RESUMO
El síndrome de Kounis fue definido, por primera vez, en 1991, como la aparición simultánea de episodios coronarios agudos y reacciones alérgicas anafilácticas o anafilactoides. Los agentes etiológicos asociados a su aparición son múltiples y los más frecuentes son los fármacos, en especial, los antibióticos. Su diagnóstico es eminentemente clínico, no existe ninguna prueba patognomónica. No hay consenso ni guías de práctica clínica específicas; se recomienda el tratamiento específico para el síndrome coronario agudo enfocado en tratar el vasoespasmo y la anafilaxia, con el agravante de que puede haber contraindicaciones cuando se usan conjuntamente y que dichos fármacos antianginosos pueden desencadenar el cuadro. Se presenta un caso clínico de síndrome de Kounis asociado a cefditorén, el primero descrito en la literatura(AU)
Kounis syndrome was first described in 1991 as the simultaneous occurrence of acute coronary events and allergic anaphylactic or anaphylactoid reactions. Multiple etiologic agents are associated with this syndrome, the most common are drugs, especially antibiotics. Diagnosis is eminently clinical, there are not pathognomonic tests. Consensus and specific clinical practice guidelines are lacking; specific acute coronary syndrome treatment is recommended focusing on vasospasm and anaphylaxis, with the aggravating circumstance that contraindications can be present when used together and such antianginal drugs may trigger the condition. We present a case of Kounis syndrome associated with cefditoren, the first reported in the literature.(AU)
RESUMO
Fifty-eight nursing Zebu cows averaging 5922 days postpartum were used to evaluate the early embryonic development by ultrasound under a natural mating system (bulls A to F). Three consecutive mating periods of 21 days were established. Sixty two percent of the animals were diagnosed as pregnant (36/58). During the first period (AB) 76% (27/36) of the animals become pregnant, 17% (6/36) during the second (CD) and 9% (3/36) in the last mating period (EF). Sixty two percent of the animals were true positives (animals found pregnant diagnosed by ultrasound (US), and conforming with the embryonic scale proposed by Rosiles et al. (2006); 12% (n = 7) of false negatives (pregnant cows by US but not conforming with the scale); 2% (n = 1) of false positives (pregnant cows, evaluated with US and conforming with the embryonic scale but not pregnant at the end of the study); and a 26% (n = 15) of true negatives (not pregnancy evaluated with US). The sensitivity of the test was 97%, with a specificity of 68% with a positive predictive value of 83% and a negative predictive value of 6%. Relation between the measuring scale of embryo development and the results obtained by ultrasonography was k = 0.69. No significant correlation were observed between body condition score (BCS) evaluation and body fat (BF) measurement at any of the three evaluations performed after mating, however, measurements of BCS and BF among time showed a positive correlation (0.48 P < 0.05, 0.29, P < 0.07, respectively) from the beginning of the evaluation period to the end of the trial. Ultrasonography to monitor embryonic development to determine the early establishment of pregnancy in natural mating reproductive programs can be a valuable technique to monitor reproductive efficiency.
