RESUMEN
No disponible
Asunto(s)
Femenino , Adolescente , Humanos , Trasplante de Corazón/efectos adversos , Neumatosis Cistoide Intestinal/etiologíaRESUMEN
No disponible
Asunto(s)
Niño , Masculino , Humanos , Cardiopatías Congénitas , Válvulas CardíacasRESUMEN
A girl with Down's syndrome, moyamoya disease and sagittal sinus thrombosis is described. She was diagnosed after acute neurological deterioration by MRI and angiography. Recombinant tissue plasminogen activator (r-TPA) was injected locally to recanalise the thrombus. The patient's condition significantly improved and she was discharged. After 2 years of follow-up the child remains asymptomatic. Moyamoya syndrome and cerebral venous thrombosis should not be overlooked as a cause of acute neurological deterioration in a child with Down's syndrome. MRA appears to be a safe and accurate alternative to traditional angiography for the diagnosis of moyamoya disease. Local fibrinolysis with r-TPA is the treatment of choice for cerebral venous thrombosis due to its safety and efficacy.
Asunto(s)
Síndrome de Down/complicaciones , Enfermedad de Moyamoya/etiología , Trombosis de los Senos Intracraneales/diagnóstico , Trombosis de los Senos Intracraneales/etiología , Preescolar , Femenino , Fibrinolíticos/uso terapéutico , Humanos , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Enfermedad de Moyamoya/diagnóstico , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Activador de Tejido Plasminógeno/uso terapéuticoRESUMEN
A 14-year-old boy manifested acute abdominal pain, vomiting, high temperature and diarrhea. He also underwent increasing hyponatremia and hyperkalemia after appendectomy. Further testing confirmed Addison disease. The serum adrenal antibody test was positive, and other autoimmune diseases were excluded.
Asunto(s)
Enfermedad de Addison/diagnóstico , Enfermedad de Addison/inmunología , Corteza Suprarrenal/inmunología , Apendicitis/complicaciones , Autoanticuerpos/sangre , Dolor Abdominal/etiología , Enfermedad de Addison/complicaciones , Adolescente , Apendicitis/cirugía , Autoinmunidad , Diagnóstico Diferencial , Diarrea/etiología , Fiebre/etiología , Humanos , Hiperpotasemia/etiología , Hiponatremia/etiología , Masculino , Vómitos/etiologíaRESUMEN
Background percutaneous PDA occlusion has been proposed as a valid therapeutic alternative to surgical closure. Between April 1990 and July 1994, 44 patients underwent percutaneous PDA occlusion. Thirteen patients were less than 18 months old and weighed 8.7 +/- 3.2 Kg (Group I). Thirty-one patients, older than 18 months of age, had a mean weight of 36.8 +/- 20.6 Kg (Group II). Four patients in group I and two in group II had associated cardiac anomalies Residual shunt after percutaneous occlusion was studied by color Doppler. Fifty-one occluding devices were used. Forty-nine were implanted and there were two device embolizations. Twelve devices were implanted in group I. One device needed surgical removal from the right ventricle where it had embolized. In group II, 31 devices were implanted and one embolized to the descending aorta and was percutaneously removed through the femoral artery sheath. In two patients of group I and four of group II, a second device was implanted. The total occlusion rate immediately after implantation at 24 hours and at 6 months was 75%, 83% and 83% in group I and 64.5%, 77% and 84% in group II. After implantation of a second device the total occlusion rate without residual shunt reached 100% in group I (after 16 +/- 12 months follow-up) and 97% in group II (after 23 +/- 16 months of follow-up). We conclude that percutaneous ductal occlusion with a Rashkind device is a valid therapeutic alternative to surgical closure in all age groups.
Asunto(s)
Cateterismo Cardíaco/métodos , Conducto Arterioso Permeable/terapia , Embolización Terapéutica/métodos , Adolescente , Cateterismo Cardíaco/instrumentación , Niño , Preescolar , Conducto Arterial/diagnóstico por imagen , Conducto Arterioso Permeable/diagnóstico , Embolización Terapéutica/instrumentación , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Radiografía , Ultrasonografía Doppler en ColorRESUMEN
The authors studied the ECGs of 21 boys with Duchenne's progressive muscular dystrophy (group D) aged from 8 months to 10.5 years. They were compared with 21 age matched healthy boys. There were no statistical significant differences between both groups on maximal or minimal heart rates, nor on their subtractions. There were no differences between the electrical axis of P, QRS or T waves in the frontal plane, nor in the duration or amplitude of P waves. R wave in V1 had 1.06 +/- 0.38 (mean +/- 1 standard deviation) mV in group D, and 0.62 +/- 0.29 mV in group C (p less than 0.001). R/S ratio in V1 was 1.24 +/- 0.53 in group D, and 0.70 +/- 0.50 in group C (p less than 0.01). Q wave in V6 had 0.27 +/- 0.18 mV in group D, and 0.13 +/- 0.09 mV in group C (p less than 0.01). Q/R ratio in V6 was 0.19 +/- 0.14 in group D, and 0.09 +/- 0.047 in group C (p less than 0.01). Sensibility, specificity, positive predictive value, and negative predictive values for signs over 75 percentile (Davignon standards) were: for R wave in V1 71.4%, 76.2%, 75%, and 72.7%; for R/S ratio in V1 71.4%, 76.2%, 75% and 72.7%; for Q wave in V6 38.1%, 85.7%, 72.7%, and 58%.
