RESUMEN
"Wheezing in young children is problematic for most practitioners. Difficulties arise in both the diagnosis and management of this clinical phenotype. Not all preschool children who wheeze have asthma. Therefore; we suggest that the ""Ten Commandments"" of managing preschool wheezing include thinking that in very young infants ( 1 year) wheezing is likely to be viral in origin; realising that allergy testing is mandatory to diagnose the cause of early wheezing; taking a history of asthma and allergy in family members; noting that chronic coughing is a pointer to asthma; using the term ""asthma"" if that is the diagnosis; ensuring that the environmental avoidance of triggers is addressed; using a short course of montelukast for virus-induced wheezing episodes; avoiding steroids to treat virus-induced wheezing; treating associated nasal symptoms; and making sure that the follow-up of children addresses the issue of stopping therapy if it is not working."
Asunto(s)
Asma , Niño , Ambiente , Fenotipo , Ruidos RespiratoriosRESUMEN
Se presenta um caso de carcinosarcoma mamário (CSM) diagnosticado en una mujer de 41 años de edad. Se describe la histopatología y se realiza una revisión de la bibliografía, resumiendo el manejo de estos casos.
Asunto(s)
Mama , CarcinosarcomaRESUMEN
The majority of patients with atrial septal defect require a single device for closure but a small proportion have more than one defect in the atrial septum. We report a patient who had two moderate-sized atrial septal defects in whom transcatheter closure of both the defects using two Amplatzer septal occluders was performed successfully.
Asunto(s)
Adulto , Oclusión con Balón/instrumentación , Ecocardiografía Transesofágica , Diseño de Equipo , Seguridad de Equipos , Estudios de Seguimiento , Defectos del Tabique Interatrial/terapia , Humanos , Masculino , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
The presently employed procedure of radial keratotomy is essentially unchanged from that developed by Fyodorov and introduced into the United States by Bores in 1978. The surgical procedure essentially consists of six basic steps: 1) application of appropriate anesthesia; 2) marking the visual axis; 3) marking the optical zone; 4) measuring the corneal thickness; 5) setting the depth of the blade; and 6) marking the corneal incisions. This review will carefully consider the pros and cons of many potential variations associated with each of these steps.