RESUMO
The sinus pericranii refers to a set of clinical presentations that share a pathological communication between the scalp veins and the underlying cranial venous sinus. The nature of this connection ranges from the simple dilatation of the emissary veins, to wide connections through a calvarial bone loss leaving almost the cranial venous sinus in direct contact with the subcutaneous tissue. The authors present the case of an occipital pericranii sinus of intraoperative discovery. Congenital, post-traumatic or spontaneous, this anomaly is most often frontal and located on or close to the midline. The usual clinical presentation is that of a soft mass that empties to the pressure while standing, while it fills in all situations that increase the intracranial pressure (Valsalva maneuver ). The diagnosis is not always easy to establish, and relies on a bundle of clinical and radiological arguments. Through a review of the literature we propose to focus on the clinical features, diagnostic means and therapeutic options of this rare entity.
Assuntos
Couro Cabeludo/cirurgia , Seio Pericrânio/cirurgia , Pré-Escolar , Humanos , Masculino , Seio Pericrânio/patologiaRESUMO
The main concern of this paper is to study the dynamic of a predator-prey system with diffusion. It incorporates the Holling-type-II and a modified Leslie-Gower functional responses under Robin boundary conditions. More concretely, we study the dissipativeness of the system by using the comparison principle, and we derive a criteria for permanence and for predator extinction.
Assuntos
Modelos Biológicos , Comportamento Predatório , Animais , Difusão , Ecologia , Ecossistema , Cadeia Alimentar , Dinâmica PopulacionalRESUMO
The excessive and unsustainable exploitation of our marine resources has led to the promotion of marine reserves as a fisheries management tool. Marine reserves, areas in which fishing is restricted or prohibited, can offer opportunities for the recovery of exploited stock and fishery enhancement. This study examines the impact of the creation of marine protected areas, from both economic and biological perspectives. The consequences of reserve establishment on the long-run equilibrium fish biomass and fishery catch levels are evaluated. We include reserve size as control variable to maximize catch at equilibrium. A continuous time model is used to simulate the effects of reserve size on fishing catch. Fish movements between the sites is assumed to take place at a faster time scale than the variation of the stock and the change of the fleet size. We take advantage of these two time scales to derive a reduced model governing the dynamics of the total fish stock and the fishing effort. Simulation results suggest that the establishment of a protected marine reserve will always lead to an increase in total fish biomass, an optimal size of a marine reserve can achieve to maximize the catch at equilibrium.
Assuntos
Peixes , Biologia Marinha , Animais , Pesqueiros , Modelos Teóricos , Dinâmica PopulacionalRESUMO
The plastic surgeon rarely encounters patients with factitious disorders. The syndrome of Münchausen by proxy is a part of it. We put the point on this syndrome through a clinical observation of an eight-year-old girl victim of parental abuse.
Assuntos
Relações Mãe-Filho , Síndrome de Munchausen Causada por Terceiro/diagnóstico , Síndrome de Munchausen Causada por Terceiro/psicologia , Criança , Maus-Tratos Infantis/diagnóstico , Maus-Tratos Infantis/psicologia , Diagnóstico Diferencial , Feminino , HumanosRESUMO
[This corrects the article DOI: 10.1016/j.heliyon.2019.e01628.].
RESUMO
Defect pyrochlore oxide powders ABi2Ta5O16, in the pseudo-binary systems BiTaO4-ATa3O8 (A = Na, Tl), were prepared by solid state method. The structural study showed that all oxides crystallize in a cubic system with the space group Fd3m, the lattice parameter "a" were determined using Rietveld refinement method. For systematic study on densification from powders, the samples were pressed with a uniaxial pressure into pellets; sintering temperature, holding time and heating rate were optimized. Techniques, including X-ray diffraction, IR-Raman, MEB, dilatometry, were employed to investigate the structure and the morphology of the synthesized powders and sintered materials. The dielectric characteristics, relative permittivity and dielectric losses (tgδ), determined at room temperature are comparable to those of other pyrochlores.
RESUMO
Acute injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb is a condition frequently seen by hand surgeons. Most can be treated conservatively except in the presence of a Stener lesion, when surgical treatment is necessary. What is difficult is to obtain the diagnosis of the Stener lesion. Some authors have proposed the use of echography, because sensitivity and specificity can reach 100%. The goal of our study was to demonstrate that the quality of echography depends upon the type of device used. Our retrospective series contained 25 gamekeeper's thumbs studied from March 2005 to March 2007. The first echograph, a Toshiba Ecccocee SMA-736SA-7.5MHz (ECHO 1) was used for the first 18 patients. The second one, a Toshiba APLIO SSA-700A/SSA-770A (ECHO 2) was used for the following six patients. It was equipped with a "tissue harmonic imaging" mode. ECHO 1 was inaccurate in 30% of cases in detecting the presence or absence of a Stener lesion. In contrast ECHO 2 enabled the echographer to be confident in diagnosing the presence or absence of a Stener lesion and peroperative findings or clinical result at review confirmed all the data obtained by ECHO 2. Echography is useful to look for a Stener lesion in the emergency situation because it is available, cheap, non-invasive, and dynamic. Echography is "echographer-dependent", but also "echograph-dependent". Our study revealed the advantage in using an echograph with "tissue harmonic imaging".
Assuntos
Ligamentos Colaterais/diagnóstico por imagem , Ligamentos Colaterais/lesões , Articulação Metacarpofalângica/lesões , Polegar/lesões , Adolescente , Adulto , Feminino , Humanos , Masculino , Articulação Metacarpofalângica/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos , Polegar/diagnóstico por imagem , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Adulto JovemRESUMO
The solitary fibrous tumor is a rare tumor, ubiquitous, mesenchymatous essentially affecting serosal surfaces. The location in the scalp is exceptional. We report a case of tumor in left occipital scalp discovered after recurrence of a tumor initially taken for a lipoma. The motive for consultation was mainly aesthetic. The pathological examination is the main element of diagnosis. The assumption is based on a large lumpectomy and an extended and regular clinical monitoring. The forecast is favourable with a decline of one year. However, relapses may occur in the long-term and there are malignant forms.
Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Couro Cabeludo , Neoplasias Cutâneas/cirurgia , Tumores Fibrosos Solitários/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Tumores Fibrosos Solitários/patologia , Resultado do TratamentoRESUMO
Epithelioid hemangioendothelioma (EHE) is an infrequent vascular tumor that has an intermediate prognosis between the prognosis of the angioma and that of the angiosarcoma. Its evolution is characterized by a tendency to recurrence and metastases. EHE has been reported in locations such as: lungs, liver, bone and soft tissues. There are very few reports of cases involving the head and neck region. The occurrence of EHE in the orbital region and/or the eyelid is extremely rare. The authors report a case of EHE in the right upper eyelid. Surgical excision has been performed resulting in a good local control of the disease after a 5-year follow up.
Assuntos
Neoplasias de Cabeça e Pescoço , Hemangioendotelioma Epitelioide , Hemangiossarcoma , Humanos , Recidiva Local de Neoplasia , PrognósticoRESUMO
Traumatic injuries of the hip, mostly fractures of the proximal femur, are in constant progression. Though morbidity has decreased due to improved surgical and anesthesiologic techniques and postsurgical rehabilitation, mortality from hip fractures remains significant. Radiographs of the hip remain helpful, but MDCT and MRI have become indispensable tools. Findings on imaging studies must be well characterized to ensure rapid and cost-effective management. Difficult or cases with imaging features that are difficult to interpret or misleading will be presented to avoid incorrect interpretations that could lead to inadequate management of patients.
Assuntos
Luxação do Quadril/diagnóstico , Fraturas do Quadril/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada Espiral , Acetábulo/lesões , Análise Custo-Benefício , Diagnóstico Diferencial , Fixação Intramedular de Fraturas , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/cirurgia , Luxação do Quadril/economia , Luxação do Quadril/cirurgia , Fraturas do Quadril/economia , Fraturas do Quadril/cirurgia , Prótese de Quadril , Humanos , Ílio/lesões , Imageamento por Ressonância Magnética/economia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Falha de Prótese , Sensibilidade e Especificidade , Tomografia Computadorizada Espiral/economiaRESUMO
Saccharomyces cerevisiae is a cosmopolitan yeast, widely used in agro-alimentary and pharmaceutical industry. Its impact in human pathology is rare, but maybe still underestimated compared to the real situation. This yeast is currently considered as an emerging and opportunistic pathogen. Risk factors are immunosuppression and intravascular device carrying. Fungemias are the most frequent clinical forms. We report the first case of S. cerevisiae invasive infection described in Morocco, and to propose a review of the literature cases of S. cerevisiae infections described worldwide. A 77-year-old patient, with no notable medical history, who was hospitalized for a upper gastrointestinal stenosis secondary to impassable metastatic gastric tumor. Its history was marked by the onset of septic shock, with S. cerevisiae in his urine and in his blood, with arguments for confirmation of invasion: the presence of several risk factors in the patient, positive direct microbiological examination, abundant and exclusive culture of S. cerevisiae from clinical samples. Species identification was confirmed by the study of biochemical characteristics of the isolated yeast. Confirmation of S. cerevisiae infection requires a clinical suspicion in patients with risk factors, but also a correct microbiological diagnosis.
Assuntos
Infecções Fúngicas Invasivas/patologia , Micoses/microbiologia , Micoses/patologia , Saccharomyces cerevisiae , Idoso , Evolução Fatal , Humanos , Infecções Fúngicas Invasivas/microbiologia , Masculino , Marrocos , Saccharomyces cerevisiae/isolamento & purificação , Saccharomyces cerevisiae/patogenicidadeAssuntos
Adenocarcinoma/secundário , Carcinoma de Células em Anel de Sinete/diagnóstico , Neoplasias Duodenais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Retais/diagnóstico , Neoplasias Cutâneas/secundário , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/patologia , Carcinoma de Células em Anel de Sinete/patologia , Colonoscopia , Neoplasias Duodenais/patologia , Feminino , Gastroscopia , Humanos , Pessoa de Meia-Idade , Neoplasias Retais/patologia , Neoplasias Cutâneas/patologia , Neoplasias Gástricas/patologiaRESUMO
The authors report an uncommon case of a 74-year old man with prostatic cancer revealed by pelvic mass. Ultrasound exam and CT-scan showed a bilateral laterorectal mass with high density. Presence of such a mass in an old patient is very suggestive of lymph nodes than retroperitoneal tumor. Serum prostate specific antigen (PSA) is rather helpful in such conditions. Biopsy of the mass allows confirmation of the prostatic cancer diagnosis. Bilateral Surgical pulpectomy is performed in combination with oral hormonal therapy. Follow-up after 6 months showed a good course or ultrasound exam and PSA level.
Assuntos
Imidazolidinas , Neoplasias da Próstata/diagnóstico , Idoso , Antagonistas de Androgênios/uso terapêutico , Antineoplásicos/uso terapêutico , Biópsia , Quimioterapia Adjuvante , Humanos , Imidazóis/uso terapêutico , Masculino , Antígeno Prostático Específico/sangue , Prostatectomia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The pelviureteral junction upon a horse shoe kidney remains a frequent congenital malformation. The authors report 13 cases collected during a period of 16 years and treated surgically. The review of literature permits to discuss the different therapeutic means.
Assuntos
Anormalidades Múltiplas , Pelve Renal/anormalidades , Rim/anormalidades , Ureter/anormalidades , Anormalidades Múltiplas/cirurgia , Adulto , Feminino , Humanos , Rim/cirurgia , Pelve Renal/cirurgia , Masculino , Síndrome , Ureter/cirurgiaRESUMO
Perineo-scrotal gangrene is a necrotizing infection of the tissues of the perineum and scrotum. It accounts for 0.6% of our hospitalizations. The commonest etiology is urologic (86% of our cases). A proctologic origin was found in 6%, while the condition appeared to be primary in 8%. Concomitant diseases were found in 37% with diabetes the commonest. The diagnosis is clinically evident. The majority of patients are seen late (5 to 10 days) and the necrotizing process spreads rapidly. This is a multidisciplinary emergency, requiring intensive care, antibiotics, surgical excision of all necrotic tissues and possible urinary and/or fecal diversion. Extensive skin loss requires surgical cutaneous reconstruction procedures. The prognosis is severe, with a 12% mortality rate in our series.
Assuntos
Gangrena/epidemiologia , Períneo/patologia , Escroto/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Terapia Combinada , Comorbidade , Gangrena/tratamento farmacológico , Gangrena/etiologia , Gangrena/cirurgia , Doenças dos Genitais Masculinos/tratamento farmacológico , Doenças dos Genitais Masculinos/epidemiologia , Doenças dos Genitais Masculinos/etiologia , Doenças dos Genitais Masculinos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Transplante de Pele , Retalhos Cirúrgicos , Taxa de Sobrevida , Fatores de TempoRESUMO
Acute renal failure due to hydronephrosis is a rare pathology. It can occur unilaterally, or as a pyelo-ureteral junction (PUJ) bilateral syndrome. In the present study, two cases have been reported. The diagnosis was based on ultrasonographic findings which showed hydronephrosis, and on descending pyelo-ureterography (DPU), which demonstrated an absence of opacification. Infection was present in one case. Preliminary treatment consisted of percutaneous nephrostomy, followed by surgical pyelo-ureteral resection and Anderson-Hynes pyeloplasty which gave good results (95% success rate), and which enabled a satisfactory recovery of renal function to be obtained.
Assuntos
Injúria Renal Aguda/etiologia , Hidronefrose/complicações , Injúria Renal Aguda/diagnóstico por imagem , Injúria Renal Aguda/cirurgia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Ultrassonografia , Ureter/cirurgiaRESUMO
Cystic renal cancer is uncommon and raises real preoperative diagnostic problems, requiring the use of medical imaging, and sometimes even surgery. The authors report 3 cases of cystic renal cancer in 2 men and 1 woman, aged 87, 67 and 20 years, respectively. Three patients presented with the urological triad (haematuria, pain and lumbar mass). Ultrasonography suggested the diagnosis of cystic cancer in all 3 cases. Computed tomography was performed in 2 patients and more precisely confirmed the ultrasound findings. Selective arteriography, performed in one patient, confirmed the hypothesis of malignancy. Surgical exploration resulted in radical total nephrectomy. Histology confirmed the diagnosis of adenocarcinoma. The course was favourable in 2 cases after a follow-up of 4 years. One patient presented a local recurrence with pulmonary metastases 6 months after the operation. A review of the literature illustrates the diagnostic difficulties of this form of renal cancer.
Assuntos
Adenocarcinoma de Células Claras/diagnóstico , Neoplasias Renais/diagnóstico , Adenocarcinoma de Células Claras/diagnóstico por imagem , Adenocarcinoma de Células Claras/secundário , Adenocarcinoma de Células Claras/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia , Cistos/patologia , Diagnóstico por Imagem , Feminino , Seguimentos , Hematúria/diagnóstico , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Nefrectomia , Dor/diagnóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , UltrassonografiaRESUMO
The authors report a rare case of hydatid cyst of the psoas muscle in a 28-year-old woman, operated for vertebrospinal hydatid cyst. The patient presented with a left iliac fossa mass. Ultrasonography and computed tomography contributed to the preoperative diagnosis, despite negative hydatid serology. A retroperitoneal approach by left lumbotomy with partial pericystectomy was performed. In the light of this case, the authors discuss the diagnostic and therapeutic problems raised by hydatid cyst of the psoas muscle.
Assuntos
Equinococose/cirurgia , Músculos Psoas/parasitologia , Adulto , Equinococose/diagnóstico por imagem , Ensaio de Imunoadsorção Enzimática , Feminino , Seguimentos , Testes de Hemaglutinação , Humanos , Doenças Musculares/diagnóstico por imagem , Doenças Musculares/parasitologia , Doenças Musculares/cirurgia , Músculos Psoas/diagnóstico por imagem , Músculos Psoas/cirurgia , Tomografia Computadorizada por Raios X , Ultrassonografia , UrografiaRESUMO
The authors discuss the diagnostic and therapeutic aspects of primary pyogenic abscess of the psoas muscle based on a series of 5 cases. Five patients between the ages of 15 and 64 years (mean: 38.2 years) were admitted to the urology department between January 1994 and December 1996 with fever, abdominal pain and low back pain, and psoitis in 1 case. The mean delay to consultation was 42 days. Clinical examination revealed a painful mass in the lumbar region and flank in 5 cases. Leukocytosis was detected in 5 patients. Radiological examination demonstrated loss of the lateral border of the psoas in 4 cases. Ultrasonography showed an enlarged psoas muscle in every case with a hypoechoic mass in 2 cases and a heterogeneous mass in the other 3 cases. Computed tomography, performed in 2 patients, confirmed the ultrasound findings in 1 case and excluded the diagnosis of type IV hydatid cyst of the psoas muscle in the other patient. The abscess was evacuated by percutaneous drain in 1 patient requiring a second percutaneous drainage for reconstitution of the abscess. Surgical drainage was performed immediately in 3 patients and after failure of antibiotic treatment in 1 patient. The hospital stay did not exceed 7 days after surgical drainage, but was 25 days after the first percutaneous drainage and 20 days after the second percutaneous drainage. The authors emphasize the multiple advantages and efficacy of surgical drainage of psoas abscess.
Assuntos
Infecções por Escherichia coli/diagnóstico , Abscesso do Psoas/diagnóstico , Infecções Estafilocócicas/diagnóstico , Dor Abdominal/diagnóstico , Adolescente , Adulto , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Drenagem , Equinococose/diagnóstico , Infecções por Escherichia coli/diagnóstico por imagem , Infecções por Escherichia coli/cirurgia , Feminino , Febre/diagnóstico , Humanos , Tempo de Internação , Leucocitose/diagnóstico , Dor Lombar/diagnóstico , Masculino , Pessoa de Meia-Idade , Doenças Musculares/diagnóstico , Doenças Musculares/parasitologia , Miosite/diagnóstico , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/cirurgia , Estudos Retrospectivos , Infecções Estafilocócicas/diagnóstico por imagem , Infecções Estafilocócicas/cirurgia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The authors report two cases of cystitis glandularis revealed by hematuria and urinary retention. Cystitis glandularis is a rare disease, caused by metaplasia of the vesical submucosa, probably related to a chronic irritative factor. In its minor form, it has the same clinical features as simple cystitis, but its major pseudoneoplastic form may be mistaken for bladder tumor. The diagnosis is essentially histological. Treatment is usually medical, based on eradication of the irritative factors. Surgery is performed in the case of complications of this disease. The clinical course is unclear, requiring long-term surveillance.