Assuntos
Angioplastia/economia , Angioplastia/instrumentação , Doenças das Artérias Carótidas/economia , Doenças das Artérias Carótidas/terapia , Centers for Medicare and Medicaid Services, U.S./economia , Política de Saúde/economia , Reembolso de Seguro de Saúde , Stents/economia , Angioplastia/efeitos adversos , Angioplastia/legislação & jurisprudência , Centers for Medicare and Medicaid Services, U.S./legislação & jurisprudência , Medicina Baseada em Evidências , Humanos , Reembolso de Seguro de Saúde/legislação & jurisprudência , Seleção de Pacientes , Formulação de Políticas , Medição de Risco , Fatores de Risco , Estados UnidosRESUMO
Tracheobronchial injuries are rare among all age groups and are extremely rare among the pediatric age group. Yet, the incidence has seemed to increase. Most of these patients die before reaching the hospital from severe associated injuries. Isolated bronchial injury is even more rare than tracheal injury, and it is the focus of the present study. A retrospective national survey was conducted among all tertiary referral and trauma centers in Israel regarding the period between the years 1983 and 1998. Only six cases (3 males and 3 females) of isolated bronchial rupture were found the throughout the country. Ages of the patients ranged from 2 to 14 years; all were involved in motor vehicle accidents, four of them as pedestrians. Ruptures occurred in the bronchus intermedicus (2 cases), left and right main bronchus (2 cases each). All but one patient went through primary repair. We give a full description of the procedure and discuss the literature regarding incidence, diagnosis, treatment, and outcome.
Assuntos
Brônquios/lesões , Acidentes de Trânsito , Adolescente , Brônquios/cirurgia , Broncografia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Ruptura , Tomografia Computadorizada por Raios X , Ferimentos e Lesões/fisiopatologiaRESUMO
We present the computed tomographic (CT) findings in two cases of small bowel diverticulitis, one affecting the jejunum and the other a Meckel's diverticulum. The main CT finding was that of a mass with an air-fluid collection in contiguity with small bowel loops.
Assuntos
Diverticulite/diagnóstico por imagem , Divertículo Ileal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doença Aguda , Idoso , Diagnóstico Diferencial , Diverticulite/complicações , Diverticulite/cirurgia , Humanos , Obstrução Intestinal/complicações , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Laparotomia , Masculino , Divertículo Ileal/complicações , Divertículo Ileal/cirurgia , Pessoa de Meia-Idade , Ruptura EspontâneaRESUMO
OBJECTIVES: Our major goals in this study were to determine the prevalence of Helicobacter pylori among Israeli children with recurrent abdominal pain and to establish whether a link exists between eradication of Helicobacter pylori and the recovery from abdominal pain. The alternative target was to examine whether the serological test can replace endoscopy in children. METHODS: Upper gastrointestinal endoscopy was performed in 80 children with recurrent abdominal pain. During endoscopy, antral biopsies were taken and sent for histological and bacteriological examination. RESULTS: The prevalence of H. pylori, which was indicated by Gram stain and urease test, was 54%. The positive cases were treated with bismuth combined with amoxycillin and metronidazole. Two months after completion of the treatment, 34 patients were reexamined. Twenty-nine of them (85%) became symptom free, and five (15%) remained symptomatic. These five children were retreated, and they also became symptom free. Eight months after completion of treatment, all 34 patients were reexamined and found to be asymptomatic. CONCLUSIONS: We found a high prevalence of H. pylori (54%) among Israeli children with recurrent abdominal pain; we also found that symptoms were effectively and significantly reduced by the eradication of H. pylori. The endoscopic examination cannot be replaced by serological test.
