RESUMO
A study of anaphylactoid reactions (AR) observed between September 1982 and September 1983 was carried out in the surgical departments of a French regional hospital. The patients who had presented clinical symptoms suggesting an AR (bronchospasm, collapse, tachycardia, with or without skin rash) during a general anaesthesia were included in this study. A precise history of previous anaesthesias and allergy was taken; allergological testing was carried out six to eight weeks after the AR. It included intradermal skin tests (ST) and a human basophil degranulation test (HBDT) with the suspected drugs. Out of 12,855 patients operated on under general anaesthesia in the hospital, 21 AR were seen during the year under study, in 18 women and 3 men, of median age 27 years (extreme values: 11 and 62). The median number of previous anaesthesias was 2 (extreme values: 0--in 4 cases- and 22). Cardiocirculatory abnormalities were the most frequent clinical symptoms of the AR: they consisted of decreased arterial pressure in 13 cases, with 8 cases of vascular collapse. Respiratory symptoms were less frequent but severe bronchospasm was observed in 5 cases. Skin rashes were seen simultaneously in 13 out of the 21 observations. A history of allergy was found in 11 patients. Total IgE serum concentration averaged 134 kU X 1(-1) (extreme values: 32-378). Results of histamine-sensitivity skin tests were not significantly different from those observed in a control group. Calcemia and magnesemia were in the normal range. One to four drugs were tested in each patient: 41 tests combining ST and HBDT were carried out.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Anafilaxia/epidemiologia , Anestesia/efeitos adversos , Adolescente , Adulto , Idoso , Mistura de Alfaxalona Alfadolona/efeitos adversos , Anafilaxia/induzido quimicamente , Anafilaxia/imunologia , Basófilos/imunologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares não Despolarizantes/efeitos adversos , Risco , Fatores Sexuais , Testes Cutâneos , Succinilcolina/efeitos adversos , Tiopental/efeitos adversosAssuntos
Assistência Ambulatorial/psicologia , Criança Hospitalizada/psicologia , Serviços Comunitários de Saúde Mental/organização & administração , Transtornos Mentais/terapia , Adolescente , Leitos , Criança , Pré-Escolar , Continuidade da Assistência ao Paciente , Família , Feminino , França , Humanos , Lactente , Masculino , Transtornos Psicóticos/psicologiaRESUMO
It is hypothesized that infantile autism could represent a defensive position with variable clinical characteristics whose expressions are notably influenced by the environment. We examined a group of ten children under the age of three who were followed up on home care. Our research focused on a double-blind correlation test between two types of data: the diagnostic on the one hand and the child video recording observation on the other hand. Certain objectivable autistic states were found in two children for which the initial diagnosis of autism were in a first time ruled out (according to DSM-III-R and French Classification). This confirms the polymorphism of children autistic states.
Assuntos
Transtorno Autístico/diagnóstico , Serviços de Assistência Domiciliar , Transtornos Mentais/diagnóstico , Pré-Escolar , Estudos de Coortes , Diagnóstico Diferencial , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Meio Social , Gravação em VídeoRESUMO
The idea of hope is paramount in the management of psychotic children. The different alternatives were developed with reference to the modern conceptions of the psychoanalytical theory. Day hospitals, each of which admits children from a given district, seem to allow optimal active therapy. Management includes: individual psychoanalysis for the child; life groups to which the child belongs during the day; a consistent institutional policy based on psychoanalytical theories; leaving the child with it's own or an auxiliary family and supporting this family; minimal chemotherapy. The authors report major improvement or recovery in one-third to one-half of the children.