ABSTRACT
La pancreatitis aguda es una complicación poco frecuente en el embarazo, pero que presenta una gran morbimortalidad, siendo su prevalencia mayor en el tercer trimestre y puerperio inmediato. Presentamos un caso de pancreatitis aguda post cesárea en una paciente sin antecedentes, a cuyo diagnóstico se llegó por el apoyo de pruebas diagnósticas de imagen. El tratamiento fue llevado por un equipo multidisciplinario que logró la remisión completa de la enfermedad.
Acute pancreatitis is an uncommon complication during pregnancy which is associated with great morbimortality and its prevalence increases during the third trimester and early puerperium. We report a case of acute pancreatitis following to caesarean section in a patient with an unremarkable medical history. Diagnosis was done by means of imaging techniques and its treatment was carried out by a multidisciplinar/ team.
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications , Pancreatitis , Puerperal Disorders , Acute Disease , Cesarean Section , Pregnancy Complications/therapy , Pancreatitis/therapy , Tomography, X-Ray Computed , Puerperal Disorders/therapyABSTRACT
The olivocochlear efferent system of the mammalian cochlea, which is divided into two lateral and medial bundles, contains numerous neuroactive substances (acetylcholine, GABA, dopamine, enkephalins, dynorphins and CGRP). These have been located at the brainstem in neurons belonging to the lateral superior olive (lateral efferent system) or in neurons of the periolivary region around the medial superior olive and the trapezoid body (medial efferent system). All of these substances were found in well-characterized projections corresponding to lateral and medial nerve fibres and terminals which connect to the type I afferent dendrites and the outer hair cells, respectively. All could be involved in the modulation of the auditory process, as is suggested by the cochlear turnover increases observed in some of them (i.e. enkephalins or dopamine) induced by sound stimulation. Recently, the presence and distribution of serotonin-containing fibres has been included in the long list of cochlear neuroactive substances. However, its highly particular peripheral pattern of distribution together with the lack of response to sound stimulation could suggest that serotonergic fibres constitute a previously unknown cochlear innervation.
Subject(s)
Nerve Fibers/diagnostic imaging , Organ of Corti/anatomy & histology , Serotonin/physiology , Animals , Auditory Pathways/anatomy & histology , Auditory Perception/physiology , Cats , Hair Cells, Auditory, Outer/anatomy & histology , Neurotransmitter Agents/physiology , Olivary Nucleus/anatomy & histology , Rabbits , Rats , Rats, Long-Evans , Species Specificity , Superior Cervical Ganglion/anatomy & histology , UltrasonographySubject(s)
Carbamazepine/therapeutic use , Clofibrate/therapeutic use , Diabetes Insipidus/drug therapy , Diuresis/drug effects , Mannitol , Carbamazepine/administration & dosage , Child , Clofibrate/administration & dosage , Diabetes Insipidus/genetics , Diabetes Insipidus/physiopathology , Drug Evaluation , Drug Therapy, Combination , Humans , Kidney Concentrating Ability , Male , Osmolar Concentration , Vasopressins/deficiencyABSTRACT
A modified technique of amnnitol-induced diuresis is described, in order to assess renal concentrating ability in infants and children. The infusion of 10% mannitol in 0.9% saline avoided the hypertonic saline overload and the fluid restriction period, both badly tolerated by infants and small children. In a control group of children aged from two months to seven years, the values of T(H2O) plotted against C(OSM) allowed to calculate the adjustment curve y=0.80x0.75, r=0.98 (p is less than 0.0001). In six patients with pituitary diabetes insipidus (PDI), the test was used in order to quantify the degree of ADH deficiency and evaluate the carbamazepine and clofibrate effect, in the renal concentrating mechanism. The test was tolerated perfectly in every case, obtaining qualitative and quantitative data and avoiding the hyponatremia and hypokalemia produced by the mannitol.
