RESUMO
Background: The Arnold-Chiari malformation (ACM) is a group of congenital abnormalities of the hindbrain and the spinal cord and is characterized by herniation of the cerebellum, kinking of the medulla oblongata and hydrocephalus, the anesthetic management Is complicated due to the anatomic and physiologic alterations. Case description: A 23 years old woman with Arnold-Chiari type II malformation, and perforated appendicitis. Conclusions: The present case demonstrates that patients with partially corrected ACM type II, restrictive lung disease due to scoliosis and perforated appendicitis delivery require an interdisciplinary team approach, diligent preparation, and skilled physicians.
Antecedentes: La malformación de Arnold-Chiari (ACM) es un grupo de anomalías congénitas del cerebro posterior y la médula espinal que se caracteriza por la herniación del cerebelo, retorcimiento del bulbo raquídeo e hidrocefalia, el manejo anestésico se complica debido a la anatomía y alteraciones fisiológicas. Descripción del caso: Una mujer de 23 años con Arnold-Chiari tipo II malformación y apendicitis perforada. Conclusiones: El presente caso demuestra que los pacientes con corregido parcialmente ACM tipo II, enfermedad pulmonar restrictiva debido a la escoliosis y la entrega apendicitis perforada requieren un enfoque multidisciplinario en equipo, preparación diligente, y los médicos cualificados.
Assuntos
Humanos , Adulto , Feminino , Anestesia/métodos , Apendicite/cirurgia , Malformação de Arnold-Chiari/complicações , Apendicite/complicaçõesRESUMO
OBJECTIVE: To analyze the short-term impact of air pollution on daily mortality in the City of Zaragoza (Spain). MATERIAL AND METHODS: This ecologic study was conducted in Zaragoza, Spain, from 1991 to 1993. Poisson autoregressive models were constructed to assess the association between air particulate matter and sulphur dioxide SO2 and daily deaths. Four outcome variables were studied: overall mortality (excluding external deaths), mortality in subjects over 69 years of age, mortality due to respiratory disease, and mortality due to cardiovascular disease. A sample size was not obtained. Data analysis was conducted using the statistical software EGRET and SPSS. RESULTS: SO2 levels were significantly associated with cardiovascular deaths (RR = 1.018 IC 95%: 1.001-1.036) and particulate matter levels with respiratory deaths (RR = 1.028 IC 95%: 1.006-1.051). During the warm season, a significant relationship was found between particulate mater and cardiovascular deaths (RR = 1.020 IC 95%: 1.001-1.040). CONCLUSIONS: Low levels of air pollution were found in Zaragoza, with considerable variation in the concentration of air pollutant concentrations and daily respiratory and cardiovascular deaths, particularly during the warm season. The English version of this paper is available at: http://www.insp.mx/salud/index.html
Assuntos
Poluição do Ar/efeitos adversos , Mortalidade/tendências , Saúde da População Urbana/estatística & dados numéricos , Idoso , Causas de Morte/tendências , Humanos , Espanha/epidemiologia , Fatores de TempoRESUMO
The phospholipase A2 activity in young amniotic fluids: 1.782, was determined. In the term amniotic fluids, the activity was 10.693. The detected activity in fluids from premature rupture of membranes was 29.077 in the group with infection, add 12.357 for the samples without infection. It was seen that young amniotic fluid has less activity. The group with infection showed the greatest activity. The significant increase of phospholipase A2 activity in term amniotic fluids and with PRM, in comparison with what is seen in young fluids suggests the active participation of the soluble form of this enzyme as mediator in the increase of Prostaglandin E2 seen in the amniotic fluid of the two first groups. Accordingly, one may think that PPLA2 could be a central mediator in membranes rupture mechanism in normal labor, as in PRM.