RESUMO
BACKGROUND: Herpes zoster is an illness which is especially common amongst the elderly in the Netherlands and which can express itself in various ways. Besides affecting sensory nerves, which leads to postherpetic pain, the varicella zoster virus may also invade motor nerves. CASE DESCRIPTION: A 73-year-old female went to the surgeon with symptoms of a painful swelling in the left lower abdomen. She had experienced herpes zoster at the site of the swelling a few months earlier. A CT scan revealed asymmetry of the abdominal wall musculature, which led us to suspect a link between motor involvement of herpes zoster and the abdominal swelling. EMG revealed denervation of the affected abdominal wall muscle, which confirmed the link with herpes zoster in that dermatome. CONCLUSION: Abdominal wall paresis caused by herpes zoster is a rare condition. It can be diagnosed on the basis of clinical findings and may be confirmed by EMG investigation of the affected muscle. In view of the temporary nature of the paresis, it is possible to opt for conservative management of the condition.
Assuntos
Parede Abdominal , Herpes Zoster/complicações , Herpesvirus Humano 3 , Paresia/virologia , Dor Abdominal/virologia , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/virologia , Idoso , Feminino , Herpes Zoster/virologia , Humanos , Países Baixos , Tomografia Computadorizada por Raios XRESUMO
A theory was developed on the creation, growth, and decline of relationships among organizations and was tested, using a longitudinal study of 95 dyadic relationships among child care and health organizations in Texas. Using LISREL V, the test of the theory showed that substantial revision of the model was required to explain the data adequately. When the model was revised, important new patterns were revealed in the development of interorganizational relationships over time: (1) Perceptions of dependence on others for resources spurs the development of interorganizational relationships. Resource dependence is a powerful direct determinant of communications, resource transactions, and consensus; (2) The growth of interorganizational relationships is fostered by frequent communications to formalize the relationship and build consensus about the terms of the relationship among the parties involved; (3) Monetary transactions and client referrals entail different patterns of coordination; and (4) Consensus among parties in an interorganizational relationship is both a positive outcome of initial resource dependence and communications and has a negative influence on subsequent perceptions of resource dependence.