ABSTRACT
BACKGROUND: Intrathoracic meningocele is a rare pathology, almost always associated with neurofibromatosis type I and with a few cases related in the literature. In the majority of cases cysts are small or asymptomatic, and the surgery is indicated when big or symptomatic cysts are present. We report a case of giant intrathoracic cysts surgically extirpated through out thoracotomy. CASE: A 59-year-old male with familiar Von Recklinghausen's disease which developed thoracic radicular pain after a fall. On examination he presented some difficulty in walking fast and dyspneia on small efforts. The chest plain x-ray showed the presence of 3 huge left side intrathoracic cysts (10 to 15cm). The patient was submitted to a surgical treatment and complete extirpation of the cysts was performed through a left side thoracotomy. During the surgery a fourth smaller cyst was detected and also extirpated. Evolution was uneventful and the patient remains well in these last 12 years. This finding of intrathoracic cysts related to neurofibromatosis type I is rare and is probably unique in the literature the presence of 4 huge cysts in one side of the thorax
Subject(s)
Humans , Male , Middle Aged , Meningocele , Neurofibromatosis 1 , Magnetic Resonance Imaging , Meningocele , Neurofibromatosis 1 , Thorax , Tomography, X-Ray ComputedABSTRACT
A 15 year-old male adolescent was hospitalized in a severe septic condition, due to infectious endocarditis which abided for 20 days. The admittance echocardiogram displayed a mitral valve vegetation in conjunction to a hypertrophic cardiomyopathy. In spite of applied antibiotics the patient expired. The authors emphasize the diagnostic difficulties of this compound entity and stress the need of antibiotic prophylaxis for patients who bear a hypertrophic cardiomyopathy, even in those with a non-obstructive disposition
Subject(s)
Humans , Male , Adolescent , Cardiomyopathy, Hypertrophic/complications , Endocarditis, Bacterial/complications , Streptococcal Infections/complications , Cardiomyopathy, Hypertrophic , Echocardiography , Endocarditis, Bacterial , Streptococcal InfectionsABSTRACT
Foram estudados 32 portadores de diabetes mellitus insulino-dependente (tipo I), com a finalidade de detectar o envolvimento do sistema nervoso autonômico cardiovascular. Eram 16 homens (50%), com idades variando de 9 a 64 (média de 29,03) anos e tempo médio de duraçäo da doença de 6,5 anos. O estudo do sistema autonômico consistiu na realizaçäo de testes clínicos (arritmia sinusal respiratória, Valsalva, isométrico e supinoz) e farmacológicos (propranolol e atropina), com medidas de freqüência cardíaca e pressäo arterial. Os resultados obtidos foram submetidos a diversos estudos estatísticos. Aplicando a escala de complicaçöes diabéticas, verificou-se que 10 doentes (31,25%) näo apresentavam complicaçöes, 14 (43,75%) alcançaram o grau 1 da escala, 4 (12,05%) 2, 2 (6,25%) 3 e 2 (6,25%) 4. Tal distribuiçäo apresentou correlaçäo significativa com o tempo de duraçäo da doença (p < ,01). A análise dos testes autonômicos revelou que 12 (37,50%) apresentavam lesäo parassimpática, 5 (15,62%) lesäo simpática e 2 (6,25%) lesäo mista. Na populaçäo estudada, 13 doentes (40,62%) näo apresentavam alteraçöes autonômicas, 19 (59,38%) possuiam algum grau de disautonomia cardiovascular; desses, 15 (46,87%) apresentavam lesöes precoces e 4 (12,50%) lesöes definitivas