RESUMEN
INTRODUCTION: Anaphylactic reactions can lead to a life-threatening situation. In the event of anaphylaxis, rapid and targeted emergency treatment is indicated. STUDY OBJECTIVE: The study sought to determine the emergency therapy administered for anaphylaxis in children and adults. Focus was placed on therapy with adrenaline. In addition, the study aimed to investigate demographic data, triggers, and hospitalization rates of the different severities of anaphylaxis. METHODS: A retrospective analysis of anaphylactic reactions was conducted using data from prehospital emergency missions performed by the Air Rescue Dresden/Germany from 2008 through 2015 using the standardized application protocol EPRO-5.0 (MIND 3) anonymized. Data from 152 adults and 29 children were evaluated, focusing especially on the acute treatment as well as demographic information, triggers, and symptoms of anaphylactic reactions. RESULTS: In total, 152 adults (73 female, 79 male) from 18 to 87 years (mean 50.5 years) and 29 children (9 female, 20 male) from 1 to 16 years (mean 7.5 years) with anaphylactic reactions were analyzed. The most common trigger for severe anaphylactic reactions (Grade II-IV; classification modified according to Ring and Messmer) was food in children (33%) and insect venom in adults (59%). The data show that 19% of adults with Grade II-IV anaphylactic reactions (classification modified according to Ring and Messmer) received adrenaline. Regarding children, the appliance of adrenaline was only administered in seven percent of the cases of Grade II-IV anaphylactic reactions. Adults with Grade II or higher anaphylactic reactions were hospitalized in 92%. Three percent refused hospitalization and five percent were not transferred to hospital. One-hundred percent of the children with Grade II-IV anaphylaxis were hospitalized. CONCLUSIONS: Analysis of data from the Air Rescue Dresden/Germany shows that despite existing recommendations, only 19% of adults with severe anaphylaxis received adrenaline. Among children, only in seven percent was a treatment with adrenaline performed.On the other hand, all patients survived the acute emergency treatment without apparent adverse outcomes. Thus, further studies are needed to determine the proper use of adrenaline in anaphylactic reactions.
Asunto(s)
Anafilaxia , Adulto , Aeronaves , Anafilaxia/tratamiento farmacológico , Anafilaxia/epidemiología , Niño , Tratamiento de Urgencia , Epinefrina/uso terapéutico , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
We report the case of a 49-year-old female patient who suffered from anosmia following an apparently mild head trauma when bumping into a door at her home. She reported no other accompanying symptoms after the injury that day. Olfactory function was completely lost, which was noted the day after the trauma. Gustatory function remained normal. Magnetic resonance imaging indicated lesions/bleeding in the right frontal lobe and in the area of the olfactory sulcus/bulb. The present case indicates that in case of apparently mild head trauma with anosmia, an MRI scan of the head should be performed because of suspect brain damage. This case also points to the deeper question how to gauge severity of head trauma.
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Anosmia , Traumatismos Craneocerebrales , Traumatismos Craneocerebrales/complicaciones , Traumatismos Craneocerebrales/diagnóstico por imagen , Femenino , Lóbulo Frontal , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Bulbo OlfatorioRESUMEN
Recent studies have revealed a variety of genes and mechanisms that influence the rate of aging progression. In this study, we identified cell cycle factors as potent regulators of health and longevity in C. elegans. Focusing on the cyclin-dependent kinase 2 (cdk-2) and cyclin E (cye-1), we show that inhibition of cell cycle genes leads to tolerance towards environmental stress and longevity. The reproductive system is known as a key regulator of longevity in C. elegans. We uncovered the gonad as the central organ mediating the effects of cell cycle inhibition on lifespan. In particular, the proliferating germ cells were essential for conferring longevity. Steroid hormone signaling and the FOXO transcription factor DAF-16 were required for longevity associated with cell cycle inhibition. Furthermore, we discovered that SKN-1 (ortholog of mammalian Nrf proteins) activates protective gene expression and induces longevity when cell cycle genes are inactivated. We conclude that both, germline absence and inhibition through impairment of cell cycle machinery results in longevity through similar pathways. In addition, our studies suggest further roles of cell cycle genes beyond cell cycle progression and support the recently described connection of SKN-1/Nrf to signals deriving from the germline.