RESUMO
Mirror-guided self-inspection is seen as a cognitive hallmark purportedly indicating the existence of self-recognition. Only a few species of great apes have been reported to pass a standard mark test for mirror self-recognition in which animals attempt to touch a mark. In addition, evidence for passing the mark test was also reported for Asian elephants, two species of corvids, and a species of cleaner fish. Mirror self-recognition has also been claimed for bottlenose dolphins, using exposure of marked areas to a mirror as evidence. However, what counts as self-directed behaviour to see the mark and what does not has been debated. To avoid this problem, we marked the areas around both eyes of the animals at the same time, one with visible and the other with transparent dye to control for haptic cues. This allowed the animal to see the mark easily and us to investigate what side was exposed to the mirror as an indicator for mark observation. We found that the animals actively chose to inspect their visibly marked side while they did not show an increased interest in a marked conspecific in the pool. These results demonstrate that dolphins use the mirror to inspect their marks and, therefore, likely recognise a distinction between self and others.
Assuntos
Comportamento Animal , Golfinho Nariz-de-Garrafa , Reconhecimento Facial , Animais , Elefantes , Peixes , Corvos , Reconhecimento Visual de ModelosRESUMO
Surgical treatment is not commonly recommended in the management of autoimmune pancreatitis. The article describes a dilemma in diagnostics and treatment of a 68-year old man with the mass in the head of the pancreas that mimicked pancreatic cancer and that was diagnosed as a type 1 autoimmune pancreatitis (IgG4-related pancreatitis) after a surgical resection. Diagnosis of the autoimmune pancreatitis is a real clinical challenge, as in the current diagnostic criteria exists some degree of overlap in the findings between autoimmune pancreatitis and pancreatic cancer (indicated by the similarity in radiologic findings, elevation of IgG4, sampling errors in pancreatic biopsy, and the possibility of synchronous autoimmune pancreatitis and pancreatic cancer). Despite the generally accepted corticosteroids as the primary treatment modality in autoimmune pancreatitis, we believe that surgical resection remains necessary in a specific subgroup of patients with autoimmune pancreatitis (Fig. 4, Ref. 37).
Assuntos
Doenças Autoimunes/diagnóstico , Imunoglobulina G/sangue , Icterícia Obstrutiva/etiologia , Pâncreas/diagnóstico por imagem , Pancreatite/diagnóstico , Corticosteroides , Idoso , Doenças Autoimunes/imunologia , Doenças Autoimunes/patologia , Diagnóstico Diferencial , Humanos , Masculino , Pâncreas/patologia , Neoplasias Pancreáticas , Pancreatite/imunologia , Pancreatite/patologia , Resultado do TratamentoRESUMO
UNLABELLED: Skin and Soft Tissue Infections (SSTIs) encompass a wide spectrum of inflammatory diseases of the skin, subcutis, fascia and muscles. Recent national trends indicate increasing rates of patients treated for these diagnoses at outpatient surgical department, but also of patients hospitalized with severe forms of SSTIs. Up to 90% fatality rates are reported in the literature for the most severe forms, resulting from underestimation of initial symptoms and therefore delayed onset of radical therapy only the phase of septic shock. The paper provides an interdisciplinary review of essential principles of the diagnosis and therapy of SSTIs, reflecting present knowledge supported by evidence-based medicine. KEY WORDS: skin and soft tissue infections - SSTIs - necrotizing fasciitis - diagnosis - therapy.
Assuntos
Medicina Baseada em Evidências , Dermatopatias Infecciosas/terapia , Infecções dos Tecidos Moles/terapia , Progressão da Doença , Diagnóstico Precoce , Intervenção Médica Precoce , Humanos , Choque Séptico/etiologia , Dermatopatias Infecciosas/complicações , Dermatopatias Infecciosas/diagnóstico , Infecções dos Tecidos Moles/complicações , Infecções dos Tecidos Moles/diagnósticoRESUMO
Our report presents the case of a young woman who suffered liver trauma after electrical current injury and ensuing fall from an electricity pylon. The resulting intrahepatic hematoma manifested after a time interval of 48 hours following the injury, with initially negative CT scan.Key words: liver hematoma electrical current - polytrauma burns.
Assuntos
Traumatismos Abdominais/complicações , Desaceleração/efeitos adversos , Hematoma/etiologia , Hepatopatias/etiologia , Fígado/lesões , Traumatismo Múltiplo , Traumatismos Abdominais/diagnóstico , Adulto , Feminino , Hematoma/diagnóstico , Humanos , Hepatopatias/diagnóstico , Tomografia Computadorizada por Raios XRESUMO
Secondary peritonitis is the most common cause of inflammatory acute abdomen treated at general surgery departments. Only early and correct diagnosis may improve the prognosis of these patients. The authors compiled an interdisciplinary review of the basic principles of diagnosis and treatment of secondary peritonitis, which reflects current findings supported by evidence-based medicine. The work is based on published international literature but also shares opinions and experiences of the selected specialists. The presented work in its extent is not meant to substitute an in-depth study of the issue, but to allow a basic and quick review of the topic.
Assuntos
Peritonite/diagnóstico , Peritonite/terapia , Anti-Infecciosos/uso terapêutico , Diagnóstico por Imagem , Procedimentos Cirúrgicos do Sistema Digestório , Humanos , Masculino , Peritonite/etiologia , PrognósticoRESUMO
Dolphin communication is suspected to be complex, on the basis of their call repertoires, cognitive abilities, and ability to modify signals through vocal learning. Because of the difficulties involved in observing and recording individual cetaceans, very little is known about how they use their calls. This report shows that wild, unrestrained bottlenose dolphins use their learned whistles in matching interactions, in which an individual responds to a whistle of a conspecific by emitting the same whistle type. Vocal matching occurred over distances of up to 580 meters and is indicative of animals addressing each other individually.
Assuntos
Golfinhos/fisiologia , Comportamento Imitativo , Aprendizagem , Comportamento Social , Vocalização Animal , Animais , Animais Selvagens/fisiologiaRESUMO
BACKGROUND: Arosion of peripancreatic arteries in acute or chronic pancreatitis is a rare cause of bleeding into gastrointestinal tract--hemosuccus pancreaticus. Aim of the paper is to show the diagnostic and therapeutic options in this serious clinical stage. METHODS AND RESULTS: We report a case of a patient with chronic pancreatitis who developed acute bleeding into the gastrointestinal tract due to the perforation of a pseudoaneurysm into pancreatic pseudocyst in the area of the pancreatic body. The diagnosis of hemosuccus pancreaticus, established by endoscopy and postcontrast CT examination, was confirmed by angiography. We stopped the acute bleeding from pseudoaneurysm, unusually well supplied by both gastric arteries by embolization of both arteries with metallic coils. CONCLUSIONS: Angiography plays an irreplaceable role in patients with hemosuccus pancreaticus. Our case demonstrates bleeding from pseudoaneurysm supplied by both gastric arteries, whose embolization produced an immediate hemostasis and improvment the patient's condition.
Assuntos
Falso Aneurisma/complicações , Aneurisma Roto/complicações , Embolização Terapêutica , Hemorragia Gastrointestinal/terapia , Pancreatite Crônica/complicações , Estômago/irrigação sanguínea , Adulto , Falso Aneurisma/diagnóstico por imagem , Aneurisma Roto/diagnóstico por imagem , Artérias , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pseudocisto Pancreático/complicações , RadiografiaRESUMO
Cutting wounds and bruises in the area of neck are very specific. The overall rehabilitation of these conditions is difficult and often needs to be combined with special and customised orofacial prostheses. This case-study reports special multidisciplinary treatment. The surgical diagnosis was: a cutting wound on a neck caused by a chain saw and disruption of oropharynx. Due to contusion of the tongue root and contusion of both hypoglossal nerves, a complete paralysis of tongue occurred. The tongue was immobile and the patient has problems with swallowing fluids. A special palatal prosthesis was made to reduce the space between the tongue and the palate. The fluoroscopically monitored swallowing action helps to receive optimal patient's rehabilitation.
Assuntos
Lacerações/cirurgia , Lesões do Pescoço/cirurgia , Tentativa de Suicídio , Adulto , Humanos , Masculino , Lesões do Pescoço/patologia , Orofaringe/lesões , Orofaringe/cirurgiaRESUMO
Because cetaceans are difficult to study in the wild, little is known about how they use their sounds in their natural environment. Only the recent development of passive acoustic localization systems has enabled observations of the communication behaviour of individuals for correlation with their surface behaviour. Using such a system, I show that bottlenose dolphins in the Moray Firth, Scotland, produce low-frequency bray calls which are clearly correlated with feeding on salmonids. The production of these calls is followed by fast approaches by conspecifics in the area. In animals which use sound as a foraging tool, it is difficult to distinguish between food calls which have evolved because of their role in attracting conspecifics, and food manipulation or searching calls which may attract conspecifics as a by-product. However, the low-frequency structure of the bottlenose dolphin bray suggests that it evolved because of a role in manipulating prey rather than in attracting conspecifics. This conclusion suggests that dolphins exploit the perceptual systems of their prey to facilitate capture.
Assuntos
Golfinhos/fisiologia , Animais , Comportamento Alimentar , Salmonidae , Escócia , Vocalização AnimalRESUMO
BACKGROUND: Although many reports describe the use of diagnostic endoscopic retrograde cholangiopancreatography (ERCP) in children, few mention therapeutic application of this technique in pediatric patients with pancreatic or biliary disease. METHODS: We report our 4-year experience of 80 ERCPs performed in 59 children for obstructive jaundice or cholestasis with dilatation of the biliary tree (32 children), biliary atresia (11), recurrent pancreatitis (8), and blunt trauma to the abdomen (8). RESULTS: The patients' ages ranged from 5 weeks to 18 years. The appropriate duct was cannulated in 94% of cases. Common bile duct sphincterotomy was performed in 35 patients and pancreatic duct sphincterotomy in one. Multiple procedures were done in 16 patients where biliary stents were inserted; in one patient with chronic pancreatitis and pancreaticolithiasis, pancreatic stent was inserted. Four patients developed mild pancreatitis, one had moderate pancreatitis and one had leak of contrast, which was treated by administration of clear fluids orally for one day. One patient with benign stenosis of the hepatic duct developed cholangitis after migration of the stent into the bowel lumen. CONCLUSION: Diagnostic and therapeutic ERCP can be done as safely and effectively in pediatric patients as in adults.
Assuntos
Doenças Biliares/diagnóstico , Doenças Biliares/cirurgia , Colangiopancreatografia Retrógrada Endoscópica/métodos , Pancreatopatias/diagnóstico , Pancreatopatias/cirurgia , Adolescente , Criança , Pré-Escolar , Colangiopancreatografia Retrógrada Endoscópica/estatística & dados numéricos , Feminino , Humanos , Índia , Lactente , Recém-Nascido , Masculino , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
Southern Moravia is one of the areas where there are long-term natural foci of tularaemia. In 1994 in the Breclav district an exacerbation of the disease was recorded in hares. During autumn hunts a positive reaction was recorded in 5.75% of examined hares. An elevated seropositivity persisted also in subsequent years and at the same time a higher human morbidity in the mentioned region. The objective of the investigation was to assess the causes and circumstances which led to the exacerbation of old known but in recent years quiescent foci in the mentioned region. To this end 350 small terrestrial mammals were examined. In one case it proved possible to detect the causal agent in Microtus arvalis. By examination of arthropods it proved possible to isolate 33 strains, i.e. 32 strains from ticks Dermacentor reticulatus and one strain from Ixodes ricinus. The results of the examination revealed that tularaemia as a classical infection with a natural focus may persist in areas where there are prerequisites for survival of the causal agent in the environment. One of the important factors of the environment are susceptible individuals (hares, small terrestrial mammals) as well as blood sucking arthropods as vectors of the disease.
Assuntos
Reservatórios de Doenças , Lagomorpha/microbiologia , Roedores/microbiologia , Tularemia/veterinária , Animais , República Tcheca/epidemiologia , Francisella tularensis/isolamento & purificação , Humanos , Incidência , Carrapatos/microbiologia , Tularemia/epidemiologiaRESUMO
The authors demonstrate a 23-year-old women in the fourth month of pregnancy with complaints and findings typical for Takayasu's arteritis. The onset of the disease can be safely located to the area of the pulmonary artery where the aorta and its branches were still unaltered. In the course of nine years not only a severe occlusive stage developed in the area of the thoracic aorta and its branches but there was also progression as regards the affection of the pulmonary artery. In the area of the subclavicular artery on the left balloon dilatation was performed. The collateral arterial blood supply of the left lung from the left coronary artery is also unusual.
Assuntos
Complicações Cardiovasculares na Gravidez , Artéria Pulmonar , Arterite de Takayasu , Adulto , Constrição Patológica/diagnóstico por imagem , Feminino , Humanos , Hipertensão Pulmonar/etiologia , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/patologia , Radiografia , Arterite de Takayasu/complicações , Arterite de Takayasu/diagnóstico por imagem , Arterite de Takayasu/patologiaRESUMO
The authors used in 1987-1988 Grüntzing's balloon catheter for the treatment of oesophageal strictures in nine children. They were successful in eight, in one patient after burning of the oesophagus with sulphuric acid the dilatation by means of the balloon failed. These injuries must be treated by surgery. The method is safe, easy and effective, in particular in the treatment of tight, long and irregular oesophageal strictures which cannot be dilated by the standard technique, using dilatation bougies. Dilatation by means of balloon catheters is a perspective method for severe oesophageal strictures.
Assuntos
Cateterismo , Estenose Esofágica/terapia , Cateterismo/instrumentação , Cateterismo/métodos , Pré-Escolar , Estenose Esofágica/etiologia , Feminino , Humanos , Lactente , MasculinoRESUMO
Haemorrhage from distal parts of the GIT is as a rule associated with diagnostic and therapeutic difficulties, in particular when massive haemorrhage is involved. The authors describe a group of three patients where the source of haemorrhage was an inoperable rectal tumour. This problematic condition was successfully treated by embolization of the upper rectal artery.
Assuntos
Embolização Terapêutica , Hemorragia Gastrointestinal/terapia , Doenças Retais/terapia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Both stercoral peritonitis and pyothorax are rare but until nowadays threatening conditions. The presence of stool in the pleural cavity represents a curiosity, the gangrene and loss of the diaphragma is eminently rare. All above mentioned conditions occurred at the same time in the patient operated on for diffuse peritonitis after diverticular perforation of sigmoid. Surgery rescued peritoneal and pleural cavity. The absent diaphragma was replaced by mesh prosthesis, due to late intraabdominal complications the mesh was explantated. The patient survived and healed after repeated surgeries and long-lasting highly intensive therapy. Thanks to dislocation of viscera and adhaesive obliteration of the site of missing diaphragma left lung remained inflated and functional. The complication after 1 year--gastrobronchial fistula--was healed by left-sided pneumonectomy and suturing of the stomach.
Assuntos
Diafragma/patologia , Doença Diverticular do Colo/complicações , Perfuração Intestinal/complicações , Peritonite/complicações , Gangrena , Humanos , Masculino , Pessoa de Meia-Idade , NecroseRESUMO
During the period from January 2000 to November 2001 the authors performed in 98 patients 129 drainages of pathological fluid collections. In all instances the drainages were performed under CT control. In 80 patients the drain was placed in the area of the pleural cavity, in 47 in the area of the peritoneal cavity and in three patients the localization was different. For drainage they used catheters of the pigtail type size from 8F to 24 F, depending on the extent of the pathological collection, its depth, and nature of the drained contents. In 119 cases Seldinger's method was used, in 10 the tandem troacar method of placement of drainage catheters. The placement of the drainage catheter under CT control is a safe and effective method for removal of pathological fluid collection. In the authors' group successful drainage was proved in 71 of 84 (84.5%) patients followed up on a long-term basis.
Assuntos
Drenagem/métodos , Radiografia Intervencionista , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ascite/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/terapiaRESUMO
The authors describe a new method of treatment of male infertility. In 25 men aged 19-45 years with varicocele, after percutaneous transfemoral catheterization, embolization of the spermatic vein with the Czechoslovak preparation Vilan 500 (hydrolyzed co-polymer of polyvinyl acetate and polyvinyl alcohol in 96% ethyl alcohol) was performed. Six patients were treated on account of marked subjective complaints and 19 because of reduced fertility. Of these in 16 after embolization the spermiogram improved. The authors describe the diagnostic procedure, the technique of embolization, its complications and results. The described method is simple, safe, effective and as compared with other embolization methods it is cheaper.