RESUMO
Juvenile Huntington's Disease (JHD) is an involuntary movement disorder that comprises both neurological and psychiatric symptoms. Whilst it has many similarities to Huntington's Disease, it is regarded as a separate clinical entity. The anaesthetic plan should be based on careful assessment of the important issues, including the risk of regurgitation and pulmonary aspiration, possible associated autonomic neuropathy, poor respiratory function and the avoidance of precipitating convulsions and clonic spasms. We describe the management of a 12-year-old girl with JHD scheduled for gastroscopy under general anaesthesia necessitating the use of suxamethonium. We suggest an alternative mechanism for the delayed recovery seen in our patient and in other adult case reports.
Assuntos
Anestesia Geral , Doença de Huntington , Succinilcolina , Criança , Feminino , Gastroscopia , Humanos , Fármacos Neuromusculares DespolarizantesRESUMO
We present a case report of an asymptomatic 12-year-old girl who was incidentally noted to have a collapsed upper lobe of her right lung during anaesthesia for angiography. After initial success at reexpansion using manual ventilation and suctioning, the lobe collapsed again some 15 min later. Physiological parameters remained stable throughout. Consent was obtained for fibreoptic bronchoscopy which was performed uneventfully and resulted in reexpansion of the lobe. We discuss the difficulty in identifying patients at risk of this complication, the need for therapeutic intervention and the issue of consent.
Assuntos
Complicações Intraoperatórias , Atelectasia Pulmonar/etiologia , Angioplastia com Balão , Coartação Aórtica/diagnóstico por imagem , Coartação Aórtica/cirurgia , Coartação Aórtica/terapia , Aortografia , Lavagem Broncoalveolar , Broncoscopia , Criança , Feminino , Tecnologia de Fibra Óptica , Humanos , Consentimento Livre e Esclarecido , Respiração com Pressão Positiva , Atelectasia Pulmonar/terapia , Recidiva , Respiração Artificial , Fatores de Risco , SucçãoRESUMO
Strains of Salmonella typhi isolated in Singapore were susceptible to chloramphenicol (except from two imported cases) and most of them also generally susceptible to ampicillin and septrin. Drug-resistant strains of Salmonella typhimurium appeared in 1971 and caused out-breaks among young children. However, decreasing drug-resistance of S. typhimurium was recorded in recent years following a drop in the number of cases. Other Salmonella serovers were found relatively susceptible to the antibiotics tested.