RESUMEN
A 51-year-old chemical engineer sustained phosphorous pentachloride partial skin thickness burns over 20 per cent of his body surface area. Although macroscopically and microscopically the wound seemed to be superficial, the course of clinical healing of this injury was very slow and painful. Retrospectively this burn should have been treated by early excision and grafting.
Asunto(s)
Quemaduras Químicas/fisiopatología , Cloruros/efectos adversos , Compuestos de Fósforo , Fósforo/efectos adversos , Cicatrización de Heridas/fisiología , Accidentes de Trabajo , Quemaduras Químicas/etiología , Ingeniería Química , Humanos , Masculino , Persona de Mediana EdadRESUMEN
An 11-year-old boy sustained high-voltage electrical and flame burns over 85% of his body surface area, 75% of which were full-thickness burns. After 4 months of treatment and multiple operations and skin graftings before his discharge from hospital, he exhibited irritability, hallucinations, and eventually, seizures and respiratory and cardiac arrest. He was resuscitated successfully. Diffuse bilateral brain damage was observed by means of computerized tomography and magnetic resonance imaging. Acute hypertension (up to 290/220 mm Hg) developed the following day. Recovery began 48 hours later. Most clinical symptoms and the hypertension resolved within 1 week. However, the computerized tomographic scans and magnetic resonance imaging findings persisted but were resolved within 2 months. Irritability and low tolerance for frustration were the only remaining symptoms at the time of a 12-month follow-up examination.
Asunto(s)
Daño Encefálico Crónico/etiología , Quemaduras por Electricidad/complicaciones , Hipertensión/etiología , Encéfalo/patología , Daño Encefálico Crónico/diagnóstico , Daño Encefálico Crónico/psicología , Niño , Humanos , Imagen por Resonancia Magnética , Masculino , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
Congenital double lip is a rare entity. During the last 10 years, we performed surgery on 5 patients with this deformity. The patients are reported with a special mention of the embryology, and the relevant literature is reviewed.
Asunto(s)
Labio/anomalías , Mucosa Bucal/anomalías , Vestibuloplastia/métodos , Adolescente , Adulto , Femenino , Humanos , Labio/cirugía , Masculino , Mucosa Bucal/cirugíaRESUMEN
The strange case of a 37-year-old modern, Western woman who presented with a giant black mass on her inner right thigh is presented. She was treated 10 months before this present admission by an excision of a nodular melanoma, and she was treated, thereafter, by a homeopathic practitioner until she came late to follow-up. The woman is discussed with special attention to the fact that alternative medicine does not always constitute good advice, and the relevant literature is reviewed.
Asunto(s)
Homeopatía , Melanoma/cirugía , Neoplasias Cutáneas/cirugía , Colgajos Quirúrgicos/métodos , Adulto , Braquiterapia , Terapia Combinada , Femenino , Humanos , Melanoma/patología , Melanoma/radioterapia , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/radioterapia , MusloRESUMEN
A 25-year-old female with a scarred and contracted nose following burns, because the upper limbs could not be used as donor areas, had a free dorsalis pedis flap used to reconstruct the nose 18 months post-burn. The case is reported and the literature reviewed.
Asunto(s)
Quemaduras/cirugía , Nariz/lesiones , Colgajos Quirúrgicos/métodos , Adulto , Femenino , Pie , Humanos , Pronóstico , Trasplante de PielRESUMEN
A 20-year-old soldier sustained 35 per cent body surface area burns by open flames. He was treated with topical application of 1 per cent silver sulphadiazine (SSD) twice daily. Four days postburn he developed acute haemolytic anaemia. Withdrawal of SSD was followed by complete recovery. A glucose-6-phosphate dehydrogenase (G6PD) deficiency was proven by pathological Motulski tests. Although the hazards of SSD are well indicated by the manufacturers, there appear to be no written reports of haemolysis induced by this drug in G6PD-deficient patients.
Asunto(s)
Anemia Hemolítica/inducido químicamente , Quemaduras/tratamiento farmacológico , Deficiencia de Glucosafosfato Deshidrogenasa/complicaciones , Sulfadiazina de Plata/efectos adversos , Enfermedad Aguda , Administración Tópica , Adulto , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
The technique of burying small pieces of skin under old granulation tissue after recurrent failure of conventional skin grafting is described in a patient with 95 per cent full skin thickness burns. This method of treatment, which was described in the past and neglected, is of value for massive burns or grafting in difficult areas. The technique is described again and the relevant literature reviewed.
Asunto(s)
Quemaduras/cirugía , Trasplante de Piel/métodos , Adolescente , Superficie Corporal , Quemaduras/patología , Enfermedad Crónica , Humanos , Masculino , RecurrenciaRESUMEN
A simple method to ease the removal of stitches in hair-bearing areas is presented. The method consists of applying a depilatory cream to remove the masking hair.
Asunto(s)
Cara/cirugía , Preparaciones para el Cabello/administración & dosificación , Remoción del Cabello/métodos , Cuero Cabelludo/cirugía , Suturas , Humanos , Israel , Masculino , Pomadas , Cuidados Posoperatorios , Cuero Cabelludo/efectos de los fármacosRESUMEN
Torsade de pointes (atypical ventricular tachycardia) occurred in a 75-year-old man 1 day after blunt head injury, in association with a focal intracerebral hematoma in the left thalamic area. The causal relationship between the traumatic stimulation of the left sympathetic pathway and the development of this life-threatening arrhythmia is discussed.
Asunto(s)
Lesiones Encefálicas/complicaciones , Taquicardia/etiología , Anciano , Lesiones Encefálicas/diagnóstico por imagen , Lesiones Encefálicas/fisiopatología , Hemorragia Cerebral/complicaciones , Ventrículos Cardíacos/fisiopatología , Hematoma/complicaciones , Humanos , Lidocaína/uso terapéutico , Masculino , Taquicardia/tratamiento farmacológico , Tálamo , Tomografía Computarizada por Rayos XRESUMEN
Eikenella corrodens, a gram-negative, slow-growing rod, belongs to the normal flora of mucous membranes. Infections of the hand including this pathogen, are described in human bite and clenched fist injuries. Our case demonstrates another possibility of wound contamination with normal oral flora causing Eikenella corrodens infection. The consequences due to the delay of appropriate therapy are discussed.
Asunto(s)
Infecciones por Bacteroides/etiología , Traumatismos de los Dedos/complicaciones , Infección de Heridas/etiología , Infecciones por Bacteroides/diagnóstico por imagen , Infecciones por Bacteroides/cirugía , Eikenella corrodens/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Cicatrización de Heridas , Infección de Heridas/terapiaRESUMEN
The possibility of a link between parathyroid hyperfunction and cellular immune functions was studied in primary hyperparathyroid (1 degree HP) patients. The effect of cimetidine on lymphocyte functions in 1 degree HP patients and control subjects was also investigated. Histamine-induced suppressor activity of lymphocytes from 1 degree HP patients was significantly greater than that of controls. Cimetidine addition to both normal and 1 degree HP lymphocyte cultures abolished histamine-induced suppression. In vivo administration of cimetidine, while ineffective towards normal lymphocytes, depressed phytohemagglutinin stimulation of 1 degree HP lymphocytes, indicating possible immunological damage caused by this drug, which is frequently used in the treatment of patients with 1 degree HP.
Asunto(s)
Cimetidina/farmacología , Histamina/farmacología , Hiperparatiroidismo/inmunología , Concanavalina A/farmacología , Humanos , Inmunidad Celular/efectos de los fármacos , Técnicas In Vitro , Activación de Linfocitos/efectos de los fármacos , Fitohemaglutininas/farmacología , Linfocitos T Reguladores/efectos de los fármacosRESUMEN
To evaluate the acute effect of histamine H2-receptor blockade with cimetidine on PTH concentrations and its endogenous biological activity, we studied the effect of iv administration of cimetidine (50-mg bolus followed by 500 mg/60 min infusion) in normal subjects and patients with primary and secondary hyperparathyroidism. No significant changes in serum concentrations of calcium, phosphate, or immunoreactive C-terminal PTH were found in any group. However, the control group had decreased calciuria, increased phosphaturia, and decreased tubular reabsorption of phosphate, while the primary hyperparathyroid group had increased phosphaturia, increased nephrogenous cAMP excretion, and decreased tubular reabsorption of phosphate. In both of these groups, the finding suggest an increase in PTH-like biological activity. These findings suggest that cimetidine is not useful in the diagnosis or medical management of hyperparathyroidism. In fact, the changes in renal calcium and phosphorous excretion indicative of PTH-like biological activity along with a decrease in creatinine clearance in the primary hyperparathyroid group suggest a relative contraindication to the use of this drug in these patients.