ABSTRACT
Los quistes de Tarlov son una dilatación patológica de las meninges. Su incidencia es más frecuente en mujeres de edades comprendidas entre 30 y 50 años. La prueba de imagen de elección para su diagnóstico es la RM. De etiología desconocida, la mayoría de los casos son asintomáticos, pero pueden manifestarse síntomas de irritación radicular, entre otros. Las posibilidades terapéuticas son múltiples, reservando la escisión quirúrgica como último escalón. Presentamos un caso en el que se realiza con éxito una anestesia raquídea para una cesárea electiva en una paciente con un quiste de Tarlov gigante, pero con potencial compromiso de la vía aérea, en la que la que los riesgos de una anestesia general podrían estar aumentados. El manejo anestésico presenta un desafío para el anestesiólogo, especialmente en situaciones en las que el paciente presente un riesgo anestésico aumentado para la anestesia general, como es el caso de la paciente obstétrica.(AU)
Tarlov cysts are a pathological dilatation of the meninges. Their incidence is more frequent in women between 30 and 50 years of age. The imaging test of choice for diagnosis is MRI. Of unknown etiology, most cases are asymptomatic, but symptoms of radicular irritation, among others, may occur. The therapeutic possibilities are multiple, reserving surgical excision as the last option. We report a case of successful spinal anaesthesia for elective cesarean section in a patient with a giant Tarlov cyst but with potential airway compromise, in whom the risks of general anaesthesia would be increased. Anaesthetic management presents a challenge for the anesthesiologist, especially in situations where the patient presents an increased anaesthetic risk for general anaesthesia, as is the case in the obstetric patient.(AU)
Subject(s)
Humans , Female , Adult , Tarlov Cysts/diagnosis , Tarlov Cysts/etiology , Cesarean Section , Analgesia, Obstetrical , Anesthesia, Obstetrical , Anesthesiologists , Patients , Pregnant Women , Symptom Assessment , Diagnosis, Differential , Cardiopulmonary Resuscitation , Anesthesiology , Anesthesia , Magnetic Resonance Spectroscopy , Pain ManagementABSTRACT
Tarlov cysts are a pathological dilatation of the meninges. Their incidence is more frequent in women between 30 and 50 years of age. The imaging test of choice for diagnosis is MRI. Of unknown etiology, most cases are asymptomatic, but symptoms of radicular irritation, among others, may occur. The therapeutic possibilities are multiple, reserving surgical excision as the last option. We report a case of successful spinal anaesthesia for elective cesarean section in a patient with a giant Tarlov cyst but with potential airway compromise, in whom the risks of general anaesthesia would be increased. Anaesthetic management presents a challenge for the anesthesiologist, especially in situations where the patient presents an increased anaesthetic risk for general anaesthesia, as is the case in the obstetric patient.
Subject(s)
Anesthesia, Spinal , Anesthetics , Tarlov Cysts , Cesarean Section , Female , Humans , Magnetic Resonance Imaging , Pregnancy , Tarlov Cysts/epidemiology , Tarlov Cysts/pathology , Tarlov Cysts/surgeryABSTRACT
BACKGROUND: Today, advances in technology provide the best success rates in the reproductive medicine field. One of the biggest concerns about it, is the high risk of achieving multiple pregnancies, which may carry greater health risks for both; the mother and fetuses. Besides that, multiple pregnancies are considered a complication or an adverse effect of assisted reproduction treatments. OBJECTIVES: To compare the factors associated with multiple pregnancy in patients who underwent complex assisted reproduction techniques. MATERIAL AND METHODS: A retrospective and transversal case control study was rolled to compare the factors associated with multiple pregnancy rates, these results were correlated using a logistic regression model. RESULTS: a total of 1063 cases were reviewed, we obtained a pregnancy rate of 35.9%, and a multiple pregnancy rate of 31.5%. We found positive statistical association between patient age, total number of oocytes obtained, total embryos transferred, total vitrified embryos per cycle, total serum cuantitative B-GCH level, endometrial thickness in milimeters, and the Honest of a multiple pregnancy. In the logistic regression model, we found statistical association between the number of embryos transferred, number of embryos obtained, embryo quality, total vitrified embryos and the risk for multiple pregnancies. CONCLUSIONS: The total number of embryos transferred in a cycle of a complex assisted reproduction, is the most important factor for the onset of multiple pregnancies. The age of patients, the number of oocytes, total number of embryos obtained, the number of embryos transferred, the quality of embryos transferred and the number of frozen embryos per cycle, correlate significantly with more risk for multiple pregnancies.
Subject(s)
Fertilization in Vitro/methods , Pregnancy Rate , Pregnancy, Multiple/statistics & numerical data , Reproductive Techniques, Assisted , Adult , Age Factors , Case-Control Studies , Cross-Sectional Studies , Embryo Transfer/statistics & numerical data , Female , Humans , Logistic Models , Middle Aged , Oocytes/metabolism , Pregnancy , Retrospective Studies , Young AdultABSTRACT
La cefalopolisindactilia de Greig es un síndrome autosómico dominante de baja prevalencia causado por mutaciones en el gen GLI3, localizado en 7p14.1 y caracterizado por la tríada clínica de polisindactilia, macrocefalia e hipertelorismo. En aproximadamente el 20% de los casos se detecta una deleción de tamaño variable. Si la deleción es grande y afecta a otros genes además de GLI3, puede aparecer un fenotipo más severo, aceptándose la denominación de cefalopolisindactilia de Greig-síndrome de genes contiguos para estos casos. Describimos el caso de una niña recién nacida con polisindactilia, hipertelorismo y microcefalia, que presenta una micro deleción en 7p14.1 de 1,5 Mb de origen paterno diagnosticada mediante array-CGH (AU)
Greig cephalopolysyndactyly is a rare autosomic dominant syndrome caused by mutations in GLI3 gene located on cytob and 7p14.1 and characterized by the clinical triad ofpolysyndactyly, macrocephaly and hypertelorism. In approximately 20% of the cases a deletion of variable size is detected. If deletion is large and affects other genes as well as GLI3, a more severe phenotype is expected. Thus, Greig cephalopolysyndactyly contiguous gene syndrome is a multiple malformation syndrome caused by haploinsufficiency of GLI3 and adjacentgenes. We describe the case of a newborn female with polysyndactyly, hypertelorism and microcephaly and a 1.5 Mb 7p14.1 microdeletion of paternal origin diagnosed by array-CGH (AU)
Subject(s)
Humans , Female , Infant, Newborn , Syndactyly/genetics , INDEL Mutation/genetics , Hypertelorism/genetics , Abnormalities, Multiple/genetics , Microcephaly/genetics , Intellectual Disability/geneticsABSTRACT
Greig cephalopolysyndactyly is a rare autosomic dominant syndrome caused by mutations in GLI3 gene located on cytoband 7p14.1 and characterized by the clinical triad of polysyndactyly, macrocephaly and hypertelorism. In approximately 20% of the cases a deletion of variable size is detected. If deletion is large and affects other genes as well as GLI3, a more severe phenotype is expected. Thus, Greig cephalopolysyndactyly contiguous gene syndrome is a multiple malformation syndrome caused by haploinsufficiency of GLI3 and adjacent genes. We describe the case of a newborn female with polysyndactyly, hypertelorism and microcephaly and a 1.5 Mb 7p14.1 microdeletion of paternal origin diagnosed by array-CGH.
Subject(s)
Chromosome Deletion , Chromosomes, Human, Pair 7/genetics , Acrocephalosyndactylia/genetics , Female , Humans , Infant, Newborn , PhenotypeABSTRACT
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