Anafilaxia por medios de contraste con gadolinio / Anaphylaxis by gadolinium contrast media

El uso de medios de contraste con gadolinio en resonancia magnética nuclear (RMN) ha sido considerado como un elemento de diagnóstico eficiente y seguro. Sin embargo, se han comunicado reacciones alérgicas severas. A pesar de ser infrecuentes, las reacciones anafilácticas deberían ser consideradas como una complicación potencial y por ende conducirnos a tomar medidas para su temprano diagnóstico y tratamiento. El propósito de este artículo es describir cinco casos de anafilaxia luego de la administración de este medio de contraste.(AU)

The use of gadolinium contrast media has been considered as a safe and efficient method for diagnosis. However, severe anaphylactic reactions have been reported. Although infrequent, they must be considered a potential complication in this diagnostic procedure and must therefore lead us to take measures for an early recognition and treatment. Five cases of anaphylactic reaction to gadolinium are described in this article.(AU)

Complications in surgical removal of mandibular third molars.

The most frequent complications after surgical removal of an impacted mandibular third molar are the following: alveolar osteitis, infections, neurological damage involving the inferior alveolar and lingual nerves. All of these postoperative complications are more frequent in older patients. Their increase starts at about 25 years of age. Alveolar osteitis is the most frequent postoperative complication, but it is easily handled; its pathogenesis remains unknown, even if cigarette smoking enhances its incidence; other putative risk factors have not been confirmed. An effective etiologic therapy is not yet available, but the symptoms can be managed by means of local medication. Postoperative infections can still cause very severe problems, especially in elderly patients, if the treatment is not correct and timely. Antibiotic prophylaxis is indicated in selected cases. The possibility of neurological complications is often associated with anxiety both in the patient and doctor: fortunately, their incidence has been lowered by improved surgical techniques; moreover, risk indicators have been identified on the panoramic radiographs; three-dimensional imaging is useful in planning the surgical intervention in risky cases.