Assuntos
Obstrução das Vias Respiratórias/etiologia , Região Branquial/anormalidades , Infecções por Escherichia coli , Feminino , Fístula/etiologia , Humanos , Recém-Nascido , Doenças da Laringe/etiologia , Masculino , Doenças Faríngeas/etiologia , Fístula do Sistema Respiratório/etiologia , Saliva , Infecções Estreptocócicas , Streptococcus/classificação , Streptococcus agalactiaeAssuntos
Neoplasias Renais/radioterapia , Recidiva Local de Neoplasia/radioterapia , Tumor de Wilms/radioterapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Pré-Escolar , Terapia Combinada , Feminino , Humanos , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Recidiva Local de Neoplasia/patologia , Nefrectomia , Tumor de Wilms/diagnóstico , Tumor de Wilms/patologiaRESUMO
We describe a 15-year-old black boy with hemoglobin S-C disease living in Atlanta (altitude 1,034 ft), with no prior history of aircraft or mountain travel, who developed splenic infarction. The clinical picture was characterized by severe left upper quadrant abdominal pain, fever, splenomegaly, and hematologic and scintigraphic evidence of functional asplenia. The diagnosis was suggested by liver/spleen scintigraphy and further confirmed by ultrasonography and computerized tomography (CT) of the spleen. Treatment consisted of analgesics, intravenous fluids, and short-term antibiotic therapy. The child recovered without sequelae.
Assuntos
Anemia Falciforme/complicações , Doença da Hemoglobina SC/complicações , Infarto do Baço/etiologia , Adolescente , Altitude , Humanos , Masculino , Cintilografia , Baço/diagnóstico por imagem , Infarto do Baço/diagnóstico , Infarto do Baço/terapia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The clinical criteria for brain death in children remain controversial. An accepted confirmatory test for brain death is the documented absence of intracranial blood flow, the most common methods being arteriography and radionuclide cerebral angiography. We correlated the common carotid arterial blood velocity patterns measured by pulsed Doppler ultrasound in 32 brain-dead infants and children with results of their clinical examinations and, whenever possible, with radionuclide cerebral angiography. A distinct, characteristic carotid arterial blood velocity waveform indicating absent cerebral blood flow appeared in 19 of the 23 brain-dead patients 4 months of age or older. The velocity patterns of the other four older children were similar, but not identical, to the characteristic waveform. The remaining nine brain-dead patients were infants 4 months of age or younger. These infants had velocity waveforms different from those of healthy infants, but also were totally different from the characteristic brain death pattern of older children. No patient had the characteristic brain death waveform without being clinically brain dead. Measurement of carotid arterial blood velocity with pulsed Doppler ultrasound is a repeatable, noninvasive, portable test useful for confirmation of brain death in children.