Assuntos
Transtorno Autístico/complicações , Corpos Estranhos/complicações , Íleo , Perfuração Intestinal/etiologia , Pseudo-Obstrução Intestinal/etiologia , Jejuno , Agitação Psicomotora/etiologia , Adolescente , Bezoares/complicações , Índice de Massa Corporal , Ingestão de Alimentos , Serviço Hospitalar de Emergência , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Íleo/cirurgia , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/cirurgia , Pseudo-Obstrução Intestinal/diagnóstico por imagem , Pseudo-Obstrução Intestinal/cirurgia , Jejuno/cirurgia , Masculino , Radiografia , Resultado do Tratamento , Tricotilomania/complicações , Redução de PesoAssuntos
Abscesso/diagnóstico , Canal Anal/patologia , Doença de Crohn/diagnóstico , Fístula Retal/diagnóstico , Abscesso/microbiologia , Abscesso/cirurgia , Adolescente , Canal Anal/cirurgia , Anticorpos Monoclonais/uso terapêutico , Constipação Intestinal/etiologia , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Doença de Crohn/cirurgia , Diarreia/etiologia , Feminino , Fissura Anal/etiologia , Fissura Anal/cirurgia , Seguimentos , Fármacos Gastrointestinais/uso terapêutico , Hemorroidas/etiologia , Hemorroidas/cirurgia , Humanos , Infliximab , Fístula Retal/etiologia , Fístula Retal/cirurgia , Resultado do Tratamento , Redução de PesoRESUMO
BACKGROUND: A short course of dexamethasone therapy may attenuate the course of acute chest syndrome (ACS) of sickle cell disease, but it also increases the risk of early readmission after discharge. Over several years at our institution, an "asthma regimen" of prednisone [2 mg/kg/d (max 80 mg) in 2 divided doses for 5 days] has increasingly been used to treat moderate-to-severe ACS. METHODS: Review of medical records identified 63 patients hospitalized 78 times with ACS over a 2-year period. The clinical course of patients who received prednisone was compared with that of those who did not, particularly to assess the frequency of early (within 2 weeks) readmission after discharge. RESULTS: Eight (15.1%) of the 53 children receiving prednisone and 2 (8%) of the 25 who did not were readmitted within 2 weeks (P=0.33), usually for treatment of pain. Patients with moderate-to-severe ACS were more likely to receive prednisone. There was no difference in the duration of stay or the need for blood transfusion between the 2 groups; 21.8% of all the patients received blood. CONCLUSION: A short course of prednisone did not significantly increase readmission rate after discharge. Larger prospective studies are needed to confirm safety and to establish efficacy.
Assuntos
Síndrome Torácica Aguda/tratamento farmacológico , Síndrome Torácica Aguda/etiologia , Anemia Falciforme/complicações , Glucocorticoides/uso terapêutico , Readmissão do Paciente/estatística & dados numéricos , Prednisona/uso terapêutico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Adulto JovemRESUMO
Iniencephaly is an uncommon and fatal neural tube defect involving the occiput and inion, this occurs together with rachischisis of the cervical and thoracic spine, and retroflexion of the head. We report the ultrasound (US) and magnetic resonance (MR) imaging findings of a case of iniencephaly with clubfeet and arthrogryposis. The diagnosis of iniencephaly is easy to make on ultrasound due to the typical star-gazing fetus. However, the details of the fetal brain and spinal cord may not be adequately delineated on US. We found MR imaging to be superior for depicting central nervous system abnormalities. MR imaging has evolved as an imaging modality and it is complementary to fetal US, yet US remains the screening modality of choice.