ABSTRACT
We report two cardiac surgery patients on whom local hypothermia with slushed ice for myocardial protection was used. Bilateral diaphragm paralysis with respiratory failure occurred. In both cases, neurophysiologic studies have been used for the diagnosis. Prolonged ventilatory support was required for several weeks and they were totally recovered after months.
Subject(s)
Coronary Artery Bypass/methods , Hypothermia, Induced/adverse effects , Respiratory Paralysis/etiology , Aged , Female , Heart Arrest, Induced/adverse effects , Heart Arrest, Induced/methods , Humans , Hypothermia, Induced/methods , Mitral Valve Insufficiency/surgery , Myocardial Infarction/surgery , Prosthesis Failure , Reoperation , Respiration, Artificial , Respiratory Paralysis/therapyABSTRACT
Se describe a 2 pacientes sometidos a cirugía cardíaca en los que se utilizó hipotermia local con hielo picado como método de protección miocárdica. En el postoperatorio presentaron una insuficiencia respiratoria grave secundaria a una parálisis diafragmática bilateral completa. El diagnóstico de esta complicación y su posterior seguimiento se realizaron, en ambos casos, mediante un estudio neurofisiológico. Los 2 enfermos precisaron ventilación mecánica durante algunas semanas y la parálisis revirtió de forma completa después de varios meses (AU)
Subject(s)
Aged , Female , Humans , Mitral Valve Insufficiency , Myocardial Infarction , Prosthesis Failure , Respiration, Artificial , Reoperation , Respiratory Paralysis , Coronary Artery Bypass , Hypothermia, Induced , Heart Arrest, InducedABSTRACT
BACKGROUND: The generalized convulsive status epilepticus (GCSE) is a medical emergency with a high morbimortality rate. We analyzed the casuistry in our hospital and we assessed the causes related to mortality. PATIENTS AND METHODS: This is a retrospective study of 57 cases of GCSE that took place between january 1992 to december 1998. The variables studied were mortality among groups according to age, previous epilepsy and the duration of the convulsive episode. RESULTS: We found male prevalence (63.2%). The 49.2% of patients didn't have previous history of epilepsy. In 38.6% of cases the treatment dose was insufficient and in 61.4% it was delated. The mortality rate was 36.8% with a higher significance in patients older than 65 (p < 0.02), without previous history of epilepsy (p < 0.001) and in episodes lasting more than 4 hours (p < 0.05). Only 12.9% of patients received prehospital treatment. CONCLUSIONS: The mortality of GCSE is very high. The initial treatment is inadequate. We must establish a premature and adequate protocol, with optim pharmacological doses and a good coordination with intensive care units.
Subject(s)
Status Epilepticus , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Anticonvulsants/therapeutic use , Child , Child, Preschool , Critical Care , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Factors , Status Epilepticus/mortality , Status Epilepticus/therapyABSTRACT
Introducción: El status epiléptico convulsivo generalizado (SECG) es una urgencia médica que se acompaña de una elevada morbimortalidad. Analizamos la casuística en nuestro hospital y valoramos las causas relacionadas con la mortalidad. Pacientes y métodos: Estudio retrospectivo de 57 casos de SECG ocurridos entre enero 1992-diciembre 1998; las variables estudiadas fueron la mortalidad entre grupos según la edad, la existencia previa de epilepsia y la duración del episodio convulsivo.Resultados: Hubo predominio masculino (63,2 por ciento). El 49,2 por ciento de los pacientes no tenían antecedentes de epilepsia. En el 38,6 por ciento de los casos el tratamiento administrado fue insuficiente en su dosificación, y en un 61,4 por ciento fue tardío. La mortalidad fue del 36,8 por ciento siendo significativamente más elevada en mayores de 65 años (p<0,02), en pacientes sin antecedentes de epilepsia (p<0,001) y en los episodios de más de 4 horas de duración (p<0,05). Solo el 12,9 por ciento de los pacientes recibieron tratamiento prehospitalario.Conclusiones: La mortalidad del SECG es muy elevada, el tratamiento inicial es inadecuado. Es necesario el establecimiento de un protocolo de actuación precoz y adecuado, con dosis farmacológicas óptimas y una buena coordinación con las unidades de cuidados intensivos. (AU)
Subject(s)
Middle Aged , Child , Child, Preschool , Adolescent , Adult , Aged, 80 and over , Aged , Male , Infant , Female , Humans , Status Epilepticus , Risk Factors , Sex Factors , Critical Care , Retrospective Studies , Anticonvulsants , Age FactorsSubject(s)
Dermatitis, Allergic Contact/etiology , Hair Preparations/adverse effects , Organometallic Compounds/adverse effects , Pyridines/adverse effects , Scalp Dermatoses/chemically induced , Adult , Female , Humans , Organometallic Compounds/therapeutic use , Patch Tests , Pityriasis/drug therapy , Pyridines/therapeutic useSubject(s)
Antioxidants/adverse effects , Dermatitis, Allergic Contact/etiology , Dermatologic Agents/adverse effects , Vitamin A/analogs & derivatives , Vitamin E/analogs & derivatives , alpha-Tocopherol/analogs & derivatives , Adolescent , Diterpenes , Eczema/chemically induced , Humans , Male , Retinyl Esters , Tocopherols , Vitamin A/adverse effects , Vitamin E/adverse effectsSubject(s)
Angiokeratoma/classification , Angiokeratoma/pathology , Skin Neoplasms/classification , Skin Neoplasms/pathology , Adult , Age of Onset , Angiokeratoma/genetics , Angiokeratoma/physiopathology , Female , Humans , Remission, Spontaneous , Skin Neoplasms/genetics , Skin Neoplasms/physiopathologyABSTRACT
Benign cephalic histiocytosis is a rare, benign, self-healing form of non-X histiocytosis. A case in a 3-month-old girl is reported. The papular eruption involved her face, neck, shoulders and upper trunk. Light and electron microscopic findings and clinical evolution confirmed the diagnosis. The differential diagnosis with the micronodular form of juvenile xanthogranuloma is discussed.
