RESUMEN
It can be challenging to determine which findings are associated with focal infiltrates in young wheezing children. A prospective study of wheezing children < or = 18 months of age revealed focal infiltrates on chest radiograph in 23%. By use of multivariate analysis, findings significantly associated with focal infiltrates included grunting (OR 4.1, 95% CI, 2.0, 8.6) and oxygen saturation < or = 93% (OR 2.2, 95% CI, 1.1, 4.8); with a sensitivity and specificity of 12.5% and 97%, respectively. Variables not associated with focal infiltrates included first-time wheezing, fever, and tachypnea. The combination of grunting and oxygen saturation < or = 93% is highly specific and can be used to help diagnose pneumonia in wheezing infants and toddlers.
Asunto(s)
Pulmón/diagnóstico por imagen , Neumonía/diagnóstico por imagen , Ruidos Respiratorios/etiología , Femenino , Humanos , Lactante , Pulmón/patología , Masculino , Análisis Multivariante , Oxígeno/metabolismo , Neumonía/complicaciones , Neumonía/patología , Estudios Prospectivos , Radiografía , Factores de Riesgo , Sensibilidad y Especificidad , Rayos XAsunto(s)
Bienestar del Animal , Animales de Laboratorio , Animales , Animales Domésticos , Educación MédicaRESUMEN
A patient with an unusual variant of Sweet's syndrome, in which the course of the disease was chronic and relapsing, was treated successfully with intravenous methylprednisolone (pulse therapy). Remission was then maintained with oral chlorambucil.
Asunto(s)
Clorambucilo/uso terapéutico , Fiebre , Metilprednisolona/uso terapéutico , Neutrófilos , Enfermedades de la Piel/tratamiento farmacológico , Biopsia , Clorambucilo/administración & dosificación , Enfermedad Crónica , Dermatitis , Femenino , Humanos , Metilprednisolona/administración & dosificación , Persona de Mediana Edad , Neutrófilos/patología , Prednisona/uso terapéutico , Psicosis Inducidas por Sustancias/etiología , Recurrencia , Enfermedades de la Piel/patología , SíndromeRESUMEN
Neonatal lupus erythematosus (LE) is a syndrome that is manifested by LE skin lesions and/or congenital heart block, occurring in infants at, or shortly after, birth. The syndrome is believed to be caused by transplacental passage of an IgG antibody, usually the anti-Ro (SS-A) antibody, from the mother to the infant. Although the mother may have a connective tissue disease or may be healthy, the common characteristic is the presence of maternal circulating anti-Ro antibody. It has been believed that the HLA determinants demonstrated in children who have neonatal LE were not a factor in the expression of the syndrome. We report the occurrence of neonatal LE, manifested by photosensitivity and discoid LE skin lesions, in one fraternal twin. HLA studies of this affected twin demonstrated the presence of DR3. Anti-Ro antibody was present in the mother, but was not present in either child at 4 months post-delivery. HLA determinants may be involved in the expression of disease in neonates who have been exposed to the anti-Ro antibody. Furthermore, the presence of circulating antibodies in the unaffected twin causes us to question the assumption that the anti-Ro antibody is the causative factor for the occurrence of tissue injury in children with neonatal LE.
Asunto(s)
Enfermedades en Gemelos/congénito , Lupus Eritematoso Sistémico/congénito , Adulto , Enfermedades en Gemelos/inmunología , Epítopos , Femenino , Antígenos HLA/inmunología , Prueba de Histocompatibilidad , Humanos , Lactante , Lupus Eritematoso Sistémico/genética , Lupus Eritematoso Sistémico/inmunología , Masculino , LinajeAsunto(s)
Argiria/patología , Piel/patología , Anciano , Argiria/etiología , Humanos , Masculino , Nitrato de Plata/efectos adversosRESUMEN
An elderly patient is presented who developed a fatal angiosarcoma of the hip about ten years after surgery and radiation for a uterine malignancy. She developed a metastasis of the uterine tumor, requiring additional radiation, which led to aseptic necrosis of the hip and chronic joint and soft tissue infection of the hip from a joint prosthesis. Subsequently she developed chronic lymphedema of the hip and finally the cutaneous angiosarcoma in this area. Any or all of these factors might bear a causative relationship to the angiosarcoma, but none can be proved.