Sulfato de magnesio inhalado en el tratamiento del asma aguda / INHALED MAGNESIUM SULFATE FOR THE TREATMENT OF ACUTE ASTHMA

Antecedentes: Las exacerbaciones del asma pueden ser frecuentes y variar en gravedad, desde relativamente leves hasta el estado asmático. El uso del sulfato de magnesio (MgSO4) es una de las muchas opciones de tratamiento disponibles para las exacerbaciones agudas que no se ha estudiado vía inhalada. Objetivo: Determinar la utilidad del sulfato de magnesio inhalado, administrado en el asma aguda, sobre la función pulmonar y en las horas de estancia intrahospitalaria. Métodos: Previa firma de consentimiento informado se incluyó a los pacientes con asma ingresados a urgencias los cuales respondieron un cuestionario sobre cuestiones generales. Por aleatorización simple 1:1 se formaron 2 grupos: a) al que se le aplicó el tratamiento estándar para este padecimiento b) al que además del tratamiento estándar se le administró 500mcgrs de S. Magnesio inhalado por 3 dosis con intervalo de 20 minutos. Se realizaron mediciones clínicas y por flujometría al ingreso, 20, 40 y 60 minutos. Resultados: No se observaron diferencias estadísticamente significativas iniciales entre los grupos de tratamiento con el género, turno o mortalidad. En cuanto a las horas de estancia intrahospitalaria se vio una disminución significativa en el grupo de casos. El Tiempo de Apnea Voluntaria de forma inicial en el grupo tratado con Sulfato de Magnesio alcanzaron mayores tiempos en mayor cantidad de participantes, con una diferencia significativa (p=0.01). Los valores de la FEM se comportaron de forma similar, siendo mayores y con diferencia significativa (0.05) en el grupo de casos. Conclusiones: El magnesio nebulizado no ha sido ampliamente probado, sin embargo en nuestro estudio, parece ser eficaz al mejorar la función pulmonar de los pacientes que ingresan con crisis asmática, disminuir el tiempo de estancia intrahospitalaria y mejoría en la clínica del paciente

Background: Asthma exacerbations can be frequent and range in severity from relatively mild to asthmatics status. The use of magnesium sulphate (MgSO4) is one of the many treatment options available during acute exacerbations has not been studied inhaled. Objective: To determine the utility of inhaled magnesium sulfate, administered in acute asthma on lung function and hours of hospital stay. Methods: After obtaining informed consent were included patients admitted to the emergency department with asthma who answered a questionnaire on general issues. For simple randomization 1: 1 2 groups were formed: a) to which was applied the standard treatment for this condition b) that in addition to standard treatment was administered 500mcgrs S. Magnesium inhaled by 3 doses with an interval of 20 minutes. Clinical measurements were made and flowmetry at admission, 20, 40 and 60 minutes. Results: No statistically significant differences between initial treatment group gender, shift or mortality were observed. As for the hours of hospital stay was a significant decrease in the case group. The Apnea Time Volunteer initial shape in the treated group achieved Magnesium Sulfate older times more participants, with a significant difference (p = 0.01). EMF values behaved similarly, with higher and significant difference (0.05) in the case group. Conclusions: nebulized magnesium has not been extensively tested, but in our study, appears to be effective in improving lung function in patients admitted with acute asthma, decrease hospital stay time and improvement in clinical patient

[Amyand's hernia and complicated appendicitis; case presentation and surgical treatment choice]. / Hernia de Amyand y apendicitis complicada; presentación de un caso y elección de tratamiento quirúrgico.

BACKGROUND: A caecal appendix within an inguinal hernia, with or without appendicitis, is defined as Amyand's hernia. In 1% of inguinal hernias an appendix without inflammation can be found, however, the prevalence of appendicitis in a hernia sac is only 0.08-0.13%. CLINICAL CASE: Male of 43 years old, began two days before admission with pain in the right inguinal region. He was scheduled for surgery due to a complication of a right inguinal hernia. The surgical findings were Amyand's hernia, necrotic spermatic cord, and perforated appendix. Surgical repair was performed with a favourable outcome, and he was discharged on the fourth postoperative day. DISCUSSION: Most of Amyand's hernia exhibit characteristics of incarcerated or strangulated inguinal hernia. Even acute appendicitis or perforated appendix within the hernia sac does not reflect specific symptoms or signs, therefore, a preoperative clinical diagnosis of Amyand's hernia is difficult to achieve. In our case, the patient had perforated appendicitis, developing necrosis of the spermatic cord. Orchiectomy, appendectomy, and inguinal hernia repair was performed without placing mesh. Due to the controversy on the use of mesh in contaminated abdominal wall defects, it was not indicated here, due to the high risk of wound infection and appendicular fistula. CONCLUSION: An extremely rare condition is presented, with a surgical choice that led to a favourable outcome.

[Mesoappendix cyst. A case report]. / Quiste de mesoapéndice. Informe de un caso.

Mesenteric cysts are lesions that appear very rare. Its incidence ranges from 1:20,000 in children and 1:100,000 in adults. Their clinical manifestations are atypical and they include abdominal pain, vomit, tumor and complications from hemorrhage, peritonitis when there is a rupture of infected cyst, intestinal occlusion, renal failure, volvulus and malignant transformation. We present a case of mesenteric cyst, located in the mesoappendix with slight vascular compromise and chronic symptoms, its treatment and evolution.