Do you remember scurvy?

Scurvy, a disease caused by a deficiency of ascorbic acid (vitamin C), is not very common disease especially in pediatric age. In the late nineteenth century, instead, we assisted to increase incidence of this problem for the use of heated milk and convenience foods. We report two cases of scurvy: a child of 3 years old came to our observation for an important gums' stomatitis, fever, widespread petechiae and ecchymosis on the skin of the lower limbs; in the second moment he had pain in upper and lower limbs with difficulty in walking; a second child of 4 years came to our observation for pain lower limbs and maintained the posture of the legs down, inability to walking, with reduced muscle tone and trophism in all limbs; at the instrumental examination he had an alveolar hemorrhage. The two boys had a history of a diet completely lacking in fruits and vegetables; they were drinking almost only milk. They carried various laboratory and instrumental tests, in particular X-ray of lower limbs that showed "a thick sclerotic metaphyseal line with beak-like excrescences of tibiae and femur". The characteristic radiological appearance, the particular clinical aspects, the dietary history and the dosage of vitamin C, have led us to the diagnosis of scurvy. They started therapy with vitamin C and they had a progressive improvement in general condition.

A case of spontaneous gastric rupture in a 5 years girl.

We describe a case of spontaneous gastric rupture in a child of 5 years old. The patient reached us in a serious condition; the anamnesis was negative for traumatic events or gastrointestinal disorders. An abdominal X-ray and CT scan revealed free air and fluid in the abdominal cavity, leading to the diagnosis of gastro-intestinal perforation. Submitted to urgent surgery, a rupture of the posterior wall of the stomach was found that was treated with gastrectomy "à la demande". The surgery follow-up was regular. Morphological and immunohistochemical study showed some muscular abnormalities of the muscular gastric wall.

Tuberculosis del sistema nervioso central: aspectos clínicos y tomográficos / Central nervous system tuberculosis: clinical and radiological findings

No disponible

No disponible

[Cerebral aneurysm related to pediatric AIDS. Case report]. / Aneurisma cerebral asociado al síndrome de inmunodeficiencia adquirida en la infancia: descripción de un caso.

INTRODUCTION: Aneurysms, described in pediatric AIDS, are related with bad prognosis with high mortality in 5 months. The twenty reports found in literature were considered late (mean age 9.97 years old) and associated with severe immunological involvement. The mean CD-4 count was 79.17 cells and mean viral load 222,662 copies/mL. Some authors consider this complication associated to the human immunodeficiency virus (HIV), to an opportunistic agent (citomegalovirus and Mycobacterium avium) or due to inflammatory mechanisms related with the immunological improvement. CASE REPORT: This paper present a 9 years old girl with severe AIDS (C-3) and with transient amaurosis related to transient ischemic attacks on ophthalmic artery during her immunological improvement on viral load and CD-4 counts. Necropsy showed aneurysm due to atypical micobateriosis. CONCLUSION: This report highlights the occurrence of this rare but severe HIV complication witch was associated with an opportunistic etiology during an immunological recovery, when inflammatory mediators could play a role.

Aneurisma cerebral asociado al síndrome de inmunodeficiencia adquirida en la infancia: descripción de un caso / Cerebral aneurysm related to pediatric aids. Case report

Introducción. Los aneurismas descritos en el síndrome de inmunodeficiencia adquirida (sida) pediátrico indican un mal pronóstico, con una supervivencia de 5,5 meses. De los 20 casos encontrados en la literatura, su presentación es tardía (edad media de 9,97 años) y está asociada a una infección grave por el virus de inmunodeficiencia humana (VIH) con un bajo recuento de CD-4 (media de 79,17 células) y elevados niveles de carga viral (media de 222.662 copias/mL). Algunos autores consideran el aneurisma resultado de la acción del propio VIH, de un agente oportunista (citomegalovirus o Mycobacterium avium) o de los mecanismos inflamatorios relacionados con la recuperación inmunológica. Caso clínico. Presentamos a una niña de 9 años de edad, sida C-3, en recuperación de sus niveles de CD-4 y carga viral, con amaurosis fugaz como consecuencia de isquemias transitorias en el área de la arteria oftálmica. La necropsia puso de manifiesto una lesión aneurismática secundaria a una micobacteria atípica. Conclusión. La descripción llama la atención sobre esa complicación poco frecuente, pero relacionada con un mal pronóstico, y remarca la importancia de considerar un agente oportunista asociado a la rápida recuperación inmunológica como etiología del proceso

Introduction. Aneurysms, described in pediatric AIDS, are related with bad prognosis with high mortality in 5 months. The twenty reports found in literature were considered late (mean age 9,97 years old) and associated with severe immunological involvement. The mean CD-4 count was 79.17 cells and mean viral load 222,662 copies/mL. Some authors consider this complication associated to the human immunodeficiency virus (HIV), to an opportunistic agent (citomegalovirus and Mycobacterium avium) or due to inflammatory mechanisms related with the immunological improvement. Case report. This paper present a 9 years old girl with severe AIDS (C-3) and with transient amaurosis related to transient ischemic attacks on ophthalmic artery during her immunological improvement on viral load and CD-4 counts. Necropsy showed aneurysm due to atypical micobateriosis. Conclusion. This report highlights the occurrence of this rare but severe HIV complication witch was associated with an opportunistic etiology during an immunological recovery, when inflammatory mediators could play a role

[Cardiopulmonary echinococcosis: a report of a clinical case]. / Echinococcosi cardio-polmonare: descrizione di un caso clinico.

The authors report a case of hydatid cyst of the ventricular septum. The patient, an asymptomatic 30-year-old woman, was hospitalized in the Department of Pneumology after a routine chest X-ray test which detected two round masses in the lungs. During hospitalization the patient was asymptomatic and standard ECG was normal, but two-dimensional echocardiography (2D echo) revealed a cardiac cyst localized in the mediobasal portion of the ventricular septum. The finding was confirmed by computed tomography and nuclear magnetic resonance imaging. An echinococcosis was suspected on the basis of the patient's origin (Morocco) and because of the presence of cystic lesion also in the lungs, and was confirmed by positive hemagglutinin test. The patient underwent surgery (suction of cardiac cyst in extracorporeal circulation and washing with formaline 2%). This case is of particular interest because of the rarity of cardiac localization of echinococcosis (0.02-2%) and the lack of symptoms or of asymptomatic cardiac arrhythmias despite the location in the ventricular septum. Patients with hepatic or pulmonary hydatid disease could be routinely investigated by 2D echo because this imaging technique is: noninvasive, feasible and has a high sensitivity for detecting intracardiac echinococcal cysts.

Comparisons of diet and biochemical characteristics of stool and urine between Chinese populations with low and high colorectal cancer rates.

In an investigation of the roles of diet and stool biochemistry in human colorectal carcinogenesis, 24-hour food, urine, and stool samples were collected from randomly selected participants from two populations with a fourfold difference in colorectal cancer risk: Chinese in Sha Giao, People's Republic of China (low risk), and Chinese-Americans of similar ages in San Francisco County, Calif, in the United States (high risk). The findings supported the hypotheses that colorectal cancer risk is increased by the consumption of high-fat, high-protein, and low-carbohydrate diets and is associated with high levels of cholesterol in stool as well as increased daily outputs of 3-methyl-histidine and malonaldehyde in urine. However, risk does not increase with low stool bulk and low total stool fibers.

Separation and quantitation of fatty acids, sterols and bile acids in feces by gas chromatography as the butyl ester-acetate derivatives.

A system allowing the separation and quantitation of individual species of fecal fatty acids, sterols and bile acids in a single chromatographic step is described. The system is based on the butylation of carboxyl groups and acetylation of free hydroxyls of the compounds in fecal lipid extracts, followed by their resolution by temperature-programmed gas chromatography. As the butyl ester-acetate derivatives, fatty acids, sterols and bile acids elute separately and with no overlap on a variety of chromatographic columns, obviating the need for prior separation of each class by thin-layer or column chromatography. All common bile acids, a wide variety of sterols and keto-steroids, as well as saturated and unsaturated fatty acids may be routinely resolved. Quantitation is facilitated by the addition of the internal standards, heptadecanoic acid and nor-deoxycholic acid to each sample. With an automatic sample injector, the rapid assessment of a wide range of potential risk factors for colorectal cancer may be carried out in large numbers of samples.