RESUMEN
A prospective study was conducted to study the splenic function among sickle cell anemia (SCA) patients in Qatif (Eastern Province of Saudi Arabia). Seventy-seven patients (30 children and 47 adults aged 2-57 years) were included. (99m)Tc stannous colloid liver-spleen scan was done for each patient during steady state. The splenic function was graded from 0 to 4 in relation to liver uptake. Seventy percent of our patients showed evidence of splenic hypofunction, and most of them (83%) had severe hyposplenism. Up to the age of 4 years, only 17% of the children showed evidence of functional hyposplenism, but by the age of 10 years >50% were hyposplenic. Most of the hyposplenic children had functional hyposplenism, whereas only one-third of hyposplenic adults had autosplenectomy. There was no effect of level of HbF on the frequency of hyposplenism, but on the other hand low MCV seems to be protective against hyposplenism. A significant number of adult SCA patients have clinically enlarged spleens, and almost a third have normally functioning spleens. Because of the low prevalence of hyposplenism in children younger than 4 years of age, routine penicillin prophylaxis is probably not indicated in this population, an issue which needs further evaluation.
Asunto(s)
Anemia de Células Falciformes/epidemiología , Enfermedades del Bazo/diagnóstico por imagen , Enfermedades del Bazo/epidemiología , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , Ensayos Clínicos como Asunto , Comorbilidad , Índices de Eritrocitos , Femenino , Hemoglobina Fetal/metabolismo , Hepatomegalia/diagnóstico , Humanos , Hígado/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Sistema Mononuclear Fagocítico/diagnóstico por imagen , Prevalencia , Estudios Prospectivos , Cintigrafía , Arabia Saudita/epidemiología , Distribución por Sexo , Bazo/diagnóstico por imagen , Enfermedades del Bazo/diagnóstico , Esplenomegalia/diagnóstico , Compuestos de Tecnecio , Fluoruros de EstañoRESUMEN
We present two cases of medulloblastoma in adults patients showing extensive astrocytic differentiation. In one case, there was synchronous oligodendroglial differentiation, both changes appearing after treatment with radiotherapy. The possible role of radiotherapy in the differentiation is discussed.
Asunto(s)
Astrocitoma/patología , Neoplasias Encefálicas/patología , Meduloblastoma/patología , Recurrencia Local de Neoplasia/patología , Oligodendroglioma/patología , Adulto , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/terapia , Transformación Celular Neoplásica , Terapia Combinada , Humanos , Masculino , Meduloblastoma/diagnóstico por imagen , Meduloblastoma/terapia , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/etiología , Tomografía Computarizada por Rayos XAsunto(s)
Neoplasias Encefálicas/cirugía , Disgerminoma/cirugía , Neoplasias Encefálicas/patología , Tronco Encefálico/patología , Cerebelo/patología , Fosa Craneal Posterior , Disgerminoma/patología , Humanos , Lactante , Masculino , Microscopía Electrónica , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Tomografía Computarizada por Rayos XRESUMEN
A quantitative analysis of the results obtained by sequential 99mTc methylene diphosphonate (MDP) and 67Ga-citrate (Ga) imaging to disclose and distinguish infections in bone, synovium and adjacent soft tissue is reported. There were 129 patients with proved or probable osteomyelitis, septic arthritis and cellulitis, and 94 patients who were eventually shown to be free of sepsis, but not necessarily free of some other nonseptic affliction. Of the 159 patients referred with a presumptive clinical diagnosis of osteomyelitis 94 were eventually shown to be free of infection. The results of this group by sequential imaging were true positive 0.72, true negative 0.86 and accuracy 0.80 when low-grade Ga uptakes, which were similar in distribution to MDP, were excluded. In 26 patients with septic arthritis, the true-positive fraction for combined MDP and Ga was 0.84. The true-positive fraction for Ga in 38 patients with cellulitis was 0.79.
