Biomedical subjects
Publications and source records attributed to F Gilsanz.
A case of spontaneous spinal subdural hematoma is presented. Contrarily to the three cases previously reported, this patient didn't suffer a sudden onset with transient thoracic pain. Important neurological recovery followed surgical evacuation. The physiopathology of this entity and the myelographic findings in spinal subdural masses are briefly discussed.
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BACKGROUND: Parvovirus B19 is the etiologic agent of transient aplastic crisis, an acute episode of bone marrow failure in persons with underlying hemolysis. Successful administration of gammaglobulin in some chronic cases and immunocompromised patients infected with parvovirus B-19, resulting in the elimination of this virus has been reported. However little is known about the evolution of acute aplastic crisis in treated patients with chronic hemolysis nor about the minimal effective dose of immunoglobulin. METHODS: We report a family infected by Parvovirus B 19, discovered when a pure red blood-cell aplasia broke out in one family member who was suffering from a chronic haemolytic disease. The diagnosis was considered by presence of giant proerythroblasts in bone marrow and later confirmed by DNA viral detection using PCR technique. RESULTS: The patient was treated with a small dose of polivalent intravenous gammaglobulin, with a temporary disappearance of the virus from his serum during treatment. CONCLUSION: The usefulness, doses and length of immunoglobulin treatment in patients with transient aplastic crisis is discussed. Our results show that treatment with low doses of I.V. gammaglobulin able to control viremia and probably shorten the episode of anemia and acute aplastic crisis in this patient with chronic hemolytic anemia and parvovirus B-19 infection. This observation could be useful and cost saving also in chronic cases and in immunocompromised.
Sevoflurane is a fluoridated derivative of methyl isopropyl ether. Its administration does not require the use of sophisticated vaporizers and its blood/gas partition coefficient is 0.69. Sevoflurane is the only ethereal anesthesia that does not trigger a reflex response or cause airway irritation during inhaled induction. It offers a high level of precision in the control of deep anesthesia during maintenance, recovery is rapid, and MAC is 2%. Sevoflurane seems to be the pediatric anesthetic of choice and it is also highly useful for anesthesia in ambulatory patients. Sevoflurane gives rise to hemodynamic stability, is not arrhythmogenic, and does not sensitize the myocardium to the effects of catecholamines. The effects on cerebral blood flow are minimal at low concentrations. Metabolism is 3-4%. Renal toxicity has not been reported even though fluoride is a metabolic product. Sevoflurane breaks down in the presence of soda lime, producing compound A and giving rise to controversy and investigation although the toxicity of compound A is more theoretical than real. Sevoflurane is not harmful to the ozone layer.