RESUMEN
Hereditary angioedema (HAE) is characterized by potentially life-threatening recurrent episodes of oedema. The open-label extension (OLE) phase of the For Angioedema Subcutaneous Treatment (FAST)-1 trial (NCT00097695) evaluated the efficacy and safety of repeated icatibant exposure in adults with multiple HAE attacks. Following completion of the randomized, controlled phase, patients could receive open-label icatibant (30 mg subcutaneously) for subsequent attacks. The primary end-point was time to onset of primary symptom relief, as assessed by visual analogue scale (VAS). Descriptive statistics were reported for cutaneous/abdominal attacks 1-10 treated in the OLE phase and individual laryngeal attacks. Post-hoc analyses were conducted in patients with ≥ 5 attacks across the controlled and OLE phases. Safety was evaluated throughout. During the OLE phase, 72 patients received icatibant for 340 attacks. For cutaneous/abdominal attacks 1-10, the median time to onset of primary symptom relief was 1·0-2·0 h. For laryngeal attacks 1-12, patient-assessed median time to initial symptom improvement was 0·3-1·2 h. Post-hoc analyses showed the time to onset of symptom relief based on composite VAS was consistent across repeated treatments with icatibant. One injection of icatibant was sufficient to treat 88·2% of attacks; rescue medication was required in 5·3% of attacks. No icatibant-related serious adverse events were reported. Icatibant provided consistent efficacy and was well tolerated for repeated treatment of HAE attacks.
Asunto(s)
Angioedemas Hereditarios/tratamiento farmacológico , Bradiquinina/análogos & derivados , Adulto , Angioedemas Hereditarios/diagnóstico , Bradiquinina/administración & dosificación , Bradiquinina/efectos adversos , Bradiquinina/uso terapéutico , Antagonistas de los Receptores de Bradiquinina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Retratamiento , Resultado del Tratamiento , Adulto JovenRESUMEN
We describe the archeological and imaging findings of a unique specimen (skull and mandible) with leontiasis ossea (LO) that is on display in the National Museum of Anthropology and History in Mexico City. The specimen shows diffuse and irregular periosteal bone proliferation, which produces a grossly nodular appearance involving the neurocranium and the facial skeleton. Plain radiography and helical computed tomography revealed generalized hyperostosis obliterating the maxillary and sphenoidal sinuses and 2 exuberant bony masses arising from the maxilla with encroachment of the anterior nasal aperture.Currently, LO is a purely descriptive term applied to a variety of osseous conditions that have in common hyperostosis of craniofacial bones leading to a leonine appearance. Clinicians who see such lionlike facies should consider the main causes of LO, which include renal osteodystrophy, Paget disease and, as most likely in this specimen, fibrous dysplasia.
Asunto(s)
Antropología Física , Cefalometría , Displasia Fibrosa Ósea/complicaciones , Hiperostosis Frontal Interna/diagnóstico por imagen , Osteítis Deformante/complicaciones , Adulto , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/complicaciones , Femenino , Humanos , Hiperostosis Frontal Interna/etiología , México , Radiografía , CráneoRESUMEN
We report a case of hyperplastic callus formation that occurred in both femurs in a patient with type V osteogenesis imperfecta (OI), with 4-year follow-up and resolution. The clinical, histological and imaging aspects of this condition are discussed. Recognition of the hyperplastic callus formation in this particular type of OI is important in order to avoid misdiagnosis.
Asunto(s)
Callo Óseo/diagnóstico por imagen , Fémur , Osteogénesis Imperfecta/diagnóstico por imagen , Callo Óseo/patología , Preescolar , Diagnóstico Diferencial , Femenino , Neoplasias Femorales/diagnóstico por imagen , Fémur/diagnóstico por imagen , Fémur/patología , Humanos , Osteogénesis Imperfecta/patología , Osteosarcoma/diagnóstico por imagen , RadiografíaRESUMEN
A new sign of anterior cruciate ligament (ACL) tear based on secondary changes of the posterior cruciate ligament (PCL) is described. Thirty-one patients with magnetic resonance (MR) examinations of the knee suspicious for ACL injury and 50 normal controls were examined. In each patient a line was drawn adjacent and parallel to the posterior margin of the distal portion of the PCL and was extended proximally. A positive PCL line did not intersect the medullary cavity of the femur. A positive line correctly predicted ACL injury in 19 of 22 patients.
Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/patología , Imagen por Resonancia Magnética , Adolescente , Adulto , Anciano , Niño , Humanos , Traumatismos de la Rodilla/patología , Persona de Mediana EdadRESUMEN
The 256 skulls and 66 skull fragments of the pre-Columbian Peruvian Indians in the Hrdlicka archeologic collection were examined for a porous bone lesion known as porotic hyperostosis. The age, sex, and geographic distribution, as well as the severity and pattern of involvement of the skull bones were noted in an attempt to define the etiology and the pathogenesis of the lesion. Porotic hyperostosis of the skull was present in 20% of the specimens and was probably caused by marrow expansion on the basis of iron deficiency. The lesion was more prevalent and severe among coastal dwellers; men and women were equally affected, and the parietal and occipital bones were the most frequently involved sites. Severe cases were observed only in infants and children, presumably because of limited marrow space and a special predilection for iron deficiency in infants, and of healing of the lesion in adults. Radiographic abnormalities included thinning of the outer table of the skull, diploic space widening, and a "hair-on-end" appearance. Sixty percent of all cases and 100% of severe cases demonstrated one or more of these findings.
Asunto(s)
Exostosis/historia , Indígenas Sudamericanos/historia , Paleopatología , Cráneo/patología , Anemia Hipocrómica/historia , Exostosis/patología , Historia Antigua , Humanos , PerúRESUMEN
By using patient radiographs and pathologic specimens, the bicipital groove of the humerus was studied to determine the normal configuration and common abnormalities of this region. Factors analyzed in evaluating the bicipital groove included the medial wall angle, depth and width of the intertubercular sulcus, and presence or absence of bony spurs arising from the floor or medial wall of the groove. The supratubercular ridge was observed as an osseous protuberance in about one-half of the population; it does not seem to be of pathologic significance. A specific radiographic projection is described, which allows evaluation of the bicipital groove.
Asunto(s)
Húmero/diagnóstico por imagen , Historia Antigua , Humanos , Húmero/anomalías , Húmero/anatomía & histología , Paleopatología , Perú , Estudios Prospectivos , RadiografíaRESUMEN
A review of available radiographic and pathologic material revealed evidence that two distinct anatomical variations may be found on the posteromedial aspect of the distal femur. One, the femoral cortical irregularity, is a common finding on clinical radiographs, shows a definite predilection for children and adolescents, and is closely located to the site of attachment of tendinous fibers of the adductor magnus muscle. It is almost certainly related to stress, and can be associated with a degree of periosteal proliferation that simulates malignancy. In a study of prehistoric adult femoral specimens, the second lesion, the femoral cortical excavation, was a frequent finding. However, it appears to be less common in clinical radiology. It occurs at the osseous site of attachment of the medial head of the gastrocnemius, which supports a stress-related pathogenesis. Its relationship to fibrous cortical defects is not clear.