RESUMEN
OBJECTIVE: Colour stability is important in the long-term aesthetic success of restorative materials and is affected by both internal and external factors. Internal discolourations are due to the properties of the restorative materials. External discolourations can be associated with frequent consumption of food and beverages and the use of suspensions or syrups containing colourants/additives. Fluoride varnish application has an important place in preventive dentistry. The purpose of the research was to examine the protective effect of fluoride varnish application on the colour change on polyacid-modified composite resin restorative materials caused by the use of various paediatric drugs. METHODS: Two hundred ten discs were prepared from polyacid-modified composite resin material and divided into two groups: flouride varnish was applied to one group and flouride varnish was not applied to the other group. The groups were further divided into seven subgroups and the samples were kept in artificial saliva, amoxicillin + clavulanic acid, cefuroxime axetil, clarithromycin, paracetamol, ibuprofen, and iron supplement drug solutions. The colour change values of the discs were measured using a spectrophotometer device before immersion in the drug solutions and on the 7th, 14th, 21st, and 28th days after the immersion. The obtained data were calculated and statistically evaluated using IBM SPSS V23 software. RESULTS: It was found that the application of fluoride varnish in the iron supplement drug group prevented the colour change of the polyacid-modified composite resins for 28 days. In the amoxicillin + clavulanic acid, cefuroxime axetil, and paracetamol groups, the fluoride varnish did not prevent colour change in the polyacid-modified composite resin restorative materials at the end of the 14th day. CONCLUSION: It is thought that fluoride varnish application may be beneficial as a preservative in the colour change of polyacid-modified composite resins due to the use of various paediatric drugs, and this protective feature may be effective for a specific period of time.
Asunto(s)
Color , Resinas Compuestas , Fluoruros Tópicos , Resinas Compuestas/química , Fluoruros Tópicos/química , Humanos , Técnicas In Vitro , Ensayo de Materiales , Espectrofotometría , Saliva Artificial/química , Fluoruro de Sodio/química , Materiales Dentales/químicaRESUMEN
PURPOSE OF THE STUDY As in orthopedic trauma patients, a hyperinflammatory response due to cytokine release occurs in patients with moderate and severe COVID-19 infection. In these patients, untimely surgical intervention can create more destructive situations in the postoperative period. Our aim in this study was to investigate the effect of COVID-19, trauma and surgical intervention on acute phase reactants' levels in patients with and without COVID-19 infection. MATERIAL AND METHODS Twenty-four patients diagnosed with COVID-19 infection and major fractures requiring surgical treatment were evaluated retrospectively (Group 1). Twenty-four COVID-19 negative patients with similar trauma were included in the study as a control group (Group 2). These two groups were compared in terms of demographic data, time to surgery, total hospitalization time, and preoperative and postoperative acute phase reactants' [C-reactive protein (CRP), D-dimer, ferritin, fibrinogen and white blood cell (WBC)] values. RESULTS Time to surgery was 8.3 ± 0.7 days and the total hospital stay was 15.2 ± 0.8 days, in Group 1. These values were determined as 3.3 ± 0.4 and 6.5 ± 0.6 days, respectively for the patients in Group 2 (p < 0.001 and p < 0.001, respectively). When the acute phase reactant values studied during admission were examined, a significant difference was found between the two groups in terms of CRP, D-dimer, ferritin and WBC (p = 0009, p = 0.002, p < 0.001 and p < 0.001, respectively). In the preoperative period, a significant difference was observed between the groups in terms of CRP and ferritin (p = 0.011, p < 0.001, respectively). A significant difference was found only in terms of ferritin from the laboratory values studied in the postoperative period (p < 0.001). DISCUSSION To our knowledge, the present study is the first study which compares and investigates the effects of COVID-19 infection, major fracture and surgical intervention on acute phase reactants' values. Surgical treatment is generally recommended as soon as possible in daily orthopedic practice. However, in patients with asymptomatic or mildly symptomatic COVID-19 infection, it remains unclear how long surgical intervention will be delayed after admission and clinical stabilization of patients with a fracture that requires surgical fixation. In a meta-analysis, patients with COVID-19 infection accompanying hip fracture had a mortality rate of 32.6% in the early postoperative period, and the mortality risk of these patients was found to be 5.66 times higher compared to patients without COVID-19 infection. In our study, one patient (4.2%) with COVID-19 infection who underwent partial hip arthroplasty due to femoral neck fracture. CONCLUSIONS The follow-up and treatment of patients with COVID-19 infection with accompanying a major fracture requiring orthopedic surgery is a complex situation. We recommend that acute phase reactants such as CRP, D-dimer, erythrocyte sedimentation rate (ESR), and ferritin should be closely monitored in these patients during the period from admission to surgery, and surgical intervention should be performed while these values are in remission or decline. Key words: COVID-19, fracture, trauma, acute phase reactants, surgical timing.
Asunto(s)
COVID-19 , Fracturas de Cadera , Proteínas de Fase Aguda/metabolismo , Proteína C-Reactiva/metabolismo , COVID-19/complicaciones , Ferritinas , Fracturas de Cadera/cirugía , Humanos , Estudios RetrospectivosRESUMEN
Despite intensified chemotherapy, adolescents with acute lymphoblastic leukemia (ALL) still have lower rates of survival than younger children. The purpose of our study was to compare the treatment outcome and presenting clinical and laboratory features of adolescent and younger children with newly diagnosed ALL who were treated at our pediatric hematology department. Between April 1991 and February 2000, 42 children up to 18 years of age who were newly diagnosed with ALL and treated adequately with modified ALL Berlin-Frankfurt-Münster (BFM) 90 or 95 protocols were included in this study. The patients were examined in two groups according to their ages: the first group consisted of children who were <14 years old and the second group consisted of adolescents who were >14 years old. The median age of 42 patients was 6.5 years (range: 1-16.5 years); 26% of the patients were adolescents. The results of this study demonstrated that after a median observation time of 6 years the overall survival (OS) and event-free survival (EFS) of patients who were <14 and >14 years of age were 75% vs 49% and 70% vs 40%, respectively. When adolescent and younger patients were compared to each other according to gender, WBC count at administration, French-American-British (FAB) classification, immunophenotypes, risk groups, early deaths, and relapse rates, there were no statistically significant differences. Comparative data from other studies and data from this study indicate that adolescents with ALL still have shorter OS and EFS than younger children and a steady improvement in treatment outcome for adolescents with ALL over time suggests that more intensive therapy favorably influences prognosis.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Metotrexato/administración & dosificación , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Prednisona/administración & dosificación , Pronóstico , Factores de Riesgo , Análisis de Supervivencia , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
Protein-energy malnutrition (PEM) has been estimated to occur in 10 to 50% of children with juvenile chronic arthritis (JCA). Thirty-eight children with JCA were evaluated and their nutritional status determined, and they were compared with 23 healthy sex and age-matched children as controls. A standardized, 9-parameter comprehensive nutritional assessment profile was used. The simple anthropometric measurements, height and weight for age, were abnormal in 30% and 27% of the patients, respectively. A detailed evaluation revealed that 71% had abnormal somatic protein stores, and that they also had significantly low levels of visceral protein stores, when compared to their healthy peers. The results were consistent with the fact that inflammation put the JCA patients at significant risk for developing complicated malnutrition and it might result in PEM without any obvious signs of malnutrition. A nutritional screening test would be very useful in detecting early PEM in children with chronic arthritis.
Asunto(s)
Artritis Juvenil/complicaciones , Desnutrición Proteico-Calórica/epidemiología , Desnutrición Proteico-Calórica/prevención & control , Adolescente , Antropometría , Antirreumáticos/uso terapéutico , Artritis Juvenil/tratamiento farmacológico , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Masculino , Riesgo , Estadísticas no Paramétricas , Turquía/epidemiologíaRESUMEN
Allogeneic bone marrow transplantation has proved to be a radical form of cure in patients with beta-thalassemia major who have a human leukocyte antigen identical donor. Although malignant neoplasms are serious late complications of bone marrow transplantation, very few reports describing the development of malignant tumors after allografting for thalassemia appeared in the literature. A case is presented here of extraosseous Ewing's sarcoma that developed 8 years after allogeneic bone marrow transplantation performed for beta-thalassemia major. The phenotypic features of the patient's family fulfill the criteria for Li-Fraumeni syndrome. The patient was treated with chemotherapy and radiotherapy and died with recurrent disease. To the authors' knowledge, this is the first case of extraosseous Ewing's sarcoma after bone marrow transplantation for thalassemia. The possible contribution of transplantation procedure and the genetic factors as well as the primary genetic hemoglobinopathy to the development of this malignant tumor are discussed.
Asunto(s)
Sarcoma de Ewing/etiología , Neoplasias de los Tejidos Blandos/etiología , Adulto , Trasplante de Médula Ósea/efectos adversos , Niño , Salud de la Familia , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Células Neoplásicas Circulantes , Linaje , Sarcoma de Ewing/genética , Neoplasias de los Tejidos Blandos/genética , Trasplante Homólogo/efectos adversos , Talasemia beta/complicaciones , Talasemia beta/terapiaRESUMEN
Landau-Kleffner syndrome (LKS) is a rare childhood disorder characterized by acquired aphasia with seizures and electroencephalogram (EEG) abnormalities. Tc-99m-HMPAO SPECT was performed in three right handed children with LKS. A relative decrease in perfusion was found in the left temporal cortex of all three patients and also in the left frontoparietal cortex of one patient with hyperkinetic behavior. Degree of regional cerebral perfusion impairment did not correlate with the severity of clinical and EEG abnormalities. Asymmetrical temporoparietal perfusion appears characteristic of LKS. SPECT findings in LKS were evaluated as useful in elucidating the pathogenic features of the disorder in the brain.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Encéfalo/fisiopatología , Electroencefalografía , Síndrome de Landau-Kleffner/diagnóstico por imagen , Síndrome de Landau-Kleffner/fisiopatología , Radiofármacos , Exametazima de Tecnecio Tc 99m , Encéfalo/diagnóstico por imagen , Carbamazepina/uso terapéutico , Circulación Cerebrovascular , Preescolar , Clonazepam/uso terapéutico , Dexametasona/uso terapéutico , Potenciales Evocados Auditivos del Tronco Encefálico , Lóbulo Frontal/irrigación sanguínea , Humanos , Síndrome de Landau-Kleffner/tratamiento farmacológico , Masculino , Lóbulo Parietal/irrigación sanguínea , Radiofármacos/farmacocinética , Exametazima de Tecnecio Tc 99m/farmacocinética , Lóbulo Temporal/irrigación sanguínea , Tomografía Computarizada de Emisión de Fotón Único , Ácido Valproico/uso terapéuticoRESUMEN
Peripheral vascular disease are structural and functional abnormalities of the peripheral blood vessels that produce blood flow irregularities. The signs and symptoms relate either to ischemia or inflammation of the involved vessels, or to both. A previously healthy 4.5-year-old girl was referred to our hospital with bruises on fingers and toes. She had no history of environmental causes, including drug intake. Symptoms of abdominal pain, fever, and a swollen face preceded the symptoms of her extremities. On physical examination, her blood pressure, which could be obtained only on the things, was high. There were no pulses on the upper extremities or on either the a. dorsalis pedis or the a. tibialis anterior dextra. There was massive necrosis on fingers which led to dry gangrene. A rise in acute phase reactants accompanied the physical findings, and a segmental obstruction was found proximally to a. brachiales, and distally to a. radialis dextra and a. dorsalis pedis dextra on digital subtraction angiography (DSA). High-dose methylprednisolone, cyclophosphamide, salicylates and dipyridamole were given; as these medications did not relieve the symptoms, a thoracal sympathatectomy was performed. The peripheral circulation improved, but a demarcation zone developed on the fingertips, leading to amputation.
Asunto(s)
Poliarteritis Nudosa/diagnóstico por imagen , Amputación Quirúrgica , Angiografía de Substracción Digital , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Necrosis , Poliarteritis Nudosa/patología , Poliarteritis Nudosa/cirugía , SimpatectomíaRESUMEN
Respiratory functions are affected during hemodialysis. Ultrafiltration rate, acid-base balance and the strength of respiratory muscles have been suggested as important factors in adults undergoing chronic hemodialysis. L-carnitine is crucial for energy producing utilization fatty acid and, possible amino acids. Carnitine treatment has been associated with hypertrophy of type I muscle fibers. Carnitine supplementation in nondialysis patients increases exercise tolerance. Eventually, administration of L-carnitine to adult hemodialysis patients improves exercise capacity, energy metabolism and muscle mass. The study was performed to investigate the chronic effects of L-carnitine treatment on respiratory functions in children receiving chronic hemodialysis therapy. Predialytic and postdialytic respiratory function tests were performed in ten children with end-stage renal disease before and after a three-month L-carnitine treatment period. The mean age was 12 +/- 4 years. L-carnitine was administered at a dose of 20 mg/kg intravenously at the end of each hemodialysis session. Mean predialytic serum carnitine value before and after the carnitine treatment period were 21.8 +/- 3 and 132.0 +/- 48.5 mmol/L, respectively, and the increase was significant (p < 0.05). Respiratory function tests performed just before the carnitine treatment period implied bronchospasm that was clinically vague and could only be detected by a significant decrease in FEV1/FVC, PEF and FEF25-75 values (p < 0.05). Nevertheless, at the end of the three-month carnitine therapy period these respiratory function parameters did not show any significant variation. Hence, it is implied that carnitine therapy might have prevented the subclinic bronchospasm that developed in children during hemodialysis.
Asunto(s)
Espasmo Bronquial/tratamiento farmacológico , Espasmo Bronquial/etiología , Carnitina/uso terapéutico , Fallo Renal Crónico/terapia , Diálisis Renal/efectos adversos , Adolescente , Adulto , Carnitina/sangre , Niño , Femenino , Humanos , Masculino , Estudios Prospectivos , Pruebas de Función RespiratoriaRESUMEN
The first week of life is a time when hereditary or more frequently acquired factors lead to some important differences in the hemostatic mechanism of the newborn. It has been well known that ill neonates are prone to both hemorrhage and thrombosis. The aim of this study was to answer the question of whether there is a difference in platelet activation in healthy neonates during the first days of life that may contribute to both hemorrhage and thrombosis in the presence of additional pathologic insults. Platelet activation was determined with flow cytometry using monoclonal antibodies in 63 healthy children (29 neonates, 17 infants, and 17 older children). There was no significant difference in platelet activation among these three age groups (p > 0.05). In addition, platelet activation did not show any significant relationship to age, sex, mode of delivery, or blood bilirubin concentration (p > 0.05). It has been previously reported that platelet activation occurs at the time of birth. We could not find any evidence that healthy newborns during the first 3 days of life exhibit increased platelet activation. Further studies on platelet activation in ill neonates will help to clarify whether platelet activation plays a role in the pathogenesis of thrombotic and/or hemorrhagic disorders.
Asunto(s)
Activación Plaquetaria , Anticuerpos Monoclonales , Bilirrubina/sangre , Femenino , Citometría de Flujo , Humanos , Lactante , Recién Nacido , Masculino , Recuento de PlaquetasRESUMEN
The research presented here investigated platelet activation in cyanotic and acyanotic congenital heart diseases (CHD). Children with cyanotic CHD are prone to both thrombosis and hemorrhage. However, patients with acyanotic CHD may also have a mild bleeding disorder. The platelet activation in CHD was investigated in support of a hypothesis that platelet activation may play a role in the hemostatic abnormalities reported in these patients. Platelet activation was determined by using flow cytometry with anti-CD62 monoclonal antibody (mAb), which has been shown to be a specific marker of platelet activation. Thirteen children with cyanotic CHD, 33 children with acyanotic CHD and 17 healthy children serving as controls were studied. Platelet activation was significantly higher in the cyanotic group and also in the acyanotic group compared with the healthy children (P = 0.0000 and P = 0.019, respectively). In the cyanotic group, platelet activation showed a direct correlation with arterial O2 saturation (SaO2) (P = 0.014). There was no correlation between platelet activation and erythrocyte related parameters in either group. Platelet activation occurs in CHD, particularly in patients with cyanotic CHD (even in patients with no evidence of clinical thrombosis) and it may play a role in the pathogenesis of thrombotic disorders seen in these patients.
Asunto(s)
Cardiopatías Congénitas/sangre , Activación Plaquetaria/fisiología , Preescolar , Femenino , Citometría de Flujo , Humanos , Lactante , Masculino , Oxígeno/sangre , Recuento de PlaquetasRESUMEN
A 14-year-old boy had a 1-month history of diplopia (due to a VI nerve palsy), motor ataxia and dizziness. Brain MRI showed a 1.5-cm mass posterior to the pons. Histopathological examination of a biopsy specimen showed the lesion to be of viral origin. After 3 months, the ataxia and dizziness had resolved and the MRI findings returned to normal. By 5 months the abducens paralysis had also resolved. Viral encephalitis should be considered in the differential diagnosis of posterior fossa tumours.
Asunto(s)
Tronco Encefálico/patología , Encefalitis Viral/complicaciones , Imagen por Resonancia Magnética , Seudotumor Cerebral/virología , Adolescente , Astrocitoma/diagnóstico , Biopsia , Neoplasias Encefálicas/diagnóstico , Fosa Craneal Posterior , Errores Diagnósticos , Encefalitis Viral/diagnóstico , Estudios de Seguimiento , Humanos , Masculino , Seudotumor Cerebral/diagnósticoRESUMEN
Juvenile ankylosing spondylitis (JAS) is a chronic inflammatory arthritis of the peripheral and axial skeleton, frequently accompanied by enthesitis. About four percent of patients with JAS have ulcerative colitis or Crohn's disease. Crohn's disease is the more common of the two and is diagnosed in 26 percent of patients with chronic spondyloarthropathy. In this paper, a 14-year-old male patient is presented as a typical case of juvenile ankylosing spondylitis and Crohn's disease with low back pain, morning stiffness, limited motion in anterior and lateral flexion and extension, left sacroiliitis, ankylosis in the apophyseal joints of the lumbar vertebrae, abdominal pain, bloody diarrhea, characteristic histopathologic changes of colonic involvement such as lymphoid follicles, fissures, submucosal polymorphonuclear cell infiltration and definite ganglion cells. The current therapy with mesalazin, having fewer side effects than sulfosalazin, and its applicability in combination with naproxen sodium is also discussed.
Asunto(s)
Artritis Juvenil/complicaciones , Enfermedad de Crohn/complicaciones , Espondilitis Anquilosante/complicaciones , Adolescente , Ácidos Aminosalicílicos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Artritis Juvenil/diagnóstico por imagen , Artritis Juvenil/tratamiento farmacológico , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/patología , Humanos , Masculino , Mesalamina , Naproxeno/uso terapéutico , Radiografía , Espondilitis Anquilosante/diagnóstico por imagen , Espondilitis Anquilosante/tratamiento farmacológicoRESUMEN
Increased nitric oxide (NO) levels are thought to play an important role in the pathophysiology of the systemic inflammatory response syndrome (SIRS) which is caused by disseminated vascular endothelial damage. Clinical studies have shown that urinary nitrite (NO2-) and nitrate (NO3-) excretions can be utilized as indexes of NO formation. The SIRS and NO relationship was investigated in 15 neonates with SIRS, gestational age 32.5 +/- 4.4 weeks and weight 1,737 +/- 753 g. The control group comprised 18 neonates with a gestational age of 32.8 +/- 3.5 weeks and a weight of 1,778 +/- 538 g. There was no significant difference in birth weights and gestational ages between the two groups (p > 0.05 and p > 0.05). The urinary nitrite levels obtained in the subjects were normalized for urinary creatinine concentrations. The mean urinary nitrite levels in the control group neonates were found to be 4.22 +/- 1.8 micromol/mmol creatinine on the 1st day, 4.09 +/- 2.28 on the 2nd, 3.62 +/- 1.6 on the 3rd, and 4.01 +/- 1.12 micromol/mmol creatinine on the 7th day. There were no statistically significant differences between these levels (p > 0.05). We determined urinary levels of nitrite in neonates in the study group within the first 24 h of SIRS symptoms and found these levels (18.35 +/- 11.16 micromol nitrite/mmol creatinine) to be elevated as compared with those of the control subjects on the 7th day of life (p < 0.0005). In conclusion, urinary nitrite excretion is significantly elevated in neonates with SIRS due to septic events, and these results suggest that NO might play a part in SIRS.
Asunto(s)
Recién Nacido de Bajo Peso/orina , Nitritos/orina , Síndrome de Respuesta Inflamatoria Sistémica/orina , Peso al Nacer , Candidiasis/sangre , Candidiasis/microbiología , Edad Gestacional , Humanos , Recién Nacido de Bajo Peso/sangre , Recién Nacido , Infecciones por Klebsiella/sangre , Infecciones por Klebsiella/orina , Valores de Referencia , Infecciones Estreptocócicas/sangre , Infecciones Estreptocócicas/microbiología , Síndrome de Respuesta Inflamatoria Sistémica/sangre , Síndrome de Respuesta Inflamatoria Sistémica/microbiologíaRESUMEN
Nuchal vascular hamartoma was found in a newborn premature infant who presented with nonimmune hydrops fetalis, pulmonary hypoplasia due to bilateral pleural effusion and polyhydramnios in utero. The baby died 26 hours after birth despite maximal respiratory and circulatory support. Postmortem examination revealed a vascular hamartoma localized to the left posterolateral region of the neck. We suggest that nuchal vascular hamartoma may be associated with fetal hydrops, probably due to compromised lymph drainage.
Asunto(s)
Anomalías Múltiples , Hamartoma/complicaciones , Hidropesía Fetal/complicaciones , Pulmón/anomalías , Resultado Fatal , Femenino , Hamartoma/patología , Humanos , Recién Nacido , Recien Nacido Prematuro , Cuello/patología , Derrame Pleural/complicaciones , Polihidramnios/complicaciones , EmbarazoRESUMEN
Hypertrophic cardiomyopathy (HCM) is a rare primary myocardial disease, characterized by hypertrophy of the left and/or right ventricle. Infants of diabetic mothers (IDM) are at risk for development of HCM, respiratory distress and persistent pulmonary hypertension. A case of severe right sided HCM in an infant born to a diabetic mother is presented. The patient's findings were complementary to the previous observations reporting HCM in IDM. The presence of disproportionate septal hypertrophy in the echocardiography of an infant born to a diabetic mother is highly suggestive of HCM in IDM. In our opinion, further cardiac evaluation is not indicated unless other cardiac abnormalities are suspected.
Asunto(s)
Cardiomiopatía Hipertrófica/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Embarazo en Diabéticas/diagnóstico , Ecocardiografía , Femenino , Estudios de Seguimiento , Humanos , Hipertrofia Ventricular Izquierda/diagnóstico , Recién Nacido , Masculino , Embarazo , Remisión EspontáneaRESUMEN
McArdle's disease is a hereditary, metabolic myopathy characterized by weakness and muscle cramps after exercise, appearing mostly in the second or third decade of life. Due to myophosphorylase deficiency in skeletal muscle, glycogen cannot be used and deposited in the sarcolemmal spaces, leading to lack of endurance to sustained work. The ischemic exercise test is a screening procedure for muscle energy disorders, and the diagnosis is confirmed by reduced enzyme activity in muscle biopsy. In this report, a family with one child having enzyme assay-proven McArdle's disease and two other children demonstrating a positive ischemic exercise test is presented.
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Enfermedad del Almacenamiento de Glucógeno Tipo V , Adolescente , Adulto , Niño , Preescolar , Prueba de Esfuerzo , Femenino , Enfermedad del Almacenamiento de Glucógeno Tipo V/sangre , Enfermedad del Almacenamiento de Glucógeno Tipo V/diagnóstico , Enfermedad del Almacenamiento de Glucógeno Tipo V/genética , Humanos , Lactatos/sangre , Masculino , Músculo Esquelético/patología , Fosfocreatina/sangreRESUMEN
Magnetic resonance imaging (MRI) of the cervical spine was performed on 20 patients (mean age 10 years) with a preliminary diagnosis of juvenile rheumatoid arthritis (JRA). In all patients conventional x-rays of the cervical spine were obtained, and the relationship between clinical status and MRI findings were evaluated. Two patients with clinical manifestations, including neck pain and diminished range of motion, exhibited significant pathologic features on radiogram and MRI, the latter providing more detailed information. Among 18 patients who had no complaints about their cervical spines, 3 patients (65%) had either soft tissue involvement, pannus formation or erosions on the surface of atlantoaxial joints; only four patients (20%) had erosions on plain x-ray views. Since the early diagnostic ability of MRI in JRA allows early therapeutic intervention, every patient with a probable diagnosis of JRA would benefit from MRI.
Asunto(s)
Artritis Juvenil/diagnóstico , Vértebras Cervicales/patología , Adolescente , Artritis Juvenil/patología , Vértebras Cervicales/diagnóstico por imagen , Niño , Preescolar , Enfermedad Crónica , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , RadiografíaRESUMEN
Postictal serum prolactin and cortisol levels were measured in 37 children having either epilepsy, febrile seizure or syncopal attack and in 37 normal controls. Blood samples were obtained within 1.5 h following the seizure episode. All serum levels were compared between each group and the control groups. Significantly higher (P < 0.005) prolactin levels (56.64 +/- 34.78 ng/mL) were found in the epileptic group, compared to the levels in children with febrile seizures (21.72 +/- 12.92 ng/mL), syncope attacks (13.88 +/- 5.27 ng/mL) and the control group (14.32 +/- 5.05 ng/mL). In contrast, serum cortisol levels were non-specifically elevated in children with epilepsy, febrile seizures and syncopal attacks. Cortisol secretion appears to be non-specifically elevated in all stressful events. Elevated prolactin levels may be helpful in differentiating epilepsy from febrile seizures and syncope.
Asunto(s)
Hidrocortisona/sangre , Prolactina/sangre , Convulsiones/sangre , Adolescente , Niño , Preescolar , Diagnóstico Diferencial , Epilepsia/complicaciones , Epilepsia/diagnóstico , Humanos , Lactante , Convulsiones/etiología , Convulsiones Febriles/complicaciones , Convulsiones Febriles/diagnóstico , Síncope/complicaciones , Síncope/diagnósticoRESUMEN
In order to measure the effects of high-dose intravenous methylprednisolone (HIVMP) and compare its efficiency with that of oral prednisolone (OP), 18 patients with active rheumatic carditis were studied. Ten patients received OP, while eight patients were treated with HIVMP. Clinical and laboratory responses to treatment were followed by sleeping pulse rate, systolic blood pressure, erythrocyte sedimentation rate (ESR), cardiothoracic ratio (CTR), PR interval on electrocardiogram, spectral and color flow imaging and Doppler echocardiographic findings; mitral and aortic regurgitant jet flow area, left atrial area, proximal width of mitral regurgitant jet area and regurgitation fractions. The results of patients in the HIVMP group showed statistically significant changes in ESR and CTR when compared with the patients receiving OP, and the recovery was more rapid. HIVMP therapy can be considered as a new method of treatment for acute rheumatic carditis.
Asunto(s)
Metilprednisolona/administración & dosificación , Cardiopatía Reumática/tratamiento farmacológico , Administración Oral , Niño , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Electrocardiografía/efectos de los fármacos , Femenino , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Humanos , Infusiones Intravenosas , Masculino , Metilprednisolona/efectos adversos , Prednisolona/administración & dosificación , Prednisolona/efectos adversos , Cardiopatía Reumática/fisiopatologíaRESUMEN
OBJECTIVES AND METHODS: The curing of several commercial powder/liquid mixtures of acrylic denture base materials was carried out at different temperatures and curing times. The levels of residual monomer, tensile strength, percentage elongation before break and water absorption were measured. RESULTS AND CONCLUSION: It was found that the level of residual monomer determined by gas-liquid chromatography decreased with curing time and temperature increase. At the same time, the tensile strength was improved and water absorption decreased.