RESUMEN
This paper presents a follow-up of a child with Balint's syndrome over more than a decade. The patient experienced traumatic brain injury before age 12, resulting in bilateral occipito-parietal infarctions and a clinical presentation of Balint's syndrome. Neuropsychological assessments at three time points showed average verbal abilities alongside persistent difficulties in visual orientation, mirrored in the patient's daily life. Her outstanding compensatory abilities in the face of these impairments are discussed with respect to the recruitment of the ventral visual stream and the role of top-down processing. This profile may help to determine interventions for younger patients with similar lesions.
Asunto(s)
Lesiones Traumáticas del Encéfalo/psicología , Lóbulo Occipital/lesiones , Lóbulo Parietal/lesiones , Lesiones Traumáticas del Encéfalo/diagnóstico , Lesiones Traumáticas del Encéfalo/rehabilitación , Niño , Femenino , Estudios de Seguimiento , Humanos , Pruebas Neuropsicológicas , Recuperación de la FunciónRESUMEN
BACKGROUND: We evaluated the effect of surfactant on platelet function as a potential contributing mechanism to the pathogenesis of pulmonary hemorrhage (PHEM) in term and preterm infants. METHODS: Cord blood samples were collected from neonates following delivery. Complete blood count and platelet function were measured using a cone and platelet analyzer (CPA). Increasing surfactant concentrations were added to platelets in vitro, and the adhesion molecule P-selectin and the monoclonal antibody PAC-1 were evaluated following platelet activation by flow cytometry. RESULTS: Forty-one infants (11 preterm and 30 term) were studied. CPA revealed a significant decrease in the average size of the aggregates and in platelet adhesion when surfactant was added. In term infants, the addition of surfactant to native platelets yielded an increased binding capacity of PAC-1 but did not affect P-selectin expression. In preterm infants, platelet activation with adenosine diphosphate in the presence of a high surfactant concentration (0.5 mg/mL) resulted in increased PAC-1 binding and no change in P-selectin expression. CONCLUSIONS: The platelets of preterm infants are less active (hyporesponsive) than those of term infants, both in their native state as well as after stimulation with various agonists. Surfactant may play an important role in treating PHEM in preterm infants.
Asunto(s)
Hemorragia/tratamiento farmacológico , Enfermedades Pulmonares/tratamiento farmacológico , Tensoactivos/uso terapéutico , Plaquetas/citología , Plaquetas/efectos de los fármacos , Plaquetas/metabolismo , Fosfatasa 2 de Especificidad Dual/química , Fosfatasa 2 de Especificidad Dual/metabolismo , Hemorragia/diagnóstico , Humanos , Recién Nacido , Recien Nacido Prematuro , Enfermedades Pulmonares/diagnóstico , Selectina-P/metabolismo , Unión ProteicaRESUMEN
Bilateral adrenal hemorrhage can complicate severe sepsis in the neonate and is most commonly attributed to meningococcal disease; however, it can be caused by other etiologic agents as well. We report herein a fatal case of Enterobacter cloacae sepsis in a preterm infant, resulting in massive adrenal hemorrhages. This is the first documented case of adrenal hemorrhage following infection with this pathogen.