Espiroadenoma ecrino de presentación inusual en párpado / Eccrine spiradenoma of inusual presentation on the eyelid

Reportamos el caso de un espiroadenoma ecrino en una paciente de 90 años de edad, que empezó un año antes de la consulta con una lesión en el párpado. Se trata de un tumor benigno de la glándulas sudoríparas que es raro en el párpado. Al principio pensamos en otro tumor, como el carcinoma sebáceo, por su rápido crecimiento. La posibilidad de un tumor de glándulas sudoríparas debiera considerarse en el diagnóstico de tumores palpebrales.

We report a case of an eccrine spiradenoma in a 90 years old woman, who began a year before with the lesion on the eyelid. It is a begin sweat gland tumor, that is rare on the eyelid. At the beginning we thougth in an other tumor, like sebaceous carcinoma for its quick growth. The possibility of sweat gland tumor should be kept in mind in the diagnosis of eyelid tumours.

Relation of exercise Doppler left ventricular filling to thallium lung uptake.

The exercise-induced changes in left ventricular filling in patients with coronary artery disease are poorly understood. Therefore these changes were studied in relation to a noninvasive indicator of exercise pulmonary venous congestion, the lung-to-heart (L:H) ratio on symptom-limited thallium stress testing. Fifty-six patients undergoing diagnostic treadmill testing were studied; 50 of them had technically adequate Doppler recordings and became the subjects of this study. Doppler left ventricular filling was assessed with patients in the supine position both before and after exercise. Measurements included early (E) and late (A) filling velocities, their ratio, the diastolic time-velocity integral, and the diastolic filling time. The L:H ratio was considered abnormal if it was greater than the upper 95% confidence limit for a separate group of normal subjects. Twelve subjects had a documented prior myocardial infarction, 16 had stress-induced ischemia, and 20 had abnormal L:H ratios. A greater E and a longer diastolic filling time in the group with an abnormal L:H ratio were the only postexercise measurements that differed; however, E was the only filling parameter that both differed between groups after exercise (abnormal L:H group 87 +/- 25 cm/sec; normal 68 +/- 20 cm/sec; p < 0.01) and whose change from rest to after exercise was significantly different (p < 0.05). Since Doppler velocities are directly related to instantaneous gradients, the higher E in patients with evidence of exercise pulmonary congestion suggests a higher exercise early diastolic left atrial pressure.

Part II. Behavioral and electrophysiological characteristics of the addicted neonate.

The neonatal withdrawal period was characterized by heightened auditory responsiveness and orientation, lowered overall alertness and poor attentiveness to and following of visual stimuli. Electroencephalographic recordings revealed high-frequency dysynchronous activity suggestive of cns irritability. Analysis of evoked response data further corroborated the behavioral findings with evidence for low arousal value of visual stimulation in the vertex frequency characteristics and poorly defined occipital responses. Auditory evoked responses appeared better integrated, and a significant correlation was found between auditory orienting ability and latency of the P2 component. The long-range developmental significance of these neonatal characteristics awaits further follow-up investigation.

Neonatal addiction: a two-year study. Part I. Clinical and developmental characteristics of infants of mothers on methadone maintenance.

Thirty-five infants born over a two-year period to mothers participating in a methadone-maintenance treatment program were studied The average birthweight was normal (3240 gms) for infants born to mothers who conceived while taking methadone, and 465 gms less (2775 gms) for infants conceived while their mothers were taking heroin (p less than .01). Sixty percent of the infants demonstrated mild or no symptoms and 40% developed moderate or severe symptoms. The infants whose symptoms were most severe were born to mothers who had documented histories of polydrug abuse. Many infants were slow to gain weight in the neonatal period. Thereafter growth and development have remained generally within the normal range.