RESUMO
Angiography may play an important role in the understanding of the cause and treatment of Perthes' disease. Angiograms were performed in 30 patients, including 26 aortographies and six selective angiographies. The major angiographic alterations were: general decrease of blood flow in the affected hip, lack of a patent medial circumflex artery, an atrophic medial circumflex artery or obstruction of its branches, distended vessels in subluxations of the hip joint, and almost complete absence of the obturator artery. These anatomic differences between normal and pathologic hips suggest a deficient blood supply in the affected side and an ischemic epiphysis. Surgical treatment is indicated in cases in which distention of the circumflex vessels is noted and the condition progresses to massive necrosis. There were no differences in circulation of the hip between men and women afflicted with Perthes' disease.
Assuntos
Angiografia , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Doença de Legg-Calve-Perthes/diagnóstico por imagem , Adolescente , Aorta Abdominal/diagnóstico por imagem , Aortografia , Criança , Pré-Escolar , Feminino , Quadril/irrigação sanguínea , Humanos , Masculino , Fatores SexuaisRESUMO
Twenty five children with chronic idiopathic thrombocytopenic purpura followed from 6-96 months in 7 Italian paediatric departments were treated with high dose immunoglobulin according to a multicentre protocol. Positive responses were observed in 20 of 25 patients (80%) and negative responses in 5 of 25 (20%). On previous steroid treatment 7 of 10 positive responders were steroid resistant and 13 of 15 were steroid dependent. Within four weeks of beginning treatment 16 of 20 patients (80%) relapsed, while 4 of 20 (20%) maintained normal platelet values after 4-12 months' follow up. Statistical analysis of the platelet count on day five of treatment enabled us to divide positive responders into three groups: good, intermediate, and poor. The possible mode of action and clinical application of high dose immunoglobulin are discussed.
Assuntos
Imunização Passiva , Púrpura Trombocitopênica/terapia , Adolescente , Criança , Pré-Escolar , Doença Crônica , Feminino , Humanos , Masculino , Contagem de Plaquetas , Púrpura Trombocitopênica/sangue , Fatores de TempoRESUMO
Os autores apresentam a sua experiencia com o metodo da angioplastia transluminar percutanea realizada com o cateter balao dilatador de Gruntzic. A referida tecnica foi usada em 16 doentes portadores de estenoses e obstrucoes localizadas em arterias iliacas, femorais e popliteas. Bons resultados imediatos foram obtidos em 13 casos (81%). Um periodo de seguimento que variou de 5 a 15 meses mostrou que 12 pacientes (75%) se encontravam em boas condicoes clinicas. Concluem pelas vantagens do metodo desde que obedecidos criterios rigidos e seguros na sua indicacao
