Shock e isquemia miocárdica por reacción disulfiram-alcohol / Shock and myocardial ischaemia because disulfiram-alcohol reaction

Los síntomas de la reacción disulfiram-alcohol, aunque intensos y desagradables, suelen ser transitorios. La persistencia de las alteraciones hemodinámicas graves o con signos de disfunción orgánica se han descrito de forma excepcional, constituyendo en la actualidad una rareza por la escasa utilización del fármaco. Presentamos el caso de un paciente atendido por un cuadro de shock y síndrome coronario agudo, sus particularidades clínicas, dificultad diagnóstica y de tratamiento, que resultó ser consecuencia de una reacción disulfiram-alcohol inicialmente no advertida (AU)

Bibliografía Internacional

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[Development and evaluation of food supplements for the education, health, and nutrition program]. / Desarrollo y evaluación de suplementos alimenticios para el programa de educación, salud y alimentación.

OBJECTIVE: To develop and evaluate nutritional supplements destined to a program of social assistance. MATERIAL AND METHODS: In the design of the nutritional supplements a series of criteria were considered including nutrient composition, physicochemical properties and feasibility of production and utilization. Final products were initially evaluated to determine the level of acceptance in 40 children, 52 pregnant women and 62 lactating women in Mexico City. A community trial was also carried out to determine acceptance and consumption in 108 children and 128 women from a rural community in the state of Morelos. RESULTS: The specific formulation and technical processes of production of the nutritional supplements are presented. Products proved to be widely accepted, with average scores of 4.11-4.29 for the children's beverage, and 3.98-4.15 for a more viscous pap (range of scores was 1 to 5). Products for women received average scores from 4.75 to 5.70 in pregnant and from 4.8 to 5.4 in lactating women (range of scores from 1 to 7). In the community trial, supplements were very well accepted. Average consumption was > 75% among children and > 98% among women. Mean energy intake from supplements was 244 Kcal/day for women, and for children, 168 Kcal/day with the pap and 147 Kcal/day with the beverage. Consumption was consistent in all cases along the study. CONCLUSIONS: Nine nutritional supplements were developed and evaluated which comply with the necessary nutritional, physicochemical and hygienic characteristics for the target population, besides being relatively simple to prepare, and widely well accepted and consumed.

[Infectivity by HIV of different blood products used in Aragon]. / Infectividad para el VIH de diferentes hemoderivados empleados en Aragón.

In our region, prevalence of anti-HIV antibodies among hemophiliacs B (83.3%) is higher than among hemophiliacs A (47%), as reported in other spanish communities and contrary to other countries, were the opposite phenomenon has been observed. This seems to be due to the volume of hemo-derivatives received, rather than to their different infectivity, as it has been suggested sometimes. In order to assess this infectivity, independently of doses, we have studied two groups of patients, hemophiliacs A transfused with factor III and non-hemophiliacs who had received concentrate of prothrombinic complex factors (CPCF), in doses lower than 10,000 units. Both groups were transfused during the period when seroconversions were observed in our area (1981-1985) and we demonstrated that the difference between their prevalences of anti-HIV antibodies was not statistically significant.

[Hemophagocytosis and undifferentiated carcinoma of the lung]. / Hemofagocitosis y carcinoma indiferenciado de pulmón.

Hemophagocytosis (HP) constitutes a valuable sign in the diagnosis of a number of hematologic diseases such as malignant histiocytosis (MH). It has also been described in the course of hematologic neoplasias being extremely rare in solid tumors. We present the case of a patient with pancytopenia, hepatomegaly, skin lesions and rapidly fatal evolution in whom the finding of HP in bone marrow arouse the suspicion of a MH. The post mortem study revealed the existence of undifferentiated lung carcinoma with a high degree of invasiveness, not finding histiocytic proliferation. The cases in the literature of the association of HP with non hematological neoplasias are revised as well as its possible pathogenic mechanisms. We conclude that MH needs to be considered as a non specific finding and that exhaustive cytochemical studies are necessary for the correct identification of the phagocytic cell.

[Spleen abscess]. / Absceso esplénico.

3 cases of splenic abscess (SA), all of them with similar clinical findings; abdominal pain, liver and splenic enlargement and leukocytosis, are presented. The diagnosis was suspected by abdominal ultrasound and confirmed by CTR. We focused the interest on the etiopathogenesis, diagnosis and the rareness of the bacteria isolated: Salmonella group D (two cases) and Bacteroides Fragilis.

[Pancreatitis in infants with a clinical diagnosis of septicemia]. / Pancreatitis en niños lactantes con diagnóstico clínico de septicemia.

Considering the possibility that during septicemic processes, pancreatitis could develop, 10 infants were studied when the clinical diagnosis of septicemia was established. With this purpose, the clinical manifestations present in the patients were recorded and the activities of serum amilase and lipase were determined at 24 hour intervals during the first three days and these studies were repeated on the 5th and 7th days. The results showed an abnormally high serum lipase activity, especially in 6 of the 10 infants. The amilase was found within normal limits with a tendency to drop in certain cases. This information suggest the presence of acute pancreatitis in some of the subjects studied.