RESUMO
A 12-year-old boy was referred by the general practitioner with a 3-week history of pain in the popliteal fossa. There was no sign of trauma or infection, physical examination was normal, and his CRP level was mildly elevated. X-ray and MRI revealed a Brodie's abscess, which was treated surgically and with antibiotics and he made a good recovery.
Assuntos
Abscesso/diagnóstico , Dor Musculoesquelética/diagnóstico , Osteomielite/diagnóstico , Abscesso/complicações , Abscesso/terapia , Antibacterianos/uso terapêutico , Criança , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Procedimentos Ortopédicos , Osteomielite/complicações , Osteomielite/terapia , RadiografiaRESUMO
Transient neonatal diabetes mellitus (TNDM) is associated with paternal over-expression of an imprinted locus on chromosome 6q24, which contains one differentially methylated region (DMR); maternal demethylation at the DMR accounts for approximately 20% of cases. Here we report female monozygous triplets, two of whom have TNDM arising from loss of maternal methylation within the TNDM DMR.
Assuntos
Cromossomos Humanos Par 6/genética , Metilação de DNA , Diabetes Mellitus/genética , Impressão Genômica/genética , Doenças do Recém-Nascido/genética , Trigêmeos/genética , Feminino , Humanos , Recém-Nascido , Repetições de Microssatélites/genética , Reação em Cadeia da Polimerase/métodosRESUMO
Topical treatment of allergic or vasomotor rhinitis is possible by means of pressurized metered dose inhalers, aqueous spray, or dry powder inhalers. In children, little is known about nasal drug delivery by dry powder inhalation. The airflow through the device is critical for the drug release and a sufficient nasal inspiratory flow is needed for intranasal drug delivery from a dry powder inhaler. In order to investigate from what age children with allergic or vasomotor rhinitis can reliably use such a device, device-dependent nasal peak inspiratory flow (DnPIF) was measured. The maximal DnPIF was measured in children aged 4-13 years making use of a dry powder inhaler (Turbuhaler) connected to a spirometer (Vitalograph). In the clinically relevant context, instructions from the doctor and one week's use of a Turbuhaler at home were found to be sufficient to obtain a good inhalation technique and were shown to improve DnPIF at least as effectively as visual feedback training at the clinic. Children with rhinitis, as well as healthy children from the age of 6 years, were able to generate a DnPIF sufficient to obtain a reliable nasal delivery of a dry powder drug dose. DnPIF values correlated with age. Consequently, a recommendation to use a nasal Turbuhaler from the age of 6 for topical drug delivery in the treatment of allergic or vasomotor rhinitis seems reasonable.
