RESUMO
The purpose of this study was to limit prophylactic treatment of children with febrile convulsions to patients who have the highest risk of recurrence. Two hundred and thirty-one children with a first febrile seizure were divided into high- and low-risk groups according to estimated risk of recurrence. All high-risk children were offered treatment with valproic acid. If this was declined they were offered treatment with diazepam instead. Low-risk children were untreated. Valproic acid and diazepam were found to be equally effective in reducing the risk of recurrence of febrile convulsions. By selecting for prophylactic treatment according to estimated risk of recurrence it is possible to reduce the rate of recurrence of febrile seizures in children at high-risk (60%) to the same level as that of untreated low-risk children (23%). Only about half of all children with febrile convulsions need treatment and follow-up according to these criteria.
Assuntos
Diazepam/uso terapêutico , Convulsões Febris/prevenção & controle , Ácido Valproico/uso terapêutico , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Feminino , Humanos , Lactente , Masculino , Recidiva , RiscoRESUMO
A case of neurofibromatosis in a 7-year-old boy from Greenland is presented. The patient suddenly developed a severe thoracic scoliosis because of a total luxation of the upper thoracic vertebrae caused by erosion from soft tissue tumours in the region. Tomography revealed the bone changes, and CT whole-body scanning showed the extent of the soft tissue tumours and also the destruction of the vertebrae. The diagnosis was verified by biopsy.
Assuntos
Neurofibromatose 1/diagnóstico por imagem , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Torácicas/diagnóstico por imagem , Criança , Pré-Escolar , Humanos , Luxações Articulares/complicações , Luxações Articulares/diagnóstico por imagem , Masculino , Escoliose/complicações , Escoliose/diagnóstico por imagem , Neoplasias da Coluna Vertebral/complicações , Tomografia Computadorizada por Raios XRESUMO
A newborn infant with severe hypoglycaemia and nesidioblastosis was subjected to subtotal pancreatectomy without any sign of improvement. In spite of very low plasma levels of glucose (i.e. less than 1 mmol/l) plasma insulin concentrations were high (i.e. greater than 700 pmol/l). Plasma proinsulin was considerably enhanced comprising 43% of the total insulin immunoreactivity. Plasma glucagon concentrations were normal. Postoperatively normal to subnormal plasma glucose levels could only be maintained by treatment with frequent meals, diazoxide and intramuscular injections of a long-acting glucagon preparation. With time, signs of mental retardation became obvious.
