RESUMEN
INTRODUCTION: Opportunistic pulmonary infections frequently occur after liver transplantation, and affect mortality and morbidity significantly. The purpose of this study was to define the incidence, types, and imaging characteristics of pulmonary infections in liver transplant recipients with multidetector CT (MDCT) evaluation. METHODS: Thirty-five adult transplant recipients diagnosed with a pulmonary infection within the first 45 days posttransplantation were reviewed retrospectively from March 2002 to December 2013. MDCT features were evaluated retrospectively by 2 radiologists in consensus. All diagnoses were made by sputum analysis, cultures, biopsies, and postmortem histopathologic evaluation. RESULTS: Pneumococcus pneumonia was found in 7 patients. Five patients had nonspecific pneumonia, Candidiasis, Klebsiella, and Aspergillosis separately. S aureus pneumonia was detected in 2 patients and the other 2 patients had Escherichia coli pneumonia. Two patients had active tuberculosis and 1 patient had Acinetobacter pneumonia also. Four main MDCT patterns were identified: patchy infiltrations (10%), tree-in-bud pattern (9.5%), ground-glass opacity (8.5%), and nodules with halo sign (6%). One patient had a cavitary lesion owing to tuberculosis. CONCLUSION: Although the incidence of pulmonary complications in liver recipients was relatively low, mortality from serious infections was high. Care must be taken with pulmonary infectious complications in the posttransplant period. For any suspicious case, MDCT evaluation for specific patterns of early accurate diagnosis is very important.
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Fallo Hepático/cirugía , Trasplante de Hígado/efectos adversos , Tomografía Computarizada Multidetector , Neumonía/diagnóstico por imagen , Adulto , Femenino , Humanos , Incidencia , Fallo Hepático/diagnóstico por imagen , Fallo Hepático/etiología , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Neumonía/epidemiología , Neumonía/microbiología , Estudios Retrospectivos , Adulto JovenRESUMEN
Morgagni hernia (MH) is the least common type of congenital diaphragmatic hernias. Although its course is often asymptomatic, it may be associated with various respiratory and gastrointestinal symptoms. We describe 7 children with MH during a 5-year period in three pediatric centers in Turkey. All children had acute or chronic respiratory symptoms; cough was the most frequent. The diagnosis was made by posterior-anterior (PA) and lateral chest X-rays. The PA chest X-rays showed a homogenous mass in 2 and a gas-filled cystic image in 3 children in the right cardiophrenic angle. A retrocardiac homogeneous density in one child, and bilateral consolidation in lower lung areas in another child were also seen. All lateral chest X-rays showed gas-filled bowel loops above the diaphragm. The diagnosis was confirmed by barium-contrast radiograph. Four patients had five additional anomalies, i.e., ventricular septal defect, right inguinal hernia, congenital hip dislocation, pectus carinatum, and obstruction of the uretero-pelvic junction. All of the hernias were repaired by an abdominal approach. There were no complications or recurrences during follow-up. In conclusion, MH should be considered in the differential diagnosis of cases of long-standing respiratory symptoms and/or when an unexplained radiological image, especially on the right cardiophrenic area, is present.
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Hernia Diafragmática/diagnóstico , Hernias Diafragmáticas Congénitas , Trastornos Respiratorios/etiología , Compuestos de Bario , Niño , Preescolar , Tos/etiología , Diagnóstico Diferencial , Femenino , Hernia Diafragmática/complicaciones , Hernia Diafragmática/cirugía , Humanos , Lactante , Pulmón/diagnóstico por imagen , Masculino , Radiografía , TurquíaRESUMEN
In order to determine the efficiency of intranasal midazolam in prolonged convulsive episodes, we conducted a prospective study in children with various types of seizures. Nine patients (six boys, three girls; age range 6 months to 9 years) with prolonged convulsions lasting more than 10 min were treated with intranasal midazolam, 0.3 mg/kg. The success rate was 100% with only one case requiring a second dose. Estimated duration of seizures was 12-30 min (mean 18.6) while mean time elapsed until cessation of seizures was 139.6 s (range 60-480). No significant adverse effects were noted except for one patient who had seizures secondary to serious CNS infection and respiratory depression after intranasal midazolam.
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Midazolam/administración & dosificación , Convulsiones/tratamiento farmacológico , Administración Intranasal , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Midazolam/efectos adversos , Estudios Prospectivos , Convulsiones/clasificación , Convulsiones/diagnóstico , Factores de Tiempo , Resultado del TratamientoRESUMEN
In this study, 11,284 mg/m3 (2600 ppm) of xylene was administered for 8 hours a day to pregnant rats by means of inhalation, starting from the sixth day of their pregnancies. Furthermore, while a group of non-pregnant rats inhaled the same amount of xylene during the same period, the control group inhaled clean air. Consequently, in addition to the embryotoxic effects of xylene, the effects on the various tissues of the mothers and their litters were observed light and electron microscopes. No external anomalies were observed in any of the rats born at the end of the 21st day, and there were no macroscopic defects in their organs either. While following xylene inhalation no structural defects in the kidney and pancreas was found, expansions in the smooth endoplasmic reticulum of the liver tissues, increases in the lysosomes, and defective mitochondrion structures were found in the pregnant and non-pregnant rats. It was noticed that xylene in particular caused structural defects in the liver of the fetus. Compared to the control groups, increases were observed in the activities of the AST, ALT, ALP, and Arginase enzymes in the liver.