ABSTRACT
Two children were thought to have an atypical gastroduodenal motility disorder because of the history and clinical course; both had received parenteral alimentation because of claims of inability to tolerate enteral feedings, and both continued to have unusual medical problems during parenteral alimentation. Both children had motility studies that were interpreted by a pediatric gastroenterologist to be "abnormal" and "diagnostic" of a motility disorder, but each was eventually shown to have a behavioral abnormality related to Munchausen syndrome by proxy.
Subject(s)
Gastrointestinal Diseases/diagnosis , Gastrointestinal Motility , Munchausen Syndrome by Proxy/diagnosis , Child, Preschool , Diagnostic Errors , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/therapy , Humans , Infant , Male , Manometry , Munchausen Syndrome by Proxy/complications , Parenteral Nutrition, Total , Reference ValuesABSTRACT
In 18 children receiving long-term total parenteral nutrition (TPN) without iodide supplements, thyroid function test results were normal but serum iodide levels were greater than in control subjects (p less than 0.01). Iodine contamination of TPN solutions and fat emulsions accounted for only half of the recommended parenteral intake. Skin absorption of topical iodinated disinfectant may explain the adequate, if not excessive, iodine intake. We conclude that iodine is an unnecessary supplement in TPN solutions.
Subject(s)
Food, Formulated/analysis , Iodine/analysis , Parenteral Nutrition, Total , Adolescent , Amino Acids/analysis , Child , Child, Preschool , Disinfectants , Electrolytes , Fat Emulsions, Intravenous/analysis , Glucose , Humans , Infant , Iodine/administration & dosage , Iodine/blood , Male , Parenteral Nutrition Solutions , Povidone-Iodine , Skin Absorption , Solutions , Thyroid Function TestsABSTRACT
Os autores relatam um caso de reoclusäo de artéria coronária logo após trombólise por infusäo seletiva de estreptoquinase, em paciente com infarto agudo do miocárdio. Discutem os benefícios possíveis com o procedimento e assinalam que a causa da retrombose seja, possivelmente, a quantidade da enzima. (2000 U.I/min) utilizada e a distância do cateter ao trombo. O aumento da dose de estreptoquinase (4000 U.I./min) e um cateter especial atualmente em uso podem evitar esta ocorrência