RESUMO
The purpose of the study was to determine whether the incidence of periventricular-intraventricular hemorrhage (PV-IVH) is significantly different between the firstborn and secondborn of very low birth weight twins. The firstborn and secondborn of 102 sets of twins were compared by incidence of PV-IVH, mode of delivery, birth weight, 5-minute Apgar score, pH, duration of oxygen therapy, duration of ventilator support, and occurrence of patent ductus arteriosus, air leak, bronchopulmonary dysplasia, or hyaline membrane disease. PV-IVH was graded by the Papile classification. Statistical data were analyzed by either the paired t test or McNemar's test. Major PV-IVH (grades III and IV) occurred in 11 firstborn and 14 secondborn infants. Minor PV-IVH (grades I and II) occurred in 11 firstborn and 8 secondborn twins. Neither these findings nor those from other measured variables showed a statistically significant difference.
Assuntos
Ordem de Nascimento , Hemorragia Cerebral , Doenças em Gêmeos , Doenças do Recém-Nascido , Recém-Nascido de muito Baixo Peso , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/etiologia , Ventrículos Cerebrais/diagnóstico por imagem , Humanos , Incidência , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico por imagem , Doenças do Recém-Nascido/etiologia , Prontuários Médicos , Estudos Retrospectivos , Fatores de Risco , UltrassonografiaRESUMO
The purpose of this study was to determine the relationship of a cranial midline shift accompanying periventricular hemorrhagic infarction to subsequent handicap in very-low-birth-weight infants. A study group of 44 infants with intraventricular hemorrhage and an associated periventricular hemorrhagic infarction was retrospectively selected from 1,080 very-low-birth-weight infants evaluated by cranial sonography. A cranial midline shift is defined sonographically as displacement of the septum pellucidum (or cavum septi pellucidi) more than 3 mm from the spatial midline. The midline is measured as half the distance between the right and left inner tables on an anterior coronal view. Other sonographic data recorded were the size of the lateral ventricle, the intracranial hemisphere, and the periventricular hemorrhagic infarction. Also noted was the appearance of the area of infarction at the time of initial detection of a midline shift. After discharge, the infants were periodically evaluated for major handicap in vision, hearing, cognition, and motor activity. A midline shift was identified in 29 (66%) of 44 infants with periventricular hemorrhagic infarction. Seven (24%) of the 29 infants with midline shift and 3 (20%) of the 15 infants without a midline shift died. In all of the 22 surviving infants with a midline shift and in 3 (25%) of 12 survivors without a midline shift, a handicap developed (p < 0.01). As a predictor of handicap, midline shift showed a sensitivity of 88% and a specificity of 100%. Predictability was not improved by combining midline shift with the size of the parenchymal infarct.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Hemorragia Cerebral/diagnóstico por imagem , Infarto Cerebral/diagnóstico por imagem , Ecoencefalografia , Recém-Nascido de Baixo Peso , Hemorragia Cerebral/complicações , Infarto Cerebral/complicações , Ventrículos Cerebrais , Humanos , Recém-Nascido , Prognóstico , Estudos RetrospectivosRESUMO
The acardiac anomaly is a rare condition found only in monozygotic multiple pregnancies, usually twins. We present a review of the pathophysiology of acardia and a case report. Twin embryonic membrane formation is discussed, since a conceptual understanding of the subject is necessary for the early recognition of this and other severe anomalies. Emphasis is placed on close sonographic monitoring to insure the best chance of survival of the normal twin, who may die of heart failure if delivery is not properly timed.
Assuntos
Anormalidades Múltiplas/diagnóstico , Doenças em Gêmeos , Cardiopatias Congênitas/diagnóstico , Ultrassonografia , Anormalidades Múltiplas/etiologia , Malformações Arteriovenosas/etiologia , Cardiomegalia/diagnóstico , Feminino , Cardiopatias Congênitas/etiologia , Humanos , Recém-Nascido , Placenta/irrigação sanguínea , Gravidez , Diagnóstico Pré-Natal , Gêmeos MonozigóticosAssuntos
Gota/diagnóstico , Nódulo Reumatoide/diagnóstico , Ultrassonografia , Idoso , Diagnóstico Diferencial , HumanosRESUMO
A review of the results of the evaluation of the gallbladder by gray scale ultrasonography in 52 patients is presented. When the gallbladder was successfully identified by ultrasound (46 patients) the detection of stones was 98% accurate. When the gallbladder was not identified (four patients), a contracted gallbladder containing numerous stones was found at operation. The left lateral decubitus position proved very helpful in displaying the gallbladder when it could not be identified in the standard supine position. Ultrasonic evaluation of the gallbladder is of most value in the patients who have had unsuccessful radiographic studies.
Assuntos
Colelitíase/diagnóstico , Ultrassonografia , Colelitíase/cirurgia , HumanosRESUMO
A case of mitral regurgitation apparently caused by extrinsic pressure of the large intrapericardial cyst distorting the mitral valve is reported. The initial radiographic appearance of the cyst suggested an atypically enlarged left atrium. The mitral regurgitation subsided after surgical drainage of the cyst. The angiogram showed elevation of the right pulmonary artery and depression of the left atrium.
