Massive hemoptysis following Rasmussen's aneurysm: a case report

Rasmussen's aneurysm (RA) is a pseudoaneurysm of a pulmonary artery (AP), adjacent to or within a tuberculous cavity, appearing in 5% of these lesions. Its rupture might provoke massive hemoptysis (MH) with a near 50% mortality. The aim of this article is to report a case of massive hemoptysis following Rasmussen's aneurysm. 52-year-old man with recent history of hospita-lization due to pneumonia associated to influenza A and decompensated hyperthyroidism, pre-sents outpatient chest radiograph with signs of hyperinflation and scarring apical opacities, the patient returned to the hospital due to sharp pain of left hemi thorax during inspiration accom-panied with bloody sputum, asthenia and non-quantified weight loss. He evolves to frank MH, requiring endotracheal intubation managed in the intensive care unit (ICU). Chest computed tomography (CT) reported ground-glass opacity, nodules with a tendency to cavitation, tree-in-bud pattern in agreement with inflammation and infection, active TB is considered, and truncus of PA with vascular lesion suggestive of aneurysm dependent on pulmonary circulation, possibly RA. Fibrobronchoscopy reported signs of old and recent bleeding of left bronchial tree, probably of the lingula, blood clots in right bronchial tree. Molecular study and TB cultures was negative. Endovascular procedure with arteriography was carried out, revealing amputation of left distal segmental PA carrying the pseudoaneurysm with complete regression, discarding embolization RA It must be considered among the differential diagnoses of MH, especially on patients with pulmonary TB complications, such as the reported case. Due to its associated increased morta-lity, once RA is identified, it must be either endovascularly or surgically eradicated.

Participación invisible: niñez y prácticas participativas emergentes / Participação Invisivel: infância e práticas emergentes participativas / Invisible participation: children and emerging participatory practices

En el presente artículo nuestro objetivo es sistematizar una serie de conocimientos en torno a la participación infantil, indagados en diversas experiencias que hemos vivenciado los autores durante más de cinco años de trabajo directo con niños y niñas, tales como la intervención en estudios cualitativos sobre participación social de niños y niñas, así como la vinculación directa a comunidades, trabajando con la niñez del norte y del centro del país. A partir de dichos trabajos intentamos comprender los significados que están asociados a la participación infantil por medio de la subjetividad de niños y niñas involucrados en instituciones que van en apoyo a la infancia. Los resultados muestran que ambas zonas del país están lejos de producir una cultura de derechos; no obstante, niños y niñas participan para poder posicionarse como protagonistas de sus propias vidas y sociedad. En este sentido, es necesario resaltar que de los mismos niños y niñas nacen propuestas de trabajo y desafíos a cumplir en torno a la participación.

Este artigo pretende sistematizar um conjunto de conhecimentos, em torno da participação das crianças, investigada em diversas experiências por que passaram os autores, mais de cinco anos de trabalho direto com as crianças, como a participação em estudos qualitativos sobre a participação social das crianças, as intervenções no vínculo direto nas comunidades que trabalham com crianças do norte do Chile e central. A partir deste trabalho procuramos compreender os significados que estão associados com a participação das crianças através da subjetividade de crianças que estão envolvidas em instituições que apoiam crianças. Os resultados mostram que ambas as partes do país estão longe de produzir uma cultura de direitos, no entanto as crianças estão envolvidas se posicionarem como protagonistas de suas próprias vidas e na sociedade. A este respeito deve salientar-se que essas crianças nascem predispostas ao trabalho e enfrentar os desafios em torno da participação.

This article aims to systematize a body of knowledge, around children’s participation. Investigation has taken place in various experiences that the authors have experienced in more than five years of direct work with children, such as participation in qualitative studies on social participation of children. This can be seen in the direct link interventions in communities working with children of northern and central Chile. From this work we tried to understand the meanings that are associated with children’s participation through the subjectivity of children who are involved in institutions that are supporting children. The results showed that both parts of the country are far from producing a culture of rights; however children are involved in positioning themselves as protagonists in their own lives and society. In this regard it should be emphasized that these children are born work proposals and meet challenges around participation.