RESUMO
Lymphedema praecox, a type of primary lymphedema, becomes evident at puberty, occurs mostly in girls, and is usually confined to the lower extremities. Arms tend to be involved in either congenital or secondary lymphedema. We describe a unique localization in an 11-year-old girl who had primary lymphedema of the right hand and arm. The pertinent literature is reviewed.
Assuntos
Braço , Linfedema/diagnóstico , Criança , Feminino , Humanos , Linfedema/epidemiologia , PuberdadeRESUMO
Pseudoaneurysms of the extracranial vertebral artery are extremely rare due to their deep location and the anatomical protection of this artery. They can be caused by cervical traumas (firearm inhuries, sports, hyperextension of the neck and iatrogeny). The authors report the case of a patient who developed a giant pseudoaneurysm of the extracranial vertebral artery after surgery for the removal of a tumor of the cerebellopontine angle in which surgical lesion of the artery occurred. Treatment was performed by endovascular approach. Literature is reviewed and comments are made on the physiopathogeny of the lesion and the different forms of treatment.
Assuntos
Humanos , Masculino , Adulto , Falso Aneurisma/etiologia , Cisto Epidérmico/cirurgia , Complicações Pós-Operatórias , Artéria Vertebral , Falso Aneurisma/terapia , Angiografia , Cateterismo , Craniotomia/efeitos adversos , Tomografia Computadorizada de Emissão , Tomografia Computadorizada por Raios XRESUMO
We compared the clinical and bacteriologic response of 5-day treatment with cefixime, 8 mg/kg per day, with the response to trimethoprim-sulfamethoxazole (TMP-SMX), 10-50 mg/kg per day, the currently recommended therapy. Of the assessable children with acute, culture-proven shigellosis, 38 received cefixime and 39 received TMP-SMX. Pretreatment data on the two study groups were similar. In the first group, all isolates were susceptible to cefixime; in the TMP-SMX group, 32 isolates were resistant and 7 were susceptible to TMP-SMX. Clinical response (day 5) showed cure, improvement, and failure in 89%, 8%, and 3%, respectively, of the cefixime group, and in 25%, 44%, and 31%, respectively, of the TMP-SMX-resistant group (p < 0.001). Bacteriologic cure (day 3) occurred in 78% and 23% of the cefixime and TMP-SMX-resistant groups, respectively (p < 0.001). Clinical or bacteriologic relapse (day 12) was infrequent in both groups. The response to treatment of the cefixime and the TMP-SMX-susceptible groups was similar. No significant side effects were noted. We conclude that cefixime is superior to TMP-SMX in the treatment of suspected shigellosis in areas with a high rate of resistance to TMP-SMX.
Assuntos
Cefotaxima/análogos & derivados , Disenteria Bacilar/tratamento farmacológico , Shigella/efeitos dos fármacos , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Adolescente , Cefixima , Cefotaxima/uso terapêutico , Criança , Pré-Escolar , Diarreia Infantil/tratamento farmacológico , Diarreia Infantil/microbiologia , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Shigella boydii/efeitos dos fármacos , Shigella flexneri/efeitos dos fármacos , Shigella sonnei/efeitos dos fármacos , Resistência a TrimetoprimaRESUMO
In three young children a newly acquired clinical sign--the knee-chest position--was associated with increased intracranial pressure. This sign may serve as an additional marker to suggest increased intracranial pressure in young children.
Assuntos
Postura/fisiologia , Pseudotumor Cerebral/fisiopatologia , Astrocitoma/complicações , Neoplasias Encefálicas/complicações , Neoplasias Cerebelares/complicações , Pré-Escolar , Feminino , Humanos , Hidrocefalia/complicações , Lactente , Joelho , Glândula Pineal , Pseudotumor Cerebral/etiologia , TóraxRESUMO
A 52-year-old man who presented symptoms compatible with paraneoplastic limbic encephalopathy (PLE) was found to have small cell lung cancer. Antineoplastic therapy resulted in complete remission. Because the neuropsychiatric symptoms are potentially reversible, it is important to recognize these symptoms as a manifestation of malignancy so that treatment can be instituted.