Adverse effects related with norepinephrine through short peripheral venous access: Scoping review.

Peripheral administration of norepinephrine is restricted due to the association of extravasation with tissue necrosis. METHOD: Scoping review with the objective of describing the adverse effects related to the administration of norepinephrine through short peripheral venous access and the characteristics of drug administration in patients hospitalized in ICU, surgery, and emergency services. RESULTS: 12 studies with heterogeneous characteristics by size and type of population were included. The proportion of complications associated with peripheral norepinephrine administration was less than 12% in observational studies and it was less than 2% in those that used doses less than 0.13µg/kg/min, and concentrations less than 22.3µg/mL. The main associated complication was extravasation and there were no cases of tissue necrosis at the venipuncture site, some extravasation cases were treated with phentolamine, terbutaline or topical nitroglycerin. The drug administration time ranged between 1 and 528hours with a weighted mean of 2.78h. CONCLUSION: The main adverse effect was extravasation, no additional complications occurred, phentolamine and terbutaline seem to be useful, and its availability is a necessity. It is essential for the nursing staff to carry out a close assessment and comprehensive care in patients receiving norepinephrine by peripheral route.

[3 cases of hematogenous lung abscess of amebic origin]. / Tres casos de absceso pulmonar hematógeno de origen amibiano.

Invasive amebiasis is a very serious health problem in Mexico as it is presumably related to the presence of virulent strains of Entamoeba histolytica and poor hygienic and sanitary conditions; other factors related to invasive amebiasis are undernutrition, alcoholism, and homosexuality. We present three patients with pulmonary amebic hematogenous abscess. Clinically all patients had the typical "chocolate" exudate. The three patients had pulmonary consolidations by chest roentgenogram; one of them had multiple opacities with air fluid level, and the others had an isolated opacity with air fluid level. The ultrasound and hepatogammagram were negative for diaphragmatic communication in all; in one of them the pneumoperitoneum was negative for diaphragmatic communication. The transthoracic needle biopsy of the lesions was positive to ameba in two patients. The serologic tests were positive in all. We treated the patients with metronidazole and emetine during 10 days; since the clinical picture and the radiologic findings did not remit completely, we gave a second course of metronidazole during 10 days more and achieved complete resolution.

Evaluacion del dano respiratorio en una zona cementera de la Republica Mexicana / Evaluation of respitarory damage in a cement dust zone in the Mexican Republic

Resumen Se estudió la contaminación atmosférica pro-- vacada por el emplazamiento industrial cementero que se localiza al sur del Estado de Hidalgo y al Norte del Estado de México y que tiene una extensión superficial cercana a 2,000 kilómetros cuadrados. se eligió al área de Vito-Atotonilco-Apaseo por la presencia de fábricas en la región. En el área de estudio se estimó que las emanaciones fabriles serían de 117.735 toneladas de partículas sólidas, así como 14,037 toneladas de óxidos de azufre y 4,848 toneladas de óxidos de nitrógeno anualmente. Como población control se eligió Ajacuba. el poblado más distante dentro de la zona fabril. Se diseñó un cuestionario socíoepídemiológico para aplicarse a los adultos y otro para ser aplicado a los escolares. para objetivar alteraciones respiratorias agudas y crónicas. Un primer análisis de los cuestionarios respondidos mostró que en la población de Vito existe mayor prevalencia y persistencia de sintomatología respiratoria crónica; a partir de estos datos se eligieron 32 individuos para obtener en ellos radiogramas de torax (postero anterior) y evaluar la función respiratoria mediante la espirometria con espirómetro de campana; Durante el análisis de la información se encontró que la espirometria estaba proveyendo información valiosa de la alteración de las vías aéreas. La alteración más franca se observó en el flujo espiratorio máximo, pues al compararlo con cifras teóricas normales se obtuvieron cifras por abajo de lo esperado como límite de normalidad. El flujo espiratorio medio resultó también un dato sensible para objetivar la obstrucción de las vías aéreas. La capacidad vital se encontr6 dentro de límites normales. En la población de Vito se encontró afectada la función respiratoria. en todos los rangos de edad. atribuible a la contaminación atmosférica de la zona