Síndrome de reel como causa del mal funcionamiento del marcapasos: A propósito de un caso / Reel syndrome as cause of pacemaker malfunction: Apropos of a case

Implantation of cardiac electronic devices is an increasingly common technique and the possibility of device dysfunction caused by electrode displacement should be taken into account. We describe the case of an 88-year-old patient with syncopes several months after pacemaker implantation in which a pacemaker dysfunction was found. Chest X-ray confirmed lead displacement reeled around the generator. Reel syndrome is an entity that should be ruled out as a possible cause of pacemaker malfunction mainly in patients with risk factors for developing this syndrome.

La implantación de dispositivos cardíacos electrónicos es una técnica cada vez más habitual y debe tenerse en cuenta la posibilidad de disfunción del dispositivo debido al desplazamiento de los electrodos. Describimos el caso de una paciente de 88 años que comenzó con clínica de cuadros sincopales varios meses después de la implantación de un marcapasos, y en la que se demostró una disfunción del dispositivo. Mediante radiografía de tórax se confirmó el desplazamiento de los electrodos debido a un enrollamiento alrededor del generador. El síndrome de reel es una entidad que debe ser descartada como una de las posibles causas de mal funcionamiento de un marcapasos, principalmente en pacientes con factores de riesgo para presentar dicho síndrome.

Anestesia locorregional en una paciente adulta con síndrome de Prader-Willi: consideraciones anestésicas / Anesthetic consideration: Regional anesthesia with Prader-Willi

Prader-Willi syndrome (PWS) is a disorder caused by a genetic alteration that causes a multisystem clinic. It can be due mainly to three genetic mechanisms; a paternal deletion of the 15q11-13 region, a maternal uniparental disomy, or an imprinting defect. The paternal deletion is observed in 70% of the patients, the disomy in 25% and the imprinting defect in only 5% of those affected by this syndrome. 1) It is the most common syndromic cause of obesity with an estimated prevalence in the population of 1: 50,000; 2) The clinic is very variable, which is why clinical criteria have been created that, supported by the genetic study, confirm the diagnosis; 3) They have difficulty feeding during lactation, which leads to hyperphagia in childhood that leads to obesity. In the adult stage, in addition to obesity, respiratory pathology, sleep disturbances and psychological disorders stand out; 4) Objective: the aim of the present review was to compile the cases recorded in the scientific literature of patients anesthetized with PWS and the anesthetic options used in said patients.

El síndrome de Prader-Willi (SPW) es un trastorno causado por una alteración genética que provoca una clínica multisistémica. Puede ser debido principalmente a tres mecanismos genéticos; una deleción paterna de la región 15q11-13, una disomía uniparental materna o un defecto de impronta. La deleción paterna se observa en el 70% de los pacientes, la disomía en el 25% y el defecto de impronta en tan solo el 5% de los afectados por este síndrome. 1) Constituye la causa sindrómica más frecuente de obesidad con una prevalencia estimada en la población de 1:50.000; 2) La clínica es muy variable por lo que se han creado unos criterios clínicos que apoyados por el estudio genético confirman el diagnóstico; 3) Presentan dificultad para la alimentación durante la lactancia, que da paso a una hiperfagia en la infancia que deriva en obesidad. En la etapa adulta, además de la obesidad destacan la patología respiratoria, alteraciones del sueño y trastornos psicológicos; 4) Objetivo: el objetivo de la presente revisión fue recopilar los casos registrados en la literatura científica de pacientes anestesiados con SPW y las opciones anestésicas utilizadas en dichos pacientes.

Cardiac complications in a metamizole-induced type I Kounis syndrome / Complicações cardíacas em síndrome de Kounis tipo I induzida por metamizol

ABSTRACT Kounis syndrome is defined as the coincidental occurrence of allergic reaction and acute coronary syndrome secondary to vasospasm. Anti-inflammatory drugs are included as one of the multiple causes. Current data available about this syndrome come from case reports. We present the case of a patient who suffered Kounis syndrome with cardiogenic shock and asystole after intravenous infusion of Metamizole, and in which no lesions were observed in coronariography.

RESUMO A síndrome de Kounis é definida como a ocorrência concomitante de reação alérgica e síndrome coronariana aguda secundária ao vasoespasmo. Os medicamentos anti-inflamatórios estão incluídos como uma das múltiplas causas. Os dados atuais disponíveis sobre essa síndrome são provenientes de relatos de caso. Relatamos o caso de um paciente que apresentou síndrome de Kounis com choque cardiogênico e assistolia após infusão intravenosa de metamizol e no qual não foram observadas lesões na coronariografia.

Cardiac complications in a metamizole-induced type I Kounis syndrome.

Kounis syndrome is defined as the coincidental occurrence of allergic reaction and acute coronary syndrome secondary to vasospasm. Anti-inflammatory drugs are included as one of the multiple causes. Current data available about this syndrome come from case reports. We present the case of a patient who suffered Kounis syndrome with cardiogenic shock and asystole after intravenous infusion of Metamizole, and in which no lesions were observed in coronariography.

[Cardiac complications in a metamizole-induced type I Kounis syndrome]. / Complicações cardíacas em síndrome de Kounis tipo I induzida por metamizol.

Kounis syndrome is defined as the coincidental occurrence of allergic reaction and acute coronary syndrome secondary to vasospasm. Anti-inflammatory drugs are included as one of the multiple causes. Current data available about this syndrome come from case reports. We present the case of a patient who suffered Kounis syndrome with cardiogenic shock and asystole after intravenous infusion of Metamizole, and in which no lesions were observed in coronariography.

Rotura hepática espontánea en el síndrome HELLP: tratamiento mediante packing / Spontaneous hepatic rupture in HELLP syndrome: treatment through hepatic packing

La rotura hepática espontánea asociada a síndrome de HELLP (hemólisis, elevación de enzimas hepáticas y plaquetopenia) es extremadamente rara y se acompaña de una elevada tasa de complicaciones y mortalidad maternofetal. Es necesario un tratamiento urgente basado en la finalización del embarazo, reposición de hemoderivados y hemostasia hepática.Presentamos el caso de una paciente con síndrome HELLP y rotura hepática espontánea tratada mediante cesárea urgente y packing hepático (AU)

Spontaneous hepatic rupture associated with HELLP syndrome (hemolysis, elevated liver enzyme levels and low platelet count) is a very rare phenomenon that is frequently associated with a substantial rate of complications and mortality. In these cases, urgent management based on prompt delivery, blood transfusion and hepatic hemostasis is required.We report the case of a patient with spontaneous hepatic rupture caused by HELLP syndrome, which was treated with urgent cesarean section and hepatic packing (AU)

A novel phase assignment protocol and driving system for a high-density focused ultrasound array.

Currently, most phased-array systems intended for therapy are one-dimensional (1-D) and use between 5 and 200 elements, with a few two-dimensional (2-D) systems using several hundred elements. The move toward lambda/2 interelement spacing, which provides complete 3-D beam steering, would require a large number of closely spaced elements (0.15 mm to 3 mm). A solution to the resulting problem of cost and cable assembly size, which this study examines, is to quantize the phases available at the array input. By connecting elements with similar phases to a single wire, a significant reduction in the number of incoming lines can be achieved while maintaining focusing and beam steering capability. This study has explored the feasibility of such an approach using computer simulations and experiments with a test circuit driving a 100-element linear array. Simulation results demonstrated that adequate focusing can be obtained with only four phase signals without large increases in the grating lobes or the dimensions of the focus. Experiments showed that the method can be implemented in practice, and adequate focusing can be achieved with four phase signals with a reduction of 20% in the peak pressure amplitude squared when compared with the infinite-phase resolution case. Results indicate that the use of this technique would make it possible to drive more than 10,000 elements with 33 input lines. The implementation of this method could have a large impact on ultrasound therapy and diagnostic devices.