ABSTRACT
The authors report the case of a female patient (41 years old) affected by mucopolysaccharidosis type III or Sanfilippo syndrome submitted to a gynecologic surgical procedure and describe the main anesthesiologic problems. A sub-arachnoid anesthesia with hyperbaric Bupivacain 0.5% was used. This technique proved to be safe and convenient without peri- and postoperative complications.
Subject(s)
Anesthesia, Spinal , Intraoperative Complications/prevention & control , Mucopolysaccharidosis III/complications , Ovarian Cysts/surgery , Respiration Disorders/prevention & control , Adult , Anesthesia, Inhalation , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Female , Humans , Laryngeal Masks , Monitoring, Intraoperative , Ovarian Cysts/complications , Subarachnoid SpaceSubject(s)
Hemodynamics/drug effects , Iloprost/pharmacology , Oxygen/blood , Critical Illness , Humans , Iloprost/administration & dosage , Iloprost/therapeutic use , Infusions, Intravenous , Respiratory Insufficiency/blood , Respiratory Insufficiency/drug therapy , Respiratory Insufficiency/physiopathology , VeinsSubject(s)
Plethysmography , Rheology , Thrombophlebitis/diagnosis , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Phlebography , Plethysmography, Impedance , Thrombophlebitis/diagnostic imagingSubject(s)
Laser Therapy , Surgical Procedures, Operative , Animals , Carbon Dioxide , Evaluation Studies as Topic , Rats , Rats, Inbred StrainsABSTRACT
In view of the growing number of examinations proposed and employed for the diagnosis of diseases of the thyroid, a retrospective evaluation was made of their validity in a series of 2500 patients (1500 operated). Attention was paid to scintiscanning, oncotropic indicators, echography, needle biopsy, thyrolymphography and thyroid hormones as aids to determining the nature of thyroid lesions and the planning of their treatment. Scintiscanning and needle biopsy proved of primary importance in determination of the nature of a lesion. Echography supplied additional, though not necessarily indispensable information. Oncotropic indicators and thyrolymphography do not appear to be useful. They do not provide data enabling a diagnostic problem to be solved, but can only help to increase any doubts that may exist. Determination of thyroid hormones is clearly indicated when planning the management of hot lesions (single, multiple or disseminated nodes), in cold lesions where thyroiditis is suspected, and in all cases where the clinical evidence suggests hypothyroidism. In euthyroid subjects requiring surgery with no objective signs of hypofunction, preoperative determinations appear to be unnecessary, where as post-operative values are of assistance in assessing the functional efficiency of the residual thyroid tissue. The conclusion to be drawn, therefore, is that diagnostic examinations should be employed in a more selective and discriminating manner.
