ABSTRACT
Introducción: El SDRC lo define la IASP como "un cuadro de dolor desproporcionado a la causa que lo produce, acompañado de alteraciones sensoriales tales como alodinia/hiperalgesia, disfunción autonómica y motora que ocurre después de un trauma que, con frecuencia, es trivial y que se presenta, por lo general, en una extremidad". Estos síntomas están bien descritos en los adultos, pero existen pocos datos sobre la prevalencia en la población pediátrica. A diferencia del adulto, el 90 % de los casos aparecen en niñas, en edades comprendidas entre los 8-16 años con afectación, sobre todo, de una extremidad inferior. Material y método: Presentamos un total de dos pacientes, de 11 y 13 años de edad, con un cuadro severo de SDRC de extremidad inferior, tratadas previamente mediante tratamiento farmacológico y rehabilitador sin alivio de sus síntomas. En las dos pacientes se realizó un bloqueo simpático lumbar continuo mediante la colocación de un catéter epidural y la administración de una infusión continua de anestesia local, con lo que se consiguió una mejoría tanto del dolor como del resto de la sintomatología acompañante. Se implantó, en quirófano y bajo anestesia general un electrodo octopolar a nivel epidural dorsal iniciándose la estimulación eléctrica de la extremidad afectada. En las dos pacientes se valoró tanto la evolución de la intensidad del dolor así como su repercusión en la calidad de vida antes del inicio de la estimulación y a las dos semanas de haber iniciado el tratamiento, momento en el que se dio por terminado el periodo de prueba y se procedió a la implantación (en quirófano y bajo anestesia general) de un generador programable (AU)
Introduction: The IASP defined CRPS as "pain box disproportionate to the cause that produces it, accompanied by sensory disturbances such as allodynia/hyperalgesia, autonomic and motor dysfunction that occurs after a trauma that often is trivial andi s presents ussually a limb". These symptoms are well described in adults, but there are few data on the prevalence in the pediatric population. Unlike the adult, 90% of cases occur in girls aged between 8 - 16 years with involvement mainly of a lower limb. Materials and methods: We present a total of two patients, aged 11 and 13 years old with severe symptoms of lower extremity CRPS, previously treated with medication and rehabilitation without relief from their symptoms. In the two patients underwent continuous lumbar sympathetic block by placing on epidural catheter and administration of a continuous infusión of local anesthetic, so the patient improved both pain and the resto f the accompanying symptoms. Was implanted in the operating room under general anesthesia octupole electrode starting at dorsal epidural electrical stimulation of the affected limb. In the two patients was evaluated both the evolution of the intensity of pain and its impacto n quality of life befote the Honest of stimulation and within two weeks of starting treatment, at which time it terminated the period of proceeded to test the implementation (in the operating room under general anesthesic) programmable generator (AU)
Subject(s)
Humans , Male , Female , Child , Complex Regional Pain Syndromes/complications , Complex Regional Pain Syndromes/diagnosis , Hyperalgesia/complications , Hyperalgesia/diagnosis , Quality of Life , Pain Measurement/instrumentation , Pain Measurement/methods , Pain Measurement , Complex Regional Pain Syndromes/physiopathology , Complex Regional Pain Syndromes , Anesthesia, General/instrumentation , Anesthesia, General/methods , Anesthesia, GeneralABSTRACT
Breeding of tomato genotypes that limit whitefly (Bemisia tabaci) access and feeding might reduce the spread of Tomato yellow leaf curl virus (TYLCV), a begomovirus (genus Begomovirus, family Geminiviridae) that is the causal agent of tomato yellow leaf curl disease. TYLCV is restricted to the phloem and is transmitted in a persistent manner by B. tabaci. The tomato breeding line ABL 14-8 was developed by introgressing type IV leaf glandular trichomes and secretion of acylsucroses from the wild tomato Solanum pimpinellifolium accession TO-937 into the genetic background of the whitefly- and virus-susceptible tomato cultivar Moneymaker. Results of preference bioassays with ABL 14-8 versus Moneymaker indicated that presence of type IV glandular trichomes and the production of acylsucrose deterred the landing and settling of B. tabaci on ABL 14-8. Moreover, electrical penetration graph studies indicated that B. tabaci adults spent more time in nonprobing activities and showed a reduced ability to start probing. Such behavior resulted in a reduced ability to reach the phloem. The superficial type of resistance observed in ABL 14-8 against B. tabaci probing significantly reduced primary and secondary spread of TYLCV.
Subject(s)
Begomovirus/physiology , Hemiptera/virology , Insect Vectors/virology , Plant Diseases/virology , Solanaceae/virology , Acylation , Animals , Begomovirus/isolation & purification , Biological Assay , Disease Management , Feeding Behavior , Genotype , Hemiptera/physiology , Insect Vectors/physiology , Plant Leaves/genetics , Plant Leaves/parasitology , Plant Leaves/physiology , Plant Leaves/virology , Seasons , Solanaceae/genetics , Solanaceae/parasitology , Solanaceae/physiology , Sucrose/analogs & derivatives , Sucrose/metabolism , Time FactorsABSTRACT
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Subject(s)
Humans , Morphine/pharmacology , Infusion Pumps, Implantable , Pain/drug therapy , Morphine/administration & dosage , Injections, Spinal/methodsSubject(s)
Humans , Analgesia, Epidural , Low Back Pain/drug therapy , Medulla Oblongata/drug effects , Nerve BlockABSTRACT
We have treated a total of 40 patients who presented chronic pain secondary to a neoplastic condition; the patients were treated with morphine in a continuous perfusion by means of an implanted perfusion pump. The route used was the epidural route in seven patients and the intrathecal route in the remaining 33 patients. In 22 patients, the implanted pump was the continuous flow Infusaid model and in the remaining 18, the programmable flow Synchromed (Medtronic) model. The daily dose of morphine ranged from 2.4 mg to 48 mg and maximum perfusion period was 19 months. Main complications were displacement of the catheter and rejection of perfusion system. Despite its high prize, we believe that such treatment system should be considered because of the quality of life improvement of the patients.
Subject(s)
Analgesia, Epidural/instrumentation , Infusion Pumps, Implantable , Morphine/administration & dosage , Neoplasms/complications , Pain/drug therapy , Adult , Aged , Chronic Disease , Female , Humans , Injections, Spinal , Male , Middle Aged , Pain/etiologyABSTRACT
Strains of Pseudomonas aeruginosa isolated from patients in the University of Granada (Spain) from 1981 to 1986 were pyocin-typed in order to determine which types were the most common. The proportions of typable and non typable strains were similar to those obtained by other authors. A high percentage of typable strains were unclassifiable (UC) according to Govan's method. The most frequent types of typable strains were 580 (55 of Govan), 270 (UC), 280 (UC), 570 (UC), 670 (73 of Govan), 113 (10 of Govan), 470 (86 of Govan) and 180 (58 of Govan). These types were responsible for the appearance of several nosocomial outbreaks during the years of this study. Types 580, 113 and 280 remained constant for these six years; for this reason, they can be considered endemic of our hospital.