Asunto(s)
Fibrosis Quística , Enfermedad de Gilbert , Humanos , Fibrosis Quística/complicaciones , Fibrosis Quística/tratamiento farmacológico , Fibrosis Quística/genética , Enfermedad de Gilbert/diagnóstico , Enfermedad de Gilbert/tratamiento farmacológico , Enfermedad de Gilbert/genética , Hiperbilirrubinemia , Aminofenoles/efectos adversos , Benzodioxoles/efectos adversos , Regulador de Conductancia de Transmembrana de Fibrosis Quística/genética , Mutación , Agonistas de los Canales de Cloruro/efectos adversos , Combinación de MedicamentosRESUMEN
Three deaths following facial impacts in the presence of witnesses and resulting in brain lesions that were visualized only on pathological examination were studied at the forensic medicine institute of Marseille. Craniofacial impacts, even of low intensity, received during brawls may be associated with brain lesions ranging from a simple knock-out to fatal injuries. In criminal cases that are brought to court, even by autopsy it is still difficult to establish a direct link between the violence of the impact and the injuries that resulted in death. During a facial impact, the head undergoes a movement of violent forced hyperextension. Death may thus be secondary to the transmission of forces to the brain, either by a mechanism involving nerve conduction that may be termed a reflex mechanism (for example by vagal hyperstimulation) or by injury to the central nervous system (axonal damage). In such situations, autopsy does not make it possible to determine the cause of death, but only to suspect it in a context of voluntary violence in the presence of witnesses, with or without violent injury observed on external examination or on superficial incisions to determine the extent of bruises or hematoma. Systemic and comprehensive investigation involving pathology and toxicology is essential in any medicolegal case for positive interpretation and discrimination of other causes of death.
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Muerte Súbita , Cara , Autopsia , Tronco Encefálico , Muerte Súbita/etiología , HumanosRESUMEN
OBJECTIVE: The Greulich and Pyle (GP) atlas is one of the most frequently used methods of bone age (BA) estimation. Our aim is to assess its accuracy and to calculate the prediction intervals at 95% for forensic use. METHODS: The study was conducted on a multi-ethnic sample of 2614 individuals (1423 boys and 1191 girls) referred to the university hospital of Marseille (France) for simple injuries. Hand radiographs were analysed using the GP atlas. Reliability of GP atlas and agreement between BA and chronological age (CA) were assessed and prediction intervals at 95% were calculated. RESULTS: The repeatability was excellent and the reproducibility was good. Pearson's linear correlation coefficient between CA and BA was 0.983. The mean difference between BA and CA was -0.18 years (boys) and 0.06 years (girls). The prediction interval at 95% for CA was given for each GP category and ranged between 1.2 and more than 4.5 years. CONCLUSION: The GP atlas is a reproducible and repeatable method that is still accurate for the present population, with a high correlation between BA and CA. The prediction intervals at 95% are wide, reflecting individual variability, and should be known when the method is used in forensic cases. KEY POINTS: ⢠The GP atlas is still accurate at the present time. ⢠There is a high correlation between bone age and chronological age. ⢠Individual variability must be known when GP is used in forensic cases. ⢠Prediction intervals (95%) are large; around 4 years after 10 year olds.
Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Antropología Forense/métodos , Adolescente , Adulto , Niño , Preescolar , Femenino , Francia , Mano/diagnóstico por imagen , Humanos , Lactante , Masculino , Radiografía , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
The act to transfuse is a prescription following basic rules similar to drug prescriptions. If harm happens, potentially linked with this prescription, the harm's responsibility is borne by the physician, the paramedics, the care organization but by the supplier laboratory too. The setting of good practice rules consistent with science data at the time when the act is performed, the respect of the patient's rights and the quality of supplied products will be assessed during the expertise. Under restorative responsibility, it is necessary to previously establish a direct and certain causation between the litigious act and the harm to enforce the vicarious liability. Nowadays, legal precedents grant a larger protection to more and more numerous victims, enhancing the field of the fault with the appeal to assumption of fault. At the same time, the lawmaker himself promulgated objective conditions of compensation for many categories of victims of medical risk from which transfused people are part. The law of March the 4th of 2002 went one step closer devoting a new foundation of compensation: national solidarity.
Asunto(s)
Seguridad de la Sangre , Transfusión Sanguínea/legislación & jurisprudencia , Mala Praxis , Prescripciones , Responsabilidad Social , Técnicos Medios en Salud , Bancos de Sangre , Seguridad de la Sangre/normas , Transfusión Sanguínea/normas , Patógenos Transmitidos por la Sangre , Causalidad , Compensación y Reparación/legislación & jurisprudencia , Errores Diagnósticos , Transmisión de Enfermedad Infecciosa/legislación & jurisprudencia , Transmisión de Enfermedad Infecciosa/prevención & control , Francia , Humanos , Prescripción Inadecuada/legislación & jurisprudencia , Errores Médicos , Guías de Práctica Clínica como Asunto , Prescripciones/normas , Parejas Sexuales , Reacción a la Transfusión , Negativa del Paciente al Tratamiento/legislación & jurisprudenciaRESUMEN
BACKGROUND AND AIMS: The independent role of serum uric acid (SUA) as a marker of cardio-renal risk is debated. The aim of this study was to assess the relationship between SUA, metabolic syndrome (MS), and other cardiovascular (CV) risk factors in an Italian population of hypertensive patients with a high prevalence of diabetes. METHODS AND RESULTS: A total of 2429 patients (mean age 62 ± 11 years) among those enrolled in the I-DEMAND study were stratified on the basis of SUA gender specific quartiles. MS was defined according to the NCEP-ATP III criteria, chronic kidney disease (CKD) as an estimated GFR (CKD-Epi) <60 ml/min/1.73 m(2) or as the presence of microalbuminuria (albumin-to-creatinine ratio ≥2.5 mg/mmol in men and ≥3.5 mg/mmol in women). The prevalence of MS, CKD, and positive history for CV events was 72%, 43%, and 20%, respectively. SUA levels correlated with the presence of MS, its components, signs of renal damage and worse CV risk profile. Multivariate logistic regression analysis revealed that SUA was associated with a positive history of CV events and high Framingham risk score even after adjusting for MS and its components (OR 1.10, 95% CI 1.03-1.18; P = 0.0060; OR 1.28, 95% CI 1.15-1.42; P < 0.0001). These associations were stronger in patients without diabetes and with normal renal function. CONCLUSIONS: Mild hyperuricemia is a strong, independent marker of MS and high cardio-renal risk profile in hypertensive patients under specialist care. Intervention trials are needed to investigate whether the reduction of SUA levels favorably impacts outcome in patients at high CV risk.
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Enfermedades Cardiovasculares/epidemiología , Hipertensión/epidemiología , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Ácido Úrico/sangre , Anciano , Albuminuria/sangre , Albuminuria/epidemiología , Biomarcadores/sangre , Índice de Masa Corporal , Enfermedades Cardiovasculares/sangre , Estudios de Cohortes , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Humanos , Hipertensión/sangre , Hiperuricemia/sangre , Hiperuricemia/epidemiología , Italia , Modelos Logísticos , Masculino , Síndrome Metabólico/sangre , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/epidemiología , Factores de RiesgoRESUMEN
The maternal mortality is rare and when it arises, the family often puts the medical profession in guilty's position. We present the case of a 38-year-old woman, died in the post-partum in a context of intense back pains. The autopsy found an incidental hemorrhagic syndrome to a two-stage rupture of the splenic artery. We shall discuss the aetiology. The autopsy and the anatomopathological examination are practiced only in hardly more than a quarter of the cases while they will be important in proceedings and will allow the family to go into mourning.
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Aneurisma Roto/complicaciones , Aneurisma Roto/patología , Hemorragia/etiología , Periodo Posparto , Arteria Esplénica , Adulto , Resultado Fatal , Femenino , Hemorragia/patología , Humanos , Embarazo , Rotura EspontáneaRESUMEN
Adjustable gastric banding is recognized for its effectiveness in obtaining long-term weight loss with low morbidity-mortality for patients with morbid obesity. However, life-threatening complications can sometimes occur, and surgeons may end up in court. We analyzed complications, some of them lethal, arising from gastric banding surgery in nine patients and the main issues identified by the experts, contributing to the judge's decision. Gastric banding is considered a benign operation, but, of the nine cases examined herein, five resulted in death while the other four had serious consequences with several damages, especially aesthetic and psychological suffering. Perforations of the oesophagus or stomach remain the leading causes of complications; the experts identified several issues from the records that helped the judge to render a decision and condemn seven of the nine surgeons. Three types of faults were considered the responsibility of the doctors: the lack of patient information or incomplete medical records, a clumsy mistake or delay of appropriate treatment due to underestimation of clinical symptoms, and finally, failure to observe the proper indications. Expert opinion focused most often on criticism of postoperative behaviour and failure to make decisions according to the state of the art.
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Gastroplastia/efectos adversos , Responsabilidad Legal , Obesidad Mórbida/cirugía , Complicaciones Posoperatorias/cirugía , Adulto , Índice de Masa Corporal , Femenino , Estudios de Seguimiento , Gastroplastia/métodos , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/diagnóstico , Obesidad Mórbida/mortalidad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/mortalidad , Reoperación , Estudios Retrospectivos , Medición de Riesgo , Tasa de Supervivencia , Adulto JovenRESUMEN
To report blood pressure control in the Hypertension in the Very Elderly Trial, a placebo-controlled trial of hypertensive (systolic blood pressure (SBP) 160-199 mm Hg, diastolic blood pressure (DBP) <110 mm Hg) participants over the age of 80 years, given treatment in three steps: indapamide slow release 1.5 mg alone, indapamide plus 2 mg perindopril and indapamide plus 4 mg perindopril. The difference in control between participants with combined systolic and diastolic hypertension (SDH, DBPî¶90 mm Hg) and those with isolated systolic hypertension (ISH, DBP<90 mm Hg) is determined together with the effects of increments in the treatment regimen. At 2 years, the active treatment lowered blood pressure by 16.5/6.9 mm Hg more than that on placebo in participants with SDH and by 19.3/4.8 mm Hg more in those with ISH. The 2-year falls in pressure on placebo alone were 13.2/8.5 mm Hg in SDH and 8.2/1.5 mm Hg in ISH participants. With full titration of active treatment, 62% of SDH participants achieved goal SBP (<150 mm Hg) by 2 years and 71% of those with ISH. The corresponding results for DBP control (<80 mm Hg) were 40 and 78%. The addition of active perindopril 2 mg roughly doubled the percentage controlled, as did increasing to 4 from 2 mg. Blood pressure control was good with ISH and better than with SDH. The fall in SBP accounted for the observed 30% reduction in strokes, but the 21% reduction in total mortality and 64% reduction in heart failure were greater than predicted.
Asunto(s)
Antihipertensivos/uso terapéutico , Hipertensión/tratamiento farmacológico , Anciano de 80 o más Años , Presión Sanguínea/efectos de los fármacos , Quimioterapia Combinada , Femenino , Insuficiencia Cardíaca/prevención & control , Humanos , Indapamida/uso terapéutico , Masculino , Perindopril/uso terapéutico , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/prevención & controlRESUMEN
Several studies have attempted to describe the morphology of the hyoid bone, while other authors have focused on discovering the role of this bone in the occurrence of fractures. Hyoid fractures are known to be dependent on the force applied against the bone, or on the location at which the force is applied. We wished to assess the value of defining one or more models of the hyoid bone by analyzing variations in the size and angle of the various component parts of the bone relative to the sex and morphology of an individual (height and weight) in a sample of 72 bones obtained during forensic autopsy at our institution. Statistical analyses were developed using SAS software (Statistical Analysis System, version 9.2). We observed that the length of the hyoid bone and the angle between the greater horns differed significantly between men and women. Length was significantly greater in men (38.20 ± 4.67 mm) than in women (30.49 ± 7.90 mm) and the angle between the greater horns of the hyoid bone was larger in women (36.46 ± 13.77°) than in men (27.56 ± 13.02°). There was also a statistically significant correlation between the body mass index of an individual and the length of the hyoid bone. As weight increased, the hyoid bone was found to be longer. The weight of an individual was also significantly correlated with the angle of the hyoid bone, with lower weight resulting in larger angles of the bone. Furthermore, hierarchical classification enabled the hyoid bone to be differentiated into two groups or clusters according to anthropometric measurements. ROC curves were used to determine threshold values of length, width and angle to classify the hyoid bones in these two clusters: the first was composed of individuals with longer hyoid bones, and the second of individuals with greater hyoid bone widths and wider angles. Logistic regression showed male gender was more frequently associated with the first group. The morphology of the hyoid bone can be differentiated according to the gender and corpulence of an individual because these parameters are correlated. These findings are crucial in establishing a protocol for modelling the mechanism of fracture of the hyoid bone in strangulation. Two models of the hyoid bone appear to be needed to meet the practical requirements that are the purpose of these biomechanical studies.
Asunto(s)
Asfixia/diagnóstico , Patologia Forense/métodos , Fracturas Óseas/diagnóstico , Hueso Hioides/lesiones , Imagenología Tridimensional , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Autopsia , Cadáver , Femenino , Antropología Forense/métodos , Humanos , Masculino , Persona de Mediana Edad , Modelos Anatómicos , Reproducibilidad de los Resultados , Factores Sexuales , Adulto JovenAsunto(s)
Traumatismos Abdominales/diagnóstico por imagen , Angiografía/métodos , Autopsia/métodos , Traumatismo Múltiple/diagnóstico por imagen , Traumatismos Torácicos/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Medios de Contraste/administración & dosificación , Estudios de Factibilidad , Arteria Femoral/diagnóstico por imagen , Humanos , Masculino , Ultrasonografía Intervencional , Adulto JovenRESUMEN
Misuse of medications can have major consequences for the consumer or patient's health. In the case of a drug delivered only on medical prescription, the misuse usually results from an error or negligence on the part of the prescribing doctor and/or the pharmacist dispensing the medication. But whereas, under French Law, doctors are regularly prosecuted for their irresponsibility, pharmacists frequently avoid any legal charges. This is even more surprising in view of the fact that French Legislation controls the practice of pharmacy very strictly. The authors discuss four cases that illustrate this issue and present a study of comparative pharmaceutical law requirements.
Asunto(s)
Responsabilidad Legal , Farmacéuticos/legislación & jurisprudencia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Médicos/legislación & jurisprudencia , Quebec , Suiza , Estados UnidosRESUMEN
OBJECTIVES: Cranial base development during fetal life is of major interest for many research purposes. In this study, we focused on fetal age estimations which are extremely important in forensic contexts. Nevertheless, there have been very few studies using occipital measurements to determine fetal age. OBJECTIVES: To evaluate change in the sagittal length/maximum width ratio of the basilar part of the occipital bone and to propose a simple and reliable method for fetal age determination. METHODS: A sample of 30 male and 7 female fetuses aged 24 to 41 weeks amenorrhea underwent CT scan. Occipital bones were reconstructed (Amira 4.0) and measurements were carried out on each part. RESULTS: A multivariate analysis (ANOVA) gave an age formula using right exoccipital measurements and a linear regression supplied the age of reversion of the sagittal length/maximum width ratio. CONCLUSION: This preliminary study clearly highlighted the promises of 3D CT-Scan studies of fetal cranial base and gave interesting results and the method deserves to be tested on a larger sample.
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Edad Gestacional , Imagenología Tridimensional/métodos , Hueso Occipital/embriología , Tomografía Computarizada por Rayos X/métodos , Determinación de la Edad por el Esqueleto/estadística & datos numéricos , Cefalometría/métodos , Cefalometría/estadística & datos numéricos , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Procesamiento de Imagen Asistido por Computador/estadística & datos numéricos , Imagenología Tridimensional/estadística & datos numéricos , Modelos Lineales , Masculino , Análisis Multivariante , Hueso Occipital/diagnóstico por imagen , Reproducibilidad de los Resultados , Base del Cráneo/diagnóstico por imagen , Base del Cráneo/embriología , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Ultrasonografía PrenatalRESUMEN
BACKGROUND: When preparing neuropsychological expert reports, the neuropsychologist is asked to make a precise assessment of the victims' cognitive dysfunction, generally after traumatic head injury. The expert is usually required to assess the nature of the neuropsychological deficits, their correlation with any brain lesions and their imputability to the accident or crime in question, to estimate a possible date of stabilisation and to evaluate the heads of damage. The basic principle of compensation for personal injury is to consider the circumstances in which the victim would have been if the prejudicial event (for example, the accident) had not occurred and to assess, on the basis of these various heads of damage, compensation for the injury suffered. While it is not the neuropsychologist's role to evaluate the compensation as such, he or she has however to specify which aspects of cognitive function are deficient and what impact this dysfunction has on a personal and occupational level. Until recently, compensation for personal injury, and notably for cognitive deficits, was assessed with reference to nine principal heads of damage, in particular the conventional concepts of total temporary disability (incapacité temporaire totale [ITT]), defined as the period during which the victim was temporarily unable to carry out their usual occupational and personal activities, and partial permanent disability (incapacité partielle permanente [IPP]), defined as a percentage and corresponding to the reduction, after stabilisation, in the victim's functional capacity - that is, their physical and psychological potential - here again from an occupational and personal viewpoint. However, concretely, the emphasis had shifted to take into account only the pecuniary aspects of injury relating to the domain of "having", that is the loss of income due to cessation of work, while the non-pecuniary aspects relating to the domain of "being" were often ignored. NEW CLASSIFICATION: The Dintilhac report has established a new classification of heads of physical damage which abandons these two ambiguous concepts of ITT and IPP. Damage now includes three categories: pecuniary and non-pecuniary; temporary and permanent and damage to direct and indirect victims. We define the new heads of damage to direct victims, illustrate them with examples from neuropsychological expert reports, compare the old and the new classifications and discuss the implications of the Dintilhac report for expert assessment. The report appears to remove the ambiguities previously mentioned, since ITT has been replaced by two new heads of damage which are clearly defined as pecuniary and non-pecuniary: "loss of present occupational income" (pertes de gains professionnels actuels [PGPA]) and "temporary functional deficiency" (déficit fonctionnel temporaire [DFT]), respectively. Similarly, IPP is replaced by two new heads of damage, which are also clearly defined as pecuniary and non-pecuniary and are the poststabilisation equivalents of PGDA and DFT: these are "loss of future earnings" (pertes de gains professionnels futurs [PGPF]) and "permanent functional deficiency" (déficit fonctionnel permanent [DFP]). Concerning the other heads of damage, the amendments introduced by the new classification do not basically modify the earlier concepts but are nevertheless more precise in certain respects. The "pretium doloris", or "price of pain", is replaced by "suffering sustained" (souffrances endurées [SE]) with little fundamental change. The same is true of "loss of amenity" (préjudice d'agrément [PA]). The term of "aesthetic impairment" (préjudice esthétique [PE]) also remains the same, but whereas it previously related only to permanent impairment, it now includes temporary impairment, before stabilisation. What was formerly termed "loss of sexual function" now consists of "loss of sexual function" (préjudice sexuel [PS]) as well as "loss of the prospect of founding a family" (préjudice d'établissement [PE]), allowing a finer distinction to be made between the damages sustained. The former "third party" (tierce personne) is now covered under the headings of "assistance by a third party" (assistance par tierce personne [ATP]), "expenses of accommodation conversion" (frais de logement adapté [FLA]) and "expenses of vehicle conversion" (frais de véhicule adapté [FVA]), which here again provides greater precision in the heads of compensation. Lastly, what was previously known as "loss of opportunity" (perte de chance) is divided into three different categories: "loss of education, whether at school, university or in training" (préjudice scolaire, universitaire ou de formation [PSU]), "loss of future occupational earnings" (perte de gains professionnels futurs [PGPF]) and in part the "occupational impact" (incidence professionnelle [IP]). CONCLUSION: In summary, these various heads of damage concerning direct victims that are proposed by the Dintilhac report result in a more detailed evaluation of compensation for personal injury. Assessment of a certain number of heads of damage is an integral part of the preparation of a neuropsychological expert report and the fact that these heads of damage are now better defined makes the expert's task easier. As the neuropsychologist, generally called upon to give an expert opinion, now has better knowledge of this new classification, he or she will be able to give clearer and fuller answers to the questions raised and so comply with the principle of civil law relating to compensation for personal injury: "compensate the injury, all the injury, but nothing except the injury".
Asunto(s)
Lesiones Encefálicas/diagnóstico , Lesiones Encefálicas/psicología , Trastornos del Conocimiento/diagnóstico , Testimonio de Experto/legislación & jurisprudencia , Pruebas Neuropsicológicas/estadística & datos numéricos , Lesión Encefálica Crónica/diagnóstico , Lesión Encefálica Crónica/psicología , Trastornos del Conocimiento/clasificación , Compensación y Reparación/legislación & jurisprudencia , Evaluación de la Discapacidad , Determinación de la Elegibilidad/legislación & jurisprudencia , Francia , HumanosRESUMEN
Compensation for victims of medical accidents identified as no-fault medical accidents (NFMA) will be financed by national solidarity: this is a major and innovative feature of the Law of March 4, 2002 relative to Patients' Rights. In this review, we analyse the decisions of the regional commission on compensation of medical accidents in the Provence-Alpes-Côtes d'Azur (PACA) region of France in 2004 and 2005, and we attempt to identify the prevalence of certain surgical procedures liable to result in NFMA and to define the concept of "unintended consequences" in the context of state of health of the patient and the predictable course of the malady. We hope to improve the medical information given to the patient and thereby the overall quality of management. NFMA was acknowledged in 57 claims, about 10% of all those received by the commission during this period. Nearly half of the claims were within the competence of the commission because of the existence of serious sequelae (Permanent Partial Disability) in 47%. No typical profile of age or gender emerged in the patients with NFMA. The majority of cases occurred after surgical procedures, in particular gastrointestinal surgery and orthopaedic surgery; 91% were planned procedures. We did not identify increased risk related to any given type of surgery, particular disease condition, or precise anatomic region. Complications were those usually observed such as neurological complications in vascular surgery or perforations in gastrointestinal surgery. The interpretation of NFMA has undergone an evolution during this two-year period. In 2004, previous poor health status precluded acknowledgment of a medical accident, the argument being that there was a predisposition to the complication which occurred. In 2005, compensation was based on a reduced Partial Permanent Disability score compared to the patient's previous health status. This became a means of measuring the impact of the medical complication on an already predictably unfavorable clinical course without medical intervention, and the legal aspect of the "ineluctable nature" of this course.
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Compensación y Reparación , Errores Médicos/economía , Adulto , Anciano , Anciano de 80 o más Años , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Procedimientos Quirúrgicos del Sistema Digestivo/estadística & datos numéricos , Femenino , Francia , Enfermedades Gastrointestinales/complicaciones , Enfermedades Gastrointestinales/cirugía , Humanos , Responsabilidad Legal , Masculino , Errores Médicos/legislación & jurisprudencia , Registros Médicos , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/complicaciones , Enfermedades Musculoesqueléticas/cirugía , Procedimientos Ortopédicos/efectos adversos , Procedimientos Ortopédicos/estadística & datos numéricos , Derechos del Paciente , Estudios RetrospectivosRESUMEN
PURPOSE: To assess the presence of ossification of the sesamoid bone of the thumb as a function of age and compare the results to data from the atlas by Greulich and Pyle describing the ossification of this bone in girls of 11 years and boys of 13 years. Materials and methods. Prospective study of 1372 children (780 boys and 592 girls between the ages of 0.4 and 19.7 years, mean age of 9.7 years) with known chronological age requiring radiographic evaluation of the wrist-hand after minor trauma. The presence of a sesamoid was analyzed by logistic regression using the method of probits. RESULTS: The minimum and maximum ages in our sample population were 10-15.1 years for boys and 8.8-15.2 years for girls. The P50 value (method of probits) corresponded to the chronological age at which 50% of the population had a visible sesamoid. It was 12.1 years for boys and 10.2 years for girls. CONCLUSION: The timing of ossification of the sesamoid of the thumb is widely variable. Ossification of this sesamoid should not be used as a precise indicator when determining bone age using the atlas by Greulich and Pyle.
Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Falanges de los Dedos de la Mano/diagnóstico por imagen , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Prospectivos , Pulgar , Adulto JovenRESUMEN
Association between cervico-thoracic liposarcoma and HIV infection is uncommon. The etiopathology remains unclear and clinical symptoms can be various, often not very evident or absolutely absent. Preoperative diagnosis is based on modern imaging techniques. In selected cases, the ideal procedure is surgical treatment which allows good long-term results. A case of cervico-thoracic liposarcoma in HIV patient is presented.
Asunto(s)
Vértebras Cervicales , Infecciones por VIH/complicaciones , Huésped Inmunocomprometido , Liposarcoma/complicaciones , Neoplasias de los Tejidos Blandos/complicaciones , Vértebras Torácicas , Anciano , Infecciones por VIH/diagnóstico , Infecciones por VIH/cirugía , Humanos , Liposarcoma/diagnóstico , Liposarcoma/cirugía , Masculino , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/cirugía , Resultado del TratamientoRESUMEN
In the industrialized West countries the breast cancer represents the most frequent malignant neoplasia in the women. From over 30 years we have a progressive increase of frequency of breast carcinoma. Mortality is substantially unchanged. The Authors, on the base of casuistry accumulated in five years of activity, trace a diagnostic-therapeutic run to the purpose to favour a line of behavior, practice and actual, for the management of breast cancer.
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Neoplasias de la Mama/terapia , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/diagnóstico , Quimioterapia Adyuvante , Femenino , Estudios de Seguimiento , Humanos , Mastectomía , Mastectomía Segmentaria , Persona de Mediana Edad , Estadificación de Neoplasias , Radioterapia Adyuvante , Estudios Retrospectivos , Factores de Riesgo , Biopsia del Ganglio Linfático Centinela , Resultado del TratamientoRESUMEN
Gastric haemangiomas are an infrequent histological type of gastrointestinal benign tumors. Diagnosis is based on imaging but only pathological examination can give certainty. Endoscopic resection, according some specific criteria, is the gold standard procedure. Authors present a case of cavernous haemangioma diagnosed and treated by endoscopic procedure.