Successful Outcome Following Intravenous Lipid Emulsion Rescue Therapy in a Patient with Cardiac Arrest Due to Amitriptyline Overdose.

BACKGROUND The management of patients with tricyclic antidepressant drug overdose can be a challenge for the emergency department physician. Tricyclic antidepressants block alpha-adrenergic receptors and the anticholinergic effects may lead to cardiotoxicity, resulting in arrhythmias and hypotension that can lead to patient mortality. This report is of a case of a 28-year-old woman who presented with cardiac arrest due to amitriptyline overdose and who responded to intravenous lipid emulsion (ILE) therapy. CASE REPORT A 28-year-old woman was admitted to the emergency department with amitriptyline overdose. She suffered a cardiac arrest followed by cardiovascular and neurological complications. Hypotension and lack of a pulse did not respond to treatment with high-dose sodium, but she stabilized following treatment with ILE. The prompt response from the emergency team guaranteed rapid intervention that may have influenced the successful results. CONCLUSIONS Despite the frequency and severity of poisoning with tricyclic antidepressants, there is little consensus among physicians regarding patient management. This case showed the successful use of ILE as rescue therapy in a patient in cardiac arrest following amitriptyline overdose. However, the successful outcome obtained in this case is not a recommendation for the use of ILE as a first-line treatment for the management of patients with tricyclic antidepressant drug overdose. Controlled clinical studies are required to evaluate the safety and efficacy of ILE in the management of tricyclic antidepressant drug overdose.

Oscillations in the evaluation of fractal dimension of RR intervals time series.

Previously, we have reported the presence of oscillations in the graphs we have used to evaluate the Higuchi's fractal dimension in RR intervals time series of congestive heart failure (CHF) patients in the sleep phase but these oscillations hardly appear in all the six hours of the awake phase. In this paper we report the same analysis for heart rate time series for different groups of healthy subjects; we are looking for the presence of this kind of oscillations in other situations. We analyzed all the time series in the Exaggerated Heart Rate Oscillations database of Physionet during two meditation techniques: volunteers with spontaneous breathing, subjects in meditation, volunteers in a metronomic breathing group and elite athletes. We have found oscillations in the graphs of the Higuchi's fractal dimension in the heart rate time series of subjects in meditation and metronomic breathing and this fact coincides with previous reported results.

The influence of an internal electric field upon protein crystallization using the gel-acupuncture method.

In this work, the influence of an internal electric field upon the crystallization of lysozyme and thaumatin is explored using a modified design of the gel-acupuncture setup. From a crystallographic point of view, the orientation of crystals that grow preferentially over different types of electrodes inside capillary tubes is also evaluated. Finally, the crystal quality and the three-dimensional structure of these proteins grown with and without the electric field influence are analyzed by means of X-ray diffraction methods.

Nemorosone, the major constituent of floral resins of Clusia rosea.

Nemorosone, the major constituent of the floral resin of Clusia rosea was isolated after exhaustive chromatography. This compound was fully characterized as it is in the nature, without methylation as reported before. A keto-enol equilibrium was observed and both isomers were totally characterized by NMR spectroscopic techniques. The previously announced structure for methylnemorosone was corrected on the basis of application of chemical methylation, high field 2D NMR techniques and NOE difference spectroscopy experiments on the natural product. Our studies concluded that an interchange occurred in the assignment of the benzoyl moiety position with an isoprenyl group in that structure.

[Prevalence of multiple sclerosis in Colombia]. / Prevalencia de la esclerosis múltiple en Colombia.

INTRODUCTION: Multiple sclerosis (MS) is the commonest demyelinating condition of the nervous system. It is characterized by numerous demyelinating areas or plaques of demyelination which are found dispersed throughout the nervous system. It has been shown that MS is less frequent in tropical regions than in subtropical regions. In Latin America particularly, there are some studies which show this phenomenon. However, in Colombia no studies of prevalence of MS have been done. OBJECTIVE: To determine the prevalence of multiple sclerosis in five provinces of Colombia (Antioquia, Caldas, Santander, Risaralda and Bolivar). PATIENTS AND METHODS: The capture-recapture method was used for two sources to determine the number of cases defined on the criteria of Poser et al seen between July 1995 and June 2000. RESULTS: The prevalence (cases of MS per 100,000 inhabitants) varied between 1.48 in Antioquia (95% CI 1.12; 1.78) and 4.98 in Risaralda (95% CI 3.52; 6.43). Seventy two percent were women. The regions included in this study represented 25% of the population of Colombia. CONCLUSIONS: There is a low prevalence of MS which is as expected in tropical areas. Persons with MS in these regions may be very useful in the study of other factors involved in the aetiology of MS (genetic). The capture-recapture method is an excellent tool for carrying out prevalence studies since it is cheap and requires little time.

Estudio de relación padres/hijos en adolecentes escolares en la Unión / Study of parent-child relation in school adolescents in la Unión

Se encuestaron 385 estudiantes de ambos sexos del 3§ y 4§ medio del Liceo B-12 de la Unión y a 98 de sus padres, encontrándose que un 72,2% vive con ambos padres. La mitad de los hijos tiene más confianza con su madre y un tercio con ninguno. El 51,9% de los hijos afirma haber recibido educación sexual de sus padres. La mayoría de los hijos y sus padres considera que la calidad del tiempo dedicado a ellos es más importante que la cantidad. Un 13% de los hijos no sabe si sus padres les quieren. Los conflictos padres/hijos variaron según el sexo. Las principales demandas de los hijos fueron más libertad, más cariño y más respeto. El 25,8% de las hijas y 40,0% de los hijos manifestó estar conforme con sus padres. Se establece la necesidad de mejorar la comunicación y acercamiento afectivo entre padres e hijos

Asociacion entre campylobacter pylori y gastritis: metodos de identificacion: estudio de 99 casos en el Hospital San Ignacio / Association between campylobacter pyloridis and gastritis: identification method: study of 99 cases in Hospital San Ignacio

Se estudian 99 biopsias gastricas incluyendo casos de gastritis y controles normales, identificando el campylobacter pylori por los metodos de coloracion en tejido, prueba de la ureasa y cultivo. Se correlaciona el tipo de gastritis histologicamente con la presencia o no de la bacteria y se analiza la utilidad de cada uno de los metodos de identificacion

Ginecomastias / Gynecomastia

Se estudian 21 varones con ginecomastia, siendo unilaterales el 6,29% y bilaterales el 15,71%; esto se traduce en 36 hipertrofias mamarias en el hombre, entre los cuales se descubren dos carcinomas implantados en ginecomastias (5,5%). La mayoría de las ginecomastias fueron de origen fisiológico, y su aparición ocurrió en la adolescencia, siendo variable el tiempo de latencia para consultar; 72% se descubrieron en la segunda y tercera décadas de la vida, y sólo una después de los 70 años. El mejor método de diagnóstico complementario en la mamografía, la que tiene un altísimo rendimento, descubriendo la bilateralidad por muy pequeña que sea la hipertrofia, y siendo decisiva para el diagnóstico diferencial con el carcinoma mamario masculino. Prácticamente todos los pacientes eran de configuración genotípica y fenotípica masculina, y la mayoría no tenía alteraciones endocrinas de importancia. El patologia mamaria agregada es importante la presencia de dos carcinomas mamarios, presentados en ginecomastias unilaterales y en personas mayores. El tratamiento fue la adenomastectomía subcutánea en todos lo casos. En los carcinomas, el tratamiento se adaptó a la características locales del tumor y generales del paciente. Concluimos que toda patología mamaria en el hombre, especialmente las ginecomastias, debe ser estudiada con acuciosidad, pues en el futuro del paciente puede acechar un carcinoma, que, por lo general, tiene peor pronóstico que en la mujer, considerando igualdad de condiciones

Campaña de información sobre factores de riesgos para cáncer mamario y enseñanza del autoexamen en al área oriente de Santiago: sus resultados / Information campaign about risk factors of breast cancer and the way to perform autoexam inations in the Eastern area of Santiago; its results

Se reseña brevemente la campaña de información sobre factores de riesgo mamario y enseñanza del autoexamen mamario, llevado a cabo durante dos años (1984-85), dirigida a la población femenina del Area Oriente de Santiago, a través de las matronas de los consultorios periféricos del Servicío de Gineco-Obstetricia del Hospital del Salvador. Se analizan sus resultados a través de una encuesta preparada especialmente, que contestaron en forma libre y anónima 350 mujeres de edades entre 17 y 64 años. Se desecharon 24 encuestas contradictorias y se obtuvieron los resultados en el análisis de 326 encuestas útiles. Estas mostraron la buena acogida de la campaña, y el éxito de motivación de la población femenina para captar la información y familiarizarse con la práctica del autoexamen mamario