RESUMO
We describe a patient found to have acute diffuse and reversible encephalopathy on magnetic resonance imaging (MRI) associated with cholesterol emboli syndrome (CES). The initial MRI showed extensive white matter, basal ganglia and cortical damage without evidence of brain infarction. Dramatic clinical and MRI improvement was observed with corticosteroids. Pathologically, cholesterol crystal emboli were found in the lumen of skin and brain arteries and were associated with varying degrees of inflammation of the arteriole wall. This case suggests that CES may be responsible for extensive, acute and reversible encephalopathy underlined by an inflammation of brain arteries.
Assuntos
Corticosteroides/uso terapêutico , Encefalopatias/tratamento farmacológico , Encefalopatias/etiologia , Embolia de Colesterol/complicações , Doença Aguda , Encefalopatias/patologia , Humanos , Inflamação , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeAssuntos
Calcinose/diagnóstico , Dermatopatias/diagnóstico , Adulto , Braço , Calcinose/complicações , Feminino , Humanos , Hiperparatireoidismo Secundário/etiologia , Falência Renal Crônica/etiologia , Lúpus Eritematoso Sistêmico/complicações , Nefrite Lúpica/complicações , Dermatopatias/complicaçõesRESUMO
Lidocaine addition to crystalloid cardioplegic solution for prevention of reperfusion ventricular fibrillation after the release of the aortic cross-clamp was studied in 50 patients undergoing coronary artery bypass grafting and in 30 patients undergoing mitral or aortic valve replacement. Twenty-six of the patients undergoing coronary artery bypass grafting received lidocaine, 100 mg/L of cardioplegia, whereas a control group of 24 patients received cardioplegia without lidocaine. In the group undergoing valve replacement, 14 patients received lidocaine cardioplegia and 16 patients served as control. In the coronary artery bypass grafting group, lidocaine cardioplegia reduced significantly the incidence of reperfusion ventricular fibrillation from 100% to 42%. In the valve group, lidocaine cardioplegia also reduced significantly the incidence of reperfusion ventricular fibrillation from 93% to 42%. In both groups, lidocaine cardioplegia decreased the number of direct-current countershocks required to defibrillate the heart, with no significant increase in the incidence of high-grade atrioventricular block.
Assuntos
Soluções Cardioplégicas , Lidocaína/uso terapêutico , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Compostos de Potássio , Fibrilação Ventricular/prevenção & controle , Ponte de Artéria Coronária , Feminino , Parada Cardíaca Induzida/métodos , Bloqueio Cardíaco/epidemiologia , Próteses Valvulares Cardíacas , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Traumatismo por Reperfusão Miocárdica/epidemiologia , Potássio , Fibrilação Ventricular/epidemiologiaRESUMO
INTRODUCTION: Hemophagocytic lymphohistiocytosis syndrome (HLS) is defined by activated macrophage proliferation. These cells phagocyte the blood elements. This syndrome can be primary as an autosomal recessive disease or secondary to neoplasia, immune diseases or infections-viral, parasitary or bacterian. CASE: Our case concerns an association of HLS and Escherichia coli (E. coli) sepsis in a metastatic prostatic cancer. The evolution was rapidly improved by antibiotics alone. The clinical and biological aspects as well as the differential diagnosis are discussed. CONCLUSION: The HLS is fatal. It can be caused by a severe infection, even an E. coli sepsis. The treatment focused on etiology can be sufficient.
Assuntos
Bacteriemia/complicações , Infecções por Escherichia coli/complicações , Histiocitose de Células não Langerhans/etiologia , Ativação de Macrófagos , Idoso , Humanos , Masculino , SíndromeRESUMO
One hundred fifty females admitted consecutively during the months of May and April 1987 during the "Lebanon Wars" to the delivery suite at Saint-Georges Hospital, Beirut, were interviewed using a structured questionnaire (DIS). This study was one of the pilot studies of our later initiated studies on depression in Lebanon. The study was conducted in two phases: [symbol: see text] the first on the second post-delivery day (1987) [symbol: see text] the second one year later. The prevalence of major depression in these females was found to be: 31.3% lifetime, 10% during pregnancy and 10.9% during one year follow-up. Lifetime depression increased with the number of children in the household. Depression during pregnancy was found to be inversely related to economic and educational levels.
Assuntos
Depressão/epidemiologia , Complicações na Gravidez/epidemiologia , Adolescente , Estudos Transversais , Características da Família , Feminino , Morte Fetal/epidemiologia , Seguimentos , Humanos , Entrevistas como Assunto , Líbano/epidemiologia , Projetos Piloto , Período Pós-Parto , Gravidez , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de TempoRESUMO
OBJECTIVE: As effects of glucocorticoids differ with respect to preparation, dose and duration, we hypothesized that a postnatal regimen of a low-dose, short-course betamethasone treatment had comparable efficacy and a better safety profile compared to the conventional high-dose, dexamethasone. STUDY DESIGN: To test our hypothesis, we selected premature neonates with a birth weight
Assuntos
Anti-Inflamatórios/uso terapêutico , Betametasona/administração & dosagem , Displasia Broncopulmonar/tratamento farmacológico , Dexametasona/administração & dosagem , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Anti-Inflamatórios/efeitos adversos , Betametasona/efeitos adversos , Dexametasona/efeitos adversos , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Recém-Nascido , Infusões Intravenosas , Injeções Intramusculares , Tempo de Internação , Masculino , Oxigênio/sangue , Projetos Piloto , Desmame do RespiradorRESUMO
This article examines the effect of war events and pre-war depression on the prevalence of major depression during war. A total of 658 subjects aged 18-65 years were randomly selected from four Lebanese communities differentially exposed to the Lebanon Wars and were interviewed using the Diagnostic Interview Schedule (Arabic version). The individual levels of exposure to war events were assessed through a War Events Questionnaire. The lifetime prevalence of the DSM-III-R-defined major depression varied across the four communities from 16.3 to 41.9%; the final parameters predicting major depression since the onset of the wars were: depression before the wars and exposure to the wars. Both, individual levels of exposure to war and a history of pre-war depression, predict the development of depression during war.