ABSTRACT
Myoepithelial carcinoma is a rare pathological variant, usually expressed in salivary gland. This case report describes a case of pediatric myoepithelial carcinoma in the urinary bladder. A 4-year-old male patient was admitted to a specialized hospital in Lima, Peru for hematuria. A CT scan showed a tumor lesion in the bladder wall, and biopsy revealed myoepithelial carcinoma of urinary bladder. Six courses of chemotherapy + partial cystectomy + radiotherapy was completed. The treatment was defined based on the pathological variant and the tumor location. The patient is currently at 2 years of disease-free survival.
Subject(s)
Myoepithelioma , Urinary Bladder Neoplasms , Child, Preschool , Combined Modality Therapy , Humans , Male , Myoepithelioma/diagnosis , Myoepithelioma/therapy , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/therapyABSTRACT
Objetivo: Evaluar el manejo de enfermedad diarreica aguda en niños en el Hospital Grau EsSalud. Material y métodos: Investigación retrospectiva, observacional y analítica de hospitalizados por enfermedad diarreica aguda durante 2005, en el Servicio de Pediatría del Hospital III Grau. EsSalud. Resultados: Se evaluaron 194 pacientes, 57% hombres y 43% mujeres. El 43% correspondió a lactantes entre 6 y 12 meses y el 42% a niños entre 1 a 5 años. Fueron 84% eutróficos. El 61% recibió lactancia materna exclusiva y 22% automedicación antibiótica previa. Ingresaron con deshidratación moderada 88%, leve 10% y severa 2%. De 16 cuadros diarreicos disentéricos, 15 recibieron antibióticos. De 178 casos de diarrea acuosa, 80 tuvieron reacción inflamatoria positiva compatible con etiología bacteriana, todos recibieron antibióticos, mientras que 98 fueron virales por reacción inflamatoria negativa, 73 de las cuales no recibieron antibióticos y 25 sí por mala evolución. Criterio inicio de antibióticos: recuento leucocitos fecales, hemograma y clínica. Se inició con + 40 leucocitos fecales y algunos con menos de 20. Los 194 pacientes recibieron hidratación endovenosa, sólo 19% reinició vía oral antes de la cuarta hora, 88% recibió ranitidina, 76% dimenhidrinato y 62% antibióticos, destacando amikacina 61% y cloranfenicol 19%.Conclusiones: 1) Faltan pruebas diagnósticas rápidas para rotavirus, y otras como lactoferrina fecal, 2) Hay subutilización de suero de rehidratación oral, 3) Abuso terapia endovenosa y otros medicamentos como antieméticos, 4) No se cumple con realimentación temprana, 5) Abuso en prescripción antibióticos.
Objetive: Evaluate the management of children hospitalized with acute diarrhea. Method: A retrospective observed and analyzed trial in hospitalized diarrhea during 2005, at Pediatric Service Grau Hospital. Results: 194 patients were enrolled, 57% males and 43% females. The most important group was major lactants 43% and pre-schoolchildren 42%. We had 84% well nutried. 61% received exclusively breast-feeding and 22% got antibiotic itself. They were hospitalized: 88%, with moderate, 10% mild and 2% severe dehydration. From 16 dysenteric diarrhea, 15 Received ATB. From 178 watery diarrhea, 80 were bacterial all of them got antibiotics, and 98 were viral: 73 without ATB and 25 with ATB for abrupt evolution. To decide ATB: value of fecal leukocytes, CBC and appearance clinical. It started with + 40 fecal leukocytes and some one with less than 20. All 194 patients received hydration EV, 19% started refeeding before 4º hours, 88% accepted ranitidina, 76% dimenhidrinato and 62% ATB, specially amikacina 61% and cloranfenicol 19%. Conclusions:ò There arenÆt diagnostic tests fastest for rotavirus, and others like fecal lactoferrin.ò We noted sub utilization of oral dehydration therapy.ò We found excess intravenous therapy and other medicaments.ò Early Refereeing is not right.ò Excessive use of antibiotics.ôThis study reflexes the kind of work of most of Hospitals of our countryõ.
