RESUMEN
OBJECTIVES: Analysis of our experience and propositions on the diagnosis and treatment of congenital bronchopulmonary malformations (BPM). POPULATION AND METHODS: Retrospective study of BPM diagnosed between 1997 and 2001. Analysis of clinical spectrum, diagnosis tools, treatment, and clinical outcome. RESULTS: Thirty-two cases of BPM have been investigated (11 cystic adenomatoid malformations, 7 pulmonary sequestrations, 7 bronchogenic cysts, 4 congenital lobar emphysema, and 3 complex emphysematous malformations). Nineteen patients had a prenatal diagnosis. For 9 others, symptoms occurred before 4 years of age. Evaluation included a CT-scan in all patients (BPM involution in one). Surgical treatment was performed in 30 patients (lobectomy in 18), with a mean age of 7 months for asymptomatic patients. During the follow-up (mean: 3 years), respiratory symptoms were reported in 10 cases, 3 of them were related to the BPM. DISCUSSION: Improvement in prenatal ultrasound diagnosis modified the management strategy. Considering the risk of pulmonary complications, surgical treatment is required during the first months of life. For congenital lobar emphysema, and some pulmonary sequestrations or small cystic adenomatoid malformations (<3 cm), conservative attitude may be preferred. BPM justify a multidisciplinary management.
Asunto(s)
Pulmón/anomalías , Anomalías del Sistema Respiratorio/diagnóstico , Anomalías del Sistema Respiratorio/terapia , Adolescente , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Diagnóstico Prenatal , Pronóstico , Anomalías del Sistema Respiratorio/cirugía , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
We report two cases of prenatal diagnosis of osteogenesis imperfecta (type S of Marotaux), diagnosed at 23 and 24 weeks of gestation, revealed by of an ultrasound scan which noted an abnormal femoral incurvation. The problem of differential diagnosis with other diseases causing femoral incurvation (notably campomelic dysplasia) is difficult, especially at early stage. This question is debated here. The interest to associate ultrasound scan and uterine contents radiography is so demonstrated.
Asunto(s)
Osteogénesis Imperfecta/diagnóstico por imagen , Ultrasonografía Prenatal , Adulto , Femenino , Fracturas del Fémur/etiología , Fémur/patología , Humanos , Osteogénesis Imperfecta/clasificación , Osteogénesis Imperfecta/complicaciones , Embarazo , Segundo Trimestre del Embarazo , Tibia/patologíaRESUMEN
The lipid chemistry of the normal equine hoof, together with the effect of oral supplementation with an evening primrose oil mixture (EPOM) on its growth, growth rate and lipid content was assessed in a controlled and blinded feeding trial at the Defence Animal Centre. Twelve horses were paired as closely as possible according to sex, age, weight, height and colour and then one from each pair was randomly allocated to treatment or control groups. The treatment group received 30 ml of oral EPOM/day, otherwise the nutrition and management regimes were the same for all horses. No significant differences (P > 0.05) were seen between treatment and control groups for hoof horn growth or growth rate. However, there was a significant difference (P < 0.05) in hoof horn growth within the treatment group only between weeks 4 and 8 after the start of supplementation. The stratum medium contained significantly higher amounts of cholesterol ester (P < 0.05), triglycerides (P < 0.001) and free fatty acids (P < 0.05) than the periople. The periople contained significantly higher levels of free cholesterol and phospholipid (P < 0.001) than the stratum medium of the hoof wall. There were no significant differences (P > 0.05) between treatment and control groups for any of the lipid fractions measured for the stratum medium from the clippings of the hoof wall. However, there were differences in perioplic lipid analysis with significant increases (P < 0.05) in cholesterol esters and partial glycerides and a significant reduction (P < 0.001) in free cholesterol in the treatment group following supplementation.