ABSTRACT
Cardiac myxomas are the most common primary cardiac tumours in adults. They usually present as a solitary, solid mass in the left atrium. Their most common radiographic appearance is that of a hypodense lesion on computed tomography (CT) and inhomogeneous lesion (hypo to isointense on T1 sequences and hyperintense on T2 sequences) on magnetic resonance (MR) with some contrast enhancement. However, different patterns are recognized due to secondary changes within the tumour. We present a case of a 60-year-old man with a hypervascular myxoma. The lesion was a sessile mass located in the left atrium and rigidly attached to the interatrial septum. On CT and MR, it showed vivid contrast enhancement due to intratumoural flush of arterial blood form branches of dominant left circumflex artery and a possible fistula to the left atrium. Furthermore, we review the literature for different atypical radiographic appearances of myxomas.
Subject(s)
Heart Neoplasms , Myxoma , Humans , Male , Middle Aged , Diagnosis, Differential , Heart Atria/diagnostic imaging , Heart Neoplasms/diagnostic imaging , Magnetic Resonance Imaging/methods , Myxoma/diagnostic imaging , Myxoma/complicationsABSTRACT
Nine children with immunodeficiency syndromes who developed persistent or disseminated Bacillus Calmette-Guérin (BCG) infections after BCG vaccination at birth were observed in Santiago, Chile, over a period of 10 years. This represents a risk for persistent or disseminated BCG infections of 3.4/1,000,000 vaccinated newborns. This may closely reflect the incidence of severe combined immunodeficiency syndromes, cellular immunodeficiency syndromes and chronic granulomatous disease in the study area. The clinical presentation and course of the infection varied considerably depending on the underlying immunodeficiency syndrome. Two patients with severe combined immunodeficiency presented with cutaneous nodules in the absence of any local reaction at the site of BCG vaccination. Both patients died of disseminated BCG infection within the first year of life. Four patients with cellular immunodeficiency syndromes presented with regional lymphadenitis resistant to treatment after the fifth month of life. Three of these patients had specific unresponsiveness to tuberculin and survived from 5 to 6 years of age. Two boys with X-linked chronic granulomatous disease presented with regional lymphadenitis in the first 3 months of life. A girl with autosomal recessive chronic granulomatous disease presented at 18 months of age with regional lymphadenitis. All three patients with chronic granulomatous disease had positive tuberculin reactions and died from infections other than BCG.
Subject(s)
BCG Vaccine/adverse effects , Immunologic Deficiency Syndromes/complications , Mycobacterium Infections/diagnosis , Opportunistic Infections/pathology , Biopsy , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Mycobacterium Infections/etiology , Mycobacterium bovis , Opportunistic Infections/diagnosis , Opportunistic Infections/etiology , Skin/pathologySubject(s)
Pneumothorax/complications , Respiratory Distress Syndrome, Newborn/etiology , Adrenal Cortex Hormones/therapeutic use , Diagnosis, Differential , Female , Humans , Infant, Newborn , Male , Mediastinal Emphysema/diagnosis , Oxygen Inhalation Therapy , Respiration, Artificial/adverse effectsABSTRACT
El neumotorax y el neumomediastino deben tenerse presente en la etiologia del SDR del recien nacido. Se ha insistido en que la introduccion de procedimientos de ventilacion asistida ha aumentado su riesgo e incidencia. Se analizan 12 casos clinicos de neumotorax sintomatico pesquisados en el Servicio de Neonatologia del Hospital Paula Jaraquemada en el lapso de 2 anos.En el analisis destaca la falta de antecedentes predisponentes definidos. En 7 casos se efectuo toracotomia minima. Se observo una sobrevida a la semana de vida de 8 casos (66%). Se comenta el manejo actual del neumotorax, a fin de mejorar sus expectativas de vida
Subject(s)
Infant, Newborn , Humans , Male , Female , Pneumothorax , Respiratory Distress Syndrome, Newborn , Diagnosis, DifferentialSubject(s)
Infant, Newborn , Humans , Female , Chylothorax , Drainage , Food, Formulated , Infant, PrematureSubject(s)
Asthma/rehabilitation , Asthma/therapy , Adolescent , Adrenal Cortex Hormones/therapeutic use , Child , Child, Preschool , Female , Humans , Male , Respiratory Function Tests , Skin TestsABSTRACT
Se estudian las caracteristicas de una muestra representativa (265 pacientes) de los asmaticos en control en nuestros servicios, demostrandose que entre nuestros enfermos existe una alta proporcion de las formas mas severas de asma, lo que se traduce en que estos ninos, a su ingreso a tratamiento y control, presentaban un importante numero de hospitalizaciones y consultas al Servicio de Urgencia, asi como ausentismo escolar,intolerancia al ejercicio y alteraciones en el sueno. Una nueva evaluacion hecha luego de un minimo de dos anos de terapia demuestra una gran mejoria en todos los indices de gravedad del asma y en la condicion de vida de estos pacientes
Subject(s)
Asthma , Respiratory Function Tests , Skin TestsSubject(s)
Infant , Child, Preschool , Child , Humans , Male , Female , Bronchopulmonary Sequestration , BronchographyABSTRACT
Con el objeto de evaluar la respuesta con broncodilatores en ninos menores con bronquitis obstructiva, se realizo un estudio clinico con fenoterol y metaproterenol, comparandolo con un grupo control. El analisis estadistico de cada parametro clinico demostro diferencia significativa solamente en relacion al descenso de la frecuencia respiratoria con el uso de estimulantes beta-adrenergicos con respecto a los controles. En los demas parametros no se demostro diferencia estadisticamente significativa entre el grupo con broncodilatores y el grupo control. Por lo tanto, este estudio corrobora la utilidad limitada del uso de broncodilatores en bronquitis obstructiva, traducida un una disminucion de la frecuencia respiratoria, que indirectamente demuestra una disminucion de la resistencia al flujo aereo, hecho que deberia ser confirmado con pletismografo
Subject(s)
Bronchitis , Fenoterol , MetaproterenolSubject(s)
Bronchial Diseases/congenital , Cysts/congenital , Bronchial Diseases/diagnosis , Child , Cysts/diagnosis , Humans , Infant , MaleABSTRACT
The action of a medicinal spray that contains anti-inflammatory and bacterio-static drugs integrated with the penetrating and potentiating agent DMSO has been evaluated clinically in 60 infants with acute respiratory obstruction. A dose of 2 ml of this spray is applied in the posterior pharynx and the tonsil region; 1 to 4 applications are made, according to the clinical evolution of the case. Two groups were chosen at random; 60 patients were paired off, and one of each pair received the treatment with DMSO spray. All the patients received ampicillin (50-100 mg/kg body weight). The following clinical results were observed. First there was an immediate recovery, after an average lapse of 30 min; improvement of sensorial involvement was observed in 80% of the cases, reduction of the intercostal retraction in 75%, reduction of polypnea in 76%, and transformation of the obstructive syndrome into a catarrhal syndrome in 80% (with fluidification of the secretions, which were expelled more easily by the upper air tracts). There was also a deferred or maintenance effect, which evaluated in comparsion with the control group that received similar treatment except for the nebulizations with DMSO spray. A sequential design, based on whether or not it was necessary to use the croupette, demonstrated the superiority of the DMSO spray over the control treatment in the bronchiolar process; in the group treated with DMSO spray it was not necessary to use the croupette. The sequential design based on the effect of this therapy on the general condition and the tabulated clinical factors permitted the inference that the therapeutic responses are more favorable in the group treated with DMSO spray than in the control group. In the sequential design, the line of significance is cut at the fifteenth pair (an error of 0.05 and P equals 0.95%). Since the application is easy, there are no toxic side effects and in view of the favorable results in the clinical evolution of the acute respiratory obstructive processes, we consider the use of this therapeutic spray very useful and beneficial in bronchiolitis.
