ABSTRACT
Introducción : Un niño hospitalizado representa una oportunidad, en algunos casos la primera o incluso la única, de recibir una completa evaluación médica que optimice su potencial de desarrollo humano, y el pediatra debe estar conciente de ello y comprometido con su tarea. Objetivo : Evaluar la utilidad del examen físico completo y el interrogatorio dirigido en niños internados para la detección de patologías no detectadas anteriormente y que pueden tener importancia en su vida y cuidados. Material y Método : Se estudiaron niños ingresados al CIM 63 durante el año 2002.Estudio descriptivo, transversal y prospectivo. El examen físico consistió en la valoración semiológica sistemática. No se tuvieron en cuenta los cambios clínicos que ocurrieron como parte de la evolución natural de la enfermedad que motivó la internación. No se incluyeron las inmunizaciones incompletas, la anemia, ni los aspectos psicosociales, trastornos escolares y del lenguaje. Resultados : encontramos patologías no diagnosticadas en 12 de 3.485 pacientes egresados (3.4/1000). Los hallazgos fueron : 2 escoliosis, 1 neurofibromatosis, 1 osteogénesis imperfecta, 1 cardiopatía, 1 púrpura trombocitopénica crónica, 2 afecciones urinarias, 3 afecciones neurológicas, 1 ambliopía, y en 3 niños se detectaron malformaciones menores. Sólo 3 pacientes (25 por ciento) tenían pediatra de cabecera. Un enfoque clínico integral y examenes complementarios mínimos permitió efectuar diagnósticos como osteogénesis imperfecta, escoliosis, cardiopatías, uropatías, siringomielia, púrpura, etc que son importantes ya que muchos de estos cuadros son invalidantes o incapacitantes si no son controlados a tiempo
Subject(s)
Child, Preschool , Child , Adolescent , Cross-Sectional Studies , Prospective Studies , Clinical Diagnosis , Epidemiology, Descriptive , Physical Examination , Child, Hospitalized , PediatricsABSTRACT
Introducción : Un niño hospitalizado representa una oportunidad, en algunos casos la primera o incluso la única, de recibir una completa evaluación médica que optimice su potencial de desarrollo humano, y el pediatra debe estar conciente de ello y comprometido con su tarea. Objetivo : Evaluar la utilidad del examen físico completo y el interrogatorio dirigido en niños internados para la detección de patologías no detectadas anteriormente y que pueden tener importancia en su vida y cuidados. Material y Método : Se estudiaron niños ingresados al CIM 63 durante el año 2002.Estudio descriptivo, transversal y prospectivo. El examen físico consistió en la valoración semiológica sistemática. No se tuvieron en cuenta los cambios clínicos que ocurrieron como parte de la evolución natural de la enfermedad que motivó la internación. No se incluyeron las inmunizaciones incompletas, la anemia, ni los aspectos psicosociales, trastornos escolares y del lenguaje. Resultados : encontramos patologías no diagnosticadas en 12 de 3.485 pacientes egresados (3.4/1000). Los hallazgos fueron : 2 escoliosis, 1 neurofibromatosis, 1 osteogénesis imperfecta, 1 cardiopatía, 1 púrpura trombocitopénica crónica, 2 afecciones urinarias, 3 afecciones neurológicas, 1 ambliopía, y en 3 niños se detectaron malformaciones menores. Sólo 3 pacientes (25 por ciento) tenían pediatra de cabecera. Un enfoque clínico integral y examenes complementarios mínimos permitió efectuar diagnósticos como osteogénesis imperfecta, escoliosis, cardiopatías, uropatías, siringomielia, púrpura, etc que son importantes ya que muchos de estos cuadros son invalidantes o incapacitantes si no son controlados a tiempo
Subject(s)
Child, Preschool , Adolescent , Child , Child, Hospitalized , Physical Examination , Clinical Diagnosis , Cross-Sectional Studies , Prospective Studies , Epidemiology, Descriptive , PediatricsABSTRACT
Carcinoma of hepatic duct confluence was characterized by Klatskin, as a small, relatively slow-growing and sharply localized tumor. Sixty consecutive patients with carcinoma of the hepatic duct confluence were surgically resected in our Department between January 1984 and December 1996. All histological section of each patient included in the study were reviewed. The nuclear content was measured. Twenty-nine patient (48%) had diploid tumors and 31 (51%) were found to have aneuploid tumors. Survival of patients with a diploid tumor was significantly longer than those with aneuploid tumors. Our results indicate that DNA ploidy is an important, prognostic factor of carcinoma of the hepatic duct confluence.
Subject(s)
Bile Duct Neoplasms/genetics , DNA, Neoplasm/genetics , Hepatic Duct, Common/pathology , Klatskin Tumor/genetics , Adult , Aged , Aneuploidy , Bile Duct Neoplasms/diagnosis , Bile Duct Neoplasms/mortality , Diploidy , Female , Genetic Markers , Humans , Klatskin Tumor/diagnosis , Klatskin Tumor/mortality , Male , Middle Aged , Prognosis , Survival RateABSTRACT
The use of a gallbladder patch to cover duodenal wall defects was attempted on 36 dogs. This defect was surgically induced on the second part of the duodenum. All the dogs survived and had an uneventful postoperative course. The healing of the defect was satisfactory and the structure and thickness of the graft remained unchanged This method could be a suitable alternative in the treatment of large duodenal defects, especially in the presence of other intra-abdominal injuries, and when the use of other graft material is not feasible.
Subject(s)
Duodenum/surgery , Gallbladder/surgery , Surgical Flaps , Animals , Dogs , Duodenal Diseases/surgery , Duodenum/pathology , Gallbladder/pathologyABSTRACT
Ten patient with exocrine pancreatic carcinomas were studied immunohistochemically, using a monoclonal antibody against PCNA. The percentage of tumor cells with positive staining was defined as PCNA Labelling Index (L.I.), and ranged from 13.8% to 92.8%. PCNA L.I. was found to correlate significantly with grading and more specifically with mitotic activity and degree of nuclear anaplasia. No correlation was found with granular differentiation or with vessel invasion, lymphatic vessel invasion, lymph node metastasis, perineural invasion or size of tumor. Our results indicate that mitotic activity and degree of nuclear anaplasia might be the most important parameters to take into consideration, when studying the role of PCNA in exocrine pancreatic carcinomas.
Subject(s)
Pancreatic Neoplasms/pathology , Proliferating Cell Nuclear Antigen/analysis , Female , Humans , Immunohistochemistry , Male , Middle AgedABSTRACT
The zinc deficiency syndrome, also called enteropathic acrodermatitis, has been mostly observed in those pathologies of the gastroenteric system characterized by grave food shortages during long term TPN in association with inflammatory intestinal pathologies. The authors believe this to be caused of such syndrome, that in the case in question is demonstrated before the normal period described in the literature to be caused by both increased request related to TPN and a greater loss or less absorption due to intestinal phlogosis. The case described has been noted in a general surgery division in a young patient suffering from Crohn's disease for many years in treatment with medical therapy and now complicated by perianal abscess following burrowing on the outside subjected and therefore in treatment with artificial parenteral nutrition pre and post operative. Such pathology to be due when to begin a symptomatology characterized by consciousness alteration, diarrhoea, vesicular squamous cutaneous lesions around orifices, often infected by bacteria and mycosis in patients in treatment nutritional artificial continued for digestive apparatus diseases. The knowledge of this syndrome and its diagnosis lead, through integrative therapy, to its resolution in a short time. The authors describe the course of a clinical case occurred to then and ended with the patient's recovery. They underline the risks of ignoring this pathology.
Subject(s)
Parenteral Nutrition, Total/adverse effects , Zinc/deficiency , Acrodermatitis/etiology , Adult , Crohn Disease/therapy , Humans , Male , SyndromeABSTRACT
After some considerations about lymphedema and the progresses in its study, the surgical procedures to its treatment are exposed, considering this treatment technically and also orientate to lymphedema etiology. Afterwards, a clinical case, its treatment, and its discussion are exposed.
Subject(s)
Lymph Nodes/surgery , Lymphedema/surgery , Saphenous Vein/surgery , Anastomosis, Surgical/methods , Female , Groin , Humans , Middle AgedSubject(s)
Fingers , Glomus Tumor/pathology , Adult , Aged , Glomus Tumor/diagnosis , Glomus Tumor/surgery , Humans , MaleSubject(s)
Abdomen , Hernia/complications , Intestinal Obstruction/etiology , Adult , Aged , Herniorrhaphy , Humans , Intestinal Obstruction/surgery , MaleABSTRACT
The Authors report on their experience regarding lesions of the oesophago-gastric tract due to ingestion of caustic substances. Although prognosis of these patients is always severe, the reported data show that it can be improved by a prompt diagnostic and therapeutic approach. Firstly, a correct evaluation of the lesions through endoscopic examination at a very early stage is capable of guiding the search for the most effective therapy, which, in cases of necrotic, coagulative, haemorrhagic or in any way severe lesions, must always be surgical, begun as early as possible and accompanied by broad spectrum antibiotic cover and, above all, total parenteral feeding.
Subject(s)
Burns, Chemical , Caustics/adverse effects , Esophagus/injuries , Stomach/injuries , Adolescent , Adult , Aged , Burns, Chemical/diagnosis , Burns, Chemical/surgery , Endoscopy , Female , Gastrectomy , Humans , Male , Middle Aged , Parenteral Nutrition, TotalABSTRACT
An assessment is made of the meaningfulness of endoscopy and histology in the diagnosis of oesophagitis via an examination of 240 endoscopies. An endoscopic diagnosis of oesophagitis was given in 69 cases. Biopsy was performed in only 44 cases. This confirmed the endoscopic diagnosis on all but one occasion. There were 1 histological and 10 endoscopic false negatives. It is suggested, therefore, that perendoscopic biopsy should always be performed to reduce false negatives in cases where oesophagitis or gastro-oesophageal reflux is suspected, or when hiatal hernia (even if asymptomatic) is present.
Subject(s)
Esophagitis/diagnosis , Biopsy , Endoscopy , Esophagitis/pathology , HumansABSTRACT
A rare case of arteriovenous angiodysplasia leading to portal hypertension due to absolute hyperafflux is reported. After a note on the singularity and rarity of the case, the importance of hepatic manometric, oxymetric and fluximetric observations in diagnosis of hyperafflux is stressed. In the case described, in particular, the pre-operative hemodynamic examinations, although they did not lead to certain diagnosis, served to demonstrate the excellent perfusion capacity a histologically healthy liver can have, even in conditions of pure portal hyperafflux lasting for a long time.
