Anaphylaxis.

The syndrome of anaphylaxis is a life-threatening event in which the potential for patient morbidity and mortality is high. An understanding of the pathophysiology of anaphylaxis, the most serious of the allergic disorders, is paramount for its diagnosis. In addition to these elements, this article discusses newly recognized causes of anaphylaxis and reviews its treatment.     

Anaphylaxis.

Anaphylaxis is a severe systemic allergic reaction that can involve multiple systems of the body. Anaphylaxis often is unpredictable, can have a rapid onset, and, if serious enough, can have life-threatening consequences. If an anaphylactic reaction is the result of an antigen antibody response, it is considered anaphylaxis. If the reaction is caused by a nonantibody trigger, it is considered anaphylactoid. Clinically, however, both responses appear the same and require the same management and treatment. With the development of new protein drugs and their use as therapeutic agents, the risk of anaphylaxis will most likely increase. For this reason, the infusion nurse specialist needs to have the knowledge and skills necessary to recognize and respond appropriately when anaphylaxis occurs. This article discusses the history, definition, incidence, risk factors, etiology, pathophysiology, and clinical findings of anaphylaxis. Appropriate prevention, management, and treatment also are discussed, with special attention given to medication-related anaphylaxis.     

胎头前不均倾13例临床分析

目的探讨头位难产中前不均倾的诊断与处理。方法对2000年6月至2006年6月13例前不均倾位难产合并症进行回顾分析。结果颅内出血1例，宫颈裂伤1例，全部病例均行剖宫产术。结论前不均倾易合并胎膜早破，宫颈裂伤，颅内出血，胎儿窘迫，脐带绕颈，胎盘早剥，一经诊断立即手术结束妊娠。     

脑囊虫病致癫痫58例临床研究

脑囊虫病致癫痫临床常见，据报道癫痫型脑囊虫病占脑囊虫病患者50．77％。但是有关脑囊虫病致癫痫的专题临床研究资料不多，我们回顾性分析了1998年以来本院门诊和住院确诊的58例脑囊虫病致癫痫的临床特点、脑电图(EEG)、免疫学、影像学及治疗过程，现报道如下。     

Susceptibility of Clostridium botulinum to thirteen antimicrobial agents.

A total of 224 strains of Clostridium botulinum (including isolates from 14 patients with infant botulism and 4 with wound botulism) and 15 strains of C. sporogenes were tested by agar dilution for susceptibility to tetracycline, metronidazole, erythromycin, penicillin, rifampin, chloramphenicol, clindamycin, cephalothin, cefoxitin, vancomycin, sulfamethoxazole-trimethoprim, nalidixic acid, and gentamicin. At least 90% of the C. botulinum strains tested (except for nonproteolytic strains of toxin type F with penicillin) were susceptible to all drugs except sulfamethoxazole-trimethoprim, nalidixic acid, and gentamicin. Minimal inhibitory concentrations for strains from patients with infant and wound botulism were similar to those for other C. botulinum strains.     

支气管哮喘合并肺吸虫病13例误诊分析

支气管哮喘并发肺吸虫病,临床易误诊漏诊。我院1988年～1996年间共收治13例,全部误诊误治。为提高对该病的认识,今就其误诊原因作如下探讨。 1 临床资料 1.1 一般资料本组男12例,女1例;年龄13～34岁。农民7例,学生5例,职工1例。12例在2～4个月内有进食生、醉、腌石蟹史,另1例有常饮溪、涧生水史。全部病例均有反复发作支气管哮喘病史7～25年。     

踝关节镜下治疗距后三角骨损伤13例分析

目的 探讨踝关节镜下治疗距后三角骨损伤的疗效.方法 2004年1月～2008年6月采用踝关节镜下治疗距后三角骨损伤13例,随访8个月以上,进行疗效评定.结果 随访8～36个月,评定术后疗效:优12例,良1例.结论 采用踝关节镜下治疗距后三角骨损伤具有:创伤小、恢复快、治疗时间短、术后效果可靠的优点.     

Anaphylaxis. How to manage and prevent this medical emergency.

Anaphylaxis is a dramatic, major medical emergency. Understanding of the pathogenesis, emergency treatment, and subsequent prophylaxis can reduce both morbidity and mortality. Treatment of anaphylaxis should begin with a high degree of suspicion. Taking a wait-and-see attitude in hopes that the reaction will be mild may have serious results.     

Immediate and middle-term cardiorespiratory effects of positive end-expiratory pressure in thirteen cases of non-haemodynamic pulmonary oedema.

Thirteen patients with severe acute respiratory failure were ventilated with positive end-expiratory pressure (PEEP) for 9 days. Haemodynamic measurements were performed after 15 min during 100% oxygen breathing, first with intermittent-positive pressure ventilation, secondly with positive end-expiratory pressure. The latter improved the Pa, O2 from 89 to 150 torr, decreased the QS/QT from 43% to 32% and decreased the Pa, CO2 from 37 to 34 torr; this improvement in gas exchange was accompanied by a decrease in cardiac index from 4.4 to 3.7 1 min-1m-2 without changing the systemic arterial pressure. Despite this beneficial effect on arterial blood oxygenation, it did not improve the survival rate of patients with severe acute respiratory failure.