RESUMO
Renal arteriovenous malformation is a rarely encountered disease characterized by the presence of a direct arteriovenous shunt between the renal artery and vein. This nosology was first described by Varela in 1928, and by 1997 the number of such cases amounted to slightly more than 200. Endovascular closure of a fistula seems to be an attractive method of treatment in view of low traumaticity and a short period of rehabilitation. However, as shown by our case report, this type of intervention in large-diameter fistulas may be associated with the development of life-threatening complications. In case of rupture of the renal capsule and/or arteriovenous aneurysm, radical nephrectomy, unfortunately, remains to be a method of choice. Described below is a case concerning treatment of a female patient presenting with bilateral arteriovenous malformations and the world's first emergency operation for a ruptured intraparenchymatous arteriovenous aneurysm using an extracorporeal technique.
Assuntos
Aneurisma Roto/cirurgia , Fístula Arteriovenosa/cirurgia , Malformações Arteriovenosas/cirurgia , Procedimentos Endovasculares/métodos , Circulação Extracorpórea/métodos , Rim , Adulto , Aneurisma Roto/diagnóstico , Fístula Arteriovenosa/diagnóstico , Fístula Arteriovenosa/etiologia , Malformações Arteriovenosas/diagnóstico , Malformações Arteriovenosas/fisiopatologia , Feminino , Humanos , Rim/irrigação sanguínea , Rim/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Reoperação/métodos , Resultado do TratamentoRESUMO
The aim of the study was to search for the association between efficacy of botulinum treatment (dysport) and the formation of antibodies to botulinum toxin in children with cerebral palsy (CP). Fourteen children with CP received dysport, 42 children (29 with CP and 13 patients with paresises of other etiologies) were not treated with this drug. No association between the presence of antibodies in blood serum and efficacy of treatment was found. However, further research of the role of antibody genesis as a factor influencing the formation of reaction to treatment is needed.
Assuntos
Anticorpos Antibacterianos/sangue , Toxinas Botulínicas Tipo A/imunologia , Toxinas Botulínicas Tipo A/uso terapêutico , Paralisia Cerebral/tratamento farmacológico , Paralisia Cerebral/imunologia , Adolescente , Paralisia Cerebral/sangue , Criança , Pré-Escolar , Feminino , Humanos , MasculinoRESUMO
The refuse of the parents of the child with spastic cerebral palsy to use botulinum toxine as a part of multidisciplinary prolonged treatment can be destructive for the achievement of the goals of the rehabilitation. 65 parents of children with CP were assessed to clarify the substituted causes for rejection. Answers, caused by real adverse effects of the medication were rarest. Most of the parents were afraid of the reactions, which are the part of pharmaceutical effect. Psychological background and the opinion of the other persons are the most difficult causes to be resolved.
Assuntos
Toxinas Botulínicas/administração & dosagem , Paralisia Cerebral/tratamento farmacológico , Pais/psicologia , Recusa do Paciente ao Tratamento/psicologia , Criança , Pré-Escolar , Esquema de Medicação , Humanos , Injeções/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
Solid-pseudopapillary pancreatic tumors (SPPT) are slow-growing tumors and have a considerably good prognosis, in case of radical removal. Thus, results of surgical treatment of 10 patients with SPPT were analyzed. On the basis of ultrasound examination, computed tomography, magnetic resonance imaging and intraoperative picture 2 groups of patients were formed. 1st group consisted of 3 patients and was characterized by small tumor diameter (2,5-5 sm) and solid structure. The rest 7 patients formed the 2nd group; tumor was larger (more than 5 sm) and had a cystic structure. Radiologic features of SPPT were: cystic component of the tumor (especially with papillary structures), hemorragic contents of the cysts, capsule and calcinates both in stroma and capsule. Magnetic resonance imaging proved to be the most effective diagnostic method. All patients with solid-pseudopapillary carcinomas of pancreas had adjuvant chemotherapy. At present all patients are in satisfactory state.
Assuntos
Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Pancreatectomia/métodos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirurgia , Adolescente , Adulto , Idoso , Colangiopancreatografia por Ressonância Magnética/métodos , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Tomografia Computadorizada Espiral/métodos , Ultrassonografia Doppler/métodos , Adulto JovemRESUMO
Visceral arterial aneurysms are a rare vascular pathology, which lacks specific clinical signs. Imaging modalities play a key role in their diagnosis. Today radiological endovascular interventions appear to be the method of choice for the management of most patients with azygous visceral arterial aneurysms. Various endovascular methods are used for circulatory exclusion of aneurysms, depending on particular anatomy and topology. The paper describes radiological endovascular management of 23 patients with aneurysms of abdominal aorta azygous visceral branches in the A. V. Vishnevsky Institute of Surgery for the period from 1995 to 2007.
