ABSTRACT
Six patients who developed de Quervain's disease during pregnancy or within 12 months of childbirth were treated surgically. Histopathological examination of the tendon sheaths using alcian blue stain showed that myxoid degeneration was responsible for the thickening observed in the sheath. Characteristic intramural deposits of mucopolysaccharides were present, predominantly in the subsynovial region. Acute or chronic inflammatory changes were not seen. These findings were the same as those described in patients with de Quervain's disease unrelated to pregnancy or childbirth.
Subject(s)
Pregnancy Complications/pathology , Puerperal Disorders/pathology , Tenosynovitis/pathology , Wrist Joint/pathology , Adult , Female , Humans , Pregnancy , Pregnancy Complications/surgery , Puerperal Disorders/surgery , Tenosynovitis/surgerySubject(s)
Rhabdoid Tumor/pathology , Stomach Neoplasms/pathology , Biomarkers/analysis , Fatal Outcome , Female , Humans , Immunohistochemistry , Middle Aged , Rhabdoid Tumor/metabolism , Rhabdoid Tumor/surgery , Rhabdoid Tumor/ultrastructure , Stomach Neoplasms/metabolism , Stomach Neoplasms/surgery , Stomach Neoplasms/ultrastructureABSTRACT
It has been suggested that all children with skull fractures require urgent CT scanning to exclude intracranial injury. Adhering to such a policy could both tax limited scanning facilities and result in unnecessary exposure to radiation. The aim of this study is to assess the level of consciousness in determining the need for urgent CT scanning, and the possible role of the mechanism of injury as a secondary risk factor. We identified 140 children admitted during a 7-year period with a skull fracture after falling outside the home. Thirteen children had a diminished level of consciousness. Scans were performed in nine, and seven of the scans revealed significant intracranial injuries. By comparison, all 127 children with a normal level of consciousness recovered fully. Scanning was performed in only eight of them; seven scans were normal and one revealed a small subarachnoid heamorrhage which did not require active treatment. In addition, all 13 children with a diminished level of consciousness had sustained their injuries by falling from greater than their own standing height. By comparison, none of the children who had sustained their skull fractures by tripping up had a diminished level of consciousness or a significant intracranial injury. We conclude that all children with a diminished level of consciousness need to undergo an urgent CT scan. Children with skull fractures and a normal conscious level may be managed initially by neuroobservations and the clinician may be further reassured if the child's injury resulted from tripping up.
