[Pulmonary edema of neurogenic origin and transtentorial hernia during anesthesia induction in a child with ventriculoperitoneal shunt]. / Edema pulmonar de origen neurogénico y herniación transtentorial durante la inducción anestésica en un niño con derivación ventriculoperitoneal.

We report the case of a 12-year-old boy with a peritoneal ventricular shunt who developed acute pulmonary edema of neurogenic origin after laryngoscopy and orotracheal intubation. Such maneuvers in the presence of diminished intracranial distensibility caused transtentorial herniation. Delayed diagnosis led to death in spite of appropriate treatment of postoperative complications.

[Miliary tuberculosis in adults. Study of 67 patients]. / Tuberculosis miliar en adultos. Estudio en 67 pacientes.

67 patients with miliary TB diagnosed over a 15 year period (1973-1987) have been retrospectively studied. The clinical and analysis data were evaluated, highlighting different factors associated to higher mortality. 53 patients diagnoses were made premortem and 14 had the diagnosis made post-mortem. The age of the patients was of 48 +/- 21 (mean +/- DE) years, inferior to other series, this showing a higher prevalence and early age of infection in the area. 63% had miliary radiological features; the most frequent tests performed were liver biopsy with profitability of 80% and bronchoscopy which, together with transbronchial biopsy and bacterial analysis of the bronchoalveolar lavage, showed a positive diagnosis of 60%. The factors which were associated with bad prognosis were cavitated or chronic lesions (P less than 0.01), chronic diseases and immunosuppression factors associated, this not being statistically significant.