Assuntos
Osteomielite/diagnóstico por imagem , Fratura da Base do Crânio/diagnóstico por imagem , Acidentes por Quedas , Idoso , Antibacterianos/uso terapêutico , Diabetes Mellitus Tipo 2/complicações , Humanos , Imageamento por Ressonância Magnética , Masculino , Osteomielite/complicações , Osteomielite/tratamento farmacológico , Base do Crânio , Fratura da Base do Crânio/complicações , Osso Temporal/lesões , Perfuração da Membrana Timpânica/complicações , Perfuração da Membrana Timpânica/diagnóstico por imagemRESUMO
PURPOSE: To document the prevalence and variable appearance of gastric heterotopic pancreas (HP) in children undergoing upper gastrointestinal (GI) endoscopy. METHODS: A prospective 4-year study of children undergoing flexible upper GI endoscopy in a single institution. RESULTS: A total of 607 upper GI endoscopies were performed in 478 pediatric patients during the 4-year period. Eleven children (6 girls, 5 boys) aged 2.9 to 16.9â¯years had endoscopic features typical of gastric HP. All but one lesion was located in the gastric antrum and most appeared as an umbilicated submucosal nodule measuring 1-2â¯cm in diameter. Five of 13 children with repaired esophageal atresia (EA) and two of nine children with trisomy 21 had gastric HP. The prevalence of endoscopically visualized gastric HP in children without a history of EA or trisomy 21 was 1.1%. CONCLUSIONS: Gastric HP is present in about 1% of pediatric upper GI endoscopies. It is significantly more common in patients with EA and may also be associated with trisomy 21. Gastric HP typically appears as a single 1-2â¯cm antral submucosal nodule, usually with a central pit. Recognition of this lesion is important to avoid misdiagnosis and inappropriate treatment. LEVEL OF EVIDENCE: Level II (diagnostic).
Assuntos
Coristoma/diagnóstico por imagem , Coristoma/epidemiologia , Pâncreas , Gastropatias/diagnóstico por imagem , Gastropatias/epidemiologia , Adolescente , Criança , Pré-Escolar , Coristoma/cirurgia , Síndrome de Down/epidemiologia , Endoscopia Gastrointestinal , Atresia Esofágica/epidemiologia , Feminino , Humanos , Masculino , Nova Zelândia/epidemiologia , Prevalência , Estudos Prospectivos , Antro Pilórico/patologiaRESUMO
We have previously developed a putative model of generalized anxiety disorder in healthy volunteers using a 20-minute 7.5% carbon dioxide (CO(2)) inhalation challenge. The aim of this study was to validate the 7.5% CO(2) paradigm by assessing its effects in patients with generalized anxiety disorder in a test-retest design. Twelve medication-free generalized anxiety disorder patients attended our lab for two study days. On each study day placebo (compressed air) and 7.5% CO(2) mixture were randomly administered over 20 min, at least 30 min apart, in a single blind, randomized, placebo-controlled cross-over design. Subjective ratings, cardiovascular measures and cortisol levels were collected throughout. CO(2) challenge significantly increased ratings for anxiety and other subjective symptoms associated with generalized anxiety disorder, compared with air. It also significantly increased systolic blood pressure on day 2, indicating increased autonomic arousal. There was no change between the two test days in mean anxiety rating scores, and there also appeared to be a correlation for individual scores on a number of the subjective measures. In conclusion, 20 min of 7.5% CO(2) gas inhalation increases anxiety responses in patients with generalized anxiety disorder, and this is reliable over time.