ABSTRACT
Guillain-Barré is a rare, autoimmune disease of the peripheral nervous system. It can affect all ages beginning in the intrauterine or neonatal period. Clinical forms are diverse and include acute motor axonal neuropathy (AMAN). We report on a pediatric case of AMAN. A 2.5-year-old child presented with acute flaccid paralysis and preserved reflexes. Etiologic investigations argued in favor of Guillain-Barré syndrome in its AMAN form. Treatment based on IV immunoglobulins resulted in a total decline of paralysis and motor recovery. The AMAN form of Guillain-Barré syndrome should be considered as a potential diagnosis in all cases of acute flaccid paralysis with preserved reflexes.
Subject(s)
Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/drug therapy , Immunoglobulins, Intravenous/administration & dosage , Immunologic Factors/administration & dosage , Child, Preschool , Female , Guillain-Barre Syndrome/immunology , Humans , Paralysis/drug therapy , Treatment OutcomeSubject(s)
Carbon Monoxide Poisoning/diagnosis , Consciousness Disorders/diagnosis , Emergencies , Brain/pathology , Brain Damage, Chronic/diagnosis , Brain Damage, Chronic/therapy , Carbon Monoxide Poisoning/therapy , Child , Consciousness Disorders/therapy , Diagnosis, Differential , Epilepsy, Tonic-Clonic/diagnosis , Epilepsy, Tonic-Clonic/therapy , Humans , Hyperbaric Oxygenation , Magnetic Resonance Imaging , Male , Neuropsychological Tests , Oxygen Inhalation Therapy , Patient Admission , Tomography, X-Ray ComputedSubject(s)
Blindness, Cortical/etiology , Carbon Monoxide Poisoning/complications , Occipital Lobe/pathology , Parietal Lobe/pathology , Adolescent , Blindness, Cortical/therapy , Carbon Monoxide Poisoning/pathology , Carbon Monoxide Poisoning/therapy , Consciousness Disorders/etiology , Humans , Hyperbaric Oxygenation , Magnetic Resonance Imaging , MaleSubject(s)
Brain Stem , Neuroschistosomiasis/diagnosis , Adult , Female , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
The aim of this study was to identify risk factors for morbidity and mortality in cardiac valvular surgery. Two hundred and fifty-four patients underwent polyvalvular surgery between May 1996 and December 1998. The mean age was 36.8 years (range 4-66 years) and the group comprised 148 women. Two subgroups were defined: the first (184 patients), characterised by associated mitral and tricuspid valve disease: the second (70 patients), characterised by associated mitral and aortic valve disease with a tricuspid lesion in about half the cases. The risk factors of morbidity and mortality analysed were: Clinical: previous history of cardiac failure, NYHA classification, atrial fibrillation and cardiothoracic index. Doppler echocardiographic: left ventricular end systolic dimension > 50 mm, left ventricular and diastolic dimension > 70 mm, fractional shortening < 28%, ejection fraction < 40%: systolic pulmonary artery pressure > 30 mmHg. Haemodynamic: capillary wedge pressure > 20 mmHg, systolic pulmonary artery pressure > 30 mmHg. The authors identified three statistically significant risk factors for operative morbidity and mortality in polyvalvular cardiac surgery: Previous history of one or more episodes of cardiac failure NYHA functional Classes III or IV fractional shortening < 28%. The morbidity and mortality were lower when patients were operated before these poor prognostic factors were observed.
Subject(s)
Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation/adverse effects , Adolescent , Adult , Aged , Child , Child, Preschool , Echocardiography, Doppler , Female , Heart Failure , Hemodynamics , Humans , Male , Middle Aged , Morbidity , Mortality , Postoperative Complications , Risk Factors , Ventricular Function, LeftABSTRACT
Thirteen cases of osteoid osteoma and nine cases of osteoblastoma are reported. Diagnostic difficulties of osteoblastoma are illustrated by the versatile radiographic appearances of this tumour. The authors stress the importance of nuclear scan and CT in diagnosis and management.
Subject(s)
Osteoma, Osteoid/diagnostic imaging , Spinal Neoplasms/diagnostic imaging , Adolescent , Back Pain/etiology , Child , Diagnosis, Differential , Female , Humans , Male , Osteoma, Osteoid/complications , Osteoma, Osteoid/pathology , Spinal Neoplasms/complications , Spinal Neoplasms/pathology , Tomography, X-Ray ComputedSubject(s)
Bacterial Infections/blood , Blood/microbiology , Endocarditis, Bacterial/blood , Sepsis/blood , Algeria/epidemiology , Bacteria/isolation & purification , Bacterial Infections/epidemiology , Bacterial Infections/microbiology , Cross Infection/blood , Cross Infection/microbiology , Endocarditis, Bacterial/epidemiology , Endocarditis, Bacterial/microbiology , Humans , Retrospective Studies , Salmonella typhi/isolation & purification , Sepsis/epidemiology , Sepsis/microbiology , Typhoid Fever/blood , Typhoid Fever/epidemiology , Typhoid Fever/microbiologyABSTRACT
Delayed hypersensitivity skin testing was performed in 129 critically ill patients. Six intradermal antigens were used: tuberculin, candidin, varidase, epidermophytin, trichophytin and CCB (a polyvalent microbial vaccine from the Pasteur Institute). The response was judged as positive when one test or more were positive. Patients were devided in four groups: group A (40 cases): non-infected patients, a priori without immunodeficiency; group B (14 cases); suspected of immunodeficiency (cancers, hemopathies, collagen diseases receiving corticosteroids); group C (24 cases): decompensated chronic respiratory insufficienceis; group D (50 cases): overwhelming sepsis (septicaemias, septic acute respiratory distress syndromes, thoracic empyemas, purulent meningitis, peritonitis, mediastinitis). A significant diminution of delayed hypersensitivity was observed in groups B, C and D. No relation was found between delayed hypertensitivity and prognosis in groups C and D.
