adrenalina. En este artículo se describe la clínica, pruebas diagnósticas, así como protocolos de prevención y tratamiento del cuadro de anafilaxia perioperatoria. Será importante desarrollar protocolos de detección y manejo precoz de estas reacciones en circuitos de cirugía ambulatoria y establecer un adecuado seguimiento posterior (AU)
Perioperative anaphylaxis may be a life threatening clinical condition and is typically due to the results of drugs used for anesthesia. Once anaphylaxis occurs, allergy studies are essential to identify the responsible agent so to prevent recurrences. The overall incidence is estimated at 1 in 10,000-20,000 anesthetic procedures. The most commonly involved agents are neuromuscular blocking agents, latex and antibiotics. The initial diagnosis is presumptive; including clinical signs and adrenalin is the treatment of choice. The aim of this article is to review etiology, diagnosis, prevention and treatment of perioperative anaphylaxis. It will be important to produce action protocols to ensure the detection of these reactions of anaphylaxis in outpatient surgery and to establish the correct follow-up (AU)
Subject(s)
Humans , Anaphylaxis/complications , Anesthetics/adverse effects , Drug Hypersensitivity/complications , Intraoperative Complications , Ambulatory Surgical ProceduresABSTRACT
AIM: Two patients suffering from congenital insensitivity to pain were studied. They corresponded to types IV and V of the 'hereditary sensory and autonomic neuropathies' (HSAN) classification. CASE REPORTS: The first case showed important autonomic dysfunctions, such as anhidrosis, hyperthermia, skin and bone trophic impairment, and mental retardation; the second one only exhibited alterations in pain and temperature sensibilities. In both, chronic indolent corneal ulcers were also present. Conventional neurophysiological evaluation of the neuromuscular system was normal, but an afferent disturbance of the blink reflex (BR) was evident in both. The sympathetic skin response was absent in the HSAN type IV case and normal in the HSAN type V. Notable reduction of the small myelinated fibres, associated to almost no unmyelinated fibres in the first case, were found in the sural nerve biopsies. CONCLUSIONS: So far there haven't been described BR abnormalities in patients with congenital insensitivity to pain, which should be related to a trigeminal sensory impairment, which could explain the corneal ulcers that suffered these cases. BR studies should be included in the neurophysiological evaluation of the suspected small fibre neuropathies even when there are no facial symptoms shown.
Subject(s)
Hereditary Sensory and Autonomic Neuropathies , Pain Insensitivity, Congenital , Adolescent , Blinking/physiology , Corneal Ulcer/pathology , Female , Hereditary Sensory and Autonomic Neuropathies/classification , Hereditary Sensory and Autonomic Neuropathies/pathology , Hereditary Sensory and Autonomic Neuropathies/physiopathology , Humans , Male , Neurologic Examination , Pain Insensitivity, Congenital/pathology , Pain Insensitivity, Congenital/physiopathology , Pain MeasurementSubject(s)
Androgen Antagonists/adverse effects , Dermatitis, Photoallergic/diagnosis , Drug Eruptions/diagnosis , Flutamide/adverse effects , Androgen Antagonists/administration & dosage , Dermatitis, Photoallergic/etiology , Dermatitis, Photoallergic/pathology , Diagnosis, Differential , Drug Eruptions/etiology , Drug Eruptions/pathology , Flutamide/administration & dosage , Humans , Male , Middle Aged , Neoplasm Metastasis , Orchiectomy , Patch Tests/methods , Postoperative Period , Predictive Value of Tests , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgerySubject(s)
Acetates/adverse effects , Anti-Asthmatic Agents/adverse effects , Asthma/drug therapy , Asthma/etiology , Churg-Strauss Syndrome/chemically induced , Churg-Strauss Syndrome/complications , Leukotriene Antagonists/adverse effects , Quinolines/adverse effects , Acetates/administration & dosage , Acetates/therapeutic use , Adult , Anti-Asthmatic Agents/administration & dosage , Anti-Asthmatic Agents/therapeutic use , Churg-Strauss Syndrome/diagnosis , Cyclopropanes , Humans , Leukotriene Antagonists/administration & dosage , Leukotriene Antagonists/therapeutic use , Male , Quinolines/administration & dosage , Quinolines/therapeutic use , Sulfides , Time FactorsABSTRACT
El Trastorno por Estrés Postraurnático hace referencia a una constelación de síntomas que aparecen tras la exposición a un evento estresante y que se encuentra fuera del rango de las experiencias humanas habituales. Para tratarlo se han propuesto diferentes técnicas: exposición, inundación, desensibilización, inoculación de estrés... En esta artículo se expone una nueva técnica cognitivo-conductual, la Desensibilización por Movimientos Oculares (DMO) que se caracteriza por su fácil aplicación y rápidos resultados. Se revisa el procedimiento, sus posibles mecanismos de acción y los estudios realizados sobre su eficacia (AU)
