ABSTRACT
El síndrome de Rubinstein-Taybi es una enfermedad infrecuente que puede acompañarse de malformaciones cardiovasculares. Se presenta el caso de un paciente adulto con síndrome de Rubinstein-Taybi intervenido bajo circulación extracorpórea por presentar una válvula aórtica bicúspide
Rubinstein-Taybi syndrome is a rare disease that may be associated with cardiovascular malformations. We report the case of an adult patient with Rubinstein-Taybi syndrome who underwent an open heart procedure due to a bicuspid aortic valve
Subject(s)
Humans , Male , Rubinstein-Taybi Syndrome/genetics , Rubinstein-Taybi Syndrome/surgery , Mitral Valve/abnormalities , Mitral Valve/physiology , Dyspnea/congenital , Dyspnea/metabolism , Intellectual Disability/complications , Intellectual Disability/pathology , Rubinstein-Taybi Syndrome/metabolism , Rubinstein-Taybi Syndrome/pathology , Mitral Valve/metabolism , Mitral Valve/pathology , Dyspnea/diagnosis , Dyspnea/pathology , Intellectual Disability/psychologyABSTRACT
Pulmonary carcinomatous lymphangitis is a form of neoplastic metastatic spread to the lungs, which represents a poor prognosis for the patient. The physician may be confronted by a differential diagnosis with diffuse pulmonary interstitial affections requiring specific treatment, including lung transplantation. We present the case of a patient, diagnosed with pulmonary interstitial disease with rapidly progressive worsening of lung function, who was considered for lung transplantation. Videothoracoscopic lung biopsy demonstrated the existence of carcinomatous lymphangitis, which completely changed the therapeutic direction.
Subject(s)
Lung Neoplasms/secondary , Lung Transplantation , Lymphangitis/pathology , Contraindications , Diagnosis, Differential , Humans , Lung/pathology , Lung Diseases, Interstitial/pathology , Lung Neoplasms/pathology , Male , Middle AgedSubject(s)
Bronchial Fistula/etiology , Esophageal Stenosis/etiology , Esophagectomy/adverse effects , Gastric Fistula/etiology , Anastomosis, Surgical/adverse effects , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/surgery , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/surgery , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/surgery , Esophageal Stenosis/diagnostic imaging , Esophageal Stenosis/surgery , Esophagectomy/methods , Esophagoscopy , Follow-Up Studies , Gastric Fistula/diagnostic imaging , Gastric Fistula/surgery , Humans , Male , Middle Aged , Reoperation , Risk Assessment , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The association of pneumothorax and lung cancer is rare and diagnosis is complex in such cases. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, the clinical significance of the association, and the recommended diagnostic approach and therapeutic guidelines.
Subject(s)
Adenocarcinoma/diagnosis , Carcinoma, Bronchogenic/diagnosis , Carcinoma, Large Cell/diagnosis , Lung Neoplasms/diagnosis , Pneumothorax/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/surgery , Aged , Carcinoma, Bronchogenic/complications , Carcinoma, Bronchogenic/surgery , Carcinoma, Large Cell/complications , Carcinoma, Large Cell/surgery , Fatal Outcome , Humans , Lung Neoplasms/complications , Lung Neoplasms/surgery , Male , Middle Aged , Pneumonectomy , Pneumothorax/etiology , Pneumothorax/surgeryABSTRACT
La asociación de un neumotórax y un carcinoma broncopulmonar es muy infrecuente. El diagnóstico es complicado. La sospecha clínica debe establecerse a partir de los hallazgos radiográficos y la existencia de factores de riesgo. Se discuten los mecanismos implicados en la génesis del neumotórax en enfermos con neoplasias malignas del pulmón, así como la significación clínica que tal asociación tiene y, por consiguiente, la actitud diagnóstica y terapéutica recomendada en tales casos. (AU)
Subject(s)
Middle Aged , Aged , Male , Humans , Carcinoma, Large Cell , Fatal Outcome , Pneumonectomy , Pneumothorax , Carcinoma, Bronchogenic , Adenocarcinoma , Lung NeoplasmsSubject(s)
Chylothorax/etiology , Chylothorax/therapy , Lung Neoplasms/surgery , Postoperative Complications , Aged , Humans , MaleABSTRACT
The characteristics and clinical course of 1040 cases of acute myocardial infarction (AMI) among non-insulin-dependent diabetics (146) and nondiabetics (894) were compared. Patients with non-insulin-dependent diabetes mellitus (NIDDM) historically showed a greater percentage of AMI, angina, and risk factors than nondiabetic patients. Although the degree of left-ventricular function upon admission (according to the Killip and Kimball scores) was similar in both the diabetic and nondiabetic groups, the prevalence of hypertension and hypercholesterolemia was significantly higher in the NIDDM patients. All told, NIDDM cases were 1.73 [relative risk (RR)] times more likely to die of AMI than nondiabetic patients. The age factor and the presence of shock of any type also significantly increased the case-fatality rate. Diabetic patients showed signs of successful reperfusion less often than control subjects, an event that was closely associated with their case-fatality rate. In the NIDDM group, both the age and gender factor as well as a history of either casual or in-hospital clinical events such as cardiogenic shock, reinfarction, unsuccessful reperfusion, and incidence of anterior AMI along with either pain or previous angina were clear prognosticators of poor outcome from AMI. In the nondiabetic group, cardiogenic shock and hypertension were indicators of poor prognosis. These results would suggest that an improvement in the incidence of successful reperfusion in NIDDM patients, particularly in the face of clinical indicators of poor AMI prognosis, could decrease the high AMI mortality currently observed in these patients.
