RESUMO
Ectopic pregnancy (EP), is the consequence of an abnormal implantation of the blastocyste. EP is frequently located in the tubal (95-98%); and is located in the ovary, 0.5-1%. It is presented the clinical pathological case of a 29 year-old woman, who showed acute abdominal symptoms at her arrival to emergency room. This diagnostic case made fulfilling the four pathological criteria described by Spielgelberg.
Assuntos
Ovário/ultraestrutura , Gravidez Ectópica/diagnóstico , Adulto , Feminino , Humanos , Ovário/cirurgia , Gravidez , Gravidez Ectópica/cirurgiaRESUMO
There were reviewed 145 cases of children in which hepatic biopsy was done at the Hospital Infantil del Estado de Sonora, from 1978 to 1990. The larger age group were infants and preschool children (74.3 percent) males being predominant; signs and symptoms were related with hepatic illness, as well as the admission diagnoses. The indication of biopsy was for confirmation of liver disease in more than 50 percent, 37.1 percent for unknown diagnoses and 20.6 percent to look for liver disease by a systemic illness. The most usual procedure was percutaneous biopsy with Vim-Silverman needle in 111 cases (76.5 percent), in 23 percent, the biopsy was done by major surgical method. Nine percent of the children needed open surgical method after percutaneous biopsy. The time from the admission to biopsy performance in patients with neonatal hepatitis vs biliary atresia was 14 days. In other type of illness the time was 25 days. The morbidity was 1 percent. There was no mortality. The histopathologic diagnosis of liver diseases was done in 96 cases (66.7 percent) by this method in 31 children (21.3 percent) with investigation of jaundice (neonatal hepatitis vs biliary atresia). The diagnostic mistake in tissues obtained by percutaneous needle, was statistically significant (p < 0.05). Average hospitalization stay was less than two months in 70 percent of the cases.
Assuntos
Biópsia por Agulha , Hepatopatias/patologia , Fígado/patologia , Adolescente , Biópsia por Agulha/instrumentação , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos RetrospectivosRESUMO
The authors describe the results of five pediatric patients with nonmetastatic osteosarcoma of an extremity, admitted from 1987 to 1989 to the Hospital Infantil del Estado de Sonora. Four patients presented with their primary tumor located at the distal end of the femur, whereas one had a primary lesion of the humerus. All of them received preoperative chemotherapy consisted of two cycles of cisplatin and adriamycin. One of the patients presented immediate complications after first cicle and died due to overwhelming sepsis by Candida albicans. Surgery was an amputation in one patients and block ressection in three cases. Necrosis was good in three cases, fair in one. Postoperative chemotherapy consisted of bleomycin, cyclophosphamide and dactinomycin every four weeks alternated with cisplatin plus adriamycin. One of the three patients, in which block ressection was made, had a local recurrence 12 months after diagnosis, without metastasis. He underwent desarticulation and died four months later of leukoencephalopathy and no tumor was found on necropsy. Three patients have remained continuously free of disease with follow up of 20, 26 and 31 months after diagnosis and are out of chemotherapy since 5, 12 and 17 months, respectively. In two of them the affected extremity still is safe.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Osteossarcoma/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Ósseas/cirurgia , Criança , Terapia Combinada , Humanos , Osteossarcoma/cirurgia , Cuidados Pós-Operatórios , Pré-MedicaçãoRESUMO
Se informa el caso de un adolescente de 14 anos de edad que ingreso al Hospital del Nino del Noroeste DIF, por presentar cuadro clinico y bioquimico de insuficiencia renal aguda, estableciendose el diagnostico de leucemia un dia antes de su fallecimiento. El estudio postmortem revelo crecimiento renal bilateral por infiltracion de celulas leucemicas. Se describe el caso en sus aspectos clinicos; de laboratorio y anatomopatologicos mas sobresalientes ademas se enfatiza la necesidad de hacer diagnostico diferencial con leucemia ante un paciente con insuficiencia renal aguda y pancitopenia periferica
Assuntos
Adolescente , Humanos , Masculino , Injúria Renal Aguda , Leucemia Linfoide , LinfomaRESUMO
Se analizaron 40 casos de muerte extrahospitalaria en el Hospital del Nino DIF del Noroeste, en Hermosillo, Sonora, de abril de 1978 a marzo de 1981, habiendose encontrado un caso de muerte subita inexplicable. Se reinterrogo a los familiares de 16 de los caso y en la mayoria se encontraron datos premonitorios como insuficiencia respiratoria, rechazo al alimento, vomito frecuente, epistaxis, hematemesis y convulsiones, que de haber sido detectados a tiempo, muy probablemente hubieran contribuido a evitar el deceso. Se enfatiza la importancia de la autopsia en todos los casos de muerte extrahospitalaria
Assuntos
Recém-Nascido , Lactente , Pré-Escolar , Humanos , Masculino , Feminino , Morte Súbita do Lactente , Edema Encefálico , ChoqueRESUMO
La hemosiderosis pulmonar idiopatica (HPI) es una entidad clinica de presentacion poco frecuente; tiene estigmas clinicos que en el curso de su evolucion pocas veces tomamos en cuenta, a pesar de que estos son senalados insistentemente en las diversas publicaciones de la literatura medica; nos referimos basicamente a la presencia de tos cronica, anemia hipocromica ferropenica, disnea, expectoracion hemoptoica e infiltrado pulmonar difuso, con imagenes de condensacion del espacio aereo, rapidamente cambiantes y evolucion a fibrosis intersticial.Esta situacion nos motivo a revisar el numero de casos existentes en el Hospital del Nino del Noroeste DIF, en sus primeros cinco anos de labores (1977-1982). Encontramos tres casos de pacientes que reunieron los requisitos minimos para catalogarlos bajo el diagnostico de HPI, descartandose previamente patologias tales como cardiopatias congenitas, lupus eritematoso, anemias hemoliticas talasemias e infecciones cronicas. En este trabajo informamos los rasgos mas sobresalientes, sobre evolucion, estudios para diagnostico y tratamiento, a la vez sue se vierten los conceptos mas aceptables acerca de la etiopatogenia
Assuntos
Pré-Escolar , Adolescente , Humanos , Feminino , Hemossiderose , Prednisona , Fibrose PulmonarRESUMO
Se revisaron los expedientes clinicos de cinco pacientes con coccidioidomicosis meningea, internados en el Hospital del Nino del Noroeste DIF. La edad de los pacientes vario de cuatro meses a 13 anos, todos eran residentes de area endemica y cursaron con sintomatologia neurologica cronica y vaga. El diagnostico etiologico no fue posible establecerlo en base a los hallazgos clinicos, radiologicos ni aun con las alteraciones descritas en el estudio citoquimico del liquido cefalorraquideo, por lo que fue necesario realizar pruebas inmunologicas especificas en este y buscar intencionadamente el hongo para llegar al diagnostico de certeza. El tratamiento en tres de los casos fue medicoquirurgico mediante la administracion de anfotericina B intravenosa e intratecal y colocacion de reservorio subcutaneo craneal y/o derivacion ventriculoperitoneal. La respuesta al tratamiento fue mala, interviniendo varios factores para ello, principalmente la tardanza para establecer la etiologia del padecimiento. De los casos tratados, un solo paciente vive (33%); no ha presentado recaidas y lleva una vida normal. Se concluye que la coccidioidomicosis meningea no es rara en areas endemicas, debiendose investigar en todos aquellos pacientes con manifestaciones neuropsiquiatricas de evolucion prolongada y que residan en dichas areas, ya que la tardanza en su diagnostico se acompana de una alta morbilidad y letalidad. Coccidioidomicosis meningea
Assuntos
Lactente , Pré-Escolar , Criança , Humanos , Masculino , Feminino , Coccidioidomicose , Meningite , Anfotericina B , Líquido CefalorraquidianoRESUMO
The case of a 3 month old child with severe combined sex linked immunodeficiency is presented. The diagnosis was well doccumented, during his life. The child presented as a case of mucocutaneous moniliasis resistant to treatment. There was a history of similar cases in the family; diagnosis was made at post-mortem in one cousin and death occurred at early age in all kins so affected. Blood marrow transplant was not feasible in our case because histocompatibility was lacking in the kins studied. Three units of transfer factor were given as well as hyperimmune plasma but the child died in respiratory failure. Autopsy demonstrated pulmonary infection by Pneumocystic carinii and generalized citomegalic inclussion virus infection; almost complete absence of immune tissue was also demonstrated.