[Postictal pulmonary oedema: a review of the literature]. / Edema pulmonar postictal: revision de la bibliografia.

INTRODUCTION: Postictal neurogenic pulmonary oedema is an infrequent condition of varying severity, probably related to sudden unexpected death in epilepsy (SUDEP). It is more frequent in patients with generalised tonic-clonic seizures of long duration or with status epilepticus. AIM: Based on a review of the literature, the aim is to describe the clinical characteristics, pathophysiology, radiological findings, treatment and prognosis of patients with postictal pulmonary oedema. DEVELOPMENT: A search of the literature was performed in the PubMed, Embase, Cochrane Database of Systematic Reviews and BVS databases using a combination of free terms. The limits of the search applied were: papers published between 1 January 2000 and 26 April 2018, and papers for which the abstract was available. Altogether 23 papers were found, most of which were clinical cases, and used to extract the information needed to carry out the review. CONCLUSIONS: In postictal pulmonary oedema, generalised tonic-clonic seizures are the most frequently reported type. The most common clinical manifestations were dyspnoea and tachycardia appearing within a few minutes after the seizure. Among the paraclinical findings the most frequent was leukocytosis. In general terms, a good prognosis was found in most cases, with improvement of the oedema within a period of between 12 and 96 hours. Only two of the 21 patients reported died. In addition, in a clinical pathology study in patients with SUDEP, pulmonary oedema appeared in most cases.

TITLE: Edema pulmonar postictal: revision de la bibliografia.Introduccion. El edema pulmonar neurogeno postictal es una patologia poco frecuente con gravedad variable, probablemente en relacion con la muerte subita asociada a la epilepsia (SUDEP). La frecuencia es mayor en pacientes con crisis tonicoclonicas generalizadas de larga duracion o con estado epileptico. Objetivo. Por medio de una revision de la bibliografia se pretende describir las caracteristicas clinicas, la fisiopatologia, los hallazgos radiologicos, el tratamiento y el pronostico de los pacientes con edema pulmonar postictal. Desarrollo. Se realizo una busqueda de la bibliografia en las bases de datos PubMed, Embase, Cochrane y BVS empleando una combinacion de terminos libres. Se aplicaron como limites de busqueda: articulos publicados desde el 1 de enero de 2000 hasta el 26 de abril de 2018 y articulos que contaran con el resumen disponible. En total se revisaron 23 articulos, en su mayoria casos clinicos, de los cuales se obtuvo la informacion para desarrollar la revision. Conclusiones. En el edema pulmonar postictal, el tipo de crisis mas frecuentemente comunicada es la tonicoclonica generalizada. Las manifestaciones clinicas mas habituales fueron disnea y taquicardia de aparicion en los minutos posteriores a la crisis. En los paraclinicos, el hallazgo mas frecuente fue leucocitosis. En general se encontro un buen pronostico en la mayoria de los casos, con mejoria del edema entre las 12 y las 96 horas. Unicamente dos de los 21 pacientes comunicados fallecieron. Ademas, en un estudio clinico de patologia en pacientes con SUDEP, el edema pulmonar aparecio en la mayoria de los casos.

Visibility oscillation in a multimode laser interferometer signal and its use in optimizing path lengths.

The interference signal visibility V (difference to sum ratio of intensities at maximum and minimum interference) of an interferometer that uses a multimode laser is here derived for a given laser gain profile and spectral mode separation as a function of the difference Z(S) between the probe and reference beam optical path lengths and the spectral separation k(S) between the center of the laser gain profile and the nearest laser mode of higher frequency. k(S) has a significant effect on V for a given Z(S). This parameter, in lasers where it sweeps freely across the gain profile, and other effects, such as various misalignments and optical coupling inefficiencies, render V alone an unreliable parameter for quantifying Z(S) (for the purpose of reducing it, say). However, the difference to sum ratio of the maximum and minimum V due to variations in k(S) for a given Z(S) is an intrinsic property of the laser insensitive to configurational details. Parameter W so defined, therefore, proves very useful for balancing path lengths. This is of particular importance for systems where probe and/or reference beams are transmitted via long single mode optical fibers, so this application is detailed. Optical path lengths within such fibers often cannot be measured to sufficient accuracy by spatial path length measurements due to fiber nonuniformity resulting in variations in the mode's group velocity (needed to convert to optical path length). Two examples are provided using different makes and models of 0.633 µm HeNe lasers with similar specifications. In the first case, the function W(Z(S)) is calculated directly from the laser's published gain profile and mode separation. In the second case, W is determined empirically for a range of Z(S)values for a laser with an unknown gain profile in a (heterodyned) interferometer whose interference signal oscillates between maximum and minimum intensity at 80 MHz due to the reference beam's optical frequency being acousto-optically upshifted by that amount, while k(S) spontaneously varies on an acoustic time scale. A single high-bandwidth waveform record for each Z(S), therefore, provides all the information needed to determine W. Despite the second laser's gain profile apparently differing in detail, qualitative agreement is achieved between the two methods sufficient to validate the technique.

Applied magnetic field design for the field reversed configuration compression heating experiment.

Detailed calculations of the formation, guide, and mirror applied magnetic fields in the FRC compression-heating experiment (FRCHX) were conducted using a commercially available generalized finite element solver, COMSOL Multiphysics(®). In FRCHX, an applied magnetic field forms, translates, and finally captures the FRC in the liner region sufficiently long to enable compression. Large single turn coils generate the fast magnetic fields necessary for FRC formation. Solenoidal coils produce the magnetic field for translation and capture of the FRC prior to liner implosion. Due to the limited FRC lifetime, liner implosion is initiated before the FRC is injected, and the magnetic flux that diffuses into the liner is compressed. Two-dimensional axisymmetric magnetohydrodynamic simulations using MACH2 were used to specify optimal magnetic field characteristics, and this paper describes the simulations conducted to design magnetic field coils and compression hardware for FRCHX. This paper presents the vacuum solution for the magnetic field.

[Intraoperative high frequency oscillatory ventilation in 2 children undergoing lung surgery]. / Uso intraoperatorio de ventilación de alta frecuencia oscilatoria en dos casos pediátricos de cirugía pulmonar.

Over the past 10 years, the application of high frequency oscillatory ventilation (HFOV) has been extended beyond the neonatal period. The technique is now used in various respiratory disease settings when conventional mechanical ventilation fails. Even though HFOV has become increasingly routine in some pediatric intensive care units, familiarity with it is still limited among anesthesiologists and surgeons and it is not often applied during surgery. We report our experience using HFOV during thoracic surgery on 2 pediatric patients, one aged 5 years and the other aged 1 month. The respective surgical procedures were to close a bronchopleural fistula and to obtain a lung biopsy in order to provide guidance for limiting therapeutic intervention. In both cases the procedure was performed without adverse effects and allowed medical interventions to be carried out. We conclude that it is possible to perform thoracic surgery in pediatric patients undergoing HFOV. This ventilation mode can be useful during surgery and teams that care for critically ill children should be familiar with the equipment.

Uso intraoperatorio de ventilación de alta frecuencia oscilatoria en dos casos pediátricos de cirugía pulmonar / Intraoperative high frequency oscillatory ventilation in 2 children undergoing lung surgery

En la última década se ha extendido el uso de la ventilaciónde alta frecuencia oscilatoria (VAFO) más alládel período neonatal, para diversas patologías respiratorias,ante el fracaso de la ventilación mecánica convencional.Pero a pesar de esta situación, cada vez más rutinariaen las diversas Unidades de Cuidados IntensivosPediátricas, está aún poco extendido su conocimiento yuso durante el intraoperatorio por el anestesiólogo y elcirujano.Presentamos nuestra experiencia con dos pacientespediátricos de cinco años y de un mes de edad, en quienesse efectuó cirugía de tórax mientras se mantenían enVAFO con diversos objetivos: cierre de fístula broncopleuraly biopsia pulmonar para limitar esfuerzos terapéuticosrespectivamente. En ambos casos el procedimientofue realizado sin inconvenientes y permitiómodificar la conducta médica. Concluimos que es posibleefectuar cirugía torácica en pacientes pediátricosmientras estén en VAFO.Este modo de ventilación puede ser útil intraoperatoriamentey debe de ser familiar al equipo que atiende aestos niños críticamente enfermos

Over the past 10 years, the application of high frequencyoscillatory ventilation (HFOV) has been extendedbeyond the neonatal period. The technique isnow used in various respiratory disease settings whenconventional mechanical ventilation fails. Even thoughHFOV has become increasingly routine in some pediatricintensive care units, familiarity with it is stilllimited among anesthesiologists and surgeons and it isnot often applied during surgery.We report our experience using HFOV during thoracicsurgery on 2 pediatric patients, one aged 5 yearsand the other aged 1 month. The respective surgical procedureswere to close a bronchopleural fistula and toobtain a lung biopsy in order to provide guidance forlimiting therapeutic intervention. In both cases the procedurewas performed without adverse effects andallowed medical interventions to be carried out. We concludethat it is possible to perform thoracic surgery inpediatric patients undergoing HFOV.This ventilation mode can be useful during surgeryand teams that care for critically ill children should befamiliar with the equipment

[Esophageal squamous papilloma: a case report and review of the literature]. / Papiloma escamoso de esófago (PEE): reporte de un caso y revisión de literatura.

We report a case of an esophagic squamous papilloma (SP) in a 90 year old patient. This pathology is benign and its diagnosis is generally a finding during an upper digestive endoscopy. Only 150 cases have been reported in the world's medical literature. Treatment consists in an endoscopic resection with diathermic snare or a conservative approach with periodical endoscopic control and observation depending of the type of patient.