RESUMO
This study compared intubation conditions produced by the Macintosh and Airtraq™ laryngoscopes when used in obese patients in the ramped position. One hundred and thirty-two patients having bariatric surgery were placed in the ramped position and randomly assigned to have their tracheas intubated using either the Macintosh (n=64) or an Airtraq (n=68) laryngoscope. Mean (SD) intubation times were 37 (23) s and 14 (3) s for Macintosh and Airtraq, respectively (p<0.0001). Compared with the Macintosh laryngoscope, the Airtraq laryngoscope provided an improved vocal cord view as assessed by the Cormack and Lehane score (number of patients with Cormack-Lehane scores of 1/2/3/4/37/20/4/3 for the Macintosh, and 65/3/0/0 for the Airtraq laryngoscopes, p<0.0001). One patient in the Macintosh group had a failed intubation and intubation was achieved with the Airtraq. For obese patients in ramped position, Airtraq affords faster tracheal intubation than the Macintosh laryngoscope.
Assuntos
Laringoscópios , Laringoscopia/métodos , Obesidade/complicações , Adulto , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Eletrocardiografia , Feminino , Glote/anatomia & histologia , Frequência Cardíaca/fisiologia , Humanos , Hipnóticos e Sedativos , Intubação Intratraqueal , Masculino , Pescoço/anatomia & histologia , Oximetria , Oxigênio/sangue , Postura/fisiologia , Falha de Tratamento , Prega Vocal/anatomia & histologiaRESUMO
Vasa previa occurs in pregnancy when one of the membrane vessels extends down to the level of the internal cervical os, ahead of the fetal presenting part and unsupported by the placenta tissue or umbilical cord. The rupture of the vessels might happen spontaneously or artificially and frequently results in fetal exsanguination and demise. Ultrasound prenatal diagnosis is highly important as it allows the identification of patients at risk, thus an elective cesarean can be performed before rupture the membranes. We report a case of vasa previa diagnosed through color Doppler mode in the 30th week of gestation, emphasizing the contribution of three-dimensional power Doppler to the adequate mapping of aberrant vessels, which greatly contributed to the success of the perinatal result.
Assuntos
Imageamento Tridimensional , Placenta Prévia/diagnóstico , Diagnóstico Pré-Natal , Ultrassonografia Doppler em Cores , Adulto , Cesárea , Feminino , Humanos , GravidezRESUMO
Intersex states are associated with rare syndromes within a wide clinical spectrum, true hermaphroditism being the rarest of them all. It is a condition that is characterized by ovotestis, i.e. the presence of ovarian and testicular tissues in the same individual, either in separate gonads or in the same gonad. Diagnostic investigation of hermaphroditism involves ultrasound examination of the gonads, karyotype analysis and histological studies. We report the case of a 21-year-old individual with true hermaphroditism, in whom ovotestis was diagnosed on ultrasonography and which was later confirmed by anatomopathological study of the gonads. The role of ultrasound in the initial diagnostic investigation of intersex states, especially true hermaphroditism, is discussed.
Assuntos
Transtornos do Desenvolvimento Sexual/diagnóstico por imagem , Óvulo/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adulto , Corpo Lúteo/diagnóstico por imagem , Feminino , Humanos , Cariotipagem , Masculino , Ultrassonografia , Útero/diagnóstico por imagem , Vagina/diagnóstico por imagemRESUMO
PURPOSE: To evaluate if the presence of right bundle branch block (RBBB), without structural myocardial abnormalities (SMA) can generate fragmented potentials (FP) and spectral turbulence on signal-averaged electrocardiogram (SAECG). METHODS: Twelve children with atrial septal defect (ASD) and incomplete right bundle branch block (IRBBB without SMA (group I) were compared to 17 children with post-operative tetralogy of Fallot (TF) with CRBBB, all with SMA, 5 with ventricular premature beats and 2 with sustained ventricular tachycardia (group II). All had SAECG on time (TD) and frequency domain (FD) with 5 variables analysed. RESULTS: All patients of group I had normal variables, in contrast with group II which presented abnormal variables suggesting FP and ST. CONCLUSION: In ASD without SMA, the isolated IRBBB did not generate FP and ST.
Assuntos
Bloqueio de Ramo/fisiopatologia , Eletrocardiografia/métodos , Comunicação Interatrial/fisiopatologia , Tetralogia de Fallot/fisiopatologia , Bloqueio de Ramo/diagnóstico , Criança , Feminino , Comunicação Interatrial/diagnóstico , Humanos , Masculino , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/fisiopatologia , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/fisiopatologiaRESUMO
We report a large Brazilian kindred with 28 cases of the autosomal dominant multiple synostosis syndrome. The main anomalies were symphalangism and carpal and tarsal synostoses. Other common findings included synostosis involving other bones, absence of phalanges and nails, short metacarpals, pes planovalgus with prominent lateral border, hypoplastic alae of nose, short upper lip, and dermatoglyphic abnormalities. This may be a variant of the WL syndrome.