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Sample records for intersticial pulmonar unilateral

  1. Tratamiento del enfisema intersticial pulmonar unilateral con ventilación monopulmonar contralateral: Presentación de 1 caso

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    González Alonso, María Victoria; Mesa Riquelme, . Luis Antonio; Domínguez Dieppa, Fernando; Porto Rodríguez, Aida Silvia

    1998-01-01

    Se presenta el caso de un recién nacido de 750 g de peso y 27 semanas de edad gestacional, que durante su evolución en la asistencia respiratoria mecánica, presentó enfisema intersticial pulmonar a tensión en el pulmón derecho, el cual producía desplazamiento mediastinal y pobre aereación del pulmón izquierdo. La subsecuente hipercapnia hizo fracasar todos los intentos de disminuir la presión inspiratoria en la vía aérea proximal y el enfisema intersticial fue empeorando. A los 6 días de vida...

  2. Enfermedad pulmonar intersticial asociada a rituximab

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    Marcelo Fernández Casares

    2013-08-01

    Full Text Available La introducción en la práctica clínica del anticuerpo anti-CD20 rituximab ha mejorado sustancialmente el pronóstico de diversas enfermedades autoinmunes y hematológicas. Con el incremento de su uso ha aumentado el registro de efectos adversos, entre ellos la toxicidad pulmonar. Una de sus complicaciones más serias es la enfermedad pulmonar intersticial, entidad potencialmente fatal que debe ser considerada en pacientes que han recibido rituximab y presentan disnea, fiebre y tos sin clara evidencia de infección. Presentamos un caso de enfermedad pulmonar intersticial asociada a rituximab.

  3. Tratamiento del enfisema intersticial pulmonar unilateral con ventilación monopulmonar contralateral: Presentación de 1 caso

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    María Victoria González Alonso

    1998-06-01

    Full Text Available Se presenta el caso de un recién nacido de 750 g de peso y 27 semanas de edad gestacional, que durante su evolución en la asistencia respiratoria mecánica, presentó enfisema intersticial pulmonar a tensión en el pulmón derecho, el cual producía desplazamiento mediastinal y pobre aereación del pulmón izquierdo. La subsecuente hipercapnia hizo fracasar todos los intentos de disminuir la presión inspiratoria en la vía aérea proximal y el enfisema intersticial fue empeorando. A los 6 días de vida se decide realizar intubación selectiva del bronquiotronco izquierdo y mantener al paciente con ventilación monopulmonar izquierda durante 36 horas. Al recolocar el tubo en la tráquea y reexpandirse el pulmón derecho, se observó una disminución notable del enfisema intersticial pulmonar y una mejoría gasométrica importante que permitió reducir la intensidad del apoyo ventilatorio. El paciente falleció posteriormente durante una enteritis necrosante.It is presented a case of a newborn of 750 g of weight and 27 weeks of gestational age that during his evolution in the mechanical respiratory assistance had a pulmonary interstitial emphysema on stress in the right lung, which produced mediastinal displacement and poor airing of the left lung. The subsequent hypercapsia made all the attempts to reduce the inspiratory pressure in the proximal air passage fail and therefore, the interstitial emphysema got worse. After the 6th day of life, it was decided to carry out selective intubation of the left bronchial trunk and to mantain the patient with left monopulmonary ventilation during 36 hours. On placing the tube into the trachea again, the right lung reexpanded and it was observed a remarkable decrease of the pulmonary interstitial emphysema and an important gasometric improvement that allowed to reduce that intensity of the ventilatory support. The patient died later due to a necrotizing enteritis.

  4. Enfermedad pulmonar intersticial difusa en trabajadores de la limpieza

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    Bravo Graterol, Ricardo Alejandro

    2011-01-01

    En este trabajo se describen las características de 5 trabajadores de la limpieza que fueron diagnosticados de enfermedad pulmonar intersticial difusa no aguda de causa desconocida mediante biopsia pulmonar quirúrgica. La edad media fue de 64 años y 4 fueron mujeres. Las exposiciones más frecuentes fueron el salfumán y lejía, y ninguno de los pacientes utilizó protección adecuada. Las características más llamativas de estos pacientes se observaron en la TACAR y la histopatología que mostraron...

  5. Agenesia pulmonar unilateral

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    Malcon,Maura Cavada; Malcon,Claudio Mattar; Cavada,Marina Neves; Caruso,Paulo Eduardo Macedo; Real,Lara Flório

    2012-01-01

    A agenesia pulmonar é uma anomalia congênita rara. Relatamos um caso de um menino de 8 anos de idade com agenesia pulmonar à esquerda sem associação com outras malformações. O diagnóstico foi realizado por achados de imagem quando o paciente apresentou sintomas como tosse, sibilância e dispneia sem melhora do quadro clínico após evolução de 30 dias.

  6. Agenesia pulmonar unilateral Unilateral pulmonary agenesis

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    Maura Cavada Malcon; Claudio Mattar Malcon; Marina Neves Cavada; Paulo Eduardo Macedo Caruso; Lara Flório Real

    2012-01-01

    A agenesia pulmonar é uma anomalia congênita rara. Relatamos um caso de um menino de 8 anos de idade com agenesia pulmonar à esquerda sem associação com outras malformações. O diagnóstico foi realizado por achados de imagem quando o paciente apresentou sintomas como tosse, sibilância e dispneia sem melhora do quadro clínico após evolução de 30 dias.Pulmonary agenesis is a rare congenital anomaly. We report the case of an 8-year-old boy with left lung agenesis, without any other congenital mal...

  7. Agenesia pulmonar unilateral Unilateral pulmonary agenesis

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    Maura Cavada Malcon

    2012-08-01

    Full Text Available A agenesia pulmonar é uma anomalia congênita rara. Relatamos um caso de um menino de 8 anos de idade com agenesia pulmonar à esquerda sem associação com outras malformações. O diagnóstico foi realizado por achados de imagem quando o paciente apresentou sintomas como tosse, sibilância e dispneia sem melhora do quadro clínico após evolução de 30 dias.Pulmonary agenesis is a rare congenital anomaly. We report the case of an 8-year-old boy with left lung agenesis, without any other congenital malformations. When the patient presented symptoms, including cough, wheezing, and dyspnea, with no clinical improvement after a period of 30 days, imaging studies were conducted and the diagnosis was made.

  8. Doença pulmonar intersticial associada a bronquiolite respiratória Respiratory bronchilitis-associated interstitial lung disease

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    Sílvia CS. Rodrigues

    2004-12-01

    Full Text Available A doença pulmonar intersticial associada a bronquiolite respiratória faz parte do espectro anatomopatológico das lesões pulmonares infiltrativas difusas induzidas pela fumaça de cigarro. Raramente tem apresentação clínico-funcional exuberante. Descrevemos dois casos diagnosticados por biópsia pulmonar aberta, caracterizados por dispnéia de evolução insidiosa, baqueteamento digital, lesões císticas à tomografia computadorizada e hipoxemia ao exercício. Enfatizamos considerar, em indivíduos tabagistas, a doença pulmonar intersticial associada a bronquiolite respiratória no contexto das pneumopatias intersticiais císticas, juntamente com a linfangioleiomiomatose, o granuloma eosinofílico e a fibrose pulmonar idiopática.Respiratory bronchiolitis-associated interstitial lung disease is one of many within the spectrum of smoking-related diffuse infiltrative lung diseases. The clinical and functional characteristics are typically subtle. Herein, we describe two cases of diagnosed through open-lung biopsy, and characterized by insidious evolution of dyspnea, digital clubbing, cystic lesions on computed tomography scans, and hipoxemia upon exertion. We emphasize that, when smokers are evaluated, it is imprtant to consider a diagnosis of respiratory bronchiolitis-associated interstitial lung disease in the context of interstitial cystitis, as well as in that of lymphangioleiomyomatosis, eosinophilic granuloma and idiophatic pulmonary fibrosis.

  9. Biopsia en enfermedad intersticial pulmonar Lung biopsy for the diagnosis of interstitial lung disease

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    Silvia Quadrelli

    2007-12-01

    Full Text Available El objetivo del presente estudio fue determinar el rédito diagnóstico y los factores asociados a mayor morbimortalidad en la biopsia quirúrgica de pulmón en pacientes con enfermedad intersticial difusa. Se analizaron en forma retrospectiva los registros clínicos de 71 pacientes. Se registraron complicaciones en 16 pacientes (22.5%. La mortalidad operatoria fue 11.2%. Los pacientes en quienes la biopsia se realizó por videotoracoscopia (n = 52 y por toracotomía (n = 17 tuvieron la misma duración de estadía en terapia intensiva y de estadía hospitalaria. La tasa de complicaciones (22.2% vs. 21.0%, p = 1.0000 y la mortalidad (9.2 vs. 15.7%, p = 0.2738 no fueron diferentes. Ocho pacientes murieron dentro de los 30 días. La prevalencia de inmunosupresión (4/8 vs. 9/63, p = 0.0325 fue significativamente superior en el grupo de pacientes fallecidos. Estos pacientes tuvieron valores preoperatorios más elevados de urea (50 ± 20.1 mg/dl vs. 31.2 ± 10.3 mg/ dl, p = 0.0013 y menores valores de saturación de O2: 82.7 ± 14.8% vs. 92.8 ± 3.4%, p = 0.0009. En los 11 pacientes con iniciación aguda la mortalidad fue significativamente más elevada (36.3% vs. 7.1%, p = 0.0223. La biopsia aportó un diagnóstico específico en 100% de los pacientes y cambió la estrategia terapéutica en 66.7%. En conclusión, la biopsia de pulmón por vía toracoscópica es un procedimiento útil y seguro en los pacientes con enfermedad intersticial difusa del pulmón. Sin embargo, en el grupo de pacientes inmunocomprometidos, con cuadros de presentación aguda y con insuficiencia respiratoria preoperatoria, la mortalidad es elevada y deben balancearse muy críticamente los riesgos contra los beneficios en ese grupo de enfermos.The objective of this study was to determine the morbidity, mortality and diagnostic yield of video assisted thoracoscopy (VATS and thoracotomy lung biopsy in interstitial lung disease (ILD. Clinical records of 71 patients were

  10. ¿Hay un rol para los agentes biológicos en el tratamiento de la patología pulmonar intersticial asociada a enfermedades del tejido conectivo?

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    Quadrelli, Silvia; Dubinsky, Diana; Alvarez, Sabrina

    2016-01-01

    Excepto en la esclerodermia, no hay ensayos clínicos controlados válidos para guiar la decisión de tratamiento en enfermedad pulmonar intersticial asociada a enfermedades del tejido conectivo (EPID-ETC). Los únicos dos estudios randomizados, controlados, publicados en pacientes con esclerodermia, mostraron un beneficio modesto pero significativo del uso de ciclofosfamida, y la transformaron en el esquema más convencional de tratamiento de toda la EPID-ETC. Los tratamientos iniciales aceptados...

  11. Doença pulmonar intersticial crônica na criança Chronic interstitial lung disease in children

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    Maria Aparecida S. S. Paiva

    2007-06-01

    Full Text Available OBJETIVOS: Descrever aspectos clínicos, diagnósticos e resultados de conduta terapêutica em um grupo de pacientes pediátricos com doença pulmonar intersticial crônica.Métodos: Estudo retrospectivo de 25 pacientes imunocompetentes, de 2 meses a 17 anos, com doença pulmonar intersticial crônica, internados no Setor de Pneumologia, Serviço de Pediatria do Hospital dos Servidores do Estado, por um período de 20 anos (1984-2004. Seguiu-se protocolo para pneumopatias crônicas persistentes e selecionaram-se os casos de doença intersticial. Foram avaliados aspectos clínicos, laboratoriais e de imagem, diagnóstico final e tratamento. RESULTADOS: Vinte e cinco pacientes tiveram diagnóstico de doença pulmonar intersticial crônica, 13 menores de 2 anos e 17 do sexo masculino. O diagnóstico foi realizado pela história, exame físico e exames de rotina em um paciente, por exames mais complexos em três pacientes e por exames invasivos em 21 pacientes (20 por biópsia e um por lavado broncoalveolar. Com exceção do paciente com linfangiectasia pulmonar, o tratamento consistiu de corticoterapia, em seis casos associada à hidroxicloroquina e foi prolongado (1 a 7 anos. Quatro pacientes necessitaram oxigenoterapia domiciliar. Foram realizadas de seis a oito consultas de acompanhamento/ano pelas autoras. Evolução dos pacientes: boa (15; regular, com seqüela leve (4; ruim, com seqüela grave (3; dois óbitos e um perdido. CONCLUSÃO: As doenças pulmonares intersticiais crônicas constituem um grupo raro, porém relevante dentre as pneumopatias crônicas na criança, em razão da possível evolução para fibrose pulmonar. São importantes para a evolução o diagnóstico oportuno e o acompanhamento especializado e prolongado do paciente. Os pediatras devem ser alertados, pois certamente muitos casos não são diagnosticados nem tratados adequadamente.OBJECTIVES: To describe clinical and diagnostic features and the results of therapeutic

  12. Doença pulmonar intersticial relacionada a miosite e a síndrome antissintetase Myositis-related interstitial lung disease and antisynthetase syndrome

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    Joshua Solomon

    2011-02-01

    Full Text Available Em pacientes com miosite, é comum o comprometimento pulmonar, e a presença de anticorpos anti-aminoacil-RNAt sintetase (anti-ARS é preditora da presença ou do desenvolvimento de doença pulmonar intersticial (DPI. Uma entidade clínica distinta - a síndrome antissintetase - é caracterizada pela presença de anticorpos anti-ARS, miosite, DPI, artrite, fenômeno de Raynaud e "mãos de mecânico". O mais comum anticorpo anti-ARS é o anti-Jo-1. Anticorpos anti-ARS mais recentemente descritos podem conferir um fenótipo que é distinto daquele de pacientes com positividade para anti-Jo-1, sendo caracterizado por uma menor incidência de miosite e uma maior incidência de DPI. Nos pacientes com DPI relacionada à síndrome antissintetase, a resposta a medicações imunossupressoras é em geral favorável.In patients with myositis, the lung is commonly involved, and the presence of anti-aminoacyl-tRNA synthetase (anti-ARS antibodies marks the presence or predicts the development of interstitial lung disease (ILD. A distinct clinical entity-antisynthetase syndrome-is characterized by the presence of anti-ARS antibodies, myositis, ILD, fever, arthritis, Raynaud's phenomenon, and mechanic's hands. The most common anti-ARS antibody is anti-Jo-1. More recently described anti-ARS antibodies might confer a phenotype that is distinct from that of anti-Jo-1-positive patients and is characterized by a lower incidence of myositis and a higher incidence of ILD. Among patients with antisynthetase syndrome-related ILD, the response to immunosuppressive medications is generally, but not universally, favorable.

  13. Doença intersticial pulmonar em doentes com artrite reumatóide: comparação com a alveolite fibrosante criptogénica

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    B.A. Rajasekaran

    2002-09-01

    interstício na AR estava estimada em 5%, contudo a TAC torácica de alta resolução veio a revelar uma prevalência superior a 20%, apresentando nas conectivopatias uma boa correlação com a biópsia pulmonar cirúrgica.A história natural da fibrose na AR não está bem definida, existindo alguns estudos que sugerem um melhor prognóstico em relação às fibroses idiopáticas.Neste estudo não foram encontradas diferenças estatisticamente significativas do ponto de vista clínico ou funcional respiratório, sendo porém mais frequente o hipocratismo digital em doentes com fibrose pulmonar sem AR, o que está de acordo com outras séries. Nenhum doente com AR nesta série tinha sido medicado com metotrexato, excluindo-se assim este factor de risco de fibrose apontado noutros estudos.A distribuição mais periférica das lesões intersticiais observada na TAC parece influenciar positivamente o prognóstico da doença. Não são conhecidas diferenças histológicas ou funcionais respiratórias que caracterizem as fibroses pulmonares idiopáticas ou associadas a conectivopatias. Contudo, a progressão da DIP na esclerodermia é seguramente mais lenta do que nas AFC e parece estar a surgir a mesma evidência em relação à AR, faltando ainda estudos que o confirmem com rigor.O eventual efeito protector de fibrose pulmonar atribuído ao Factor Reumatóide na AR é contrariado noutros trabalhos em que se verificou exactamente o contrário. Também este estudo não distingue as DIP na AR em pneumonite intersticial usual (UIP e não específica (NSIP que, como se sabe, tem prognósticos diferentes mesmo nas conectivopatias. Salienta-se que a prevalência e prognóstico das UIP e NSIP nas conectivites permanece por definir. Palavras-chave: artrite reumatóide, alveolite fibrosante criptogénica, Key-Words: rheumatoid arthritis, cryptogenic fibrosing alveolitis

  14. Autopsy-proven causes of death in lungs of patients immunocompromised by secondary interstitial pneumonia Causas de óbito por pneumonia intersticial secundária em autópsias pulmonares de pacientes imunocomprometidos

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    Alberto Antonio Terrabuio Junior

    2007-02-01

    thromboembolism was associated with an appreciable risk of death (OR = 2.4 in patients with arterial hypertension. The risk of death was also high in patients presenting hepatic cancer (OR = 2.5 or steroid therapy (OR = 2.4 who developed pulmonary hemorrhage as the histological pattern of secondary interstitial pneumonia . The risk of death by lung metastasis was also elevated (OR = 1.6 for patients that were immunosuppressed after radiotherapy. CONCLUSION: Patients with secondary immunosuppression who developed secondary interstitial pneumonia during treatment in hospital should be evaluated to avoid death by diffuse alveolar damage, pulmonary edema, bronchopneumonia, lung hemorrhage, pulmonary thromboembolism, or lung metastasis. The high-risk patients are those immunosuppressed by hematologic disease; those under steroid treatment; or those with colon or hepatic carcinoma, cachexia, or arterial hypertension.OBJETIVO: Apresentar as associações mais freqüentes encontradas em autópsias de pacientes imunossuprimidos que desenvolveram pneumonia intersticial secundária bem como o risco de óbito (Odds Ratio de desenvolver PIS associada à causa da imunossupressão. MÉTODO: De janeiro de 1994 a março de 2004, 17000 autópsias foram realizadas no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A partir da revisão dos laudos patológicos foram selecionados 558 destas autópsias (3,28% de pacientes com 15 anos de idade ou mais, com alguma doença de base que desenvolveu um infiltrado pulmonar radiologicamente difuso durante o curso da hospitalização e que depois foi para óbito com pneumonia intersticial secundária (broncopneumonia, pneumonia lobar, pneumonia intersticial, dano alveolar difuso, doença pulmonar recorrente, doença pulmonar induzida por drogas, edema pulmonar cardiogênico e embolismo pulmonar. As lâminas histológicas foram revisadas por patologistas experientes para confirmar ou não a presença de pneumonia intersticial

  15. Avaliação de parâmetros histológicos na pneumonia intersticial usual (fibrose pulmonar idiopática Evaluation of the histological parameters in usual interstitial pneumonia (idiopathic pulmonary fibrosis

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    RIMARCS GOMES FERREIRA

    2000-12-01

    Full Text Available A fibrose pulmonar idiopática (alveolite fibrosante criptogênica é uma doença pulmonar intersticial progressiva de etiologia desconhecida, morfologicamente reconhecida como pneumonia intersticial usual. Desde a publicação de Hamman e Rich (1944 até os dias atuais, uma das grandes preocupações foi a tentativa de encontrar um marcador histológico para correlacionar com prognóstico e resposta terapêutica. A busca desta situação não tem sido muito alentadora, pois existem vários pontos duvidosos na patogênese desta doença. Admite-se que a resposta terapêutica desta entidade se relaciona com a celularidade e fibrose presentes no tecido. A proposta deste estudo é descrever os resultados de método semiquantitativo segundo a avaliação independente de dois patologistas, das alterações exsudativo-inflamatórias, reparativo-fibróticas e de vias aéreas, em 24 pacientes com diagnóstico de fibrose pulmonar idiopática, submetidos à biópsia a céu aberto. Foram analisados 14 parâmetros histológicos segundo escala de 0 a 5 para as alterações intersticiais e de 0 a 2 para o comprometimento de vias aéreas e de espaços aéreos. Da análise independente realizada pelos dois observadores constatou-se concordância significante em todas as variáveis histológicas com Kw (teste de Kappa indo de 0,47 a 0,92. Apenas na análise da intensidade da inflamação septal as discordâncias também foram significantes, sugerindo que para este parâmetro a percentagem de comprometimento tecidual deve ser previamente discutida entre os observadores. O método utilizado demonstrou ser rápido e eficiente.Idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis is a progressive interstitial pulmonary disease of unknown etiology. Since Hamman's and Rich's (1944 reports, many studies have tried to find a histological marker for the correlation between prognosis and response to therapy. However, there are many doubts regarding pathogenesis

  16. Análise semiquantitativa de biópsias cirúrgicas de diferentes lobos pulmonares de pacientes com pneumonia intersticial usual/fibrose pulmonar idiopática Semiquantitative analysis of surgical biopsies of distinct lung lobes of patients with usual interstitial pneumonia/idiopathic pulmonary fibrosis

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    José Júlio Saraiva Gonçalves

    2009-07-01

    Full Text Available OBJETIVO: Avaliar as diferenças histológicas da pneumonia intersticial usual entre biópsias cirúrgicas de lobos pulmonares distintos, utilizando um escore semiquantitativo. MÉTODOS: Foram selecionados todos os pacientes com o diagnóstico de fibrose pulmonar idiopática e submetidos à biópsia cirúrgica em dois lobos distintos no Hospital São Paulo e em hospitais afiliados da Universidade Federal de São Paulo, no período entre 1995 e 2005. Foi utilizado um método semiquantitativo na avaliação histológica dos espécimes, com base em estudos prévios, aplicando-se um escore para cada local submetido à biópsia. RESULTADOS: Nenhuma diferença estatisticamente significante foi encontrada nesta amostra de pacientes que viesse alterar o estágio da doença, com base no escore utilizado. Este achado foi independente do local da biópsia (lobo médio ou segmento lingular. CONCLUSÕES: Não foram observadas diferenças histológicas significantes entre os lobos pulmonares estudados. O diagnóstico histológico definitivo de pneumonia intersticial usual não alterou o estágio da doença.OBJECTIVE: To evaluate the differences between surgical biopsies of distinct lung lobes in terms of the histopathological features of usual interstitial pneumonia, using a semiquantitative score. METHODS: We selected all of the patients diagnosed with idiopathic pulmonary fibrosis and submitted to surgical biopsy in two distinct lobes between 1995 and 2005 at the Hospital São Paulo and other hospitals operated by the Federal University of São Paulo. In the histological evaluation of the specimens, we used a semiquantitative method based on previous studies, assigning a score to each of the biopsied sites. RESULTS: In this sample of patients, we found no statistically significant differences that would alter the stage of the disease, based on the score used. This finding was independent of the biopsy site (middle lobe or lingular segment. CONCLUSIONS: No

  17. Pneumonite intersticial crónica

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    Rui Almeida

    2004-05-01

    Full Text Available RESUMO: A patologia pulmonar intersticial compreende um grupo de doenças crónicas caracterizadas por alterações das paredes alveolares e perda das unidades funcionais alveolocapilares. São doenças raras nas crianças, na sua maioria de causa desconhecida e revestindo-se habitualmente de uma elevada morbimortalidade, dada a pouca eficácia da terapêutica actualmente disponível.Os autores descrevem o caso clínico de uma criança de 3 anos, previamente saudável, que no contexto de uma infecção respiratória desenvolve um quadro de sibilância e insuficiência respiratória grave, na investigação do qual é diagnosticada uma pneumonite intersticial crónica. Foram tentadas diversas terapêuticas (corticoterapia sistémica, hidroxicloroquina, N-acetilcisteína sem melhoria evidente.REV PORT PNEUMOL 2004; X (3: 243-251 ABSTRACT: Interstitial lung disease includes a group of chronic diseases characterized by alterations in alveolar walls and loss of functional alveolar-capillary units. These are rare diseases in children, mostly with an unknown cause and associated with a high morbidity and mortality due to insufficient therapeutic effectiveness.The authors report a case of a previously healthy 3 years old child who presented with wheezing and severe respiratory insufficiency following a respiratory infection. The investigation performed led to the diagnosis of chronic interstitial pneumonitis. Several treatments have been tried (corticosteroids, hydroxychloroquine, N-acetylcysteine without any obvious improvement.REV PORT PNEUMOL 2004; X (3:243-251 Palavras-chave: pneumonite intersticial, sibilância, doença pulmonar crónica, crianças, Key-words: interstitial pneumonitis, wheezing, chronic pulmonary disease, children

  18. Unilateral pulmonary veins atresia: evaluation by computed tomography; Atresia unilateral das veias pulmonares: avaliacao por tomografia computadorizada

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    Eifer, Diego Andre; Arsego, Felipe Veras, E-mail: felipesoarestorres@gmail.com [Hospital de Clinicas de Porto Alegre (HCPA), RS (Brazil). Serv. de Radiologia; Torres, Felipe Soares [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Escola de Medicina

    2013-11-15

    Unilateral pulmonary vein atresia is a rare congenital condition. In addition to cardiac malformations or pulmonary hypertension, patients may present with recurrent pulmonary infections or hemoptysis in childhood or adolescence. The authors report a case where the typical findings of such condition were observed at computed tomography in an adult patient. (author)

  19. Forma acelerada da fibrose pulmonar idiopática no pulmão nativo após transplante pulmonar unilateral Accelerated form of interstitial pulmonary fibrosis in the native lung after single lung transplantation

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    Rogério Rufino

    2007-12-01

    Full Text Available Relatamos o caso de um paciente de 56 anos submetido a transplante pulmonar unilateral esquerdo em decorrência de fibrose pulmonar idiopática (FPI. No pós-operatório imediato, sob intensa imunossupressão, houve progressão rápida da FPI no pulmão nativo direito, confirmada pela biópsia pulmonar videotoracoscópica, necessitando de ventilação mecânica durante 104 dias até a realização de outro transplante pulmonar à direita. Obteve alta hospitalar após o 26º dia do segundo pós-operatório.We report the case of a 56-year-old patient who underwent left single lung transplantation for idiopathic pulmonary fibrosis (IPF. Despite the high level of immunosuppression after the surgery, there was rapid progression to IPF in the native (right lung as demonstrated by thoracoscopic lung biopsy. After 104 days on mechanical ventilation (MV, the patient underwent right lung transplant and was discharged from the hospital on postoperative day 26.

  20. Dispneia expiratória restritiva em um gato com fibrose pulmonar idiopática: relato de caso

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    Pereira, C.O.; Costa, F.V.A.; Gomes, D.C.; Kasper, P.N.; Vieira, A.B.; Driemeier, D.

    2017-01-01

    RESUMO As doenças pulmonares intersticiais constituem um grupo de doenças difusas do parênquima pulmonar, no qual a fibrose pulmonar intersticial está incluída. Histologicamente, esta se caracteriza por hiperplasia de pneumócitos tipo II, hiperplasia ou hipertrofia de músculo liso e fibrose. Embora a patogenia da fibrose pulmonar intersticial não esteja bem elucidada, devido às semelhanças microscópicas encontradas nos pneumócitos tipo II em felinos e na forma familiar da doença em humanos, a...

  1. Fatores preditores da qualidade de vida relacionada à saúde física e mental em pacientes com doença pulmonar intersticial: uma análise multifatorial Predictors of physical and mental health-related quality of life in patients with interstitial lung disease: a multifactorial analysis

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    Ana Cláudia Coelho

    2010-10-01

    Full Text Available OBJETIVO: Avaliar fatores preditores da qualidade de vida relacionada à saúde (QVRS em pacientes com doença pulmonar intersticial (DPI. MÉTODOS: Estudo transversal com 63 pacientes, submetidos a provas de função pulmonar e teste de caminhada de seis minutos. Foram aplicados os seguintes instrumentos: Medical Outcomes Study 36-item Short-form Survey (SF-36, Saint George's Respiratory Questionnaire (SGRQ, os inventários de ansiedade e depressão de Beck e Modified Medical Research Council Dyspnea Scale. A análise de componentes principais foi utilizada para reduzir as variáveis em fatores preditivos, e a análise de regressão linear múltipla foi utilizada como um modelo explicativo. RESULTADOS: Dos 63 pacientes, 34 eram mulheres. A média de idade foi de 60,1 ± 13,3 anos, média de CVF = 64,17 ± 15,54% do previsto e média de DLCO = 44,21 ± 14,47% do previsto. Todos os pacientes avaliados tinham sua QVRS prejudicada, e os piores escores foram observados nos domínios capacidade funcional do SF-36 e atividade do SGRQ. Dos pacientes avaliados 60,3% e 57,1% apresentaram sintomas de ansiedade e depressão, respectivamente. A análise de componentes principais identificou um fator preditor para QVRS física e um fator preditor para QVRS mental. A depressão apresentou uma forte influência sobre o fator preditor de QVRS mental, e o grau de dispneia apresentou uma influência significativa sobre os dois fatores preditores de QVRS nos pacientes avaliados. Variáveis relacionadas à função pulmonar, capacidade de exercício e ansiedade não apresentaram impactos sobre esses fatores preditores. CONCLUSÕES: Em nossa amostra de pacientes com DPI, o grau de dispneia teve um impacto importante sobre a QVRS física e mental, e a depressão teve um impacto sobre a QVRS mental nos pacientes com DPI.OBJECTIVE: To determine predictors of health-related quality of life (HRQoL in patients with interstitial lung disease (ILD. METHODS: A cross

  2. Comprometimento pulmonar na leptospirose

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    Jorge Eduardo Manhães de Carvalho

    1992-03-01

    Full Text Available Em 23 pacientes com leptospirose apresentando comprometimento pulmonar, internados no Hospital Universitário Antônio Pedro da XJFF, Niterói, hemoptise e hemoptóicos foram observados em 21,7% e 30,4%, respectivajnente. Gasometria arterial revelou hipoxemia e hipocapnia na maioria dos casos. Radiografia de tórax em 15 pacientes mostrou comprometimento alveolar em 60%, comprometimento intersticial-reticular em 6%, padrão misto (alveolar e intersticial em20%e ausência de alterações radiológicas em 14%. A necrópsiade 13 pacientes mostrou edema, congestão e hemorragia nos pulmões em 100% dos casos. A hemorragia foi focal em 46% e difusa em 54% dos casos. Houve formação de membrana hialina em 30% e trombos de fibrina em 46% dos pulmões estudados, o que estabelece o diagnóstico da coagulação intravascular disseminada e a ocorrência da síndrome de angústia respiratória na leptospirose.

  3. Avaliação da utilização de biópsia transbrônquica em pacientes com suspeita clínica de doença pulmonar intersticial Evaluation of the use of transbronchial biopsy in patients with clinical suspicion of interstitial lung disease

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    Cristiano Claudino Oliveira

    2011-04-01

    Full Text Available OBJETIVO: Estudar os padrões clínicos, radiológicos e histopatológicos da biópsia transbrônquica (BTB utilizados para a confirmação diagnóstica em pacientes com suspeita clinica de doença pulmonar intersticial (DPI atendidos em um hospital universitário de nível terciário. MÉTODOS: Os prontuários, laudos radiológicos e de biópsias transbrônquicas de todos os pacientes com suspeita de DPI submetidos a BTB entre janeiro de 1999 e dezembro de 2006 no Hospital das Clínicas de Botucatu, localizado na cidade de Botucatu (SP, foram revisados. RESULTADOS: Foram incluídos no estudo 56 pacientes. Desses, 11 (19,6% apresentaram o diagnóstico definitivo de fibrose pulmonar idiopática (FPI, que foi significativamente maior nos casos nos quais DPI era uma possibilidade diagnóstica em comparação com aqueles nos quais DPI era a principal suspeita (p = 0,011, demonstrando a contribuição da BTB para a definição diagnóstica dessas doenças. O exame histopatológico dessas biópsias revelou que 27,3% dos pacientes com FPI apresentavam o padrão de pneumonia organizante, o que pode sugerir doença mais avançada. O padrão histológico indeterminado foi o mais frequente, refletindo a característica periférica da FPI. Entretanto, o padrão fibrose apresentou alta especificidade e alto valor preditivo negativo. Para os padrões sugestivos de FPI em TC, a curva ROC indicou que a melhor relação entre sensibilidade e especificidade ocorreu com a presença de cinco alterações radiológicas, sendo o aspecto de favo de mel fortemente sugestivo de FPI (p = 0,01. CONCLUSÕES: Nas DPIs, a TC de tórax deve ser sempre realizada e a BTB usada em situações individualizadas, conforme a suspeita e distribuição das lesões.OBJECTIVE: To study the clinical, radiological, and histopathological patterns of transbronchial biopsy (TBB used in order to confirm the diagnosis in patients with clinical suspicion of interstitial lung disease (ILD

  4. Enfermedades con alteraciones de la circulación pulmonar

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    Suñé Ysamat, Bertila

    1982-01-01

    El edema pulmonar es el acúmulo de líquido seroso o serohemático en el exterior de los vasos. Cualquiera que sea su etiología, el mecanismo de producción es siempre el mismo: en primer lugar es intersticial; es decir, alrededor de los alveolos. Se traduce clínicamente por una aceleración de la frecuencia respiratoria. A medida que la extravasación de líquido aumenta, los alveolos se ven afectados por el edema. Al edema intersticial se le ha añadido el edema alveolar...

  5. Neumonía intersticial linfoidea asociada a inmunodeficiencia común variable

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    Gonzalo Peralta

    2011-10-01

    Full Text Available La neumonía intersticial linfoidea (NIL es una rara entidad, descripta como hiperplasia no neoplásica del tejido linfoide pulmonar y clasificada dentro de las enfermedades intersticiales idiopáticas. Se la ha descripto asociada a infección por HIV, fenómenos autoinmunes, hipergamaglobulinemia policlonal o menos frecuentemente a hipogammaglobulinemia. Presentamos una paciente de 66 años de edad con diabetes mellitus, síndrome de Sjögren e hipertensión arterial, derivada a nuestro centro por tos seca y disnea clase funcional II-III. En el examen físico presentaba rales tipo “velcro” bibasales y esplenomegalia. Los estudios de laboratorio evidenciaron plaquetopenia (50 000/mm³ e hipogammaglobulinemia; la tomografía axial computarizada (TAC de tórax mostró compromiso intersticial bibasal, con nódulos peribroncovasculares menores a un centímetro. Se realizó una videotoracoscopia con biopsia pulmonar, la anatomía patológica mostró hallazgos compatibles con neumonía intersticial linfoidea. Se inició tratamiento con metilprednisona 40 mg/día vía oral e infusión endovenosa de gammaglobulina 500 mg/kg, mensual, evolucionando con mejoría clínico-radiológica. Por persistencia de plaquetopenia, asociada a hiperesplenismo, se realizó esplenectomía con buena respuesta. En la anatomía patológica no se observo clonalidad linfoide.

  6. NEUMOTÓRAX ESPONTÁNEO ASOCIADO A FIBROSIS PULMONAR EN UN PACIENTE CON NEUROFIBROMATOSIS TIPO 2

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    Gabriel Alcalá Cerra

    2010-04-01

    Full Text Available El compromiso pulmonar en pacientes con neurofibromatosis ha sido reiteradamente descrito como una complicación muy rara en la variedad tipo 1. Se caracteriza por enfermedad pulmonar intersticial difusa, fibrosis pulmonar, neoplasias torácicas y formación de bulas, estas últimas, con alto riesgo de ruptura. Describimos un caso de neumotórax espontáneo en una paciente con neurofibromatosis tipo 2, como consecuencia de cambios fibróticos pulmonares. A nuestro conocimiento, esta asociación no había sido reportada.

  7. Análise de 39 casos de pneumonia intersticial crônica idiopática Analysis of 39 cases of idiopathic chronic interstitial pneumonia

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    Rogério Rufino

    2006-12-01

    Full Text Available OBJETIVO: Analisar de forma retrospectiva fragmentos de biópsias pulmonares que receberam o diagnóstico de pneumonia intersticial crônica idiopática, à luz da classificação da American Thoracic Society e European Respiratory Society, de 2000. MÉTODOS: A partir da revisão de 252 fragmentos de biópsias pulmonares a céu aberto de pacientes com doença intersticial pulmonar, no período de 1977 a 1999, 39 casos de doença pulmonar intersticial idiopática foram selecionados e reavaliados por dois patologistas, segundo a classificação da American Thoracic Society e European Respiratory Society, de 2000. RESULTADOS: Vinte e oito dos 39 diagnósticos foram mantidos (71,8%. Uma nova entidade patológica, a pneumonia intersticial não específica, foi incluída na reclassificação e houve superposição de padrões em seis casos. Mantiveram o mesmo diagnóstico 28 casos, 4 casos apresentaram associação entre fibrose pulmonar idiopática e organização pneumônica criptogênica, 1 entre organização pneumônica criptogênica e pneumonia intersticial não específica, e 1 entre pneumonia intersticial descamativa e pneumonia intersticial não específica. Todos os casos de fibrose pulmonar idiopática foram confirmados, embora 3 deles estivessem associados a organização pneumônica criptogênica. Os diagnósticos anteriores foram quase todos mantidos na revisão dos espécimes (p > 0,05. CONCLUSÃO: A classificação das doenças pulmonares intersticiais da American Thoracic Society e European Respiratory Society é uma ferramenta útil aos patologistas que lidam com biópsias pulmonares.OBJECTIVE: To make a retrospective analysis of lung biopsy samples obtained from patients diagnosed with chronic idiopathic interstitial pneumonia, as defined in the American Thoracic Society/European Respiratory Society classification system made public in 2000. METHODS: Samples from 252 open-lung biopsies of patients with interstitial lung disease, all

  8. Linfangioleiomiomatosis pulmonar

    OpenAIRE

    Carlos Salazar-Vargas; Victoria Monterroso-Azofeifa; Gloria Arauz-Pacheco; Bayardo Robelo-Pentzke

    2000-01-01

    La Linfangioleiomiomatosis pulmonar es una enfermedad muy rara, que afecta sólo mujeres en edad reproductiva. Se presenta con disnea progresiva, pneumotórax a repetición y, ocasionalmente, con hemoptisis y quilotórax. El TAC de alta resolución muestra quistes pulmonares bilaterales de tamaño variable hasta bulas francas. Histológicamente, se aprecian múltiples cavidades de paredes finas, dilatación de vasos linfáticos, venas, arterias, bronquiolos y sacos alveolares, por proliferación de hace...

  9. Blastoma pulmonar

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    Mauro Zamboni

    2007-05-01

    Full Text Available Resumo: O blastoma pulmonar é um tumor primário do pulmão, raro, de mau prognóstico e que acomete doentes mais jovens do que os portadores do carcinoma de células não pequenas do pulmão. Geralmente, são vistos sob a forma de grandes massas pulmonares, sintomáticas e com metástases para linfonodos mediastinais. Do ponto de vista anátomo-patológico, estes tumores são bifásicos, englobando na sua estrutura componentes mesenquimal e epitelial. Embora infrequente, este tipo de tumor deve fazer parte do diagnóstico diferencial das neoplasias pulmonares. Os autores apresentam um caso de blastoma pulmonar e fazem revisão da literatura.Rev Port Pneumol 2007; XIII (3: 391-395 Abstract: Pulmonary blastoma is a rare primary lung tumor with poor prognosis that commonly presents at a younger age than the non-small cell lung cancer. Classicaly they are large, symptomatic tumors with lymph nodal metastasis and carry poor prognosis. Pathological examination revealed features suggesting a biphasic tumor with mesenchymal and epithelial components. Over 200 cases have been reported so far worldwide since the first description of the tumor in 1945. Authors present a case of pulmary blastoma with literature revision.Rev Port Pneumol 2007; XIII (3: 391-395 Palavras-chave: Cancro do pulmão, blastoma, blas-toma pulmonar, tumor primário do pulmão, Keywords: Lung cancer, blastoma, pulmonary blastoma, primary tumors of lung

  10. Lesiones pulmonares relacionadas con el tabaquismo. Hallazgos y diagnósticos diferenciales por tomografía computada multidetector

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    N.E. Bernard; V. Pardo; A.C. Benítez Mendes; A. Seehaus

    2017-01-01

    Resumen: Desde hace tiempo se ha establecido la relación entre el hábito tabáquico y diferentes enfermedades pulmonares, particularmente el cáncer y el enfisema pulmonar. Sin embargo, es menos conocida la asociación del tabaquismo con otras entidades, como la bronquiolitis respiratoria asociada a la enfermedad intersticial (BREI), la neumonitis descamativa (ND), la histiocitosis de Langerhans (HL), la neumonía eosinofílica aguda (NEA), la fibrosis pulmonar (FP) y la combinación de esta última...

  11. Lesiones pulmonares relacionadas con el tabaquismo: Hallazgos y diagnósticos diferenciales por tomografía computada multidetector

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    Bernard, N.E; Pardo, V; Benítez Mendes, A.C; Seehaus, A

    2017-01-01

    Desde hace tiempo se ha establecido la relación entre el hábito tabáquico y diferentes enfermedades pulmonares, particularmente el cáncer y el enfisema pulmonar. Sin embargo, es menos conocida la asociación del tabaquismo con otras entidades, como la bronquiolitis respiratoria asociada a la enfermedad intersticial (BREI), la neumonitis descamativa (ND), la histiocitosis de Langerhans (HL), la neumonía eosinofílica aguda (NEA), la fibrosis pulmonar (FP) y la combinación de esta última con el e...

  12. DIP (pneumonia intersticial descamativa: como quadro do pulmão do tabaco – apresentação de um caso

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    Vítor Sousa

    2004-09-01

    Full Text Available RESUMO: A DIP (pneumonia intersticial descamativa é uma doença pulmonar intersticial caracterizada pela acumulação difusa e uniforme de macrófagos alveolares. Há forte associação com o tabaco sendo que 90% dos doentes são fumadores. As doenças relacionadas com o tabaco no pulmão são diversas e incluem os tumores, enfisema, bronquite crónica, RBILD (bronquiolite respiratória associada a doença pulmonar intersticial, DIP e histiocitose de células de Langerhans. Os autores apresentam um caso de DIP. É realizada breve revisão teórica e discussão do caso à luz da sua associação com o tabaco.REV PORT PNEUMOL 2004; X (5: 431-435 ABSTRACT: DIP (Desquamative Interstitial Pneumonia is an interstitial lung disease with diffuse and uniform accumulation of alveolar macrophages. There is a strong association with tobacco since 90% of the patients are smokers. The interstitial lung diseases related to tobacco are diverse and include tumours, emphysema, chronic bronchitis, RBILD (Respiratory Bronchilites associated Interstitial Lung Disease, DIP and Langerhans Cell Histiocitosis. The authors present a case of DIP. A brief theorycal revision and discussion of a case is made facing the association with tobacco.REV PORT PNEUMOL 2004; X (5:431-435 Palavras-chave: Pulmão, pneumonia intersticial descamativa, DIP, interstício, Key-words: Lung, desquamative interstitial pneumonia, DIP, interstitium

  13. Ossificação pulmonar dendriforme Dendriform pulmonary ossification

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    Andrezza Araújo de Oliveira Duarte

    2006-06-01

    Full Text Available A ossificação pulmonar difusa é uma condição rara, de etiologia desconhecida, na qual osso maduro é encontrado no parênquima pulmonar. É quase sempre descoberta como um achado incidental de autópsias. Freqüentemente afeta homens de meia-idade e é assintomática. Relata-se o caso de um paciente de 75 anos, que apresentou uma radiografia torácica com comprometimento pulmonar difuso e cujo diagnóstico foi baseado no exame histopatológico de fragmento pulmonar obtido através da biópsia a céu aberto, o qual demonstrou fibrose intersticial acentuada com ossificação do parênquima pulmonar.Diffuse pulmonary ossification is a rare condition of unknown pathogenesis in which mature bone is found in the pulmonary parenchyma. It is almost invariably discovered as an incidental finding at autopsy. Most commonly, it affects middle-aged men and is asymptomatic. We present the case of a 75-year-old man in which the chest X-ray showed diffuse interstitial infiltrate. Diagnosis was based on histopathological examination by open-lung biopsy, which revealed interstitial fibrosis with pulmonary ossification.

  14. Experiencia en la Argentina del Programa de uso compasivo con nintedanib en el tratamiento de la Fibrosis Pulmonar Idiopática

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    Tabaj, Gabriela C; Sívori, Martín; Cornejo, Laura; Plotquin, Martín

    2017-01-01

    Introducción: La Fibrosis Pulmonar Idiopática (FPI) es una enfermedad pulmonar difusa (EPD) de etiología desconocida, crónica y progresiva. Ocurre en adultos mayores, se encuentra limitada a los pulmones y se asocia con la patente anatomopatológica y/o tomográfica de neumonía intersticial usual (NIU). El curso de la enfermedad es progresivo y se asocia con una supervivencia media a 5 años del 20%. Objetivos: Conocer las características clínicas y de función pulmonar del grupo de pacientes con...

  15. Tuberculosis pulmonar de campos inferiores

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    Alejandra González

    2010-10-01

    Full Text Available La tuberculosis (TB que compromete sólo los campos pulmonares inferiores (TBCI es poco frecuente en el adulto y en general está asociada a alguna causa de inmunodepresión. El objetivo de nuestro trabajo fue determinar la incidencia de TBCI en nuestra población y comparar sus características respecto de la TB pulmonar de localización habitual. Se estudiaron en forma retrospectiva en el período de 2004 a 2008, 42 pacientes con TBCI que fueron comparados con 84 pacientes con TB pulmonar de localización habitual (grupo control. Se excluyeron pacientes con HIV. La TBCI representó el 6% del total de TB pulmonar. No se encontraron diferencias significativas en cuanto a edad, sexo, presencia de cavidades en la radiografía, días de evolución y nivel de albúmina. La TBCI tuvo significativamente mayor proporción de comorbilidades (p < 0.001, presencia de condensación (p < 0.001 y compromiso unilateral (p < 0.001 en la radiografía de tórax, junto con mayor número de internaciones (p = 0.02. Cabe destacar que sólo16 de los 42 pacientes con TBCI (38% tenían alguna comorbilidad demostrada. La TBCI puede presentarse aun sin comorbilidades asociadas y debe sospecharse en neumonías de evolución tórpida independientemente de su localización.

  16. Tabaco e morfologia: Doenças pulmonares

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    Lina Carvalho

    2007-05-01

    Full Text Available Resumo: O tabaco está implicado na carcinogénese multiorgâni-ca, com identificação de mais de cinquenta substâncias carcinogénicas que induzem mutações, alterando o ciclo celular, a resposta auto-imune e a regulação endócrina. É um dos nove factores identificados responsáveis por um terço de mortes por neoplasias malignas juntamente com erros dietéticos, obesidade, sedentarismo, consumo de álcool, promiscuidade sexual, toxicodependência e po-luição ambiental geral e limitada. Está implicado nas doenças cardiovasculares que representam a primeira causa de morte nos países civilizados e, no aparelho respiratório, é o factor principal para o desenvolvimento de DPOC (doença pulmonar obstrutiva crónica, RB-ILD (bron-quiolite respiratória e doença pulmonar intersticial, DIP (pneumonia intersticial descamativa, bronquiolite e fi-brose intersticial bronquiolocêntrica, histiocitose de células de Langerhans, pneumonia eosinofílica, sarcoidose, metaplasia epidermóide do epitélio respiratório e carcinoma bronco-pulmonar. O estado inflamatório crónico sistémico induzido pelo tabaco constitui a base de desenvolvimento de alterações genéticas também dependentes dos contaminantes do tabaco.Rev Port Pneumol 2007; XIII (3: 383-389 Abstract: Tobacco is implicated in multisystemic carcinogenesis through more than fifty identified carcinogenic metabolites that produce mutations responsible for alterations in cell cycle, immune response and endocrine regulation. Is one of nine risk factors identified in one third of cancer deaths together with obesity, sedentary, alcohol consumption, sexual promiscuity, drug addiction, and open and closed air contamination. Answering for cardiovascular diseases as the first cause of death in civilized world, tobacco is also pointed as the major factor implicated in the development of COPD (chronic obstructive pulmonary disease, RB-ILD (respira-tory bronchiolitis and interstitial lung disease

  17. Tabaco e morfologia: Doenças pulmonares

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    Lina Carvalho

    2007-05-01

    Full Text Available Resumo: O tabaco está implicado na carcinogénese multiorgânica, com identificação de mais de cinquenta substâncias carcinogénicas que induzem mutações, alterando o ciclo celular, a resposta auto-imune e a regulação endócrina. É um dos nove factores identificados responsáveis por um terço de mortes por neoplasias malignas juntamente com erros dietéticos, obesidade, sedentarismo, consumo de álcool, promiscuidade sexual, toxicodependência e poluição ambiental geral e limitada. Está implicado nas doenças cardiovasculares que representam a primeira causa de morte nos países civilizados e, no aparelho respiratório, é o factor principal para o desenvolvimento de DPOC (doença pulmonar obstrutiva crónica, RB-ILD (bronquiolite respiratória e doença pulmonar intersticial, DIP (pneumonia intersticial descamativa, bronquiolite e fibrose intersticial bronquiolocêntrica, histiocitose de células de Langerhans, pneumonia eosinofílica, sarcoidose, metaplasia epidermóide do epitélio respiratório e carcinoma bronco-pulmonar. O estado inflamatório crónico sistémico induzido pelo tabaco constitui a base de desenvolvimento de alterações genéticas também dependentes dos contaminantes do tabaco. Abstract: Tobacco is implicated in multisystemic carcinogenesis through more than fifty identified carcinogenic metabolites that produce mutations responsible for alterations in cell cycle, immune response and endocrine regulation. Is one of nine risk factors identified in one third of cancer deaths together with obesity, sedentary, alcohol consumption, sexual promiscuity, drug addiction, and open and closed air contamination. Answering for cardiovascular diseases as the first cause of death in civilized world, tobacco is also pointed as the major factor implicated in the development of COPD (chronic obstructive pulmonary disease, RB-ILD (respiratory bronchiolitis and interstitial lung disease, DIP (desquamative interstitial pneumonia

  18. Agenesia isolada da artéria pulmonar direita ou esquerda: avaliação da evolução natural e a longo prazo, após intervenção corretiva Isolated unilateral pulmonary artery agenesis: evaluation of natural and long term evolution after corrective surgery

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    Edmar Atik

    2006-10-01

    Full Text Available OBJETIVO: Agenesia da artéria pulmonar, direita ou esquerda, rara como anomalia isolada, foi relatada em 119 casos desde 1978. Apresenta-se clinicamente com hipertensão pulmonar (HP na infância e com hemoptise no adulto. Intervenções como reconstrução arterial pulmonar e lobectomia foram realizadas em 17% dos casos. Analisamos quatro destes casos, sendo dois em evolução natural e dois com regressão da HP, após longo tempo da correção operatória. MÉTODOS: Quatro crianças, três do sexo masculino, com 22,10 e 35 meses de idade e uma do sexo feminino com 20 meses, com insuficiência cardíaca direita (ICD e cianose na primeira e ICD na segunda e cansaço aos esforços nas outras duas. Todas tinham sinais de HP, sobrecarga ventricular direita no ECG e cardiomegalia. Cateterismo cardíaco mostrou pressões sistêmicas na artéria pulmonar contralateral na agenesia à direita em três e na agenesia à esquerda em um caso. RESULTADOS: Restabelecimento cirúrgico da continuidade arterial pulmonar foi possível em dois casos, na criança de 22 e na de 10 meses de idade, pela interposição de Goretex de diâmetro de 7 mm entre as artérias pulmonares até o hilo pulmonar contralateral hipoplásico. Houve regressão dos sinais de HP em período imediato e tardio, com 7 e 2,5 anos de idade respectivamente. A relação das pressões entre os ventrículos direito e esquerdo era de 30 e 40%, nos dois casos. A perfusão pulmonar aumentou de 8 para 44% e de 8 para 23%, nos dois casos. O mesmo procedimento foi programado para os outros pacientes. CONCLUSÃO: Esta técnica se torna a operação de escolha para casos similares, raramente descritos na literatura, mesmo em presença de acentuada HP e hipoplasia arterial pulmonar contralateral.OBJECTIVE: Unilateral pulmonary artery agenesis is an uncommon isolated anomaly and since 1978 only 119 cases have been reported. In general the condition presents as pulmonary hypertension (PH in children and

  19. Papel del sistema angiotensina en la fisiopatología de la fibrosis pulmonar

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    Molina Molina, María

    2007-01-01

    La Fibrosis Pulmonar Idiopática (FPI) es la enfermedad pulmonar intersticial difusa mas frecuente y con peor pronóstico, la supervivencia media desde el diagnostico es de 3-4 años. No existe en la actualidad ningún tratamiento efectivo. La hipótesis fisiopatologica actualmente aceptada es que una lesión o lesiones de la célula epitelial alveolar provocaría la apoptosis de estas células y su activación, la síntesis y secreción de diversos mediadores profibroticos, que, a su vez, provocarían en...

  20. Neumonía intersticial linfoidea asociada a inmunodeficiencia común variable Interstitial lymphoid pneumonia associated with common variable immunodeficiency

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    Gonzalo Peralta

    2011-10-01

    Full Text Available La neumonía intersticial linfoidea (NIL es una rara entidad, descripta como hiperplasia no neoplásica del tejido linfoide pulmonar y clasificada dentro de las enfermedades intersticiales idiopáticas. Se la ha descripto asociada a infección por HIV, fenómenos autoinmunes, hipergamaglobulinemia policlonal o menos frecuentemente a hipogammaglobulinemia. Presentamos una paciente de 66 años de edad con diabetes mellitus, síndrome de Sjögren e hipertensión arterial, derivada a nuestro centro por tos seca y disnea clase funcional II-III. En el examen físico presentaba rales tipo “velcro” bibasales y esplenomegalia. Los estudios de laboratorio evidenciaron plaquetopenia (50 000/mm³ e hipogammaglobulinemia; la tomografía axial computarizada (TAC de tórax mostró compromiso intersticial bibasal, con nódulos peribroncovasculares menores a un centímetro. Se realizó una videotoracoscopia con biopsia pulmonar, la anatomía patológica mostró hallazgos compatibles con neumonía intersticial linfoidea. Se inició tratamiento con metilprednisona 40 mg/día vía oral e infusión endovenosa de gammaglobulina 500 mg/kg, mensual, evolucionando con mejoría clínico-radiológica. Por persistencia de plaquetopenia, asociada a hiperesplenismo, se realizó esplenectomía con buena respuesta. En la anatomía patológica no se observo clonalidad linfoide.The interstitial lymphoid pneumonia (LIP is an uncommon disorder, described as non-neoplastic lung lymphoid tissue hyperplasia and classified as an interstitial lung disease. It has been described in association with HIV infection, autoimmune disorders, policlonal hypergammaglobulinemia and less frequently, with hypogammaglobulinemia. We report the case of a 66 year old female patient with a history of diabetes, Sjögren syndrome and hypertension. She was referred to our hospital due to a dry cough and dyspnea (FC II-III. The physical examination showed bilateral dry crackles and splenomegaly

  1. El tromboembolismo pulmonar (TEP)

    OpenAIRE

    Álvarez Alonso, Elena

    2015-01-01

    El trombo-embolismo pulmonar (TEP) consiste en la obstrucción de la arteria pulmonar o de una de sus ramas, normalmente por un trombo, aunque también puede existir una obstrucción por otras sustancias que impiden la circulación. El objetivo principal de este trabajo es dar conocer los síntomas del TEP para poder prevenir posibles complicaciones, comenzar a tratarlo desde sus inicios e informar a la población de cuáles son los principales factores de riesgo que pueden causar esta enfermed...

  2. Absceso y tuberculosis pulmonar

    OpenAIRE

    Hercelles García, Oswaldo

    2014-01-01

    Si la tuberculosis pulmonar es conocida desde los tiempos más remotos y el absceso del pulmón es considerado, desde el siglo XIX, como una entidad patológica perfectamente definida, es evidente que la asociación absceso y tuberculosis pulmonar no tiene su verdadera expresión de estudio, sino en los últimos años. If pulmonary tuberculosis has been known since ancient times and lung abscess is considered, since the nineteenth century as a well-defined disease entity, it is clear that the abs...

  3. La tuberculosis pulmonar

    OpenAIRE

    Suñé Ysamat, Bertila

    1982-01-01

    La tuberculosis pulmonar todavía no es una enfermedad erradicada, aunque su incidencia ha disminuido considerablemente. El tratamiento y el pronóstico de esta enfermedad han dado un cambio profundo durante estos últimos 30 años con el descubrimiento de nuevos medicamentos antituberculosos.

  4. Eosinofilia pulmonar Pulmonary eosinophilia

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    Luiz Eduardo Mendes Campos

    2009-06-01

    Full Text Available As formas de eosinofilia pulmonar constituem um grupo heterogêneo definido pela presença de um ou dois critérios: infiltrado pulmonar com eosinofilia sanguínea e/ou eosinofilia tissular caracterizada por eosinófilos demonstrados na biópsia pulmonar ou no lavado broncoalveolar. Embora o infiltrado inflamatório seja composto de macrófagos, linfócitos, neutrófilos e eosinófilos, a presença de eosinofilia é um marcador importante para o diagnóstico e tratamento. A apresentação clínica e radiológica pode revelar eosinofilia pulmonar simples, pneumonia eosinofílica crônica, pneumonia eosinofílica aguda, aspergilose broncopulmonar alérgica e eosinofilia pulmonar associada à doença sistêmica, como na síndrome de Churg-Strauss e na síndrome hipereosinofílica. A asma está frequentemente associada, podendo ser um pré-requisito, como na aspergilose broncopulmonar alérgica e na síndrome de Churg-Strauss. Nas doenças com acometimento sistêmico, a pele, o coração e o sistema nervoso são os órgãos mais comprometidos. A apresentação radiológica pode ser considerada como típica, ou pelo menos sugestiva, para três formas de eosinofilia pulmonar: pneumonia eosinofílica crônica, aspergilose broncopulmonar alérgica e pneumonia eosinofílica aguda. A etiologia da eosinofilia pulmonar pode ser de causa primária (idiopática ou secundária, compreendendo causas conhecidas, como drogas, parasitas, infecções por fungos e micobactérias, irradiação e toxinas. A eosinofilia pulmonar pode também estar associada a doenças pulmonares difusas, doenças do tecido conectivo e neoplasias.Pulmonary eosinophilia comprises a heterogeneous group of diseases defined by eosinophilia in pulmonary infiltrates (bronchoalveolar lavage fluid or in tissue (lung biopsy specimens. Although the inflammatory infiltrate is composed of macrophages, lymphocytes, neutrophils and eosinophils, eosinophilia is an important marker for the diagnosis

  5. Volúmenes pulmonares normales en pacientes con fibrosis pulmonar idiopática y enfisema Normal lung volumes in patients with idiopathic pulmonary fibrosis and emphysema

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    Juan Pablo Casas

    2008-08-01

    Full Text Available La fibrosis pulmonar idiopática (FPI es una enfermedad que se caracteriza por presentar un compromiso pulmonar de tipo restrictivo, resultante de una reducción en la complacencia pulmonar secundaria a fibrosis difusa. En el enfisema, la pérdida de elasticidad pulmonar y el colapso de las vías aéreas periféricas generan obstrucción e hiperinflación. El efecto simultáneo que ambas enfermedades producen sobre la fisiología pulmonar no es del todo claro y se han descripto volúmenes pulmonares normales o casi normales. Presentamos 4 pacientes de sexo masculino de 64, 60, 73 y 70 años, con antecedentes de tabaquismo e historia de disnea progresiva, tres de ellos con grave limitación en su calidad de vida al momento de la consulta. En la tomografía de tórax de alta resolución todos los pacientes presentaban signos de enfermedad intersticial pulmonar avanzada, con cambios de tipo fibrótico con predominio basal y subpleural, que coexistían con enfisema centroacinar con predominio en lóbulos superiores. Uno de ellos tuvo confirmación diagnóstica de ambas condicioes por biopsia pulmonar a cielo abierto. En los cuatro pacientes la espirometría y volúmenes pulmonares fueron normales, pero tenían importante compromiso del intercambio gaseoso evaluado mediante el test de caminata de 6 minutos. Tres de los pacientes tenían hipertensión pulmonar grave diagnosticado por ecocardiograma. La presencia de volúmenes pulmonares normales no excluye un diagnóstico de fibrosis pulmonar idiopática en pacientes fumadores si coexisten evidencias tomográficas de enfisema. En estos pacientes el grado de compromiso funcional, determinado por la reducción de los volúmenes pulmonares, no debería ser considerado en la evaluación de la gravedad.Pulmonary function tests in idiopathic pulmonary fibrosis characteristically show a restrictive pattern, resulting from reduction of pulmonary compliance due to diffuse fibrosis. Conversely, an obstructive

  6. Leptospirose pulmonar Pulmonary leptospirosis

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    João Cláudio Barroso Pereira

    2007-12-01

    Full Text Available No presente artigo, os autores discutem brevemente sobre a leptospirose, realçando a forma pulmonar da doença. Revê-se a patologia, achados clínicos, diagnóstico por métodos de imagem e broncoscopia e tratamento da leptospirose pulmonar. É também lembrado o diagnóstico clínico e radiológico precoces, para que se possa iniciar terapêutica adequada. Os autores concluem que a forma pulmonar da leptospirose deve ser sempre considerada como causa e diagnóstico diferencial da hemorragia alveolar difusa e síndroma de dificuldade respiratória do adulto.In this article, the authors discuss briefly the leptospirosis, emphasizing mainly the pulmonary form of disease. The authors review pathology, clinical findings, imaging and broncoscopy diagnosis, treatment of pulmonary leptospirosis. It is also remembered about early clinics and radiology diagnosis to start therapeutics. The authors conclude that pulmonary form of disease must always be remembered and considered as cause and differential diagnosis of Diffuse Alveolar Hemorrhage and Adult Respiratory Distress Syndrome.

  7. Proteinosis alveolar pulmonar

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    Concepción Sánchez Infante

    2011-12-01

    Full Text Available La proteinosis alveolar pulmonar es una enfermedad respiratoria crónica, caracterizada por alteración en el metabolismo del surfactante, lo que determina su acumulación anormal en el espacio alveolar. Es una enfermedad extremadamente rara. Se han reportado solamente 500 casos en la literatura. Se describió por primera vez en 1958. Se presenta un caso de proteinosis alveolar pulmonar en un lactante de 2 meses, con desnutrición proteico energética, que ingresa por dificultad respiratoria e hipoxemia, y, con imágenes radiológicas de tipo retículo-nodulillar, en vidrio deslustrado, en el cual se plantea inicialmente el diagnóstico de bronconeumonía. Ante la evolución desfavorable y no respuesta al tratamiento, se realizó un estudio para descartar enfermedades pulmonares crónicas. El paciente fallece y se confirma el diagnóstico por anatomía patológica. Se realiza una revisión del tema.

  8. Nefrite Intersticial Aguda Após Exposição a Losartan

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    Letícia Schwerz Weinert

    2007-07-01

    Full Text Available Nefrite intersticial aguda é uma causa comum de perda aguda de função renal. Exposição a drogas é o fator desencadeante mais freqüentemente relatado, porém auto-imunidade e infecções também estão associadas. Os inibidores da enzima de conversão da angiotensina têm sido relatados como possíveis agentes, porém não há relato na literatura de nefrite intersticial com uso de losartan. Descrevemos então, o caso de perda aguda de função renal após exposição a losartan, em paciente com dano renal prévio por nefropatia diabética, cuja biópsia renal diagnosticou nefrite intersticial aguda.

  9. Tabaco e morfologia: Doenças pulmonares Tobacco and morphology: Pulmonary diseases

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    Lina Carvalho

    2007-05-01

    Full Text Available O tabaco está implicado na carcinogénese multiorgânica, com identificação de mais de cinquenta substâncias carcinogénicas que induzem mutações, alterando o ciclo celular, a resposta auto-imune e a regulação endócrina. É um dos nove factores identificados responsáveis por um terço de mortes por neoplasias malignas juntamente com erros dietéticos, obesidade, sedentarismo, consumo de álcool, promiscuidade sexual, toxicodependência e poluição ambiental geral e limitada. Está implicado nas doenças cardiovasculares que representam a primeira causa de morte nos países civilizados e, no aparelho respiratório, é o factor principal para o desenvolvimento de DPOC (doença pulmonar obstrutiva crónica, RB-ILD (bronquiolite respiratória e doença pulmonar intersticial, DIP (pneumonia intersticial descamativa, bronquiolite e fibrose intersticial bronquiolocêntrica, histiocitose de células de Langerhans, pneumonia eosinofílica, sarcoidose, metaplasia epidermóide do epitélio respiratório e carcinoma bronco-pulmonar. O estado inflamatório crónico sistémico induzido pelo tabaco constitui a base de desenvolvimento de alterações genéticas também dependentes dos contaminantes do tabaco.Tobacco is implicated in multisystemic carcinogenesis through more than fifty identified carcinogenic metabolites that produce mutations responsible for alterations in cell cycle, immune response and endocrine regulation. Is one of nine risk factors identified in one third of cancer deaths together with obesity, sedentary, alcohol consumption, sexual promiscuity, drug addiction, and open and closed air contamination. Answering for cardiovascular diseases as the first cause of death in civilized world, tobacco is also pointed as the major factor implicated in the development of COPD (chronic obstructive pulmonary disease, RB-ILD (respiratory bronchiolitis and interstitial lung disease, DIP (desquamative interstitial pneumonia, bronchiolitis and

  10. Linfangioleiomiomatosis y trasplante pulmonar

    OpenAIRE

    Ansótegui Barrera, Emilio

    2012-01-01

    La linfangioleiomiomatosis (LAM) es una enfermedad rara que afecta predominantemente a la mujer, sobre todo en edad fértil. Se caracteriza por una proliferación anormal de células musculares lisas inmaduras, células LAM, que crecen de una manera aberrante en la vía aérea, parénquima, linfáticos y vasos sanguíneos pulmonares, lo que determina una evolución progresiva hacia la insuficiencia respiratoria que condiciona el fallecimiento de las pacientes. Tiene carácter multisistémico afectando as...

  11. Linfonodo pulmonar na paracoccidioidomicose aguda infantil (relato de um caso

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    Evanil Pires de Campos

    1992-09-01

    Full Text Available Observou-se a evolução de um linfonodo pulmonar na paracoccidioidomicose (PCM aguda infantil. Doente, masculino, 6 anos, branco, natural de Curitiba (PR, procedente de Guaratinguetá (SP, que há 3 meses desenvolveu quadro gripal, febre diária, bimodal, prolongada, precedida de calafrio, acompanhada de sudorese inodora, cefaléia frontal e anorexia. Diagnosticado e tratado como pneumonia por cinco dias, sem melhora do quadro. Há 2 meses, apresentou dor óssea nos braços e articulações do pé, com edema inflamatório e emagrecimento de 6 kg em 3 meses. Exame físico revelou: peso 20 kg; estatura 120 cm; P. A. 90/60 mmHg; facies atípica, hipoativo, palidez cutâneo-mucosa (+ +, hipotrofia muscular, adenopatiageneralizada, sopro sistólico suave em foco aórtico acessório e hepatesplenomegalia. Imunodifusão com exoantígeno glicoprotéico 43 kdpositiva (1/32. A biópsia de gânglio revelou Paracoccidioides brasiliensis. A radiologia demonstrou na primeira consulta, discreto infiltrado intersticial bilateral com linfoadenomegaliapara-hilar que desaparecu em 30 dias. Observou- se, ainda, massa tumoral mediastínica superior, hiperplasia do sistema fagocítico mononuclear e lesões osteolíticas nos 60 dias iniciais da evolução.

  12. Envolvimento pulmonar na polimiosite

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    Direndra Hasmucrai

    2010-07-01

    Full Text Available Resumo: Introdução: A polimiosite (PM e a dermatomiosite são classificadas como miopatias inflamatórias idiopáticas. O envolvimento pulmonar por PM é pouco frequente, estando descrito na literatura em cerca de 10% de casos.Os autores apresentam um caso de uma mulher de 75 anos, com queixas de febre, perda ponderal, artralgias, mialgias e diminuição simétrica e proximal da força muscular com impotência funcional dos membros superiores e inferiores, com início um mês antes do internamento. Apresentava infiltrados pulmonares na telerradiografia de tórax. Após estudo exaustivo estabeleceu-se o diagnóstico de envolvimento pulmonar na forma de pneumonia organizativa por PM. Efectuou-se corticoterapia e terapêutica com micofenolato com melhoria clínica, analítica e radiológica. Conclusão: Neste caso, foi a alteração na telerradiografia de tórax numa doente sem sintomatologia respiratória que levou ao estudo exaustivo até ao diagnóstico de PM, realçando mais uma vez a importância da telerradiografia no rastreio de patologias de outros foros. Abstract: Introduction: Polymyositis and dermatomyositis are classified as idiopathic inflammatory myopathies. Interstitial lung disease is rare and is described in the literature in about 10% of cases.The authors describes a case of 75 year old woman presenting with one month evolution of fever, weight loss, arthralgia, myalgia and symmetric and proximal muscle weakness of upper and lower limbs. Nonspecific interstitial changes was found in chest X-ray. After exhaustive study, the diagnosis of pulmonary envolvement in the form of organizing pneumonia by polymyositis, was established. Glucocorticoids and mycophenolate were prescribed with good clinical, analytical and radiological outcome. Conclusion: In this case, it was the changes in the chest X-ray in a patient without respiratory symptomatology, that conducted to exhaustive study to polymyositis diagnosis, enhancing once again the

  13. Infecção pulmonar tripla em paciente gravemente imunocomprometido por AIDS: relato de caso

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    Faucz Rafael Artigas

    2006-01-01

    Full Text Available Os autores relatam um caso de paciente do sexo masculino, 38 anos de idade, motorista, soropositivo para HIV há oito anos, sem acompanhamento, com quadro de tosse produtiva com secreção acinzentada e episódios intermitentes de dispnéia há 15 dias. Informava dois episódios pregressos de tuberculose pulmonar (1983 e 2001 tratados. A radiografia de tórax evidenciou áreas de hipotransparência nodular e broncogramas aéreos bilateralmente. A tomografia computadorizada de tórax evidenciou vários achados inespecíficos, dentre eles áreas esparsas de consolidação, cavitação, bronquiectasia, opacidade em vidro fosco, espessamento intersticial e broncogramas aéreos. A lavagem broncoalveolar evidenciou numerosas hifas com raros septos bifurcados sugestivos de Aspergillus sp. e a cultura foi positiva para Nocardia sp. e Mycobacterium tuberculosis. Foi instituída terapia com anfotericina B, sulfametoxazol-trimetoprim e anti-retrovirais. Após 20 dias, recebeu alta sem queixas pulmonares. Decorridos 15 dias, retornou com diarréia, febre, disfagia e emagrecimento importante. Foi a óbito após cinco dias, por sepse estafilocócica.

  14. Unilateral initiatives

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    This paper reports on arms control which is generally thought of in terms of formal negotiations with an opponent, with the resulting agreements embodied in a treaty. This is not surprising, since arms control discussions between opponents are both important and politically visible. There are, however, strong reasons for countries to consider and frequently take unilateral initiatives. To do so is entirely consistent with the established major precepts of arms control which state that arms control is designed to reduce the risk of war, the costs of preparing for war, and the death and destruction if war should come. Unilateral initiatives on what weapons are purchased, which ones are eliminated and how forces are deployed can all relate to these objectives. There are two main categories of motives for unilateral initiatives in arms control. In one category, internal national objectives are the dominant, often sole, driving force; the initiative is undertaken for our own good

  15. VASCULITIS DE CHURG-STRAUSS: PRESENTACIÓN CLÍNICA COMO GLOMERULONEFRITIS EXTRACAPILAR NECROTIZANTE PAUCI-INMUNE CON NEFRITIS TUBULO-INTERSTICIAL EOSINOFÍLICA.

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    Fernanda da Cunha

    2004-01-01

    Full Text Available RESUMEN: Se presenta el caso clínico de una mujer de 81 años con antecedentes patología pulmonar obstructiva crónica "idiopática" que desarrolló un cuadro de insuficiencia renal aguda aparentemente prerrenal, con posterior oliguria y eosinofilia simulando una nefropatía túbulo-intersticial alérgica. La evolución atípica y la presencia de p-ANCA, sugerían una vasculitis, patología que se confirmó con la biopsia renal. Los resultados anatomopatológicos revelaron la existencia de una glomerulonefritis necrotizante con semilunas e infiltrado eosinófilo. Estos datos y el historial de la paciente llevaron al diagnóstico de vasculitis de Churg-Strauss. El tratamiento inicial con corticoides y ciclofosfamida y posteriormente con Azatioprina mostró excelentes resultados con mejoría de la función renal, de los parámetros inflamatorios y de la clínica sistémica, que la paciente mantuvo posteriormente. ABSTRACT: We report a case of a 81 year-old woman with idiopathic chronic obstructive pulmonary disease, who developed a functional acute renal failure with delayed oliguria and eosinophily, simulating an acute interstitial nephropathy. The unusual clinical course and the presence of antimyeloperoxidase antibodies (p-ANCA suggested a vasculitis; the renal biopsy confirmed this diagnosis. The histology revealed a crescentic glomerulonephritis with eosinophilic infiltration. With these data and the pulmonary history of the patient, a diagnosis of Churg-Struss Vasculitis was made. The initial treatment with steroids and ciclophosphamide switched later to azatioprine, was succeeded with a sustained improvement in renal function, inflammatory markers and clinical course.

  16. Braquiterapia intersticial para recidivas de câncer de colo uterino pós-radioterapia

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    Oliveira,Antonio Carlos Zuliani de; Esteves,Sérgio Carlos Barros; Feijó,Luiz Fernando Andrade; Tagawa,Eduardo Komai; Cunha,Maércio de Oliveira

    2005-01-01

    OBJETIVO: Analisar a resposta e toxicidade da braquiterapia de alta taxa de dose (BATD) intersticial para carcinoma do colo do útero com recidiva pélvica pós-radioterapia. MATERIAIS E MÉTODOS: Entre 1998 e 2001, 11 pacientes com carcinoma de colo de útero e que tiveram recidiva pélvica pós-radioterapia receberam BATD intersticial. Idade: 41 a 71 anos (média: 56,5 anos); estádios (FIGO): IIA, IIB, IIIB e IVA. Nove (82%) pacientes tinham carcinoma de células escamosas e duas (18%), adenocarcino...

  17. Cistitis intersticial o vejiga dolorosa: Un desafío para el clínico

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    Pablo Young

    2010-08-01

    Full Text Available La cistitis intersticial se define como un síndrome clínico caracterizado por un incremento de la frecuencia urinaria, urgencia miccional y/o dolor abdominal o perineal en ausencia de infección urinaria o enfermedad conocida del aparato urinario. Se divide de acuerdo a los hallazgos citoscópicos en ulcerativa o no. La base del diagnóstico es clínica apoyada en scores de probabilidad y pruebas invasivas. Con la comprensión de la fisiopatología se ha desarrollado un abanico de posibilidades terapéuticas. Comunicamos el caso de una paciente sintomática por cuatro años con diagnóstico de cistitis intersticial con úlcera de Hunner por cistoscopia y excelente respuesta a la amitriptilina. Es una enfermedad que produce considerable alteración de la calidad de vida, por lo que es importante que los médicos estén familiarizados con este cuadro.

  18. AVALIAÇÃO MORFOLÓGICA DO PARÊNQUIMA PULMONAR DE RATAS SUBMETIDAS AO USO DO DECANOATO DE NANDROLONA

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    Larissa Balbino Zanarotti

    2017-01-01

    Full Text Available Altas doses de esteróides anabólicos androgênicos são utilizadas, sem indicação terapêutica, por indivíduos que visam aumentar a força muscular ou melhorar a aparência física. Este estudo teve por objetivo analisar a morfologia do parênquima pulmonar, diante da administração do esteróide anabólico decanoato de nandrolona. Para isso, foram utilizadas 8 ratas Wistar adultas, divididas equitativamente em dois grupos: controle e experimental. Os animais do grupo experimental receberam por seis semanas consecutivas uma injeção intramuscular de 6 mg/kg de decanoato de nandrolona (Deca-Durabolin® eo grupo controle receberam uma injeção intramuscular de solução salina (0,9%. Após a eutanásia foram retirados os pulmões para a análise histológica de rotina sob microscopia de luz.Os resultados morfológicos do grupo experimental indicaram na região peribronquiolar um espessamento dos septos alveolares, um intenso infiltrado inflamatório misto constituído de monócitos e polimorfonucleares, quando comparado com o grupo controle. Observou-se também capilares repletos de hemácias, indicando uma hiperemia ativa, há também uma hiperplasia de nódulo linfóide associada aos bronquíolos assim como um edema intersticial, comparado ao grupo controle. Nossos achados morfológicos se coadunam com investigações semelhantes que indicam o uso indiscriminado e abusivo do decanoato de nandrolona (Deca-durabolin® como fator de risco no desenvolvimento da hipertrofia cardíaca e renal, e para sobrecarga da artéria pulmonar, podendo produzir a hipertensão arterial pulmonar (HAP em ratos. Podemos concluir, portanto, que a hiperemia aguda pode ser um indício de alterações hemodinâmicas resultando em congestão vascular, edema intersticial com infiltrado inflamatório agudo, demonstrando um quadro de pneumonia intersticial.

  19. Toxicidade pulmonar induzida pela rapamicina Lung toxicity induced by rapamycin

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    C Damas

    2006-11-01

    Full Text Available As doenças pulmonares induzidas por fármacos constituem uma causa crescente de morbilidade, tendo sido descritas diferentes formas de toxicidade associadas a inúmeras substâncias. O sirolimus (rapamicina é um fármaco imunossupressor usado de forma crescente no contexto do transplante de órgãos sólidos, nomeadamente no transplante renal. A toxicidade pulmonar tem sido descrita como um dos potenciais efeitos laterais, nomeadamente causando formas de pneumonite intersticial ou, mais raramente, hemorragia alveolar. Os autores descrevem os casos de quatro doentes (3 do sexo masculino, 1 do sexo feminino com idades compreendidas entre os 46-71 anos, recipientes de transplante renal (rim cadáver há 3 anos (1 doente e 7 anos (3 doentes. A imunosupressão consistia em micofenolato mofetil, prednisolona e rapamicina. Os quatro doentes foram admitidos por febre, tosse produtiva (2 e dispneia (3. Apresentavam imagem radiológica de infiltrados pulmonares bilaterais de predomínio basal. O LBA mostrou alveolite linfocítica em 3 doentes, tendo-se observado no entanto diferentes relações CD4/CD8., para além de neutrofilia em 2 deles. No restante doente, observou-se hemorragia alveolar grave. Não houve em nenhum dos casos qualquer isolamento de micro organismos patogénicos no LBA. As queixas apresentadas, bem como as alterações radiológicas regrediram com a suspensão do fármaco. Estes quatro casos revelaram alguma variedade, quer na apresentação clínica, quer nos achados dos exames subsidiários efectuados, nomeadamente no LBA. Este facto pode ter como causa diferentes mecanismos fisiopatológicos a nível do pulmão induzidos pelo sirolimus.Drug induced lung diseases (DILD are an increasingly cause of morbidity. Many drugs have been described, causing several patterns of injury. Sirolimus is an immunosuppressive agent increasingly used in renal and other solid organ transplantation. Pulmonary toxicity has been recognised as a potential

  20. Neurite hipertrófica intersticial: estudo de três casos

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    Lineu Cesar Werneck

    1978-09-01

    Full Text Available São relatados 3 casos de neuropatia hipertrófica intersticial que apresentam conduções nervosas motoras bastante reduzidas; no estudo anatomopatológico foram encontradas estruturas em forma de "casca de cebola", com proliferação de tecido conjuntivo. São abordadas as teorias sobre a formação das "cascas de cebola" e a correlação com a diminuição da velocidade de condução nervosa. Os autores concluem que somente um dos casos corresponde a descrição original de Dejerine-Sottas, sendo que os outros são provavelmente doença de Charcot-Marie-Tooth.

  1. FIBROSIS PULMONAR IDIOPÁTICA

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    Álvaro Undurraga P., DR.

    2015-05-01

    Diversas comorbilidades se han descrito como la hipertensión pulmonar, la asociación con enfisema y el reflujo gastroesofágico. Sólo recientemente aparecen fármacos útiles, que son la Pirfenidona y el Nintedanib. El clásico esquema de prednisona, azatriopina y N-acetil cisteina, se ha demostrado ineficaz. Otros recursos que pueden utilizarse como complementos útiles en la enfermedad son el oxígeno, la rehabilitación, las terapias antirreflujo y el manejo sintomático de la tos.

  2. Doenças pulmonares intersticiais: Acuidade diagnóstica e riscos da biópsia pulmonar cirúrgica

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    Miguel Guerra

    2009-05-01

    Full Text Available Resumo: Os autores descrevem a sua casuística de biópsias pulmonares cirúrgicas em doentes com doença pulmonar intersticial, de forma a determinar a acuidade diagnóstica, os riscos e a morbimortalidade associados ao procedimento. Entre Janeiro de 1998 e De-zembro de 2007, 53 doentes (idade média de 47,2±13 anos foram referenciados para a realização de biópsia pulmonar cirúrgica, dos quais 22 eram mulheres (41,5%. As biópsias pulmonares foram realizadas quer por videotoracoscopia (37 doentes, 69,8%, quer por minitoracotomia (16 doentes, 30,2%. Foi escolhido o pulmão direito para biopsar em 88,7% dos casos. Registaram-se complicações pós-operatórias em 5 doentes (9,4%: fuga aérea prolongada em 3 doentes (5,7%, persistência de loca de pneumotórax num doente (1,9% e hemorragia com necessidade de revisão de hemostase noutro doente (1,9%. Ocor-reu um óbito de causa desconhecida num doente sem risco acrescido. A duração média da drenagem foi de 4,4±3 dias e o tempo de internamento médio de 5,5±4 dias. O diagnóstico histológico definitivo foi conseguido em 50 doentes, registando-se uma acuidade diagnóstica de 94,3%. Em conclusão, o potencial benefício de um diagnóstico histopatológico conclusivo através de uma biópsia pulmonar cirúrgica deve ser balanceado com os riscos associados ao procedimento cirúrgico, especialmente para aqueles doentes com disfunção cardiopulmonar severa.Rev Port Pneumol 2009; XV (3: 433-442 Abstract: This study reports our experience, diagnostic accuracy and safety of surgical lung biopsy in patients with interstitial lung diseases. From January 1998 – December 2007 surgical lung biopsy was performed in 53 patients (22 female [41.5%]; age 47.2±13 years. A total of 37 patients (69.8% underwent videothoracoscopic lung biopsy and minithoracotomy was performed in 16 patients (30.2%. Right lung was the

  3. Linfonodo pulmonar na paracoccidioidomicose aguda infantil (relato de um caso

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    Evanil Pires de Campos

    1992-09-01

    Full Text Available Observou-se a evolução de um linfonodo pulmonar na paracoccidioidomicose (PCM aguda infantil. Doente, masculino, 6 anos, branco, natural de Curitiba (PR, procedente de Guaratinguetá (SP, que há 3 meses desenvolveu quadro gripal, febre diária, bimodal, prolongada, precedida de calafrio, acompanhada de sudorese inodora, cefaléia frontal e anorexia. Diagnosticado e tratado como pneumonia por cinco dias, sem melhora do quadro. Há 2 meses, apresentou dor óssea nos braços e articulações do pé, com edema inflamatório e emagrecimento de 6 kg em 3 meses. Exame físico revelou: peso 20 kg; estatura 120 cm; P. A. 90/60 mmHg; facies atípica, hipoativo, palidez cutâneo-mucosa (+ +, hipotrofia muscular, adenopatiageneralizada, sopro sistólico suave em foco aórtico acessório e hepatesplenomegalia. Imunodifusão com exoantígeno glicoprotéico 43 kdpositiva (1/32. A biópsia de gânglio revelou Paracoccidioides brasiliensis. A radiologia demonstrou na primeira consulta, discreto infiltrado intersticial bilateral com linfoadenomegaliapara-hilar que desaparecu em 30 dias. Observou- se, ainda, massa tumoral mediastínica superior, hiperplasia do sistema fagocítico mononuclear e lesões osteolíticas nos 60 dias iniciais da evolução.The primary complex like Ghon was observed in a child's clinical roentgenographic study. C.S., white, male, 6 years old, was born in Curitiba (PR, Brazil and living in Guaratingueta (SP, Brazil, developed "common cold", bimodal diary fever, chills, shake and sweats. Dyspnea, cough with general fymphadenopathy. Foot and right shoulder artralgies. Six months ago visited a cave, equitation practice, dog and cat contacts and notransfusion, frontal sweats, fever (38.4°C. T.A. was 8/6, tachicardia in generalizated fymphadenopathy. Cardiopulmonary system was normal, mesogastric tumoral mass, hepatesplenomegaly and no ascitis. Bone marrow with eosinophilia; nodule demonstred presence of P. brasiliensis; hypoalbuminemia

  4. Esclerose sistêmica difusa com hipertensão pulmonar isolada: relato de caso Diffuse systemic sclerosis with isolated pulmonary hypertension: a case report

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    SILMÉIA GARCIA ZANATI

    2000-12-01

    Full Text Available A esclerose sistêmica (ES é uma doença incomum, caracterizada por alterações vasculares e fibrose em pele e vários órgãos. O envolvimento pulmonar é freqüente na ES; entretanto, hipertensão pulmonar (HP na ausência de fibrose intersticial é raramente observada. Os autores descrevem um caso de ES difusa com HP isolada em paciente do sexo feminino, de 49 anos. O diagnóstico de HP pôde ser sugerido pelo exame físico e confirmado por ecodopplercardiograma, que permitiu estimar a pressão sistólica em artéria pulmonar em 80mmHg. Tratamento foi iniciado com nifedipina; entretanto, devido a efeitos colaterais da droga, não foi possível o aumento da dose além de 30mg ao dia; nesta dosagem, a nifedipina não acarretou redução da pressão arterial pulmonar.Systemic sclerosis (SS is an uncommon disease characterized by small blood vessel vasculopathy and increased connective tissue in the skin and in other organs. The pulmonary involvement is common in SS; however, pulmonary hypertension without interstitial fibrosis is rare. The authors present a case of the diffuse form of SS with isolated pulmonary hypertension. The diagnosis of pulmonary hypertension was suggested by physical examination and confirmed by doppler-echocardiography which allowed for the estimation of the pulmonary artery systolic pressure in 80 mmHg. The authors started treatment with nifedipine; however, as the patient presented side effects, it was not possible to increase the dose beyond 30 mg/day. In this dosage, nifedipine did not decrease the pulmonary arterial pressure.

  5. Criptococose pulmonar: aspectos na tomografia computadorizada

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    Silva Ana Carina Gamboa da

    2003-01-01

    Full Text Available A criptococose pulmonar é uma doença causada pelo Criptococcus neoformans, um fungo unimórfico que possui distribuição mundial, existindo na mesma forma tanto no seu habitat natural quanto em animais e humanos. A doença possui apresentações clínica e patológica variáveis e pode manifestar-se tanto em pacientes com a imunidade normal como em imunocomprometidos, que representam a maioria dos casos. Neste trabalho são analisados os aspectos encontrados nas tomografias computadorizadas do tórax de 14 pacientes com criptococose pulmonar confirmada. Os achados mais freqüentes na tomografia do tórax foram as massas e os nódulos pulmonares. Outros aspectos observados foram as áreas de escavação, as consolidações, o espessamento do interstício peribroncovascular e o reticulado difuso. Massa pulmonar foi o achado isolado mais comum (64,2%, seguido dos nódulos isolados ou múltiplos (35,7%. Doença pulmonar difusa foi vista em apenas 14,2% dos casos. Os lobos superiores foram os mais comprometidos, sendo a doença mais comum nas regiões anteriores. A tomografia do tórax permitiu avaliar com precisão o grau de comprometimento do parênquima pulmonar.

  6. Exacerbação aguda da fibrose pulmonar idiopática

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    Natália Melo

    2009-03-01

    Full Text Available Resumo: Alguns doentes com fibrose pulmonar idiopática (FPI apresentam durante a sua evolução fases de agravamento clínico sem causa conhecida, designadas como “exacerbação aguda” ou “fase acelerada” da doença (EA. Caracterizam-se pelo agravamento marcado da dispneia, hipoxemia e pelo aparecimento de novas opacidades pulmonares ou pelo agravamento das já existentes no estudo imagiológico. Os achados histológicos típicos são o dano alveolar difuso (DAD sobreposto a alterações de pneumonia intersticial usual (UIP. Esta entidade clínica associa-se a uma mortalidade elevada, não havendo até ao momento nenhuma terapêutica de comprovada eficácia.Os autores descrevem os casos clínicos de cinco doentes que apresentaram alterações clínicas, funcionais e radiológicas sugestivas de EA-FPI, assim como o tratamento efectuado e a evolução observada, enquadrando-os na discussão das características normalmente apresentadas por esta entidade. Abstract: Some patients with Idiopathic Pulmonary Fibrosis (IPF have disease accelerated deterioration without identifiable cause referred as “acute exacerbation” or “accelerated stage”. It is characterized by severe worsening of dyspnea, hypoxemia and new or progressive opacities on imaging studies. The typical histological findings are diffuse alveolar damage in addition to the features of usual interstitial pneumonia pattern. Mortality in this clinical entity is very high and no efficacious therapeutic have been described.The authors describe the clinical, functional and radiological features, treatment and evolution of five patients with IPF acute exacerbation. A discussion will be carry out concerning the IPF acute exacerbation usual features comparing with the alterations noticed in those patients. Palavras-chave: Fibrose pulmonar idiopática, exacerbação aguda, Key words: Idiopathic

  7. Uso de neumocitos de tipo II en el tratamiento de enfermedades pulmonares asociadas con fibrosis pulmonar

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    Serrano-Mollar, Anna; Closa, Daniel; Bulbena, Oriol

    2005-01-01

    Se describe el empleo de neumocitos tipo II como agentes inhibidores de la proliferación de fibroblastos, por lo que pueden ser utilizados en la elaboración de un medicamento para el tratamientode enfermedades pulmonares que cursan con fibrosis pulmonar.

  8. Diagnóstico pasivo de nefritis intersticial en cerdos de mataderos

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    Dra. C. Bárbara Yaislyn Ortíz Hurtado

    2018-04-01

    Full Text Available El objetivo del presente trabajo fue determinar la incidencia de nefritis intersticial en el matadero de Salamina I en la provincia de Villa Clara y su contribución a la vigilancia epidemiológica. La investigación se realizó en el período comprendido de enero de 2012 a diciembre de 2016. Se realizó un análisis de la serie cronológica mensual para determinar la ocurrencia de las principales causas de decomisos en los cerdos sacrificados. Se determinó la tendencia, estacionalidad y canales de comportamiento habitual de las patologías de mayor incidencia. Se evaluó el impacto económico-sanitario de las pérdidas por concepto de decomisos La nefritis manifestó una alta tendencia al incremento y la estacionalidad de la ocurrencia de decomisos es marcada en el último cuatrimestre del año. El canal de comportamiento habitual muestra un rango de 500 a 2500 decomisos mensuales. El impacto económico-sanitario de las pérdidas por concepto de decomisos asciende a 45 905,6 CUP.

  9. Quistes pulmonares congénitos

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    Nuvia Suárez García

    2014-06-01

    Full Text Available Introducción: las malformaciones pulmonares congénitas constituyen una alteración en el desarrollo embriológico y fetal de las distintas estructuras pulmonares y una rara expresión de estas son los quistes pulmonares congénitos. Caso clínico: se presenta un recién nacido a término, de buen peso, asintomático y estable hasta el tercer día de vida al debutar con un estado de shock séptico secundario, de bronconeumonía complicada con derrame pleural derecho. En los estudios evolutivos hacia el cuarto de día de vida se le diagnostica como hallazgo radiológico la presencia de quistes pulmonares que evolucionan de forma asintomática. Después de una valoración multidisciplinaria es egresado con un seguimiento por su condición de alto riesgo. Actualmente saludable y con buen desarrollo psicomotor. Conclusiones: la importancia del tema que se presenta es que se describe una presentación rara de quistes pulmonares congénitos en un recién nacido que desarrolló un estadio avanzado de sepsis.

  10. Doença pulmonar induzida pelas radiações ou pelos fármacos citostáticos

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    Ulrich Costabel

    2000-03-01

    Full Text Available RESUMO: O artigo discute dois temas afins: 1 doença pulmonar induzida pela radioterapia nas suas diferentes apresentações: pneumonite de radiação clássica e fibrose pulmonar e outras duas mais recentemente descritas, BOOP e alveolite linfocitária bilateral São discutidos os mecanismos patoeenicos, clinic:a e tratamento; 2 a patologia intersticial induzida por fármacos citostáticos nas suas várias formas de apresentação.REV PORT PNEUMOL 2000; VI (2: 141-144 ABSTRACT: In this paper two topics art adressed: 1 the radiation induced lung injury in its possible forms: classical radiation pneumonitis and radiation fibrosis or two other newly recoenised sindromes BOOP and bilateral lymphodtic alveolitis. The mecanism and treatment are discussed; 2 the cytotocic drug-induced lung diseases and their pulmonary reaction patterns.REV PORT PNEUMOL 2000; VI (2: 141-144 Palavras-chave: Radioterapia, Citostaticos, BOOP, Alveolite Linfocitica, Key-words: Radiation, Cytotocic Drugs, Lymphocitic Alveolitis

  11. Pneumonite intersticial não específica: entidade clínico-patológica, padrão histológico ou apenas grupo heterogéneo de pneumonites intersticiais não classificadas?

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    António Morais

    2004-07-01

    Full Text Available RESUMO: A pneumonite intersticial não específica (NSIP, descrita pela primeira vez em 1994 por Katzenstein e Fiorelli, apresenta-se como uma eventual entidade clínico-patológica individualizável dentro do grupo das pneumonites intersticiais idiopáticas (IIP. Aliada a alterações histológicas distintas, apresentauma evolução clínica mais favorável, com consequente melhor prognóstico do que a fibrose pulmonar idiopática (IPF, grupo onde geralmente estas alterações eram incluídas. Estas diferenças levam a que, apesar das dúvidas que ainda envolvem a NSIP, o seu reconhecimento seja importante, uma vez que as atitudes clínicas e terapêuticas se diferenciam da IPF. A NSIP engloba padrões histológicos diferentes, dividindo-se nomeadamente em casos de predomínio inflamatório (tipo celular ou de predomínio fibroso (tipo fibrosante, com os últimos a evidenciarem uma maior gravidade e pior prognóstico do que os primeiros. Os autores descrevem dois casos de NSIP, seguidos de uma revisão e discussão do tema.REV PORT PNEUMOL 2004; X (4: 331-345 ABSTRACT: Nonspecific interstitial pneumonitis (NSIP initially described by Katzenstein and Fiorelli in 1994, seems to be a distinct clinicopathologic entity among idiopathic interstitial pneumonitis (IIP. Besides different histologic features from other IIP, NSIP is characterized by a better long-term outcome, associated with a better steroids responsiveness than idiopathic pulmonar fibrosis (IPF, where usually were included. Thus, differentiating NSIP from other IIP, namely IPF is very significant, since it has important therapeutic and prognostic implications. NSIP encloses different pathologies, namely those with inflammatory predominance (cellular subtype or fibrous predominance (fibrosing subtype. NSIP is reviewed and discussed by the authors, after two clinical cases description.REV PORT PNEUMOL 2004; X (4: 331-345 Palavras chave: pneumonites intersticiais idiopáticas, pneumonite

  12. Exacerbação aguda da fibrose pulmonar idiopática Acute exacerbation of idiopathic pulmonary fibrosis

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    Natália Melo

    2009-03-01

    Full Text Available Alguns doentes com fibrose pulmonar idiopática (FPI apresentam durante a sua evolução fases deagravamento clínico sem causa conhecida, designadas como “exacerbação aguda” ou “fase acelerada” da doença (EA. Caracterizam -se pelo agravamento marcado da dispneia, hipoxemia e pelo aparecimento de novas opacidades pulmonares ou pelo agravamento das já existentes no estudo imagiológico. Os achados histológicos típicos são o dano alveolar difuso (DAD sobreposto a alterações de pneumonia intersticial usual (UIP. Esta entidade clínica associa -se a uma mortalidade elevada, não havendo até ao momento nenhuma terapêutica de comprovada eficácia. Os autores descrevem os casos clínicos de cinco doentes que apresentaram alterações clínicas, funcionais e radiológicas sugestivas de EA-FPI, assim como o tratamento efectuado e a evolução observada, enquadrando-os na discussão das características normalmente apresentadas por esta entidade.Some patients with Idiopathic Pulmonary Fibrosis (IPF have disease accelerated deterioration without identifiable cause referred as “acute exacerbation” or “accelerated stage”. It is characterized by severe worsening of dyspnea, hypoxemia and new or progressive opacities on imaging studies. The typical histological findings are diffuse alveolar damage in addition to the features of usual interstitial pneumonia pattern. Mortality in this clinical entity is very high and no efficacious therapeutic have been described. The authors describe the clinical, functional and radiological features, treatment and evolution of five patients with IPF acute exacerbation. A discussion will be carry out concerning the IPF acute exacerbation usual features comparing with the alterations noticed in those patients.

  13. Utilidad de la biopsia transbronquial en el diagnostico de enfermedades pulmonares en pacientes VIH/SIDA

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    Carmen Elena Fuenmayor

    2014-04-01

    Full Text Available La biopsia transbronquial es una herramienta útil en el diagnóstico de un grupo heterogéneo de enfermedades pulmonares. El objetivo del presente estudio fue determinar la etiología de los procesos pulmonares más frecuentes en el grupo de pacientes VIH/SIDA controlados en el Instituto Autónomo Hospital Universitario de los Andes durante el periodo febrero a septiembre del 2009. Se realizó un estudio observacional, analítico y descriptivo con enfoque epidemiológico, clínico y anatomopatológico en un grupo de 39 pacientes portadores de virus de Inmunodeficiencia Humana. De estos solamente 36 cumplieron los criterios de inclusión para esta investigación. Se hicieron análisis sanguíneo, perfil inmunológico, estudios imagenológicos, lavado bronco-alveolar, cepillado bronquial y biopsia transbronquial. Los cortes histológicos mostraron respuesta inflamatoria en diferentes fases de evolución, daño alveolar difuso y edema intraalveolar. Se realizó el diagnóstico de un grupo de enfermedades oportunistas tales como: neumocistosis, Histoplasmosis, Candidiasis y lesiones probablemente debidas a virus Herpes y Citomegalovirus. Se destaca la participación de más de un germen. Además hubo vasculitis, trombos, áreas de infarto, fibrosis intersticial y hallazgos sugestivos de Hipertensión Pulmonar. Uno de los pacientes presento neoplasia maligna epitelial indiferenciada. El empleo de esta técnica permitió evaluar la presencia de infecciones oportunistas y neoplasias infrecuentes, así como los hallazgos sugestivos de Hipertensión pulmonar. Se avala su utilización ante la necesidad de realizar un diagnóstico etiológico de certeza y establecer así la terapéutica adecuada. Utility transbronchial biopsy in the diagnosis ofpulmonary disease in patients HIV/AIDS Abstract Transbronchial biopsy is a useful tool in the diagnosis of a heterogeneous group of lung diseases. The aim of this study was to determine the etiology of pulmonary

  14. Síndrome pulmonar e cardiovascular por hantavírus Hantavirus pulmonary and cardiovascular syndrome

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    Mariangela Pimentel Pincelli

    2003-10-01

    Full Text Available A síndrome pulmonar e cardiovascular por hantavírus é uma doença de conhecimento relativamente recente e freqüentemente fatal, apresentando-se como síndrome do desconforto respiratório agudo. No Brasil, desde o primeiro surto, relatado em novembro/dezembro de 1993, em Juquitiba, 226 casos já foram registrados pela Fundação Nacional da Saúde. A doença afeta indivíduos previamente hígidos, apresentando-se com pródromo febril e sintomas semelhantes aos de um resfriado comum, podendo rapidamente evoluir para edema pulmonar, insuficiência respiratória aguda e choque. A hemoconcentração e a plaquetopenia são comuns da síndrome pulmonar e cardiovascular por hantavírus, e o quadro radiológico típico é de um infiltrado intersticial bilateral difuso, que progride rapidamente para consolidações alveolares, paralelamente à piora do quadro clínico. A mortalidade inicial era em torno de 75% e declinou para aproximadamente 35%, nos últimos anos. Os pacientes que sobrevivem geralmente recuperam-se completamente, cerca de uma semana após o estabelecimento do quadro respiratório. O agente causal, não reconhecido até há pouco, foi identificado como um hantavírus, cujo reservatório natural são animais roedores da família Muridae, subfamília Sigmodontinae. O tratamento específico antiviral ainda não é bem estabelecido, estando em estudo a eficácia de ribavirina. Cuidados de terapia intensiva como ventilação mecânica e monitoramento hemodinâmico invasivo são necessários nas formas mais graves da doença. Essas medidas, se instituídas precocemente, podem melhorar o prognóstico e a sobrevida dos pacientes com síndrome pulmonar e cardiovascular por hantavírus.Hantavirus pulmonary and cardiovascular syndrome is a recently identified and often fatal disease, which presents as acute respiratory distress syndrome (ARDS. Since the first outbreak, in Nov/Dec 1993, in Juquitiba, Brazil, 226 cases have been registered by

  15. Compromiso pulmonar en esclerosis sistémica Lung involvement in systemic sclerosis

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    Silvia Quadrelli

    2007-10-01

    Full Text Available El objetivo del estudio fue determinar las características clínicas de los pacientes con esclerodermia y compromiso pulmonar y evaluar si existen factores clínicos predictores de mayor riesgo de enfermedad intersticial. Se estudiaron en forma retrospectiva 40 pacientes con esclerodermia. Fueron divididos en 2 grupos: capacidad de difusión del monóxido de carbono (DLCO normal (n = 22 y DLCO disminuida (n = 18, 45%. Los pacientes con DLCO disminuida no fueron diferentes en edad (51.1 ± 13.5 vs. 53.5 ± 9.3 años, p = 0.5182, sexo (varones 13.6%, p = 0.6088 , presencia de Raynaud (86.6% vs. 85%, p = 0.6272, síndrome de ojo seco (6.2% vs. 10.5%, p = 1.0000 prevalencia de enfermedad difusa (94.1% vs. 83.3%, p = 0.6026 o de dilatación esofágica. El tiempo de evolución de la enfermedad no fue diferente. La sensibilidad de la disnea para detectar una DLCO alterada fue 46.6% con una especificidad del 90% y la de la caída de la saturación de O2 (SaO2 del 71.4% y 80% respectivamente. Los pacientes con DLCO baja tuvieron mayor prevalencia de anticuerpos anti-Scl 70 positivos (5/9 vs. 0/11, p = 0.0081 y de incapacidad ventilatoria restrictiva aunque en 56.7% de los pacientes con DLCO disminuida la capacidad pulmonar total (CPT era normal. La presencia de hipertensión pulmonar medida por ecocardiograma Doppler fue idéntica (11/13 vs. 10/11, p = 1.0000. Los pacientes con DLCO disminuida tuvieron una prevalencia muy superior de tomografía computada de tórax con evidencias de compromiso intersticial (82.3% vs. 5.8%, p ≤ 0.0001. En conclusión, nuestros datos sugieren que la disminución de la DLCO es un hallazgo, muy frecuentemente asociado a TAC de tórax con compromiso intersticial y que no hay variables clínicas que permitan predecir su anormalidad.The objective of this study was to determine clinical predictors of interstitial lung disease in patients with systemic sclerosis (SSc and pulmonary involvement as defined by presence of a

  16. Endocarditis infecciosa de válvula pulmonar nativa

    OpenAIRE

    Franco Romaní R; Fernando Atencia M; José Cuadra A

    2007-01-01

    La endocarditis infecciosa en válvulas derechas es predominantemente en la válvula tricuspídea, mientras la válvula pulmonar es excepcionalmente afectada (menos de 1,5%), por lo que son pocos los casos reportados en la literatura mundial. Las manifestaciones clínicas de endocarditis en válvula pulmonar no son las clásicas de endocarditis infecciosa, como son los síntomas de embolismo séptico pulmonar. La endocarditis aislada de válvula pulmonar nativa es inusual en personas que no consumen dr...

  17. Diagnóstico do embolismo pulmonar

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    João Castaño

    2003-03-01

    Full Text Available RESUMO: O diagnóstico do Embolismo Pulmonar é considerado por vezes difícil. É importante reconhecer as situações clínicas que podem ser potencialmente desencadeantes. Existe uma série de meios auxiliares de diagnóstico, quer laboratoriais quer imagiológicos, que devem ser adaptados aos meios disponíveis em cada instituição.REV PORT PNEUMOL 2003; IX (2: 129-137 ABSTRACT: Pulmonary Embolism is often considered a difficult diagnosis to establish. It is important to recognise clinical situations that leads to it. There are a few laboratory and imaging tests, that should be tailored to the available facilities in each institution.REV PORT PNEUMOL 2003; IX (2: 129-137 Palavaras-chave: Tromboembolismo Pulmonar, Pulmão, Perfusão Pulmonar, Tomografia Computorizada (TC, Angiografia, Helicoidal, Key-words: Pulmonary Embolism, Lung, Lung Perfusion, Computed Tomography (CT, Angiography, Helical

  18. ENFOQUE ACTUAL DE LAS MALFORMACIONES PULMONARES

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    Dra. Mónica Saavedra

    2017-01-01

    Full Text Available Las malformaciones pulmonares corresponden a distintas anomalías del sistema respiratorio que se presentan con baja incidencia (1 en cada 10.000 a 35.000 embarazos, dentro de las que se incluye a las Malformaciones Pulmonares Congénitas y de la vía aérea (MCPA, antes conocida malformación adenomatosa quística, secuestros pulmonares, lesiones híbridas y enfisema lobar congénito. Durante los últimos años se ha visto un aumento en el diagnóstico antenatal y avances en el conocimiento de la patogénesis e historia natural de esta enfermedad, pero aún existe controversia en cuanto a la clasificación a utilizar y a su tratamiento. La mayoría de los recién nacidos (90% son asintomáticos al nacer, pero hay malformaciones que generan serias complicaciones para el feto o recién nacido. El propósito de esta publicación es hacer un resumen actualizado de la historia natural, diagnóstico y tratamiento de las MCPA.

  19. Massas pulmonares bilaterais. Mesma etiologia?

    Directory of Open Access Journals (Sweden)

    C. Damas

    2007-03-01

    Full Text Available Resumo: Os autores descrevem o caso de uma mulher de 50 anos, fumadora. Assintomática até Setembro de 2003, altura em que refere o aparecimento de tosse seca, cansaço e perda de peso. Na radiografia do tórax eram evidentes duas massas, uma no lobo superior direito e outra no lobo lingular. A doente foi submetida a biópsia aspirativa transtorácica e a citologia obtida foi compatível com carcinoma de pulmão do tipo pequenas células. No estadiamento da doença foram identificadas lesões hepáticas secundárias, motivo porque a doença foi considerada como disseminada, dada a existência de lesões hepáticas e pulmonares contra-laterais. Foi, nesta fase, iniciada quimioterapia com carboplatinum e etoposídeo. Seis meses mais tarde, a lesão direita inha diminuído, mas a lesão esquerda apresentava aumento das suas dimensões. A biópsia desta lesão mos-trou uma citologia compatível com adenocarcinoma do pulmão, motivo porque inicia novo ciclo de quimioterapia com vinorelbina e gencitabina. Aos quatro ciclos e por não se evidenciar nenhuma resposta ao tratamento, foi realizada radioterapia da lesão esquerda. Durante este período (28 meses mantém-se assintomática, mantendo a sua actividade diária habitual.De acordo com o momento do diagnóstico as neo-plasias do pulmão podem ser consideradas síncronas ou metácronas. Estas últimas são mais frequentes, re-presentando cerca de 50-70% dos casos, sendo o pa-drão histológico mais frequente o adenocarcinoma.No caso apresentado, a situação parecia ser uma doença disseminada, o que afastou a hipótese de tumores síncronos. Apesar de a doença se apresentar num estádio avançado aquando do diagnóstico e do mau prognósti-co associado, a evolução dos dois tipos de tumor não pareceu comprometer a actividade diária da doente.Rev Port Pneumol 2007; XIII (2: 287

  20. Reoperação de tromboendarterectomia pulmonar em recidiva de tromboembolismo pulmonar crônico hipertensivo

    OpenAIRE

    Gomes,Walter José; Imaeda,Carlos Jogi; Perfeito,João Alessio; Sarmento,Petrúcio Abrantes; Souza,Rodrigo Caetano; Forte,Vicente

    2009-01-01

    A cirurgia de tromboendarterectomia tem se estabelecido como método padrão de tratamento do tromboembolismo pulmonar crônico hipertensivo, com excelentes resultados. Entretanto, a reoperação na recidiva do embolismo pulmonar não tem relato na literatura nacional, permanecendo obscuras a sua segurança e efetividade. Relatamos o caso de uma paciente com recorrência de tromboembolismo pulmonar crônico hipertensivo ocorrido cinco anos após a primeira cirurgia de tromboendarterectomia pulmonar, e ...

  1. Unilateralism in International Law

    DEFF Research Database (Denmark)

    Hartmann, Jacques

    2015-01-01

    or foreign territory. Many States, however, viewed the EU’s initiative as a unilateral act in violation of their sovereignty. The EU has since suspended the application of the ETS to foreign aircraft. Even so, this incident raises important questions concerning the legality of unilateral acts under...... Union (EU) decided to act unilaterally to reduce emission from aviation, by including aviation within its Emission Trading System (ETS). Initially, the EU set out to include in the ETS emissions from all major aircraft flying to or from European airports, even when these fly over the high seas...

  2. Doenças pulmonares intersticiais: Acuidade diagnóstica e riscos da biópsia pulmonar cirúrgica Interstitial lung disease: Diagnostic accuracy and safety of surgical lung biopsy

    Directory of Open Access Journals (Sweden)

    Miguel Guerra

    2009-05-01

    Full Text Available Os autores descrevem a sua casuística de biópsias pulmonares cirúrgicas em doentes com doença pulmonar intersticial, de forma a determinar a acuidade diagnóstica, os riscos e a morbimortalidade associados ao procedimento. Entre Janeiro de 1998 e Dezembro de 2007, 53 doentes (idade média de 47,2±13 anos foram referenciados para a realização de biópsia pulmonar cirúrgica, dos quais 22 eram mulheres (41,5%. As biópsias pulmonares foram realizadas quer por videotoracoscopia (37 doentes, 69,8%, quer por minitoracotomia (16 doentes, 30,2%. Foi escolhido o pulmão direito para biopsar em 88,7% dos casos. Registaram-se complicações pós-operatórias em 5 doentes (9,4%: fuga aérea prolongada em 3 doentes (5,7%, persistência de loca de pneumotórax num doente (1,9% e hemorragia com necessidade de revisão de hemostase noutro doente (1,9%. Ocorreu um óbito de causa desconhecida num doente sem risco acrescido. A duração média da drenagem foi de 4,4±3 dias e o tempo de internamento médio de 5,5±4 dias. O diagnóstico histológico definitivo foi conseguido em 50 doentes, registando-se uma acuidade diagnóstica de 94,3%. Em conclusão, o potencial benefício de um diagnóstico histopatológico conclusivo através de uma biópsia pulmonar cirúrgica deve ser balanceado com os riscos associados ao procedimento cirúrgico, especialmente para aqueles doentes com disfunção cardiopulmonar severa.This study reports our experience, diagnostic accuracy and safety of surgical lung biopsy in patients with interstitial lung diseases. From January 1998 – December 2007 surgical lung biopsy was performed in 53 patients (22 female [41.5%]; age 47.2±13 years. A total of 37 patients (69.8% underwent videothoracoscopic lung biopsy and minithoracotomy was performed in 16 patients (30.2%. Right lung was the choice in 47 patients (88.7%. Postoperative complications were rare (9.4% and included three prolonged air leaks (5.7%, one pneumothorax requiring a

  3. Achados histológicos e sobrevida na fibrose pulmonar idiopática Histological features and survival in idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Ester Nei Aparecida Martins Coletta

    2003-12-01

    Full Text Available INTRODUÇÃO: A fibrose pulmonar idiopática foi recentemente redefinida como pneumonia intersticial usual de etiologia desconhecida. O valor prognóstico dos achados histológicos deve ser reavaliado. OBJETIVO: Neste estudo foram correlacionados os achados histológicos e alguns dados clínicos e funcionais (duração dos sintomas, capacidade vital forçada, idade, sexo, hábito de fumar com a sobrevida. MÉTODO: Foram estudados 51 pacientes portadores de fibrose pulmonar idiopática. A média de idade foi de 66 ± 8 anos. Vinte e um pacientes eram do sexo feminino; 26 eram fumantes ou ex-fumantes. Todos apresentavam quadro de pneumonia intersticial usual na histologia. Grau de faveolamento, fibrose estabelecida, descamação, celularidade, espessamento vascular miointimal e focos fibroblásticos foram graduados por método semiquantitativo. RESULTADOS: A mediana do tempo de sintomas foi de 12 meses e a capacidade vital forçada inicial foi de 72 ± 21%. Por análise de risco proporcional de Cox, a sobrevida correlacionou-se, de maneira significativa (p BACKGROUND: Idiopathic pulmonary fibrosis was recently redefined as usual interstitial pneumonia of unknown etiology. Consequently, the prognostic value of histological findings needs to be reassessed. OBJECTIVE: To correlate clinical, functional and histological findings with survival in patients with idiopathic pulmonary fibrosis. METHOD: Patients (n = 51; mean age: 66 ± 8 years; gender: 21 females/30 males were evaluated. Of the 51, 26 were smokers or ex-smokers. Duration of symptoms, forced vital capacity and smoking habits were recorded. All patients presented usual interstitial pneumonia verified through histology. Degree of honeycombing, established fibrosis, desquamation, cellularity, myointimal thickening of blood vessels and number of fibroblastic foci were graded according to the semiquantitative method. RESULTS: Median duration of symptoms was 12 months and initial forced vital

  4. Atresia pulmonar con comunicación interventricular

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    Tomasa Centella Hernández

    2014-04-01

    Full Text Available La atresia pulmonar con comunicación interventricular es una cardiopatía congénita cianótica, severa y rara, de alta complejidad, que se caracteriza por la ausencia de conexión entre el ventrículo derecho y las arterias pulmonares. Coexiste con una comunicación interventricular. El flujo hacia el territorio pulmonar puede realizarse a través del ductus arterioso o de colaterales sistémico-pulmonares. La dificultad de esta cardiopatía viene determinada por los diferentes niveles de interrupción desde el ventrículo derecho hasta el territorio pulmonar, y por la diferencia anatómica de las fuentes del flujo hacia dicho territorio, lo que determina diferentes tipos de abordaje quirúrgico.

  5. Alterações histopatológicas pulmonares em pacientes com insuficiência respiratória aguda: um estudo em autopsias Pulmonary histopathological alterations in patients with acute respiratory failure: an autopsy study

    Directory of Open Access Journals (Sweden)

    Alexandre de Matos Soeiro

    2008-02-01

    Full Text Available OBJETIVOS: Apresentar alterações histopatológicas pulmonares encontradas em autopsias de pacientes falecidos por insuficiência respiratória aguda (IRA e verificar se doenças de base e específicos fatores de risco associados aumentam a incidência dessas alterações. MÉTODOS: Foram revisados laudos finais de autopsias e selecionadas 3.030 autopsias de pacientes > 1 ano de idade, com infiltrado pulmonar radiológico, portadores de doença de base e fatores de risco associados, que morreram por alterações pulmonares decorrentes de IRA. RESULTADOS: As principais alterações histopatológicas pulmonares causadoras de morte imediata foram: dano alveolar difuso (DAD; edema pulmonar; pneumonia intersticial linfocítica (PIL e hemorragia alveolar. As principais doenças de base encontradas foram: AIDS; broncopneumonia; sepse; cirrose hepática; tromboembolismo pulmonar; infarto agudo do miocárdio (IAM; acidente vascular cerebral; tuberculose; câncer; insuficiência renal crônica e leucemia. Os principais fatores de risco associados foram: idade > 50 anos; hipertensão arterial; insuficiência cardíaca congestiva; doença pulmonar obstrutiva crônica e diabetes mellitus. Pacientes com esses fatores de risco e AIDS apresentaram alta probabilidade de desenvolver PIL; pacientes com esses mesmos fatores, de desenvolver DAD, se portadores de sepse ou cirrose hepática; pacientes com tromboembolismo e os mesmos fatores de risco, de desenvolver hemorragia alveolar; pacientes com esses fatores de risco e IAM, de desenvolver edema pulmonar. CONCLUSÕES: Os achados pulmonares em pacientes com óbito por IRA apresentaram quatro padrões histopatológicos: DAD, edema pulmonar, PIL e hemorragia alveolar. Doenças de base e específicos fatores de risco associados correlacionaram-se positivamente com determinados padrões histopatológicos detectados à autópsia.OBJECTIVE: To present the pulmonary histopathological alterations found in the autopsies of

  6. Ultrassom pulmonar em pacientes críticos: uma nova ferramenta diagnóstica Lung ultrasound in critically ill patients: a new diagnostic tool

    Directory of Open Access Journals (Sweden)

    Felippe Leopoldo Dexheimer Neto

    2012-04-01

    Full Text Available A avaliação pulmonar através do ultrassom é um tema de crescente interesse na avaliação de pacientes críticos, muitas vezes aplicado por não radiologistas. Como essa técnica baseia-se no fato de que todas as agressões agudas reduzem a aeração pulmonar, o ultrassom pulmonar pode fornecer informações complementares ao exame físico e à impressão clínica, com a principal vantagem de ser realizado à beira do leito. O objetivo dessa revisão foi avaliar as aplicações clínicas do ultrassom pulmonar, através da pesquisa das bases de dados PubMed e Biblioteca Virtual em Saúde dos seguintes termos, em português e em inglês: ultrassom, pulmão e cuidados críticos. Além dos artigos mais relevantes, estendeu-se a busca a livros especializados. Dados da literatura mostram que o ultrassom pulmonar é útil na interpretação de infiltrados pulmonares, tendo boa acurácia na identificação de consolidações e de síndrome intersticial. Além disso, ultrassom pulmonar tem sido amplamente utilizado na avaliação e abordagem de derrames pleurais, assim como na identificação de pneumotórax. Essa técnica pode também ser útil na avaliação imediata de pacientes com dispneia ou insuficiência respiratória aguda. Outras aplicações descritas são a monitorização da resposta ao tratamento e o aumento da segurança na realização de procedimentos invasivos. Embora ainda haja a necessidade de uma padronização dos critérios de treinamento e certificação, esse é um método rápido, barato e amplamente disponível, e a incorporação dessa nova tecnologia deve tornar-se progressivamente maior no cuidado de doentes críticos.The evaluation of critically ill patients using lung ultrasound, even if performed by nonspecialists, has recently garnered greater interest. Because lung ultrasound is based on the fact that every acute illness reduces lung aeration, it can provide information that complements the physical examination and

  7. Proteinosis alveolar pulmonar Pulmonary alveolar proteinosis

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    Concepción Sánchez Infante

    2011-12-01

    Full Text Available La proteinosis alveolar pulmonar es una enfermedad respiratoria crónica, caracterizada por alteración en el metabolismo del surfactante, lo que determina su acumulación anormal en el espacio alveolar. Es una enfermedad extremadamente rara. Se han reportado solamente 500 casos en la literatura. Se describió por primera vez en 1958. Se presenta un caso de proteinosis alveolar pulmonar en un lactante de 2 meses, con desnutrición proteico energética, que ingresa por dificultad respiratoria e hipoxemia, y, con imágenes radiológicas de tipo retículo-nodulillar, en vidrio deslustrado, en el cual se plantea inicialmente el diagnóstico de bronconeumonía. Ante la evolución desfavorable y no respuesta al tratamiento, se realizó un estudio para descartar enfermedades pulmonares crónicas. El paciente fallece y se confirma el diagnóstico por anatomía patológica. Se realiza una revisión del tema.The pulmonary alveolar proteinosis is a chronic respiratory disease characterized by surfactant metabolism alteration determining its abnormal accumulation in the alveolar space. It is a disease very rare and in literature only 500 cases have been reported; it was described for the first time in 1958. This is a case presentation of pulmonary alveolar proteinosis in an infant aged 2 months with energetic protein malnutrition admitted due to respiratory difficulty and hypoxemia and with radiologic images of the reticulonodulillary, in frosting glass, where initially is made the diagnosis of bronchopneumonia. In the face of unfavorable evolution and no response to treatment, a study was conducted to rule out chronic pulmonary diseases. Patient died confirming the diagnosis according to the pathologic anatomy. A review on subject is carried out.

  8. Diagnóstico do embolismo pulmonar

    OpenAIRE

    Castaño, João; Alpendre, João; Pisco, João Martins

    2003-01-01

    RESUMO: O diagnóstico do Embolismo Pulmonar é considerado por vezes difícil. É importante reconhecer as situações clínicas que podem ser potencialmente desencadeantes. Existe uma série de meios auxiliares de diagnóstico, quer laboratoriais quer imagiológicos, que devem ser adaptados aos meios disponíveis em cada instituição.REV PORT PNEUMOL 2003; IX (2): 129-137 ABSTRACT: Pulmonary Embolism is often considered a difficult diagnosis to establish. It is important to recognise clinical situation...

  9. Autoimmune thyroiditis presenting as interstitial granulomatous dermatitis Dermatite intersticial granulomatosa como apresentação de tireoidite autoimune

    Directory of Open Access Journals (Sweden)

    Joana Antunes

    2012-10-01

    Full Text Available A 54-year-old female presented with recurrent, widespread, erythematous, painful plaques, over a 3-month period. Skin biopsy was compatible with interstitial granulomatous dermatitis. Additional investigation revealed hypothyroidism and positive anti-thyroid antibodies. Normalization of thyroid function and high-potency topical corticosteroids provided only transitory improvement of the dermatosis. Interstitial granulomatous dermatitis is a histologic inflammatory reaction, with variable cutaneous expression. It has been reported in association with several drugs, lymphoproliferative diseases and autoimmune disorders, such as rheumatoid arthritis, systemic lupus erythematosus and vasculitis, but association with autoimmune thyroiditis is rare. Optimal therapy for this condition is yet to be established, but topical corticosteroids have been a mainstay of treatment. In most cases, this disease is characterized by flares and remissions.Uma doente de 54 anos foi avaliada por placas eritematosas, dolorosas, disseminadas, recorrentes, com 3 meses de evolução. A biopsia cutânea foi compatível com dermatite intersticial granulomatosa. Os restantes exames laboratoriais revelaram hipotiroidismo e anticorpos anti-tiroideus positivos. Apesar da normalização da função tiroideia e de tratamento com corticóide tópico de alta potência, a dermatose melhorou apenas parcialmente. Dermatite intersticial inflamatória é um diagnóstico histopatológico, com expressão clínica variável. Tem sido associada a vários fármacos, doenças linfoproliferativas e autoimunes, nomeadamente artrite reumatóide, lupus eritematoso sistémico e vasculites, mas a associação com tireoidite autoimune é rara. Até ao momento, não foi definido nenhum tratamento específico, mas os corticóides tópicos são dos fármacos mais utilizados. A doença caracteriza-se por períodos de agravamento e remissão.

  10. Interstitial neumonia and cytomegalovirus: and immunopathological process Neumonía intersticial y citomegalovirus: un proceso inmunopatológico

    Directory of Open Access Journals (Sweden)

    Ana Isabel Toro

    1995-03-01

    Full Text Available

    Cytomegalovirus (CMV infection is a frequent cause of morbidity and mortality in immunocompromised individuals. including renal and bone marrow transplant recipients and patients with the acquired immunodeficiency syndrome (AIDS. CMV infection often affects the lung producing a fatal interstitial pneumonitis (IP. The pathogenesis of CMV IP is not well understood, but clinical observations in humans and laboratory studies with murine models, offer possibilities for explaining CMV-induced IP as an immunopathological disease.

    La infección activa por Citomegalovirus (CMV es causa frecuente de morbi-mortalidad en individuos inmunocomprometidos, particularmente entre receptores de trasplante renal y médula ósea y en personas afectadas por el virus de la inmunodeficiencia adquirida (HIV, en las cuales, a menudo, se presenta neumonía intersticial (NI fatal (1,2. La patogénesis de la NI causada por CMV no es clara aún, pero las observaciones clínicas en el hombre y los estudios con modelos murinos permiten pensar en ella como una alteración inmunopatológica. El análisis de tales conceptos es el objetivo de esta revisión.

  11. Unilateral CHARGE association

    NARCIS (Netherlands)

    Trip, J; van Stuijvenberg, M; Dikkers, FG; Pijnenburg, MWH

    A case with a predominantly unilateral CHARGE association is reported. The CHARGE association refers to a combination of congenital malformations. This boy had left-sided anomalies consisting of choanal atresia. coloboma and peripheral facial palsy. The infant had a frontal encephalocele. an anomaly

  12. Unilateral hyperhidrosis and hypothermia

    DEFF Research Database (Denmark)

    Dyring-Andersen, B; Kamp, S; Madelung, A

    2016-01-01

    A 34-year old man presented at the Department of Dermato-allergology, Herlev and Gentofte Hospital with unilateral hyperhidrosis localized to the right axilla through approximately 10 years without progression of symptoms. The patient often experienced that his right hand was colder than the left...

  13. Endocarditis infecciosa de válvula pulmonar nativa

    Directory of Open Access Journals (Sweden)

    Franco Romaní R

    2007-04-01

    Full Text Available La endocarditis infecciosa en válvulas derechas es predominantemente en la válvula tricuspídea, mientras la válvula pulmonar es excepcionalmente afectada (menos de 1,5%, por lo que son pocos los casos reportados en la literatura mundial. Las manifestaciones clínicas de endocarditis en válvula pulmonar no son las clásicas de endocarditis infecciosa, como son los síntomas de embolismo séptico pulmonar. La endocarditis aislada de válvula pulmonar nativa es inusual en personas que no consumen drogas intravenosas. Se presenta el caso de un paciente varón con diabetes mellitus tipo 2 y sin otro factor predisponente.

  14. Embolectomía en una embolia pulmonar aguda masiva

    Directory of Open Access Journals (Sweden)

    Manuel Carnero Alcázar

    2007-07-01

    Full Text Available Presentamos el caso de un varón de 57 años que, en el seno de un meningioma microcítico, padece una tromboembolia pulmonar masiva aguda con inestabilidad hemodinámica. Dado el riesgo de hemorragia por el tumor craneal, se contraindica la terapia fibrinolítica y se procede a practicar embolectomía pulmonar. Ésta se realiza bajo anestesia general, con canulación convencional y bajo hipotermia moderada. Se extrae émbolo en el tronco de la arteria pulmonar y con catéter de Fogarty se extraen émbolos en ramas lobares y segmentarias. Discutimos la asociación de enfermedad tromboembólica con determinadas neoplasias y el tratamiento de la tromboembolia pulmonar

  15. Idade pulmonar em mulheres com obesidade mórbida

    Directory of Open Access Journals (Sweden)

    Fabiana Sobral Peixoto-Souza

    2013-06-01

    Full Text Available OBJETIVO: Verificar a influência da obesidade mórbida na idade pulmonar de mulheres e correlacionar com a massa corporal, índice de massa corporal (IMC e variáveis ventilatórias. MÉTODOS: Estudo longitudinal realizado com 72 obesas mórbidas e grupo controle constituído de mulheres eutróficas. As voluntárias realizaram um teste de função pulmonar para determinação da idade pulmonar e os resultados foram correlacionados com as variáveis antropométricas e volumes pulmonares. RESULTADOS: As obesas mórbidas apresentaram uma idade pulmonar significativamente superior (50,1 ± 6,8 anos às eutróficas (38,8 ± 11,4 anos. Não houve diferença entre a idade cronológica entre os grupos. Houve uma correlação significativa e positiva entre idade cronológica, massa corporal e IMC com a idade pulmonar (r = 0,3647, 0,4182, 0,3743, respectivamente. Houve uma correlação negativa entre a capacidade vital forçada (CVF, volume expiratório forçado no primeiro segundo (VEF1, razão (VEF1/CVF e volume de reserva expiratório (VRE com a idade pulmonar (r = -0.7565, -0.8769, -0.2723, -0.2417, respectivamente. CONCLUSÃO: A idade pulmonar das obesas mórbidas encontra-se aumentada e está associada com o aumento da massa corporal e IMC.

  16. Factores de riesgo de mortalidad precoz del Trasplante Pulmonar

    OpenAIRE

    Kreis Esmendi, Germán

    2006-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada A pesar de la experiencia acumulada, la mortalidad postoperatoria temprana del trasplante pulmonar continua siendo elevada. Los factores asociados a este evento permanecen siendo controvertidos. Objetivo: Revisar la serie de trasplantes pulmonares realizados en el Hospital Vall d' Hebron para establecer la supervivencia acumulada e identificar los factores asociados con riesgo de mortalidad postoperatoria precoz. Pacient...

  17. Edema pulmonar agudo neurogênico: relato de caso

    OpenAIRE

    Brito,José Correia De Farias; Diniz,Maria Cerly Almeida; Rosas,Roberto Ramalho; Silva,José Alberto Gonçalves Da

    1995-01-01

    Os autores apresentam um caso de edema pulmonar agudo numa paciente de 28 anos de idade acometida de hemorragia subaracnóidea secundária à rotura de aneurisma intracraniano. A sintomatologia respiratória ocorreu durante o agravamento do quadro neurológico. Alguns aspectos etiológicos e fisiopatogênicos do edema pulmonar agudo neurogênico são analisados.

  18. Unilateral Hemispheric Encephalitis

    Directory of Open Access Journals (Sweden)

    Mohan Leslie Noone

    2014-10-01

    Full Text Available A 10 year old boy presented with history of mild fever and upper respiratory symptoms followed by recurrent seizures and loss of consciousness on the next day. Normal blood counts and abnormal hepatic transaminases were noted. MRI of the brain, done on the fourth day of illness, showed extensive involvement of the cortex in the right hemisphere. Lumbar CSF was normal. The EEG showed bilateral slowing with frontal sharp wave discharges and marked attenuation over the entire right hemisphere. The patient succumbed to the illness on the ninth day. A similar pattern of acute unilateral hemispheric cortical involvement is described in the hemiconvulsion-hemiplegia-epilepsy (HHE syndrome, which is typically described to occur in children below 4 years of age. This case of fulminant acute unilateral encaphilitic illness could represent the acute phase of HHE syndrome.

  19. Comprometimento pulmonar na malária (revisão Pulmonary involvement in malaria

    Directory of Open Access Journals (Sweden)

    Marcos Boulos

    1993-02-01

    Full Text Available Com uma incidência de 3 a 10% dos casos e letalidade próxima a 70%, o comprometimento pulmonar constitui uma das manifestações mais graves da malária por Plasmodium falciparum. Embora sua patogênese não esteja perfeitamente esclarecida, reconhece-se que a hiperativação do sistema imune por antígenos liberados pelo Plasmodium falciparum desempenhe um importante papel no desencadeamento e agravamento das lesões. A estrutura alvo parece ser o endotélio capilar, responsável pelo fluxo de líquidos para o espaço intersticial. Essas células são ativadas por ação de citocinas, produzidas por linfócitos e macrófagos durante a resposta imune, e passam a expressar em sua membrana celular receptores e moléculas de aderência que facilitam a sequestração de eritrócitos parasitados e também a aderência de células capazes de produzir mediadores inflamatórios. A reação inflamatória e a lesão endotelial que se seguem, juntamente com as alterações hemodinâmicas induzidas pelo bloqueio capilar devido ao acúmulo local de eritrócitos e células inflamatórias causam alterações de permeabilidade vascular e, consequentemente, acúmulo de líquido nos espaços intersticiais e alvéolos. Nos casos mais graves, as manifestações clínicas assemelham-se às do quadro da Síndrome do desconforto respiratório do adulto. Comprometimento pulmonar grave pode se instalar rapidamente em qualquer estágio da evolução clínica da malária, mesmo após a cura parasitológica, desconhecendo-se os fatores desencadeantes. Hiperparasitismo, insuficiência renal e gravidez constituem fatores predisponentes. O prognóstico dependerá da rapidez com que o diagnóstico for estabelecido e o correto tratamento instituído. Além do tratamento instituído contra o parasita, especial atenção deverá ser dispensada à monitorização hemodinâmica, se possível através de cateter de Swan-Ganz, à manutenção de adequada oxigenação e balanço h

  20. Lung volume reduction surgery: an overview Cirurgia redutora de volume pulmonar: uma revisão

    Directory of Open Access Journals (Sweden)

    Rodrigo Afonso da Silva Sardenberg

    2010-01-01

    Full Text Available This study intends to review the literature on the efficacy, safety and feasibility of lung volume reduction surgery (LVRS in patients with advanced emphysema. Studies on LVRS from January 1995 to December 2009 were included by using Pubmed (MEDLINE and Cochrane Library literature in English. Search words such as lung volume reduction surgery or lung reduction surgery, pneumoplasty or reduction pneumoplasty, COPD or chronic obstructive pulmonary disease and surgery, were used. We also compared medical therapy and surgical technique. Studies consisting of randomized controlled trials, controlled clinical trials (randomized and nonrandomized, reviews and case series were analyzed. Questions regarding validity of the early clinical reports, incomplete follow-up bias, selection criteria and survival, confounded the interpretation of clinical data on LVRS. Patients with upper, lower and diffuse distribution of emphysema were included; we also analyzed as key points perioperative morbidity and mortality and lung function measurement as FEV1. Bullous emphysema was excluded from this review. Surgical approach included median sternotomy, unilateral or bilateral thoracotomy, and videothoracoscopy with stapled or laser ablation. Results of prospective randomized trials between medical management and LVRS are essential before final assessment can be established.O objetivo deste estudo é revisar a literatura acerca da eficácia, segurança e viabilidade da cirurgia redutora de volume pulmonar (CRVP em pacientes com enfisema pulmonar avançado. Estudos de CRVP de janeiro de 1995 a dezembro de 2009 foram incluídos através de pesquisa na Pubmed (MEDLINE e Cochrane Library, na literatura inglesa. Palavras de busca tais como lung volume reduction surgery ou lung reduction surgery, pneumoplasty ou reduction pneumoplasty, COPD ou chronic obstructive pulmonary disease e surgery foram utilizadas. Também realizamos comparação entre terapia médica e cir

  1. Actualizacin en el diagnstico y tratamiento de la hipertensin pulmonar

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    Juan A. Mazzei

    2011-05-01

    Full Text Available El trmino hipertensin pulmonar agrupa a un conjunto heterogneo de enfermedades que tienen en comn una remodelacin obstructiva del lecho vascular pulmonar. Esta alteracin provoca un estado hemodinmico caracterizado por una elevacin sostenida de la presin del circuito arterial pulmonar. La morbilidad y mortalidad de esta enfermedad son la consecuencia del fracaso de la compensacin del ventrculo derecho a este aumento de la poscarga. La presuncin clnica y el diagnstico precoz, una estratificacin adecuada basada en las causas subyacentes y los diferentes territorios vasculares comprometidos, la respuesta a los frmacos y el grado de gravedad, la seleccin de las diferentes alternativas teraputicas y su indicacin oportuna son los objetivos para el tratamiento contemporneo ptimo de los enfermos con hipertensin pulmonar y ser una importante tarea en el futuro. Estas recomendaciones estn destinadas al mdico general y tienen por objeto facilitar la deteccin precoz, el diagnstico y el tratamiento de los pacientes con hipertensin pulmonar, y pueden representar una diferencia significativa en el pronstico. Adems, como la evaluacin diagnstica requiere exmenes complementarios que habitualmente no estn disponibles en todas las instituciones asistenciales, tambin pueden ser utilizadas como fundamento para solicitar la derivacin oportuna a centros asistenciales de referencia.

  2. Diagnóstico precoz de enfermedades pulmonares por tabaquismo

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    Dr. D. Rodrigo Gil

    2010-09-01

    Full Text Available El tabaquismo es una epidemia y en Chile la prevalencia no ha disminuido. Entre las causas más importantes de muerte por tabaquismo están el cáncer pulmonar y la enfermedad pulmonar obstructiva crónica (EPOC. La erradicación del tabaquismo es la mejor estrategia de prevención de estas enfermedades. La segunda estrategia es la detección precoz de ellas. Sin embargo la EPOC está sub diagnosticada en todo el mundo. No está claro si la solución es hacer más espirometrías en población de riesgo. Es posible que otros métodos diagnósticos como la tomografía axial computada de tórax (TAC y la difusión pulmonar, puedan mejorar la capacidad de diagnóstico precoz de esta enfermedad. El cáncer pulmonar es el más mortal de los cánceres. El diagnóstico en etapas tempranas mejora significativamente su pronóstico. Hay varios estudios en curso que evalúan el beneficio de hacer pesquisa de cáncer pulmonar con TAC.

  3. Congenital unilateral hydrocephalus - CT findings

    International Nuclear Information System (INIS)

    Schulman, H.; Landau, D.; Schulman, P.; Hertzanu, Y.

    2000-01-01

    Congenital unilateral hydrocephalus is extremely uncommon with 18 cases previously reported in the English literature. Two additional newborns with unilateral hydrocephalus are presented. The second baby also presented a mega cisterna magna. This unusual association between Dandy-Walker variant and unilateral hydrocephalus has not been previously reported. Following ventriculo-peritoneal shunt, the babies had a normal cognitive neurodevelopment. The role of cranial computed tomography (CT) in diagnosis and follow-up is emphasized

  4. Unilateral retinitis pigmentosa sine pigmento.

    Science.gov (United States)

    Pearlman, J T; Saxton, J; Hoffman, G

    1976-05-01

    A patient presented with unilateral findings of night blindness shown by impaired rod function and dark adaptation, constricted visual fields with good central acuity, a barely recordable electro-retinographic b-wave, and a unilaterally impaired electro-oculogram. There were none of the pigmentary changes usually associated with retinitis pigmentosa. The unaffected right eye was normal in all respects. Therefore the case is most probably one of unilateral retinitis pigmentosa sine pigmento.

  5. Hipertensión pulmonar postparto

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    Juan Pablo Escalante

    2015-02-01

    Full Text Available La presencia de hipertensión pulmonar (HP en el embarazo es poco frecuente y conlleva un alto riesgo para madres e hijos. Existe escasa bibliografía relacionada al diagnóstico de la misma luego del parto. Se describen tres pacientes a quienes se diagnostica HP luego de cursar sus embarazos y partos libres de eventos. A pesar de desconocerse las causas, son varios los mecanismos propuestos, como la hipercoagulabilidad, la hipoxia placentaria o la embolia de líquido amniótico. Resulta difícil definir si la HP diagnosticada en el puerperio, corresponde a una HP en período asintomático que fue desenmascarada por el estrés fisiológico del parto o es una condición de reciente comienzo. A pesar de la falta de datos que avalen la ausencia de HP previa al embarazo en nuestras tres casos, el curso libre de eventos en sus embarazos, sin síntomas y con partos normales, indican que no padecían esta enfermedad hasta el momento del parto, y que la desarrollaron posteriormente. De haberla padecido antes se hubieran presentado síntomas previos al parto o en el puerperio inmediato, ya que las demandas hemodinámicas deterioran gravemente a un ventrículo con poca reserva.

  6. Coriocarcinoma con metástasis pulmonar

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    Vicia Sánchez Abalos

    2014-05-01

    Full Text Available Se presenta el caso clínico de una fémina de 44 años de edad, con 32 semanas de embarazo, la cual fuera ingresada en la Unidad de Cuidados Intensivos del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, por presentar insuficiencia respiratoria aguda como consecuencia de una sepsis. La paciente fue tratada con cefalosporina de tercera generación y ventilación mecánica no invasiva, pero se mantuvieron las características gasométricas de hipoxemia y una mala reacción terapéutica, por lo que se requirió instrumentación de las vías respiratorias y soporte hemodinámico, sin lograr regresión del cuadro clínico, lo cual condujo a un paro cardiorrespiratorio y, con ello, a la muerte. La necropsia mostró un coriocarcinoma del endometrio con metástasis pulmonar

  7. Tratamiento acortado estrictamente supervisado para tuberculosis pulmonar

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    Alvarez-Gordillo Guadalupe del Carmen

    1998-01-01

    Full Text Available Objetivo. Evaluar la posibilidad de aplicar el tratamiento acortado estrictamente supervisado (TAES en el Programa de Control de la Tuberculosis en Chiapas, México. Material y métodos. Se evaluó la eficacia y la eficiencia del tratamiento en una cohorte de pacientes con tuberculosis pulmonar confirmada por baciloscopía, que ingresaron a tratamiento con esquemas de autoadministración semisupervisión y estricta supervisión, de enero a junio de 1996. Resultados. La eficacia fue de 90.9. 97.7 y 100% para los esquemas de tratamiento autoadministrado, semisupervisado y TAES, respectivamente, mientras que la eficiencia fue de 68.1. 77.6 y 88.5% en el mismo orden. Conclusiones. Para la salud pública el TAES demostró ser la actividad más importante en el control de la tuberculosis, al elevar las tasas de curación y disminuir, por lo tanto, las fuentes de transmisión de la enfermedad.

  8. Unilateral removable partial dentures.

    Science.gov (United States)

    Goodall, W A; Greer, A C; Martin, N

    2017-01-27

    Removable partial dentures (RPDs) are widely used to replace missing teeth in order to restore both function and aesthetics for the partially dentate patient. Conventional RPD design is frequently bilateral and consists of a major connector that bridges both sides of the arch. Some patients cannot and will not tolerate such an extensive appliance. For these patients, bridgework may not be a predictable option and it is not always possible to provide implant-retained restorations. This article presents unilateral RPDs as a potential treatment modality for such patients and explores indications and contraindications for their use, including factors relating to patient history, clinical presentation and patient wishes. Through case examples, design, material and fabrication considerations will be discussed. While their use is not widespread, there are a number of patients who benefit from the provision of unilateral RPDs. They are a useful treatment to have in the clinician's armamentarium, but a highly-skilled dental team and a specific patient presentation is required in order for them to be a reasonable and predictable prosthetic option.

  9. Correlação dos achados tomográficos com parâmetros de função pulmonar na fibrose pulmonar idiopática em não fumantes Correlation of tomographic findings with pulmonary function parameters in nonsmoking patients with idiopathic pulmonary fibrosis

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    Agnaldo José Lopes

    2007-12-01

    Full Text Available OBJETIVO: Correlacionar os achados tomográficos com os parâmetros de função pulmonar em portadores de fibrose pulmonar idiopática (FPI. MÉTODOS: Foi realizado um estudo de corte transversal, em que foram avaliados 30 pacientes não tabagistas, portadores de FPI. Utilizando um sistema de escore semiquantitativo, os seguintes achados na tomografia computadorizada de alta resolução (TCAR foram quantificados: extensão total da doença intersticial (Tot, infiltrado reticular e faveolamento (Ret+Fav, e opacidade em vidro fosco (Vif. As variáveis funcionais foram mensuradas através de espirometria, técnica de oscilações forçadas (TOF, método da diluição com hélio e método da respiração única para medir a capacidade de difusão do monóxido de carbono (DLCO. RESULTADOS: Dos 30 pacientes estudados, 18 eram mulheres e 12 eram homens, com média de idade de 70,9 anos. Foram encontradas correlações significativas de Tot e Ret+Fav com as medidas de capacidade vital forçada (CVF, capacidade pulmonar total (CPT, DLCO e complacência dinâmica do sistema respiratório (correlações negativas, e de Vif com volume residual/CPT (correlação positiva. A relação fluxo expiratório forçado entre 25 e 75% da CVF/CVF (FEF25-75%/CVF correlacionou-se positivamente com Tot, Ret+Fav e Vif. CONCLUSÕES: Em portadores de FPI, as medidas de volume, difusão e complacência dinâmica são as variáveis fisiológicas que melhor refletem a extensão da doença intersticial na TCAR.OBJECTIVE: To correlate tomographic findings with pulmonary function parameters in patients with idiopathic pulmonary fibrosis (IPF. METHODS: A cross-sectional study was carried out, in which 30 nonsmoking patients with IPF were evaluated. Using a semiquantitative scoring system, the following high-resolution computerized tomography (HRCT findings were quantified: total interstitial disease (TID, reticular abnormality/honeycombing, and ground-glass opacity (GGO. The

  10. Micetoma pulmonar por Scedosporium sp, reporte de dos casos

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    José G. Somocurcio

    2009-07-01

    Full Text Available Se reporta los dos primeros casos de micetoma pulmonar por Scedosporium sp, en el Perú, tratados quirúrgicamente en el Hospital Nacional Hipólito Unanue. Se practicó resección pulmonar debido a micetoma pulmonar de donde se tomó muestras que fueron enviadas a microbiología y anatomía patológica para cultivo y estudio histopatológico. Se identificó el moho Scedosporium sp en dos pacientes con secuelas cavitarias por tuberculosis, quienes presentaron tos y hemoptisis de dos meses y tres años de evolución, respectivamente. Radiológicamente las cavidades estaban ocupadas por una "bola fúngica". La histopatología indicó presencia de abundantes hifas, indistinguibles de las de Aspergillus sp, mientras que la inmunodifusión para Aspergillus fue negativa.

  11. Tromboendarterectomía pulmonar en el tratamiento de la hipertensión pulmonar tromboembólica crónica

    OpenAIRE

    José Antonio Blázquez; José María Cortina; Enrique Pérez; Alberto Forteza; María Jesús López; Jorge Centeno; Enrique Ruiz; Carlos Esteban Martín; Javier de Diego; Juan José Rufilanchas

    2007-01-01

    La tromboendarterectomía pulmonar representa el tratamiento potencialmente curativo de la hipertensión pulmonar tromboembólica crónica. Material y método: Entre febrero de 1996 y mayo de 2006, 20 pacientes con hipertensión pulmonar tromboembólica crónica fueron sometidos a tromboendarterectomía pulmonar. El 90% (18/20) presentaba clase funcional III-IV. Los datos hemodinámicos preoperatorios son: presión sistólica pulmonar 86 ± 17 mmHg, presión arterial pulmonar media 49 ± 9 mmHg, resisten...

  12. A case of unilateral dysmenorrhea

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    Tulon Borah

    2010-01-01

    Full Text Available Unilateral dysmenorrhea in an adolescent may be associated with uterine malformation. Relevant investigations in suspected cases and timely intervention can prevent future complications in such cases. Here, we present a case of unicornuate uterus with rudimentary horn in an adolescent complaining of unilateral dysmenorrhea.

  13. La tuberculosis pulmonar, enfermedad reemergente en Cuba

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    Margarita González Tapia

    2014-08-01

    Full Text Available Sr. Editor: La tuberculosis es una de las enfermedades remergentes en Cuba; por ello en todas las provincias cubanas se trabaja con mucha fuerza, dedicación y profesionalidad con respecto a esta problemática. En este contexto, resulta muy acertada la publicación del artículo “Algunas variables clínico-epidemiológicas de la tuberculosis pulmonar. Puerto Padre, 2008-2012”, que salió en el Vol.38 No.6.01 del mes de junio de 2013 de la Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta; tanto por el significado social que reviste la divulgación de este tema, como por el propio resultado de la investigación realizada. La historia de la tuberculosis es un tema apasionante. En pocas enfermedades es posible documentar su estrecha relación con la historia de la propia humanidad como en la que nos ocupa. Existen evidencias paleológicas de tuberculosis vertebral en momias egipcias que datan aproximadamente del año 2400 a.C. La tuberculosis se ha conocido a través de la historia, con los nombres de: tisis, consunción, escrófula, mal de Pott, plaga blanca y mal del rey.1 En el artículo se plantea como conclusión que la tendencia de la tuberculosis en el quinquenio de estudio es estacionaria, pero en los últimos cuatro años tiende al ascenso. En los casos diagnosticados de tuberculosis en este quinquenio más de dos tercios correspondieron al sexo masculino y mayores de 45 años, las ocupaciones que más prevalecieron fueron recluso, desocupado, ama de casa y jubilado. Los factores de riesgo que más se relacionaron fueron el albergamiento prolongado en instituciones cerradas, el alcoholismo, y la edad mayor de 65 años; la forma clínica de mayor incidencia en casi la totalidad de los pacientes fue la pulmonar y, dentro de ella, los casos con baciloscopia positiva. Hubo fallas en el diagnóstico, ya que alrededor de la mitad de los casos se diagnosticaron en la atención secundaria y con un tiempo de demora de más de dos meses de

  14. Rehabilitación pulmonar en hipertensión pulmonar

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    Vilma Gómez

    2017-09-01

    Full Text Available El manejo del paciente con hipertensión pulmonar es complejo y requiere de un equipo interdisciplinario. Es trascendental que los programas de rehabilitación cuenten con neumólogo, fisioterapeutas entrenados, psicólogos, profesionales en trabajo social, nutrición y enfermería. Para el ingreso al programa los pacientes deben contar con manejo farmacológico óptimo y prueba de ejercicio cardiopulmonar integrada o prueba de caminata de seis minutos para determinar la condición basal, las causas de limitación al ejercicio y la intensidad del ejercicio, y prever riesgos. Se indican al menos dos a tres sesiones a la semana supervisadas durante 10 a 12 semanas para lograr mejoría en cuanto a capacidad de ejercicio, calidad de vida y niveles de actividad física. Se puede hacer entrenamiento en ambiente hospitalario, ambulatorio o mixto aunque siempre con comienzo en un ámbito supervisado y con el equipo de monitorización necesario. En cuanto al riesgo, en pacientes con hipertensión pulmonar clase funcional IV, la frecuencia de eventos adversos no fue mayor al compararse con pacientes en clase funcional II y III; los efectos del entrenamiento en estos pacientes son similares a los obtenidos en aquellos con mejor clase funcional con necesidad de reducir la intensidad del ejercicio para que sea tolerado y seguro. Es vital educar tanto al paciente como a su cuidador en cuanto a la enfermedad, y adicionalmente brindar soporte psicosocial y nutricional.

  15. Enfermedades pulmonares intersticiales en el niño

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    Roberto Razón Behar

    Full Text Available Las enfermedades pulmonares intersticiales en el niño, comprenden un gran y heterogéneo grupo de raras enfermedades difusas pulmonares de morbilidad variada. Se caracterizan por cambios inflamatorios y fibróticos que causan remodelación de las paredes alveolares y de las vías respiratorias distales, y ocasionan un defecto restrictivo funcional y una alteración en el intercambio gaseoso, con hipoxemia progresiva. Son muchas las enfermedades que pueden afectar al intersticio pulmonar y múltiples las formas etiológicas causadas por una variedad de procesos patológicos, que incluyen, factores genéticos, asociación a enfermedades sistémicas, así como a respuestas inflamatorias o fibróticas a diferentes estímulos. Sin embargo, algunas veces su origen es desconocido, y se catalogan entonces como idiopáticas. Los neumólogos pediátricos han tratado de clasificar los casos de las enfermedades pulmonares intersticiales en las diferentes categorías descritas originalmente en adultos, pero, en realidad, existen formas del adulto que no se observan en la infancia, y formas únicas de presentación pediátrica. Se señala la importancia del conocimiento de estas entidades, particularmente las de origen desconocido o idiopáticas.

  16. Estado actual del tratamiento del cáncer pulmonar

    Directory of Open Access Journals (Sweden)

    Dr. Clavero R. José Miguel

    2013-07-01

    Pese a la letalidad de esta neoplasia y el aumento de su incidencia a nivel mundial, los avances que se describen en el presente artículo permiten vislumbrar un mejor futuro para los pacientes con cáncer pulmonar.

  17. Unilateral darier′s disease

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    Singh Ravi

    1996-01-01

    Full Text Available Various variations of Darier′s disease have been mentioned in the literature. Here we describe a young male with unilateral involvement with clinical and histopathological features typical of Darier′s disease.

  18. Cistitis intersticial o vejiga dolorosa: Un desafío para el clínico Interstitial cystitis: A challenge for the clinician

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    Pablo Young

    2010-08-01

    Full Text Available La cistitis intersticial se define como un síndrome clínico caracterizado por un incremento de la frecuencia urinaria, urgencia miccional y/o dolor abdominal o perineal en ausencia de infección urinaria o enfermedad conocida del aparato urinario. Se divide de acuerdo a los hallazgos citoscópicos en ulcerativa o no. La base del diagnóstico es clínica apoyada en scores de probabilidad y pruebas invasivas. Con la comprensión de la fisiopatología se ha desarrollado un abanico de posibilidades terapéuticas. Comunicamos el caso de una paciente sintomática por cuatro años con diagnóstico de cistitis intersticial con úlcera de Hunner por cistoscopia y excelente respuesta a la amitriptilina. Es una enfermedad que produce considerable alteración de la calidad de vida, por lo que es importante que los médicos estén familiarizados con este cuadro.Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of an urinary tract infection. The disorder can be divided clinically into two groups -ulcerative and non-ulcerative- based on cystoscopic findings and response to treatment. Management follows an approach of applying the least invasive therapy that affords sufficient relief of symptoms. We report a case of a patient with interstitial cystitis. The diagnosis was performed by symptoms and lesion in the cystoscopy and excellent response to amitriptyline.

  19. Estado del arte en hipertensión pulmonar y cateterismo cardiaco derecho

    Directory of Open Access Journals (Sweden)

    Rubén Dueñas V.

    2017-09-01

    Full Text Available La definición universalmente aceptada de hipertensión pulmonar corresponde a todos los pacientes con presión arterial pulmonar media igual o mayor a 25 mm Hg en reposo, medida por cateterismo cardíaco derecho, sin olvidar que la presión promedio normal de la arteria pulmonar es de máximo 20 mm Hg, lo cual obliga a seguir a los pacientes con presión arterial pulmonar media entre 20 y 24 mm Hg. También cabe recordar ser claros al diferenciar entre hipertensión pulmonar e hipertensión arterial pulmonar. La hipertensión pulmonar incluye cinco grupos, entre los cuales la hipertensión arterial pulmonar constituye el grupo 1. El concepto de hipertensión arterial pulmonar inducida por el ejercicio puede definirse como todos los pacientes con presión arterial pulmonar por encima de los 30 mm Hg a un gasto cardíaco menor de 10 l, o una resistencia pulmonar total de más de 3 unidades Wood. La hipertensión pulmonar inducida por el ejercicio es un campo de investigación hasta ahora poco explorado. La clasificación continúa con los cinco grupos, y es dinámica de acuerdo con el progreso en entender la fisiopatología de cada enfermedad.

  20. Metastização pulmonar de neoplasia da mama

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    Jorge Dionísio

    2002-03-01

    Full Text Available RESUMO: Para caracterizar os doentes com metastização pulmonar de neoplasia da mama, procedemos a um estudo retrospectivo dos processos de 129 doentes referenciados à Unidade de Pneumologia entre Julho de 1990 e Janeiro de 2000.Foi considerada a existência de metastização pulmonar em 89 casos.Avaliámos as manifestações clínicas apresentadas, o intervalo de tempo até ao diagnóstico de metastização pulmonar, os aspectos radiológicos, endoscópicos, as terapêuticas efectuadas e a sobrevida.O intervalo médio entre o diagnóstico da neoplasia da mama e o diagnóstico de metastização pulmonar foi de 81,9±5,7 meses. Os sintomas respiratórios foram referidos em 83,1% dos doentes. O padrão radiológico mais comum foi a presença de massas ou nódulos pulmonares (66,3%. Foram observadas 49 com sinais directos de neoplasia na broncofibroscopia. Em 47 os aspectos anatomopatológicos encontrados foram compatíveis com metastização endobrônquica de tumor da mamaO tratamento mais frequentemente utilizado após o diagnóstico de metástase pulmonar foi a quimioterapia, em 60,2% dos casos.Após o diagnóstico de metastização, a sobrevida mediana foi de 20,1 meses, com 63,4% dos doentes vivos ao fim de 1 ano.Nos doentes com carcinoma da mama e suspeita de metastização verificámos um grande intervalo livre entre o diagnóstico do tumor da mama e o aparecimento de metastização. Os sintomas respiratórios tra-duziram a grande frequência de envolvimento endobrônquico. O diagnóstico anatomopatológico de metastização pulmonar foi obtido em 52,8% dos doentes. A terapêutica mais utilizada após diagnóstico de metastização foi a quimioterapia e a sobrevida ao ano foi de 63,4%.REV PORT PNEUMOL 2002; VIII (2: ABSTRACT: We performed a retrospective study of 129 patients observed in Pneumology unit between July 1990 and January 2000 to evaluate the clinical, radiological and endoscopic patterns as well as the clinical evolution of

  1. Trasplante pulmonar: experiencia en clínica las condes

    Directory of Open Access Journals (Sweden)

    C. María Teresa Parada, Dra

    2010-03-01

    Hace 10 años Clínica Las Condes inicia su programa de trasplante pulmonar el que ha sido pionero nacional en número de injertos realizados y resultados obtenidos a largo plazo. Se realiza una revisión de las indicaciones, complicaciones precoces y tardías, capacidad física posterior al trasplante y sobrevida alejada de los pacientes trasplantados de pulmón en nuestro programa.

  2. Patología de la tuberculosis pulmonar.

    OpenAIRE

    FERRUFINO, JC

    2013-01-01

    Este artículo trata sobre la patología de la tuberculosis pulmonar desde el momento del ingreso del bacilo de Koch a los pulmones del paciente. Para ello se ha dividido en dos partes. La primera se ocupa de algunos aspectos de la inmunopatología de esta enfermedad y en la segunda se desarrolla los diferentes periodos en la evolución natural de este mal.

  3. Nuevas intervenciones en hipertensión arterial pulmonar

    Directory of Open Access Journals (Sweden)

    Juan Esteban Gómez Mesa

    2017-09-01

    Full Text Available El manejo farmacológico de la hipertensión arterial pulmonar se basa en agentes que actúan en tres vías principales: endotelina 1, prostaglandina I2 y óxido nítrico. La mayoría de estudios clínicos para aprobación de medicamentos desarrollados para tratar esta condición, han sido cortos y enfocados en el cambio en la caminata de 6 minutos. Al tener en cuenta que las diferentes formas de hipertensión arterial pulmonar tienen como denominador común para las alteraciones moleculares y celulares el entrecruzamiento celular con la pared vascular asociado a procesos inflamatorios e inmunes inapropiados, disbalance entre la síntesis y degradación de matriz extracelular, alteraciones genéticas (gen BMPR2 en hipertensión arterial pulmonar hereditaria y epigenéticas, se requiere un mejor entendimiento de la fisiopatología de la enfermedad, lo cual permitirá desarrollar nuevos tratamientos o intervenciones en estos pacientes en cada uno de estos niveles.

  4. Posible papel del grado de vascularización pulmonar en la resistencia/susceptibilidad a la hipertensión arterial pulmonar en una estirpe comercial de pollos de engorde

    OpenAIRE

    Areiza Rojas, Rafael Alfonso

    2010-01-01

    Desde hace varias decadas se conoce la baja capacidad de adaptacion de los pollos de engorde a la hipoxia hipobarica. Si bien el sistema parabronquial pulmonar de las aves permite una mayor eficiencia para el intercambio gaseoso pulmonar, los programas de mejoramiento genetico de los pollos de engorde han resultado colateralmente en una disminucion en la capacidad pulmonar de intercambio gaseoso. La respuesta angiogenica del lecho vascular pulmonar como consecuencia de la ex...

  5. C14. Um caso de polimiosite, fibrose pulmonar e cancro do pulmão

    Directory of Open Access Journals (Sweden)

    Carlos Lopes

    2003-11-01

    Full Text Available Os autores apresentam o caso clínico de um doente do sexo masculino, de 67 anos, fumador (50 UMA. Trabalhou na marinha durante 30 anos, onde esteve exposto a fibras de asbestos.Aparentemente estável até aos 62 anos, altura em que refere início de quadro clínico de dispneia de esforço, de agravamento progressivo. Um ano depois episódio de febre, tosse produtiva e mialgias.Ao exame objectivo eram evidentes hipocratismo digital e fervores subcrepitantes em ambas as bases, na auscultação torácica.Os aspectos vizualizados na TC Torácica eram compatíveis com Pneumonia Intersticial Usual e o lavado broncoalveolar excluiu outras doenças.O estudo da função respiratória mostrou um síndrome restritivo com diminuição da capacidade de difusão do CO.Foi administrada terapêutica com Deflazacort, acetilcisteína e azatioprina. Devido a agravamento clínico e funcional, azatioprina foi substituída por ciclofosfamida. Dois anos depois foi iniciada terapêutica com Interferão Gamma 1b, com melhoria clínica e funcional, durante um ano.Foi então feito o diagnóstico de Polimiosite e recebeu terapêutica com imunoglobulina.Doze meses depois foi internado com quadro clínico de febre intermitente, tosse seca, dispneia de esforço de agravamento progressivo e mialgias. A TC Torácica revelou pulmão em favo e bronquiectasias. No lobo inferior esquerdo foi detectado um nódulo periférico. O doente foi submetido a biópsia aspirativa transtorácica, o padrão imunohistoquímico do tecido revelou Cancro do Pulmão de Pequenas Células. No estadiamento foram identificadas adenopatias hilares e mediastínicas e múltiplas metástases hepáticas. Apenas foi efectuada uma administração de quimioterapia (carboplatinum e etoposido, sem qualquer tipo de resposta. O doente faleceu duas semanas depois.Está documentada a associação de Polimiosite com várias Neoplasias, neste caso clínico, o doente desenvolveu fibrose pulmonar antes de ter sido feito

  6. Secuestro pulmonar una infrecuente causa de hipertension pulmonar persistente en el recién nacido reporte de un caso

    Directory of Open Access Journals (Sweden)

    Lupo Méndez

    2017-01-01

    Full Text Available La hipertensión pulmonar persistente del recién nacido ( HPPRN es una entidad frecuente en las unidades de cuidados intensivos neonatales ( UCIN , sin embargo, algunas de sus causas pasan desapercibidas, debido a su baja frecuencia y poca asociación con esta patología. A propósito de un caso en nuestra UCIN , en un neonato a término que presentó HPPRN secundario a una malformación pulmonar, raramente asociada con esta patología en este grupo etareo, ya que se encontró mayor disposición a factores propios del nacimiento, y noxas maternas. El paciente presentó dificultad respiratoria horas después de su nacimiento, con evolución y persistencia de su sintomatología, por lo que se necesitó de diversos medios diagnósticos para establecer su etiología. Es importante destacar que el primer ecocardiograma doppler no mostró ninguna alteración anatómica o funcional, reportado normal; con posterior empeoramiento clínico del neonato, por lo que se ordenó un control ecocardiografico, y se evidenció una presión pulmonar estimada de 71 mmHg; se continuó el estudio etiológico con imágenes complemen - tarias, en esta caso una tomografía de tórax contrastada, y finalmente fue corroborado con un cateterismo cardiaco, lo cual permitió a su vez, manejo terapéutico y corrección de anomalía estructural de vasos pulmonares.

  7. Primary unilateral cleft lip repair

    OpenAIRE

    Adenwalla, H. S.; Narayanan, P. V.

    2009-01-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform clos...

  8. Os abcessos pulmonares em revisão

    Directory of Open Access Journals (Sweden)

    Ana Moura Gonçalves

    2008-01-01

    Full Text Available Resumo: Os abcessos pulmonares são cavidades que surgem no parênquima pulmonar, apresentando maior ou menor quantidade de tecido necrosado no seu interior. Surgem em indivíduos predispostos, como sejam os doentes com doença pulmonar crónica ou obstrução secundária a neoplasia e os doentes com maior risco de aspiração, estando incluidos os doentes com alteração do estado neurológico, os utilizadores de drogas endovenosas, os doentes com alcoolismo, patologia da faringe e esofágica, doença neuromuscular, entre outras. É feita a revisão dos principais agentes causais, da metodologia diagnóstica, da abordagem terapêutica na actualidade e do prognóstico destas situações.Os abcessos pulmonares, para além de relativamente pouco frequentes, são difíceis de caracterizar, sendo a resistência aos antibióticos um problema a ter presente, na sua abordagem terapêutica. Abstract: Lung abscesses are cavitating lesions containing necrotic debris caused by microbial infection. Patients with chronic lung disease, bronchial obstruction secondary to cancer, a history of aspiration or risk of aspiration caused by alcoholism, altered mental status, structural or physiologic alterations of the pharynx and esophagus, neuromuscular disorders, anesthesia, are among others at higher risk of developing lung abcess.The main bacteriological characteristics, the diagnosis, therapy and prognosis are considered. The problem of antimicrobial resistance is also referred. Palavras-chave: Abcesso pulmonar, pneumonia de aspiração, resistência antimicrobiana, anaeróbios, Key-words: Lung abscesses, aspiration pneumonia, antimicrobial resistance, anaerobes

  9. Cirurgia da catarata infantil unilateral Unilateral pediatric cataract surgery

    Directory of Open Access Journals (Sweden)

    Adriana Maria Drummond Brandão

    2008-04-01

    Full Text Available OBJETIVO: Analisar os resultados visuais de uma série de crianças operadas de catarata unilateral. MÉTODOS: Um estudo retrospectivo foi realizado através da análise de 35 prontuários médicos do Serviço de Catarata Congênita da UNIFESP/EPM. RESULTADOS: Quanto à etiologia, a primeira causa de catarata foi idiopática, a segunda causa foi o trauma e a terceira foi a rubéola congênita. Em 51,4% dos olhos tinham acuidade visual pré-operatória de ausência de fixação. E em 42,8% dos casos operados a acuidade visual final foi igual ou melhor que 20/200. DISCUSSÃO: Embora a cirurgia em catarata unilateral seja motivo de controvérsias entre os oftalmologistas, obteve-se melhora de acuidade visual em número significativo de casos.PURPOSE: To analyze the results in a series of children submitted to unilateral cataract surgery. METHODS: A retrospective study was conducted through the analysis of 35 patient files from the Congenital Cataract Service of UNIFESP/EPM. RESULTS: The main cause of unilateral cataract was idiopathic, the second cause was ocular trauma and the third cause was congenital rubella. Initial visual acuity was very poor in 51.4% of the cases (did not fix or follow, and the best corrected final visual acuity was better than 20/200 in 42.8% of the eyes. DISCUSSION: Although controversial, the surgical treatment of unilateral cataract, in this study, showed improvement in many cases.

  10. Unilateral anterior ischemic optic neuropathy

    DEFF Research Database (Denmark)

    Herbst, Kristina; Sander, Birgit; Lund-Andersen, Henrik

    2013-01-01

    of this study was to investigate the ipRGC mediated pupil response in patients with a unilateral non-arteritic anterior ischemic optic neuropathy (NAION). Consensual pupil responses during and after exposure to continuous 20 s blue (470 nm) or red (660 nm) light of high intensity (300 cd/m(2)) were recorded...

  11. Transdermal hyoscine induced unilateral mydriasis.

    LENUS (Irish Health Repository)

    Hannon, Breffni

    2012-03-20

    The authors present a case of unilateral mydriasis in a teenager prescribed transdermal hyoscine hydrobromide (scopolamine) for chemotherapy induced nausea and vomiting. The authors discuss the ocular side-effects associated with this particular drug and delivery system and the potential use of transdermal hyoscine as an antiemetic agent in this group.

  12. Linfangioleimiomatose pulmonar - LAM. Um caso de associação de LAM e angiomiolipoma renal

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    Carlos Mendonça

    1997-09-01

    Full Text Available RESUMO: Relatase o caso clínico de uma jovem mulber, que é submetida a uma nefrectomia radical por volumoso tumor à direita, tendo verificado tratarse dum angiomiolipoma. Até então sem qualquer queixa, sinal ou sintoma do foro respiratório. No decurso do pós-operatório, fez complicação aparatosa no contexto da qual foi identificado um pneumotorax espontâneo bilateral. Após a alta hospitalar, foram observados e registados vários episódios de pneumotorax espontâneo, unilateral. A partir do episodio inicial desenvolve, lenta e progressivamente, um quadro clínico de dispneia. Apresenta-se a evolução clínica e alguns parâmetros caracterizadores das alterações funcionais respiratórias, ao longo de seis anos, bem como a documentação de TAC-HR do tórax e histológica, que permitiram fundamentar o diagnóstico desta associação de entidades raras. SUMMARY: We present the case report of a young woman submited to a radical nefrectomy of the right kidney due to the presence of a large tumor diagnosed as an angiomyolipoma. Until such time no respiratory signs and symptoms were referred. Complications during post-op led to the identification of a bilateral spontaneous pneumothorax. After being released from the hospital the patient returned several times due to unilateral spontaneous pneumothorax. After the first of these episodes she developed slowly progressive dyspnea. We present the clinical evolution and respiratory function parameters for a six year follow-up as well as thoracic HR-CT scan documentation and histologic studies that permit the diagnosis of these associated and rare entities. Palavras chave: Linfangioleirniomatose pulmonar - LAM, angiomiolipoma, pneumotorax espontâneo bilateral, : Key -words, Pulmonary Lymphangioleiomyomatosis - LAM, angiomyolipoma, Bilateral spontaneous pneumothoraces

  13. Primary unilateral cleft lip repair.

    Science.gov (United States)

    Adenwalla, H S; Narayanan, P V

    2009-10-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

  14. Primary unilateral cleft lip repair

    Directory of Open Access Journals (Sweden)

    Adenwalla H

    2009-10-01

    Full Text Available The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web.

  15. Nonhomogeneous immunostaining of hyaline membranes in different manifestations of diffuse alveolar damage Imunomarcação não homogênea das membranas hialinas na sindrome da angustia respiratório do adulto pulmonar, extrapulmonar e idiopática

    Directory of Open Access Journals (Sweden)

    André Peres e Serra

    2006-01-01

    Full Text Available PURPOSE: To determine the nature of hyaline membranes in different manifestations of diffuse alveolar damage, [pulmonary and extrapulmonary acute respiratory distress syndrome], and idiopathic [acute interstitial pneumonia]. MATERIALS AND METHODS: Pulmonary specimens were obtained from 17 patients with acute respiratory distress syndrome and 9 patients with acute interstitial pneumonia. They were separated into 3 different groups: (a pulmonary diffuse alveolar damage (pDAD (n = 8, consisting only of pneumonia cases; (b extrapulmonary diffuse alveolar damage (expDAI (n = 9, consisting of sepsis and septic shock cases; and (c idiopathic diffuse alveolar damage (iDAD (n = 9, consisting of idiopathic cases (acute interstitial pneumonia. Hyaline membranes, the hallmark of the diffuse alveolar damage histological pattern, were examined using various kinds of antibodies. The antibodies used were against surfactant apoprotein-A (SP-A, cytokeratin 7 (CK7, cytokeratin 8 (CK8, alpha smooth muscle actin (a-SMA, cytokeratin AE1/AE3 (AE1/AE3, and factor VIII-related antigen (factor VIII. RESULTS: Pulmonary diffuse alveolar damage showed the largest quantity of hyaline membranes (12.65% ± 3.24%, while extrapulmonary diffuse alveolar damage (9.52% ± 3.64% and idiopathic diffuse alveolar damage (7.34% ± 2.11% showed intermediate and lower amounts, respectively, with the difference being statistically significant between pulmonary and idiopathic diffuse alveolar damage (P OBJETIVO: Determinar a natureza da membrana hialina nas diferentes manifestações do dano alveolar difuso [pulmonar e extrapulmonar síndrome do desconforto respiratório] e idiopático [pneumonia intersticial aguda]. MATERIAIS E MÉTODOS: Espécimes pulmonares foram obtidos de 17 pacientes com SDRA e 9 pacientes com pneumonia intersticial aguda e separados em três diferentes grupos: (a dano alveolar difuso pulmonar (DADp (n=8 constituído por casos de pneumonia, (b dano alveolar difuso

  16. Pseudocisto pulmonar pós-traumático em jogador de futebol: relato de caso

    Directory of Open Access Journals (Sweden)

    Andre Nathan Costa

    2013-04-01

    Full Text Available Pseudocistos pulmonares são lesões raras que se desenvolvem no parênquima pulmonar após traumas fechados e de grande energia, cujo diagnóstico se baseia na associação da história clínica com exames de imagem. Relata-se a seguir um pseudocisto pulmonar ocorrido no parênquima contralateral ao trauma em um homem de 31 anos que apresentou episódio de hemoptise após queda durante partida de futebol.

  17. Biomarcadores de lesión miocárdica y edema pulmonar de las alturas

    OpenAIRE

    Uribe, Hellen C.; Linares, Gerardo; Cortés, Luis A.

    2014-01-01

    El edema pulmonar de las alturas es una entidad potencialmente fatal que se presenta en individuos que ascienden rápidamente por encima de 2.500 msnm. La hipoxia, el deterioro de la clase funcional y la dificultad respiratoria son el resultado de un edema pulmonar no cardiogénico. En este caso clínico de edema pulmonar de las alturas se encontró elevación de biomarcadores de lesión miocárdica y de sobrecarga de presión, sin compromiso estructural cardiaco o coronario, hallazgo que no ha sido ...

  18. Edema pulmonar assimétrico por pressão negativa pós-obstrução de via aérea superior: relato de caso Edema pulmonar asimétrico por presión negativa pós-obstrucción aguda de vía aérea superior: relato de caso Asymmetric negative pressure pulmonary edema after acute upper airway obstruction: case report

    Directory of Open Access Journals (Sweden)

    Aldo José Peixoto

    2002-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Edema pulmonar por pressão negativa pós-obstrução de via aérea é atualmente uma entidade bem descrita, porém, provavelmente pouco diagnosticada e os casos pouco publicados. O objetivo deste relato é apresentar um caso de edema pulmonar por pressão negativa pós-obstrução de via aérea superior, cuja principal característica foi a assimetria do edema pulmonar, sendo muito mais acentuado no pulmão direito. RELATO DO CASO: Menino de 4 anos, 17 kg, estado físico ASA I, foi submetido a adenoamigdalectomia e cauterização de cornetos, sob anestesia geral com sevoflurano/óxido nitroso/O2. A cirurgia durou 1 hora e 30 minutos sem qualquer intercorrência. Com a superficialização da anestesia o paciente, ventilando espontaneamente, reagiu ao tubo traqueal, que foi retirado. Após isto, os esforços ventilatórios resultaram em retração da parede torácica, sem aparente movimento de ar, sendo impossível ventilá-lo com máscara facial, ocorrendo hipoxemia grave (SpO2 de 50%, necessitando ser reintubado. Neste momento foi verificado que o pulmão se encontrava mais duro e havia estertores bilateralmente, caracterizando edema pulmonar. Uma radiografia de tórax mostrou infiltrado pulmonar difuso bilateralmente, porém, com atelectasia do lobo superior direito, mostrando acentuada assimetria do edema pulmonar. O paciente teve que ser ventilado mecanicamente com PEEP durante 20 horas, quando foi extubado. Houve melhora progressiva do edema pulmonar, recebendo alta em 48 horas. CONCLUSÕES: O edema pulmonar por pressão negativa é uma entidade rara com alto grau de morbidade, pouco diagnosticada e exige do anestesiologista conhecimento atualizado e tratamento adequado. Costuma ser bilateral, raramente unilateral e excepcionalmente com expressiva assimetria como no nosso relato. A maioria dos casos é tratada com suporte ventilatório com PEEP ou CPAP, não necessitando de qualquer outra terapia. O prognóstico

  19. Envolvimento pulmonar na polimiosite Pulmonary disease in polymyositis

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    Direndra Hasmucrai

    2010-08-01

    Full Text Available Introdução: A polimiosite (PM e a dermatomiosite são classificadas como miopatias inflamatórias idiopáticas. O envolvimento pulmonar por PM é pouco frequente, estando descrito na literatura em cerca de 10% de casos. Os autores apresentam um caso de uma mulher de 75 anos, com queixas de febre, perda ponderal, artralgias, mialgias e diminuição simétrica e proximal da força muscular com impotência funcional dos membros superiores e inferiores, com início um mês antes do internamento. Apresentava infiltrados pulmonares na telerradiografia de tórax. Após estudo exaustivo estabeleceu -se o diagnóstico de envolvimento pulmonar na forma de pneumonia organizativa por PM. Efectuou-se corticoterapia e terapêutica com micofenolato com melhoria clínica, analítica e radiológica. Conclusão: Neste caso, foi a alteração na telerradiografia de tórax numa doente sem sintomatologia respiratória que levou ao estudo exaustivo até ao diagnóstico de PM, realçando mais uma vez a importância da telerradiografia no rastreio de patologias de outros foros.Introduction: Polymyositis and dermatomyositis are classified as idiopathic inflammatory myopathies. Interstitial lung disease is rare and is described in the literature in about 10% of cases. The authors describes a case of 75 year old woman presenting with one month evolution of fever, weight loss, arthralgia, myalgia and symmetric and proximal muscle weakness of upper and lower limbs. Nonspecific interstitial changes was found in chest X -ray. After exhaustive study, the diagnosis of pulmonary envolvement in the form of organizing pneumonia by polymyositis, was established. Glucocorticoids and mycophenolate were prescribed with good clinical, analytical and radiological outcome. Conclusion: In this case, it was the changes in the chest X -ray in a patient without respiratory symptomatology, that conducted to exhaustive study to polymyositis diagnosis, enhancing once again the importance of X

  20. Cierre percutáneo de fístulas coronario-pulmonares en el adulto

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    Pedro Trujillo, MD

    2014-01-01

    Full Text Available El cierre percutáneo de las fístulas coronario-pulmonares con implante de “coils” es eficaz y pueden realizarlo los cardiólogos intervencionistas de adultos. Se presentan tres casos clínicos de cierre percutáneo exitoso de fístulas coronario-pulmonares con implante de “coils”.

  1. Fusariosis como nódulo pulmonar solitario.

    Directory of Open Access Journals (Sweden)

    Nelson Moreno

    2008-07-01

    Full Text Available Las micosis invasivas son causa común de morbilidad y mortalidad en pacientes inmunosuprimidos. De éstas las más importantes en frecuencia son la Aspergilosis y la Fusariosis, ambas agrupadas bajo el término de Hialohifomicosis. Uno de los órganos afectados con mayor frecuencia es el pulmón. Desafortunadamente las manifestaciones clínicas son inespecíficas como la tos, el dolor pleurítico y la hemoptisis. Radiológicamente puede presentar desde infiltrados difusos, hasta lesiones nodulares o cavitaciones. Este es el primer informe en Colombia de un nódulo pulmonar único por hongos del género Fusarium en una paciente inmunocompetente.

  2. Unilateral antler combs from Romuliana

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    Petković Sofija

    2006-01-01

    Full Text Available In the course of investigations at Romuliana nine antler three-partite combs with a single row of teeth were found in the Late Roman horizons dating from the late 4th - mid 5th century. They were found in Tower 19, in the Palace II sector and in the Thermae sector. The combs can be classified as two types: three-partite unilateral combs with semicircular handle (Petković comb type VII and three-partite unilateral combs with triangular handle decorated with horse protomes (Petković comb type VI. Two groups of these finds were distinguished after more detailed analysis; the earlier one including specimens originating from the Chernyahov-Sîntana de Mureº culture and later one including specimens made under "barbarian"influence and produced in Romuliana. These finds confirm the continuity of settlement at Romuliana in the Late Roman period, from the final quarter of the 4th until the end of the 5th century and open up the question of the character of the settlement.

  3. Una mirada general a las enfermedades pulmonares intersticiales y una específica a la fibrosis pulmonar idiopática

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    Pedro J. Marcos

    2013-03-01

    Full Text Available Las enfermedades pulmonares intersticiales difusas (EPID engloban un conjunto heterogéneo de patologías caracterizadas por afectar predominantemente al intersticio pulmonar, que es el espacio anatómico comprendido entre lasmembranas basales del epitelio alveolar y el endotelio capilar. Con frecuencia se observa un retraso en el diagnósticode las EPID. La falta de especificidad de los síntomas y el escaso uso de técnicas diagnósticas como es la espirometría en los primeros niveles asistenciales, hacen que sea bastante frecuente que los clínicos achaquen los síntomasrespiratorios del paciente a entidades más prevalentes comoes la enfermedad pulmonar obstructiva crónica (EPOC

  4. Comunicación de un caso de malformación arteriovenosa pulmonar en la adolescencia

    OpenAIRE

    Flores Hernández, Salomón Sergio; González Zamora, José Francisco; Carrasco Daza, Daniel; González Flores, María de Lourdes

    2006-01-01

    Las malformaciones arteriovenosas pulmonares (MA VP) son comunicaciones anormales entre las arterias y las venas pulmonares. Las MAVP, están caracterizadas por cortocircuitos de derecha a izquierda de grado variable y el efecto de estas comunicaciones depende del tamaño de los vasos involucrados. Puede presentarse hipoxemia, hipocratismo digital y poliglobulia secundario al cortocircuito intrapulmonar. Presentamos el caso de un paciente femenino de 14 años de edad con MA VP pulmonar, cuyos ha...

  5. Clinical and surgical management of unilateral prepubertal gynecomastia

    Directory of Open Access Journals (Sweden)

    Giuseppe Andrea Ferraro

    2014-01-01

    CONCLUSION: The exact mechanism of unilateral gynecomastia formation in our case is unclear. The evaluation of unilateral gynecomastia can therefore be complex. In conclusion, the surgical treatment of unilateral gynecomastia requires an individual approach, based on an appropriate diagnostic algorithm.

  6. Unilateral exophthalmos in primary hyperthyroidism

    International Nuclear Information System (INIS)

    Park, C. Y.; Kim, Y. J.; Choi, K. O.

    1980-01-01

    The exophthalmos of Graves' disease remains a pathophysiologic and therapeutic puzzle. Its relation to the hyperthyroidism of Grave's disease is far from clarified. It is a common clinical observation that exophthalmos does not often relate temporally with the onset of hyperthyroidism. Furthermore, exophthalmos may occur in patients who have no evidence of thyroid disease. Pathologically, exophthalmos is characterized by marked lymphocytic infiltration of the retro-orbital muscles, with edema and mucopolysaccharide deposition. Recently, cellular immunity in response to retro-orbital antigens and abnormal humoral immunity are suggested for the pathogenesis of exophthalmos. We experienced 2 patients with hyperthyroidism and unilateral exophthalmos. The clinical and laboratory features of the patients are presented with review of articles, with emphasis on pathogenesis.

  7. Esputo induzido nas doenças pulmonares intersticiais – Um estudo piloto

    Directory of Open Access Journals (Sweden)

    L. Araújo

    2013-03-01

    Full Text Available Resumo: Introdução: A indução de esputo com soro hipertónico tem sido apontada como uma alternativa, mais económica e segura, ao lavado broncoalveolar na avaliação de doentes com doença pulmonar intersticial (DPI. Objetivo: Avaliar a segurança e a exequibilidade do esputo induzido nas DPI e comparar os perfis celulares do estudo com os resultados obtidos por lavado broncoalveolar. Material e métodos: Vinte doentes realizaram indução de esputo com soro hipertónico (4,5% num intervalo de 2 semanas após a realização de lavado broncoalveolar. Foram analisadas as contagens diferenciais e a viabilidade celular. Para a análise foram utilizados os testes de Wilcoxon e a correlação de Spearman's e um valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: Dos 20 sujeitos estudados (média de idade 49,4 ± 16,4 anos, 70% do sexo masculino, foi obtida uma amostra satisfatória de esputo em 15 (75%. A indução foi interrompida num doente, devido a uma queda significativa do PEF. Os perfis celulares obtidos do esputo induzido e do lavado broncoalveolar foram distintos (p < 0,05, com exceção dos eosinófilos, e não se verificaram correlações estatisticamente significativas entre os 2 métodos. Comparando os resultados do esputo com os valores de referência, verificou-se um aumento de linfócitos (3,2 vs. 0,5% e eosinófilos (1,4 vs. 0,0%. Quando se compararam os resultados do esputo dos doentes com sarcoidose e pneumonite de hipersensibilidade, ambos os grupos apresentaram um aumento de linfócitos (4,4 vs. 3,9% e a contagem de neutrófilos estava significativamente aumentada na pneumonite de hipersensibilidade (65,4 vs. 10,6%; p < 0,05, achado também presente no lavado. Conclusão: O esputo induzido é um método seguro e exequível nas DPI. Embora as contagens celulares obtidas não se correlacionem

  8. Reoperação de tromboendarterectomia pulmonar em recidiva de tromboembolismo pulmonar crônico hipertensivo Repeat pulmonary thromboendarterectomy after recurrence of chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Walter José Gomes

    2009-01-01

    Full Text Available A cirurgia de tromboendarterectomia tem se estabelecido como método padrão de tratamento do tromboembolismo pulmonar crônico hipertensivo, com excelentes resultados. Entretanto, a reoperação na recidiva do embolismo pulmonar não tem relato na literatura nacional, permanecendo obscuras a sua segurança e efetividade. Relatamos o caso de uma paciente com recorrência de tromboembolismo pulmonar crônico hipertensivo ocorrido cinco anos após a primeira cirurgia de tromboendarterectomia pulmonar, e que necessitou de reoperação para resolução dos sintomas.Pulmonary thromboendarterectomy has been established as the standard method for the treatment of chronic thromboembolic pulmonary hypertension, with excellent results. However, repeat pulmonary thromboendarterectomy due to recurrence of pulmonary embolism has never been reported in the Brazilian literature. Its safety and effectiveness remain obscure. We report the case of a patient presenting recurrence of chronic thromboembolic pulmonary hypertension five years after the first pulmonary thromboendarterectomy and requiring a second operation for resolution of the symptoms.

  9. Lesao pulmonar induzida pela ventilacao em recem-nascidos prematuros

    Directory of Open Access Journals (Sweden)

    Clarissa Gutierrez Carvalho

    2013-12-01

    Full Text Available A necessidade de intubação e do uso de ventilação mecânica na prematuridade está relacionada à chamada lesão pulmonar induzida pela ventilação e à consequente displasia broncopulmonar. Busca-se a melhor compreensão dos mecanismos de lesão envolvendo resposta inflamatória mediada pelas citocinas para o desenvolvimento de novas estratégias protetoras. Pesquisou-se na base de dados PubMed, incluindo artigos relevantes, os unitermos "ventilator induced lung injury preterm", "continuous positive airway pressure", "preterm" e "bronchopulmonary dysplasia". Dados e informações significativas foram compilados em tópicos, com o objetivo de formar uma visão crítica e plena acerca da lesão induzida pela ventilação e de suas consequências ao prematuro. Foi revisado o papel das citocinas pró-inflamatórias como mediadores da lesão, especialmente interleucinas 6 e 8, e fator de necrose tumoral alfa. Foram apresentadas evidências em estudos com animais e também em humanos, mostrando que breves períodos de ventilação mecânica são suficientes para a liberação dessas interleucinas inflamatórias. Também foram revisadas outras formas de ventilação mecânica e de ventilação não invasiva, como alternativas protetoras aos modos convencionais. Concluiu-se que o uso de ventilação não invasiva, a intubação com administração precoce de surfactante e a extubação rápida para CPAP nasal, além de estratégias que regulam o volume corrente evitando o volutrauma (como a ventilação com volume garantido, são medidas protetoras da lesão pulmonar induzida pela ventilação mecânica no prematuro.

  10. Comportamiento del Programa Nacional de Tuberculosis pulmonar, en un municipio

    Directory of Open Access Journals (Sweden)

    René F. Espinosa Alvarez

    1998-10-01

    Full Text Available Se conoce que la tuberculosis pulmonar constituye un serio problema de salud en la mayor parte de los países del mundo. En el nuestro existe un programa de control de dicha entidad y su conocimiento y objetivos son de vital importancia para el médico de la familia. Se analizó el comportamiento del programa nacional de tuberculosis pulmonar en el policlínico docente Lawton en el trienio 1995-1997, a cuyo efecto se revisaron desde el 1-1-95 al 31-12-97 los esputos indicados por los médicos de la familia de los 49 consultorios que existen en dicha unidad y se extrajeron los datos de las hojas de cargo de los médicos del departamento de estadísticas y del laboratorio clínico que controla esta actividad. Los resultados demuestran algunas dificultades que subsisten en el control de la enfermedad que pudieran solucionarse con una mayor dedicación a esta actividad por parte de los médicos de la familia como responsables directos de sus diferentes áreas de salud, así como de las autoridades sanitarias que tienen que ver con el problemaIt is known that pulmonary tuberculosis is a serious health problem in most of the countries. In our country, there is a tuberculosis control program whose knowledge and objectives are of vital importance for the family physician. The behavior of the national program to control pulmonary tuberculosis was analyzed at "Lawton" Teaching Polyclinic from 1995 to 1997. To this end the sputa ordered from 1-1-95 to 31-12-97 by the family physicians from the 49 physicians’ offices existing in this unit were reviewed. Data were given by the Statistics Department and by the Clinical Laboratory controlling this activity. The results show that there are still some difficulties to control this disease that may be solved through a greater dedication to this activity on the part of the family physicians as direct responsible of their different health areas, and of the health authorities having to do with this problem

  11. Enfermedad pulmonar obstructiva: diferencias entre hombres y mujeres

    Directory of Open Access Journals (Sweden)

    María Soledad Rodríguez-Pecci

    2012-06-01

    Full Text Available La enfermedad pulmonar obstructiva crónica (EPOC ha aumentado su prevalencia en el sexo femenino. Los casos de mujeres se describen como más sintomáticas. A pesar de que la EPOC se ha vinculado a elevado riesgo cardiovascular, hay pocos estudios sobre diferencias por sexo. El objetivo de nuestro estudio fue determinar la influencia del sexo sobre calidad de vida y síntomas, tratamiento, factores de riesgo y enfermedad cardiovascular (ECV en una población de pacientes con EPOC. En este estudio prospectivo observacional de corte transversal, se incluyeron pacientes con EPOC ingresados consecutivamente entre el 1 de septiembre de 2008 al 1 de marzo de 2010. Se registraron edad, sexo, habito tabáquico, factores de riesgo y enfermedad cardiovascular, tratamiento y gravedad de la EPOC. Se midió índice tobillo-brazo (ITB y se realizó Euroqol-5D. Se incluyeron 246 pacientes (195 hombres. Los hombres fueron más ex fumadores (68.7% vs. 15.7%, p < 0.001, tuvieron un VEF1 menor (48.7% ± 15.7 vs. 58.2% ± 10.9 de teórico, p < 0.001 y mayor frecuencia de cardiopatía isquémica (16.4% vs. 5.9%, p = 0.04. Las mujeres presentaron más prevalencia de EPOC sin exposición al tabaco (64.7% vs. 7.2%, p < 0.001, más síntomas de ansiedad y depresión (p = 0.004 e ITB alterado en menor frecuencia (20% vs. 41.6%, p = 0.01. Concluimos que hubo diferencias en la EPOC en relación al sexo, con compromiso pulmonar y cardiovascular más grave en hombres y más síntomas de ansiedad y depresión en mujeres.

  12. Abcesso Pulmonar – Estudo Retrospectivo

    Directory of Open Access Journals (Sweden)

    M. José Augusto

    1995-11-01

    Full Text Available RESUMO: O abcesso pulmonar é definido como uma supuração colectada numa cavidade neoformada no pulmão, por uma inflamação aguda não tuberculosa. Por esta definição, estão excluídas as supuraçãoes desenvolvidas em cavidades pré existentes (quistos aereos, carcinoma escavado, bronquiectasias e as resultantes de processos bacilares (1,2,4.Os autores apresentam os resultados de uma revisão clínica de 24 casos correspondentes aos doentes internados com aquele diagnóstico desde 1 de Janeiro de 1990 a 31 de Dezembro de 1994 no Serviço de Medicina Interna do Hospital Distrital de Aveiro.O estudo incidiu na análise dos processos clínicos e radiológicos avaliando a distribuição por sexo, faixa etária, factores predisponentes, tempo de internamento, expressão clínica, radiológica, bacteriológica e finalizando com a terapêutica e evolução. SUMMARY: Lung abcess is defined as a collected suppuration in a neoformed cavity in the lung, caused by a non tuberculous inflammation. From this definition, supurations developed in pre-existant cavities (aerial cysts, escavated carcinoma, bronchiectasis and those resulting from bacillary process, are excluded.The authors submit the results of a clinical revision of 24 cases corresponding to resident patients with that diagnosis from 1st. January 1990 to 31st December 1994 in the Internal Medicine at R.D. Aveiro.The study rests on the analysis of the radiologic and clinical processes taking into account distribution by age and sex, predisposing factors, lenght of internment, radiological and clinical expression, bacteriological profile, therapy and evolution. Palavras-chave: Abcesso Pulmonar, terapêutica, radiologia, Key-Words: Lung abcess, therapy, radiology

  13. Prepubertal Unilateral Gynecomastia: Report of 2 Cases

    Science.gov (United States)

    Demirbilek, Hüseyin; Bacak, Gökhan; Baran, Rıza Taner; Avcı, Yahya; Baran, Ahmet; Keleş, Ayşenur; Özbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-01-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign fibroglandular gynecomastia and intensive (3+) estrogen receptor expression in 100% of periductal epithelial cells. Although an extremely rare and generally benign condition, patients with prepubertal unilateral gynecomastia should have a full endocrine and oncologic work-up. PMID:25541897

  14. Prepubertal unilateral gynecomastia: report of 2 cases.

    Science.gov (United States)

    Demirbilek, Hüseyin; Bacak, Gökhan; Baran, Rıza Taner; Avcı, Yahya; Baran, Ahmet; Keleş, Ayşenur; Özbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-12-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign fibroglandular gynecomastia and intensive (3+) estrogen receptor expression in 100% of periductal epithelial cells. Although an extremely rare and generally benign condition, patients with prepubertal unilateral gynecomastia should have a full endocrine and oncologic work-up.

  15. Selección de donantes y receptores en trasplante pulmonar: procedimientos generales

    Directory of Open Access Journals (Sweden)

    C. María Teresa Parada, Dra.

    2010-03-01

    Full Text Available El trasplante pulmonar es una alternativa terapéutica que se ha validado en lo últimos 30 años para aquellos pacientes portadores de una enfermedad pulmonar terminal. Las características propias del trasplante pulmonar dadas por su conexión al ambiente a través de la vía aérea y la isquemia presente en las suturas durante el primer mes han constituído por mucho tiempo la principal causa de morbilidad y mortalidad de los pacientes trasplantados pulmonares. Los nuevos medicamentos inmunosupresores, la mejoría de las soluciones de preservación y de las técnicas quirúrgicas han disminuido las complicaciones y mortalidad precoz, siendo el gran desafío aún, el rechazo crónico conocido como el Sindrome de Bronquiolitis Obliterante (SBO. La selección del receptor de acuerdo a la patología de base se ha modificado, promoviendo la derivación precoz en patologías como la fibrosis pulmonar y la fibrosis quística disminuyendo así la mortalidad en la lista de espera.

  16. Hipertensión pulmonar a moderada altura en niños

    Directory of Open Access Journals (Sweden)

    Gabriel F. Díaz, MD

    2012-07-01

    Full Text Available Se reporta la carencia de estudios sobre la relación entre hipertensión pulmonar y altura en niños y, con base en la fisiología de esta última, se hace énfasis en la importancia de la hipoxia hipobárica, que desempeña un papel determinante en la etio y biopatogénesis de la hipertensión pulmonar del habitante de la altura. En cuanto a la biopatogénesis, se señala la importancia de la hiperreactividad del lecho vascular pulmonar y su correcta evaluación. De igual forma, se resumen las patologías relacionadas con hipertensión pulmonar en el niño habitante de la altura y, finalmente, en lo que respecta al tratamiento de la hipertensión pulmonar del habitante de la altura, se resalta, a través de la evolución de casos clínicos, la importancia de vivir a baja altura sobre el nivel del mar.

  17. Unilateral traumatic oculomotor nerve paralysis

    International Nuclear Information System (INIS)

    Asari, Syoji; Satoh, Toru; Yamamoto, Yuji

    1982-01-01

    The present authors report a case of unilateral traumatic oculomotor nerve paralysis which shows interesting CT findings which suggest its mechanism. A 60-year-old woman was admitted to our hospital with a cerebral concussion soon after a traffic accident. A CT scan was performed soon after admission. A high-density spot was noted at the medial aspect of the left cerebral peduncle, where the oculomotor nerve emerged from the midbrain, and an irregular, slender, high-density area was delineated in the right dorsolateral surface of the midbrain. Although the right hemiparesis had already improved by the next morning, the function of the left oculomotor nerve has been completely disturbed for the three months since the injury. In our case, it is speculated that an avulsion of the left oculomotor nerve rootlet occurred at the time of impact as the mechanism of the oculomotor nerve paralysis. A CT taken soon after the head injury showed a high-density spot; this was considered to be a hemorrhage occurring because of the avulsion of the nerve rootlet at the medial surface of the cerebral peduncle. (J.P.N.)

  18. Pneumonia intersticial em bovinos associada à ingestão de batata-doce (Ipomoea batatas mofada Interstitial pneumonia in cattle fed moldy sweet potatoes (Ipomoea batatas

    Directory of Open Access Journals (Sweden)

    Rafael A. Fighera

    2003-12-01

    Full Text Available Uma doença respiratória foi diagnosticada em cinco dentre 23 bovinos (21,7% após terem sido alimentados com batata-doce (Ipomoea batatas mofada em uma pequena propriedade rural em São Vicente do Sul, Rio Grande do Sul, Brasil. Três dos cinco bovinos afetados morreram espontaneamente, e o quarto foi sacrificado para necropsia quando mostrava sinais clínicos respiratórios avançados. A manifestação clínica iniciara cerca de 24 horas após a ingestão das batatas-doces e a evolução clínica foi de 1 a 4 dias. Os sinais clínicos incluíam dispnéia (respiração laboriosa e abdominal, taquipnéia, pescoço estendido com cabeça baixa e dilatação ritmada das narinas. Dois bovinos foram necropsiados. Os achados de necropsia incluíam pulmões distendidos, pálidos e de consistência borrachenta, que não colapsavam quando o tórax era aberto; enfisema e edema acentuados eram evidentes no pulmão. Os linfonodos e o baço apresentavam alterações características de hiperplasia linfóide. Histologica-mente, as lesões eram típicas de pneumonia intersticial. Os septos alveolares estavam espessados por fibroblastos e células inflamatórias, havia hipertrofia e hiperplasia de pneumócitos tipo II; os septos interlobulares estavam distendidos por edema e enfisema. A cultura de amostras das batatas-doces mofadas produziu Fusarium solani e F. oxysporum.Cases of respiratory disease were diagnosed in five out of 23 cattle (21.7% after they were fed moldy damaged sweet potatoes (Ipomoea batatas on a small farm in the county of São Vicente do Sul, state of Rio Grande do Sul, Brazil. Of those five cattle, three died spontaneously and another one was euthanatized for necropsy while showing advanced respiratory clinical signs. The disease manifested itself approximately 24 hours after the ingestion of the sweet potatoes and lasted from 1 to 4 days. Clinical signs included dyspnea (labored breathing and abdominal respiration, tachypnea, extended

  19. United Nations and Multilateralism: Appraising USA's Unilateralism ...

    African Journals Online (AJOL)

    DrNneka

    global peace and security, as well as the survival of the United Nations. This is because ... Key Words: United Nations, multilateralism, United States, unilateralism, national interest, UN Charter ..... Lebanon, Iraq, Turkey, Egypt, Jordan, etc.

  20. Perfusão pulmonar anterógrada "versus" retrógrada na preservação pulmonar para transplante em modelo canino de viabilidade pulmonar pós-morte Antegrade versus retrograde lung perfusion in pulmonary preservation for transplantation in a canine model of post-mortem lung viability

    Directory of Open Access Journals (Sweden)

    Jean Carlo Kohmann

    1999-04-01

    Full Text Available A doação pulmonar após parada cardiocirculatória tem sido estudada experimentalmente na obtenção de órgãos para transplante, porém a severa lesão isquêmica/reperfusão exigem métodos de preservação que permitam viabilidade pulmonar. A perfusão do enxerto com solução cristalóide hipotérmica via anterógrada (artéria pulmonar é o método de preservação mais utilizado, porém esta via não perfunde a circulação brônquica, permitindo a retenção sanguínea neste território capaz de desencadear fenômenos de lesão de reperfusão. Isto nos levou a testar os efeitos da perfusão anterógrada versus retrógrada (via átrio esquerdo, capaz de perfundir a circulação brônquica em modelo canino de transplante unilateral cujos pulmões foram extraídos 3 horas após parada cardiorrespiratória. Doze cães doadores foram sacrificados com tiopental sódico e mantidos à temperatura ambiente sob ventilação mecânica durante 3 horas, após as quais os animais foram randomizados e os blocos cardiopulmonares perfundidos via retrógrada (n = 6 ou anterógrada (n = 6 com solução de Euro-Collins modificada e extraídos. Os receptores (n = 12 foram anestesiados, pneumonectomizados e submetidos a transplante pulmonar esquerdo recebendo enxertos perfundidos por via retrógrada (grupo I ou anterógrada (grupo II. Após a reperfusão do enxerto, os animais foram mantidos sob ventilação mecânica (FiO2 = 1 por 6 horas, sendo então sacrificados. Durante este período obtiveram-se medidas hemodinâmicas e gasometrias arteriais, além de amostras de tecido pulmonar para dosagem de ATP intracelular. As medidas hemodinâmicas não diferiram entre os grupos. Nos animais do grupo I a PaO2 e PaCO2 foram superiores às do grupo II (p = 0,016 e p = 0,008, respectivamente. O ATP intracelular não diferiu entre os grupos, embora tenha se reduzido nas amostras obtidas na extração do enxerto do doador quando comparados aos valores após a

  1. Unilateral Condylar Hyperplasia of the Mandible

    Directory of Open Access Journals (Sweden)

    Malachovsky I

    2015-12-01

    Full Text Available Condylar hyperplasia (CH of the mandible is a rare pathology that occurs at the head of the condyle and can lead to facial asymmetry affecting occlusion and possible association with pain and dysfunction. Unilateral condylar hyperplasia is an uncommon condition of unknown aetiology, proper diagnosis of which has to be established, as the patients may look for surgical help. A rare case of unilateral condylar hyperplasia of the mandible is reported here.

  2. Prepubertal Unilateral Gynecomastia: Report of 2 Cases

    OpenAIRE

    Demirbilek, H?seyin; Bacak, G?khan; Baran, R?za Taner; Avc?, Yahya; Baran, Ahmet; Kele?, Ay?enur; ?zbek, Mehmet Nuri; Alanay, Yasemin; Hussain, Khalid

    2014-01-01

    Prepubertal unilateral gynecomastia is an extremely rare condition. At present, its etiology and management strategy are not well known. Two unrelated prepubertal boys of ages 8 and 9 who presented with complaints of unilateral enlargement of breast tissue are reported. Physical examination, biochemical, hormonal and oncologic work-up findings were normal. Both patients were treated with peripheral liposuction successfully. Histopathological and immunohistochemical examinations showed benign ...

  3. Tromboembolismo pulmonar masivo de alto riesgo asociado a foramen oval permeable

    Directory of Open Access Journals (Sweden)

    Antonio Miranda

    2012-04-01

    Full Text Available La alta mortalidad de los pacientes con tromboembolismo pulmonar masivo de alto riesgo amerita un enfoque terapéutico enérgico e invasivo que incluya la embolectomía pulmonar quirúrgica en aquellos pacientes con contraindicación para trombolisis o trombolisis fallida. Describimos un caso de tromboembolismo pulmonar masivo de alto riesgo que recibió tratamiento quirúrgico en vez de trombolisis debido a que al momento del diagnóstico presentaba un trombo móvil a través de un foramen oval permeable con altísima posibilidad de embolismo paradójico arterial.

  4. Tratamento da hipertensão pulmonar persistente do recém-nascido

    OpenAIRE

    Rodrigues, Marisa Isabel Garcia

    2008-01-01

    A hipertensão pulmonar persistente do recém-nascido (HPPRN) é um síndrome clínico complexo com múltiplas causas que resulta da incapacidade da circulação pulmonar fetal fazer a transição para a vida extra-uterina. Define-se como uma resistência vascular pulmonar aumentada e shunt direito-esquerdo através do foramen ovale e/ou do ductus arteriosus, causando hipoxémia arterial refractária à suplementação de oxigénio. Com o aparecimento de novas modalidades terapêuticas, fruto ...

  5. Trombolisis farmacológica y mecánica en tromboembolismo pulmonar submasivo

    Directory of Open Access Journals (Sweden)

    Jorge O. Cáneva

    2014-04-01

    Full Text Available La enfermedad tromboembólica pulmonar, en sus formas aguda, subaguda o crónica, presenta dificultades para su tratamiento y tiene elevada morbimortalidad. La gravedad del evento agudo y su potencial compromiso sobre la función del ventrículo derecho necesitan estrategias terapéuticas, a veces combinadas, para cambiar el curso de la enfermedad a favor de la supervivencia del paciente. Las trombolisis farmacológica y mecánica son instrumentos útiles para tratar un evento embólico pulmonar agudo grave. Se presenta el caso de una joven que desarrolló una embolia pulmonar submasiva de instalación subaguda en quien la terapia combinada y secuencial trombolítica, farmacológica y mecánica, fue exitosa.

  6. Acometimento pulmonar em crianças com a síndrome da imunodeficiência humana (AIDS: estudo clínico e de necrópsia de 14 casos Necroscopic study of 14 children with AIDS and pneumonia

    Directory of Open Access Journals (Sweden)

    I.T.R. YPARRAGUIRRE

    2001-06-01

    Full Text Available OBJETIVOS: Descrever os aspectos clínicos, laboratoriais, radiológicos e anatomopatológicos encontrados em tecidos pulmonares de necrópsias de crianças com Aids e acometimento pulmonar. MÉTODOS: Foram revisados, retrospectivamente, prontuários, radiografias simples de tórax e laudos de necrópsias de 14 crianças com Aids e acometimento pulmonar. RESULTADOS: Oito casos eram do sexo masculino e seis do feminino. As idades variaram de três meses a nove anos, mediana de 1,2, sendo nove deles menores de dois anos. A transmissão foi vertical em 10 pacientes, dos quais cinco mães tinham história de contaminação por relação heterossexual; três, por hemotransfusão e em duas, ignorada. Pneumonia (n=8, candidíase oral (n=8 e diarréia (n=5 foram as doenças prévias mais referidas. Os sinais e sintomas observados à internação foram febre (n=12, dispnéia (n=10, tosse (n=11, linfoadenomegalia (n=11, hepato e/ou esplenomegalia (n=10, desnutrição (n=9, palidez (n=8, cianose (n=5 e baqueteamento digital (n=2. Os achados radiológicos mais comuns foram infiltrados difusos (n=6 e condensações (n=5. As alterações histológicas pulmonares foram compatíveis com pneumonia pelo citomegalovírus (n=9, por bactérias (n=8, por Pneumocystis carinii (n=3, por Hystoplasma capsulatum (n=1, por Toxoplasma gondii (n=1 e pneumonia intersticial linfocítica (n=1. A associação CMV e bactéria foi observada em seis casos. CONCLUSÕES: Houve predomínio de menores de dois anos, de transmissão vertical, de quadro clínico inespecífico de doença pulmonar e de infiltrados e condensações à radiografia. Citomegalovírus e bactérias foram os agentes mais comuns, sendo freqüente a sua associação. Pneumonia Intersticial Linfocítica e Pneumonia pelo P. carinii não foram causas freqüentes de doenças pulmonares.BACKGROUND: To describe clinical, laboratorial, radiological, and histopathological lung findings from necroscopy of aidetic children

  7. Lesões pulmonares em caninos (achados de necrópsias)

    OpenAIRE

    Souza, V. T. F. de; Paraguassu, A. A.; Moreira, E. L. T.

    2001-01-01

    p. 43-47 O estudo macroscópico dos pulmões de 381 caninos necropsiados no Setor de Anatomia Patológica do HOSPMEV/UFBA, revelou alta incidência de lesões pulmonares ( 499 ). Das alterações diagnosticadas, os distúrbios circulatórios compareceram com maior frequência (284) casos, seguidos das alterações da expansão pulmonar (121 ), das inflamatórias ( 69 ), das pigmentares (16 ), das neoplásicas ( metástases) (08) e das parasitárias ( 01 caso ).

  8. Enfermedad periodontal inflamatoria asociada a un absceso pulmonar. Presentación de un caso

    OpenAIRE

    López Rodríguez, Vania Julexis; Garcías Rodríguez, Marisel; Gómez Martínez, Ana Iris; Díaz Gonzáles, Gabriela

    2015-01-01

    Fundamento: A pesar, de que hay reportes de casos en la literatura internacional, que asocian la enfermedad periodontal con enfermedades respiratorias y medidas para la prevención de la enfermedad periodontal inflamatoria, sino se establece un adecuado manejo de esta última, puede evolucionar con una complicación sistémica como es el absceso pulmonar. Objetivo: Ilustrar cómo la enfermedad periodontal inflamatoria puede asociarse a un absceso pulmonar como complicación sistémica en su evolució...

  9. Tratamiento de la enfermedad pulmonar obstructiva crónica: Conceptos actuales

    OpenAIRE

    Pino Alfonso, Pedro Pablo; Rodríguez Vázquez, Juan Carlos; Gassiot Nuño, Carlos; Rodríguez Fernández, Rolando

    1997-01-01

    Se revisan los conceptos actuales en el tratamiento de la enfermedad pulmonar obstructiva crónica, incluidos la bronquitis crónica y el enfisema pulmonar. Se hace hincapié en el abandono del hábito de firmar como paso más importante en el tratamiento. Se dan recomendaciones para el uso de la terapia preventiva, así como la mejor manera de establecer el tratamiento broncodilatador, por pasos, a base de bromuro de ipratropiun, en dosis regulares y beta 2 agonistas, a demanda, así como el uso de...

  10. Artritis reumatoidea y síndrome combinado de fibrosis pulmonar y enfisema

    OpenAIRE

    Fernández Casares, Marcelo; Fielli, Mariano; Cristaldo, Laura; Zárate, Lucía; Capozzi, María Nieves

    2015-01-01

    La combinación de fibrosis pulmonar y enfisema es un síndrome descripto en los últimos años que tiene características propias y no es la casual asociación de dos entidades. El componente de fibrosis más común corresponde a la fibrosis pulmonar idiopática. Sin embargo, otras enfermedades intersticiales pueden formar parte de este síndrome, entre ellas las asociadas a enfermedades del tejido conectivo. Se presenta un caso de este síndrome asociado a artritis reumatoidea con la particularidad qu...

  11. Breve Apontamento da Recente Unidade de Oncologia Pulmonar do Hospital CUF Porto

    Directory of Open Access Journals (Sweden)

    Bárbara Parente

    2017-09-01

    Full Text Available A Unidade de Oncologia Pulmonar do Hospital CUF Porto, iniciou a sua atividade no tratamento de doentes com patologia do foro torácico em janeiro de 2014. Tendo em conta toda a infraestrutura pré-existente no Hospital na área do diagnóstico e estadiamento, deu-se início à consulta Especializada em Oncologia Pulmonar com referenciação de doentes, quer interna, quer externamente, organizando o serviço centrado na doença e no doente.

  12. Edema pulmonar neurogênico: uma revisão atualizada da literatura

    OpenAIRE

    Flávio Antônio Siqueira Ridenti

    2012-01-01

    O edema pulmonar neurogênico ainda é um fenômeno pouco compreendido no contexto da assistência ao paciente neurológico grave. Trata-se de uma situação clínica relativamente rara. Situações de importante dano cerebral como hemorragia subaracnóidea, traumatismos encefálicos severos, hemorragias cerebrais intra-parenquimatosas, crises convulsivas ou outras condições específicas fazem o perfil do paciente com risco de desenvolver edema pulmonar neurogênico. A falta de reconhecimento desta condiçã...

  13. Fibrosis pulmonar asociada a vasculitis con anticuerpos anticitoplasmáticos positivos

    OpenAIRE

    Marcelo Fernández Casares; Alejandra González; Flavia Caputo; Yanina Bottinelli; Patricia Nastavi; Marcelo Zamboni

    2012-01-01

    Las complicaciones pulmonares más conocidas de las vasculitis con anticuerpos anticitoplasmáticos de los neutrófilos (ANCA) positivos (VAA), son la hemorragia alveolar, los granulomas y la estenosis de la vía aérea. En los últimos años han aparecido algunos informes aislados que muestran la asociación con fibrosis pulmonar (FP), sugiriendo que ésta sería otra complicación de las VAA. En este trabajo informamos dos casos con dicha asociación describiendo sus características clínicas, tomográfi...

  14. Hipertensión arterial pulmonar primaria o idiopática

    OpenAIRE

    Yazmín Ravelo-Calzado; Vivian Molina-Cuevas; María de Lourdes Arruzazabala-Valmaña; Daisy Carbajal-Quintana

    2010-01-01

    La hipertensión arterial pulmonar primaria (HAPP) es una enfermedad crónica de causa desconocida que se caracteriza por un incremento de la presión sanguínea media en la arteria pulmonar, mayor de 25 mmHg en reposo o más de 30 mmHg durante el ejercicio. Es una enfermedad que afecta a ambos sexos y no tiene predilección racial. La HAPP sin tratar puede conducir a una insuficiencia ventricular derecha y por consiguiente, a la muerte. La HAPP involucra varios mecanismos subyacentes, dentro de lo...

  15. Edema pulmonar pós-pneumonectomia Postpneumonectomy pulmonary edema

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    Marcos Naoyuki Samano

    2005-02-01

    Full Text Available A pneumonectomia, embora seja tecnicamente simples, está associada a alta incidência de complicações (cerca de 60%. As complicações respiratórias correspondem a aproximadamente 15% deste total. A mortalidade global dessa cirurgia é de 8,6%, mas em presença de complicações respiratórias, a taxa de mortalidade chega a 30%. O edema pulmonar pós-pneumonectomia é uma complicação rara (3% a 5%, mas muito grave, sendo fatal na maioria dos casos. Foi descrito pela primeira vez há pouco mais de vinte anos mas, apesar da gravidade alarmante, pouco sabemos acerca de sua fisiopatologia, embora muitas hipóteses tenham sido levantadas. Uma vez instalado, nenhuma medida é comprovadamente eficaz no seu tratamento. Vários fatores de risco estão associados ao aparecimento do edema pulmonar pós-pneumonectomia, dentre os quais a sobrecarga hídrica, que foi o primeiro fator evitado. Entretanto, muitos trabalhos mostram não haver relação direta entre o volume recebido e o desenvolvimento do edema. A prevenção é a melhor forma de evitá-lo e deve ser realizada de maneira multifatorial, envolvendo toda a equipe médica, desde o momento da anestesia até os cuidados cirúrgicos e na terapia intensiva. No entanto, tão importante quanto a prevenção, é a suspeita clínica precoce, identificando os pacientes em risco para essa grave complicação.Although pneumonectomy is a technically simple procedure, it has been associated with a high (60% incidence of complications. Respiratory complications account for approximately 15% of such complications. Worldwide, the mortality rate among patients subjected to pneumonectomy is 8.6%. However, the rate among patients developing respiratory complications is 30%. Although postpneumonectomy pulmonary edema is rare (occurring in 3% to 5% of cases, it is a serious complication and is almost always fatal. It was first described twenty years ago and, despite these alarming statistics, little is known

  16. Embolia pulmonar na sala de cirurgia: relato de caso Embolia pulmonar en sala operatoria: relato de caso Pulmonary embolism in the operating room: case report

    Directory of Open Access Journals (Sweden)

    Karina Bernardi Pimenta

    2002-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Embolia pulmonar é uma complicação freqüente no período pós-operatório. O objetivo deste relato é apresentar um caso de embolia pulmonar ocorrida na sala de operação e chamar a atenção para a importância da profilaxia de trombose venosa em pacientes cirúrgicos. RELATO DO CASO: Trata-se de um paciente do sexo masculino, 55 anos e 83 kg com diagnóstico de câncer de próstata, submetido a prostatectomia supra-púbica sob anestesia geral. Ao final da cirurgia, o paciente já extubado e logo após sua passagem para a maca de transporte apresentou instabilidade hemodinâmica e diminuição da SpO2 para 80%. Foi reintubado e encaminhado para a UTI. A tomografia computadorizada mostrou imagens com aspecto de embolia pulmonar. O paciente evoluiu para óbito no 5º dia de pós-operatório. CONCLUSÕES: O elevado índice de suspeita não é suficiente para firmar o diagnóstico pois a embolia pulmonar é uma doença silenciosa e a rotina de investigação não possui elevada sensibilidade. A profilaxia precoce e adequada é a melhor estratégia.JUSTIFICATIVA Y OBJETIVOS: Embolia pulmonar es una complicación frecuente en el período pós-operatorio. El objetivo de este relato es presentar un caso de embolia pulmonar ocurrida en la sala de operación y llamar la atención para la importancia de la profilaxis de trombosis venosa en pacientes cirúrgicos. RELATO DE CASO: Se trata de un paciente del sexo masculino, 55 años y 83 kg con diagnóstico de cáncer de próstata, sometido a prostatectomia supra-púbica bajo anestesia general. Al final de la cirugía, el paciente ya entubado y luego después de pasar para la camilla de transporte presentó inestabilidad hemodinámica y diminución de la SpO2 para 80%. Fue reintubado y encaminado para la UTI. La tomografía computadorizada mostró imágenes con aspecto de embolia pulmonar. El paciente evolucionó para óbito en el 5º día de pós-operatorio. CONCLUSIONES: El

  17. Association between unilateral or bilateral mastectomy and breast cancer death in patients with unilateral ductal carcinoma.

    Science.gov (United States)

    Agarwal, Shailesh; Pappas, Lisa; Agarwal, Jayant

    2017-01-01

    Utilization of bilateral mastectomy for unilateral breast cancer is increasing despite cost and surgical risks with conflicting reports of survival benefit. Current studies evaluating death after bilateral mastectomy have included patients treated both with breast conservation therapy and unilateral mastectomy. In this study, we directly compared breast cancer-specific death of patients who underwent bilateral or unilateral mastectomy for unilateral breast cancer using a matched cohort analysis. This was an observational study of women diagnosed with unilateral breast cancer from 1998 through 2002, using the Surveillance, Epidemiology, and End Results (SEER) database. A 4-to-1 matched cohort of patients was selected including 14,075 patients. Mortality of the groups was compared using Cox proportional hazards models for cause-specific death. A total of 41,510 patients diagnosed with unilateral breast cancer were included. Unilateral mastectomy was performed in 93% of patients, while bilateral mastectomy was performed in the remaining 7% of patients. When 4-to-1 matching was performed, 11,260 unilateral mastectomy and 2,815 bilateral mastectomy patients were included. Patients with bilateral mastectomy did not have a significantly lower hazard of breast cancer-specific death when compared with patients with unilateral mastectomy (hazard ratio: 0.92 vs 1.00, p =0.11). Bilateral mastectomy did not provide a clinically or statistically significant breast cancer-specific mortality benefit over unilateral mastectomy based on a matched cohort analysis of a nationwide population database. These findings should be interpreted in the context of patient preference and alternative benefits of bilateral mastectomy.

  18. Estudo angiográfico da circulação pulmonar na tetralogia de Fallot com atresia pulmonar Angiographic study of pulmonary circulation in tetralogy of Fallot with pulmonary atresia

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Santos

    2005-02-01

    Full Text Available OBJETIVO: Identificar os tipos de suprimento sangüíneo vascular pulmonar na tetralogia de Fallot com atresia pulmonar por meio de estudo hemodinâmico. MÉTODOS: Foram submetidos a estudo cineangiocardiográfico 56 pacientes portadores de tetralogia de Fallot com atresia pulmonar com idade de 20 dias a 4 anos e efetuadas injeções de contraste nas seguintes estruturas vasculares: 1 veia pulmonar encunhada, 2 colaterais aortopulmonares, 3 aorta torácica e 4 ductus arteriosus e/ou shunt sistêmico pulmonar. RESULTADOS: Dos 56 pacientes, 15 tinham o suprimento sangüíneo pulmonar através de colaterais aortopulmonares, em 36 o suprimento sangüíneo pulmonar era feito isoladamente pelo ductus arteriosus e em 5 pelo ductus arteriosus e colaterais aortopulmonares. Conforme a presença ou ausência de estruturas vasculares que compõem a circulação pulmonar na tetralogia de Fallot com atresia pulmonar e do tipo de perfusão vascular pulmonar, os doentes foram classificados em 6 tipos. CONCLUSÃO: Em função da grande complexidade e extrema variabilidade do suprimento sangüíneo pulmonar na tetralogia de Fallot com atresia pulmonar torna-se possível, com este tipo de abordagem, a obtenção de informações, suficientemente necessárias, para o correto manuseio clínico-cirúrgico.OBJECTIVE: To identify the types of pulmonary vascular blood supply in tetralogy of Fallot with pulmonary atresia by use of hemodynamic study. METHODS: Fifty-six patients with tetralogy of Fallot and pulmonary atresia, and ages ranging from 20 days to 4 years, underwent cineangiocardiographic study with contrast medium injections in the following vascular structures: 1 wedged pulmonary vein; 2 aortopulmonary collaterals; 3 thoracic aorta; and 4 ductus arteriosus or systemic-pulmonary shunt. RESULTS: In the 56 patients studied, pulmonary blood was supplied as follows: in 15, by aortopulmonary collaterals; in 36, only by the ductus arteriosus; and in 5, by the ductus

  19. Análisis in vivo de la vasculopatía arterial pulmonar mediante ultrasonido intravascular (IVUS) en pacientes con insuficiencia respiratoria crónica evaluados para trasplante pulmonar

    OpenAIRE

    Acosta Vélez, Juan Gabriel

    2013-01-01

    El objetivo del estudio es evaluar el remodelado estructural y funcional de las arterias pulmonares asociado a insuficiencia respiratoria crónica severa, mediante ecografía intravascular (IVUS). Se incluyeron 80 pacientes en estudio pretrasplante pulmonar a los que se les realizó cateterismo cardiaco derecho e IVUS de una arteria pulmonar de mediano calibre. A través del IVUS se determinó el módulo elástico, pulsatilidad y porcentaje de fibrosis arterial. La insuficiencia respiratoria crónica...

  20. Procedimento e complicações anestésicas no manejo de lavagem pulmonar total em paciente obeso com proteinose alveolar pulmonar: relato de caso

    Directory of Open Access Journals (Sweden)

    Helena Marta Rebelo

    2012-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O primeiro caso de proteinose alveolar pulmonar (PAP foi descrito por Rose em 1958, mas ainda é um distúrbio raro. PAP é caracterizada pela deposição de material lipoproteico secundário ao processamento anormal de surfactantes pelos macrófagos. Os pacientes podem ter dispneia progressiva e tosse, às vezes acompanhadas pelo agravamento da hipóxia, e seu curso pode variar de deterioração progressiva a melhora espontânea. Muitas terapias foram usadas, incluindo antibióticos, drenagem postural e ventilação com pressão positiva intermitente com acetilcisteína, heparina e soro fisiológico em aerossol. Atualmente, a base do tratamento é a lavagem pulmonar total (LPT. A LPT, embora seja geralmente bem-tolerada, pode estar associada a algumas complicações. RELATO DE CASO: Relatamos um caso de PAP grave durante o procedimento anestésico e as complicações no manejo da proteinose alveolar pulmonar em um paciente que havia sido submetido a múltiplas e alternadas lavagens de um dos pulmões ao longo de sete anos (os últimos três em nosso hospital, com melhora dos sintomas depois de cada tratamento.

  1. Drenaje venosa pulmonar anómalo total. Técnicas y resultados

    Directory of Open Access Journals (Sweden)

    Ángel Aroca

    2014-04-01

    Se citan recomendaciones para el a veces complejo manejo postoperatorio y se revisa la literatura más reciente que aporta datos sobre el tratamiento y resultados de la complicación tardía más letal: la obstrucción anastomótica y/o de venas pulmonares.

  2. O problema da hemossiderose pulmonar na doença de Chagas

    Directory of Open Access Journals (Sweden)

    Leila Andrade Siqueira

    1972-10-01

    Full Text Available Os autores estudaram a existência de hemosiderose pulmonar em 60 casou de autopsia, 20 dos quais chagásicos crônicos com cardiopatia, 20 pacientes com cardiopatia não chagásica e 20 casos sem nenhuma manifestação de doença cardíaca. A incidência de hemossiderose pulmonar foi de 75% entre os chagásicos e de 80% entre os pacientes de cardiopatia não chagásica. Nos casos controle sem cardiopatia a incidência foi relativamente baixa (45% e, guando presente, o grau de intensidade era mínimo. Com esses achados, conclui-se que a hemossiderose pulmonar na Doença de Chagas é uma conseqüência da congestão crônica passiva, resultante da insuficiência cardíaca congestiva, do mesmo modo que ocorre em outras condições mórbidas tais como Estenose mitral e Cor-pulmonar crônico, não havendo evidências de uma pneumopatia peculiar em chagásicos.

  3. Linfangioleiomiomatose pulmonar inicial provável e linfangioleiomioma mediastínico

    Directory of Open Access Journals (Sweden)

    M. Pontes

    2014-03-01

    Full Text Available Resumo: Uma mulher de 68 anos foi submetida a uma ressecção de um linfoangioendotelioma mediastinal observado na monitorização de uma lobectomia inferior esquerda devido a bronquiectasia, complicada por quilotórax. Isto levou a uma reavaliação do espécime pulmonar que revelou, além da bronquiectasia inflamatória, nódulos de pequenas células fusiformes no parênquima pulmonar, semelhantes a nódulos pulmonares de tipo meningotelial, mas com positividade imunohistoquímica para actina do músculo liso. A hipótese de desenvolvimento inicial de linfangioleiomiomatose pulmonar é discutida. Abstract: A 68 year old woman was submitted to a mediastinal lymphangioleiomyoma resection found in a follow-up study of lower left lung resection due to bronchiectasis complicated by chylothorax. This led to a revaluation of the pulmonary specimen that revealed, in addition to inflammatory bronchiectasis, small spindle cell nodules in the lung parenchyma, similar to minute pulmonary meningothelial-like nodules, but with smooth muscle actin immunohistochemical positivity. The possibility of initial pulmonary development of lymphangioleiomyomatosis is discussed. Palavras-chave: Mediastinal, Linfangioleiomioma, Linfangioleiomiomatose, Keywords: Mediastinal, Lymphangioleiomyoma, Lymphangioleiomyomatosis

  4. An exercise in preferential unilateral breathing

    International Nuclear Information System (INIS)

    Cheong, D.; Tucker, B.; Jenkins, S.; Robinson, P.; Curtin University, Shenton Park, WA

    1999-01-01

    Full text: In preparation for major thoracic surgery, physiotherapists have traditionally taught unilateral breathing exercises. There are no studies that prove that these exercises are effective This study was undertaken to demonstrate the effects of unilateral thoracic expansion exercises (TEE) using 99 Tc m -Technegas Ten physiotherapists were taught unilateral TEE to increase ventilation to the right lower lobe. Each subject underwent two separate Technegas ventilation studies using a single-breath technique, one with normal deep inspiration and the other during a right TEE. Dynamic and static images were acquired in the seated position for each ventilation study. Analysis was undertaken by dividing the lungs into 6 zones of equal height and calculating the relative ventilation of each zone and each lung. Seven subjects (70%) achieved significantly increased ventilation to the right lower zone, while 9 (90%) achieved greater ventilation to the right lung. Total lung ventilation was reduced during right TEE when compared with normal deep inspiration

  5. 58. Actitud frente al flujo sanguíneo pulmonar adicional en la operación de glenn

    Directory of Open Access Journals (Sweden)

    F. Serrano Martínez

    2010-01-01

    Conclusiones: El mantenimiento de FPAC no incrementa la morbimortalidad post-Glenn ni altera la conservación funcional del ventrículo único, permitiendo llegar a la fase pre-Fontan con mayor SaO2 y mejor tamaño de ramas pulmonares. La existencia o ausencia de FPAC no influyó en los resultados del Fontan posterior, aunque consideramos interesante mantenerlo, especialmente en casos con ramas pulmonares pequeñas. La paliación pre-Glenn tipo banding pulmonar se asoció a mayor imposibilidad de conservar un FPAC.

  6. Diagnóstico por imagem do tromboembolismo pulmonar agudo Imaging of acute pulmonary thromboembolism

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    C. Isabela S. Silva

    2004-10-01

    Full Text Available O diagnóstico do tromboembolismo pulmonar agudo é baseado na probabilidade clínica, uso do dímero D (quando disponível e na avaliação por imagem. Os principais métodos de imagem utilizados no diagnóstico são representados por cintilografia ventilação-perfusão, angiografia pulmonar e tomografia computadorizada (TC. Na última década vários estudos têm demonstrado que a TC espiral apresenta elevada sensibilidade e especificidade no diagnóstico de tromboembolismo pulmonar agudo. Uma melhor avaliação das artérias pulmonares tornou-se possível com a recente introdução dos equipamentos de TC espirais com multidetectores. Vários pesquisadores têm sugerido que a angiografia pulmonar por TC espiral deve substituir a cintilografia na avaliação de pacientes com suspeita clinica de tromboembolismo pulmonar agudo. Os autores discutem os principais métodos de imagem utilizados no diagnóstico de tromboembolismo pulmonar agudo enfatizando o papel da TC espiral.The diagnosis of acute pulmonary thromboembolism is based on the clinical probability, use of D-dimer (when available and imaging. The main imaging modalities used in the diagnosis are ventilation-perfusion (V/Q, scintigraphy, angiography, and computed tomography (CT. In the last decade several studies have demonstrated that spiral CT has a high sensitivity and specificity in the diagnosis of acute pulmonary thromboembolism. The evaluation of the pulmonary arteries has further improved with the recent introduction of multidetector spiral CT scanners. Various investigators have suggested that spiral CT pulmonary angiography should replace scintigraphy in the assessment of patients whose symptoms are suggestive of acute PE. This article discusses the role of the various imaging modalities in the diagnosis of acute pulmonary thromboembolism with emphasis on the role of spiral CT.

  7. The impact of unilateral divorce on crime

    OpenAIRE

    Cáceres-Delpiano, Julio; Giolito, Eugenio P.

    2008-01-01

    In this paper, we evaluate the impact of unilateral divorce on crime. First, using crime rates from the FBI's Uniform Crime Report program for the period 1965-1998 and differences in the timing in the introduction of the reform, we find that unilateral divorce has a positive impact on violent crime rates, with an 8% to 12% average increase for the period under consideration. Second, arrest data not only confirms the findings of a positive impact on violent crime but also shows that this impac...

  8. Trilateral retinoblastoma with unilateral eye involvement

    Directory of Open Access Journals (Sweden)

    Gabriel Costa de Andrade

    2015-08-01

    Full Text Available SummaryRetinoblastomas (RB are the main forms of intraocular tumor in childhood, with a worldwide incidence of 1 case per 15,000 to 20,000 live births. Trilateral RB (RBT is a rare combination of unilateral or bilateral RB with a midline intracranial neoplasm of neuroblastic origin, usually found in the pineal region or the suprasellar region, presenting variable incidence of 0.5% up to 6% among patients with RB. The article reports a case of unilateral RBT in a patient treated at Hospital A.C.Camargo.

  9. Recurrent Unilateral Vulval Elephantiasis: A Case Report

    Science.gov (United States)

    G., Sampath Kumar; Venkatesh, Shreedhar

    2014-01-01

    Genital elephantiasis is caused by a variety of infective and non infective causes leading to blockage of lymphatic. We are presenting a rare case of recurrent unilateral vulval elephantiasis which has recurred after initial reconstructive surgery. A 38 year old female presented with vulval swelling and on examination there was gross unilateral vulval enlargement. FNAC (Fine needle aspiration cytology) and biopsy were contributory for diagnosis. Patient was started with antibiotics and daily dressing was done till the infection was subsided and the patient was planned for reconstructive surgery. PMID:24971141

  10. Recurrent unilateral vulval elephantiasis: a case report.

    Directory of Open Access Journals (Sweden)

    Lakshmidevi Muralidhar

    2014-06-01

    Full Text Available Genital elephantiasis is caused by a variety of infective and non infective causes leading to blockage of lymphatic. We are presenting a rare case of recurrent unilateral vulval elephantiasis which has recurred after initial reconstructive surgery. A 38 year old female presented with vulval swelling and on examination there was gross unilateral vulval enlargement. FNAC (Fine needle aspiration cytology and biopsy were contributory for diagnosis. Patient was started with antibiotics and daily dressing was done till the infection was subsided and the patient was planned for reconstructive surgery.

  11. Mandibular unilateral fusion in primary dentition

    Directory of Open Access Journals (Sweden)

    Neena Eregowda

    2017-01-01

    Full Text Available Fusion is a developmental anomaly which occurs due to a union of one or more adjacent teeth during morphodifferentiation of the dental germs. The prevalence of tooth fusion is estimated at 0.5%–2.5% in the primary dentition. These anomalies may be unilateral or bilateral and may affect either dentition although the deciduous teeth are more commonly affected. Early diagnosis of such condition is important because it may cause clinical problems, such as esthetic concerns, and caries. This report describes a case of unilateral fusion of the primary mandibular lateral incisor and canine and aims to evaluate any associated pathology.

  12. Thyrotoxicosis Presenting as Unilateral Drop Foot.

    Science.gov (United States)

    Hara, Kenju; Miyata, Hajime; Motegi, Takahide; Shibano, Ken; Ishiguro, Hideaki

    2017-01-01

    Neuromuscular disorders associated with hyperthyroidism have several variations in their clinical phenotype, such as ophthalmopathy, periodic paralysis, and thyrotoxic myopathy. We herein report an unusual case of thyrotoxic myopathy presenting as unilateral drop foot. Histopathological examinations of the left tibialis anterior muscle showed marked variation in the fiber size, mild inflammatory cell infiltration, and necrotic and regenerated muscle fibers with predominantly type 1 fiber atrophy. Medical treatment with propylthiouracil resulted in complete improvement of the left drop foot. This case expands the phenotype of thyrotoxicosis and suggests that thyrotoxicosis be considered as a possible cause of unilateral drop foot.

  13. ¿(Anti-TNF-¿ y tuberculosis pulmonar

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    Carlo Vinicio Caballero Uribe

    2006-01-01

    Full Text Available Presentación de una paciente con artritis reumatoide severa en tratamiento con inhibidores del Factor de Necrosis Tumoral (Anti-TNF, quien presenta además un cuadro de tuberculosis pulmonar. La artritis reumatoide es una enfermedad inflamatoria crónica de las articulaciones, que afecta en un inicio la membrana sinovial, pero que si no es tratada oportunamente lleva a daño estructural irreversible del sistema músculo-esquelético y eventualmente de otros sistemas orgánicos. Dentro de los criterios de la American College of Rheumatology se incluyen la Rigidez Matutina, Artritis de 3 o más articulaciones, Artritis simétrica, Nódulos reumáticos, Factor Reumatoideo y hallazgos radiográficos. Dentro de la patogenia de esta enfermedad, el Factor de Necrosis Tumoral es una citocina que juega un papel importante, una producción elevada de TNF-α se ha encontrado en la sinovial de estos pacientes, y por su capacidad de inducir la producción de otras citocinas, como IL-6, IL-17, GM-CSF, M-CSF, e incluso IL-1 y TNF-α (función autócrina, parecería que el TNF-α ejerce una acción “jerárquica” dentro de la llamada red de citocinas y una inhibición de su acción da como resultado un beneficio terapéutico en los pacientes con AR. Sin embargo, es conocido que la infección concurrente más frecuentemente informada con el uso de agentes biológicos (Anti-TNF es la TB, y la incidencia de ésta se ha incrementado desde el advenimiento de la terapia biológica. Por tanto, la descripción de este caso no corresponde a un hecho médico aislado, sino a una problemática actual y real. Este es el primer caso que se reporta en la Costa Caribe.

  14. Coexistência de infeções oportunistas pulmonares num doente com infeção por vírus da imunodeficiência humana e uma forma persistente de pneumonia por Pneumocystis jirovecii: caso clínico

    Directory of Open Access Journals (Sweden)

    D. Ponces Bento

    2013-05-01

    Full Text Available Resumo: Como é sabido, nos doentes com infeção por vírus da imunodeficiência humana (VIH existe um alto risco de ocorrência de infeções oportunistas (IO, tais como as infeções por Pneumocystis jirovecii, um agente patogénico com distribuição mundial, que provoca pneumonia intersticial (PPc. Apresentamos um caso de um doente recém-diagnosticado com infeção por VIH-1 e múltiplas IO pulmonares, incluindo uma forma persistente de PPc, aspergilose invasiva (AI, e infeções por citomegalovírus e por Mycobacterium xenopi. Descrevemos a combinação de fatores cruciais para a recuperação do doente, que incluíram a obtenção de dados laboratoriais, intervenção cirúrgica e múltipla terapêutica antimicrobiana. Abstract: It is well established that HIV patients are at high risk of opportunistic infections (OI, like the ones caused by Pneumocystis jirovecii, a worldwide pathogen implicated in interstitial pneumonia (PcP. We present a case of a newly diagnosed HIV-1 patient with multiple OI, including a persistent form of PcP, an invasive aspergillosis (IA, cytomegalovirus and Mycobacterium xenopi lung infection. We describe the combination of laboratorial screening, surgery and antimicrobial therapy that were crucial for patient recovery. Palavras-chave: Vírus da imunodeficiência humana, Pneumonia por Pneumocystis jirovecii, Infeções oportunistas, Keywords: Human immunodeficiency virus, Pneumocystis jirovecii pneumonia, Opportunistic lung infections

  15. Regulatory domain limits of unilateral agreements

    International Nuclear Information System (INIS)

    Grenier, M.

    1986-06-01

    Simple in its principle unilateral agreement application in practice arise nevertheless some problems, not only for international transport when interpretation is somewhat different between countries, but also in domestic transport. This report tries to determine what being misapprehension and to propose a way to solve misapprehension which does not facilitate radioactive materials transport [fr

  16. Unilateral nodular adrenal hyperplasia: Case series

    African Journals Online (AJOL)

    A.F. Kotb

    2016-07-26

    Jul 26, 2016 ... Abstract. Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 ...

  17. Prenatal diagnosis of congenital unilateral hydrocephalus

    International Nuclear Information System (INIS)

    Koga, Yasutsugn; Tahara, Yasuo; Kida, Takeshi; Matumoto, Yoshinori; Negishi, Hiroaki; Fujimoto, Seiichiro

    1997-01-01

    A case is presented in which fetal unilateral hydrocephalus that had not been definitively diagnosed by ultrasonography was confirmed by means of magnetic resonance imaging. Computed tomography performed in the neonatal period after intraventricular injection of contrast medium showed stenosis of the foramen of Monro. (orig.). With 1 fig

  18. Unilateral vestibular loss impairs external space representation.

    Directory of Open Access Journals (Sweden)

    Liliane Borel

    Full Text Available The vestibular system is responsible for a wide range of postural and oculomotor functions and maintains an internal, updated representation of the position and movement of the head in space. In this study, we assessed whether unilateral vestibular loss affects external space representation. Patients with Menière's disease and healthy participants were instructed to point to memorized targets in near (peripersonal and far (extrapersonal spaces in the absence or presence of a visual background. These individuals were also required to estimate their body pointing direction. Menière's disease patients were tested before unilateral vestibular neurotomy and during the recovery period (one week and one month after the operation, and healthy participants were tested at similar times. Unilateral vestibular loss impaired the representation of both the external space and the body pointing direction: in the dark, the configuration of perceived targets was shifted toward the lesioned side and compressed toward the contralesioned hemifield, with higher pointing error in the near space. Performance varied according to the time elapsed after neurotomy: deficits were stronger during the early stages, while gradual compensation occurred subsequently. These findings provide the first demonstration of the critical role of vestibular signals in the representation of external space and of body pointing direction in the early stages after unilateral vestibular loss.

  19. Codificação da sepse pulmonar e o perfil de mortalidade no Rio de Janeiro, RJ

    Directory of Open Access Journals (Sweden)

    Bruno Baptista Cardoso

    Full Text Available RESUMO: Objetivo: Descrever os óbitos com menção de sepse pulmonar, medir a associação entre sepse pulmonar e pneumonia, assim como avaliar o impacto da regra de codificação no perfil de mortalidade, com a inclusão simulada do diagnóstico de pneumonia, nas declarações de óbito (DO com menção de sepse pulmonar, no Rio de Janeiro, em 2011. Métodos: Foram identificados os óbitos com menção de sepse pulmonar independentemente da causa básica. Aos médicos atestantes, aplicou-se questionário medindo a associação entre sepse pulmonar e pneumonia. O registro de pneumonia nos prontuários dos óbitos com menção de sepse pulmonar e sem menção de pneumonia na DO foi investigado. Foi descrito o perfil de mortalidade após a inclusão simulada do código de pneumonia nas declarações com sepse pulmonar. Resultados: Sepse pulmonar correspondeu a 30,9% das menções de sepse e a menção de pneumonia estava ausente em 51,3% dessas declarações. Pneumonia constava em 82,8% da amostra de prontuários investigados. Dos médicos entrevistados, 93,3% relataram pneumonia como a mais frequente causa de sepse pulmonar. A simulação revelou que a inclusão da pneumonia alterou a causa básica de 7,8% dos óbitos com menção de sepse e 2,4% de todos os óbitos, independentemente da causa original. Conclusão: Sepse pulmonar está associada à pneumonia e a simples inclusão do código de pneumonia nas declarações de óbito com menção de sepse pulmonar impactaria o perfil de mortalidade, apontando necessidade de aprimoramento das regras de codificação na Classificação Internacional de Doenças (CID-10.

  20. Modification of unilateral otolith responses following spaceflight.

    Science.gov (United States)

    Clarke, Andrew H; Schönfeld, Uwe

    2015-12-01

    The aim of the study was to resolve the issue of spaceflight-induced, adaptive modification of the otolith system by measuring unilateral otolith responses in a pre- versus post-flight design. The study represents the first comprehensive approach to examining unilateral otolith function following space flight. Ten astronauts participated in unilateral otolith function tests three times preflight and up to four times after Shuttle flights from landing day through the subsequent 10 days. During unilateral centrifugation, utricular function was examined by the perceptual changes reflected by the subjective visual vertical (SVV) and the otolith-mediated ocular counter-roll, designated as utriculo-ocular response (UOR). Unilateral saccular reflexes were recorded by measurement of collic vestibular evoked myogenic potentials (cVEMP). The findings demonstrate a general increase in interlabyrinth asymmetry of otolith responses on landing day relative to preflight baseline, with subsequent reversal in asymmetry within 2-3 days. Recovery to baseline levels was achieved within 10 days. This fluctuation in asymmetry was consistent for the utricle tests (SVV and UOR) while apparently stronger for SVV. A similar asymmetry was observed during cVEMP testing. In addition, the results provide initial evidence of a dominant labyrinth. The findings require reconsideration of the otolith asymmetry hypothesis; in general, on landing day, the response from one labyrinth was equivalent to preflight values, while the other showed considerable discrepancy. The finding that one otolith response can return to one-g level within hours after re-entry while the other takes considerably longer demonstrates the importance of considering the otolith response as a result of both peripheral and associated central neural processing.

  1. Resonancia magnética nuclear en la evaluación de la hipertensión pulmonar

    OpenAIRE

    Caroli, Christian; aman, Bettina; Embón, Mario; Cohen Arazi, Hernán; Perrone, Sergio V.

    2009-01-01

    Se presentan las imágenes de resonancia magnética nuclear de una paciente de 38 años portadora de hipertensión pulmonar idiopática. We present the images of nuclear magnetic resonance of a 38-year-old woman with idiopathic pulmonary hypertension. Apresentam-se as imagens de ressonância magnética nuclear de uma paciente de 38 anos portadora de hipertensão pulmonar idiopatica.

  2. 115. Cirugía urgente en un caso de tromboembolia pulmonar con trombo acabalgado en foramen oval permeable

    Directory of Open Access Journals (Sweden)

    Y. Castillo

    2012-04-01

    Conclusiones: La embolectomía pulmonar bajo circulación extracorpórea es una alternativa terapéutica reservada a los casos de tromboembolia pulmonar con fallo ventricular derecho e inestabilidad hemodinámica, y puede ser utilizada de forma segura y eficaz en aquellos casos en que la fibrinólisis esté contraindicada y la localización del trombo permita su extracción quirúrgica.

  3. Neumomediastino espontáneo y fibrosis pulmonar idiopática

    OpenAIRE

    Calvo Romero, J. M.

    2000-01-01

    La asociación de fibrosis pulmonar y neumomediastino es infrecuente. La tomografía computarizada es el método adecuado para la detección de un pequeño neumomediastino, difícil de detectar mediante la radiografía de tórax. Se presenta un caso de fibrosis pulmonar idiopática, con ataques frecuentes y severos de tos, que desarrolló un neumomediastino y un enfisema subcutáneo cervical, sin neumotórax, en probable relación con la rotura de bullas. La evolución fue favorable con tratamiento sintomá...

  4. Imaginología actual del cáncer pulmonar

    Directory of Open Access Journals (Sweden)

    Dr. D. Raúl Pefaur

    2013-01-01

    Los exámenes imaginológicos que en la actualidad se utilizan en el diagnóstico del cáncer pulmonar son la radiografía simple de tórax, la tomografía computada, la resonancia magnética y el PET-CT. En este artículo se analizará el rendimiento de estos exámenes en el diagnóstico y etapificación del cáncer pulmonar, así como la influencia de éstos en el tratamiento, pronóstico y evolución de esta enfermedad.

  5. Síndromes hemorrágicas pulmonares Pulmonary hemorrhage syndromes

    Directory of Open Access Journals (Sweden)

    Eduardo da Rosa Borges

    2005-07-01

    Full Text Available As síndromes hemorrágicas pulmonares caracterizam-se por infiltrado pulmonar bilateral, queda dos níveis de hemoglobina e hipoxemia. Dentre as causas de sangramento estão as infecções, vasculites, coagulopatias e doenças do colágeno. A terapêutica consiste do tratamento da doença causal e suporte ventilatório, podendo ser associada a plasmaferese.Pulmonary hemorrhage syndromes are characterized by bilateral pulmonary infiltrates, decreased serum levels of hemoglobin, and hypoxemia. The causes of pulmonary hemorrhage include: infections, vasculitis, coagulopathies and collagen diseases. The therapy consists of treating the underlying disease and providing ventilatory support. In some cases, performing plasmapheresis can be beneficial.

  6. Complicações pulmonares de endocardite tricúspide num doente toxicómano

    Directory of Open Access Journals (Sweden)

    Carlos Lousada

    1997-01-01

    Full Text Available RESUMO: Os autore apresentam o caso clínico de um doente toxicodependente com embolias pulmonares sépticas, pneumotórax e derrame pleural secundários a endocardite tricúspide e sindrome nefrótico.Discutese o diagnóstico, mecanismos etiopatogénicos, terapêutica médica, indicações cirúrgicas e prognóstico destas situações. SUMMARY: The authors present a case of an intravenous drug addict with septic pulmonary embolism, pneumothorax and pleural effusion secondary to tricuspid infectious endocarditis and nephrotic syndrome.The diagnosis, etiopathogenic mechanisms, treatment implications, the role of surgery and the prognosis are discussed. Palavras-chave: embolia pulmonar séptica, pneumotórax, endocardite tricúspide, Key-Word: septic pulmonary emboli, pneumothorax, tricuspid endocarditis

  7. Unilateral facial pain and lung cancer

    International Nuclear Information System (INIS)

    Shakespeare, T.P.; Stevens, M.J.

    1996-01-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab

  8. Unilateral facial pain and lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shakespeare, T.P.; Stevens, M.J. [Royal North Shore Hospital, Crows Nest, NSW (Australia)

    1996-02-01

    Facial pain in lung cancer patients may be secondary to metastatic disease to the brain or skull base. Since 1983 there have been 19 published reports of hemi-facial pain as a non-metastatic complication of lung carcinoma. This report describes an additional case in whom unilateral face pain preceded the diagnosis of lung cancer by 9 months. A clinical diagnosis of trigeminal neuralgia was made after a normal brain CT scan. Later on the patient complained of global lethargy, weight loss and haemoptysis. A chest X-ray disclosed a 6 cm right hilar mass that was further defined with a whole body CT scan. The neural mechanism of the unilateral facial pain is discussed and the literature reviewed. 14 refs., 1 tab.

  9. Unilateral Punctate Keratitis Secondary to Wallenberg Syndrome

    Science.gov (United States)

    Boto, Ana; Del Hierro, Almudena; Capote, Maria; Noval, Susana; Garcia, Amanda; Santiago, Susana

    2014-01-01

    We studied three patients who developed left unilateral punctate keratitis after suffering left-sided Wallenberg Syndrome. A complex evolution occurred in two of them. In all cases, neurophysiological studies showed damage in the trigeminal sensory component at the bulbar level. Corneal involvement secondary to Wallenberg syndrome is a rare cause of unilateral superficial punctate keratitis. The loss of corneal sensitivity caused by trigeminal neuropathy leads to epithelial erosions that are frequently unobserved by the patient, resulting in a high risk of corneal-ulcer development with the possibility of superinfection. Neurophysiological studies can help to locate the anatomical level of damage at the ophthalmic branch of the trigeminal nerve, confirming the suspected etiology of stroke, and demonstrating that prior vascular involvement coincides with the location of trigeminal nerve damage. In some of these patients, oculofacial pain is a distinctive feature. PMID:24882965

  10. Unilateral glaucoma in Sotos syndrome (cerebral gigantism).

    Science.gov (United States)

    Yen, M T; Gedde, S J; Flynn, J T

    2000-12-01

    To report a patient with unilateral glaucoma associated with Sotos syndrome. Sotos syndrome (cerebral gigantism) is a disorder of growth and development with characteristic facial changes and normal endocrine function. Ocular manifestations may also include megalocornea, iris hypoplasia, cataracts, megalophthalmos, strabismus, nystagmus, and retinal dystrophy. Case report. A 50 year-old man with the clinical features of Sotos syndrome presented with complaints of decreased vision in the left eye. Ophthalmologic examination revealed bilateral megalocornea, megalophthalmos, iris hypoplasia and transillumination defects, cataracts, and unilateral glaucoma. Intraocular pressure was lowered, and visual field loss was stabilized with topical medications. Sotos syndrome patients should be examined routinely to allow for early detection and treatment of potential ocular problems, including glaucoma.

  11. Alteraciones espirométricas en pacientes con secuela de tuberculosis pulmonar

    Directory of Open Access Journals (Sweden)

    Félix Llanos-Tejada

    2010-04-01

    Full Text Available El pulmón con secuela de tuberculosis es un diagnóstico frecuente de limitación en la función pulmonar que requiere estudio. Objetivo: Determinar las alteraciones espirométricas más frecuentes en pacientes con secuela de tuberculosis pulmonar que requirieron hospitalización, grado de severidad y la respuesta a broncodilatadores. Material y Métodos: Se realizó un estudio descriptivo transversal retrospectivo con revisión de los informes de espirometría realizadas durante el año 2007 en la Unidad de Función Pulmonar del Servicio de Neumología del Hospital Nacional Dos de Mayo. Resultados: Se revisaron 104 espirometrías. El promedio de edad fue 51,2 años. El motivo de hospitalización fue broncorrea infectada en 75%, disnea en 74,04% y hemoptisis en 30,77%. La CVF, VEF1, VEF1%CVF, CVIF% y FEF25-27%, en promedio fue 109%; 72,9%, 57%, 59,7% y 31,4%, respectivamente. Se obtuvo patrón de normalidad ventilatoria en 16,35%; obstructivo en 79,81% y no-obstructivo (restrictivo en 13,46%. En los pacientes con patrón obstructivo, la presencia de reversibilidad total a los broncodilatadores se obtuvo en 28,92%. Se encontró una correlación negativa (p<0,05 entre disnea y CIVF. Conclusiones: El patrón obstructivo sin reversibilidad a broncodilatadores fue la alteración espirométrica más frecuente encontrada en pacientes con secuela de tuberculosis pulmonar. Existe una relación inversa la disnea y la CI.(Rev Med Hered 2010;21:77-83.

  12. Seqüestro pulmonar: uma série de nove casos operados

    Directory of Open Access Journals (Sweden)

    PÊGO-FERNANDES PAULO M.

    2002-01-01

    Full Text Available Seqüestro pulmonar é uma anomalia congênita que envolve parênquima e vascularização pulmonar e apresenta-se como extralobar ou intralobar. Objetivo: Descrever os casos de seqüestro pulmonar tratados no InCor e Hospital das Clínicas da FMUSP no período de 1987 a 1996. Método: Análise retrospectiva dos prontuários. Resultados: Foram tratados nove pacientes, sendo quatro mulheres e cinco homens; duas crianças e sete adultos. Infecção respiratória de repetição e hemoptise foram achados clínicos freqüentes nesses pacientes. Todos os casos eram intralobares. A principal localização foi no lobo inferior esquerdo (66%. Apenas um diagnóstico foi intra-operatório. Nos outros oito casos, o diagnóstico foi suspeitado pela radiografia de tórax (100% e confirmado pela arteriografia (77% e/ou tomografia computadorizada (66%. Lobectomia (77% foi o principal tratamento cirúrgico, com baixa morbidade pós-operatória e sem mortalidade. Exame anatomopatológico foi realizado em sete casos e confirmou a doença. Conclusões: O seqüestro pulmonar é uma entidade incomum, em que a tomografia computadorizada e a arteriografia são os exames que mais informações oferecem para um diagnóstico definitivo e seguro. A ressecção do tecido envolvido leva a excelentes resultados.

  13. Aspergiloma Pulmonar en el Hospital de Apoyo Departamental de Ica - Perú. 2000 - 2001

    Directory of Open Access Journals (Sweden)

    Alicia Arce M

    2002-10-01

    Full Text Available En el Perú, un gran porcentaje de la población que tiene lesiones cavitarias residuales puede albergar una bola fúngica conocida como aspergiloma. Objetivo: determinar los agentes etiológicos que causan los aspergilomas en estas personas y comparar la prueba diagnóstica de inmunodifusión frente al cultivo seriado de esputo. Materiales y métodos: se incluyó a pacientes atendidos en el Programa de Control de Tuberculosis del Hospital Regional de Ica (Ica, Perú que presentaron antecedentes de tuberculosis pulmonar y criterios clínico-radiológicos sospechosos de aspergilosis pulmonar. El diagnóstico de laboratorio se realizó mediante cultivos seriados y consecutivos de esputo en Agar Sabouraud Dextrosa (ASD con cloramfenicol y se detectó precipitinas aspergilares con la prueba de inmunodifusión (ID Resultados: se obtuvo un total de 20 pacientes, 70% de los pacientes (14/20 demostraron tener aspergiloma pulmonar. Los principales agentes etiológicos encontrados fueron Aspergillus fumigatus (50% y Aspergillus níger (14,5% La ID mostró 71% de sensibilidad (aumentando este valor a 82% al utilizar antígeno específico y 100% de especificidad. Conclusiones: Aspergillus fumigatus es el agente etiológico más frecuente en nuestro estudio y la prueba de inmunodifusión es útil como prueba diagnóstica de aspergiloma pulmonar. La prueba de inmunodifusión mejora su sensibilidad al emplear antígenos específicos, por lo que consideramos realizar estudios de elaboración de antígenos específicos de Aspergillus autóctonos para la prueba de ID. Es necesario continuar estudios de prevalencia y de métodos diagnósticos de esta enfermedad.

  14. Malandro, malandra, malandrinha e malandrógino: o espaço intersticial de identidade e gênero na ópera de Chico Buarque de Hollanda

    Directory of Open Access Journals (Sweden)

    Lúcia Helena de Azevedo Vilela

    2008-04-01

    Full Text Available Em De mendigos e malandros, Solange Ribeiro de Oliveira percorre os caminhos das articulações intertextuais e intersemióticas, da tradução lato sensu e das transposições histórico-culturais em sua análise das ambivalências e conflitos presentes na imagem que nós brasileiros construímos de nós mesmos – sintetizada na figura emblemática do malandro e sua escorregadia localização em um espaço intersticial entre o bandido e o herói, entre a censura e a admiração. A ambigüidade proporcionada pela própria definição do termo gera uma série de articulações dentre as quais encontram-se as representações da mulher e do homossexual – a malandra, a malandrinha e o malandrógino.

  15. Uterus didelphys associated with unilateral imperforate vagina.

    Science.gov (United States)

    Gilliland, B; Dyck, F

    1976-07-01

    Two cases of uterus didelphys associated with unilateral imperforate vagina are reported with a review of the literature. In all cases investigated, ipsilateral renal agenesis was found on the affected side. A summary of the embryologic development of the female reproductive tract is included, as well as a possible explanation for this rare anomaly. The authors describe their proposed method of management to achieve freedom from symptoms and maintenance of a relatively intact reproductive tract.

  16. Unilateral Congenital Cataract: Clinical Profile and Presentation.

    Science.gov (United States)

    Khokhar, Sudarshan; Jose, Cijin P; Sihota, Ramanjit; Midha, Neha

    2018-03-01

    To study the clinical profile and presentation of children with unilateral cataract. In this hospital-based, observational, cross-sectional study, patients 15 years of age or younger who presented with unilateral cataract were recruited. Cases of cataract secondary to causes such as trauma or uveitis were excluded. Age at detection and presentation, distance from the treatment center, presenting complaints, cataract morphology, and biometry were noted for each case. A total of 76 patients were recruited. Most patients presented with complaints of leukocoria. Persistent fetal vasculature accounted for 27.6% of cases and was the most common identifiable cause of cataract in this study. Subsequently, patients were divided into two groups: no persistent fetal vasculature (control) and persistent fetal vasculature. A male predominance was noted in both groups. The mean age at detection was 27.58 ± 37.02 and 6.17 ± 8.42 months and the mean age at presentation was 55.613 ± 45.21 and 14.83 ± 17.75 months in the control and persistent fetal vasculature groups, respectively. In the persistent fetal vasculature group, a significant difference was noted in the axial length, keratometry, and corneal diameter between the affected and normal eyes (P = .027, .00176, and .0114, respectively). In the control group, this difference was observed only in keratometry readings (P = .0464). The mean distance traveled by patients to reach the treatment center was 211 km. Persistent fetal vasculature is an important and less identified cause of unilateral cataract. A significant delay is noted in the detection and presentation of unilateral cataract. [J Pediatr Ophthalmol Strabismus. 2018;55(2):107-112.]. Copyright 2017, SLACK Incorporated.

  17. Unilateral regulation breaks regularity of Turing patterns

    Czech Academy of Sciences Publication Activity Database

    Vejchodský, Tomáš; Jaroš, F.; Kučera, Milan; Rybář, Vojtěch

    2017-01-01

    Roč. 96, č. 2 (2017), č. článku 022212. ISSN 2470-0045 EU Projects: European Commission(XE) 328008 - STOCHDETBIOMODEL Institutional support: RVO:67985840 Keywords : unilateral term * Turing instability * pattern Subject RIV: BA - General Mathematics OBOR OECD: Applied mathematics Impact factor: 2.366, year: 2016 https://link. aps .org/doi/10.1103/PhysRevE.96.022212

  18. Unilateral lung transplantation for pulmonary fibrosis.

    Science.gov (United States)

    1986-05-01

    Improvements in immunosuppression and surgical techniques have made unilateral lung transplantation feasible in selected patients with end-stage interstitial lung disease. We report two cases of successful unilateral lung transplantation for end-stage respiratory failure due to pulmonary fibrosis. The patients, both oxygen-dependent, had progressive disease refractory to all treatment, with an anticipated life expectancy of less than one year on the basis of the rate of progression of the disease. Both patients were discharged six weeks after transplantation and returned to normal life. They are alive and well at 26 months and 14 months after the procedure. Pulmonary-function studies have shown substantial improvement in their lung volumes and diffusing capacities. For both patients, arterial oxygen tension is now normal and there is no arterial oxygen desaturation with exercise. This experience shows that unilateral lung transplantation, for selected patients with end-stage interstitial lung disease, provides a good functional result. Moreover, it avoids the necessity for cardiac transplantation, as required by the combined heart-lung procedure, and permits the use of the donor heart for another recipient.

  19. Embolia pulmonar séptica de origen cutáneo

    Directory of Open Access Journals (Sweden)

    Agustina Sosa Beláustegui

    2012-08-01

    Full Text Available La embolia pulmonar séptica es una enfermedad grave y poco frecuente que se caracteriza por presentar infiltrados pulmonares bilaterales asociados a un foco infeccioso extrapulmonar. Se relaciona principalmente a endocarditis derecha, tromboflebitis pelviana, accesos vasculares y menos frecuentemente a infecciones profundas como osteomielitis, artritis séptica o piomiositis. El Staphylococcus aureus meticilino-resistente adquirido en la comunidad (SAMR-AC es un patógeno emergente, con alta virulencia y de rápida propagación, que afecta a sujetos sin enfermedades previas relacionadas o factores de riesgo conocidos. Causa infecciones de piel y partes blandas y con menor frecuencia infecciones graves como fascitis necrotizante, artritis séptica, osteomielitis, piomiositis y neumonía necrotizante. Su epidemiología, patogenia y manifestaciones clínicas difieren de las causadas por el SAMR adquirido en el hospital. Presentamos el caso de un varón de 67 años con embolias pulmonares sépticas causadas por SAMR-AC con origen en una infección cutánea.

  20. LASERTERAPIA NA INFLAMAÇÃO PULMONAR EXPERIMENTAL EM RATTUS NORVEGICUS OCASIONADO PELA PAPAÍNA

    Directory of Open Access Journals (Sweden)

    Diego Rodrigues Pessoa

    2017-01-01

    Full Text Available Resumo: A Doença Pulmonar Obstrutiva Crônica (DPOC é caracterizada pela limitação do fluxo aéreo decorrente da dilatação dos espaços aéreos distais aos bronquíolos terminais. Analisar os efeitos da laserterapia quanto ao processo cicatricial na lesão pulmonar experimental em Rattus Novergicus. Utilizaram-se trinta animais agrupados em três grupos de dez animais: grupo controle (GC (não recebeu nada, grupo DPOC (GD (foi pulverizado 3 doses de papaína 3mg/kg e grupo DPOC + Laser (GDL (após 7 dias da indução da lesão com papaína foi tratado com laser de 660 nm durante 15 dias.Para analise dos resultados foi realizado o lavado broncoalveolar. Quanto ao Lavado: GC (número de células normais, GD (aumento de células inflamatórias e GDL (diminuição de células inflamatórias. A laserterapia diminui o numero de células inflamatórias, entretanto, não possui efeito reconstrutor do parênquima pulmonar apenas estabiliza a lesão comprovando sua ação anti-inflamatória.

  1. Fisiopatología de la hipertensión arterial pulmonar

    Directory of Open Access Journals (Sweden)

    Herney Manuel Benavides-Luna

    2017-09-01

    Full Text Available El balance entre agentes vasoconstrictores y vasodilatadores, así como factores mitogénicos y antimitogénicos derivados del endotelio, está alterado en algunas situaciones y trae como resultado final un aumento en la presión arterial pulmonar. La disfunción endotelial es promovida por estímulos como hipoxia, acidosis, radicales libres, mediadores inflamatorios, tensión tangencial causada por aumento del flujo sanguíneo pulmonar de izquierda a derecha por cortocircuito intracardiaco y fibrina derivada de tromboembolia. La disfunción endotelial y el remodelado vascular son dos procesos importantes que explican el desarrollo de hipertensión pulmonar. El enfoque terapéutico de esta entidad ha progresado rápidamente en los últimos años, pero aún no existe un tratamiento ideal. Estrategias para el futuro pueden incluir mejoría en los métodos para administrar los medicamentos disponibles, combinaciones de los mismos, nuevos grupos terapéuticos y la posibilidad de terapia genética.

  2. Unilateral hallux valgus: is it true unilaterality, or does it progress to bilateral deformity?

    Science.gov (United States)

    Young, Ki Won; Park, Young Uk; Kim, Jin Su; Jegal, Hyuk; Lee, Kyung Tai

    2013-04-01

    This study was undertaken to determine whether unilateral hallux valgus progresses unilaterally and to evaluate the demographics, etiologies, and radiographic findings associated with symptomatic unilateral hallux valgus deformities. Patients treated for hallux valgus between January 2004 and December 2008 were identified, and of these, 33 patients with unilateral deformities were enrolled. Progression of deformities in normal feet were evaluated at last follow-up visit, and the clinical information and radiographic measurements of those with a deformed normal foot or an unchanged normal foot were compared. Thirty-three patients (3.4%) had a unilateral hallux valgus deformity on preoperative radiographs. The mean length of follow up was 4.7 years (range, 2.4-11). Twenty-four cases had no deformity of the normal foot at last follow-up (the unchanged group), but 15 cases had developed hallux valgus deformity (the deformed group). No significant intergroup differences were found in terms of metatarsus adductus angle (P = .412), Meary angle (P = .771), talocalcaneal angle (P = 1.000), or calcaneal pitch angle (P = .267). However, members of the deformed group were significantly younger at disease onset (P = .045), exhibited a curved first metatarsal head (P = .046), and had a larger initial hallux valgus angle (P hallux valgus was found to be over 97.3%, and significant differences were found between the deformed and unchanged groups in terms of age of onset, metatarsal head shape, and hallux valgus angle.

  3. Reabilitação pulmonar em longo prazo na doença pulmonar obstrutiva crônica (DPOC

    Directory of Open Access Journals (Sweden)

    Cintia Laura Pereira de Araújo

    2014-04-01

    Full Text Available Introdução: A Doença Pulmonar Obstrutiva Crônica (DPOC prejudica o estado funcional, com consequente limitação das Atividades de Vida Diária (AVD. Este estudo teve como objetivo investigar o efeito de um programa de Reabilitação Pulmonar (RP, em longo prazo, no estado funcional, na dispneia e no índice BODE em pacientes com DPOC. Relato de caso: Trata-se de um estudo retrospectivo e documental, com análise dos prontuários de cinco pacientes participantes de um programa de RP por um ano. Destes prontuários foram coletados dados referentes às avaliações: espirometria, Índice de Massa Corporal (IMC, escalas London Chest Activity of Daily Living (LCADL e Medical Research Council e (MRC teste de caminhada de seis minutos. Após um ano participando do programa de exercício físico, a maioria dos pacientes apresentou maior capacidade funcional, menor dispneia e redução no risco de mortalidade. Conclusão: Um ano de RP parece ter função de manutenção da melhora da capacidade funcional de pacientes com DPOC, após 24 sessões de treinamento.

  4. Qualidade de vida em voz na doença pulmonar crônica

    Directory of Open Access Journals (Sweden)

    Bruna Franciele da Trindade Gonçalves

    2015-12-01

    Full Text Available RESUMO: Objetivo: analisar a qualidade de vida relacionada à voz autorreferida por indivíduos com doença pulmonar crônica. Métodos: estudo transversal, exploratório, quantitativo, com informações obtidas a partir da aplicação de questionário de qualidade de vida em voz em usuários de um ambulatório de fisioterapia integrado em hospital universitário no interior do Rio Grande do Sul, no período de março a novembro de 2012. Resultados: participaram 19 sujeitos, 12 (63,20% do sexo masculino e 7 (36,80% do sexo feminino. Sobre a faixa etária, 14 (73,70% eram adultos e cinco (26,30% idosos, sendo essa diferença estatisticamente significante. Quanto à doença pulmonar crônica, dez (52,60% tinham bronquiectasia, seis (31,60% doença pulmonar obstrutiva crônica e três (15,80% asma. A média do questionário Qualidade de Vida em Voz Total foi de 85,8 ± 5,8 pontos. Não houve diferença estatística entre os três domínios do questionário e as variáveis sexo, idade e diagnóstico médico. Conclusão: predomínio percentual do sexo masculino e faixa etária adulta-meia idade, sendo essa última estatisticamente significante e diagnóstico médico de bronquiectasia. A média do questionário total foi de 85,8 ± 5,8 pontos. Não foram encontradas significância estatística na comparação do domínios do questionário com as variáveis sexo, idade e doença pulmonar. Tal fato pode ser explicado pela elaboração de estratégias de comunicação como forma de minimizar os efeitos da doença pulmonar na produção vocal. Sugere-se a realização de outras pesquisas abordando o mesmo tema, porém com amostras maiores a fim de verificar a significância estatística das variáveis estudadas.

  5. Comparative study of unilateral versus bilateral inferior oblique recession/anteriorization in unilateral inferior oblique overaction.

    Science.gov (United States)

    Mostafa, Attiat M; Kassem, Rehab R

    2018-05-01

    To compare the effect of, and the rate of subsequent development of iatrogenic antielevation syndrome after, unilateral versus bilateral inferior oblique graded recession-anteriorization to treat unilateral inferior oblique overaction. Thirty-four patients with unilateral inferior oblique overaction were included in a randomized prospective study. Patients were equally divided into 2 groups. Group UNI underwent unilateral, group BI bilateral, inferior oblique graded recession-anteriorization. A successful outcome was defined as orthotropia, or within 2 ∆ of a residual hypertropia, in the absence of signs of antielevation syndrome, residual inferior oblique overaction, V-pattern, dissociated vertical deviation, or ocular torticollis. A successful outcome was achieved in 11 (64.7%) and 13 (76.5%) patients in groups UNI and BI, respectively (p = 0.452). Antielevation syndrome was diagnosed as the cause of surgical failure in 6 (35.3%) and 2 (11.8%) patients, in groups UNI and BI, respectively (p = 0.106). The cause of surgical failure in the other 2 patients in group BI was due to persistence of ocular torticollis and hypertropia in a patient with superior oblique palsy and a residual V-pattern and hypertropia in the other patient. The differences between unilateral and bilateral inferior oblique graded recession-anteriorization are insignificant. Unilateral surgery has a higher tendency for the subsequent development of antielevation syndrome. Bilateral surgery may still become complicated by antielevation syndrome, although at a lower rate. In addition, bilateral surgery had a higher rate of undercorrection. Further studies on a larger sample are encouraged.

  6. Descripción de un brote de enfisema y edema pulmonar agudo del bovino (EPAB) en Parral (Chile)

    OpenAIRE

    URRUTIA, H.; BREVIS, C.; QUEZADA, M.; DONOSO, S.

    1997-01-01

    Se describe un brote de enfisema y edema alveolar agudo del bovino (EPAB) ocurrido en la zona centro-sur a fines del verano de 1995. Los animales Frisón negro, de aproximadamente 2 años de edad, fueron afectados después de cambiarse de una pradera fibrosa a una suculenta de alfalfa. La mortalidad por esta causa fue de un 23%. Las principales lesiones encontradas en la necropsia fueron enfisema y edema intersticial intenso del pulmón, lo cual fue corroborado histopatológicamente, encontrándos...

  7. Descripción de un brote de enfisema y edema pulmonar agudo del bovino (EPAB) en Parral (Chile)

    OpenAIRE

    H. URRUTIA; C. BREVIS; M. QUEZADA; S. DONOSO

    1997-01-01

    Se describe un brote de enfisema y edema alveolar agudo del bovino (EPAB) ocurrido en la zona centro-sur a fines del verano de 1995. Los animales Frisón negro, de aproximadamente 2 años de edad, fueron afectados después de cambiarse de una pradera fibrosa a una suculenta de alfalfa. La mortalidad por esta causa fue de un 23%. Las principales lesiones encontradas en la necropsia fueron enfisema y edema intersticial intenso del pulmón, lo cual fue corroborado histopatológicamente, encontrándose...

  8. Aspectos actuais da hipertensão arterial pulmonar: primária e secundária

    Directory of Open Access Journals (Sweden)

    Emilia Álvares

    1997-01-01

    Full Text Available RESUMO: A situação patológica mais importante na circulação pulmonar é o desenvolvimeoto da Hipertensão Arterial Pulmonar, que pode resultar de doença parenquimatosa pulmonar, alterações da parede vascular ou da obstrução do lúmen por trombose ou embolia.Procurouse com este trabalho, fazer uma revisão actual da literatura médica acerca da hipertensão arterial pulmonar primária e secundária.Debruçãmos-nos essencialmente, sobre os seus cooceitos fisiopatológicos, critérios diagnósticos e aspectos terapêuticos mais recentes. ABSTRACT: The most important response of pulmonary blood vessels to disease is the development of increased pulmonary arterial pressure that may result from parenchymal disease of the lungs, changes in the walls of the blood vessels or obstruction to the lumen caused by thrombosis or embolization.The aim of the authors in this study, was to make a actual review of the medical literature about of primary and secondary pulmonary hypertension.We report about this entity, essentially physiopatologic concepts, diagnosis approach and therapeutics aspects, more recent. Palavras-chave: Hipertensão Pulmonar, Primária, Secundária, Classificação, Tratamento, Key-words: Pulmonary Hypertension, Primary, Secondary, Classification, Therapeutic

  9. 149. Uso del oxigenador de membrana extracorpórea en el perioperatorio de trasplante pulmonar. Análisis de dos casos en nuestro centro

    Directory of Open Access Journals (Sweden)

    J.A. Fernández-Divar

    2012-04-01

    Conclusiones: El sistema ECMO es una herramienta válida para sustituir la CEC y disminuir sus riesgos en el trasplante pulmonar. Se puede mantener ECMO durante el postoperatorio precoz, sobre todo si se trata de pulmones de donante subóptimo o en casos de receptores de riesgo, especialmente aquellos con hipertensión pulmonar grave.

  10. Did Unilateral Divorce Raise Divorce Rates? Evidence from Panel Data

    OpenAIRE

    Leora Friedberg

    1998-01-01

    This paper revisits the evidence on the impact of unilateral divorce laws on divorce rates in the United States. Most states switched from requiring mutual consent to allowing unilateral or no-fault divorce between 1970 and 1985, while the national divorce rate more than doubled after 1965. According to the Coase theorem, however, the legal shift should have had no effect on divorce rates. Recent papers using cross-sectional micro data have disputed the empirical importance of unilateral divo...

  11. Speech perception in noise in unilateral hearing loss

    OpenAIRE

    Mondelli, Maria Fernanda Capoani Garcia; dos Santos, Marina de Marchi; José, Maria Renata

    2016-01-01

    ABSTRACT INTRODUCTION: Unilateral hearing loss is characterized by a decrease of hearing in one ear only. In the presence of ambient noise, individuals with unilateral hearing loss are faced with greater difficulties understanding speech than normal listeners. OBJECTIVE: To evaluate the speech perception of individuals with unilateral hearing loss in speech perception with and without competitive noise, before and after the hearing aid fitting process. METHODS: The study included 30 adu...

  12. Unilateral megalencephaly associated with contralateral neuronal migration defect

    International Nuclear Information System (INIS)

    Arslan, A.; Demirci, A; Ciftci, E.

    1999-01-01

    A case of unilateral megalencephaly associated with contralateral cortical dysplasia and grey matter heterotopia is reported. The corpus callosum is agenetic and the basal ganglia are dysplastic. Unilateral megalencephaly (UM) is a rare malformation characterized by unilateral enlargement of one cerebral hemisphere with ipsilateral lateral ventricle dilatation, abnormal gyral pattern and cortical thickening. Association of UM with contralateral cortical dysplasia, grey matter heterotopia and corpus callosum agenesis has not been reported in previous studies. Copyright (1999) Blackwell Science Pty Ltd

  13. Prepubertal unilateral gynecomastia: a report of two cases

    OpenAIRE

    Hoevenaren, Inge A.; Schott, Dina Antina; Otten, Barto J.; Kroese-Deutman, Henriette C.

    2010-01-01

    Background Gynecomastia is defined as the presence of excessive breast tissue in males, which can appear unilateral or bilateral. Bilateral gynecomastia is frequently found in the neonatal period, early in puberty, and with increasing age. Prepubertal unilateral gynecomastia in the absence of endocrine abnormalities is extremely rare, with only a few cases in literature. Methods We report the cases of two otherwise healthy boys of 8 and 11?years old with unilateral breast masses. No abnormali...

  14. Graves’ Disease With Unilateral Involvement: A Rare Entity

    OpenAIRE

    Gülsüm Gönülalan; Mehtap Çakır

    2011-01-01

    Graves’ disease usually affects both lobes of the gland, thus, unilateral Graves’ hyperthyroidism has been reported very rarely. Here, we report a case of Graves’ disease presenting with unilateral involvement of the thyroid gland. Thyroid function tests revealed thyrotoxicosis and scintigraphy with technetium-99m showed increased diffuse unilateral radioisotope uptake in the right lobe with suppressed activity in the left lobe. The patient underwent oral antithyroid drug treatment. Graves’ ...

  15. Unilateral nephrectomy in a juvenile llama

    International Nuclear Information System (INIS)

    Van Hoogmoed, L.; Snyder, J.R.; Roberts, G.; Harmon, F.A.

    1997-01-01

    The purpose of this study was to describe the clinical presentation, diagnostic evaluation, and surgical management of a llama with an ectopic ureter. Nine-month-old female llama. The diagnostic evaluation included the use of computed tomography and an excretory ureterogram to confirm and identify the location of the ectopic ureter. Surgical management involved a unilateral nephrectomy. Computed tomography is a valuable asset to diagnose the presence and terminal location of an ectopic ureter in llamas, and nephrectomy appears to be a viable procedure to resolve the subsequent urinary incontinence

  16. Some remarks on unilateral matrix equations

    International Nuclear Information System (INIS)

    Cerchiai, Bianca L.; Zumino, Bruno

    2001-01-01

    We briefly review the results of our paper LBNL-46775: We study certain solutions of left-unilateral matrix equations. These are algebraic equations where the coefficients and the unknown are square matrices of the same order, or, more abstractly, elements of an associative, but possibly noncommutative algebra, and all coefficients are on the left. Recently such equations have appeared in a discussion of generalized Born-Infeld theories. In particular, two equations, their perturbative solutions and the relation between them are studied, applying a unified approach based on the generalized Bezout theorem for matrix polynomials

  17. Unilateral gynecomastia: The assessment of 23 patients

    Directory of Open Access Journals (Sweden)

    Salih Onur Basat

    2016-12-01

    Results: 11 patients were treated by strictly gland excision, four patients with only liposuction and eight patients with gland excision combined with liposuction. Gynecomastia was seen on the left side of the chest in 13 patients and on the right side in 10 patients. There were no complications. The specimens did not reveal any malignant causes. Conclusion: Although most cases gynecomastia are idiopathic and bilateral, there are instances that require special at- tention and should be given unilateral status. Detailed evaluation including physical examination, history of drug use and concomitant medical disorders should be considered. [Arch Clin Exp Surg 2016; 5(4.000: 206-210

  18. A virtual reality assessment and training system for unilateral neglect.

    Science.gov (United States)

    Kim, Kwanguk; Kim, Jaehun; Ku, Jeonghun; Kim, Deog Young; Chang, Won Hyek; Shin, Dong Ik; Lee, Jang Han; Kim, In Young; Kim, Sun I

    2004-12-01

    Patients with unilateral neglect have problems reporting, responding, or orienting to novel or meaningful stimuli that is presented to the side opposite to that of a brain lesion. This creates a serous problem in regards to daily living activities. However, the established methods for assessing and training of unilateral neglect patients have several deficits. Recently, virtual reality (VR) technologies have been used as an assessment and treatment tool for rehabilitation. Hence, this study designed a VR system to assess and train unilateral neglect patients. In addition, the suitability and feasibility of our VR system for unilateral neglect patients was verified.

  19. Bilateral and unilateral ECT: effects on verbal and nonverbal memory.

    Science.gov (United States)

    Squire, S R; Slater, P C

    1978-11-01

    The memory loss associated with bilateral and nondominant unilateral ECT was assessed with verbal memory tests known to be sensitive to left temporal lobe dysfunction and with nonverbal memory tests known to be sensitive to right temporal lobe dysfunction. Bilateral ECT markedly impaired delayed retention of verbal and nonverbal material. Right unilateral ECT impaired delayed retention of nonverbal material without measurably affecting retention of verbal material. Nonverbal memory was affected less by right unilateral ECT than by bilateral ECT. These findings, taken together with a consideration of the clinical efficacy of the two types of treatment, make what appears to be a conclusive case for unilateral over bilateral ECT.

  20. Tratamento de tromboembolismo pulmonar por aspiração percutânea do trombo: relato de caso

    OpenAIRE

    Góes Junior,Adenauer Marinho de Oliveira; Mascarenhas,Fabricio; Mourão,Guilherme de Souza; Elkis,Henrique; Pieruccetti,Marco Antônio

    2010-01-01

    O tromboembolismo pulmonar (TEP) maciço é uma importante causa de mortalidade. A principal causa de óbito é a disfunção do ventrículo direito, provocada pela alta resistência ao seu fluxo de ejeção, e a sobrevida do paciente, nessas situações, depende da pronta desobstrução das artérias pulmonares. A anticoagulação, o uso de trombolíticos e a embolectomia pulmonar representam opções terapêuticas consolidadas para diferentes cenários clínicos de TEP. A Radiologia Intervencionista representa ho...

  1. BIÓPSIA PULMONAR EM BEZERROS COM BRONCOPNEUMONIA INDUZIDA PELA Mannheimia haemolytica PULMONAR BIOPSY IN CALVES WITH BRONCHOPNEUMONIA INDUCED BY Mannheimia haemolytica

    Directory of Open Access Journals (Sweden)

    Daniel Pessoa Gomes da Silva

    2009-09-01

    Full Text Available Com o propósito de avaliar a segurança, a eficácia diagnóstica da biópsia pulmonar e comparar a possível ocorrência de complicações decorrentes da técnica, entre bezerros sadios e com broncopneumonia induzida, utilizaram-se dez bezerros (G1 sadios e vinte bezerros portadores de broncopneumonia, divididos em quatro grupos de cinco bezerros (G2 a G5, os quais foram biopsiados 12, 24, 48 e 72 horas após a inoculação com Mannheimia haemolytica, respectivamente. A presença de crepitação grossa, som submaciço à percussão e as alterações radiográficas auxiliaram no diagnóstico da broncopneumonia e localizaram a área pulmonar a ser biopsiada nos grupos G2 a G5. As alterações microscópicas, visualizadas nos animais do grupo G2 a G5, foram as de broncopneumonia fibrinopurulenta. Nos bezerros do grupo G1 as alterações relacionadas à técnica foram: tosse, epistaxe, dispneia mista, taquipneia e taquicardia. Cinco (25% bezerros com broncopneumonia desenvolveram hemotórax após a biópsia e as alterações relacionadas à técnica foram: taquipneia, taquicardia, tosse, dispneia mista, apatia, mucosas pálidas e decúbito. Conclui-se que a biópsia pulmonar permite o diagnóstico de broncopneumonia em bezerros, contudo as complicações decorrentes da técnica limitam o seu uso apenas nas situações em que os métodos convencionais não tenham possibilitado o diagnóstico.

    PALAVRAS-CHAVES: Bezerros, biópsia pulmonar, broncopneumonia, Mannheimia haemolytica.

    The purpose of this study was to evaluate the safety and diagnostic efficacy of lung biopsy and to compare the possible occurrence of complications due to this technique in healthy calves and in calves with bronchopneumonia. Thirty Holstein calves were divided into a group of ten healthy animals (G1 and into four experimental groups (G2 to G5 of five calves each

  2. Unilateral otolith centrifugation by head tilt.

    Science.gov (United States)

    Winters, Stephanie M; Bos, Jelte E; Klis, Sjaak F L

    2014-01-01

    To test for otolith asymmetries, several studies described horizontal translation of the body and head en bloc during fast vertical axis rotation. This stimulus causes one otolithic organ to rotate on-axis, and the other to experience centripetal acceleration. To test a new, more simple method of unilateral stimulation with head tilt and the body remaining on axis. During stationary and during 360 deg/s rotation, 12 healthy blindfolded subjects had their heads tilted 30 degrees sideways, positioning one otolithic organ on the axis of rotation after the other. The haptic subjective vertical (SV) was recorded several times by means of a manually adjustable rod. It was found that during stationary the SV tilted about 4 degrees on average in the direction of the head. During rotation, the SV tilted about 9 degrees on average. We therefore estimate the effect of eccentric otolith rotation to be 5 degrees on average. Tilt of the subjective vertical induced by head tilt during on-axis body rotation can provide a relatively uncomplicated alternative to test unilateral otolithic function as compared to body and head translation during rotation. Moreover, unlike eccentric rotation of the entire body, somatosensory cues are minimized by keeping the body fixed on axis and by subtracting the effect of head tilt per se.

  3. Unilateral papilledema in cerebral venous sinus thrombosis

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    Girish Baburao Kulkarni

    2017-01-01

    Full Text Available In the majority of patients with raised intracranial pressure, the papilledema is bilateral. Unilateral papilledema is rare in conditions causing intracranial hypertension, and it has been described in Foster–Kennedy syndrome and in some cases of idiopathic intracranial hypertension. It has never been reported in cerebral venous thrombosis. We report a young lady presenting with features of subacute onset of headache with seizures, on evaluation she had superior sagittal and bilateral lateral sinus thrombosis. The risk factors found on evaluation were Vitamin B12 deficiency and hyperhomocysteinemia. On optic fundus examination, she had swollen optic disc on the right side with normal fundus on the left side, confirmed with the orbital ultrasound B-scan and optic coherence tomography. Her magnetic resonance imaging showed features of raised intracranial pressure with thrombosis of the superior sagittal and bilateral lateral sinus thrombosis. She was treated with anticoagulation (heparin followed by oral anticoagulants, antiedema measures, and vitamin supplementation for hyperhomocysteinemia. She improved over time and was asymptomatic during follow-up. We discuss the possible mechanisms described in the literature for unilateral papilledema. This report highlights the need for carefully performing bilateral fundus examination so as not to miss the vision or life-threatening causes of a headache.

  4. Legal Permissibility of Unilateral Humanitarian Interventions

    Directory of Open Access Journals (Sweden)

    Petra Perisic

    2013-03-01

    Full Text Available The paper explores the status of unilateral humanitarian interventions in international law. The United Nations Charter prohibits the use of force, except in case of self-defense and the collective action authorized by the Security Council. The question is whether the non-existence of unilateral humanitarian intervention among these exceptions means that they are not in conformity with the Charter and if so, whether the right to such interventions exists as the part of customary law. The issue has become even more controversial after the adoption of the “responsibility to protect” principle. Findings of legal scholars on this issue differ significantly. This paper analyzes and interprets the Charter provisions in order to answer the question of compatibility of humanitarian interventions with the Charter and examines the state practice in order to conclude whether the customary law rule allowing the humanitarian intervention exists. The conclusion of the paper is that there is no evidence to support the contentions that interventions without the Security Council authorization are permissible, although there are elements which point to the possibility of the creation of customary law allowing them.

  5. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  6. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    Hayakawa, Katsumi; Kanda, Toyoko; Yamori, Yuriko

    2002-01-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  7. Esquistossomose pulmonar. II. Forma crônica reativada com hipertensão e Cor pulmonale

    Directory of Open Access Journals (Sweden)

    Jayme Neves

    1980-12-01

    Full Text Available Os Autores descrevem um caso grave de esquistossomose mansoni (forma hepática com hipertensão portal associada a forma pulmonar com hipertensão pulmonar e cor pulmonalej sobre o qual evoluiu uma sindrome toxi-infectuosa grave e de longa duração. Sucessivos exames radiológicos do tórax revelaram acometimento predominantemente arteriolar, ao lado de uma micronodulação pulmonar grosseira e difusa em ambos os hemitóraces e configuração de coração pulmonar. A histopatologia de material de biópsia pulmonar identificou basicamente uma arterite pulmonar característica, inflamação granulomatosa atípica provocada principalmente por vermes e raros ovos de S. mansoni envolvidos por escassa reação inflamatória. Para explicar a origem de constelação clínica toxi-infectuosa, foram afastadas as hipóteses de associação da esquistossomose a concausas infectuosas ou não, mas de curso febril, e a superposição de uma forma toxêmica sobre outra crônica pré-existente. Com base em dados clínicos, particularmente em subsídios da laparoscopia, e anatômicos, concluiu-se tratar o caso de uma forma crônica de esquistossomose reativada, provavelmente em virtude de alterações imunológicas inusitadas do hospedeiro. Ao que tudo parece indicar, o desvio de ovos e de vermes aos pulmões deveu-se à sindrome de hipertensão portal, cujos shunts entre a circulação portal e sistêmica determinaram a rota preferencial da migração.

  8. Adaptação à cultura brasileira dos questionários The O'Leary-Sant e PUF, usados para cistite intersticial Adaptación a la cultura brasileña de los cuestionarios The O'Leary-Sant y Puf, usados para cistitis intersticial Adaptation of the O'Leary-Sant and the PUF for the diagnosis of interstitial cystitis for the Brazilian culture

    Directory of Open Access Journals (Sweden)

    Marcella Lima Victal

    2013-04-01

    Full Text Available O objetivo deste estudo foi traduzir e adaptar à cultura brasileira os instrumentos The O'Leary-Sant e PUF, utilizados no diagnóstico de cistite intersticial. Foram realizadas as etapas metodológicas recomendadas pela literatura internacional para a adaptação cultural. As etapas de tradução, síntese das traduções e retrotradução foram realizadas satisfatoriamente, e a avaliação das versões sintéticas pelo comitê de especialistas resultou em algumas alterações, assegurando as equivalências entre as versões originais e traduzidas. O PUF foi pré-testado entre 40 sujeitos e The O'Leary-Sant em uma amostra de 50 indivíduos, devido à necessidade de ajustes em decorrência da baixa escolaridade da população. O processo de tradução e adaptação foi realizado com sucesso e os instrumentos, após as modificações, demonstraram ser de fácil compreensão e rápido preenchimento. Entretanto, este é um estudo que antecede o processo de validação e será premente o emprego do instrumento em novas pesquisas para que sejam avaliadas suas propriedades psicométricas.Se objetivó traducir y adaptar a la cultura brasileña los instrumentos The O'Leary-Sant y PUF, utilizados para diagnosticar cistitis intersticial. Fueron efectuadas las etapas metodológicas recomendadas por la literatura internacional para adaptación cultural. Las etapas de traducción, síntesis de traducciones y retrotraducción se realizaron satisfactoriamente, la evaluación de las versiones sintetizadas por parte del comité de especialistas derivó en algunas alteraciones, asegurando las equivalencias entre versiones originales y traducidas. El PUF fue pre-testeado con 40 sujetos y The O'Leary-Sant en muestra de 50 individuos, por la necesidad de ajustes derivados de la baja escolarización de la población. El proceso de traducción y adaptación se efectuó con suceso y los instrumentos luego de las modificaciones demostraron ser de sencilla comprensión y

  9. Enfermedad pulmonar por amianto en trabajadores de acería

    Directory of Open Access Journals (Sweden)

    Rita Zurbriggen

    2013-06-01

    Full Text Available Las enfermedades relacionadas al amianto se producen por la inhalación de fibras de asbestos en su variedad crisotilo o amianto blanco. A pesar de que en la Argentina la prohibición data del año 2003, existen numerosas industrias donde se sigue trabajando con este mineral, entre ellas las metalúrgicas y acerías. Actualmente se conoce la alta patogenicidad de este material, por lo que en muchos países existen programas de seguimiento de los trabajadores expuestos. Se describen las características generales y manifestaciones clínicas pulmonares de 27 pacientes que trabajaron en una gran acería de América del Sur. El diagnóstico de amiantopatías se realizó mediante historia clínica laboral, antecedente de exposición al amianto, estudios complementarios de función pulmonar e imágenes del tórax. Se analizaron la fuente de exposición (laboral, doméstica y ambiental, tiempo de exposición y período de latencia en los pacientes de los cuales se detectó enfermedad relacionada. Los antecedentes de tabaquismo fueron tenidos en cuenta para el análisis. En 22 pacientes se presentaron patologías benignas (81.4%, 16 de ellos tenían lesiones exclusivamente pleurales y otros 6 asbestosis. Las patologías malignas se presentaron en 5 pacientes (18.5%, en 4 fueron mesoteliomas y en uno carcinoma pulmonar. El problema de la exposición al amianto tiene vigencia actual. De ahí la necesidad de un programa de vigilancia en trabajadores expuestos al amianto actualmente o en el pasado, para detectar, notificar, registrar e investigar las características de estas patologías.

  10. Prescripción de antimicrobianos en pacientes con enfermedad pulmonar obstructiva crónica

    Directory of Open Access Journals (Sweden)

    Darien Duarte Busquet

    Full Text Available Objetivo: caracterizar la prescripción de antimicrobianos en pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica descompensada. Métodos: estudio descriptivo, de corte transversal, que incluyó a 131 pacientes con enfermedad pulmonar obstructiva crónica descompensada, a quienes se les prescribió algún antimicrobiano en salas de medicina interna del Hospital Clinicoquirúrgico "Joaquín Albarrán", La Habana, Cuba, entre mayo del 2011 y abril del 2012. Se identificaron las principales causas de exacerbación, se describió la prescripción de antimicrobianos y se determinó su relación con la severidad de la descompensación y con la estadía hospitalaria. Se analizaron los resultados obtenidos a través de programa estadístico SPSS. Resultados: el 65 % de los pacientes presentaron una descompensación infecciosa. La prescripción de antimicrobianos se realizó de forma empírica en el 92 % de los casos, e inadecuada en el 49 % de ellos. Se demostró la existencia de una relación estadísticamente significativa entre la severidad de la descompensación y la prescripción de antimicrobianos. Conclusiones: se prescribió antimicrobianos de manera inadecuada en cinco de cada diez pacientes con diagnóstico de enfermedad pulmonar obstructiva crónica descompensada, mayormente en aquellos casos sin haberse constatado diagnóstico positivo de infección respiratoria. A medida que disminuye la severidad de la descompensación, incrementa la incidencia de prescripción inadecuada.

  11. Scleroderma and pulmonary hypertension Esclerodermia e hipertensão pulmonar

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    Karen A. Fagan

    2003-10-01

    Full Text Available Patients with scleroderma are at increased risk for the development of pulmonary hypertension, and the development of unexplained dyspnea or an isolated decrease in diffusing capacity should prompt evaluation. Echocardiography is often helpful in this situation, with further testing being performed as indicated. Because the prognosis of untreated pulmonary hypertension occurring in the setting of scleroderma is generally quite poor, vigilance is required on the part of physicians following this "at risk" group of patients. The past decade has seen important advances in the treatment of pulmonary arterial hypertension, including intravenous epoprostenol, oral bosentan and subcutaneously infused treprostinil. As new therapies are developed for the treatment of pulmonary arterial hypertension, it is essential that patients with scleroderma-related disease are included in clinical trials.Pacientes com esclerodermia têm risco aumentado para desenvolver hipertensão pulmonar. O aparecimento de dispnéia e/ou a diminuição da capacidade de difusão devem levar à suspeita imediata dessa complicação. A ecodopplercardiografia é importante para o diagnóstico e o seguimento desses casos. Os casos não tratados de hipertensão pulmonar em esclerodermia têm mau prognóstico, daí a necessidade em manter sob vigilância estes pacientes. Na última década surgiram avanços para o tratamento da hipertensão arterial pulmonar, incluindo os medicamentos epoprostenol EV, bosentan VO e treprostinil SC. À medida que novas terapias vão sendo desenvolvidas, torna-se necessário a realização de estudos clínicos de maior validade.

  12. Estrategia terapéutica en hipertensión arterial pulmonar

    Directory of Open Access Journals (Sweden)

    María E. Barrios Garrido-Lestache

    2017-09-01

    Full Text Available La investigación y el avance en el tratamiento de la hipertensión arterial pulmonar han permitido modificar la historia natural de esta enfermedad. El pilar del tratamiento es el empleo de terapias con vasodilatadores pulmonares específicos, pero también habrán de tenerse en cuenta otras medidas como la actividad física, el apoyo psicológico, la anticoagulación, el tratamiento diurético, la oxigenoterapia o el tratamiento anticonceptivo. Previo a iniciar cualquier tipo de tratamiento específico se requiere un estudio de vasorreactividad aguda del lecho vascular pulmonar, ya que los pacientes con respuesta positiva podrían beneficiarse del tratamiento con calcio-antagonistas. En caso de respuesta negativa o no ser respondedores sostenido, en la actualidad se dispone de fármacos frente a las tres principales vías metabólicas implicadas en el desarrollo de la enfermedad, a saber, prostanoides (epoprosterenol, treprostinil e iloprost, selexipag, antagonistas de los receptores de la endotelina o ARE (bosentan, macitentan y ambrisentan, inhibidores de la fosfodiesterasa 5 o IPDE5 (sildenafilo y tadalafilo y estimuladores de la guanilato ciclasa (riociguat. La elección del fármaco de inicio, ya sea en monoterapia o en combinación, dependerá de múltiples factores como clase funcional, comorbilidades, interacciones con otros fármacos, tolerabilidad y seguridad, y finalmente de la disponibilidad y las preferencias.

  13. Espacios aéreos pulmonares anormales por TCAR Abnormal air-filled spaces in the lung with HRCT

    OpenAIRE

    Juan Carlos Spina (h); Josefina Medina; Lucrecia Cúneo; Federico Badano; Florencia Bambaci; Juan Carlos Spina

    2008-01-01

    Objetivo: El propósito de este trabajo es revisar y dar claves para el diagnóstico de las distintas entidades que se presentan como espacios aéreos pulmonares anormales. Material y métodos: Se analizaron en forma retrospectiva los archivos de TCAR de nuestra institución con diagnóstico de espacios aéreos pulmonares anormales. En todos los casos se evaluó la localización, número (único o múltiples), grosor parietal y alteraciones parenquimatosas y mediastínicas asociadas y se los agrupo de acu...

  14. Tromboembolia pulmonar asociada al síndrome de la vena cava superior de origen trombótico

    Directory of Open Access Journals (Sweden)

    Ana Madeleine Barrera-López

    2017-07-01

    Full Text Available Se describe el caso de un paciente masculino de 32 años de edad, quien consulta al servicio de urgencias con historia clínica del síndrome de la vena cava superior, en el estudio de la angiotomografía pulmonar, se demuestra embolismo pulmonar izquierdo, trombosis de la vena yugular interna derecha y confluente yugulo subclavio. No hay evidencia de asociación con neoplasia, infecciones o enfermedades del tejido conectivo, siendo el único factor de riesgo asociado para la trombosis, hiperviscocidad (tríada de virchow por poliglobulia.

  15. Consenso intersociedades para el manejo de infecciones respiratorias: bronquitis aguda y enfermedad pulmonar obstructiva crónica

    OpenAIRE

    Gustavo Lopardo; Claudia Pensotti; Pablo Scapellato; Oscar Caberlotto; Aníbal Calmaggi; Liliana Clara; Manuel Klein; Gabriel Levy Hara; María J. López Furst; Analía Mykietiuk; Daniel Pryluka; Maria J. Rial; Claudia Vujacich; Diego Yahni

    2013-01-01

    La Sociedad Argentina de Infectología convocó a otras sociedades científicas para elaborar una guía práctica y actualizada para el manejo del tratamiento antibiótico de las bronquitis agudas (BA) y los episodios de reagudización de enfermedad pulmonar obstructiva crónica (EPOC), con el objetivo de promover el uso racional de los recursos diagnósticos y terapéuticos. La BA se caracteriza por la inflamación del árbol bronquial que afecta tanto a adultos como a niños sin enfermedades pulmonares ...

  16. Malária pulmonar: aspectos na tomografia computadorizada de alta resolução - relato de caso

    Directory of Open Access Journals (Sweden)

    Rodrigues Rosana

    2004-01-01

    Full Text Available Neste trabalho é relatado o caso de paciente do sexo masculino, de 38 anos de idade, que desenvolveu quadro de malária com comprometimento pulmonar. A tomografia computadorizada de alta resolução evidenciou espessamento de septos interlobulares e de bainhas peribroncovasculares, com áreas esparsas de atenuação em vidro fosco e de consolidações, além de derrame pleural bilateral, aspectos compatíveis com edema pulmonar. O paciente recebeu tratamento específico, evoluindo bem e tendo alta 11 dias após a internação.

  17. Destrucción costal: una rara forma de presentación de la nocardiosis pulmonar

    OpenAIRE

    Julve Pardo, R.; Carrión Valero, F.; Gonzalvo Bellver, F.; Prat Fornells, J.; Pascual Izuel, J. M.

    2001-01-01

    Clásicamente, la infección por Nocardia spp. se asocia a estados de depresión inmunológica, procesos neoplásicos y tratamientos prolongados con inmunosupresores y glucocorticoides. La afectación pulmonar es la más característica, siendo infrecuente la diseminación del proceso por extensión local a la pared costal y el tejido celular subcutáneo. Presentamos un caso de nocardiosis pulmonar por Nocardia asteroides en una paciente diabética sin otros factores de riesgo conocidos, que se manifestó...

  18. Tromboembolismo pulmonar asociado al síndrome de la vena cava superior de origen trombótico

    OpenAIRE

    Barrera-López, Ana Madeleine; Cortés-P., Luis Arcadio; Salazar-C., Erika María

    2016-01-01

    Se describe el caso de un paciente masculino de 32 años de edad, quien consulta al servicio de urgencias con historia clínica del síndrome de la vena cava superior, en el estudio de la angiotomografía pulmonar, se demuestra embolismo pulmonar izquierdo, trombosis de la vena yugular interna derecha y confluente yugulo subclavio. No hay evidencia de asociación con neoplasia, infecciones o enfermedades del tejido conectivo, siendo el único factor de riesgo asociado para la trombosis, hiperviscoc...

  19. Nivel de conocimiento sobre tuberculosis pulmonar y actitud de los pacientes, centro salud San Juan de Salinas, 2017

    OpenAIRE

    Atuncar Mendoza, Pamela

    2017-01-01

    El objetivo del estudios de investigación fue determinar la relación que existe entre el nivel de conocimiento sobretuberculosis pulmonar y la actitud hacia el tratamiento detuberculosis pulmonar de los pacientes dela Estrategia Sanitaria Nacional de Prevención y Control de la Tuberculosis, Centro de Salud San Juan de Salinas, San Martinde Porres, año 2017. En cuanto a lametodología fue de tipo de investigación aplicada, nivel descriptivo correccional,la población estuvo conformada por 50 p...

  20. Absceso hepático asociado a absceso pulmonar y endoftalmitis

    OpenAIRE

    Jairo Cordero-Chen; Eduardo Catalán-Sánchez; Juan Ignacio Padilla-Cuadra; Jorge Ramírez-Arce

    2013-01-01

    El absceso hepático piógeno producido por Klebsiella pneumoniae es relativamente raro y puede complicarse con lesiones sépticas a distancia. Esto se relaciona con características propias del germen que incluyen el genotipo K1, resistencia a la fagocitosis y la presencia del gen mag-A. Tales metástasis sépticas contemplan absceso pulmonar, meningitis, endocarditis bacteriana y, muy especialmente, endoftalmitis. Esta última ocurre con mayor frecuencia en pacientes diabéticos, y puede causar ceg...

  1. Doenças pulmonares obstrutivas crônicas na criança

    Directory of Open Access Journals (Sweden)

    Jose Dirceu Ribeiro

    2015-12-01

    Full Text Available Resumo Objetivos: Verificar e descrever os principais eventos relacionados ao diagnóstico e manejo das doenças pulmonares obstrutivas crônicas em crianças (DPOCC e adolescentes, tendo em vista a fisiopatologia e as características genéticas e ambientais inter-relacionadas. Fonte dos dados: Revisão na base de dados Pubmed com seleção de referências relevantes. Síntese dos dados: As DPOCC têm origem ambiental e/ou genética e se manifestam com diversos genótipos, fenótipos e endótipos e, embora possam ser controladas, não têm cura. O principal sintoma é a tosse crônica e muitas cursam com bronquiectasia. O manejo tem maior eficácia se baseado em guidelines e se a adesão ao regime terapêutico for estimulada e comprovada. Corticoides orais e inalatórios, broncodilatadores, antibióticos inalados e tratamento das exacerbações pulmonares (EP são vigas mestras do manejo e devem ser individualizados para cada DPOCC. Conclusões: Nas DPOCC é fundamental o diagnóstico correto, conhecer os fatores de risco e as comorbidades. Os procedimentos e os medicamentos devem ser baseados em guidelines específicos para cada DPOCC. Adesão ao tratamento é fundamental para obter os benefícios do manejo. O controle deve ser avaliado pela diminuição das EP, melhoria na qualidade de vida e redução da evolução da perda da função e do dano estrutural pulmonar. Para a maioria das DPOCC, o acompanhamento por equipes interdisciplinares em centros de referência especializados, com estratégias de vigilância e acolhimento contínuos, conduz a melhores desfechos, que devem ser avaliados pela diminuição da deterioração do dano e da função pulmonar, pelo melhor prognóstico, melhor qualidade de vida e aumento da expectativa de vida.

  2. COMPOSICIÓN DEL SURFACTANTE, DESARROLLO PULMONAR Y PRUEBAS DE MADURACIÓN EN EL FETO.

    OpenAIRE

    Ariel Iván Ruiz-Parra; Liliana Muñoz; Ligia Ome

    2010-01-01

    Resumen

    El surfactante pulmonar es una sustancia tensoactiva producida por los neumocitos tipo II, cuya concentración en el recién nacido prematuro/ inmaduro está disminuída, llevando a la producción del síndrome de dificultad respiratoria. El surfactante está constituído en un 85% por lípidos, del tipo fosfolípidos en su mayoría. El resto son proteínas surfactantes.

    Los fosfogliceridos (lecitinas) y la esfingomielina forman el grupo de fosfolipi...

  3. Estado de la ventilación pulmonar en fumadores activos y pasivos

    Directory of Open Access Journals (Sweden)

    Lourdes Gómez García

    1998-10-01

    Full Text Available Se realiza un estudio de cohorte histórico que analiza la repercusión del hábito de fumar en la ventilación pulmonar. Como universo se toma la población de 15 y más años del municipio Camagüey y como unidad de análisis, cada individuo procedente de 3 cohortes retrospectivos (fumador activo, pasivo y no fumador. Se valoran los resultados espirométricos de ventilación pulmonar disminuida y se realiza una encuesta que incluyó examen clínico y microespirometría a las 120 personas (40 procedentes de cada cohorte. Se señala que el 60% de los fumadores presentó alteración en la ventilación pulmonar con primacía de los fumadores activos (80%, la combinación cigarrillos-puros ofrece mayor repercusión en la ventilación pulmonar. El tiempo diario de exposición al humo del cigarro afecta de manera estable al fumador activo, mientras que el riesgo aumenta en el fumador pasivo a medida que es mayor el tiempo de exposición al día. El examen físico es un patrón relevante para el diagnóstico precoz de daño ventilatorio, sin necesidad de prueba especializadaA historical cohort study is conducted to analyze the repercussion of the smoking habit on pulmonary ventilation. The population aged 15 and over at the municipality of Camagüey is taken as a universe, and every individual from the three retrospective cohorts (active smoker, passive smoker and nonsmoker is considered as a unit of analysis. The sperimetric results of diminished pulmonary ventilation are assessed, and a survey including clinical examination and microspirometry is done among 120 persons (40 from every cohort. It is stressed that 60 % of the smokers presented alterations of pulmonary ventilation and mainly the active smokers (80 %. The cigarettes-cigars combination had a greater impact on pulmonary ventilation. The daily time of exposure to cigarette smoke affects the active smoker in a steady way, wherea the risk increases in the passive smoker as longer is the daily

  4. Edema pulmonar neurogênico: relato de dois casos Neurogenic pulmonary edema: report of two cases

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    Desanka Dragosavac

    1997-06-01

    Full Text Available O edema pulmonar neurogênico é rara e grave complicação de pacientes com traumatismo craniencefálico (TCE. Pode ocorrer também em outras patologias do sistema nervoso central, tais como acidentes vasculares cerebrais (AVC, tumores ou após crises epilépticas, entre outras. Foram avaliados 36 casos com TCE grave e quatro pacientes com AVC, internados na UTI geral, no período de janeiro a setembro 1995. Nesse intervalo de tempo foram diagnosticados dois casos de edema pulmonar neurogênico, um ocorrendo em paciente com TCE grave e outro em paciente com AVC hemorrágico. O diagnóstico foi estabelecido pelo rápido desenvolvimento de edema pulmonar, com hipoxemia grave, queda da complacência pulmonar e infiltrados difusos bilaterais sem história prévia de aspiração traqueal ou outro fator de risco para o desenvolvimento de síndrome de angústia respiratória aguda. No primeiro paciente com trauma craniencefálico, o edema neurogênico foi diagnosticado na internação, uma hora após o trauma, com concomitante reação inflamatória grave e boa evolução em três dias. O outro caso, com AVC hemorrágico, desenvolveu edema neurogênico no quarto dia após drenagem de hematoma intraparenquimatoso, evoluindo para o óbito.Neurogenic pulmonary edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures. Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic pulmonary edema, one with head injury and other with intracerebral hemorrhage. Diagnosis was made by rapid onset of pulmonary edema, severe hypoxemia, decrease of pulmonary complacence and diffuse pulmonary infiltrations, without previous history of tracheal

  5. Reproducibility of Tactile Assessments for Children with Unilateral Cerebral Palsy

    Science.gov (United States)

    Auld, Megan Louise; Ware, Robert S.; Boyd, Roslyn Nancy; Moseley, G. Lorimer; Johnston, Leanne Marie

    2012-01-01

    A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were…

  6. Isolated Unilateral Pulmonary Artery Agenesis complicated by Symptomatic Aspergilloma

    LENUS (Irish Health Repository)

    Daly, A

    2017-11-01

    Isolated unilateral pulmonary artery agenesis is a rare diagnosis. Poor blood flow to the lung parenchyma renders the tissue susceptible to opportunistic infections. We present the unusual case of isolated unilateral pulmonary artery agenesis complicated by aspergilloma. Management options and considerations are discussed.

  7. Prepubertal unilateral gynecomastia: a report of two cases

    NARCIS (Netherlands)

    Hoevenaren, I.A.; Schott, D.A.; Otten, B.J.; Kroese-Deutman, H.C.

    2011-01-01

    BACKGROUND: Gynecomastia is defined as the presence of excessive breast tissue in males, which can appear unilateral or bilateral. Bilateral gynecomastia is frequently found in the neonatal period, early in puberty, and with increasing age. Prepubertal unilateral gynecomastia in the absence of

  8. Functional imaging of unilateral tinnitus using fMRI

    NARCIS (Netherlands)

    Lanting, C. P.; De Kleine, E.; Van Dijk, P.; Bartels, H.

    2008-01-01

    Conclusions. This article shows that the inferior colliculus plays a key role in unilateral subjective tinnitus. Objectives. The major aim of this study was to determine tinnitus-related neural activity in the central auditory system of unilateral tinnitus subjects and compare this to control

  9. Unilateral transpedicular percutaneous vertebroplasty using puncture simulation

    International Nuclear Information System (INIS)

    Kobayashi, Ken; Takizawa, Kenji; Koyama, Masamichi; Yoshimatsu, Misako; Sakaino, Shinjiro; Nakajima, Yasuo

    2006-01-01

    The aim of this study was to improve the accuracy of puncture to the median vertebral body using the unilateral transpedicular approach on percutaneous vertebroplasty (PVP). We have developed and evaluated a simple puncture simulation method based on the puncture angle determined by preoperative computed tomography (CT). Two groups were evaluated. The first (group A) comprised 23 patients (34 vertebral bodies) who had undergone PYP without preoperative puncture simulation before May 2004, and the second group (group B) comprised 24 patients (39 vertebral bodies) who had undergone preoperative puncture simulation and PVP after May 2004. CT in the prone position was performed, and the puncture angle on CT (PAC) via the vertebral arch pedicle targeting the anterior one-third median site of the vertebral body was determined. Puncture was performed by targeting the isocenter established on a fluoroscopic monitor based on the PAC. Determinations were made of the success rate (SR) of the median puncture of the vertebral body, the effect of treatment using the visual analogue score, and the overall procedural time between groups A and B. The SR was 56% (19/34 vertebral bodies) in group A, and 97% (37/38 vertebral bodies), including only one vertebral body in which it was difficult to perform the unilateral approach on CT images, in group B, with the difference being significant by Student's t-test (P<0.001). Among patients with available follow-up data, the unipedicular and bipedicular approaches achieved adequate pain relief with mean decreases in pain severity of 5.1±2.6 and 5.9±2.8 respectively. No significant differences in the treatment effect between the two groups was observed (P=0.811). The overall procedure time per puncture was shorten for the simulation group (36.0 min) than for group A (73.1 min), as shown by regression analysis. The preoperative PAC determination for PVP under fluoroscopy increased the completion rate of PVP by the unilateral transpedicular

  10. Bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis

    Directory of Open Access Journals (Sweden)

    Nilufer Kocak

    2014-01-01

    Full Text Available X-linked juvenile retinoschisis is a rare hereditary retinal disease characterized by a tangential splitting of the neurosensory retina which may cause early-onset visual impairment. Existence of the retinal neurosensory layer splitting on cross-sectional images of optical coherance tomography (OCT and the absence of leakage on fluorescein angiography (FA help confirming the diagnosis. Such diagnostic tests are also helpful in determining the management of the disease. However, most of the retinoschisis cavities remain stable and rarely extend to the posterior pole, many authors suggest laser prophylaxis to avoid the potential risk of retinal detachment due to holes in the outer retinal layer. Herein, we report a case with bilateral foveal retinoschisis accompanying unilateral peripheral retinoschisis who was evaluated with detailed ophthalmologic examination. Visual acuity, fundoscopy, OCT, and FA remained stable in the second year of follow-up after prophylactic argon laser treatment.

  11. Pattern-reversal electroretinograms in unilateral glaucoma.

    Science.gov (United States)

    Wanger, P; Persson, H E

    1983-06-01

    Pattern-reversal and flash electroretinograms (ERG) and oscillatory potentials (OP) were recorded from 11 patients with unilateral glaucoma. All glaucomatous eyes had reduced amplitudes both compared to the opposite eye in the same patient and to reference values. In 10 of the 11 cases this reduction was below the level of normal variation. The difference in pattern-reversal ERG amplitude means from glaucomatous and opposite eyes was statistically significant. No differences were observed in flash ERGs or OPs. The histopathologic correlate to the visual field defects in glaucoma is retinal ganglion cell degeneration. The present electrophysiologic findings support the view, based on results from animal experiments, that the pattern-reversal ERG reflects ganglion cell activity.

  12. Unilateral nasal pain with migraine features.

    Science.gov (United States)

    Alvarez, Mónica; Montojo, Teresa; de la Casa, Beatriz; Vela, Lydia; Pareja, Juan A

    2013-09-01

    Migraine attacks exclusively felt in the face are very rare, the pain involving the territories supplied by the second and third branches of the trigeminal nerve. Two patients suffering from heminasal pain attacks accompanied with typical migrainous features and responsive to oral or intranasal triptans - but not to intranasal lidocaine or oxymetazoline. In one patient, the attacks could be precipitated upon slight touching on the tip of the nose, in the other attacks were preceded by the nasal sensation typically heralding sneezing. Migraine pain mostly develops within the innervation territory of the first branch of the trigeminal nerve, which includes the nose. Therefore, episodes of unilateral nasal pain with migrainous features could be considered a migraine with unusual topography (nasal migraine). Painful nasal attacks occasionally preceded by stimulation of trigeminal afferents in the nose, could be conceived of as migraine-tic syndrome.

  13. Unilateral muscle contractions enhance creative thinking.

    Science.gov (United States)

    Goldstein, Abraham; Revivo, Ketty; Kreitler, Michal; Metuki, Nili

    2010-12-01

    Following the notion of relative importance of the right hemisphere (RH) in creative thinking, we explored the possibility of enhancing creative problem solving by artificially activating the RH ahead of time using unilateral hand contractions. Participants attempted to complete the Remote Associates Test after squeezing a ball with either their left or right hand. As predicted, participants who contracted their left hand (thus activating the RH) achieved higher scores than those who used their right hand and those who did not contract either hand. Our findings indicate that tilting the hemispheric balance toward the processing mode of one hemisphere by motor activation can greatly influence the outcome of thought processes. Regardless of the specific mechanism involved, this technique has the potential for acting as a therapeutic or remedial manipulation and could have wide applications in aiding individuals with language impairments or other disorders that are believed to be related to hemispheric imbalances.

  14. Vestibular perception following acute unilateral vestibular lesions.

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    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  15. Unilateral Anterior Epistaxis Electrocautery versus Chemical Cautery

    International Nuclear Information System (INIS)

    Umar, A. S.; Rahat, Z. M.; Hussain, S. S.; Khan, M. Z.; Fareed, G.

    2013-01-01

    Objective: To evaluate and compare the two methods, electrocautery versus chemical cautery, for controlling unilateral anterior epistaxis and to identify the complications. Design: Randomized control trial. Place and Duration: This study was conducted in ENT Department PNS Shifa Hospital Karachi from August 2009 to June 2011. Patients and Methods: Ninety two cases with unilateral anterior epistaxis were divided using random number trials into two groups i.e. group A and group B containing 46 cases each. In group A electrocautery and in group B chemical cautery with 50% silver nitrate was done and the results were compared. Results: In this study 92 cases were divided randomly into two groups i.e. group A and group B containing 46 cases in each group. In group A 44 (95.6%) out of 46 cases were treated successfully with a single visit as an outpatient by electrocautery, the patients were called for follow up on the fifth day and then fortnightly for three months after the procedure, only 2 (4.3%) cases reported in first five days with mild recurrence of bleeding. In group B 42 (91.3%) cases out of 46 cases were treated successfully in a single visit and recurrence of bleeding occured in 4 (8.7%) cases who required a second visit during the first five days. There were no major complications found in either group except few complaints of post cauterization pain and mucosal inflammation observed slightly more in group B patients. Conclusion: Electrocautery and chemical cautery with 50% silver nitrate both are equally effective procedures to control anterior epistaxis if the bleeding point is visible and small. Both procedures are reliable and there are no major complications. Occasionally if the bleeding point in the anterior nasal septum is large then electrocautery may be a preferred option. (author)

  16. Case of Unilateral Peripheral Cone Dysfunction

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    Yujin Mochizuki

    2012-05-01

    Full Text Available Purpose: Peripheral cone dystrophy is a subgroup of cone dystrophy, and only 4 cases have been reported. We present a patient with unilateral peripheral cone dysfunction and report the functional changes determined by electrophysiological tests and ultrastructural changes determined by spectral domain optical coherence tomography (SD-OCT. Case: A 34-year-old woman complained of blurred vision in both eyes. Our examination showed that her visual acuity was 0.05 OD and 0.2 OS. A relative afferent pupillary defect was present in her right eye. The results of slit-lamp examination, ophthalmoscopy, and fluorescein angiography were normal except for pallor of the right optic disc. SD-OCT showed a diffuse thinning of the retina in the posterior pole of the right eye. A severe constriction of the visual fields was found in both eyes but more in the right eye. The photopic full-field electroretinograms (ERGs were reduced in the right eye but normal in the left eye. The multifocal ERGs were severely reduced throughout the visual field except in the central area of the right eye. The multifocal ERGs from the left eye were normal. The pattern visual evoked responses were within the normal range in both eyes. She had a 5-year history of sniffing paint thinner. Results: Although the visual dysfunction was initially suspected to be due to psychological problems from the results of subjective tests, objective tests indicated a peripheral cone dysfunction in the right eye. The pathophysiological mechanism and the relationship with thinner sniffing were not determined. Conclusions: Our findings indicate that peripheral cone dysfunction can occur unilaterally. Electrophysiology and SD-OCT are valuable tests to perform to determine the pathogenesis of unusual ocular findings objectively.

  17. MARATHON DESPITE UNILATERAL VOCAL FOLD PARALYSIS

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    Matthias Echternach

    2008-06-01

    Full Text Available The principal symptoms of unilateral vocal fold paralysis are hoarseness and difficulty in swallowing. Dyspnea is comparatively rare (Laccourreye et al., 2003. The extent to which unilateral vocal fold paralysis may lead to respiratory problems at all - in contrast to bilateral vocal fold paralysis- has not yet well been determined. On the one hand, inspiration is impaired with unilateral vocal fold paralysis; on the other hand, neither the position of the vocal fold paralysis nor the degree of breathiness correlates with respiratory parameters (Cantarella et al., 2003; 2005. The question of what respiratory stress a patient with a vocal fold paresis can endure has not yet been dealt with.A 43 year-old female patient was suffering from recurrent unspecific respiratory complaints for four months after physical activity. During training for a marathon, she experienced no difficulty in breathing. These unspecific respiratory complaints occurred only after athletic activity and persisted for hours. The patient observed neither an increased coughing nor a stridor. Her voice remained unaltered during the attacks, nor were there any signs of a symptomatic gastroesophageal reflux or infectious disease. A cardio-pulmonary and a radiological examination by means of an X-ray of the thorax also revealed no pathological phenomena. As antiallergic and antiobstructive therapy remained unsuccessful, a laryngological examination was performed in order to exclude a vocal cord dysfunction.Surprisingly enough, the laryngostroboscopy showed, as an initial description, a vocal fold paralysis of the left vocal fold in median position (Figure 1. The anamnestic background for the cause was unclear. The only clue was a thoracotomy on the left side due to a pleuritis in childhood. A subsequent laryngoscopic examination had never been performed. Good mucosa waves and amplitudes were shown bilateral with complete glottal closure. Neither in the acoustic analysis, nor in the

  18. Fibrosis pulmonar asociada a vasculitis con anticuerpos anticitoplasmáticos positivos

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    Marcelo Fernández Casares

    2012-08-01

    Full Text Available Las complicaciones pulmonares más conocidas de las vasculitis con anticuerpos anticitoplasmáticos de los neutrófilos (ANCA positivos (VAA, son la hemorragia alveolar, los granulomas y la estenosis de la vía aérea. En los últimos años han aparecido algunos informes aislados que muestran la asociación con fibrosis pulmonar (FP, sugiriendo que ésta sería otra complicación de las VAA. En este trabajo informamos dos casos con dicha asociación describiendo sus características clínicas, tomográficas e inmunológicas. Dado que en la asociación de FP y VAA notificada en los últimos años, la FP puede ser su primera manifestación, podría ser necesaria la búsqueda de ANCA en pacientes con FP, como causa de la misma y por el posible desarrollo posterior de vasculitis.

  19. Paraganglioma de mediastino com metástases pulmonares Pulmonary metastasis of mediastinal paraganglioma

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    Manoel Ximenes Netto

    2005-02-01

    Full Text Available Descrevemos uma paciente de 27 anos que se apresentou com paraganglioma de mediastino anterior e médio e nódulos pulmonares bilaterais. O tratamento consistiu na ressecção das lesões pulmonares através de toracotomia anterior bilateral transesternal e retirada do paraganglioma com auxílio de circulação extracorpórea. Como tratamento neoadjuvante foram usadas radioterapia e quimioterapia. A evolução pós-operatória foi satisfatória, e catorze meses depois a paciente encontrava-se assintomática.Herein, we describe the case of a 27-year-old female presenting with paraganglioma of the anterior and middle mediastinum and bilateral pulmonary nodules. Treatment consisted of pulmonary resection by anterior bilateral thoracotomy and transverse sternotomy, in which the paraganglioma was excised with the aid of extracorporeal circulation. As neoadjuvant treatments, radiotherapy and chemotherapy were applied. Postoperative evolution was uneventful, and the patient was classified as asymptomatic after 14 months.

  20. HIPERTENSIÓN PULMONAR: IMPORTANCIA DE UN DIAGNÓSTICO PRECOZ Y TRATAMIENTO ESPECÍFICO

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    Mónica Zagolin B., DRA.

    2015-05-01

    Full Text Available La hipertensión arterial pulmonar (HAP es una enfermedad crónica, que se caracteriza por el aumento de la resistencia vascular pulmonar (RVP a nivel de la arteriola pulmonar, que provoca una progresiva sobrecarga y posterior disfunción del ventrículo derecho (VD, que en etapas finales lleva a la insuficiencia cardiaca derecha, la cual sella su pronóstico. La HAP es más frecuente en mujeres jóvenes en plena edad productiva, siendo la supervivencia media de 2-3 años, antes de la aparición de terapias específicas. La base genética sugiere una herencia autosómica dominante con penetrancia incompleta, reconociéndose principalmente la afección del BMPR2. En la etiopatogenia se reconoce una alteración en las señales que controlan fundamentalmente el equilibrio vasocontrictor-vasodilatador a nivel del endotelio, con un desbalance hacia la proliferación y vasoconstricción, en las que están involucradas 3 vías patogénicas: La del Óxido nítrico (ON, de la Prostaciclina (PG y de la Endotelina (ET. El diagnóstico precoz de la HAP se asocia con una mejor supervivencia a largo plazo, por lo que su búsqueda ante un paciente con disnea, fatiga, dolor torácico y/o síncopes, así como en las poblaciones en riesgo, como son familiares en 1° con HAP, Esclerodermia y portadores de Hipertensión Portal, debería ser la estrategia de elección. La Ecocardiografía Doppler (ECO es la herramienta de pesquisa más utilizada en la práctica clínica actual. El diagnóstico debe ser confirmado mediante un cateterismo derecho, con mediciones directas de la presión arterial pulmonar, y debe realizarse prueba de vasoreactividad. El advenimiento de los tratamientos farmacológicos-HAP específicos ha provocado un cambio en la evolución natural de la enfermedad, existiendo hoy terapias orientadas a controlar las principales vías patogénicas involucradas: ON, PG, y ET. Los principales factores pronósticos que permiten guiar la terapia y la adici

  1. Avaliação e recondicionamento pulmonar ex vivo Ex vivo lung evaluation and reconditioning

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    Paulo Manuel Pêgo-Fernandes

    2010-12-01

    Full Text Available OBJETIVO: Apenas 15% dos pulmões doados são aproveitados para transplante. Um novo método de Perfusão Pulmonar Ex Vivo (PPEV foi desenvolvido e pode ser usado para avaliação e recondicionamento de pulmões "marginais" e rejeitados para o transplante. Esse trabalho relata nossa experiência com a avaliação funcional da PPEV. MÉTODOS: Foram estudados pulmões de 12 doadores considerados inapropriados para transplante pulmonar. Após a captação, os pulmões são perfundidos ex vivo com Steen Solution, uma solução de composição eletrolítica extracelular com alta pressão coloidosmótica. Um oxigenador de membrana ligado ao circuito recebe uma mistura gasosa (nitrogênio e dióxido de carbono e "desoxigena" o perfusato, mantendo uma concentração de gases semelhante a do sangue venoso. Os pulmões são gradualmente aquecidos, perfundidos e ventilados. A avaliação dos órgãos é feita por gasometrias e medidas como a resistência vascular pulmonar (RVP e complacência pulmonar (CP. RESULTADOS: A PaO2 (FiO2 100% passou de um valor médio de 193,3 mmHg no doador para 495,3 mmHg durante a PPEV. Após uma hora de PPEV, a RVP média era de 737,3 dinas/seg/ cm5 e a CP era de 42,2 ml/cmH2O. CONCLUSÕES: O modelo de avaliação pulmonar ex vivo pode melhorar a capacidade de oxigenação de pulmões "marginais" inicialmente rejeitados para transplante. Isso denota um grande potencial do método para aumentar a disponibilidade de pulmões para transplante e, possivelmente, reduzir o tempo de espera nas filas.OBJECTIVE: Only about 15% of the potential candidates for lung donation are considered suitable for transplantation. A new method for ex vivo lung perfusion (EVLP has been developed and can be used for evaluation and reconditioning of "marginal" and unacceptable lungs. This is a report of functional evaluation experience with ex vivo perfusion of twelve donor lungs deemed unacceptable in São Paulo, Brazil. METHODS: After harvesting, the

  2. Vasculites pulmonares: quando suspeitar e como fazer o diagnóstico Pulmonary vasculitis: when suspicion equal diagnosis

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    Carmen Sílvia Valente Barbas

    2005-07-01

    Full Text Available As vasculites pulmonares primárias são caracterizadas por processo inflamatório na parede dos vasos pulmonares que leva a isquemia e hemorragia pulmonar com as conseqüentes expressões clínicas e radiológicas. As vasculites pulmonares primárias são acompanhadas de expressão sistêmicas cutâneas, em nervos periféricos, rins, seios da face, olhos e ouvidos, além do trato gastrintestinal, e sistemas cardíaco e nervoso central. O diagnóstico é feito através da associação das informações clínicas, radiológicas e anatomopatológicas. O tratamento com corticosteróides e imunossupressores deve ser instituído precocemente e apresenta altas taxas de remissão.The primary forms of pulmonary vasculitis are characterized by an inflammatory process in the pulmonary vessel walls, leading to pulmonary ischemia and hemorrhage and the consequent clinical and radiological manifestations. These forms of vasculitis are accompanied by symptoms involving the skin, peripheral nerves, kidneys, sinuses, eyes, ears and gastrointestinal tract, as well as the cardiac and central nervous systems. The diagnosis is made through analysis of the clinical, radiological and pathological data. When treatment with corticosteroids and immunosuppressive therapy is initiated early, remission rates are high.

  3. Agenesia pulmonar y riñón en herradura en la edad adulta: reporte de caso y revisión de la literatura

    OpenAIRE

    Navarro Vergara, D.I.; Moreira Meyer, A.; Cícero Sabido, R.; Núñez Pérez-Redondo, C.; Garrido Alarcón, E.

    2014-01-01

    La agenesia pulmonar es una malformación congénita rara que se define como la ausencia total de parénquima pulmonar, bronquios y vasculatura. En la literatura se encuentran pocos casos de esta malformación en la edad adulta, debido a la presencia de otras malformaciones coincidentes, como desplazamiento mediastinal y cardiaco severos. La mayoría de los casos mueren prematuramente en los primeros 5 años de vida. Se presenta el caso de un paciente de 31 años de edad con agenesia pulmonar izquie...

  4. Anastomosis cava-pulmonar en el tratamiento quirúrgico de la tetralogía de Fallot

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    José Félix Patiño

    1965-01-01

    Full Text Available Se informa sobre la aplicación clínica exitosa de la técnica de anastomosis cava-pulmonar, originalmente descrito por Glenn y Patiño, en un caso de Tetralogía de Fallot. Representa este caso el primer paciente tratado en esta forma en la literatura médica occidental. La anastomosis cava-pulmonar es un procedimiento técnicamente muy sencillo que permite mejorar notablemente la oxigenación en pacientes que presentan ciertas anomalías en el corazón derecho o en la arteria pulmonar. La anastomosis cava-pulmonar parece ser una operación fisiológica fácil de realizar, bien tolerada, que da como resultado buena oxigenación de la sangre venosa desembocada al pulmón derecho, y que en el caso de la Tetralogía de Fallot, presenta notables ventajas sobre las operaciones paliativas clásicas de Blalock y Potts. La anastomosis cava-pulmonar es un procedimiento que puede ser usado en el tratamiento quirúrgico de la Tetralogía de Fallot como operación paliativa definitiva, o como la primera etapa que mejora las condiciones generales del paciente para permitir que más tarde pueda ser llevado a corrección definitiva. Esta anastomosis, que disminuye trabajo al corazón, no necesariamente tiene que ser deshecha a tiempo de la corrección definitiva, a diferencia de las operaciones clásicas de Blalock y Pott, que sí añaden trabajo al corazón al crear un ductus artificial y una hipertensión pulmonar. Se propone el uso clínico de la anastomosis cava-pulmonar en aquellos casos de Tetralogía de Fallot que requieran una operación paliativa extra-cardíaca o como la primera etapa antes de ser sometidos a la corrección definitiva por circulación extracorpórea.

  5. Quantitative electromyographic characteristics of idiopathic unilateral vocal fold paralysis.

    Science.gov (United States)

    Chang, Wei-Han; Fang, Tuan-Jen; Li, Hsueh-Yu; Jaw, Fu-Shan; Wong, Alice M K; Pei, Yu-Cheng

    2016-11-01

    Unilateral vocal fold paralysis with no preceding causes is diagnosed as idiopathic unilateral vocal fold paralysis. However, comprehensive guidelines for evaluating the defining characteristics of idiopathic unilateral vocal fold paralysis are still lacking. In the present study, we hypothesized that idiopathic unilateral vocal fold paralysis may have different clinical and neurologic characteristics from unilateral vocal fold paralysis caused by surgical trauma. Retrospective, case series study. Patients with unilateral vocal fold paralysis were evaluated using quantitative laryngeal electromyography, videolaryngostroboscopy, voice acoustic analysis, the Voice Outcome Survey, and the Short Form-36 Health Survey quality-of-life questionnaire. Patients with idiopathic and iatrogenic vocal fold paralysis were compared. A total of 124 patients were recruited. Of those, 17 with no definite identified causes after evaluation and follow-up were assigned to the idiopathic group. The remaining 107 patients with surgery-induced vocal fold paralysis were assigned to the iatrogenic group. Patients in the idiopathic group had higher recruitment of the thyroarytenoid-lateral cricoarytenoid muscle complex and better quality of life compared with the iatrogenic group. Idiopathic unilateral vocal fold paralysis has a distinct clinical presentation, with relatively minor denervation changes in the involved laryngeal muscles, and less impact on quality of life compared with iatrogenic vocal fold paralysis. 4. Laryngoscope, 126:E362-E368, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Efetividade da reabilitação pulmonar como tratamento coadjuvante da doença pulmonar obstrutiva crônica

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    RODRIGUES SÉRGIO LEITE

    2002-01-01

    Full Text Available Introdução: O paciente portador de DPOC diminui sua atividade física global devido a piora progressiva da função pulmonar como conseqüência de qualquer forma de esforço físico por ele realizado. A reabilitação pulmonar (RP é utilizada nos EUA e Europa como alternativa terapêutica no tratamento da DPOC. Objetivo: Avaliar a efetividade do programa de RP como tratamento coadjuvante da DPOC. Pacientes e métodos: 30 pacientes prospectivamente submetidos ao programa de RP desenvolvido em seis semanas com freqüência semanal de três sessões. A avaliação compôs-se da história clínica e exame físico completos, do teste de caminhada de seis minutos, do teste de carga máxima sustentada pelos MMSS, do teste de potência máxima de MMII, do questionário de percepção de esforço físico e espirometria e gasometria. Resultados: No que se refere às variáveis espirométricas e gasométricas pré e pós-programa de RP, não houve alterações estatisticamente significativas (p > 0,05. Observaram-se diferenças estatisticamente significativas (p < 0,05 nos períodos pré e pós-programa de RP em relação à diminuição da percepção do esforço físico e aumento da capacidade física funcional, do teste de carga máxima para MMSS e testes incrementais de MMII. Conclusões: Para o grupo estudado, os autores concluem que o programa de RP aumentou a sua capacidade física, carga máxima sustentada pelos MMSS e não alterou as variáveis espirométricas e gasométricas.

  7. Transplantes cardiopulmonar e pulmonar com doador em localidade distante Distant donor procurement for heart-lung and lung transplantation

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    Luis Sérgio Fragomeni

    1988-12-01

    Full Text Available Em situações específicas, os transplantes clínicos cardiopulmonar e pulmonar são, hoje, formas estabelecidas de tratamento para estágio final de doença cardiopulmonar e pulmonar. A obtenção de doadores adequados permanece o maior problema e a remoção de órgãos em localidades distantes é, hoje, uma necessidade. Embora muitos métodos de preservação pulmonar possam ser empregados, para períodos isquémicos de até 5 horas, a hipotermia e o uso de solução cardioplégica com infusão da solução de Collins modificada no tronco pulmonar tem sido método simples e eficiente para preservação do bloco coração-pulmão. Descrevemos, aqui, o método corrente que empregamos, com o qual os transplantes cardiopulmonar e pulmonar combinados foram sucedidos de excelente função cárdio-respiratória.In special situations, clinical heart-lung and lung transplantation are today established methods of therapy for end stage cardiopulmonary and pulmonary disease. Adequate donor availability remains a major problem and distant organ procurement is today a necessity. Although many methods of lung preservation can be used, for periods of up to 5 hours, hypothermic storage with cardioplegic arrest and pulmonary artery flush with modified Collins solution has proven to be a simple and reliable method of heart-lung preservation. We here describe our current method of heart-lung block protection, in which heart-lung and double lung transplantation were performed followed by excelent cardiac and pulmonary function.

  8. Unilateral Thalamic Infarct Presenting as a Convulsive Seizure.

    Science.gov (United States)

    Kumar, Rajesh; Brohi, Hazim; Mughul, Afshan

    2017-09-01

    Lesions of the thalamus and those extending into midbrain can cause various types of movement disorders such as dystonia, asterixis and ballism-chorea. Seizures are rare manifestation of thalamic disorder. Occurrence of seizures in bilateral thalamic infarct has been reported; but seizures in unilateral thalamic infarct have been reported very rarely. Literature review showed only single case of perinatal unilateral thalamic infarct presenting with seizures. We are reporting a unique case of convulsive seizure at the onset of unilateral thalamic infarct in an adult male, which has never been reported to the best of our knowledge.

  9. Unilateral corneal leukoplakia without limbal involvement

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    Hirano K

    2015-05-01

    Full Text Available Koji Hirano,1 Mihoko Koide,2 Yoshikazu Mizoguchi,3 Yasuhiro Osakabe,4 Kaoru-Araki Sasaki5 1Department of Ophthalmology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; 2Koide Internal Medicine and Eye Clinic, Nagoya, Japan; 3Department of Pathology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; 4Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan; 5Department of Ophthalmology, Japan Health Care Organization, Hoshigaoka Medical Center, Hirakata, Japan Purpose: Leukoplakia is the term given to a white patch or plaque that is found mainly on the oral mucus membrane. It can occasionally be seen on the corneal surface. We report our clinical and histopathological findings in a case of unilateral corneal leukoplakia. Methods: A 26-year-old woman was referred to our hospital because of a white patch on her right cornea that continued to expand. She first noticed the white patch when she was 20 years old, and the white patch had expanded to cover the pupillary area affecting her vision. After plastic surgery on both eyelids for bilateral entropion to alleviate the pain caused by the eyelashes rubbing the cornea, the white corneal patch decreased in size. Because of this reduction, we performed surgery to remove the patch with microforceps under topical anesthesia. The plaque was removed easily and completely, and submitted for histopathological examination. Results: Histopathological examination showed that the specimen had characteristics of epidermis with a basal cell layer, spinous cell layer, granular cell layer, and horny layer with hyperkeratosis. She was diagnosed with leukoplakia of the corneal surface. The basic structure of the squamous cell layer was preserved, and there were no signs of metaplasia. Six months after the removal of the leukoplakia, no recurrence was seen and her corrected decimal visual acuity recovered to 1

  10. Prognóstico pulmonar em prematuros Pulmonary prognosis in preterm infants

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    Luciana Friedrich

    2005-03-01

    Full Text Available OBJETIVO: O aumento da sobrevida de prematuros traz o desafio de lidar com um amplo espectro de doenças pulmonares crônicas, incluindo displasia broncopulmonar, síndrome de Wilson-Mikity e sibilância recorrente. Este artigo discute o prognóstico pulmonar clínico e funcional de prematuros na infância e na adolescência. FONTE DE DADOS: Foi realizada pesquisa no MEDLINE de publicações entre 1970 e 2004 que abordassem função e crescimento pulmonar de prematuros, bem como a evolução clínica dos mesmos. SÍNTESE DOS DADOS: Eventos pré e pós-natais como insuficiência placentária, tabagismo, infecções, oxigênio e ventilação mecânica exercem efeitos importantes no desenvolvimento pulmonar, podendo conduzir a doenças pulmonares crônicas, sendo a displasia broncopulmonar a complicação clínica mais severa. No entanto, perdas significativas de função pulmonar também podem ocorrer em prematuros sem critérios de displasia broncopulmonar e que não apresentaram doença respiratória neonatal significativa. Nestes pacientes, o impacto da prematuridade sobre o sistema respiratório é freqüentemente subestimado. Clinicamente, observa-se incidência aumentada de pneumonias e bronquiolites, re-hospitalizações por doenças respiratórias, tosse e sibilância crônicas e hiper-reatividade brônquica. Posteriormente, percebe-se uma tendência à normalização da função pulmonar, mas persistem fluxos reduzidos, menor tolerância a exercícios e hiper-reatividade brônquica. CONCLUSÕES: A prematuridade, os eventos que a provocam e as intervenções que dela decorrem alteram de maneira permanente, em maior ou menor grau, o desenvolvimento do sistema respiratório. São necessários estudos adicionais para esclarecer o efeito de cada um desses insultos perinatais no desenvolvimento do sistema respiratório.OBJECTIVE: The increased survival of preterm infants poses the challenge of dealing with a wide range of chronic pulmonary

  11. Ação da adenosina na circulação pulmonar de pacientes com hipertensão pulmonar primária Effect of adenosine on pulmonary circulation in patients with primary pulmonary hypertension

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    Rogerio Souza

    2005-02-01

    Full Text Available INTRODUÇÃO: A adenosina é um nucleosídeo com potente ação vasodilatadora. Apesar de seus efeitos sobre o território arterial pulmonar ser conhecido, seu efeito sobre o território capilar/venoso ainda não foi descrito. OBJETIVO: Estudar o comportamento das resistências arterial e venosa da circulação pulmonar de pacientes com hipertensão pulmonar primária antes e depois da administração de adenosina. MÉTODO: Foram estudados sete pacientes com hipertensão pulmonar primária que apresentaram resposta positiva durante o teste agudo com adenosina. Resistência arterial e resistência venosa foram determinadas pela estimativa da pressão capilar pulmonar realizada através da análise da curva de decaimento da pressão arterial pulmonar, antes e depois da administração da adenosina. RESULTADOS: Após a administração da adenosina, houve um aumento do índice cardíaco (1,71 ± 0,23 para 2,72 ± 0,74 L.min-1.m-2 com concomitante diminuição da resistência vascular pulmonar (2.924 ± 1.060 para 1.975 ± 764 dina.s.cm-5.m-2, sem variações significativas da pressão arterial pulmonar média (75,6 ± 16,8 para 78,1 ± 18,8 mmHg, da pressão de oclusão da artéria pulmonar (15,3 ± 1,5 para 15,4 ± 1,9 mmHg e da pressão capilar pulmonar (43,8 ± 5,8 para 44,5 ± 4,9 mmHg. A proporção entre a resistência arterial e a resistência vascular pulmonar total também apresentou variação não significativa (50 ± 15 para 49 ± 17%. Estes achados sugerem que a adenosina teve ação não somente sobre o território arterial mas também sobre o território capilar/venoso. CONCLUSÃO: Os autores concluem que o mecanismo de ação da adenosina não é restrito ao território arterial da circulação pulmonar e que este tipo de análise, através da determinação da pressão capilar pulmonar, pode ser útil no estudo das diversas drogas que agem sobre a circulação pulmonar.BACKGROUND: The nucleoside adenosine is a potent vasodilator

  12. Manifestaciones pulmonares del Lupus Eritematoso Sistémico Pulmonary manifestations of systemic lupus erithematosus

    Directory of Open Access Journals (Sweden)

    José Fernando Molina

    1991-03-01

    Full Text Available En esta revisión se describen las diversas manifestacionespulmonares del Lupus Eritematoso Sistémico; se Incluyen tanto los cuadrosrelacionados con la enfermedad (pleuritis con o sin derrame, neumonitis lúpicaaguda, enfermedad intersticlaidifusa, hipertensión pulmonar, disfunción diafragmática,atelectasia y hemorragia pulmonar como los asociados a ella (infección, edemapulmonar urémico, embolismo pulmonar, neumotórax, pseudolinfoma y sarcoidosis.Se consideran someramente aspectos clínicos, patológicos, patogénicos,diagnósticos y terapéuticos. En cuanto a los últimos se enfatizan algunasconsideraciones generales de importancia en el manejo de estos pacientes; sonellas: la necesidad de descartar ante todo la posibilidad de un proceso Infecciosoy de emplear antibióticos de amplio espectro hasta excluir1o; la de agotarrecursos hasta establecer un diagnóstico definitivo y la de recurrir a laterapia inmunosupresora una vez excluida la infección O cuando no ha habidorespuesta a los antibióticos adecuados

    The various pulmonary manifestations of Systemic Lupus Erythematosus are described in this review; it includes related (pleurisy with/without effusion, acute lupus pneumonitis, diffuse interstitial disease, pulmonary hypertension, diaphragmatic dysfunction, atelectasis, pulmonary hemorrhage as well as associated (infection, uremic pulmonary edema, pulmonary embolism, pneumothorax, pseudolymphoma, sarcoldosis, miscellaneous conditions. Clinical, pathological, pathogenic, diagnostic and therapeutic aspects are con. sidered. Emphasis is done on certain general therapeutic considerations, namely: to rule out the possibillty of an infectious process and use wide-spectrum antibiotics until certainty is acquired that it is not present; to use every available diagnostic resource until a definite diagnosis Is established

  13. Unilateral pulmonary edema after laparoscopic nephrectomy

    Directory of Open Access Journals (Sweden)

    Shreepathi Krishna Achar

    2011-01-01

    Full Text Available Unilateral-dependent pulmonary edema though reported in laparoscopic donor nephrectomies, has not been reported after laparoscopic non-donor nephrectomies. A 75-kg, 61-year-old man, a diagnosed case of right renal cell carcinoma was scheduled for laparoscopic nephrectomy. After establishing general anesthesia, the patient was positioned in the left-sided modified kidney (flank position. During the 5.75-hour procedure, he was hemodynamically stable except for a transient drop in blood pressure immediately after positioning. Intra-abdominal pressure was maintained less than 15 mmHg throughout the procedure. Blood loss was approximately 50 mL and urine output was 100 mL in the first hour followed by a total of 20 mL in the next 4.75 hours. Total fluid received during the procedure included 1.5 L of Ringer′s lactate and 1.0 L of 6% hydroxyethyl starch. After an uneventful procedure he developed respiratory distress in the postoperative period with a radiological evidence of dependent lung edema. Clinical and radiological improvement followed noninvasive ventilation, intravenous diuretics and oxygen therapy.

  14. Congenital Unilateral Hypoplasia of Depressor Anguli Oris

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    Seckin O. Ulualp

    2012-01-01

    Full Text Available Objectives. Asymmetric facial appearance may originate from abnormalities of facial musculature or facial innervation. We describe clinical features of congenital hypoplasia of depressor anguli oris muscle in a child. Material and Methods. Chart of a 10-month-old female referred to a tertiary care pediatric hospital for assessment of facial paralysis was reviewed. Data included relevant history and physical examination, diagnostic work up, and management. Results. The child presented with asymmetric movement of lower lip since birth. Asymmetry of lower lip was more pronounced when she smiled and cried. Rest of the face movement was symmetric. On examination, the face appeared symmetric at rest. The child had inward deviation of right lower lip when she smiled. Facial nerve function, as determined by frowning/forehead, wrinkling, eye closure, nasolabial fold depth, and tearing, was symmetric. Magnetic resonance imaging of the temporal bones and internal auditory canals were within normal limits. Echocardiogram did not show cardiac abnormality. Auditory brainstem response showed no abnormality. Conclusions. Congenital hypoplasia of depressor anguli oris is a rare anomaly that causes asymmetric crying face. Pediatricians and otolaryngologists need to be cognizant of cardiac, head and neck, and central nervous system anomalies associated with congenital unilateral hypoplasia of depressor anguli oris.

  15. [New developments in spastic unilateral cerebral palsy].

    Science.gov (United States)

    Chabrier, S; Roubertie, A; Allard, D; Bonhomme, C; Gautheron, V

    2010-01-01

    Hemiplegic (or spastic unilateral) cerebral palsy accounts for about 30% of all cases of cerebral palsy. With a population prevalence of 0.6 per 1000 live births, it is the most common type of cerebral palsy among term-born children and the second most common type after diplegia among preterm infants. Many types of prenatal and perinatal brain injury can lead to congenital hemiplegia and brain MRI is the most useful tool to classify them with accuracy and to provide early prognostic information. Perinatal arterial ischemic stroke thus appears as the leading cause in term infants, whereas encephalopathy of prematurity is the most common cause in premature babies. Other causes include brain malformations, neonatal sinovenous thrombosis, parenchymal hemorrhage (for example due to coagulopathy or alloimmune thrombocytopenia) and the more recently described familial forms of porencephaly associated with mutations in the COL4A1 gene. In adjunction with pharmacologic treatment (botulinium neurotoxin injection), new evidence-based rehabilitational interventions, such as constraint-induced movement therapy and mirror therapy, are increasingly being used.

  16. Nasal nitric oxide in unilateral sinus disease.

    Directory of Open Access Journals (Sweden)

    Chia-Hsiang Fu

    Full Text Available Unilateral sinus disease (USD can sometimes be difficult to accurately diagnose before surgery. The application of nasal nitric oxide (nNO for USD diagnosis and its surgical outcome in USD has not been reported in the literature. We prospectively enrolled sixty-six USD patients who underwent endoscopic sinus surgery for fungal rhinosinusitis (n = 19, chronic rhinosinusitis (CRS without nasal polyps (n = 13, CRS with nasal polyps (n = 12 and sinonasal mass lesions (n = 22. nNO levels were measured preoperatively and at three and six months postoperatively. Correlations between nNO levels and potential clinical parameters, type of disease, disease severity, and disease-related quality of life (QOL were assessed. Unlike bilateral CRS, in USD, nNO levels did not correlate with disease severity or postoperative QOL improvements. Except for fungus group, there were no differences in nNO levels between lesion and non-lesion sides in all the other groups. nNO levels on both sides were significantly elevated six months postoperatively in all groups. Fungal rhinosinusitis patients had the lowest preoperative nNO levels, and a cutoff of 239.3 ppb had the best sensitivity (79.0% and specificity (87.2% for preoperative diagnosis. While preoperative nNO levels cannot serve as an alternative marker for disease severity of USD, they were lower in fungal rhinosinusitis patients than in other USD patients and may be useful for more accurate diagnosis prior to surgery.

  17. Characteristics of children with unilateral hearing loss.

    Science.gov (United States)

    Fitzpatrick, Elizabeth M; Al-Essa, Rakan S; Whittingham, JoAnne; Fitzpatrick, Jessica

    2017-11-01

    The purpose of this study was to describe the clinical characteristics of children with unilateral hearing loss (UHL), examine deterioration in hearing, and explore amplification decisions. Population-based data were collected prospectively from time of diagnosis. Serial audiograms and amplification details were retrospectively extracted from clinical charts to document the trajectory and management of hearing loss. The study included all children identified with UHL in one region of Canada over a 13-year period (2003-2015) after implementation of universal newborn hearing screening. Of 537 children with permanent hearing loss, 20.1% (108) presented with UHL at diagnosis. They were identified at a median age of 13.9 months (IQR: 2.8, 49.0). Children with congenital loss were identified at 2.8 months (IQR: 2.0, 3.6) and made up 47.2% (n = 51), reflecting that a substantial portion had late-onset, acquired or late-identified loss. A total of 42.4% (n = 39) showed deterioration in hearing, including 16 (17.4%) who developed bilateral loss. By study end, 73.1% (79/108) of children had received amplification recommendations. Up to 20% of children with permanent HL are first diagnosed with UHL. About 40% are at risk for deterioration in hearing either in the impaired ear and/or in the normal hearing ear.

  18. Tratamiento de la compresión del tronco de la arteria coronaria izquierda en pacientes con hipertensión pulmonar

    Directory of Open Access Journals (Sweden)

    María L. Talavera

    2011-10-01

    Full Text Available La angina de pecho es un síntoma frecuente en pacientes con hipertensión pulmonar (HP de cualquier etiología. Aunque su fisiopatología no está aclarada, las causas propuestas son: la isquemia subendocárdica por aumento del estrés parietal del ventrículo derecho, la dilatación de la arteria pulmonar por incrementos transitorios de la presión pulmonar y la compresión extrínseca del tronco de la arteria coronaria izquierda (TCI por la arteria pulmonar (AP dilatada. Se presentan tres casos que muestran la relación entre la angina de pecho y la compresión del TCI en pacientes con HP asociada a cardiopatías congénitas, tratados mediante implante de stent coronario.

  19. [Primary hyperaldosteronism due to unilateral adrenal hyperplasia with surgical resolution].

    Science.gov (United States)

    Rubio-Puchol, O; Garzón-Pastor, S; Salom-Vendrell, C; Hernández-Mijares, A

    Unilateral adrenal hyperplasia is a rare cause of primary hyperaldosteronism (around a 3%) that has surgical treatment. A case of a patient with hypertension resistant to conventional therapy in treatment with 7 drugs who presented with primary hyperaldosteronism due to unilateral adrenal hyperplasia is presented. A left adrenalectomy was performed, and the patient had a good clinical response, with no need of any drug after 2 years of surgery. Unilateral adrenal hyperplasia is a different entity and it is not an asymmetric variant of the bilateral adrenal hyperplasia. In the study of patients with primary hyperaldosteronism and imaging tests with absence of adenoma is a diagnosis that must be considered before cataloguing patients with bilateral adrenal hyperplasia and start a medical treatment, because unilateral adrenal hyperplasia would have a surgical resolution. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Unilateral multiple tumorous lesions of the parotid gland

    International Nuclear Information System (INIS)

    Takahashi, Mitsuaki; Fujita, Takenori; Adachi, Tosihide; Enomoto, Kenichi; Ishii, Hidenori; Yoshida, Chikako; Hokunan, Kazuhiko; Bando, Nobuyuki; Shigyo, Hiroshi.

    1997-01-01

    Multifocal tumors within the same parotid gland are very rare. We treated 13 patients with multiple tumorous lesions within the unilateral parotid gland. We evaluated the multiple nodules by CT-sialography or magnetic resonance imaging (MRI). These imagings showed clearly two or more distinct nodular-appearing lesions. Recurrent pleomorphic adenoma (6 patients) was predominant, followed by Whartin's tumor (3 patients). The other lesions were two differential parenchymal tumors (polymorphous low grade adenoma/adenoma) within the same gland, a malignant lymphoma, a squamous cell carcinoma metastatic to the gland, and a tuberculous lesion. On palpitation, 9 of the patients had an unilateral tumor, one a palpable parotid mass in the gland, and the other four had two or more tumors in the unilateral gland. The patients with intra-parotid lymph node and metastatic lesions had extra-parotid cervical adenopathy. The clinical features and the differential diagnosis of the unilateral multiple tumors lesions of the parotid gland are discussed. (author)

  1. Endoscopic intranasal findings in unilateral primary acquired nasolacrimal duct obstruction

    Directory of Open Access Journals (Sweden)

    Swati Singh

    2017-07-01

    Conclusion: Unilateral PANDO has a higher incidence of ipsilaterally deviated nasal septum. This association is significant. Routine nasal endoscopic examination should be performed in cases undergoing dacryocystorhinostomy to better plan a concomitant septoplasty if needed.

  2. Evaluation of postural control in unilateral vestibular hypofunction

    Directory of Open Access Journals (Sweden)

    Rafaela Maia Quitschal

    2014-07-01

    Full Text Available INTRODUCTION: Patients with vestibular hypofunction, a typical finding in peripheral vestibular disorders, show body balance alterations. OBJECTIVE: To evaluate the postural control of patients with vertigo and unilateral vestibular hypofunction. METHOD: This is a clinical cross-sectional study. Twenty-five patients with vertigo and unilateral vestibular hypofunction and a homogeneous control group consisting of 32 healthy individuals were submitted to a neurotological evaluation including the Tetrax Interactive Balance System posturography in eight different sensory conditions. RESULTS: For different positions, vertiginous patients with unilateral vestibular hypofunction showed significantly higher values of general stability index, weight distribution index, right/left and tool/heel synchronizations, Fourier transformation index and fall index than controls. CONCLUSION: Increased values in the indices of weight distribution, right/left and tool/heel synchronizations, Fourier transformation and fall risk characterize the impairment of postural control in patients with vertigo and unilateral vestibular hypofunction.

  3. Size of the unaffected kidney in children with unilateral hydronephrosis

    International Nuclear Information System (INIS)

    Miler, M.; Mortensson, W.

    1980-01-01

    Children with unilateral hydronephrosis, but without evidently decreased excretion of urographic contrast medium, generally had enlargement of the unaffected mate kidney, indicating reduced function of the hydronephrotic kidney. (Auth.)

  4. Computer tomography findings and causes of unilateral exophthalmos

    International Nuclear Information System (INIS)

    Chen Fangni; Xie Sumin; Tang Haiyong

    2010-01-01

    Objective: To evaluate the common cause of unilateral exophthalmos and CT findings. Methods: The CT manifestations of 267 cases of unilateral exophthalmos were reviewed. 41 cases were confirmed by surgery and pathology. 68 cases were confirmed by biopsy. Diagnosis was made in 158 cases on the basis of typical history, laboratory findings and response to treatment. Results: The lesions were intraocular (10 cases), intraorbital (230) and periorbital lesions (27). The most common causes of unilateral exophthalmos included inflammatory pseudotumor (67 cases), pleomorphic adenoma or carcinoma of lachrymal gland (44), cavernous angioma (22), carotid cavernous fistula (20) and varices (18). The CT appearances were exophthalmos, intraocular or periorbital tumor, extraocular muscle hypertrophy. The contrast enhancement was variable without enhancement in necrotic areas. Conclusion: CT scan is valuable for diagnosis and displaying the structural change of unilateral exophthalmos. (authors)

  5. Papiledema unilateral na síndrome do pseudotumor cerebral

    Directory of Open Access Journals (Sweden)

    Mário L. R. Monteiro

    1985-06-01

    Full Text Available São apresentadas as fotografias de fundo de olho de 6 mulheres com papiledema unilateral e a síndrome do pseudotumor cerebral. Achados associados foram: obesidade em 5 e a sindrome da sela vazia parcial em 2. São discutidas as possíveis explicações para o desenvolvimento de papiledema unilateral nesses pacientes e que favorecem um mecanismo presente na porção distal dos nervos ópticos.

  6. [Characteristics of opening movement in patients with unilateral mastication].

    Science.gov (United States)

    Jia, Ling; Wang, Yun; Wang, Mengya

    2016-08-01

    To analyze characteristics of mandibular movement in patients with unilateral mastication.
 Undergraduate students in oral medicine from Grade 2011 and 2012 in Wannan Medical College were enrolled for this study by cluster sampling method, which include 30 people with unilateral mastication and 30 people with bilateral mastication. The surface electromyogram (sEMG) of masseter muscle and anterovent of digastric muscle were recorded and the trajectory of mandibular incisor point was recorded simultaneously in the maximum opening and closing movement. The results were analyzed by SPSS 19.0 software.
 Average electrical peak of left anterior digastric muscle and right anterior digastric muscle in the unilateral chewing group was lower than that in the bilateral chewing group (P<0.05). The jaw tangent point trajectory was separate in the unilateral chewing group. There were significant differences at the opening type between the 2 groups. The vertical displacement and the sagittal displacement in the unilateral chewing group were significantly lower than those in the bilateral chewing group (P<0.01). There was significant positive correlation between the average peak potential of masseter muscle and displacement on the right side.
 Average electrical peak of left masseter muscle, left anterior digastric muscle, and right anterior digastric muscle decreases in the unilateral chewing group. Jaw tracking in most people deflects to the working side. Opening and closing jaw tracking is separate in 50% unilateral chewing individuals with the decreased opening degree. Unilateral chewing leads to changes in muscle performance accompanied by trajectory anomalies.

  7. Gerstmann's syndrome and unilateral optic ataxia in the emergency department

    Science.gov (United States)

    Barbosa, Breno José Alencar Pires; de Brito, Marcelo Houat; Rodrigues, Júlia Chartouni; Kubota, Gabriel Taricani; Parmera, Jacy Bezerra

    2017-01-01

    ABSTRACT. A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke. PMID:29354229

  8. Gerstmann's syndrome and unilateral optic ataxia in the emergency department

    Directory of Open Access Journals (Sweden)

    Breno José Alencar Pires Barbosa

    Full Text Available ABSTRACT. A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke.

  9. Follow-up of prenatally diagnosed unilateral hydronephrosis

    DEFF Research Database (Denmark)

    Thorup, Jørgen Mogens; Lenz, K; Rabol, A

    1996-01-01

    Based on previous experience with prenatally diagnosed unilateral hydronephrosis, we found that the primary indications for surgical intervention should be symptoms or functional impairment of the hydronephrotic kidney. Nonoperative management of neonates without symptoms and with normal function...... of the affected kidney was proposed. However, the strategy of treatment after prenatally diagnosed hydronephrosis is still controversial. We studied 28 consecutive children with suspected unilateral pelviureteral junction obstruction and a normal contralateral kidney. The overall follow-up period varied between 2...

  10. Congenital unilateral absence of the pulmonary artery in adults

    International Nuclear Information System (INIS)

    Gonzalez Garcia, Mauricio; Escalante Mora, Hector A; Lozano Castillo, Alfonso J

    2000-01-01

    Unilateral absence of a pulmonary artery is a rare anomaly. It occurs with pulmonary ipsilateral hypoplasia and it's frequently associated with other cardiovascular malformations. The majority of the cases are diagnosed in childhood. This is a case report of two adult patients of the Hospital Central de la Policia Nacional in Bogota, Colombia, with unilateral absence of the pulmonary artery one isolated and the other with patent ductus arteriosus. We describe the clinical and roentgenographic findings of this congenital anomaly

  11. CARACTERÍSTICAS DE ATENCIÓN DE SALUD EN EL PROGRAMA DE TUBERCULOSIS PULMONAR. HOSPITAL REGIONAL HONORIO DELGADO DE AREQUIPA, 2015.

    OpenAIRE

    CHIRINOS MAYCA, LUIS ANGEL

    2016-01-01

    TUBERCULOSIS PULMONAR SIGNIFICADO EXÁMENES COMPLEMENTARIO APRECIACIÓN DIAGNOSTICA TRATAMIENTO DE LA TUBERCULOSIS PULMONAR EN UN PROGRAMA DE TBC ATENCIÓN DE SALUD CONCEPTOS Y DEFINICIONES DE ATENCIÓN EN SALUD LOS CUATROS PILARES EN LA ATENCIÓN DE SALUD PROPÓSITO, OBJETIVOS Y PRINCIPIOS DE LA ATENCIÓN EN SALUD ASPECTOS METODOLÓGICOS PARA LA ATENCIÓN SALUD ANTECEDENTES INVESTIGATIVOS

  12. Pulmonary Scintigraphy for Tumour Diagnosis; La Gammagrafia Pulmonar en Diagnostico Tumoral

    Energy Technology Data Exchange (ETDEWEB)

    Esteban, J.; Lasa, D.; Herranz, R.; Galvez, F.; Negueruela, J.; Perez-Modrego, S. [Hospital Oncologico Provincial, Madrid (Spain)

    1969-05-15

    es uno de los metodos mas utiles para el estudio de las alteraciones de.la circulacion pulmonar y para el diagnostico de embolias e infartcs. Sin embargo su utilizacion en diagnostico tumoral apenas si ha pasado de algunos ensayos. Los autores han centrado su atencion en el estudio, mediante gammagrafia, de pacientes con tumores de pulmon primitivos y secundarios a otras localizaciones, encontrando que segun el tipo de tumor el patron de distribucion del trazador es radicalmente distinto. En los tumores metastasicos la repercusion de las lesiones en la gammagraffa es pequena y depende exclusivamente del volumen de la zona de condensacion. Los nodulos tumorales se comportan exclusivamente como zonas inactivas dentro de una masa de parenquima funcional activo y su influencia en la imagen gammagrafica depende exclusivamente del tamano de la zona tumoral y de la cantidad de parenquima sano que se interponga entre ella y el detector. En los tumores pulmonares primitivos y muy especialmente en los localizados en la zona hiliar, lesiones relativamente pequenas originan defectos de captacion amplias zonas del pulmon, que pueden afectar a varios segmentos, a un lobulo e incluso a la totalidad del pulmon. Esta disminucion de captacion no puede explicarse exclusivamente por la imagen tumoral, ni por las zonas de atelectasia asociadas, sino que debe ser motivada por una modificacion profunda de la hemodinamica del puimon afecto. Varios tipos de fenomenos asociados a la progresion tumoral pueden motivar alteraciones vasculares que afecten hasta la periferia del pulmon: la alteracion del regimen ventilatorio con disminucion de la tension de oxigeno que da lugar a una modificacion de las condiciones hemodinamicas; la hipertension pulmonar por compresion de las venas pulmonares de menor resistencia que las arterias; y el estimulo nervioso directo por irritacion de los plexos bronquiales por el crecimiento del tumor y los fenomenos reactivos asociados. (author)

  13. Complicaciones pulmonares asociadas a ventilación mecánica en el paciente neonatal

    OpenAIRE

    Cristabel Torres-Castro; Jaime Valle-Leal; Alba J. Martínez-Limón; Zaira Lastra-Jiménez; Lesvia Carmina Delgado-Bojórquez

    2016-01-01

    Introducción: Se buscó determinar la incidencia de complicaciones pulmonares asociadas a ventilación mecánica en pacientes ingresados a un servicio de cuidados intensivos neonatales (UCIN) en un hospital de 2° nivel. Metodología: Estudio analítico retrospectivo en expedientes de recién nacidos ingresados a una sala de UCIN y que recibieron ventilación mecánica en un hospital de segundo nivel de atención médica. Se recabaron datos demográficos, de la ventilación mecánica, la intubación y co...

  14. Solitary pulmonary nodule: radiologic features and diagnostic approach; Nodulo pulmonar solitario: caracteristicas radiologicas y abordaje diagnostico

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Cambronero, Luis Enrique

    2012-07-01

    A literature review is conducted on the solitary pulmonary nodule, to determine the diagnostic methods and specific characteristics. The diagnostic methods used have been: chest radiography, computed tomography, positron emission tomography and magnetic resonance imaging. The radiological features are defined: location, size, definition of contours or edges (margins), densitometric and attenuation characteristics, cavitation, air bronchogram, growth, doubling time, satellite nodules, nutrient vessels [Spanish] Una revision bibliografica es realizada sobre el nodulo pulmonar solitario, para determinar los metodos de diagnostico y caracteristicas especificas. Los metodos de diagnostico utilizados han sido: la radiografia de torax, tomografia computarizada, tomografia por emision de positrones y resonancia magnetica. Las caracteristicas radiologicas son definidas: localizacion, tamano, definicion de los bordes o contornos (margenes), caracteristicas densitometricas y de atenuacion, cavitacion, broncograma aereo, crecimiento, tiempo de duplicacion, nodulos satelite, vasos nutrientes.

  15. [Pulmonary involvement in systemic sclerosis. Alveolitis, fibrosis and pulmonar arterial hypertension].

    Science.gov (United States)

    Navarro, Carmen

    2006-11-01

    Pulmonary involvement in systemic sclerosis. Alveolitis, fibrosis and pulmonar arterial hypertension Lung disease is present in most of the patients with systemic sclerosis and is now the most important cause of mortality. Interstitial lung disease and pulmonary hypertension are, so far, the main disorders found and both are difficult to detect at the earliest stages. However, diagnostic tools such as immunological test, lung function test, high resolution CT, bronchoalveolar lavage, echocardiography, right-side cardiac catheterization, or lung biopsy are necessary to accurately evaluate the clinical status and allow to improve the management organ-specific ad hoc. Progress in immunological and vascular therapies as well as other emergence drugs offer new expectations to scleroderma patients. Copyright © 2006 Elsevier España S.L. Barcelona. Published by Elsevier Espana. All rights reserved.

  16. Granulomatosis de Wegener Semejando Cáncer Epidermoide de Nasofaringe y Metástasis Pulmonares.

    Directory of Open Access Journals (Sweden)

    Gustavo Adolfo Martín Small

    2011-01-01

    Full Text Available La granulomatosis de Wegener (GW es una enfermedad idiopática, con posible componente autoinmune, que aparece generalmente en la quinta década de vida, caracterizándose por lesiones granulomatosas necrotizantes y vasculitis en vías aéreas y riñón. Paciente femenino de 54 años, quien desde Noviembre del 2008, presenta rinorrea, prurito y eritema en borde nasal inferior izquierdo, recibe antibióticos sin mejoría de los síntomas. En las radiografías torácicas, se observan dos radiopacidades redondeadas, de 4 cm de diámetro, sugestivas de lesiones tumorales en ambos campos pulmonares. La biopsia reporta cáncer epidermoide de alto grado, sospechándose primario en nasofaringe. Es remitida, por deterioro de condiciones, al Servicio de Neumonología del Hospital Universitario de Caracas el 18/03/2009, presentando disnea, tos productiva, placas purpúricas dolorosas en manos y pies, hipoacusia, hiperpigmentación del paladar duro, leucoplaquias y lesiones costrosas en lengua, insuficiencia renal (creatinina en 6,11 mg/dL y trombocitopenia. En TAC de tórax, se evidencian tumores mayores de 5 cm de diámetro, algunos con bordes bien definidos y otros mal delimitados con broncograma aéreo. Diagnostico definitivo de GW por serología. La GW con su afectación sistémica puede simular otras entidades como neoplasias de cabeza y cuello con metástasis pulmonares. Cuando las manifestaciones sistémicas son floridas debe sospecharse GW como diagnóstico diferencial. Palabras claves: Wegener, Granulomatosis, Vasculitis, Cáncer epidermoide.

  17. Uso de óxido nítrico inhalado en la hipertensión pulmonar persistente del recién nacido

    Directory of Open Access Journals (Sweden)

    S. Carrera Muiños

    2016-06-01

    Full Text Available La hipertensión pulmonar persistente del recién nacido es el resultado de un fracaso o de una mala adaptación circulatoria al momento de nacimiento; y representa una falla respiratoria aguda con un aumento sostenido de la resistencia vascular pulmonar, generando cortos circuitos extrapulmonares de derecha a izquierda, a través del conducto arterioso y foramen oval, con hipoxemia severa y acidosis secundaria. La clave del tratamiento reside en lograr una rápida mejoría de la oxigenación y dilatación de la arteria pulmonar para revertir los cortos circuitos con el uso de vasodilatadores pulmonares, de los cuales el óxido nítrico es el único agente aprobado por la FDA para su uso en neonatos con hipertensión pulmonar persistente del recién nacido, y debe ser considerado como el tratamiento de primera línea. Esta revisión se centrará en qué es el óxido nítrico y su papel como tratamiento de la hipertensión pulmonar persistente del recién nacido.

  18. Hipertensión y edema pulmonar de altura: Rol de la disfunción endotelial y de la programación fetal

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    Marcos Schwab

    2012-04-01

    Full Text Available La altura constituye un fascinante laboratorio natural para la investigación médica. Si bien al principio el objetivo de la investigación en la altura fue la comprensión de los mecanismos de adaptación del organismo a la hipoxia y la búsqueda de tratamientos para las enfermedades relacionadas con la altura, durante la última década el alcance de esta investigación se ha ampliado considerablemente. Dos importantes observaciones han generado las bases para el crecimiento del alcance científico de la investigación en la altura. Primero, el hecho de que el edema pulmonar agudo de la altura constituye un modelo único para estudiar los mecanismos fundamentales de la hipertensión pulmonar y el edema pulmonar en humanos. Segundo, que la hipoxia ambiental asociada con la exposición a la altura facilita la detección de disfunción vascular pulmonar y sistémica en un estadio precoz. Aquí revisaremos los estudios que, capitalizando estas observaciones, han llevado a la descripción de nuevos mecanismos subyacentes del edema pulmonar y de la hipertensión pulmonar, y a la primera demostración directa de la existencia de una programación fetal sobre la disfunción vascular en humanos.

  19. COMPOSICIÓN DEL SURFACTANTE, DESARROLLO PULMONAR Y PRUEBAS DE MADURACIÓN EN EL FETO.

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    Ariel Iván Ruiz-Parra

    2010-01-01

    Full Text Available

    Resumen

    El surfactante pulmonar es una sustancia tensoactiva producida por los neumocitos tipo II, cuya concentración en el recién nacido prematuro/ inmaduro está disminuída, llevando a la producción del síndrome de dificultad respiratoria. El surfactante está constituído en un 85% por lípidos, del tipo fosfolípidos en su mayoría. El resto son proteínas surfactantes.

    Los fosfogliceridos (lecitinas y la esfingomielina forman el grupo de fosfolipidos involucrados. La fosfatidil colina y la dipalmitoil fosfatidil colina son las lecitinas más abundantes en el líquido extracelular que recubre los alvéolos pulmonares normales y en el surfactante pulmonar que disminuye su tensión superficial. Así se evita la atelectasia al final de la fase espiratoria de la respiración. En el neumocito II, enzimas remodelan las diferentes lecitinas para convertirlas en dipalmitoil fosfatidil colina.

    Una vez que el surfactante es producido en el neumocito, esta substancia migra como “cuerpos la melares” desde el núcleo hasta la superficie apical de la célula desde donde es liberado por exocitosis dentro del alveolo.

    Menos de un 0.1% de los recién nacidos presentan Síndrome de Dificultad Respiratoria (llamado antiguamente Enfermedad de Membrana Hialina cada año, y alrededor de un 10 % de estos mueren. La administracion de corticoesteroides incrementa la madurez pulmonar en casos de riesgo de parto prematuro, o cuando es necesario realizar una cesárea lo más temprano posible. El tratamiento de los bebes prematuros que presentan SDR incluye la administración de surfactantes dentro del árbol traqueobronquial.

    El patrón oro de la determinación de madurez pulmonar fetal es la relación lecitina/esfingomielina (L/E, aunque hay algunas otras pruebas como la medición de cuerpos la melares, que resultan confiables, económicas y más fácilmente disponibles en hospitales de menor categor

  20. Acúfeno unilateral: Presentación de un caso UNILATERAL ACOUSMA. A CASE REPORT

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    Eulalia Alfonso Muñoz

    2004-06-01

    Full Text Available El estudio detallado de los pacientes con acúfeno unilateral es de gran importancia, sobre todo cuando se trata de pacientes en la cuarta década de su vida, sin patología auditiva demostrable e hipoacusia neurosensorial asimétrica. Es indispensable en estos casos descartar el origen coclear o no del daño auditivo, y la tomografía axial computadorizada comparativa de peñascos o en su defecto, los rayos X mastoides en diferentes vistas, nos definirán si existen tumoraciones o anomalías vasculares.The thorough study of the patients with unilateral acousma is very important, mainly when patients are in the fourth decade of life, without demonstrable auditive pathology and asymmetric neurosensorial hypoacusia. It is indispensable in these cases to discard the cochlear origin or not of the auditive damage. The computerized axial tomography of the petrous portions of the temporal bone, or the mastoideal X- rays in different views, will define if there are vascular tumours or abnormalities.

  1. Ultrasound biomicroscopy in patients with unilateral pseudoexfoliation

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    Erkan Ünsal

    2015-08-01

    Full Text Available AIM: To compare the anterior segment morphology evaluated using ultrasound biomicroscopy (UBM in patients with clinical pseudoexfoliation syndrome (XFS in one eye and no clinical XFS in the fellow eye.METHODS: Thirty patients with unilateral XFS were included in the study. All patients underwent evaluation of their anterior segment using UBM with and without dilatation with 1% cyclopentolate. The anterior chamber depth (ACD, lens thickness (LT, anterior chamber angle (ACA, ciliary body thickness (CBT, scleral thickness (ST, trabeculae -ciliary processes distance (T-CPD, and iris-ciliary processes distance (I-CPD were measured using UBM scans. All results between the eyes with clinical XFS and their fellow eyes without clinical XFS were then compared.RESULTS: Before dilatation the eyes with XFS (4.350±0.531 mm were found to have a significantly thicker lens (P=0.002 than the eyes without XFS (4.238±0.540 mm. In addition after dilatation, the eyes with XFS (4.310±0.500 mm were found to have a significantly thicker lens than the eyes without XFS (4.160±0.480 mm (P=0.019. The average ACD, for the group with XFS, comparing pre-dilatation (2.616±0.349 mm and post-dilatation measurements (2.714±0.413 was found to be statistically increased (P=0.014. The average ACD, comparing pre-dilatation to post-dilatation measurements in patients without XFS (2.680±0.360, (2.720±0.500 was found to be statistically unchanged (P=0.450.DISCUSSION: Crystalline lenses tended to be thicker in the eyes with clinical pseudoexfoliation than their fellow eyes without pseudoexfoliation.

  2. Opacidades em vidro fosco nas doenças pulmonares difusas: correlação da tomografia computadorizada de alta resolução com a anatomopatologia Ground-glass opacity in diffuse lung diseases: high-resolution computed tomography-pathology correlation

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    Maria Lúcia de Oliveira Santos

    2003-12-01

    Full Text Available Opacidade em vidro fosco é achado freqüentemente visto na tomografia computadorizada de alta resolução do tórax e se traduz pelo aumento do coeficiente de atenuação dos pulmões, mas sem apagar as marcas broncovasculares. Por sua inespecificidade, a associação com outros achados radiológicos, clínicos e anatomopatológicos deve ser considerada para uma interpretação diagnóstica mais correta. Neste trabalho foram analisados 62 exames tomográficos de pacientes com doenças pulmonares difusas, de 14 etiologias diferentes, em que opacidades em vidro fosco foram o achado único ou predominante, e feita correlação anatomopatológica por meio de biópsias ou necropsias. Na pneumocistose as opacidades em vidro fosco corresponderam, histologicamente, à ocupação alveolar por material espumoso contendo parasitos; no carcinoma bronquíolo-alveolar, a espessamento dos septos alveolares e ocupação de sua luz por muco e células tumorais; na paracoccidioidomicose, a espessamento dos septos alveolares, áreas de fibrose e alvéolos contendo exsudato broncopneumônico; na sarcoidose, a fibrose ou a acúmulo de granulomas; na fibrose pulmonar idiopática, a espessamento dos septos alveolares por fibrose; na bronquiolite obliterante com pneumonia em organização, a pneumonia intersticial com áreas de organização intra-alveolar. A ocupação alveolar por sangue foi observada nos casos de leptospirose, hemossiderose idiopática, metástases de tumor renal e na aspergilose invasiva; por vacúolos de gordura na pneumonia lipídica; por material protéico e lipoprotéico na silicoproteinose e na proteinose alveolar; e por líquido de edema na insuficiência cardíaca congestiva.Ground-glass opacity is a finding frequently seen in high-resolution computed tomography examinations of the chest and is characterized by hazy increased attenuation of lung, however without blurring of bronchial and vascular margins. Due to its unspecificity

  3. Dímero-D y resultados clínicos a corto plazo en el embolismo pulmonar: papel del tamaño del coágulo en la arteria pulmonar

    OpenAIRE

    García Gómez, Raquel

    2013-01-01

    Introducció: Existeixen factors pronòstics en el embolisme pulmonar (EP) que influeixen en la gravetat del mateix i és necessari estudiar-los. -Objectiu: comparar nivells de dímer-D amb la grandària del coàgul en l'artèria pulmonar en pacients amb EP. -Material i mètodes: Cohorts retrospectiu en pacients amb EP simptomàtic entre 2008-2010 en un hospital comarcal. -Resultats: Els nivells de dímer-D van ser de 4068±2764 ng/ml. En el 46,9% el coàgul es va situar centralment, en el 31,3% va ser s...

  4. Hipertensão pulmonar secundária à fístulas coronarianas para tronco da pulmonar Pulmonary hypertension secondary to coronary-to-pulmonary artery fistula

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    José Ramos Filho

    2008-08-01

    Full Text Available A fístula coronariana é uma anomalia caracterizada por comunicação entre uma artéria coronária e uma câmara cardíaca, artéria pulmonar, seio coronariano e veias pulmonares. Representa 0,2% a 0,4 % das cardiopatias congênitas e 0,1% a 0,2% da população adulta submetida a angiografia coronariana. Relatamos o caso clínico de uma paciente com 64 anos, cuja anomalia foi diagnosticada durante investigação clínica por desconforto torácico, dispnéia e síncope, sendo indicada correção cirúrgica com abertura da artéria pulmonar através de circulação extracorpórea.The coronary fistula is an anomaly characterized by the communication between a coronary artery and a cardiac chamber, pulmonary artery, coronary sinus and pulmonary veins. It represents 0.2 to 0.4% of the congenital cardiopathies and 0.1% to 0.2% of the adult population submitted to coronary angiography. We report the clinical case of a 64-year-old female patient, whose anomaly was diagnosed during a clinical investigation due to chest discomfort, dyspnea and syncope; the surgical correction was indicated, with opening of the pulmonary artery through extracorporeal circulation.

  5. Preditores de mortalidade hospitalar em pacientes com embolia pulmonar estáveis hemodinamicamente Predictores de mortalidad hospitalaria en pacientes con embolia pulmonar estables hemodinámicamente Predictors of hospital mortality in hemodynamically stable patients with pulmonary embolism

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    André Volschan

    2009-08-01

    Full Text Available FUNDAMENTO: A embolia pulmonar apresenta alta mortalidade em pacientes com hipotensão arterial ou choque circulatório. Entretanto, em pacientes hemodinamicamente estáveis, a associação de algumas variáveis clínicas com a mortalidade ainda não está claramente estabelecida. OBJETIVOS: Derivar um modelo de estratificação do risco de mortalidade intra-hospitalar em pacientes com embolia pulmonar hemodinamicamente estáveis. MÉTODOS: Estudo de coorte multicêntrico prospectivo de 582 pacientes consecutivos que foram admitidos em unidades de emergência ou de terapia intensiva, com suspeita clínica de embolia pulmonar, e que tiveram o diagnóstico confirmado por meio de um ou mais dos seguintes exames: arteriografia pulmonar, angiotomografia computadorizada helicoidal, angioressonância magnética, ecodopplercardiograma, cintilografia pulmonar ou duplex-scan venoso. Os dados sobre características demográficas, comorbidades e manifestações clínicas foram coletados e incluídos em uma análise de regressão logística para compor o modelo de predição. RESULTADOS: A mortalidade global foi de 14,1%. Foram identificadas como variáveis independentes de risco de óbito: idade > 65 anos; repouso no leito > 72h; cor pulmonale crônico; taquicardia sinusal e taquipnéia. Após a estratificação por faixas de risco, observaram-se mortalidades de 5,4%, 17,8% e 31,3%, respectivamente nos subgrupos de baixo, moderado e alto riscos. O modelo mostrou sensibilidade de 65,5% e especificidade de 80%, com uma área sob a curva de 0,77. CONCLUSÃO: Em pacientes hemodinamicamente estáveis com embolia pulmonar, a idade > 65 anos, o repouso no leito > 72h, o cor pulmonale crônico, a taquicardia sinusal e a taquipnéia foram preditores independentes da mortalidade intra-hospitalar. Entretanto o modelo de predição necessita ser validado em outras populações para sua incorporação à prática clínica.FUNDAMENTO: La embolia pulmonar presenta alta

  6. Nocardiose pulmonar em portador de doença pulmonar obstrutiva crônica e bronquiectasias Pulmonary nocardiosis in a patient with chronic obstructive pulmonary disease and bronchiectasis

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    Miguel Abidon Aidê

    2008-11-01

    Full Text Available Relatamos o caso de um paciente com doença pulmonar obstrutiva crônica e bronquiectasias, em uso crônico de corticosteróides, que desenvolveu nocardiose pulmonar, sob a forma de múltiplos nódulos pulmonares escavados. Os sintomas principais foram a tosse produtiva com escarro purulento, febre e dispnéia A radiografia simples e a tomografia computadorizada do tórax mostravam nódulos em ambos os pulmões, alguns escavados. O exame direto de escarro e a cultura mostraram a presença de Nocardia spp. A paciente foi tratada com imipenem e cilastatina, com excelente resposta clínica.We report the case of a patient with chronic obstructive pulmonary disease and bronchiectasis, chronically using corticosteroids, who acquired pulmonary nocardiosis, which presented as multiple cavitated nodules. The principal symptoms were fever, dyspnea and productive cough with purulent sputum. Chest X-ray and computed tomography of the chest revealed nodules, some of which were cavitated, in both lungs. Sputum smear microscopy and culture revealed the presence of Nocardia spp. The patient was treated with imipenem and cilastatin, which produced an excellent clinical response.

  7. Árgon-plasma no tratamento de leiomioma benigno metastizante pulmonar: um caso clínico

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    A. Bugalho

    2010-11-01

    Full Text Available Resumo: Os leiomiomas benignos metastizantes pulmonares são tumores raros de células musculares lisas. Uma doente de 48 anos foi avaliada devido a tosse persistente, dispneia progressiva e sintomas constitucionais. A tomografi a computorizada do tórax revelou uma massa endobrônquica à esquerda, múltiplos nódulos do parênquima pulmonar e derrame pleural. As características histológicas da biopsia brônquica foram consistentes com o diagnóstico de leiomioma benigno metastizante. A doente foi submetida a árgon-plasma e desobstrução mecânica com efi cácia terapêutica. Verifi cou-se estabilidade clínica nos últimos quatro anos. Abstract: Benign metastasizing leiomyomas of the lung are rare smooth muscle cells tumours. We report the case of a 48 year-old female who was evaluated due to persistent cough, progressive dyspnoea and constitutional symptoms. Chest computed tomography revealed a left endobronchial mass, multiple parenchyma nodules and a pleural effusion. Bronchial biopsy histological features were consistent with benign metastasizing leiomyoma. The patient was successfully treated with argon-plasma and mechanical debulking. There was no disease relapse in the last four years. : PALAVRAS-CHAVE, Leiomioma benigno, metastizante, Neoplasias pulmonares, Diagnóstico, Broncoscopia, Tratamento, Tratamento árgon-plasma, KEYWORDS: Benign metastasizing, leiomyoma, Lung neoplasms, Diagnosis, Bronchoscopy, Management, Argon-plasma Treatment

  8. Nanorradiolipossomas modulados molecularmente para estudar a drenagem linfática pulmonar profunda

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    Maria Filomena Rabaça Roque Botelho

    2009-03-01

    Full Text Available Resumo: A drenagem linfática pulmonar profunda (DLPP desempenha um papel importante na remoção de materiais estranhos, constituindo os macrófagos alveolares a primeira linha de defesa fagocitária, dada a grande afinidade para microrganismos patogénicos. Os Bacillus subtilis são saprófitas do tracto respiratório humano com ampla utilização em investigação e em biotecnologia.As cadeias linfáticas pulmonares profundas (CLPP constituem um dos primeiros locais de disseminação de tumores pulmonares.Neste trabalho pretendeu-se desenvolver e validar um método não invasivo para avaliar as CLPP através de nanorradiolipossomas aerosolisados e modulados pela parede do esporo do Bacillus subtilis. O objectivo final foi produzir uma formulação de nanorradiolipossomas capaz de imitar a dinâmica da remoção de esporos pelas CLPP e simultaneamente ter propriedades ideais como traçador para imagiologia molecular.Testámos sete diferentes formulações lipossómicas, tendo a formulação F demonstrado possuir propriedades fisicoquímicas e radiofarmacêuticas que a tornam o traçador ideal para imagiologia molecular in vivo das CLPP.Os nanorradiolipossomas da formulação F após marcação com 99mTc-HMPAO foram administrados sob a forma de aerossóis a 20 Sus scrofa. Visualizaram-se comunicações hilares e interpulmonares nos primeiros 5 minutos após a inalação, as cadeias infradiafragmáticas entre os 10 e os 20 minutos, os gânglios da cadeia aórtica aos 20 minutos e os da região hilar renal aos 30 minutos.Em conclusão, o método proposto visualiza os gânglios linfáticos e a rede linfática pulmonar profunda. A modulação dos nanorradiolipossomas permite que eles atinjam órgãos ou tecidos específicos, conferindo-lhes importantes potencialidades no âmbito do diagnóstico e/ou da terapêutica.Rev Port

  9. The Unilateral Below Elbow Test: a function test for children with unilateral congenital below elbow deficiency.

    Science.gov (United States)

    Bagley, Anita M; Molitor, Fred; Wagner, Lisa V; Tomhave, Wendy; James, Michelle A

    2006-07-01

    The Unilateral Below Elbow Test (UBET) was developed to evaluate function in bimanual activities for both the prosthesis wearer and non-wearer. Nine tasks were chosen for each of four age-specific categories defined by development stages of hand function (2-4y, 5-7y, 8-10y, and 11-21y). Two scales, Completion of Task and Method of Use, were designed to rate performance. To measure reliability, four occupational therapists scored samples of videotaped UBET performances. For Completion of Task, an interval scale, agreement in scoring was measured with interclass correlation coefficients (ICC; n=9; five females, four males). For Method of Use, a nominal scale, chance-adjusted association was calculated with Cohen's kappa coefficients (interobserver n=198; 111 females, 87 males; intraobserver n=93; 56 females, 37 males). For Completion of Task, the average ICC was 0.87 for the prosthesis-on condition, and 0.85 for the prosthesis-off condition. ICCs exceeded 0.80 for eight out of nine tasks for the two older age groups, but for only five out of nine tasks in the younger age groups. Higher inter- and intraobserver kappa coefficients for Method of Use resulted when scoring children with their prostheses on versus off. The oldest age group had lower kappa values than the other three groups. The UBET is recommended for the functional evaluation of Completion of Task in children with unilateral congenital below elbow deficiency with and without their prostheses. Method of Use scoring can evaluate individuals for directed therapy interventions or prosthetic training.

  10. Utilização de endoprótese metálica no tratamento de estenose brônquica após transplante pulmonar Treatment of bronchial stenosis after lung transplantation using a self-expanding metal endobronchial stent

    Directory of Open Access Journals (Sweden)

    Marcos Naoyuki Samano

    2005-06-01

    Full Text Available As complicações decorrentes da anastomose brônquica nos transplantes pulmonares, embora tenham diminuído ao longo do tempo, ainda figuram como um dos principais fatores de morbi-mortalidade nesses pacientes. As formas de tratamento dessas complicações incluem dilatação por balão, fotocoagulação por laser, endopróteses de silicone e metálicas, e reoperação. Relata-se o caso de um paciente que apresentou estenose brônquica após transplante pulmonar unilateral esquerdo, cujo tratamento foi realizado com endoprótese metálica auto-expansível de nitinol (Ultraflex®. Embora seja um caso pioneiro no Brasil, a boa resposta clínica, concordante com os dados da literatura, sugere que esse tratamento seja uma boa alternativa nesses casos.Although the incidence of bronchial anastomosis as a complication of lung transplantation has decreased in recent years, it remains a significant cause of morbidity and mortality in these patients. Treatment options include balloon dilatation, laser photocoagulation, placement of a stent (silicone or metal, and performing a second operation. We report the case of a patient who presented bronchial stenosis after left lung transplantation and was treated with a self-expanding metal alloy (nitinol stent (Ultraflex®. Despite the fact that this was the first case of stenosis treated in this fashion in Brazil, the positive clinical response, in agreement with results reported in the literature, indicates that this treatment is a viable alternative in such cases.

  11. Disfunção do homoenxerto pulmonar utilizado na reconstrução do trato de saída do ventrículo direito

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    Andréa Weirich Lenzi

    2011-01-01

    Full Text Available FUNDAMENTO: O homoenxerto pulmonar tem sido utilizado como uma opção na correção de cardiopatia congênita com obstrução da via de saída do ventrículo direito. Os resultados em longo prazo, no entanto, mostram-se pouco satisfatórios. OBJETIVO: Identificar os fatores de risco associados à disfunção e à falência do homoenxerto pulmonar. MÉTODOS: Estudo em crianças submetidas à ampliação da via de saída do ventrículo direito com homoenxerto pulmonar. As variáveis clínicas, cirúrgicas, evolutivas e de aspectos morfológicos da prótese foram analisadas como fatores de risco. RESULTADOS: A amostra final de 75 pacientes com idade mediana na cirurgia de 22 meses, variando de 1-157 meses, apresentou 13 pacientes (17,0% que desenvolveram disfunção do homoenxerto, caracterizado por estenose ou insuficiência pulmonar grave. O tempo de ocorrência entre o implante do homoenxerto e a detecção da disfunção foi de 45 ± 20 meses. Quando o tamanho do homoenxerto foi menor de 21 mm e o escore Z da valva pulmonar foi menor do que zero, ou maior do que três, foram considerados fatores de risco para a ocorrência de disfunção. CONCLUSÃO: O homoenxerto pulmonar de tamanho menor do que 21 mm e a valva pulmonar inadequada para idade e peso do paciente são fatores determinantes para disfunção da prótese.

  12. Proposal of unilateral single-flux-quantum logic gate

    International Nuclear Information System (INIS)

    Mikaye, H.; Fukaya, N.; Okabe, Y.; Sugamo, T.

    1985-01-01

    A new type of single flux quantum logic gate is proposed, which can perform unilateral propagation of signal without using three-phase clock. This gate is designed to be built with bridge-type Josephson junctions. A basic logic gate consists of two one-junction interferometers coupled by superconducting interconnecting lines, and the logical states are represented by zero or one quantized fluxoid in one of one-junction interferometers. The bias current of the unequal magnitude to each of the two one-junction interferometers results in unilateral signal flow. By adjusting design parameters such as the ratio of the critical current of Josephson junctions and the inductances, circuits with the noise immunity of greater than 50% with respect to the bias current have been designed. Three cascaded gates were modeled and simulated on a computer, and the unilateral signal flow was confirmed. The simulation also shows that a switching delay about 2 picoseconds is feasible

  13. Prepubertal unilateral gynecomastia in the absence of endocrine abnormalities

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    Min Kang

    2014-09-01

    Full Text Available Gynecomastia is defined as the excessive development of breast tissue in males, which can occur as unilateral or bilateral. Although the overall prevalence of gynecomastia is 40%-65%, the prepubertal unilateral gynecomastia in the absence of endocrine abnormalities is unusual, with only a few case reports in literature. Idiopathic gynecomastia in prepuberty is benign but a diagnosis of exclusion. We here report two cases of healthy prepubertal boys aged 8.8 and 9.6 years old, respectively, presented with painful palpable mass in their unilateral breast. Breast tissue with glandular proliferation was confirmed on ultrasonography. Serum levels of estradiol, testosterone, and other laboratory findings were within normal range. They seem to have the prepubertal idiopathic gynecomastia but further follow-up to see their progression is needed.

  14. Unilateral perinephric pseudocyst of undetermined origin in a dog

    International Nuclear Information System (INIS)

    Miles, K.G.; Jergens, A.E.

    1992-01-01

    Unilateral perinephric pseudocyst of undetermined origin was diagnosed in a 131/2 year old dog with a history of recurrent urinary tract infections. A presumptive diagnosis of pseudocyst was based on radiographic and sonographic findings. In survey radiographs, asymmetrical unilateral renomegaly was seen. The mass was anechoic. There was absence of opacification of the mass during excretory urography. A celiotomy was performed for removal of the perinephric mass, and histologic review of this structure confirmed it to be a pseudocyst. Perinephric accumulation of fluid is a rare condition in domestic animals. Seven examples of perinephric pseudocysts have been previously reported in the cat. Predominant clinical findings include progressive abdominal distension and nonspecific signs of renal disease. The presence of unilateral or bilateral renomegaly is a characteristic radiographic feature. This clinical report describes the first case of perinephric pseudocyst diagnosed in the dog

  15. Unilateral proptosis as the initial manifestation of malignancy

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    K. Rakul Nambiar

    2017-09-01

    Full Text Available Proptosis, a common sign with a broad differential diagnosis, is defined as anterior displacement and protrusion of one or both orbital globes. Patients can present with varying degrees of chronicity, visual loss and associated symptoms. The etiology of acquired unilateral proptosis is diverse, ranging from benign to life-threatening. The causes of unilateral proptosis include traumatic, vascular, endocrine, inflammatory, infective and malignant. Breast carcinoma is the most common metastatic cause of proptosis; however, proptosis has never been reported as the initial manifestation of breast carcinoma. Our patient presented with unilateral proptosis secondary to an intraorbital lesion and histopathology of orbital lesion was suggestive of metastatic breast adenocarcinoma. She was later diagnosed to have primary breast carcinoma. We present this unusual case of a 56-year-old woman who presented with proptosis as the initial manifestation of a metastatic breast malignancy.

  16. Unilateral proptosis as the initial manifestation of malignancy.

    Science.gov (United States)

    Rakul Nambiar, K; Ajith, P S; Arjunan, Asha

    2017-09-01

    Proptosis, a common sign with a broad differential diagnosis, is defined as anterior displacement and protrusion of one or both orbital globes. Patients can present with varying degrees of chronicity, visual loss and associated symptoms. The etiology of acquired unilateral proptosis is diverse, ranging from benign to life-threatening. The causes of unilateral proptosis include traumatic, vascular, endocrine, inflammatory, infective and malignant. Breast carcinoma is the most common metastatic cause of proptosis; however, proptosis has never been reported as the initial manifestation of breast carcinoma. Our patient presented with unilateral proptosis secondary to an intraorbital lesion and histopathology of orbital lesion was suggestive of metastatic breast adenocarcinoma. She was later diagnosed to have primary breast carcinoma. We present this unusual case of a 56-year-old woman who presented with proptosis as the initial manifestation of a metastatic breast malignancy. Copyright © 2017 National Cancer Institute, Cairo University. Production and hosting by Elsevier B.V. All rights reserved.

  17. Actualizacin en el diagnstico y tratamiento de la hipertensin pulmonar Update in the diagnosis and treatment of pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Juan A. Mazzei

    2011-05-01

    Full Text Available El trmino hipertensin pulmonar agrupa a un conjunto heterogneo de enfermedades que tienen en comn una remodelacin obstructiva del lecho vascular pulmonar. Esta alteracin provoca un estado hemodinmico caracterizado por una elevacin sostenida de la presin del circuito arterial pulmonar. La morbilidad y mortalidad de esta enfermedad son la consecuencia del fracaso de la compensacin del ventrculo derecho a este aumento de la poscarga. La presuncin clnica y el diagnstico precoz, una estratificacin adecuada basada en las causas subyacentes y los diferentes territorios vasculares comprometidos, la respuesta a los frmacos y el grado de gravedad, la seleccin de las diferentes alternativas teraputicas y su indicacin oportuna son los objetivos para el tratamiento contemporneo ptimo de los enfermos con hipertensin pulmonar y ser una importante tarea en el futuro. Estas recomendaciones estn destinadas al mdico general y tienen por objeto facilitar la deteccin precoz, el diagnstico y el tratamiento de los pacientes con hipertensin pulmonar, y pueden representar una diferencia significativa en el pronstico. Adems, como la evaluacin diagnstica requiere exmenes complementarios que habitualmente no estn disponibles en todas las instituciones asistenciales, tambin pueden ser utilizadas como fundamento para solicitar la derivacin oportuna a centros asistenciales de referencia.The term pulmonary hypertension includes a heterogeneous group of disorders which produce an obstructive remodeling of the lung vessels characterized by a steady rise in pulmonary arterial pressure. The ensuing morbidity and mortality of this disease result from the failure of the right ventricle to compensate this increase in the after-load. The conditions to achieve an optimum treatment of pulmonary hypertension patients are: a clinical presumption and early diagnosis, an adequate stratification based on the underlying causes and the different vascular territories involved, the response to

  18. Sildenafil vs. Nitroprussiato de Sódio durante Teste de Reatividade Pulmonar pré-transplante cardíaco

    Directory of Open Access Journals (Sweden)

    Aguinaldo Figueiredo Freitas Jr

    2012-09-01

    Full Text Available FUNDAMENTO: A hipertensão pulmonar é associada ao pior prognóstico no pós-transplante cardíaco. O teste de reatividade pulmonar com Nitroprussiato de Sódio (NPS está associado a elevados índices de hipotensão arterial sistêmica, disfunção ventricular do enxerto transplantado e elevadas taxas de desqualificação para o transplante. OBJETIVO: Neste estudo, objetivou-se comparar os efeitos do Sildenafil (SIL e NPS sobre variáveis hemodinâmicas, neuro-hormonais e ecocardiográficas durante teste de reatividade pulmonar. MÉTODOS: Os pacientes foram submetidos, simultaneamente, ao cateterismo cardíaco direito, ao ecocardiograma e à dosagem de BNP e gasometria venosa, antes e após administração de NPS (1 - 2 µg/Kg/min ou SIL (100 mg, dose única. RESULTADOS: Ambos reduziram a hipertensão pulmonar, porém o nitrato promoveu hipotensão sistêmica significativa (Pressão Arterial Média - PAM: 85,2 vs. 69,8 mmHg, p < 0,001. Ambos reduziram as dimensões cardíacas e melhoraram a função cardíaca esquerda (NPS: 23,5 vs. 24,8 %, p = 0,02; SIL: 23,8 vs. 26 %, p < 0,001 e direita (SIL: 6,57 ± 2,08 vs. 8,11 ± 1,81 cm/s, p = 0,002; NPS: 6,64 ± 1,51 vs. 7,72 ± 1,44 cm/s, p = 0,003, medidas pela fração de ejeção ventricular esquerda e Doppler tecidual, respectivamente. O SIL, ao contrário do NPS, apresentou melhora no índice de saturação venosa de oxigênio, medido pela gasometria venosa. CONCLUSÃO: Sildenafil e NPS são vasodilatadores que reduzem, de forma significativa, a hipertensão pulmonar e a geometria cardíaca, além de melhorar a função biventricular. O NPS, ao contrário do SIL, esteve associado a hipotensão arterial sistêmica e piora da saturação venosa de oxigênio.

  19. Raquianestesia unilateral com bupivacaína hipobárica Raquianestesia unilateral con bupivacaína hipobárica Unilateral spinal anesthesia with hypobaric bupivacaine

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2002-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Um bloqueio simpático restrito durante raquianestesia pode minimizar as alterações hemodinâmicas. Teoricamente, o uso de soluções não isobáricas de anestésicos locais pode produzir anestesia unilateral e restringir a desnervação simpática a apenas um lado do corpo. A dose do anestésico local e o tempo que o paciente permanece em decúbito lateral para a realização da raquianestesia unilateral são desconhecidos. O presente estudo prospectivo investiga a incidência de raquianestesia unilateral utilizando bupivacaína a 0,15% preparada a partir de 1,5 ml de solução isobárica de bupivacaína adicionada de 25 µg fentanil, injetada através de agulha 27G tipo Quincke no paciente em decúbito lateral, com membro a ser operado voltado para cima. MÉTODO: Raquianestesia com 0,15% de bupivacaína mais fentanil foi realizada através da agulha 27G Quincke em 22 pacientes estado físico ASA I e II submetidos à cirurgias ortopédicas. A punção subaracnóidea foi realizada com o paciente previamente colocado com o lado a ser operado voltado para cima e foram retirados de 3 a 5 ml de LCR e injetados 5 ml da solução hipobárica na velocidade de 1 ml.15s-1. Bloqueios sensitivo e motor (picada de agulha e escala de 0 a 3 foram comparados entre os lados a ser operado e o contralateral. RESULTADOS: Os bloqueios motor e sensitivo entre o lado operado e o contralateral foram significativamente diferentes em todos os tempos em ambos os grupos. Raquianestesia unilateral foi obtida em 71% dos pacientes. Estabilidade hemodinâmica foi observada em todos os pacientes. Nenhum paciente desenvolveu cefaléia pós-raquianestesia. CONCLUSÕES: A bupivacaína hipobárica a 0,15% (7,5 mg associada ao fentanil proporciona um predominante bloqueio unilateral. Vinte minutos são suficientes para a instalação do bloqueio. As principais vantagens da raquianestesia unilateral são a estabilidade hemodinâmica, a satisfação do

  20. Anastomose cavo-pulmonar total sem uso de material protético

    Directory of Open Access Journals (Sweden)

    Valdester C. PINTO Jr.

    1998-07-01

    Full Text Available Objetivo: Demonstrar a viabilidade na feitura de túnel cava inferior-cava superior com retalho da parede atrial direita, evitando o emprego de material protético. Casuística e Métodos: Foram operados 2 pacientes nos quais se empregou a técnica de anastomose cavo-pulmonar total, sem uso de material protético. O primeiro caso, A.L.M., masc, 4 anos, 15 kg, era portador de atresia tricúspide (EP, com comunicação interventricular (CIV restritiva. O segundo caso, M.E.N.O., fem, 15 anos, 47 kg, tinha doença de Ebstein. O controle pós-operatório dos pacientes foi feito com ecocardiograma e cateterismo cardíaco. As operações foram realizadas com o emprego de circulação extracorpórea (CEC, e cardioplegia sangüínea como método de proteção miocárdica. A canulação das cavas foi o mais distal possível. A tunelização foi realizada com retalho de tecido atrial direito, suturado ao septo interatrial, deixando-se o seio coronariano e a comunicação interatrial (CIA para a esquerda. Resultados: Ambos os pacientes evoluíram, sem complicações, na UTI. O primeiro apresentou derrame pleural discreto à direita, e o segundo mantém-se em estimulação artificial (VVI,R. Conclusões: A tunelização intra-atrial para anastomose cavo-pulmonar total pode ser realizada sem o uso de material protético, evitando-se os riscos advindos do seu emprego (calcificação, retração, embolização.The authors describe two cases (one tricuspid atresia without TGA or pulmonary stenosis, but with a restrictive IVC: the second of an Ebstein disease of total cavo-pulmonary anastomosis using only the tissue of the atrial wall, avoiding any prosthetic material. Both cases were done under cardiopulmonary bypass and cold blood cardioplegia. A flap of the right atrial wall was used to re-direct the blood flow. Pleural effusion in one patient and complete AV block in the other were the complications found. They conclude that right intra-atrial tunneling for

  1. Rol de la Prostaciclina y sus derivados en el tratamiento de la hipertension arterial pulmonar

    Directory of Open Access Journals (Sweden)

    j. O. Caneva

    2003-06-01

    Full Text Available La hipertensión arterial pulmonar (HTP es definida como un grupo de enfermedades caracterizadas por un aumento progresivo de la resistencia vascular pulmonar que conduce a fallo ventricular derecho y muerte. Se ha demostrado en pacientes con HTP y en modelos experimentales una desregulación en la vía metabólica de la prostaciclina. Recientemente, la terapia continua endovenosa con prostaciclina (epoprostenol ha demostrado mejorar los síntomas y el pronóstico en los pacientes con clase funcional III y IV de la New York Heart Association (NYHA, con diferentes tipos de HTP. Sin embargo, la administración de epoprostenol requiere métodos invasivos con un catéter endovenoso permanente y está asociado a varios efectos colaterales y potencialmente a complicaciones serias. Se están considerando en la actualidad otros tratamientos con prostaciclina, utilizando análogos estables de la misma administrados por inhalación (iloprost, en forma subcutánea (treprostinil o por vía oral (beraprost. En los últimos años, diferentes estudios internacionales, multicéntricos, doble ciego, han demostrado la eficacia de esos análogos estables en HTP comparados con la terapia convencional, prometiendo un futuro mejor para estos pacientes.Pulmonary arterial hypertension (PAH is defined as a group of diseases characterised by a progressive increase of pulmonary vascular resistance leading to right ventricular failure and death. A dysregulation of prostacyclin metabolic pathways has been demonstrated in patients with PAH and in experimental models. Recently, therapy with continuous intravenous prostacyclin (epoprostenol has been shown to improve symptoms and prognosis in New York Heart Association (NYHA functional class III and IV patients with different types of PAH. However, epoprostenol administration requires invasive methods with a permanent intravenous catheter and is associated with several side effects and potentially serious complications. Other

  2. Unilateral versus bilateral stent insertion for malignant hilar biliary obstruction.

    Science.gov (United States)

    Chang, Gang; Xia, Feng-Fei; Li, Hong-Fu; Niu, Su; Xu, Yuan-Shun

    2017-11-01

    To determine the clinical efficiency and long-term outcomes between unilateral and bilateral stent insertion in patients with malignant hilar biliary obstruction. From August 2012 to February 2016, 63 consecutive patients with malignant hilar biliary obstruction were treated with unilateral or bilateral stent insertion at our center. The bilateral stents were inserted using the side-by-side technique. The clinical efficiency and long-term outcomes were compared between the two groups. Unilateral and bilateral stent insertions were successfully performed in 31 of 33 and 27 of 30 patients, respectively (P = 0.912). No procedure-related complication occurred. Clinical success was achieved in 29 of 31 patients in the unilateral stent group and in 26 of 27 patients in the bilateral stent group (P = 0.637). During the follow-up, re-obstruction of stent occurred in five patients in the unilateral stent group and in three patients in the bilateral stent group (P = 0.58). The significant differences were not observed in the stent patency time (368 vs. 387 days, P = 0.685) and survival (200 vs. 198 days, P = 0.751) between two groups. Based on the univariate and multivariate analyses, the independent risk factors for decreasing the survival time included higher Eastern Cooperative Oncology Group performance status (P = 0.018), higher alanine aminotransferase level (P = 0.009), and absence of anticancer treatment after stent insertion (P = 0.002). Compared to bilateral stent insertion for malignant hilar biliary obstruction, unilateral stent insertion can provide comparable clinical efficiency and long-term outcomes.

  3. Two consecutive levels of unilateral cervical spondylolysis on opposite sides

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Kyeong Hwa; Kim, Seon Jeong; KIm Ok Hwa; Kim, Seung Ho; Lee, Kwang Hwi; Beak, Hye Jin; Lee, Ye Daun [Dept. of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan (Korea, Republic of); Cha, Yoon Ki [Dept. of Radiology, Dongguk University College of Medicine, Ilsan Hospital, Goyang (Korea, Republic of)

    2015-09-15

    Cervical spondylolysis, with or without spondylolisthesis, is a rare condition defined as a corticated cleft between the superior and inferior articular facets of the articular pillar. The defect occurs predominantly at C6, and is usually bilateral in up to two-thirds of cases. Multilevel involvement is uncommon, however, to date, no case of two consecutive levels of unilateral cervical spondylolysis on opposite sides has been reported. Here, we report a rare case of a patient affected by two consecutive levels of unilateral cervical spondylolysis at C5 and C6 on opposite sides in a 19-year-old male complaining of neck pain.

  4. Complete dorsal pancreatic agenesis and unilateral renal agenesis.

    Science.gov (United States)

    Moreira, Adriana; Carvalho, André; Portugal, Inês; Jesus, José Miguel

    2018-02-01

    Dorsal pancreatic agenesis is a very rare congenital anomaly. Unilateral renal agenesis, on the other hand, is a relatively common congenital anomaly, although its etiology is not fully understood. Renal and pancreatic embryologic development appears to be nonrelated. We report a case of a 34-year-old man who was referred to our hospital for evaluation of cholestasis and microalbuminuria. Ultrasound and magnetic resonance imaging examinations showed empty right renal fossa and absence of the pancreatic neck, body, and tail. Our case report is the second case of a dorsal pancreatic agenesis and unilateral renal agenesis in a young male patient.

  5. Compensatory renal hypertrophia in patients undergoing unilateral nephrectomy

    DEFF Research Database (Denmark)

    Mogensen, P; Munck, O; Tonnesen, K H

    1977-01-01

    Estimations of the residual glomerular filtration rate (GFR) were made from renography and GFR measurements before unilateral nephrectomy in 28 patients aged 42-77 years. The GFR was measured one week and three months after the operation and comparisons were made between the function of the remai......Estimations of the residual glomerular filtration rate (GFR) were made from renography and GFR measurements before unilateral nephrectomy in 28 patients aged 42-77 years. The GFR was measured one week and three months after the operation and comparisons were made between the function...

  6. Retinose pigmentar unilateral ou pseudorretinose pigmentar?: relato de caso

    Directory of Open Access Journals (Sweden)

    Daniela Fernandes de Carvalho Rios

    Full Text Available A retinose pigmentar unilateral é uma doença rara caracterizada pela perda de fotorreceptores e deposição de pigmento na retina sem acometimento do olho contralateral. Apesar de descrita há mais de cem anos sua existência ainda é questionada. Este artigo relata o caso de um paciente com alterações sugestivas de retinose pigmentar unilateral. Os aspectos clínicos e os exames complementares são discutidos.

  7. Distortion of maximal elevator activity by unilateral premature tooth contact

    DEFF Research Database (Denmark)

    Bakke, Merete; Møller, Eigild

    1980-01-01

    In four subjects the electrical activity in the anterior and posterior temporal and masseter muscles during maximal bite was recorded bilaterally with and without premature unilateral contact. Muscle activity was measured as the average level and the peak of the mean voltage with layers of strips...... of 0.05, 0.10, 0.15 and 2.0 mm, placed between first molars either on the left or the right side, and compared with the level of activity with undistrubed occlusion. Unilateral premature contact caused a significant asymmetry of action in all muscles under study with stronger activity ipsilaterally...

  8. Contralateral flow reduction in unilateral stroke: evidence for transhemispheric diaschisis

    International Nuclear Information System (INIS)

    Lagreze, H.L.; Levine, R.L.; Pedula, K.L.; Nickles, R.J.; Sunderland, J.S.; Rowe, B.R.

    1987-01-01

    Using clinical presentation, angiography, computed tomography, and nuclear magnetic resonance imaging, 7 patients were identified who had strictly unilateral hemispheric infarction and unilateral cerebrovascular disease. In 6, cerebral blood flow measured by fluorine-18-fluoromethane inhalation and positron emission tomography was reduced in the contralateral hemisphere (p less than 0.05). Multiple regression analysis demonstrated a high correlation between contralateral flow reduction and the degree of flow impairment in the infarcted area (r = 0.941, p = 0.0014) but not with age, risk factor profile, blood pressure, PCO 2 , hematocrit, or duration of stroke. We conclude that transhemispheric diaschisis best explains the contralateral flow reduction seen in supratentorial ischemic stroke

  9. Two consecutive levels of unilateral cervical spondylolysis on opposite sides

    International Nuclear Information System (INIS)

    Ryu, Kyeong Hwa; Kim, Seon Jeong; KIm Ok Hwa; Kim, Seung Ho; Lee, Kwang Hwi; Beak, Hye Jin; Lee, Ye Daun; Cha, Yoon Ki

    2015-01-01

    Cervical spondylolysis, with or without spondylolisthesis, is a rare condition defined as a corticated cleft between the superior and inferior articular facets of the articular pillar. The defect occurs predominantly at C6, and is usually bilateral in up to two-thirds of cases. Multilevel involvement is uncommon, however, to date, no case of two consecutive levels of unilateral cervical spondylolysis on opposite sides has been reported. Here, we report a rare case of a patient affected by two consecutive levels of unilateral cervical spondylolysis at C5 and C6 on opposite sides in a 19-year-old male complaining of neck pain

  10. Angiografia carótido-vértebro-braquial com hiperpressão pulmonar

    Directory of Open Access Journals (Sweden)

    Joel M. Guelmann

    1964-12-01

    Full Text Available São feitas considerações sôbre as várias técnicas para visibilização angiográfica do sistema vértebro-basilar e dos grandes troncos arteriais do pescoço, sendo analisadas suas dificuldades e complicações. A punção percutânea das artérias braquial direita ou esquerda com auxílio da hiperpressão pulmonar, possibilitou visibilizar fàcilmente o sistema arterial encefálico desde a sua origem no arco aórtico até sua distribuição intracraniana. Em 18 dos 20 casos submetidos a esta técnica, os resultados foram bons ou ótimos. Não ocorreram complicações. A simplicidade técnica e a perfeita visibilização dos grandes vasos arteriais do pescoço, do sistema vertebral e do carotídeo intracraniano constituem as vantagens dêste método sôbre os demais.

  11. Terapêutica do carcinoma pulmonar não de pequenas celulas

    Directory of Open Access Journals (Sweden)

    Renato Sotto-Mayor

    2002-05-01

    Full Text Available RESUMO: No presente artigo de revisão o autor aborda a terapêutica do carcinoma pulmonar nao de pcquenas células em função do estádio de apresentação da doença, dando especial relevo à sua abordagem multidisciplinar, no sentido de ultrapassarmos o mau prognóstico que o seu diagnóstico ainda acarreta.Discute o Iugar das diferentes modalidades terapêuticas, a terapeutica da recidiva e da progressão tumorais, a do cancro do pulmao no doente idoso, o papel dos novos fármacos e as potencialidades dos novos alvos terapêuticos a nivel da biologia celular e molecular.REV PORT PNEUMOL 2002; Vlll (3: 237-259 ABSTRACT: In the present paper, the author reviews the non-small-cell lung cancer treatment by stages of disease.He states about the therapeutic strategies involving surgery, radiation therapy and chemotherapy, the important role of the multimodality approach of the patients, the relapsing and refractory tumor, the elderly patient, the new drugs, and the potential role of new gene and cell­ -based therapies.REV PORT PNEUMOL 2002; VIII (3: 237-259 Palavras-chave: carcinoma do pulmão, terapêutica, Key-words: Lung cancer, therapeutic

  12. Necessidades em saúde segundo percepções de pessoas com tuberculose pulmonar

    Directory of Open Access Journals (Sweden)

    Paula Hino

    Full Text Available O presente estudo teve como objetivo conhecer as percepções sobre necessidades em saúde de pessoas com tuberculose pulmonar. Trata-se de estudo qualitativo, desenvolvido no distrito administrativo Capão Redondo, São Paulo. Os dados foram coletados em janeiro de 2010 por meio de entrevista semidiretiva. Foram entrevistadas onze pessoas em tratamento contra tuberculose, com idade mínima de 18 anos e sem limites de cognição. O material empírico foi decodificado a partir de técnica de análise de discurso. As percepções sobre necessidades em saúde estão relacionadas às dificuldades enfrentadas no processo saúde-doença, e o reconhecimento das necessidades em saúde mostrou-se condicionado à vigência do agravo à saúde. As necessidades identificadas decorrem de alterações biológicas, do cotidiano e de insuficiências no processo de produção dos serviços de saúde. A qualidade da assistência às pessoas com tuberculose está, entre outros fatores, condicionada à identificação e ao atendimento de suas necessidades em saúde.

  13. Granuloma macular por tuberculose sem manifestação pulmonar

    Directory of Open Access Journals (Sweden)

    Albert Costa Rebello

    2015-08-01

    Full Text Available RESUMO Tuberculose é uma doença infecciosa causada pelo Mycobacterium tuberculosis, também conhecido como bacilo de Koch. O principal sítio de acometimento é o pulmonar, porém o bacilo pode disseminar-se por via linfo-hematogênica para outros órgãos, dentre eles o olho. A incidência de tuberculose ocular é de 1 a 2% dos casos extrapulmonares. Os autores apresentam um caso clínico de um paciente do sexo feminino de 28 anos que procura atendimento médico devido à redução da acuidade visual em olho esquerdo há 7 dias. Apresentava a melhor acuidade visual corrigida no olho acometido de 20/200 e no olho contralateral de 20/20. Na fundoscopia era evidenciado um granuloma em área macular do olho esquerdo, com edema e hemorragia intrarretiniana adjacente. Após investigação diagnóstica, a paciente foi tratada com esquema antibiótico para tuberculose durante 6 meses, obtendo regressão do granuloma e melhora da acuidade visual deste olho para 20/50.

  14. Enfoque de la hipertensión pulmonar en el paciente pediátrico

    Directory of Open Access Journals (Sweden)

    Lina María Caicedo-Cuenca

    2017-09-01

    Full Text Available Si bien la enfermedad vascular pulmonar hipertensiva en niños comparte similitudes con la de los adultos, difiere de manera relevante en cuanto a fisiopatología, presentación y tratamientos, ya que se ven involucrados aspectos del desarrollo, perinatales y etiologías múltiples. Solo recientemente se dispone de guías y consensos específicos que se discuten en este artículo, la mayoría con menor nivel de evidencia que los de adultos, como es usual en la edad pediátrica. Se presentan algoritmos diagnósticos específicos para el grupo etario, dadas las patologías más frecuentes, con énfasis en la importancia del cateterismo cardiaco idealmente como último estudio diagnóstico. El tratamiento se enfoca según el grupo etiológico, pero, a diferencia del de los adultos, el flujograma no se establece por clase funcional sino por escala de riesgo.

  15. Mascarilla N95: una medida útil en la prevención de la tuberculosis pulmonar

    Directory of Open Access Journals (Sweden)

    JL Castañeda-Narváez

    2017-03-01

    Full Text Available La tuberculosis es una enfermedad que implica un riesgo ocupacional para el personal de salud que atiende a este tipo de pacientes, debido a que el agente Mycobacterium tuberculosis es eliminado hacia el ambiente a través de diferentes acciones como la tos, el estornudo, el acto de escupir, cantar o incluso la conversación. Las pequeñas gotas que se generan se evaporan rápidamente y se convierten en aerosoles de pequeñas partículas que, por su tamaño (1 a 3 μm, permanecen en suspensión y pueden ser transportadas, según el flujo del aire, a través de la habitación o de un edificio. El tamaño reducido facilita su llegada a los alvéolos pulmonares y el riesgo de transmisión está confinado a los que comparten lugares cerrados y mal ventilados, debido a la gran concentración de aerosoles en ese espacio.

  16. Systematic review: diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism.

    NARCIS (Netherlands)

    Kempers, M.J.E.; Lenders, J.W.M.; Outheusden, L. van; Wilt, G.J. van der; Schultze Kool, L.J.; Hermus, A.R.M.M.; Deinum, J.

    2009-01-01

    BACKGROUND: Computed tomography (CT), magnetic resonance imaging (MRI), and adrenal vein sampling (AVS) are used to distinguish unilateral from bilateral increased aldosterone secretion as a cause of primary aldosteronism. This distinction is crucial because unilateral primary aldosteronism can be

  17. Brief communication : Unilateral blindness and low vision due to ...

    African Journals Online (AJOL)

    1995-11-15

    To assess the magnitude of unilateral blindness or low vision caused by strabismic amblyopia in astrabismic population, a prospective study was conducted between November 15, 1995 and March 20, 1997 at Menelik II Hospital. The visual acuity of 361 patients with strabismus was evaluated. The average age of ...

  18. A case of Todd's Palsy following unilateral electroconvulsive therapy

    Science.gov (United States)

    Bell, Christine; Lepping, Peter; Clifford, John; Gardner-Thorpe, Catherine

    2012-01-01

    This case describes a woman undergoing unilateral electroconvulsive therapy (ECT) who developed a Todd's Palsy following the treatment, and which resolved when converted to bilateral ECT. We go on to hypothesize that this rare side effect may be an indication of the need to switch laterality during a course of ECT. PMID:22988330

  19. Unilateral nodular adrenal hyperplasia: Case series | Kot | African ...

    African Journals Online (AJOL)

    Introduction: Nodular adrenal hyperplasia is one of rare causes of adrenocortical hyperplasia. The disease usually presents bilaterally. Few publications discussed the possibility of unilateral disease, in association with hyperaldosteronism or Cushing syndrome. Case series: We are reporting 3 cases of radiologically ...

  20. A case of congenital unilateral absence of the vas deferens

    Directory of Open Access Journals (Sweden)

    Mo B

    2013-04-01

    Full Text Available Bi Mo,1 Vishnu Garla,2 Lawrence M Wyner1 1Department of Surgery, 2Department of Internal Medicine, Marshall University, Huntington, WV, USA Background: Congenital unilateral absence of the vas deferens occurs in 0.5%–1.0% of males. It has been associated with various genitourinary abnormalities, including renal agenesis. We report a case of congenital unilateral absence of the vas deferens found incidentally during vasectomy in a patient with known unilateral renal agenesis. Case presentation: A 24-year-old male presented to our urology clinic requesting vasectomy. His past history was significant for left renal agenesis. Following successful right vasectomy, several attempts to locate the left vas deferens were unsuccessful. We diagnosed congenital unilateral absence of the vas deferens. Follow-up semen analysis showed azoospermia. Conclusion: As vasectomies are increasingly performed in outpatient settings, it is imperative that physicians be aware of this condition, which can be recognized by a simple physical exam. Recognition could prevent unnecessary surgery and prompt providers to investigate for associated abnormalities. Keywords: vas deferens, embryology, abnormalities, surgery

  1. Muscle Activity during Unilateral Vs. Bilateral Battle Rope Exercises

    DEFF Research Database (Denmark)

    Calatayud, J.; Martin, F.; Colado, J. C.

    2015-01-01

    Calatayud, J, Martin, F, Colado, JC, Benitez, JC, Jakobsen, MD, and Andersen, LL. Muscle activity during unilateral vs. bilateral battle rope exercises. J Strength Cond Res 29(10): 2854-2859, 2015High training intensity is important for efficient strength gains. Although battle rope training is m...

  2. Comparison of two doses of hypobaric bupivacaine in unilateral ...

    African Journals Online (AJOL)

    Introduction: Hip fracture is a frequent and severe disease. Its prognosis depends on the perioperative hemodynamic stability which can be preserved by the unilateral spinal anesthesia especially with low doses of local anesthetics. This study aims to compare the efficacy and hemodynamic stability of two doses of ...

  3. The nose in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    Verwoerd, C. D.; Mladina, R.; Nolst Trenité, G. J.; Pigott, R. W.

    1995-01-01

    Surgeons and orthodontists are still challenged to achieve 'better' noses for children with a unilateral cleft or lip, alveoulus and palate (UCLP). Various aspects are discussed: infant anatomy and later changes, developmental mechanics, cleft syndrome in animals with surgically produced facial

  4. Hyperacute unilateral contrast-induced parotiditis during cerebral angiography

    Directory of Open Access Journals (Sweden)

    Song J. Kim, MD

    2018-02-01

    Full Text Available An uncommon complication of iodinated contrast administration is the development of bilateral sialadenitis. We report a unique case of hyperacute unilateral parotiditis during diagnostic cerebral angiography of the external carotid artery, which mimicked possible iatrogenic vascular event associated with cerebral endovascular procedures. Discussion includes the differential diagnosis, diagnostic studies, and treatments for this unusual condition.

  5. Early neurological signs in preterm infants with unilateral intraparenchymal echodensity

    NARCIS (Netherlands)

    Cioni, G; Bos, AF; Einspieler, C; Ferrari, F; Martijn, A; Paolicelli, PB; Rapisardi, G; Roversi, MF; Prechtl, HFR

    2000-01-01

    The aim of the study was to document the early developmental course of neurological signs in a group of preterm infants at risk for hemiplegia due to unilateral intraparenchymal echodensity (UIPE). Sixteen preterm infants with UIPE and sixteen controls were given serial neurological examinations,

  6. Carbon Leakage Revisited : Unilateral Climate Policy with Directed Technical Change

    NARCIS (Netherlands)

    Di Maria, C.; van der Werf, E.H.

    2005-01-01

    The increase in carbondioxide emissions by some countries in reaction to an emission reduction by countries with climate policy (carbon leakage) is seen as a serious threat to unilateral climate policy.Using a two-country model where only one of the countries enforces an exogenous cap on emissions,

  7. Abnormal 201Tl limb scan due to unilateral tremor

    International Nuclear Information System (INIS)

    Simons, M.; Schelstraete, K.; Bratzlavsky, M.

    1982-01-01

    A abnormal intra- and interextremity distribution pattern on 201 Tl was observed on the limb scan of a patient with a unilateral tremor. This is ascribed to the increased blood flow in the muscles responsible for the tremor. The suggestion is made that the existence of tremor should be considered as a possible explanation for unexpected abnormalities on 201 Tl limb scintigrams

  8. Treatment of unilateral giant fibroadenoma by breast reduction skin ...

    African Journals Online (AJOL)

    Background: Giant fibroadenoma (GFA) has been defined as fibroadenoma greater than 5 cm in it's the widest diameter and/or weighing more than 500 g. A benign lesion, its size also raises the possibility of malignancy requiring differentiation from a malignant breast disease. When unilateral GFA presents with a severe ...

  9. Unilateral Laryngeal Pacing System and Its Functional Evaluation

    Directory of Open Access Journals (Sweden)

    Taiping Zeng

    2017-01-01

    Full Text Available Goal. To establish a reliable instrumental system for synchronized reactivation of a unilaterally paralyzed vocal fold and evaluate its functional feasibility. Methods. Unilateral vocal fold paralysis model was induced by destruction of the left recurrent laryngeal nerve (RLN in anesthetized dogs. With a micro controller-based electronic system, electromyography (EMG signals from cricothyroid (CT muscle on the ipsilateral side were recorded and used to trigger pacing of paralyzed vocalis muscles. The dynamic movement of vocal folds was continuously monitored using an endoscope, and the opening and closing of the glottis were quantified with customized imaging processing software. Results. The recorded video images showed that left side vocal fold was obviously paralyzed after destructing the RLN. Using the pacing system with feedback triggering EMG signals from the ipsilateral CT muscle, the paralyzed vocal fold was successfully reactivated, and its movement was shown to be synchronized with the healthy side. Significance. The developed unilateral laryngeal pacing system triggered by EMG from the ipsilateral side CT muscle could be successfully used in unilateral vocal fold paralysis with the advantage of avoiding disturbance to the healthy side muscles.

  10. Enlarged thalamostriate vein causing unilateral Monro foramen obstruction. Case report.

    Science.gov (United States)

    Leonardo, Jody; Grand, Walter

    2009-06-01

    Causes of unilateral hydrocephalus resulting from an obstruction at the Monro foramen include foraminal atresia, tumors, gliosis, contralateral shunting, and infectious and inflammatory conditions. However, few reports in the literature cite vascular lesions as the cause of the obstruction. To their knowledge, the authors present the first report of unilateral hydrocephalus occurring due to an abnormally enlarged thalamostriate vein independent of an arteriovenous malformation or developmental venous angioma. The condition was treated successfully by endoscopic septum pellucidum fenestration. A 28-year-old man was referred for evaluation due to a 10-year history of chronic headaches that worsened in severity over the past year. A CT scan of the head revealed unilateral right ventricular dilation. Cranial MR imaging with and without contrast administration showed a dilated right thalamostriate-internal vein complex without any evidence of associated arteriovenous malformation or venous angioma. Endoscopic exploration of the right lateral ventricle showed an enlarged subependymal thalamostriate vein obstructing the Monro foramen. An endoscopic fenestration of the septum pellucidum was performed, resulting in alleviation of the patient's symptoms. Abnormally enlarged venous structures may cause obstructive unilateral hydrocephalus and can be a rare cause of chronic, intermittent headaches in adults. Endoscopic fenestration of the septum pellucidum is an effective treatment.

  11. Unilateral neglect syndrome after stroke: the role of Occupational Therapy

    Directory of Open Access Journals (Sweden)

    Tamara Pereira de Oliveira

    2014-09-01

    Full Text Available Unilateral Neglect Syndrome is one of the consequences of cerebral vascular accident (CVA generally following right parietal lobe lesion, leading to the impairment of perceptive visual, spatial and attention functions. The patient affected does not realize the environmental stimuli on the contralesional hemibody. Occupational therapy plays an important role in caring for this patient, seeking the recovery of perception, attention and social engagement. This study aimed to describe and evaluate the results of occupational therapy intervention and treatment in a single Unilateral Neglect Syndrome post CVA patient. Data were obtained from a survey of the patient’s medical records and interviews of his therapist and caretaker. The analysis of the patient’s medical records and his therapist’s report showed that the patient responded satisfactorily to treatment, presenting a decrease of the left unilateral neglect at the end of the study period. The favorable outcome of the patient outlined the relevance of evaluating the effects of Occupational Therapy interventions for clinical unilateral neglect syndrome.

  12. Traumatic glaucoma with features of unilateral pigment dispersion.

    Science.gov (United States)

    Bowler, Gordon; Ellul, Antony; Gouws, Pieter

    2014-01-01

    We report a patient with traumatic glaucoma with features of unilateral pigment dispersion. This rare form of secondary glaucoma has only been reported twice previously, with both patients demonstrating angle recession, indicating associated damage to the trabecular meshwork. To our knowledge, this is the first such case reported in which angle recession was absent.

  13. Socioeconomic and psychological impact of treatment for unilateral intraocular retinoblastoma.

    Science.gov (United States)

    Soliman, S E; Dimaras, H; Souka, A A; Ashry, M H; Gallie, B L

    2015-06-01

    To identify the socioeconomic and psychosocial impacts of clinical treatment decisions for advanced unilateral intraocular retinoblastoma. Retrospective observational case series. institutional study at Alexandria Main University Hospital. records of 66 unilateral retinoblastoma cases treated from May 2005 to May 2013 were retrospectively reviewed. Sixty cases were eligible (International Intraocular Retinoblastoma Classification [IIRC] group C, D or E). two treatment groups were compared: enucleation vs. salvage treatment. Salvage treatment eyes were further subdivided based on IIRC group. Six socioeconomic parameters (financial burden, financial impact, psychological, social, medical and tumor impacts) were scored. Parameter scores ranged from 0 to 3, for overall score range 0 (no adverse impact) to 18 (severe adverse impact). derived Socioeconomic scores were correlated with treatment and outcomes. The enucleation group (28 eyes) had a median overall Socioeconomic score of 4/18, significantly lower than the salvage treatment group (32 eyes), median score 11/18 (PSocioeconomic score varied with IIRC group. Attempted eye salvage failed in 25 children, due to uncontrolled tumor (44%) and socioeconomic impact of cumulative therapies (56%). Treatment duration and Socioeconomic score were higher for the 5 children in the salvage treatment group who developed metastatic disease compared to those without metastasis (Psocioeconomic and psychosocial impacts of attempted ocular salvage for unilateral intraocular retinoblastoma are severe, in comparison to primary enucleation. Primary enucleation is a good treatment for unilateral retinoblastoma. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. The nose in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    C.D.A. Verwoerd (Carel); R. Mladina (R.); G.J. Nolst-Trenité (Gilbert J.); R.W. Pigott (R.)

    1995-01-01

    textabstractSurgeons and orthodontists are still challenged to achieve ‘better’ noses for children with a unilateral cleft or lip, alveolus and palate (UCLP). Various aspects are discussed: infant anatomy and later changes, developmental mechanics, cleft syndrome in animals with surgically produced

  15. Unilateral maxillary molar distalization with zygoma-gear appliance.

    Science.gov (United States)

    Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

    2012-08-01

    The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  16. Causes And Pattern Of Unilateral Hand Injuries | Kaisha | East ...

    African Journals Online (AJOL)

    Objective: To assess the causes and pattern of hand injuries in patients with isolated unilateral acute hand injuries managed at the Kenyatta National Hospital (KNH). Design: A prospective cross-sectional descriptive study. Setting: Kenyatta National Hospital, Nairobi, Kenya, between May and August 2006. Subjects: All ...

  17. Unilateral liberalisation of services: a case study of the mobile phone sector in Bangladesh

    OpenAIRE

    Yusuf, Mohammad Abu

    2017-01-01

    Unilateral liberalisation of trade in goods and services has been considered an important policy objective. Most trade in services liberalisation in the developing world has taken place unilaterally; but it is not common among Least Developed Countries (LDCs). Among LDCs Bangladesh is a forerunner in pursuing unilateral liberalisation of mobile telephone services. There is a dearth of empirical studies on Bangladesh’s unilateral liberalisation of mobile phone services and its impact on use...

  18. Anuloplastia de homoenxerto pulmonar criopreservado com anel de Delrin na atresia pulmonar com comunicação interventricular Annuloplasty of cryopreserved pulmonary homograft with Delrin stent in pulmonary atresia with ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Ulisses Alexandre Croti

    2007-05-01

    Full Text Available Criança de seis anos portadora de atresia pulmonar com comunicação interventricular, submetida a correção total com um ano, empregando monoválvula de pericárdio bovino na reconstrução da via de saída do ventrículo direito. Evoluiu com importante regurgitação valvar pulmonar (RVP e disfunção do ventrículo direito. Na reoperação foi implantado homoenxerto pulmonar criopreservado (HPC com anuloplastia, utilizando anel de Delrin com o intuito de evitar distorção geométrica do conduto. Após dois anos, o ecocardiograma, semelhante ao pós-operatório imediato, demonstra RVP discreta e função ventricular direita normal, sugerindo que essa manobra pode ser utilizada como coadjuvante para otimizar o resultado do implante do HPC.A six-year-old child was suffering from pulmonary atresia with ventricular septal defect after a total correction at 1 year of age using a bovine pericardial monocusp valve in the reconstruction of the right ventricle outflow tract. The infant evolved with significant pulmonary valve regurgitation (PVR and right ventricle dysfunction. On reoperation, a cryopreserved pulmonary homograft (CPH was implanted with annuloplasty utilizing a Delrin ring with the aim of avoiding geometric distortion of the vessel. After two years, an echocardiogram proved a similar state to the immediate postoperative period with slight pulmonary valve regurgitation and normal right ventricular function suggesting that this maneuver may be used as coadjuvant treatment to optimize the result of CPH implantation.

  19. Esquistossomose pulmonar. III. Forma crônica extensa com hipertensão pulmonar e na vigência de hipertensão portal associada a provável coroidite e retinite esquistossomótica

    Directory of Open Access Journals (Sweden)

    Jayme Neves

    1980-12-01

    Full Text Available Os Autores descrevem um caso grave de esquistossomose mansoni numa criança de 9 anos de idade (forma hepática com hipertensão portai associada a forma pulmonar com hipertensão pulmonar e cor pulmonale clinicamente caracterizado por episódios de insuficiência respiratória desencadeados em face de esforços físicos moderados. Sucessivos exames radiológicos de tórax revelaram comprometimento predominantemente arteriolar ao iado de uma micronodulação delicada e difusamente distribuída e configuração de cor pulmonale. Ao contrário do caso anteriormente descrito, a evolução se deu sem que se verificassem manifestações febris. Embora tenham sido afastadas várias hipóteses de associação da esquistossomose a concausas infectuosas, optou-se pelo tratamento de prova da tuberculose pulmonar. O fundo de olho também apresentava vários nódulos esbranquiçados disseminados pelo coróide e retina, caracterizando provável coroidite e retinite esquistossomótica. O tratamento antituberculoso resultou praticamente nulo. Não se procedeu ao tratamento específico da esquistossomose, considerando-se o alto risco da cardiopatia face aos esquistossomicidas disponíveis. A alta foi fornecida após treze meses de observação hospitalar. Não compareceu a ulterior controle.

  20. Strabismus developing after unilateral and bilateral cataract surgery in children

    Science.gov (United States)

    David, R; Davelman, J; Mechoulam, H; Cohen, E; Karshai, I; Anteby, I

    2016-01-01

    Purpose To evaluate the prevalence and risk factors of strabismus in children undergoing surgery for unilateral or bilateral cataract with or without intraocular lens implantation. Methods Medical records of pediatric patients were evaluated from 2000 to 2011. Children undergoing surgery for unilateral or bilateral cataract with at least 1 year of follow-up were included. Children with ocular trauma, prematurity, or co-existing systemic disorders were excluded. The following data were evaluated: strabismus pre- and post-operation; age at surgery; post-operative aphakia or pseudophakia; and visual acuity. Results Ninety patients were included, 40% had unilateral and 60% had bilateral cataracts. Follow-up was on average 51 months (range: 12–130 months). Strabismus was found preoperatively in 34.4% children, and in 43.3% children at last follow-up. Strabismus developed in 46.2% of children who were orthotropic preoperatively, whereas 32.3% of children who had strabismus before surgery became orthotropic. Strabismus occurred after unilateral or bilateral cataract surgery in 63.9% and 29.6% children, respectively. At the last follow-up, strabismus was found in 46.7% of aphakic and 58.7% of pseudophakic children (P=0.283). Children who developed strabismus were generally operated at a younger age as compared with those without strabismus (mean of 25.9 vs 52.7 months, Pstrabismus. Conclusion Strabismus is a frequent complication after cataract surgery in children. Risk factors include unilateral cases and young age at surgery. No correlation was found between prevalence of strabismus and use of intraocular lens. Strabismus was more common in children with poor final visual acuity. PMID:27472210

  1. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    Directory of Open Access Journals (Sweden)

    Mohammed Zuhaib

    2016-01-01

    Full Text Available Context: Presurgical nasoalveolar moulding (PNAM is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. Aims: The study was conducted to evaluate the effi cacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1 To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM. (2 To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM. (3 To assess the changes in the position of the alar base and the alar cartilages. Settings and Design: Prospective study. Subjects and Methods: A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Statistical Analysis Used: Student's t-test for paired comparisons. Results: Results of the study showed a promising reduction in the cleft size before the surgery, signifi cant improvement in nasal symmetry, including the columellar length on the cleft side. Conclusions: PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle

  2. Unilateral incompatibility in Capsicum (Solanaceae): occurrence and taxonomic distribution.

    Science.gov (United States)

    Onus, A Naci; Pickersgill, Barbara

    2004-08-01

    Unilateral incompatibility (UI) occurs when pollinations between species are successful in one direction but not in the other. Self-incompatible (SI) species frequently show UI with genetically related, self-compatible (SC) species, as pollen of SI species is compatible on the SC pistil, but not vice versa. Many examples of unilateral incompatibility, and all those which have been studied most intensively, are found in the Solanaceae, particularly Lycopersicon, Solanum, Nicotiana and Petunia. The genus Capsicum is evolutionarily somewhat distant from Lycopersicon and Solanum and even further removed from Nicotiana and Petunia. Unilateral incompatibility has also been reported in Capsicum; however, this is the first comprehensive study of crosses between all readily available species in the genus. All readily available (wild and domesticated) species in the genus are used as plant material, including the three genera from the Capsicum pubescens complex plus eight other species. Pollinations were made on pot-grown plants in a glasshouse. The number of pistils pollinated per cross varied (from five to 40 pistils per plant), depending on the numbers of flowers available. Pistils were collected 24 h after pollination and fixed for 3-24 h. After staining, pistils were mounted in a drop of stain, squashed gently under a cover slip and examined microscopically under ultra-violet light for pollen tube growth. Unilateral incompatibility is confirmed in the C. pubescens complex. Its direction conforms to that predominant in the Solanaceae and other families, i.e. pistils of self-incompatible species, or self-compatible taxa closely related to self-incompatible species, inhibit pollen tubes of self-compatible species. Unilateral incompatibility in Capsicum does not seem to have arisen to prevent introgression of self-compatibility into self-incompatible taxa, but as a by-product of divergence of the C. pubescens complex from the remainder of the genus.

  3. Unilateral spondylolysis and the presence of facet joint tropism.

    Science.gov (United States)

    Rankine, James J; Dickson, Robert A

    2010-10-01

    Retrospective review of the CT scans performed in a group of patients examined for a possible spondylolysis. To investigate whether there is an association between unilateral spondylolysis and facet joint tropism. Spondylolysis is a fatigue fracture of the pars interarticularis of great importance in sports injury. The demonstration of a unilateral spondylolysis is important because there is a potential for full healing if the athletic activity is modified, whereas bilateral spondylolysis frequently leads to established nonunion. Coronally orientated facet joints are known to predispose to spondylolysis by increasing the point loading of the pars interarticularis. The importance of this finding has not been investigated in unilateral spondylolysis. A review of patients with low back pain and a possible diagnosis of spondylolysis who were investigated with multislice CT was performed. The coronal orientation of the facet joints at L4/5 and L5/S1 was measured and comparison was done between those with and without a spondylolysis. The coronal angle of 140 facet joints in 35 patients was recorded. Of 35 patients, 23 had a spondylolysis which was unilateral in 12 patients. The facet joint angle was significantly more coronally orientated in the presence of a spondylolysis when compared with an intact pars (means, 53° and 43°, respectively; P spondylolysis, the facet joint was significantly more coronally orientated on the side of the spondylolysis (means, 52° and 45°, respectively; P spondylolysis. Asymmetric facet joints do increase the force through one side of the spine, with a unilateral spondylolysis occurring on the side of the more coronally orientated facet joint.

  4. Agenesia pulmonar y riñón en herradura en la edad adulta: reporte de caso y revisión de la literatura

    Directory of Open Access Journals (Sweden)

    D.I. Navarro Vergara

    2014-07-01

    Full Text Available La agenesia pulmonar es una malformación congénita rara que se define como la ausencia total de parénquima pulmonar, bronquios y vasculatura. En la literatura se encuentran pocos casos de esta malformación en la edad adulta, debido a la presencia de otras malformaciones coincidentes, como desplazamiento mediastinal y cardiaco severos. La mayoría de los casos mueren prematuramente en los primeros 5 años de vida. Se presenta el caso de un paciente de 31 años de edad con agenesia pulmonar izquierda asociada a malformación genitourinaria: riñón en herradura.

  5. Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

    OpenAIRE

    Zampieri,Fernando Godinho; Almeida,Juliana Roberta; Schettino,Guilherme Pinto de Paula; Park,Marcelo; Machado,Fabio Santana; Azevedo,Luciano Cesar Pontes

    2011-01-01

    OBJETIVO: Avaliar o efeito de alterações hemodinâmicas, respiratórias e metabólicas sobre a pressão intracraniana em um modelo de lesão pulmonar aguda e síndrome compartimental abdominal. MÉTODOS: Oito porcos Agroceres foram submetidos, após a instrumentação, a cinco cenários clínicos: 1) estado basal com baixa pressão intra-abdominal e pulmão sadio; 2) pneumoperitôneo, com pressão intra-abdominal de 20 mm Hg; 3) lesão pulmonar aguda induzida por lavagem pulmonar e desativação de surfactante;...

  6. Hipertensión pulmonar tromboembólica crónica: caracterización, endarterectomía pulmonar y nuevas opciones terapéuticas

    Directory of Open Access Journals (Sweden)

    Sofía Martín-Suárez

    2018-03-01

    Full Text Available Resumen: La hipertensión pulmonar tromboembólica crónica se considera el único tipo de hipertensión pulmonar con un tratamiento quirúrgico potencialmente curativo. Aun hoy está infradiagnosticada o con frecuencia diagnosticada tardíamente, comportando un empeoramiento del pronóstico. La hipertensión pulmonar tromboembólica crónica se presenta con síntomas poco específicos y los médicos de atención primaria pueden no ser conscientes de su presencia o del potencial tratamiento. El tratamiento médico actual es, en el mejor de los casos, paliativo. La endarterectomía pulmonar ofrece la única posibilidad de mejora sintomática y pronóstica, siendo curativa en la mayoría de los casos a corto y a largo plazo. Por lo tanto, no solo la identificación de la enfermedad puede ser difícil y tardía sino que incluso después de que el diagnóstico se haya establecido, la evaluación de la operabilidad puede ser un reto. La operabilidad se basa en la estimación preoperatoria de la clasificación quirúrgica y de la probable resistencia vascular pulmonar postoperatoria, las cuales determinan el riesgo de la intervención y el posible resultado. Este complejo procedimiento que va desde la caracterización de la enfermedad a la intervención quirúrgica pasando por todo el proceso decisional, requiere una colaboración multidisciplinar de expertos en hipertensión pulmonar, con un equipo quirúrgico dedicado a este campo y con protocolos bien precisos. En nuestro centro, hemos construido un equipo especializado que incluye radiólogos, cardiólogos, cirujanos cardiacos, anestesistas/intensivistas y fisioterapeutas, que no solo ha permitido obtener resultados quirúrgicos comparables a centros europeos de más alto volumen, sino que también ha permitido desarrollar e implementar otras opciones terapéuticas como la angioplastia pulmonar con balón, dedicadas a los pacientes de alto riesgo descartados para la cirugía.En el siguiente art

  7. Efectos en el desarrollo pulmonar de la oclusión traqueal precoz como terapia fetal de la hipoplasia pulmonar en la hernia diafragmática congénita del feto ovino /

    OpenAIRE

    Giné Prades, Carles,

    2017-01-01

    Introducción: La oclusión traqueal mediante la colocación fetoscópica de un balón endotraqueal a las 26-29 semanas de gestación constituye el tratamiento estándar de los casos graves de hernia diafragmática congénita (CDH) diagnosticados prenatalmente. Sin embargo, algunos pacientes presentan indicadores prenatales de hipoplasia pulmonar extrema y, a pesar del tratamiento fetoscópico, su tasa de supervivencia es cercana al 0%. Algunos estudios clínicos abogan por una oclusión traqueal en esta...

  8. Contribución al estudio de la función pulmonar en pacientes intervenidos de cirugía cardíaca extracorpórea : biopsia pulmonar y lavado broncoalveolar

    OpenAIRE

    Abad Vázquez, Cipriano Carlos

    1988-01-01

    [spa] En la presente tesis se hace una introducción histórica, clasificación y se relatan las complicaciones de la circulación extracorpórea. Seguidamente se hace una revisión bibliografica y se justifica la realización de la tesis. Para el estudio se toman 31 enfermos que se intervienen de cirugia cardiaca extracorpórea y se les realiza un protocolo clínico de estudio que incluye la realización de una biopsia pulmonar (microscopia óptica y electrónica) y lavado bronco alveolar; antes y desp...

  9. Efectos en el desarrollo pulmonar de la oclusión traqueal precoz como terapia fetal de la hipoplasia pulmonar en la hernia diafragmática congénita del feto ovino

    OpenAIRE

    Giné Prades, Carles

    2017-01-01

    Introducción: La oclusión traqueal mediante la colocación fetoscópica de un balón endotraqueal a las 26-29 semanas de gestación constituye el tratamiento estándar de los casos graves de hernia diafragmática congénita (CDH) diagnosticados prenatalmente. Sin embargo, algunos pacientes presentan indicadores prenatales de hipoplasia pulmonar extrema y, a pesar del tratamiento fetoscópico, su tasa de supervivencia es cercana al 0%. Algunos estudios clínicos abogan por una oclusión traqueal en ...

  10. Avaliação do suprimento sangüíneo vascular pulmonar nos portadores de atresia pulmonar com comunicação interventricular e artérias colaterais sistêmico-pulmonares Assessment of the pulmonary vascular blood supply in patients with pulmonary atresia, ventricular septal defect, and aortopulmonary collateral arteries

    Directory of Open Access Journals (Sweden)

    Ulisses Alexandre Croti

    2005-01-01

    Full Text Available OBJETIVO: Analisar as características morfométricas das artérias pulmonares centrais e artérias colaterais sistêmico-pulmonares, avaliando a morfologia do suprimento sangüíneo vascular pulmonar, procurando estabelecer suas implicações no tratamento cirúrgico. MÉTODO: Entre janeiro/1990 e junho/2001, foram estudados 40 pacientes, incluíndo-se os que apresentavam estudo cineangiocardiográfico completo e prévio à primeira intervenção cirúrgica. Analisaram-se as características morfométricas das artérias pulmonares centrais e artérias colaterais sistêmico-pulmonares, assim como a distribuição da irrigação sangüínea nos pulmões. Calcularam-se os índices arterial pulmonar (IAAPP, arterial colateral sistêmico-pulmonar (IACSP e arterial neopulmonar total (IANPT = IAAPP + IACSP. O tratamento cirúrgico foi considerado paliativo (TP, paliativo definitivo (TPD e definitivo (TD. RESULTADOS: O TP foi predominante. Não houve diferenças estatisticamente significantes entre os pacientes com TP, TPD e TD, em relação ao IAAPP, IACSP e IANPT. Comparando o IAAPP e o IACSP, não houve diferença entre os índices para o TD (p=0,4309, o IACSP foi maior que o IAAPP para o TP (p=0,0176 e descritivamente também maior para o TPD. O IANPT dos pacientes em TD foi maior que os em TP (p=0,0959. Foram identificados cinco subgrupos morfologicamente semelhantes, denominados: B1, B2, B3, B4 e B5. A mortalidade total foi de 17,5%. CONCLUSÃO: A morfologia do suprimento sangüíneo vascular pulmonar das artérias pulmonares centrais e artérias colaterais sistêmico-pulmonares mostrou-se soberana na orientação do tratamento cirúrgico. Independentemente da divisão didática em subgrupos, o TP foi predominante. A mortalidade não apresentou correlação com as características morfométricas.OBJECTIVE: To study the morphometric characteristics of the central pulmonary arteries and aortopulmonary collateral arteries by assessing the morphology

  11. Esquistossomose pulmonar. II. Forma crônica reativada com hipertensão e Cor pulmonale

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    Jayme Neves

    1980-12-01

    Full Text Available Os Autores descrevem um caso grave de esquistossomose mansoni (forma hepática com hipertensão portal associada a forma pulmonar com hipertensão pulmonar e cor pulmonalej sobre o qual evoluiu uma sindrome toxi-infectuosa grave e de longa duração. Sucessivos exames radiológicos do tórax revelaram acometimento predominantemente arteriolar, ao lado de uma micronodulação pulmonar grosseira e difusa em ambos os hemitóraces e configuração de coração pulmonar. A histopatologia de material de biópsia pulmonar identificou basicamente uma arterite pulmonar característica, inflamação granulomatosa atípica provocada principalmente por vermes e raros ovos de S. mansoni envolvidos por escassa reação inflamatória. Para explicar a origem de constelação clínica toxi-infectuosa, foram afastadas as hipóteses de associação da esquistossomose a concausas infectuosas ou não, mas de curso febril, e a superposição de uma forma toxêmica sobre outra crônica pré-existente. Com base em dados clínicos, particularmente em subsídios da laparoscopia, e anatômicos, concluiu-se tratar o caso de uma forma crônica de esquistossomose reativada, provavelmente em virtude de alterações imunológicas inusitadas do hospedeiro. Ao que tudo parece indicar, o desvio de ovos e de vermes aos pulmões deveu-se à sindrome de hipertensão portal, cujos shunts entre a circulação portal e sistêmica determinaram a rota preferencial da migração.The Authors relate a case ofsevere schistosomiasis mansoni (hepatic form, with portal hypertension, associated with pulmonary form, with pulmonary hypertension and cor pulmonale, o ver which develloped a severe toxi-infectious syndrome of long duration. Serial chest X-rays showed that the arteriolae were predominantly affected, besides a gross and difuse pulmonary micronodulation in both hemithoraces, and pulmonary heart configuration. Histopathology of the pulmonary biopsy material identified basically a

  12. Fibrose pulmonar idiopática: uma década de progressos Idiopathic pulmonary fibrosis: a decade of progress

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    Jeffrey J. Swigris

    2006-06-01

    Full Text Available Embora diagnósticos de fibrose pulmonar idiopática continuem sendo devastadores, avanços recentes têm melhorado nossa compreensão a respeito de muitas das facetas desta doença. Estas descobertas, juntamente com o aumento da disponibilidade geral de ensaios terapêuticos, encerram a promessa de um futuro mais promissor para pacientes com fibrose pulmonar idiopática. Por exemplo, nós temos agora uma compreensão mais abrangente a respeito dos critérios diagnósticos e da história natural da doença. Vários estudos têm mostrado que a mensuração simples da fisiologia pulmonar ou troca gasosa pode ser usada para prever a sobrevida do paciente. Através da identificação de várias vias moleculares que têm papéis importantes na patogênese da fibrose pulmonar idiopática, os pesquisadores têm produzido uma lista crescente de possíveis novos alvos terapêuticos para a doença. Vários ensaios terapêuticos prospectivos e controlados têm sido realizados. Outros estão em andamento ou ainda estão em fase de planejamento. Estes esforços têm avançado nosso conhecimento atual sobre fibrose pulmonar idiopática e levantado novas questões importantes, assim como têm gerado o interesse e o impulso necessários para avançar terreno na luta contra esta doença desafiadora. Este artigo oferece ao leitor um panorama dos avanços recentes nas pesquisas sobre fibrose pulmonar idiopática, tendo como foco a história natural, patogênese e tratamento.Although idiopathic pulmonary fibrosis remains a devastating diagnosis, recent advances have improved our understanding of many facets of this disease. These breakthroughs, combined with the increased general availability of therapeutic trials, hold the promise of a brighter future for idiopathic pulmonary fibrosis patients. For example, we now have a more comprehensive understanding of the diagnostic criteria and natural history of the disease. Several studies have shown that simple

  13. Embolia pulmonar séptica de origen cutáneo Septic pulmonary embolism of cutaneous origin

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    Agustina Sosa Beláustegui

    2012-08-01

    Full Text Available La embolia pulmonar séptica es una enfermedad grave y poco frecuente que se caracteriza por presentar infiltrados pulmonares bilaterales asociados a un foco infeccioso extrapulmonar. Se relaciona principalmente a endocarditis derecha, tromboflebitis pelviana, accesos vasculares y menos frecuentemente a infecciones profundas como osteomielitis, artritis séptica o piomiositis. El Staphylococcus aureus meticilino-resistente adquirido en la comunidad (SAMR-AC es un patógeno emergente, con alta virulencia y de rápida propagación, que afecta a sujetos sin enfermedades previas relacionadas o factores de riesgo conocidos. Causa infecciones de piel y partes blandas y con menor frecuencia infecciones graves como fascitis necrotizante, artritis séptica, osteomielitis, piomiositis y neumonía necrotizante. Su epidemiología, patogenia y manifestaciones clínicas difieren de las causadas por el SAMR adquirido en el hospital. Presentamos el caso de un varón de 67 años con embolias pulmonares sépticas causadas por SAMR-AC con origen en una infección cutánea.Septic pulmonary embolism is a serious and rare illness characterized by pulmonary infiltrates associated with an extrapulmonary infectious focus. It is mainly related to right-sided endocarditis, pelvic thrombophlebitis, vascular access and less frequently to deep infections such as osteomyelitis, septic arthritis and pyomyositis. The community-acquired methicillin-resistant Staphylococcus aureus (MRSA is an emerging pathogen with high virulence and rapid spread involving subjects without previous related diseases or known risk factors. It causes infections of skin and soft tissue and less frequently other serious infections such as necrotizing fascitits, septic arthritis, osteomyelitis, pyomyositis and necrotizing pneumonia. Epidemiologically, pathogenesis and clinical manifestations differ from those caused by MRSA acquired in the hospital. We present the case of a 67 year-old male with septic

  14. Técnica de Monaldi para el tratamiento de abscesos pulmonares Monaldi's technique for treatment of pulmonary abscesses

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    Edelberto Fuentes Valdés

    2010-06-01

    Full Text Available Los abscesos pulmonares son tratados corrientemente con antibióticos y drenaje postural. Sin embargo, algunos pacientes no resuelven con las medidas conservadoras o presentan contraindicaciones para el tratamiento quirúrgico convencional. En tales individuos, el drenaje percutáneo (técnica de Monaldi puede ser una alternativa de valor. El objetivo de este trabajo fue la presentación de 3 pacientes a quienes se les realizó el drenaje percutáneo de abscesos pulmonares. Se describen la técnica empleada para la inserción del tubo, las complicaciones y la evolución posoperatoria de los pacientes. En los 3 casos la operación fue exitosa, sin mortalidad y con una sola complicación, que fue una fístula broncopleurocutánea que requirió una intervención (neumonectomía ulterior. El drenaje percutáneo de los abscesos pulmonares fue seguro y efectivo en estos pacientes.The pulmonary abscesses are usually treated with antibiotics and postural drainage. However, some patients don't improve with conservative measures or have contraindications for conventional surgical treatment. The aim of present paper was the presentation of three cases underwent percutaneous drainage of pulmonary abscesses. The technique used for tube insertion, complications and postoperative course of patients were described. In such cases operation was successful without mortality and with a bronchopleural cutaneous fistula like the only complication requiring a further intervention (pneumonectomy. The percutaneous drainage of pulmonary abscesses was safe and effective in our patients.

  15. Modelo experimental de perfusão pulmonar ex vivo em ratos: avaliação histopatológica e de apoptose celular em pulmões preservados com solução de baixo potássio dextrana vs. solução histidina-triptofano-cetoglutarato An experimental rat model of ex vivo lung perfusion for the assessment of lungs regarding histopathological findings and apoptosis: low-potassium dextran vs. histidine-tryptophan-ketoglutarate

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    Edson Azevedo Simões

    2012-08-01

    Full Text Available OBJETIVO: Comparar os achados histopatológicos e de apoptose em pulmões de ratos preservados em soluções low-potassium dextran (LPD, baixo potássio dextrana, histidine-tryptophan-ketoglutarate (HTK, histidina-triptofano-cetoglutarato ou salina normal (SN em 6 h e 12 h de isquemia pela utilização de um modelo experimental de perfusão pulmonar ex vivo. MÉTODOS: Sessenta ratos Wistar foram anestesiados, randomizados e submetidos à perfusão anterógrada pela artéria pulmonar com uma das soluções preservadoras. Após a extração, os blocos cardiopulmonares foram preservados por 6 ou 12 h a 4ºC, sendo então reperfundidos com sangue homólogo em um sistema de perfusão ex vivo durante 60 min. Ao final da reperfusão, fragmentos do lobo médio foram extraídos e processados para histopatologia, sendo avaliados os seguintes parâmetros: congestão, edema alveolar, hemorragia alveolar, hemorragia, infiltrado inflamatório e infiltrado intersticial. O grau de apoptose foi avaliado pelo método TdT-mediated dUTP nick end labeling. RESULTADOS: A histopatologia demonstrou que todos os pulmões preservados com SN apresentaram edema alveolar após 12 h de isquemia. Não houve diferenças em relação ao grau de apoptose nos grupos estudados. CONCLUSÕES: No presente estudo, os achados histopatológicos e de apoptose foram semelhantes com o uso das soluções LPD e HTK, enquanto a presença de edema foi significativamente maior com o uso de SN.OBJECTIVE: To compare histopathological findings and the degree of apoptosis among rat lungs preserved with low-potassium dextran (LPD solution, histidine-tryptophan-ketoglutarate (HTK solution, or normal saline (NS at two ischemia periods (6 h and 12 h using an experimental rat model of ex vivo lung perfusion. METHODS: Sixty Wistar rats were anesthetized, randomized, and submitted to antegrade perfusion via pulmonary artery with one of the preservation solutions. Following en bloc extraction, the heart

  16. Diseño e implementación de un pletismógrafo digital para detección de enfermedades pulmonares

    OpenAIRE

    Naula Dután, Byron Ricardo

    2018-01-01

    Se diseñó y construyó un pletismógrafo digital para determinar parámetros de función pulmonar como capacitad vital, frecuencia respiratoria y otros, este equipo sirve como herramienta de soporte para realizar diagnósticos presuntivos en consultas generales y detectar enfermedades pulmonares. I design and built a digital plethismograph to determine lung of function parameters as vital capacity, breathing frequency and others, this medical device serves as support tool to make presumptive di...

  17. Relaciones estructura-función de la proteína SP-C del surfactante pulmonar: efectos sobre la estructura de membranas y papel del colesterol

    OpenAIRE

    Roldán López, Nuria

    2017-01-01

    La función respiratoria depende del establecimiento de una interfase aire-líquido que tiene lugar en los alveolos pulmonares. La estabilización de dicha interfase requiere la presencia de un complejo lipoproteico que es sintetizado y secretado por las células epiteliales alveolares de tipo II, también llamadas neumocitos tipo II. Este material se denomina surfactante pulmonar y sus funciones principales implican la estabilización de los alveolos a lo largo de los ciclos respiratorios, así com...

  18. Vasodilatadores en la hipertensión pulmonar: selectividad por el territorio vascular, por oxígeno y efectos antiproliferativos

    OpenAIRE

    Morales Cano, Daniel

    2016-01-01

    La Hipertensión Pulmonar (HP) es una enfermedad crónica y progresiva. La HP presenta una compleja fisiopatología caracterizada por vasoconstricción, remodelado vascular y trombosis. Las terapias actuales muestran efectos beneficiosos, sin embargo presentan también importantes limitaciones: 1) pobre selectividad pulmonar, 2) modesta eficacia vasodilatadora, 3) desacoplamiento de la ventilación/perfusión (V/Q) e 4) incapacidad para prevenir la progresión de la enfermedad. La quercet...

  19. Tromboembolismo pulmonar e anticonceptivos orais – a propósito de um caso clínico.

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    Fernando Matos

    1996-05-01

    Full Text Available RESUMO: A propósito de um caso de Tromboembolismo Pulmonar (TEP, em mulher jovem a fazer anticonceptivo oral (ACO, os AA fazem uma revisão sumária dos ACO como factor de risco no TEP. SUMMARY: In reference to a clinical case of Pulmonary Thromboembolism (PTE in a young woman taking oral contraceptives (OC, the authors review the role of OC as a risk factor in PTE. Palavras-chave: Contracepção oral, Tromboembolismo pulmonar, Factores de risco vascular, Key-words: Oral contraception, Pulmonary embolism, Vascular risk factors

  20. Incontinência do choro e infarto protuberancial unilateral Incontinence of crying and unilateral pontine infarct

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    Ricardo de Oliveira-Souza

    1995-09-01

    Full Text Available O presente estudo trata do caso de um paciente que apresentou incontinência do choro e hemiplegia direita por infarto ventroprotuberancial paramediano detectado pela RNM. O caráter circunscrito da lesão foi endossado pela normalidade dos potenciais evocados sômato-sensitivos e auditivos de curta-latência. Os episódios de choro desapareceram poucos dias depois do início do tratamento com doses baixas de imipramina. Discutimos o choro e riso patológicos como forma de incontinência da mímica resultante de desconexão límbico-motora, enfatizando a impropriedade de incluí-los na síndrome pseudobulbar, uma vez que dependem de correlatos anatômicos e funcionais distintos.A 64-year-old man presented with pathologic crying and right hemiplegia due to a unilateral pontine infarct from probable branch disease of the basilar artery. The circumscribed nature of the lesion was supported by MRI and short-latency evoked potentials. The weeping spells ceased after a few days of imipramine in low doses. Pathologic laughing and crying can be viewed as a limbic-motor disconnection syndrome, in which the faciovocal motor system is released from forebrain afferents carrying information of emotional content. The inclusion of pathologic laughing and crying in the syndrome pseudobulbar palsy is inaccurate and misleading, since each is related to distinct functional and anatomic systems intrinsic to the human brainstem.

  1. Osteopatía hipertrófica secundaria a metástasis pulmonar de carcinoma mamario

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    Correa Salgado, Ricardo Andrés; Giraldo Villegas, Juan Carlos

    2015-01-01

    Propósitos: este artículo pretende reportar los hallazgos de un caso clínico de osteopatía hipertrófica. Tema: la osteopatía hipertrófica es un raro desorden paraneoplásico, asociado con el sobrecrecimiento doloroso del periostio de los huesos largos, normalmente desencadenado por neoplasias primarias o metastásicas de pulmón. Desarrollo: se presenta el caso de un rottweiler, de 12 años, con osteopatía hipertrófica asociada con metástasis pulmonar de un carcinoma mamario. Conclusiones: se com...

  2. Síndrome pulmonar por hantavirus en población infantil. Chile: Regiones IX y X. 1998-2000

    OpenAIRE

    SOZA C., GUILLERMO; LORCA O., PEDRO; PUEBLA M., SERGIO; WENZEL M., MARISOL; NAVARRETE C., MARITZA; VILLAGRA C., ELIECER; MORA R., JUDITH; LEVIS C., SILVANA; AVILES A., GABRIELA

    2000-01-01

    El síndrome pulmonar por hantavirus (SPH) ha estado presente en Chile desde 1993 y ha sido detectado desde 1997 en la IX Región. Es una grave zoonosis con alta mortalidad, que afecta a gente joven incluyendo niños. Se ha estimado oportuno dar a conocer nuestra experiencia en la atención de 6 pacientes pediátricos, atendidos en las unidades de Cuidados Intensivos y Aislamiento en el Hospital Regional de Temuco, entre enero de 1998 y enero de 2000 mediante un estudio descriptivo de la experienc...

  3. Tromboembolismo pulmonar y enfermedad cerebrovascular isquémica embólica en un anciano boliviano

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    Daymarelis Rodríguez Yero

    2014-06-01

    Full Text Available Se describe el caso clínico de un paciente de 71 años de edad, quien en el 2008, luego de un episodio de tromboembolismo pulmonar, fuera ingresado en la Unidad de Cuidados Intensivos del Hospital Integral Comunitario de Chacaltaya en Bolivia, por presentar una enfermedad cerebrovascular isquémica embólica de tipo paradójica, como consecuencia de un agujero oval permeable. Como tratamiento se indicó, primero, heparina de bajo peso molecular y, posteriormente, dicumarínicos, con lo cual el paciente evolucionó satisfactoriamente

  4. Síndrome de Mounier Kuhn en una paciente de 78 años con fibrosis pulmonar

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    Severiche-Bueno, Diego Fernando; Severiche-Hernández, Diego; Severiche-Bueno, David Felipe; Vargas, María Teresa

    2017-01-01

    Resumen Se presenta el caso de una mujer de 78 años de edad con fibrosis pulmonar idiopàtica, quien consultó por exacerbación de sus síntomas respiratorios, a quien se le realizan estudios radiológicos, donde se evidencia dilatación de la vía aérea, previamente no descrita, y se realiza diagnóstico de síndrome de Mounier Kuhn. Hasta donde el conocimiento alcanza, es el primer caso reportado en Colombia y la tercera persona de mayor edad reportada en el mundo. Este es un hallazgo incidental, d...

  5. Neumotórax bilateral como complicación de metástasis pulmonar cavitaria de un angiosarcoma

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    Lorena V. Maldonado

    2014-06-01

    Full Text Available Las metástasis pulmonares de angiosarcoma constituyen una complicación común de una neoplasia maligna poco frecuente. Habitualmente se presentan como nódulos solidos periféricos y derrame pleural. Presentamos el caso de un hombre de 65 años de edad con neumotórax bilateral recurrente, secundario a metástasis cavitadas de un angiosarcoma primitivo de cuero cabelludo. La videotoracoscopia permitió la inspección, la resección de las metástasis y la pleurodesis. No ocurrieron complicaciones ni recurrencia tumoral a los seis meses de seguimiento.

  6. Terapia com surfactante pulmonar exógeno em pediatria Exogenous surfactant therapy in pediatrics

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    Norberto A. Freddi

    2003-11-01

    Full Text Available OBJETIVO: Revisar o estágio atual do conhecimento sobre a utilização do surfactante exógeno nas diferentes doenças pulmonares que levam à insuficiência respiratória aguda em crianças. FONTES DOS DADOS: Este manuscrito baseia-se na experiência clínica dos autores sobre o assunto e na revisão da literatura recente através de consulta aos bancos de dados ONIA, Mdconsult, Medline e Cochrane Database Library. SÍNTESE DOS DADOS: Apesar do sucesso obtido com a utilização do surfactante exógeno na síndrome de desconforto respiratório do recém-nascido, questões permanecem indefinidas, como o momento do seu emprego, muito precoce (profilático, baseado na idade gestacional ou em testes rápidos de maturidade pulmonar, ou então mais tardiamente, após o quadro clínico instalado. Em outras patologias graves que levam à insuficiência respiratória grave com necessidade de suporte ventilatório, o seu uso ainda é controverso, e os dados da literatura são limitados e conflitantes. Porém, relatos de uso clínico em várias destas situações, com sucesso, têm sido freqüentes. A pesquisa em surfactante tem-se centrado ultimamente na sua inativação por várias substâncias que podem estar presentes na via aérea. Nas patologias em que a inativação parece ser um fator importante, novos surfactantes com adição de adjuvantes para reverter a tendência à inativação (por exemplo: polietilenoglicol estão atualmente em fase de testes. CONCLUSÕES: A terapia com surfactante exógeno ainda não é um tema esgotado, nem mesmo na SDR. Os surfactantes podem ser ainda aperfeiçoados, sobretudo para resistir à inibição, e as formas de utilização em outras doenças que não a SDR deverão ser aperfeiçoadas.OBJECTIVE: To review current knowledge about the use of exogenous surfactants in the treatment of different lung diseases causing acute respiratory failure in children. SOURCE OF DATA: This review is based on the authors

  7. Coccidioidomicose pulmonar em caçador de tatus Pulmonary coccidioidomycosis in a armadillo hunter

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    FABRÍCIO ANDRÉ MARTINS DA COSTA

    2001-09-01

    Full Text Available A coccidioidomicose, uma doença fúngica adquirida através da inalação do agente Coccidioides immitis sob forma de artroconídio, vem sendo descrita desde 1892. Restringe-se principalmente a áreas de clima árido, solo alcalino e regiões de baixo índice pluviométrico. Não por acaso, a maioria dos casos descritos no Brasil ocorreu na região Nordeste. Relata-se o caso de um homem de 19 anos, imunocompetente, com queixa de dor pleural bilateral, febre, adinamia e tosse seca havia dois meses. A radiografia de tórax evidenciou múltiplos nódulos bilaterais. O paciente participava de caçadas a tatus (Dasypus novemcinctus e a pesquisa direta para fungos no escarro evidenciou Coccidioides sp. Tratado com anfotericina B, apresentou pneumotórax e insuficiência respiratória, indo a óbito. A biópsia pulmonar post mortem evidenciou Coccidioides immitis sob a forma de endósporos.Coccidioidomycosis is a disease caused by inhalation of arthrospores of the fungus Coccidioides immitis. It has been recognized as a clinical entity since 1892. It is related to activities that involves dust exposure. It is found in many regions of the western hemisphere with dry and alkaline soil. In Brazil it has been described almost exclusively in the Northeast region where drought periods may favor its growth in its soil. We report a case of fatal coccidioidomycosis, in an immunocompetent host, associated to the activity of armadillo hunting (Dasypus novemcynctus in a rural area of Ceará state.

  8. Daño pulmonar agudo asociada a transfusión en el embarazo

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    Silvia María Melians Abreu

    2014-06-01

    Full Text Available Introducción: el daño pulmonar agudo asociado a la transfusión es una reacción adversa a la transfusión poco frecuente, la mortalidad se ha estimado entre 1-10 %. Su diagnóstico es clínico e infrecuentemente sospechado, su incidencia es baja. Presentación del caso: se presentaron dos transfusión-related-acute-lunginjury en dos gestantes con 28,5 y 32 semanas de embarazo respectivamente, hospitalizadas en la salas de cuidados materno perinatales con enfermedades asociadas al embarazo, a quienes se le administraron componentes sanguíneos, ambas a las 5 horas de transfundidas; presentaron el síndrome clínico con hipoxemia moderada y necesitaron ventilación; con estos hallazgos y la relación temporal con la transfusión. Se realizó el diagnóstico de síndrome de dificultad respiratoria aguda moderada asociada a transfusión. Conclusiones: el resultado fue óptimo con resolución completa del evento respiratorio. Se considera importante reportar ambos casos dado su aparición en embarazadas, causa poco frecuente informada en la literatura y la importancia de conservar la salud de la madre del niño y la niña e incentivar la notificación de esta reacción adversa a la transfusión al banco de sangre para fortalecer el sistema de hemovigilancia.

  9. Nova técnica: translocação aórtica e pulmonar com preservação da valva pulmonar New technique: aortic and pulmonary translocation with preservation of pulmonary valve

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    Gláucio Furlanetto

    2010-03-01

    Full Text Available Realizamos com sucesso novo procedimento cirúrgico, em duas crianças portadoras de transposição das grandes artérias associada a comunicação interventricular e obstrução da via de saída do ventrículo esquerdo. A cirurgia consiste na realização de translocação aórtica com a valva aórtica e as artérias coronárias para o ventrículo esquerdo, após a ampliação da via de saída desse ventrículo e da comunicação interventricular com pericárdio autólogo fixado em glutaraldeído, associada à translocação do tronco pulmonar para o ventrículo direito, conservando integralmente a valva pulmonar.We applied successfully, a new surgical technique, in two children with transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction, that utilized aortic translocation with the aortic valve and the coronary arteries to the left ventricle, after correction of left outflow tract obstruction and correction of the ventricular septal defect, associated to pulmonary root translocation to the right ventricle, conserving integrally the pulmonary valve.

  10. A Chinese patient with pusher syndrome and unilateral spatial neglect syndrome.

    Science.gov (United States)

    Chen, Xiao-Wei; Lin, Cheng-He; Zheng, Hua; Lin, Zhen-Lan

    2014-07-01

    To observe clinical manifestations, behavioral characteristics, and effects of rehabilitation on a patient with pusher syndrome and unilateral spatial neglect caused by right thalamic hemorrhage. Assessment of pusher syndrome was made by the Scale for Contraversive pushing (SCP), and unilateral spatial neglect syndrome was diagnosed using line cancellation, letter and star cancellation, line bisection tests and copy and continuation of graphic sequence test. Behavioral therapy, occupational therapy, reading training and traditional Chinese medicine methods were adopted for treatment of pusher syndrome and unilateral spatial neglect. The patient showed typical pusher syndrome and unilateral spatial neglect symptoms. The pusher syndrome and unilateral spatial neglect symptoms were significantly improved following rehabilitation treatments. Pusher syndrome and unilateral spatial neglect syndrome occurred simultaneously after right thalamic hemorrhage. Early rehabilitation therapy can reduce the symptoms of pusher syndrome and unilateral spatial neglect syndrome and improve motor function.

  11. Prevalência de refluxo gastroesofágico em pacientes com doença pulmonar avançada candidatos a transplante pulmonar Prevalence of gastroesophageal reflux in lung transplant candidates with advanced lung disease

    Directory of Open Access Journals (Sweden)

    Gustavo Almeida Fortunato

    2008-10-01

    Full Text Available OBJETIVO: Avaliar o perfil funcional do esôfago e a prevalência de refluxo gastroesofágico (RGE em pacientes candidatos a transplante pulmonar. MÉTODOS: Foram analisados prospectivamente, entre junho de 2005 e novembro de 2006, 55 pacientes candidatos a transplante pulmonar da Santa Casa de Misericórdia de Porto Alegre. Os pacientes foram submetidos a esofagomanometria estacionária e pHmetria esofágica ambulatorial de 24 h de um e dois eletrodos antes de serem submetidos ao transplante pulmonar. RESULTADOS: A esofagomanometria foi anormal em 80% dos pacientes e a pHmetria revelou RGE ácido patológico em 24%. Os sintomas digestivos apresentaram sensibilidade de 50% e especificidade de 61% para RGE. Dos pacientes com doença pulmonar obstrutiva crônica, 94% apresentaram alteração à manometria, e 80% apresentaram hipotonia do esfíncter inferior, que foi o achado mais freqüente. Pacientes com bronquiectasias apresentaram a maior prevalência de RGE (50%. CONCLUSÕES: O achado freqüente em pacientes com doença pulmonar avançada é RGE. Na população examinada, a presença de sintomas digestivos de RGE não foi preditiva de refluxo ácido patológico. A contribuição do RGE na rejeição crônica deve ser considerada e requer estudos posteriores para seu esclarecimento.OBJECTIVE: To assess the esophageal function profile and the prevalence of gastro-esophageal reflux (GER in lung transplant candidates. METHODS: From July of 2005 to November of 2006, a prospective study was conducted involving 55 candidates for lung transplantation at the Santa Casa de Misericórdia Hospital in Porto Alegre, Brazil. Prior to transplantation, patients underwent outpatient stationary esophageal manometry and 24-h esophageal pH-metry using one and two electrodes. RESULTS: Abnormal esophageal manometry was documented in 80% of the patients, and 24% of the patients presented pathological acid reflux. Digestive symptoms presented sensitivity and

  12. Congenital Unilateral Deafness Affects Cerebral Organization of Reading

    Directory of Open Access Journals (Sweden)

    Alice Mado Proverbio

    2013-06-01

    Full Text Available It is known that early sensory deprivation modifies brain functional structure and connectivity. The aim of the present study was to investigate the neuro-functional organization of reading in a patient with profound congenital unilateral deafness. Using event-related potentials (ERPs, we compared cortical networks supporting the processing of written words in patient RA (completely deaf in the right ear since birth and in a group of control volunteers. We found that congenital unilateral hearing deprivation modifies neural mechanisms of word reading. Indeed, while written word processing was left-lateralized in controls, we found a strong right lateralization of the fusiform and inferior occipital gyri activation in RA. This finding goes in the same direction of recent proposals that the ventral occipito-temporal activity in word reading seem to lateralize to the same hemisphere as the one involved in spoken language processing.

  13. Entirely saturated unilateral smear of laser spot in CCD

    International Nuclear Information System (INIS)

    Zhang Zhen; Zhou Menglian; Zhang Jianmin; Lin Xinwei

    2013-01-01

    In the video of linear CCD camera being irradiated by 532 nm CW laser, the entirely saturated unilateral smear of laser spot was found. The smear area does not represent the distribution of laser. Since this smear lies merely in one side of laser spot, it can not be induced by light leaking or carriers blooming, and it may be induced by charge transfer loss. However, the feature that the smear area is entirely saturated can not be explained by the current constant model of charge transfer inefficiency. Based on the inner structure and operating principle of buried channel CCD, a new model of charge transfer inefficiency that varies with charge quantity is proposed, which can explain the entirely saturated unilateral smear of laser spot. (authors)

  14. Analysis of a Unilateral Contact Problem with Normal Compliance

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    Touzaline Arezki

    2014-06-01

    Full Text Available The paper deals with the study of a quasistatic unilateral contact problem between a nonlinear elastic body and a foundation. The contact is modelled with a normal compliance condition associated to unilateral constraint and the Coulomb's friction law. The adhesion between contact surfaces is taken into account and is modelled with a surface variable, the bonding field, whose evolution is described by a first-order differential equation. We establish a variational formulation of the mechanical problem and prove an existence and uniqueness result in the case where the coefficient of friction is bounded by a certain constant. The technique of the proof is based on arguments of time-dependent variational inequalities, differential equations and fixed-point theorem.

  15. Surgical treatment of unilateral condylar hyperplasia with piezosurgery.

    Science.gov (United States)

    Chiarini, Luigi; Albanese, Massimo; Anesi, Alexandre; Galzignato, Pier-Francesco; Mortellaro, Carmen; Nocini, Pierfrancesco; Bertossi, Dario

    2014-05-01

    Unilateral condylar hyperplasia (UCH) is a disorder of unknown etiology mainly seen in growing patients, which results in facial asymmetry. High condylectomy alone or in association with orthognathic surgery can improve the occlusion and the facial aesthetics. Between 2005 and 2012, a total of 5 patients underwent high condylectomy for UCH using a piezoelectric cutting device. All patients were treated postoperatively with functional rehabilitation. The long-term follow-up showed that all patients had a satisfactory temporomandibular joint articular function associated with stable occlusion without any recurrence of further condylar growth. High condylectomy in the surgical treatment of unilateral UCH seems to be the procedure of choice in growing patients. The use of a piezoelectric cutting device allows a safe and less invasive high condylectomy.

  16. Global suppression of electrocortical activity in unilateral perinatal thalamic stroke.

    LENUS (Irish Health Repository)

    Kharoshankaya, Liudmila

    2014-07-01

    We present an unusual case of persistent generalized electroencephalography (EEG) suppression and right-sided clonic seizures in a male infant born at 40(+2) weeks\\' gestation, birthweight 3240g, with an isolated unilateral thalamic stroke. The EEG at 13 hours after birth showed a generalized very low amplitude background pattern, which progressed to frequent electrographic seizures over the left hemisphere. The interictal background EEG pattern remained grossly abnormal over the next 48 hours, showing very low background amplitudes (<10μV). Magnetic resonance imaging revealed an isolated acute left-sided thalamic infarction. This is the first description of severe global EEG suppression caused by an isolated unilateral thalamic stroke and supports the role of the thalamus as the control centre for cortical electrical activity.

  17. Cost-effective unilateral climate policy design: Size Matters

    Energy Technology Data Exchange (ETDEWEB)

    Boehringer, Christoph; Fischer, Carolyn; Rosendahl, Knut Einar

    2011-07-01

    Given the bleak prospects for a global agreement on mitigating climate change, pressure for unilateral abatement is increasing. A major challenge is emissions leakage. Border carbon adjustments and output-based allocation of emissions allowances can increase effectiveness of unilateral action but introduce distortions of their own. We assess antileakage measures as a function of abatement coalition size. We first develop a partial equilibrium analytical framework to see how these instruments affect emissions within and outside the coalition. We then employ a computable general equilibrium model of international trade and energy use to assess the strategies as the coalition grows. We find that full border adjustments rank first in global cost-effectiveness, followed by import tariffs and output-based rebates. The differences across measures and their overall appeal decline as the abatement coalition grows. In terms of cost, the coalition countries prefer border carbon adjustments; countries outside the coalition prefer output-based rebates.(Author)

  18. A unilateral optic perineuritis in a teenager - A case report.

    Science.gov (United States)

    Ameilia, Ahmad; Shatriah, Ismail; Wan-Hitam, Wan Hazabbah; Yunus, Rohaizan

    2015-06-01

    Optic perineuritis is an uncommon inflammatory disorder that involves optic nerve sheath. Numerous case reports have been published on optic perineuritis in adults, the majority of whom had bilateral presentation. There are limited data on optic perineuritis occurring in pediatric patients. We report a teenager who presented with a unilateral sign that mimicked the presentation of optic neuritis. The orbit and brain magnetic resonance imaging confirmed features of unilateral optic perineuritis. She was treated with a high dose of corticosteroids for 2weeks, and her final visual outcome was satisfactory. No signs of relapse were noted during follow-up visits. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  19. Unilateral segmental Darier disease following Blaschko lines: A case report

    Directory of Open Access Journals (Sweden)

    César Bimbi

    2017-07-01

    Full Text Available Darier disease is an autosomal-dominant disorder of keratin production which leads to a loss in epithelial adhesion and abnormal keratinization. The clinical correspondence is keratotic papules grouped in sebaceous areas of trunk, scalp, forehead and flexures. It is a rare disease and the variant focused on here of unilateral segmental distribution following the lines of Blaschko is rarer still, considering the fact that this presentation counts for only 10% of this already uncommom disease and with only 40 cases being reported in English medical literature. Mutation in this gene is expressed in the skin and brain. The treatment of Darier disease can be challenging and is often difficult and sometimes unsatisfactory. Systemic retinoids are considered the drug of choice for treating Darier disease. However, their use is limited by potential side effects. We described the case a metalworker male with unilateral segmental Darier disease following Blaschko lines and we review the literature on this subject.

  20. Unilateral proptosis and extradural hematoma in a child with scurvy

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Sumit; Sivanandan, Sindhu; Seth, Rachna; Kabra, Shushil [All India Institute of Medical Sciences (AIIMS), Department of Pediatrics, New Delhi (India); Aneesh, Mangalasseril K.; Gupta, Vaibhav [All India Institute of Medical Sciences (AIIMS), Department of Radiodiagnosis, New Delhi (India)

    2007-09-15

    We report a 3-year-old boy with unilateral proptosis, painful swelling of the right thigh and aphasia. He had radiographic evidence of scurvy in the limbs and bilateral frontal extradural hematomas with a mass lesion in the left orbit on MRI. He was treated with vitamin C and on follow-up 8 weeks later had recovered with no evidence of the orbital mass on clinical or radiological study. Scurvy manifesting as proptosis and extradural hematoma is rare. (orig.)

  1. The effect of unilateral partial edentulism to muscle thickness

    International Nuclear Information System (INIS)

    Koca-Ceylan, Golzem; Guler, Ahmet U.; Taskay-Yelmir, Nergiz; Lutfi, Incesu; Aksoz, Tolga

    2003-01-01

    Teeth and muscle play a very important role for occlusal equilibrium and function.when tooth loss begins ,it may also effect the function of muscle tissues. The thickness of masseter and anterior temporalis muscles were measured bilaterally in 30 healthy fully dentate adults and in 30 unilateral edentulous patients by using ultrasonographic imaging. All scans were carried out by the same radiologist to eliminate the inter-observer difference, using a real time scanner (Toshiba SSA -270A,Japan). A 7.5 MHz linear transducer was used. The effect of age, sex, duration of partial edentulism, unilateral chewing habits of the individuals to the muscle thickness were also evaluated. In all subjects,facial proportion index was also determined. Main purpose of this study was to compare and establish the differences of muscle thickness between dentate and edentulous side in unilateral partial edentulous patients with ultrasonography and to test whether the variation in the thickness of the muscle is related to the variation in the facial and morphology. Ultrasonography revealed a large variation in the thickness of the masseter and temporolis muscles in experimental and controlled groups ,both relaxed and contracted conditions.The thickness of muscles in females was less in both conditions.In experimental group, a high negative correlation was found between the thickness of the masseter muscle and Facial Proportion Index ( FPI) in the females ,however, the statistical analysis showed no significant difference in the males. Also a high negative correlation was found in female control group. There was no statistically significant relationship between unilateral chewing habits and muscle thickness .In this study the duration of partial edentulism did not affect the thickness of the muscle.Further research is required to study muscular atrophy for comparison with total edentulism. (author)

  2. Unilateral flank ovariohysterectomy in guinea pigs (Cavia porcellus).

    Science.gov (United States)

    Rozanska, D; Rozanski, P; Orzelski, M; Chlebicka, N; Putowska, K

    2016-11-01

    To describe a simple, minimally invasive method of ovariohysterectomy via a unilateral flank approach in guinea pigs, for use in routine desexing of healthy female guinea pigs or treatment of ovarian cysts. The subjects of this retrospective study were 41 client-owned guinea pigs submitted for routine desexing or treatment of ovarian cysts. They included 16 healthy female guinea pigs aged 8-12 months (Group 1), and 15 females aged from 9 months to 3 years (Group 2), and 10 females aged from 3 to 7 years (Group 3) with different-sized ovarian cysts. Prior to surgery, the animals received clinical examination, blood testing (complete blood count and serum biochemistry profile) and examination of the abdomen using ultrasonography, to assess the condition of the reproductive tract and ensure the guinea pigs were fit for surgery. Ovariohysterectomy was performed via a unilateral flank incision made close to the erector spinae muscle starting approximately 1 cm caudal to the last rib. Both ovaries, uterine horns, and the uterine cervix were localised, ligated, and dissected through this unilateral retroperitoneal incision. Ovariohysterectomy was successfully completed via a single flank incision in 38/41 (93%) guinea pigs. Three guinea pigs with ovarian cysts from Group 3, which were >6 years old died during surgery due to circulatory and respiratory failure under anaesthesia. In the remaining 38 cases, surgery proceeded without complications. A further two guinea pigs from Group 3 were reluctant to move or eat for the first 3 days after surgery but recovered after provision of supportive care. All 38 animals fully recovered and wound healing was normal. This is the first report of ovariohysterectomy via a unilateral flank incision in guinea pigs. This approach is a simple, minimally invasive and safe alternative to the midline or bilateral flank approaches currently used for surgery of the reproductive tract in guinea pigs.

  3. Unilateral refusal to supply: An agreement in disguise?

    OpenAIRE

    Lidgard, Hans Henrik

    1997-01-01

    From a company perspective it is easier to develop a marketing strategy within a company than to arrange it in collaboration with others. Internal affairs can be controlled but agreements are left to the discretion of authorities. European competition policy suffers from a system failure discriminating against vertical agreements in favor of integrated organizations. Non-dominant companies should in principle be allowed to unilaterally decide its business strategy as there are alternatives. I...

  4. Ionized calcium serum evaluation in unilateral thyroidectomized cats

    Directory of Open Access Journals (Sweden)

    Katia Barão Corgozinho

    2015-12-01

    Full Text Available ABSTRACT. Corgozinho K.B., Cunha S.C.S., Neves A.P., Belchior C., Damico C.B., Silva C.A., Souza H.J.M.& Ferreira A.M.R. [Ionized calcium serum evaluation in unilateral thyroidectomized cats.] Avaliação do cálcio ionizado em gatos submetidos a tireoidectomia unilateral. Revista Brasileira de Medicina Veterinária 37(4:345-349, 2015. Pós-Graduação em Clínica e Reprodução Animal, Faculdade de Veterinária, Universidade Federal Fluminense, Rua Vital Brasil Filho, 64, Niterói, RJ 24230-340, Brasil. E-mail: katia.barao@gmail.com Seventeen hyperthyroid cats with cervical palpable nodules were submitted to clinical and laboratorial examination and they were prepared to surgery. Unilateral thyroparathyroidectomy with parathyroid gland autotransplantation was performed. Concentrations of serum urea, creatinine, alkaline phosphatase, alanine aminotransferase, phosphorus, potassium, total thyroxine and hematologic profile were determined before and seven days after surgery. Blood samples for serum ionized calcium concentration were collected before and after surgery on days 1, 2, 7, 15, 21. All cats had ionized calcium concentration within the reference range before surgery. Serum calcium concentration fell significantly in all cats within 24 hours after surgery. Hypocalcemia occurred in two cats without clinical signs. Ionized calcium concentration decreased after surgery and returned to normal levels on day 7 postoperatively. The results of this study suggest that calcium concentration must be measured before surgery in cats submitted to thyroidectomy even if they are submitted to unilateral technique.

  5. Cervical osteophytes presenting as unilateral vocal fold paralysis and dysphagia.

    Science.gov (United States)

    Yoskovitch, A; Kantor, S

    2001-05-01

    Any process involving either the vagus nerve, its recurrent laryngeal branch or the external branch of the superior laryngeal nerve may cause paralysis of the vocal fold. The most common cause is neoplasm. Clinically, the patients often present with a hoarse, breathy voice as well as symptoms of aspiration. The following represents a unique case of unilateral vocal fold paralysis and dysphagia caused by a degenerative disease of the cervical spine, resluting in extrinsic compression of the recurrent laryngeal nerve.

  6. Unilateral hearing during development: hemispheric specificity in plastic reorganizations

    Directory of Open Access Journals (Sweden)

    Andrej eKral

    2013-11-01

    Full Text Available The present study investigates the hemispheric contributions of neuronal reorganization following early single-sided hearing (unilateral deafness. The experiments were performed on ten cats from our colony of deaf white cats. Two were identified in early hearing screening as unilaterally congenitally deaf. The remaining eight were bilaterally congenitally deaf, unilaterally implanted at different ages with a cochlear implant. Implanted animals were chronically stimulated using a single-channel portable signal processor for two to five months. Microelectrode recordings were performed at the primary auditory cortex under stimulation at the hearing and deaf ear with bilateral cochlear implants. Local field potentials (LFPs were compared at the cortex ipsilateral and contralateral to the hearing ear. The focus of the study was on the morphology and the onset latency of the LFPs. The data revealed that effects of hearing experience were more pronounced when stimulating the hearing ear. With respect to morphology of LFPs, pronounced hemisphere-specific effects were observed. Morphology of amplitude-normalized LFPs for stimulation of the deaf and the hearing ear was similar for responses recorded at the same hemisphere. However, when comparisons were performed between the hemispheres, the morphology was more dissimilar even though the same ear was stimulated. This demonstrates hemispheric specificity of some cortical adaptations irrespective of the ear stimulated. The results suggest a specific adaptation process at the hemisphere ipsilateral to the hearing ear, involving specific (down-regulated inhibitory mechanisms not found in the contralateral hemisphere. Finally, onset latencies revealed that the sensitive period for the cortex ipsilateral to the hearing ear is shorter than that for the contralateral cortex. Unilateral hearing experience leads to a functionally-asymmetric brain with different neuronal reorganizations and different sensitive

  7. Unilateral hearing during development: hemispheric specificity in plastic reorganizations.

    Science.gov (United States)

    Kral, Andrej; Heid, Silvia; Hubka, Peter; Tillein, Jochen

    2013-01-01

    The present study investigates the hemispheric contributions of neuronal reorganization following early single-sided hearing (unilateral deafness). The experiments were performed on ten cats from our colony of deaf white cats. Two were identified in early hearing screening as unilaterally congenitally deaf. The remaining eight were bilaterally congenitally deaf, unilaterally implanted at different ages with a cochlear implant. Implanted animals were chronically stimulated using a single-channel portable signal processor for two to five months. Microelectrode recordings were performed at the primary auditory cortex under stimulation at the hearing and deaf ear with bilateral cochlear implants. Local field potentials (LFPs) were compared at the cortex ipsilateral and contralateral to the hearing ear. The focus of the study was on the morphology and the onset latency of the LFPs. With respect to morphology of LFPs, pronounced hemisphere-specific effects were observed. Morphology of amplitude-normalized LFPs for stimulation of the deaf and the hearing ear was similar for responses recorded at the same hemisphere. However, when comparisons were performed between the hemispheres, the morphology was more dissimilar even though the same ear was stimulated. This demonstrates hemispheric specificity of some cortical adaptations irrespective of the ear stimulated. The results suggest a specific adaptation process at the hemisphere ipsilateral to the hearing ear, involving specific (down-regulated inhibitory) mechanisms not found in the contralateral hemisphere. Finally, onset latencies revealed that the sensitive period for the cortex ipsilateral to the hearing ear is shorter than that for the contralateral cortex. Unilateral hearing experience leads to a functionally-asymmetric brain with different neuronal reorganizations and different sensitive periods involved.

  8. Unilateral or Reciprocal Climate Policy? Experimental Evidence from China

    Directory of Open Access Journals (Sweden)

    Thomas Bernauer

    2016-09-01

    Full Text Available The traditional political economy account of global climate change governance directs our attention to fundamental collective action problems associated with global public goods provision, resulting from positive or negative externalities as well as freeriding. The governance architecture of the 1997 Kyoto Protocol uses the traditional approaches of international diplomacy for addressing such challenges: legally binding commitments based on principles of reciprocity and (fair cost/burden sharing via formalized carbon-budgeting. Yet, the 2015 Paris Agreement has essentially abandoned this approach, as it now operates on the basis of internationally coordinated and monitored unilateralism. On the presumption that public opinion matters for government policy, we examine how citizens view this shift in climate policy from reciprocity to unilateralism, after many years of exposure to strong reciprocity rhetoric by governments and stakeholders. To that end, we fielded a survey experiment in China, the world’s largest greenhouse gas (GHG emitter. The results show that there is, perhaps surprisingly, strong and robust public support for unilateral, non-reciprocal climate policy. To the extent China is interested in pushing ahead with ambitious and thus costly GHG reduction policies, our results suggest that China can leverage segments of public support in order to overcome domestic obstacles to GHG mitigation policies.

  9. Disease course of patients with unilateral pigmentary retinopathy.

    Science.gov (United States)

    Potsidis, Emorfily; Berson, Eliot L; Sandberg, Michael A

    2011-11-29

    To evaluate the change in ocular function by eye in patients with unilateral pigmentary retinopathy. Longitudinal regression was used to estimate mean exponential rates of change in Goldmann visual field area (V4e white test light) and in full-field electroretinogram (ERG) amplitudes to 0.5- and 30-Hz white flashes in 15 patients with unilateral pigmentary retinopathy. Snellen visual acuity was assessed case by case. Mean annual rates of change for the affected eyes were -4.9% for visual field area, -4.7% for ERG amplitude to 0.5-Hz flashes, and -4.6% for ERG amplitude to 30-Hz flashes. All three rates were faster than the corresponding age-related rates of change for the fellow normal eyes (P = 0.0006, P = 0.003, P = 0.03, respectively). An initial cone ERG implicit time to 30-Hz flashes in affected eyes ≥ 40 ms predicted a faster mean rate of decline of visual field area and of ERG amplitude to 0.5- and 30-Hz flashes (P 35 years of age than in patients presenting at a younger age (P = 0.0004). The affected eye in unilateral pigmentary retinopathy shows a progressive loss of peripheral retinal function that cannot be attributed to aging alone and that is faster in eyes with a more prolonged initial cone ERG implicit time. Patients presenting at >35 years of age are at greater risk for losing visual acuity.

  10. Evaluation of mandibular condyles in children with unilateral posterior crossbite.

    Science.gov (United States)

    Illipronti-Filho, Edson; Fantini, Solange Mongelli de; Chilvarquer, Israel

    2015-01-01

    The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB) has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT). Twenty CBCT images of 40 temporo mandibular joints (TMJs) in individuals in mixed dentition phase, which included 9 males (mean 7.9 years) and 11 females (mean 8.2 years), with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

  11. Evaluation of mandibular condyles in children with unilateral posterior crossbite

    Directory of Open Access Journals (Sweden)

    Edson ILLIPRONTI-FILHO

    2015-01-01

    Full Text Available The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT. Twenty CBCT images of 40 temporo mandibular joints (TMJs in individuals in mixed dentition phase, which included 9 males (mean 7.9 years and 11 females (mean 8.2 years, with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (< 40 mm, congenital or genetic anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

  12. [A modified Onizuka cheiloplasty for repairing the unilateral cleft lip].

    Science.gov (United States)

    Zhang, Bin; Wang, Chao; Liu, Qiang; Li, Zengjian; Xu, Xianyi

    2011-08-01

    To explore the surgical technique of a modified Onizuka cheiloplasty for repairing the unilateral cleft lip. 24 patients with unilateral cleft lip were repaired by modified Onizuka cheiloplasty. The rotation flap ended at the midpoint of nasal columella crease. A small triangle skin flap was formed above the vermilion border of the advancement flap. The small triangle flap was inserted to the medial side after the Cupid's bow was built. The skin of the flap C was denuded along the nasal columella crease and the muscle was sutured to the alar base for augmentation of nostril floor on the cleft side. The tip of the advancement flap was sutured at the midpoint of nasal columella crease and the skin of nasal floor was trimmed to hide the incision line around the nasal columella base. It was found that the Cupid's bow was rebuilt in a natural form and the configuration of the upper lip was reconstructed symmetrically. The long term follow up studies showed that the philtrum column was not disturbed by the small triangle flap and the nasal floor was rebuilt without obvious scars. The modified Onizuka cheiloplasty is an easy learning technique and efficient for repairing the unilateral cleft lip. This technique can satisfy the patients by reducing the length of scar as well as rebuilding a natural form of upper lip and nostril floor.

  13. Idiopathic unilateral vocal-fold paralysis in the adult.

    Science.gov (United States)

    Rubin, F; Villeneuve, A; Alciato, L; Slaïm, L; Bonfils, P; Laccourreye, O

    2018-02-02

    To analyze the characteristics of adult idiopathic unilateral vocal-fold paralysis. Retrospective study of diagnostic problems, clinical data and recovery in an inception cohort of 100 adult patients with idiopathic unilateral vocal-fold paralysis (Group A) and comparison with a cohort of 211 patients with isolated non-idiopathic non-traumatic unilateral vocal-fold paralysis (Group B). Diagnostic problems were noted in 24% of cases in Group A: eight patients with concomitant common upper aerodigestive tract infection, five patients with a concomitant condition liable to induce immunodepression and 11 patients in whom a malignant tumor occurred along the path of the ipsilateral vagus and inferior laryngeal nerves or in the ipsilateral paralyzed larynx. There was no recovery of vocal-fold motion beyond 51 months after onset of paralysis. The 5-year actuarial estimate for recovery differed significantly (Pvocal-fold paralysis. In non-traumatic vocal-fold paralysis in adult patients, without recovery of vocal-fold motion, a minimum three years' regular follow-up is recommended. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  14. AVALIAÇÃO DA FUNÇÃO PULMONAR EM IDOSOS TABAGISTAS DE LONGA DATA ATIVOS E INSTITUCIONALIZADOS

    Directory of Open Access Journals (Sweden)

    Nelson Coimbra RIBEIRO NETO

    2016-06-01

    Full Text Available Um importante acometimento decorrente do tabagismo é a doença pulmonar obstrutiva crônica (DPOC, que é reconhecida como importante problema de saúde pública. Para tal, esta pesquisa teve a pretensão de avaliar a função pulmonar em idosos tabagistas de longa data ativos e institucionalizados, por meio de um estudo de campo, exploratório e quantitativo, realizado no Clube da Amizade de Castelo (CLAC e no Lar Vila Feliz, ambos localizados no município de Castelo-ES. Foram formados 2 grupos com N=4 em cada, constituindo um grupo de idosos ATIVOS e outro de idosos ITT (institucionalizados. Os dados coletados nos testes de espirometria e manovacuometria foram tabulados e analisados estatisticamente, adotando-se valor de p<0,05. Não foram observadas diferenças significativas entre as amostras, o que não descarta a necessidade de novas e mais amplas pesquisas na área.

  15. Atelectasia pulmonar em recém-nascidos: etiologia e aspectos radiológicos = Pulmonary atelectasis in newborn infants: etiology and radiological aspects

    Directory of Open Access Journals (Sweden)

    Alvares, Beatriz Regina

    2012-01-01

    Conclusões: A presença de atelectasia pulmonar é uma importante complicação em recém-nascidos internados em unidade de terapia intensiva neonatal. O exame radiológico possui um importante papel no diagnóstico e no direcionamento do tratamento desses pacientes

  16. Osteopatia tóxica hipertrófica associada a mixocondrosarcoma pulmonar metastático: descrição de um caso

    Directory of Open Access Journals (Sweden)

    F. D Garcia de Lima

    1955-12-01

    Full Text Available O A. descreve um caso de mixocondrosarcoma pulmonar metastático associado a um quadro completo de osteopatia tóxica hipertrófica. Focaliza as dificuldades diagnósticas devidas à evolução silenciosa do tumor, que à autópsia verificou-se ocupar todo o hemitórax direito. Chamou a atenção para a importância da osteopatia hipertrófica como possível denunciadora de um câncer pulmonar primitivo ou metastático que ainda não produziu sintomas.The author describes a case of metastatis pulmonar mixocondrosarcome associated to a complete picture of a hypertrophic toxic ostheopathic condition. Reference is made to the difficulties observed in its diagnosis, due to the silent evolution of the tumor, which through the autopsy was found to spread all over the right hemitorax. Attention is called to the importance of hyperthrophic ostheopathy as a possible indication of a primitive or metastic pulmonar cancer, still without symptoms.

  17. Bromur de Glicopirroni: tractament broncodilatador de manteniment, per a l'alleujament dels símptomes en pacients adults amb malaltia pulmonar obstructiva crònica

    OpenAIRE

    2014-01-01

    Malaltia obstructiva crònica (MPOC); Broncodilatadors de llarga durada (BDLD); Broncodilatadors anticolinèrgics de llarga durada (LAMA); Chronic obstructive lung disease (COLD); Bronchodilators length; Anticholinergic bronchodilators; Enfermedad pulmonar obstructiva crónica (EPOC); Broncodilatadores de larga duración; Broncodilatadores anticolinérgicos

  18. Diagnóstico y tratamiento de la hipertensión pulmonar tromboembólica crónica

    Directory of Open Access Journals (Sweden)

    Carlos Payares-Jardim

    2017-09-01

    Por esta razón, una vez se confirma el diagnóstico de hipertensión pulmonar tromboembólica crónica, es esencial que estos pacientes sean encaminados a un centro de referencia para tratamiento quirúrgico.

  19. Life Experience of Patients With Unilateral Vocal Fold Paralysis.

    Science.gov (United States)

    Francis, David O; Sherman, Ariel E; Hovis, Kristen L; Bonnet, Kemberlee; Schlundt, David; Garrett, C Gaelyn; Davies, Louise

    2018-05-01

    Clinicians and patients benefit when they have a clear understanding of how medical conditions influence patients' life experiences. Patients' perspectives on life with unilateral vocal fold paralysis have not been well described. To promote patient-centered care by characterizing the patient experiences of living with unilateral vocal fold paralysis. This study used mixed methods: surveys using the voice and dysphagia handicap indexes (VHI and DHI) and semistructured interviews with adults with unilateral vocal cord paralysis recruited from a tertiary voice center. Recorded interviews were transcribed, coded using a hierarchical coding system, and analyzed using an iterative inductive-deductive approach. Symptom domains of the patient experience. In 36 patients (26 [72%] were female, and the median age and interquartile range [IQR] were 63 years [48-68 years]; median interview duration, 42 minutes), median VHI and DHI scores were 96 (IQR, 77-108) and 55.5 (IQR, 35-89) at the time of interviews, respectively. Frustration, isolation, fear, and altered self-identity were primary themes permeating patients' experiences. Frustrations related to limitations in communication, employment, and the medical system. Sources of fear included a loss of control, fear of further dysfunction or permanent disability, concern for health consequences (eg, aspiration pneumonia), and/or an inability to call for help in emergency situations. These experiences were modified by the following factors: resilience, self-efficacy, perceived sense of control, and social support systems. Effects of unilateral vocal fold paralysis extend beyond impaired voice and other somatic symptoms. Awareness of the extent to which these patients experience frustration, isolation, fear, and altered self-identity is important. A patient-centered approach to optimizing unilateral vocal fold paralysis treatment is enhanced by an understanding of both the physical dimension of this condition and how patients

  20. Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation.

    Science.gov (United States)

    Lindsey, Derek P; Parrish, Robin; Gundanna, Mukund; Leasure, Jeremi; Yerby, Scott A; Kondrashov, Dimitriy

    2018-03-01

    OBJECTIVE Bilateral symptoms have been reported in 8%-35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms. The biomechanical effects of 1) unilateral stabilization on the contralateral SI joint and 2) bilateral stabilization on both SI joints are currently unknown. The objectives of this study were to characterize bilateral SI joint range of motion (ROM) and evaluate and compare the biomechanical effects of unilateral and bilateral implant placement for SI joint fusion. METHODS A lumbopelvic model (L5-pelvis) was used to test the ROM of both SI joints in 8 cadavers. A single-leg stance setup was used to load the lumbar spine and measure the ROM of each SI joint in flexion-extension, lateral bending, and axial rotation. Both joints were tested 1) while intact, 2) after unilateral stabilization, and 3) after bilateral stabilization. Stabilization consisted of lateral transiliac placement of 3 triangular titanium plasma-sprayed (TPS) implants. RESULTS Intact testing showed that during single-leg stance the contralateral SI joint had less ROM in flexion-extension (27%), lateral bending (32%), and axial rotation (69%) than the loaded joint. Unilateral stabilization resulted in significant reduction of flexion-extension ROM (46%) on the treated side; no significant ROM changes were observed for the nontreated side. Bilateral stabilization resulted in significant reduction of flexion-extension ROM of the primary (45%) and secondary (75%) SI joints. CONCLUSIONS This study demonstrated that during single-leg loading the ROMs for the stance (loaded) and swing (unloaded) SI joints are significantly different. Unilateral stabilization for SI

  1. Lateralizing value of unilateral relative ictal immobility in patients with refractory focal seizures--Looking beyond unilateral automatisms.

    Science.gov (United States)

    Agarwal, Priya; Kaul, Bhavna; Shukla, Garima; Srivastava, Achal; Singh, Mamta Bhushan; Goyal, Vinay; Behari, Madhuri; Suri, Ashish; Gupta, Aditya; Garg, Ajay; Gaikwad, Shailesh; Bal, C S

    2015-12-01

    Ictal motor phenomena play a crucial role in the localization of seizure focus in the management of refractory focal epilepsy. While the importance of unilateral automatisms is well established, little attention is paid to the contralateral relatively immobile limb. In cases where automatisms mimic clonic or dystonic movements and in the absence of previously well-established signs, unilateral relative ictal immobility (RII) is potentially useful as a lateralizing sign. This study was carried out to examine the lateralizing value of this sign and to define its characteristics among patients of refractory focal epilepsy. VEEGs of 69 consecutive patients of refractory focal epilepsy who had undergone epilepsy surgery at our center over last four years were reviewed and analyzed for the presence of RII. Unilateral RII was defined as a paucity of movement in one limb lasting for at least 10s while the contralateral limb showed purposive or semi-purposive movements (in the absence of tonic or dystonic posturing or clonic movements in the involved limb). The findings were seen in the light of VEEG, radiological and nuclear imaging data, and with post-surgical outcome. Unilateral RII as a lateralizing sign was found in 24 of 69 patients (34.78%), consisting of both temporal and extra temporal epilepsy, with 100% concordance with VEEG and MRI data. All patients demonstrating this sign had a good post-surgical outcome. RII, when well characterized is a frequent and reliable lateralizing sign in patients of refractory focal epilepsy. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  2. Dermatomiosite como primeira manifestação de uma neoplasia pulmonar

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    A.S. Castro

    2013-07-01

    Full Text Available Resumo: A dermatomiosite (DM é uma doença rara, caracterizada por fraqueza muscular proximal associada a exantema cutâneo típico. A biopsia muscular apresenta lesões inflamatórias compatíveis com miosite, estando associada a um aumento de risco de neoplasia, frequentemente considerada como síndrome paraneoplásico. Os autores apresentam um caso de um homem de 63 anos, com quadro de fraqueza muscular proximal progressiva e exantema cutâneo com 2 meses de evolução. A biopsia cutânea e muscular foram compatíveis com DM. A tomografia tórax mostrou imagem nodular paracardíaca esquerda e a biopsia brônquica confirmou diagnóstico de carcinoma pulmão pequenas células. Este caso clínico pretende realçar a importância da realização do estudo diagnóstico exaustivo em doentes com DM, visto que esta patologia surge frequentemente como síndrome paraneoplásico. Abstract: Dermatomyositis (DM is a rare disease characterised by proximal muscle weakness and a typical cutaneous rash. The muscle biopsy shows inflammatory lesions consistent with myositis, being related to an increased risk of cancer, often considered as a paraneoplastic syndrome. The authors present a case of a 63-year-old man, with progressive proximal muscle weakness and cutaneous rash, appearing in two months. The muscle and skin biopsies were consistent with DM. Chest tomography showed a nodular image in the lingular region and bronchy biopsy confirmed the diagnosis of small cell lung carcinoma (SCLC. This clinical case intends to enhance the importance of a thorough diagnostic study in patients with DM, as it is often a paraneoplastic syndrome. Palavras-chave: Dermatomiosite, Síndrome paraneoplásico, Neoplasias pulmonares, Keywords: Dermatomyositis, Paraneoplastic syndrome, Lung neoplasms

  3. Enfermedad pulmonar obstructiva crónica entrenamiento domiciliario versus ambulatorio hospitalario

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    Enrique Jolly

    2014-08-01

    Full Text Available Existe poca experiencia sobre el efecto del entrenamiento domiciliario (rD en pacientes con enfermedad pulmonar obstructiva crónica (EPOC. El objetivo de este trabajo fue comparar el efecto del rD sobre la tolerancia al ejercicio, disnea y calidad de vida versus el entrenamiento ambulatorio hospitalario (rH. Se compararon dos grupos de pacientes con EPOC. Ambos entrenaron durante 24 sesiones, 8 semanas. Antes y después del entrenamiento se realizaron: espirometría, cuestionarios de disnea (MRC, Mahler y Borg y calidad de vida (St. George y SF-36, pruebas de ejercicio submáximas (caminata 6 minutos, shuttle de resistencia y resistencia en cicloergómetro -tiempo límite-Tlim y máximas (shutlle test-ST- y cardiopulmonar. El grupo rH realizó ejercicios aeróbicos y de fuerza para miembros inferiores (MI y superiores (MS. El grupo rD realizó caminatas al 70% de la velocidad alcanzada en ST y ejercicios de fuerza para MI y MS. Se aleatorizaron 25 rH y 25 rD. La condición basal fue similar en ambos grupos. El Tlim aumentó 125% (p = 0.0001 para grupo rH y 63% (p = 0.0011 para rD, sin diferencias entre sí. También mejoraron distancia en shuttle resistencia (77%, p = 0.0421 en grupo rH y 79%, p = 0.0197 en rD y distancia en prueba 6 minutos (12% en rD, p = 0.0135. El puntaje en cuestionario St. George se redujo solo en el grupo rH (p = 0.0034; en el rD abandonaron 32% vs. 20% en el rH (p = 0.4521. El entrenamiento domiciliario resultó tan eficaz como el ambulatorio hospitalario en pacientes con EPOC, aunque con mayor tendencia al abandono.

  4. Enfermedad pulmonar obstructiva crónica por exposición al humo de biomasa

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    Matías Lopez

    Full Text Available En este artículo se discute la relación existente entre la enfermedad pulmonar obstructiva crónica (EPOC y el humo de biomasa. Más de la mitad de la población utiliza biomasa como combustible principal, sobre todo en áreas rurales y en países en vías de desarrollo donde su uso llega hasta el 80%. La inhalación del humo de biomasa crea un estado inflamatorio crónico, que se acompaña de una activación de metaloproteinasas y una reducción de la movilidad mucociliar. Esto podría explicar la gran asociación existente entre la exposición a biomasa y EPOC, revelada por estudios observacionales y epidemiológicos provenientes de países en vías de desarrollo y de países desarrollados. En esta revisión exploramos también las diferencias entre la EPOC causada por tabaco y por biomasa, y encontramos que, a pesar de las diferencias fisiopatológicas, la mayoría de las características clínicas, calidad de vida y mortalidad fueron parecidas. En los últimos diez años se han realizado intervenciones para disminuir la exposición a biomasa mediante el uso de cocinas mejoradas y combustibles limpios, sin embargo, estas estrategias todavía no han sido exitosas debido a su incapacidad para reducir los niveles de contaminación a niveles recomendados por la Organización Mundial de la Salud, y por su falta de uso. Por lo tanto, hay una necesidad urgente de ensayos de campo aleatorios, cuidadosamente realizados, para determinar la verdadera gama de reducciones de contaminación potencialmente alcanzables, la probabilidad de su uso y los beneficios a largo plazo en la reducción de la gran carga mundial de EPOC

  5. Edema pulmonar de altura: Modelo de estudio de la fisiopatología del edema pulmonar y de la hipertensión pulmonar hipóxica en humanos High altitude pulmonary edema: An experiment of Nature to study the underlying mechanisms of hypoxic pulmonary hypertension and pulmonary edema in humans

    Directory of Open Access Journals (Sweden)

    Marcos Schwab

    2007-02-01

    Full Text Available La altura, fascinante laboratorio natural de investigación médica, provee resultados con importantes implicancias para la comprensión de enfermedades que afectan a millones de personas que viven en ella, asi como para el tratamiento de enfermedades ligadas a la hipoxemia en pacientes que viven en baja altitud. El edema pulmonar de altura (EPA es una entidad que pone en peligro la vida y que ocurre en sujetos predispuestos pero sanos. Esto permite estudiar los mecanismos subyacentes del edema pulmonar en humanos, sin la presencia de factores que presten a la confusión como enfermedades concomitantes. El EPA resulta de la conjunción de dos defectos mayores: acumulación de líquido en el espacio alveolar debido a una hipertensión pulmonar hipóxica exagerada, y alteración en la eliminación del mismo por un defecto en el transporte transepitelial alveolar de sodio. En esta revisión, describimos brevemente las características clínicas y revisaremos este novedoso concepto. Proveemos evidencia experimental de como la síntesis alterada de óxido nítrico y/o la disminución de su biodisponibilidad representan el defecto central que predispone a la vasoconstricción pulmonar hipóxica exagerada y a la acumulación de líquido en el espacio alveolar. Mostramos que la hipertensión pulmonar hipóxica exagerada, per se, no es suficiente para producir un EPA, y que una alteración en la eliminación del fluido del espacio alveolar representa un segundo mecanismo fisiopatológico importante. Finalmente, describimos cómo los nuevos aportes obtenidos de los estudios del EPA pueden ser trasladados al manejo de otros estados patológicos ligados a la hipoxemia.High altitude constitutes an exciting natural laboratory for medical research. Over the past decade, it has become clear that the results of high-altitude research may have important implications not only for the understanding of diseases in the millions of people living permanently at high

  6. A utilidade da TC de tórax no diagnóstico do sequestro pulmonar Usefulness of chest CT in the diagnosis of pulmonary sequestration

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    José Gustavo Pugliese

    2010-04-01

    Full Text Available O sequestro pulmonar é uma rara anomalia congênita, caracterizada por tecido pulmonar embrionário não funcionante, perfazendo 0,15-6,40% de todas as malformações pulmonares congênitas. Essa anomalia envolve o parênquima e a vascularização pulmonar, sendo classificado como intralobar ou extralobar. Neste relato, descrevemos o caso de um paciente de 56 anos com hemoptise e imagem hipotransparente retrocardíaca em base de hemitórax esquerdo na radiografia de tórax. Após a realização de TC com contraste endovenoso, foi evidenciada a presença de sequestro pulmonar. O paciente foi submetido à cirurgia para a retirada do tecido anômalo, que foi realizada com sucesso. Apresentou boa evolução pós-operatória e recebeu alta com acompanhamento ambulatorial.Pulmonary sequestration is a rare congenital anomaly, characterized by nonfunctional embryonic pulmonary tissue. Pulmonary sequestration accounts for 0.15-6.40% of all congenital pulmonary malformations. This anomaly, which is classified as intralobar or extralobar, involves the lung parenchyma and its vascularization. We report the case of a 56-year-old male presenting with hemoptysis. A chest X-ray showed an area of opacity behind the cardiac silhouette in the base of the left hemithorax. Chest CT scans with intravenous contrast revealed pulmonary sequestration. The patient underwent surgery, in which the anomalous tissue was successful resected. The postoperative evolution was favorable, and the patient was discharged to outpatient treatment.

  7. Relação da pressão sistólica em artéria pulmonar com gênero, menopausa e gravidez em portadores de hipertensão arterial pulmonar associada à esquistossomose

    Directory of Open Access Journals (Sweden)

    Anderson C. Armstrong

    2013-08-01

    Full Text Available FUNDAMENTO: A hipertensão arterial pulmonar associada à esquistossomose (HPAE é uma grande preocupação no mundo todo. No entanto, o papel de fatores contribuintes específicos do gênero em HPAE é desconhecido. OBJETIVO: Investigamos os valores da pressão arterial pulmonar sistólica (PAPS e a presença de elevação grave na PAPS relacionado ao gênero, presença de menopausa e histórico de gravidez em pacientes com HPAE. MÉTODOS: Setenta e nove pacientes diagnosticados com HPAE de 2000 a 2009 foram avaliados e 66 foram incluídos no estudo. As informações referentes à idade, status da menopausa, gravidez, PAPS derivada da ecocardiografia, e pressão arterial pulmonar média invasiva (PAPm foram coletadas de registros médicos. A relação entre os valores de PAPS e PAPm e a correlação para doença grave foram avaliados. Os modelos de regressão avaliaram a associação de gênero, status da menopausa e histórico de gravidez com valores de PAPS e a presença de PAPS severa. RESULTADOS: Houve correlação moderada entre PAPm e PAPS, com boa concordância para classificação de doença grave. Os valores de PAPS foram semelhantes para homens e mulheres. Uma tendência a valores maiores de PAPS foi encontrada para mulheres não menopausadas em comparação a homens. Valores superiores de PAPS foram encontrados para mulheres menopausadas em comparação a mulheres não menopausadas; os valores não foram significativos após o ajuste de idade. O histórico de gravidez não teve relação com a PAPS. Presença de menopausa e passado de gravidez não mostraram associação com valores de PAPS. CONCLUSÃO: Em pacientes com HPAE, nem o gênero, nem o status da menopausa nem o histórico de gravidez apresentou uma correlação independente com valores de HPAE avaliados pela ecocardiografia.

  8. Doseamento das granzimas A e B na sarcoidose pulmonar (estudo experimental

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    Marília Dourado

    2005-03-01

    Full Text Available Resumo: A sarcoidose é uma doença granulomatosa crónica de etiologia desconhecida. Atinge todos os órgãos e sistemas, particularmente o pulmão. O doseamento sérico da enzima de conversão da angiotensina (SACE e da lisozima são exames complementares que contribuem para o seu diagnóstico e monitorização laboratorial. É desejável que outros marcadores possam optimizar a informação obtida com estes parâmetros. As granzimas A e B, produzidas por diversas células, poderão modular o turnover dos granulomas sarcoidóticos, tornando-se úteis como marcadores da doença.Objectivos: Dosear as granzimas A e B e avaliar o seu interesse como marcadores laboratoriais de sarcoidose. Paralelamente, dosear a SACE e a lisozima, marcadores reconhecidos da doença.Material e métodos: Indivíduos de ambos os sexos: Controlo normal (CN, n=30; controlo-doente (CD, n=21 (patologia pulmonar não granulomatosa; grupo-doente (D, n=11 (doentes com sarcoidose pulmonar.Recolheram-se amostras de sangue periférico para obter soro que se separou por tubos identificados e guardados a –30 ºC.Doseou-se a SACE por espectrofotometria e a lisozima por turbidimetria; as granzimas A e B por ELISA.Resultados: A actividade de SACE está significa-tivamente aumentada em D, comparativamente com CN e CD. A actividade da lisozima está significati-vamante aumentada nos grupos D e CD comparativamente com CN. A granzima B está significati-vamente diminuída nos grupos CD e D relativamente ao CN; a granzima A demonstrou diminuição significativa em D comparativamente com CN. Sugere-se que a diminuição das granzimas, na sarcoidose, poderá relacionar-se com resposta imunoin-flamatória local ineficaz relacionada com a formação do granuloma. Há necessidade de alargar o estudo também ao LLBA.Rev Port Pneumol 2005; XI (2: 111-133 Abstract: Sarcoidosis is a systemic disease of

  9. Acute pulmonary injury induced by experimental muscle trauma Lesão pulmonar aguda induzida por trauma muscular experimental

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    Márcia Andréa da Silva Carvalho Sombra

    2011-01-01

    Full Text Available PURPOSE: To develop an easily reproducible model of acute lung injury due to experimental muscle trauma in healthy rats. METHODS: Eighteen adult Wistar rats were randomized in 3 groups (n=6: G-1- control, G-2 - saline+trauma and G-3 - dexamethasone+trauma. Groups G-1 and G-2 were treated with saline 2,0ml i.p; G-3 rats were treated with dexamethasone (DE (2 mg/kg body weight i.p.. Saline and DE were applied 2h before trauma and 12h later. Trauma was induced in G-2 and G-3 anesthetized (tribromoethanol 97% 100 ml/kg i.p. rats by sharp section of anterior thigh muscles just above the knee, preserving major vessels and nerves. Tissue samples (lung were collected for myeloperoxidase (MPO assay and histopathological evaluation. RESULTS: Twenty-four hours after muscle injury there was a significant increase in lung neutrophil infiltration, myeloperoxidase activity and edema, all reversed by dexamethasone in G-3. CONCLUSION: Trauma by severance of thigh muscles in healthy rats is a simple and efficient model to induce distant lung lesions.OBJETIVO: Desenvolver um modelo facilmente reprodutível de lesão pulmonar aguda decorrente de trauma muscular experimental em ratos sadios. MÉTODOS: Dezoito ratos Wistar adultos foram randomizados em 3 grupos (n=6: G-1-controle, G-2 - trauma+salina e G-3 - trauma+dexametasona. Grupos G-1 e G-2 foram tratados com salina 2,0 ml ip, G-3 ratos foram tratados com dexametasona (DE (2 mg/kg peso corporal ip. Salina e DE foram aplicadas 2h antes e 12h depois do trauma. Trauma foi induzido em ratos G-2 e G-3 anestesiados (tribromoetanol 97% de 100 ml/kg, i.p. por secção da musculatura anterior da coxa logo acima da articulação do joelho, preservando os grandes vasos e nervos. Amostras de tecido (pulmão foram coletadas para avaliação da mieloperoxidase (MPO, e exames histopatológicos. RESULTADOS: Vinte e quatro horas após a indução da lesão muscular houve um aumento significativo na infiltração de neutr

  10. Comprometimento pulmonar na esclerose sistêmica: revisão de casos Pulmonary involvement in systemic sclerosis: cases review

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    Marcel Koenigkam Santos

    2006-06-01

    Full Text Available OBJETIVO: Rever e avaliar os padrões de alterações encontrados em exames de imagem de pacientes com comprometimento pulmonar da esclerose sistêmica. MATERIAIS E MÉTODOS: Foram retrospectivamente estudados os exames de radiografia simples e tomografia computadorizada de alta resolução de 23 pacientes com esclerose sistêmica. RESULTADOS: Na radiografia simples, o padrão reticular em bases pulmonares foi predominante, tendo sido verificado em 18 pacientes (78,2%. A tomografia computadorizada de alta resolução evidenciou lesão pulmonar em todos os pacientes estudados, encontrando-se faveolamento em nove pacientes (39,1%, opacidades em vidro fosco associadas a opacidades reticulares em oito (34,7%, predomínio de opacidades reticulares em cinco (21,7% e vidro fosco em um paciente (4,3%. CONCLUSÃO: O padrão de anormalidades tomográficas possui boa correlação com os achados histopatológicos, diferenciando padrões predominantemente inflamatórios de fibróticos, com os padrões inflamatórios estando associados a uma resposta superior ao tratamento. Dessa maneira, observou-se alteração sugestiva de fibrose na maior parte dos casos (faveolamento e opacidades reticulares somando 60,8%, porém com boa parte apresentando padrões sugestivos de processo inflamatório.OBJECTIVE: To review and evaluate the patterns of imaging examinations findings of lung disease in patients with systemic sclerosis. MATERIALS AND METHODS: Plain x-rays and high-resolution computed tomography studies of 23 patients with systemic sclerosis were retrospectively analyzed. RESULTS: At plain x-rays, pulmonary disease with reticular pattern had higher prevalence, appearing in 18 patients (78.2%. High-resolution computed tomography showed lung involvement in the whole group of patients, with honeycombing in nine patients (39.1%, ground-glass opacities associated with reticular opacities in eight patients (34.7%, predominance of reticular opacities in five (21

  11. Contribución al estudio de la función pulmonar en pacientes intervenidos de cirugía cardíaca extracorpórea : biopsia pulmonar y lavado broncoalveolar

    OpenAIRE

    Abad Vázquez, Cipriano Carlos

    1988-01-01

    En la presente tesis se hace una introducción histórica, clasificación y se relatan las complicaciones de la circulación extracorpórea. Seguidamente se hace una revisión bibliografica y se justifica la realización de la tesis. Para el estudio se toman 31 enfermos que se intervienen de cirugia cardiaca extracorpórea y se les realiza un protocolo clínico de estudio que incluye la realización de una biopsia pulmonar (microscopia óptica y electrónica) y lavado bronco alveolar; antes y después de ...

  12. Clinical and Electrophysiological Report of a Unilateral Retinitis Pigmentosa Case

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    Sedaghat MR

    2014-04-01

    Full Text Available Introduction: To describe clinical and electrophysiological features of a patient with unilateral Retinitis Pigmentosa (RP. Case: A 29-year-old female with a long history of progressive visual disturbance in the right eye has undergone multiple eye examinations during the past eight years. There was nothing noticeable in her past medical and ocular history. Comprehensive eye examinations were done in the first visit. All data was suggestive of right eye RP. Posterior segment fundal examination findings were: a pallor waxy disc, vessel attenuation, and extended pigmentary degeneration of the mid-peripheral retina. The left eye examination was normal. Comparing the automated 60 degree and 30 degree visual fields of both eyes obviously showed significant defects in the right eye visual field but normal in the left eye.  All of the probable infectious agents, which can cause similar ocular manifestations, were ruled out by serological tests. The standard photopic and scotopic electroretinographies were significantly reduced in amplitude in the right eye; however, they were normal in the left eye. Also, the standard Electro-Oculography (EOG results were the same as the Electro-Retinography (ERG ones in both eyes. Eye examinations were normal in other family members. Over an eight-year follow-up period, progressive deteriorating vision has gradually become more noticeable in the right eye. The left eye has been completely normal since.  This data was compatible with the Francois and Verriesr unilateral RP diagnostic criteria. Conclusion: Clinical signs and symptoms, a minimum of a five-year follow-up period, and confirmatory ERG and EOG are very helpful to diagnose andaffirm the case of unilateral RP.

  13. Ropivacaine for unilateral spinal anesthesia; hyperbaric or hypobaric?

    Science.gov (United States)

    Cantürk, Mehmet; Kılcı, Oya; Ornek, Dilşen; Ozdogan, Levent; Pala, Yasar; Sen, Ozlem; Dikmen, Bayazit

    2012-01-01

    The aim of this study was to compare the unilaterality of subarachnoid block achieved with hyperbaric and hypobaric ropivacaine. The prospective, randomized trial was conducted in an orthopedics surgical suite. In all, 60 ASA I-III patients scheduled for elective total knee arthroplasty were included in the study. Group Hypo (n=30) received 11.25mg of ropivacaine (7.5mg.mL(-1)) + 2mL of distilled water (density at room temperature was 0.997) and group Hyper (n=30) received 11.25mg of ropivacaine (7.5mg.mL(-1)) + 2mL (5mg.mL(-1)) of dextrose (density at room temperature was 1,015). Patients in the hyperbaric group were positioned with the operated side down and in the 15° Fowler position, versus those in the hypobaric group with the operated side facing up and in the 15° Trendelenburg position. Combined spinal epidural anesthesia was performed midline at the L(3-4) lumbar interspace. Hemodynamic and spinal block parameters, regression time, success of unilateral spinal anesthesia, patient comfort, surgical comfort, surgeon comfort, first analgesic requirement time, and adverse effects were assessed. Time to reach the T10 dermatome level on the operated side was shorter in group Hyper (612.00±163.29s) than in group Hypo (763.63±208.35s) (phyperbaric and hypobaric ropivacaine (11.25mg) provided adequate and dependable anesthesia for total knee replacement surgery, with a high level of patient and surgeon comfort. Hypobaric local anesthetic solutions provide a high level of unilateral anesthesia, with rapid recovery of both sensory and motor block, and therefore may be preferable in outpatient settings. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  14. Monocular oral reading after treatment of dense congenital unilateral cataract

    Science.gov (United States)

    Birch, Eileen E.; Cheng, Christina; Christina, V; Stager, David R.

    2010-01-01

    Background Good long-term visual acuity outcomes for children with dense congenital unilateral cataracts have been reported following early surgery and good compliance with postoperative amblyopia therapy. However, treated eyes rarely achieve normal visual acuity and there has been no formal evaluation of the utility of the treated eye for reading. Methods Eighteen children previously treated for dense congenital unilateral cataract were tested monocularly with the Gray Oral Reading Test, 4th edition (GORT-4) at 7 to 13 years of age using two passages for each eye, one at grade level and one at +1 above grade level. In addition, right eyes of 55 normal children age 7 to 13 served as a control group. The GORT-4 assesses reading rate, accuracy, fluency, and comprehension. Results Visual acuity of treated eyes ranged from 0.1 to 2.0 logMAR and of fellow eyes from −0.1 to 0.2 logMAR. Treated eyes scored significantly lower than fellow and normal control eyes on all scales at grade level and at +1 above grade level. Monocular reading rate, accuracy, fluency, and comprehension were correlated with visual acuity of treated eyes (rs = −0.575 to −0.875, p < 0.005). Treated eyes with 0.1-0.3 logMAR visual acuity did not differ from fellow or normal control eyes in rate, accuracy, fluency, or comprehension when reading at grade level or at +1 above grade level. Fellow eyes did not differ from normal controls on any reading scale. Conclusions Excellent visual acuity outcomes following treatment of dense congenital unilateral cataracts are associated with normal reading ability of the treated eye in school-age children. PMID:20603057

  15. [Diagnosis and treatment of unilateral gluteal muscle contracture].

    Science.gov (United States)

    Chen, Xiaoliang; Tang, Xueyang; Jiang, Xin; Wang, Daoxi; Peng, Mingxing; Liu, Lijun

    2011-05-01

    To investigate the pathogenesis, diagnosis, and treatment of unilateral gluteal muscle contracture. Between January 1990 and September 2009, 41 patients with unilateral gluteal muscle contracture were treated and the clinical data were retrospectively analysed. Among them, 24 were male and 17 were female with an age range from 6 to 29 years (mean, 12 years). Thirty-nine patients had a definite history of repeat intragluteal injection. The locations were the left side in 9 cases and the right side in 32 cases. The main clinical manifestations included lameness and abnormal gait. The medical examination showed pelvic oblique and relative inequality of lower limbs with a mean difference of 2.1 cm (range, 1.2-3.8 cm) in the distance form navel to malleolus medials. The X-ray films of pelvis showed outpouching trochanter of femur and pelvic oblique. The CT scans showed no abnormal finding except pelvic oblique and gluteal muscle contracture. The arc longitudinal incision was made into the posterolateral area nearby the greater trochanter and then lysis of the gluteal muscles was performed, followed by the skin traction of both legs and rehabilitation exercise. All incisions healed by first intention. Forty-one patients were followed up 1-20 years (mean, 5 years), and the signs of gluteal muscle contracture disappeared. After 1 year of operation, 34 patients had equal leg length, 5 patients had mild pelvic oblique, and 2 patients had obvious pelvic oblique. According to LIU Guohui et al. evaluation standard, the results were excellent in 33 cases, good in 6 cases, and poor in 2 cases with an excellent and good rate of 95.12% at 1 year after operation. Unilateral gluteal muscle contracture leads to pelvic oblique and inequality of lower limbs, and it can be cured with the surgical release of the gluteal muscle contracture by the arc longitudinal incision into the posterolateral area nearby the greater trochanter, combined with postoperative skin traction and

  16. Masseter muscle thickness in unilateral partial edentulism: An ultrasonographic study

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    S Sathasivasubramanian

    2017-01-01

    Full Text Available Introduction: Teeth and facial muscles play a very important role in occlusal equilibrium and function. Occlusal derangement, seen in unilateral partially edentulous individuals, has an effect on masseter muscle anatomy and function. The present study aims to evaluate masseter muscle thickness in unilateral partial edentulism. Patients and Methods: Institutional ethics committee approval was obtained before the commencement of the study. The study involved patients who routinely visited the Department of Oral Medicine and Radiology, Sri Ramachandra University. The study sample included 27 unilateral edentulous patients (Group E and 30 controls (Group C. The masseter muscle thickness was evaluated using high-resolution ultrasound real-time scanner (linear transducer − 7.5–10 MHz at both relaxed and contracted states. Statistical Analysis Used: The results were analyzed using paired t-test and independent t-test. Duration of edentulism and muscle thickness was assessed using Pearson's correlation coefficient. Results: The study patients' age ranged between 25 and 48 years (mean – 36 years. The comparative evaluation of masseter muscle thickness between the dentulous and edentulous sides of experimental group was statistically significant (P < 0.05. However, no statistically significant difference in masseter muscle thickness was found between the dentulous side of control and experimental groups. The correlation between the duration of partial edentulism and muscle thickness was statistically insignificant. Conclusion: The study proves masseter atrophy in the edentulous side. However, since the difference is found to be marginal with the present sample, a greater sample is necessary to establish and prove the present findings as well as to correlate with the duration of edentulism. Further studies are aimed to assess the muscle morphology after prosthetic rehabilitation.

  17. Benign Episodic Unilateral Mydriasis in a Flight Nurse.

    Science.gov (United States)

    Schiemer, Anthony

    2017-05-01

    Benign episodic unilateral mydriasis is one cause of anisocoria. This phenomenon is thought to be related to an imbalance between the sympathetic and parasympathetic nervous systems. There is a documented association with migraines, but asymptomatic cases have also been reported. A challenge with all cases is the level of investigation required to exclude more sinister causes of nervous system dysfunction. In a dynamic flight environment, additional considerations need to be made, such as varying light levels and use of night vision devices. A 27-yr-old woman on deployment to Afghanistan as a flight nurse presented to the role one clinic with right-sided mydriasis. The patient denied headache or any history of migraines. A dilated right pupil that was reactive to light was found on exam. Symptoms and exam findings resolved shortly after initial presentation. We consulted an ophthalmologist who requested patient transfer for review. He made a diagnosis of benign episodic unilateral mydriasis. There are a variety of causes for anisocoria. A thorough history and examination are required to avoid unnecessary investigations that may not be locally available in the more austere deployed military settings. From an operational perspective, the decision needs to be made regarding the maintenance of flight status. Consideration needs to be given to patient care capability when treating a flight nurse. In cases of rapid resolution such as this, removal from operational status is not reasonable should a clinician be confident of the diagnosis.Schiemer A. Benign episodic unilateral mydriasis in a flight nurse. Aerosp Med Hum Perform. 2017; 88(5):500-502.

  18. Unilateral Eye Blinking Arising From the Ictal Ipsilateral Occipital Area.

    Science.gov (United States)

    Falsaperla, Raffaele; Perciavalle, Valentina; Pavone, Piero; Praticò, Andrea Domenico; Elia, Maurizio; Ruggieri, Martino; Caraballo, Roberto; Striano, Pasquale

    2016-07-01

    We report on an 18-month-old boy with unilateral left eye blinking as a single ictal manifestation without facial twitching. The clinical onset of this phenomenon was first recorded (as an occasional event) at age 3 months, and it was overlooked. By age 6 months, the child's blinking increased to almost daily occurrence in clusters: during blinking the infant showed intact awareness and occasional jerks in the upper limbs and right leg. A video-electroencephalography (video-EEG) documented clinical correlation with a focal pattern arising from the left occipital region, and brain magnetic resonance imaging (MRI) revealed severe brain damage, consisting in poroencephalic hollows and increased spaces in the convexities involving a large area of the left cerebral hemisphere. The boy was prescribed sodium valproate (30 mg/kg/d), resulting in drastic reduction of his clinical seizures. Follow-up to his current age documented good general status, with persistent partial right hemilateral seizures. The blinking progressively disappeared, and is no longer recorded. The pathogenic hypotheses of the unilateral ictal blinking include involvement of the ipsilateral cerebral hemisphere and/or the cerebellar pathways. Review of previous reports of unilateral eye blinking, arising from the ictal ipsilateral brain, revealed that different damaged regions may give rise to blinking ictal phenomena, likely via the trigeminal fibres innervating the subdural intracranial structures and the pial vessels in the ipsilateral affected brain. The eye blinking in the present child represents a further example of an ictal phenomenon, which is predictive of the damaged brain region. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  19. Magnetic Vestibular Stimulation in Subjects with Unilateral Labyrinthine Disorders

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    Bryan Kevin Ward

    2014-03-01

    Full Text Available We recently discovered that static magnetic fields from high-strength MRI machines induce nystagmus in all normal humans, and that a magnetohydrodynamic (MHD Lorentz force, derived from ionic currents in the endolymph and pushing on the cupula, best explains this effect. Individuals with no labyrinthine function have no nystagmus. The influence of magnetic vestibular stimulation (MVS in individuals with unilateral loss of labyrinthine function is unknown and may provide insight into mechanism of MVS. These individuals should experience MVS, but with differences consistent with their residual labyrinthine function. We recorded eye movements in the static magnetic field of a 7T MRI machine in nine individuals with unilateral labyrinthine hypofunction, as determined by head impulse testing and vestibular-evoked myogenic potentials (VEMP. Eye movements were recorded using infrared videooculography. Static head positions were varied in pitch with the body supine, and slow-phase eye velocity (SPV was assessed. All subjects exhibited predominantly horizontal nystagmus after entering the magnet head-first, lying supine. The SPV direction reversed when entering feet-first. Pitching chin-to-chest caused subjects to reach a null point for horizontal SPV. Right unilateral vestibular hypofunction (UVH subjects developed slow-phase-up nystagmus and left UVH subjects, slow-phase-down nystagmus. Vertical and torsional components were consistent with superior semicircular canal excitation or inhibition, respectively, of the intact ear. These findings provide compelling support for the hypothesis that MVS is a result of a Lorentz force and suggest that the function of individual structures within the labyrinth can be assessed with MVS. As a novel method of comfortable and sustained labyrinthine stimulation, MVS can provide new insights into vestibular physiology and pathophysiology.

  20. Clinical study on unilateral hearing loss in children

    International Nuclear Information System (INIS)

    Masuda, Sawako; Usui, Satoko

    2007-01-01

    A series of 60 children was studied (aged 0 to 10 years, 32 boys, 28 girls) with severe unilateral sensorineural hearing loss of unknown etiology. There were two peaks, at 0 and 6 years. In 19 children, hearing loss was identified during a conservative general health checkup for school or preschool children. In 21 children aged 0 years, 16 were suspected of hearing loss by newborn hearing screening. Temporal bone computed tomography scans were examined in 51 patients. Sixteen ears (31.4%) with hearing loss had inner ear and/or internal auditory canal abnormalities. In one patient, the anomaly was the presence of a bony wall dividing the internal auditory canal into two separate compartments associated with severe inner ear hypoplasia. Two patients had a common cavity. In one of these patients, the anomaly was revealed because of severe bacterial meningitis, and another was detected by newborn hearing screening. Six patients had a narrow internal auditory canal, 4 had a narrow internal auditory canal and hypoplastic cochlea, and 1 had a narrow internal auditory canal and cystic vestibule, and lateral semicircular canal dysplasia. Two patients had a cystic vestibule and lateral semicircular canal dysplasia. One case showed fluctuation of the hearing level in the contralateral ear with normal hearing during the observation period at an average of 20 months. The number of children whose unilateral hearing loss is detected early by newborn hearing screening has enormously increased. Strategies for follow-up, early intervention, and support for families are necessary for young children with unilateral hearing impairment. (author)

  1. MRI and unilateral NMR study of reindeer skin tanning processes.

    Science.gov (United States)

    Zhu, Lizheng; Del Federico, Eleonora; Ilott, Andrew J; Klokkernes, Torunn; Kehlet, Cindie; Jerschow, Alexej

    2015-04-07

    The study of arctic or subarctic indigenous skin clothing material, known for its design and ability to keep the body warm, provides information about the tanning materials and techniques. The study also provides clues about the culture that created it, since tanning processes are often specific to certain indigenous groups. Untreated skin samples and samples treated with willow (Salix sp) bark extract and cod liver oil are compared in this study using both MRI and unilateral NMR techniques. The two types of samples show different proton spatial distributions and different relaxation times, which may also provide information about the tanning technique and aging behavior.

  2. Unilateral Carotid Body Resection in Resistant Hypertension

    Directory of Open Access Journals (Sweden)

    Krzysztof Narkiewicz, MD

    2016-08-01

    Full Text Available Animal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hypertension. The procedure proved to be safe and feasible. Overall, no change in blood pressure was found. However, 8 patients showed significant reductions in ambulatory blood pressure coinciding with decreases in sympathetic activity. The carotid body may be a novel target for treating an identifiable subpopulation of humans with hypertension.

  3. Unilateral pure trigeminal motor nerve neuropathy: A rare case report

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    Nishant K Srivastava

    2014-01-01

    Full Text Available Unilateral pure trigeminal motor nerve neuropathy is an extremely rare and unique condition, characterized by atrophy of the muscles, innervated by the motor branch of the trigeminal nerve. We report such a case in a 25-year-old male patient. The diagnosis was made on the basis of clinical and radiological examinations. Magnetic Resonance Imaging (MRI proved to be the key for establishing the diagnosis, which showed atrophy and fatty infiltration over the affected side of the muscles of mastication. We were unable to establish the cause of the condition even after performing a brain MRI.

  4. Unilateral Autosomal Recessive Anophthalmia in a Patient with Cystic Craniopharyngioma

    Science.gov (United States)

    Kumar, Amandeep; Bansal, Ankit; Garg, Ajay; Sharma, Bhawani S.

    2014-01-01

    Abstract Anophthalmia is a rare ocular malformation. It is a genetically determined disorder and is typically associated with syndromes. However, sporadic nonsyndromic familial as well as non-familial cases of anophthalmia have also been reported. Non-syndromic familial cases are usually bilateral and have been attributed to autosomal recessive, autosomal dominant, and X-linked inheritance patterns. The authors hereby report a rare case of autosomal recessive unilateral anophthalmia in a patient with no other associated congenital anomaly. Patient was operated for craniopharyngioma. The clinical, radiological and intraoperative findings are discussed. PMID:27928292

  5. Unilateral giant cell lesion of the jaw in Noonan syndrome

    OpenAIRE

    Eyselbergs, M; Vanhoenacker, F; Hintjens, J; Dom, M; Devriendt, K; Dijck, H Van

    2014-01-01

    Noonan syndrome (NS) is an etiologically heterogeneous disorder caused by mutations in the RAS-MAPK signaling pathway. Noonan-Like/Multiple Giant Cell Lesion (NL/MGCL) syndrome is initially described as the occurrence of multiple gnathic giant cell lesions in patients with phenotypic features of NS. Nowadays, NS/MGCL syndrome is considered a variant of the NS spectrum rather than a distinct entity. We report the case of a 14-year-old female patient carrying a SOS1 mutation with a unilateral g...

  6. Painful unilateral temporalis muscle enlargement: reactive masticatory muscle hypertrophy.

    Science.gov (United States)

    Katsetos, Christos D; Bianchi, Michael A; Jaffery, Fizza; Koutzaki, Sirma; Zarella, Mark; Slater, Robert

    2014-06-01

    An instance of isolated unilateral temporalis muscle hypertrophy (reactive masticatory muscle hypertrophy with fiber type 1 predominance) confirmed by muscle biopsy with histochemical fiber typing and image analysis in a 62 year-old man is reported. The patient presented with bruxism and a painful swelling of the temple. Absence of asymmetry or other abnormalities of the craniofacial skeleton was confirmed by magnetic resonance imaging and cephalometric analyses. The patient achieved symptomatic improvement only after undergoing botulinum toxin injections. Muscle biopsy is key in the diagnosis of reactive masticatory muscle hypertrophy and its distinction from masticatory muscle myopathy (hypertrophic branchial myopathy) and other non-reactive causes of painful asymmetric temporalis muscle enlargement.

  7. A Very Rare Presentation of Multiple Myeloma: Unilateral Raccoon Eye

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    Ceyhun Varım

    2015-08-01

    Two thirds of patients complain of bone pain, especially lower back pain. MM could be diagnosed after a pathologic fracture occurs in one third of patients. Presentation with symptoms related to hyperviscosity, hypercalcemia and bleeding tendency could also be observed. A rare presentation of MM is peri-orbital ecchymotic lesion (raccoon eye. Here, we report a 64 years old, male patient presented with unilateral raccoon eye and high erythrocyte sedimentation rate (ESR to internal medicine outpatient. The patient was referred to hematology outpatient and was diagnosed with multiple myeloma.

  8. A case of unilateral atypical orofacial pain with Eagle's syndrome

    Directory of Open Access Journals (Sweden)

    G V Sowmya

    2016-01-01

    Full Text Available Eagle's syndrome is not an uncommon condition, but less known to physicians, where an elongated styloid process or calcified stylohyoid ligament compresses the adjacent anatomical structures leading to orofacial pain. Diagnosis is made with appropriate radiological examination. Nonsurgical treatment options include reassurance, analgesia, and anti.inflammatory medications; and the surgical option includes a transoral or external approach. Here, we present a case report of a male patient, of age38 years, with a chief complaint of unilateral atypical orofacial pain on the right side of his face radiating to the neck region, for the last two months.

  9. Carbon leakage revisited. Unilateral climate policy under directed technical change

    International Nuclear Information System (INIS)

    Maria, Corrado Di; Van derWerf, E.

    2005-01-01

    This paper analyzes the consequences of unilateral climate policy in the presence of directed technical change. We develop a dynamic two-country model in which two otherwise identical countries differ in their environmental policy: one of the countries enforces a (binding) cap on emissions while the other does not. Focusing on carbon leakage, we show how, compared with a 'traditional' endogenous growth model, directed technical change will always lead to lower emissions in the unconstrained country. When clean and dirty goods are good substitutes, it may even be induced to reduce its emissions below the optimum level when both countries are unconstrained, so leakage is negative

  10. Statistical analysis of elastic beam with unilateral frictionless supports

    International Nuclear Information System (INIS)

    Feijoo, R.A.; Barbosa, H.J.C.

    1983-06-01

    A variational formulation of the elastic beam problem with unilateral frictionless supports is presented. It is shown that the solution of this problem can be characterized as the solution of a variational inequality or as the solution of the constrained minimum of the total potential energy of the structure. THe finite dimensional counterpart of this variational formulation is obtained using the finite element method, and the Gauss-Seidel method with projection and overrelaxation can be used to obtain an approximate solution. In order to show the numerical performance of the present approach some numerical examples are also presented. (Author) [pt

  11. A rare case of unilateral diffuse melanocytic proliferation

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    Guruprasad Ayachit

    2018-01-01

    Full Text Available A 67-year-old woman presented with metamorphopsia in the right eye. Leopard mottling was seen temporal to the fovea oculus dexter with corresponding hyper- and hypo-autofluorescent lesions on fundus autofluorescence. Spectral domain-optical coherence tomography revealed hyperreflective dots in the retinal pigment epithelium and choroid with subretinal fluid (SRF. Intravitreal bevacizumab was administered with which SRF resolved, albeit with increase in the areas of mottling. The patient was diagnosed to have metastatic ductal carcinoma of the right breast. It is important to bear in mind that the well-known entity of bilateral diffuse uveal melanocytic proliferation can rarely present unilaterally.

  12. Aspectos da proteção cerebral em pacientes submetidos a tromboendarterectomia pulmonar com hipotermia profunda e parada circulatória intermitente

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    HUEB Alexandre C.

    2000-01-01

    Full Text Available INTRODUÇÃO: A tromboendarterectomia pulmonar é utilizada como método bem estabelecido para aliviar a hipertensão pulmonar nos casos de tromboembolismo pulmonar crônico. A dificuldade que se apresenta é conciliar o tempo relativamente exíguo de parada circulatória total (PCT hipotérmica com a completa desobstrução das artérias pulmonares, sob pena de danos neurológicos. CASUÍSTICA E MÉTODOS: No período de março de 1998 a abril de 1999 (13 meses, 8 pacientes, 5 do sexo masculino, 1 de cor negra, com idade variando entre 25 a 56 anos (média 46,2 anos e com diagnóstico angiográfico de tromboembolismo pulmonar, foram submetidos a tromboendarterectomia pulmonar uni ou bilateral por tromboembolismo pulmonar crônico (TEP. Instalado o circuito extracorpóreo e incisada a artéria pulmonar, procede-se à PCT e, aproximadamente a cada 20 minutos de procedimento, intermitentemente, o fluxo da circulação extracorpórea (CEC é restabelecido a 14º C por um período de 15 minutos objetivando-se a reperfusão cerebral e corpórea. Sucessivas paradas circulatórias total são realizadas e tantas quanto forem necessárias até a remoção de todos os trombos da artéria pulmonar. RESULTADOS: Não foram registrados óbitos no transoperatório. Um paciente faleceu no 30º dia de pós-operatório (PO devido a broncopneumonia que evoluiu para sepse. Os 8 pacientes foram submetidos a CEC e PCT hipotérmica, sendo que em 5 (62,5% foram necessárias 4 PCT e em 3 (37,5% apenas 3 PCT, com média de 3,6 PCT. O tempo total de CEC variou de 210 a 255 minutos, com média de 225 minutos. O tempo de PCT hipotérmica variou de 58 a 88 minutos, com média de 76,7 minutos e o período de PCT por paciente variou de 18 a 24 minutos, com média de 20,5 minutos. Em todos os pacientes foram realizadas tomografias de crânio, que não revelaram nenhuma alteração anatômica, assim como o exame físico não revelou déficit motor ou rebaixamento do sens

  13. Desnutrição em paciente com doença pulmonar obstrutiva crônica

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    Andreia Biondo

    2011-10-01

    Full Text Available A doença pulmonar obstrutiva crônica (DPOC é uma patologia responsável por muitas mortes em todo o mundo, causada principalmente pelo tabagismo. Apresenta como característica associada o estado nutricional deficiente. O caso relatado é de uma paciente de 63 anos ex-tabagista, que internou em um hospital do interior do RS por broncopneumonia e diagnóstico de DPOC há 3 anos. Permaneceu internada por 15 dias, com negativa evolução do estado nutricional mesmo superando a ingestão energética estimada. Pacientes com DPOC apresentam taxa de metabolismo basal aumentada e infecções associadas podem acelerar ainda mais o metabolismo e gerar anorexia. A terapia nutricional é muito importante para a recuperação desses pacientes.

  14. Daño pulmonar agudo relacionado con la transfusión (Trali y Bartonelosis aguda

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    Douglas López de Guimaraes

    2006-07-01

    Full Text Available Se presenta el caso de un varón de 22 años procedente de la periferia de la ciudad de Huaraz, Perú, que acude al Hospital "Victor Ramos Guardia" de Huaraz con un tiempo de enfermedad de 14 días, febril, pálido e ictérico, en el frotis de sangre periférica se encuentran formas bacilares de Bartonella bacilliformis en 99% de la lámina; se inicia tratamiento antibiótico con ceftriaxona y ciprofloxacino. Al día siguiente se le indica transfusión de dos paquetes globulares (puesto que tenía 6,2 g/dL de Hb, dos horas después presenta dolor toráxico, tos seca exigente, vómitos, dificultad respiratoria y cianosis, en la auscultación se encuentran roncantes y crepitantes, la radiografía de tórax muestra infiltrado alveolar difuso a predominio derecho. Es trasladado a la UCI donde recibe oxígeno con máscara de reservorio, dopamina, corticoides y se inicia el monitoreo hemodinámico; responde en forma satisfactoria, sale de alta con frotis negativo a Bartonella bacilliformis. Es el primer caso de daño pulmonar agudo relacionado con la transfusión (TRALI asociado con Bartonelosis aguda con cuadro clínico - radiológico y evolución compatible, es importante distinguir entre la complicación pulmonar debido a la sepsis grave por Bartonelosis aguda, que puede producir un cuadro clínico similar y el TRALI.

  15. Anatomia e segmentação pulmonar de tamanduá-bandeira (Myrmecophaga tridactyla - Linnaeus, 1758 de vida livre

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    A.C.C. Giraldi

    Full Text Available RESUMO O presente trabalho utilizou oito pulmões de tamanduá-bandeira (Myrmecophaga tridactyla, jovens e adultos, de ambos os sexos, provenientes do Setor de Atendimento Clínico Cirúrgico de Animais Selvagens (SACCAS, do Hospital Veterinário "Dr. Halim Atique"( Unirp, localizado na cidade de São José do Rio Preto, estado de São Paulo. Os animais foram encaminhados ao Laboratório de Anatomia Veterinária, onde se procedeu à separação dos órgãos, à lavagem em água corrente e à retirada do excesso de sangue, para serem fixados em formol a 10%. Após a fixação dos pulmões, estes foram dissecados para identificar os segmentos. Os animais apresentaram lobação pulmonar à direita em cranial, médio, caudal e acessório, sendo o lobo cranial dividido em partes cranial e caudal. A lobação pulmonar à esquerda apresentou cranial e caudal em 100% dos animais. Por sua vez, o lobo cranial, em 87,5%, dividiu-se em partes cranial e caudal, e em 12,5% não houve divisão. O pulmão direito apresentou maior tamanho do que o pulmão esquerdo. A árvore brônquica apresentou os brônquios principais direito e esquerdo, os quais se ramificam em brônquios lobares, que dão origem aos segmentos bronquiopulmonares. Em relação à segmentação bronquiopulmonar, foram observadas, à direita, de 14 (12,5% a 18 segmentos (25% e, à esquerda, de 10 (25% a 30 segmentos (12,5%.

  16. Enfermedad pulmonar obstructiva crónica: los pacientes en la vida real. Estudio LEONPOC

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    Silvia García García

    2017-12-01

    ón were randomly selected from Primary Care database, MEDORA. Participants: 5222 eligible COPD patients were collected from MEDORA database. We calculated a sample size of 734 patients and finally studied 577 of them. Main measurements: Patientś clinical, functional and health related quality of life information were collected. Spirometry and postbroncodilator test were performed. Results: A total of 577 patients were included in this study. 28.7% of them did not have a spirometry recorded in their files. 123 patients had a normal or non-obstructive spirometry pattern, so they were excluded from a COPD diagnostic. With regard to treatments, there was an overprescribing of inhaled steroids in patients from GOLD A and B groups, and also in patients with the called exacerbator phenotype (GesEPOC. Conclusion: Although there have been several published guidelines, management of COPD patients in real life should be improved. Palabras clave: Enfermedad pulmonar obstructiva crónica, Espirometría, Diagnóstico, Tratamiento, Keywords: Chronic obstructive pulmonary desease, Spirometry, Diagnostic, Treatment

  17. Luxación facetaria unilateral lumbosacra postraumática. [ Post-traumatic lumbosacral unilateral facet dislocation].

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    Manuel González Murillo

    2016-08-01

    Full Text Available In the literature have been reported around fifty cases of lumbosacral dislocations; treated most bilateral facet dislocations. We report the case of a female 42 year old with unilateral lumbosacral facet dislocation of one month duration after accident. Circumferential instrumented fusion L5-S1 with interbody cage and pedicle screws L5-S1 was performed.   The lumbosacral dislocation is a rare injury that occurs due to the combination of a high-energy mechanism predisposing anatomical factors. Recent publications advocate the surgical reduction and stabilization with instrumentation as standard treatment.

  18. Testes de função pulmonar no transplante de medula óssea: Revisão sistemática

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    Eliane Viana Mancuso

    2006-01-01

    Full Text Available Resumo: As complicações pulmonares constituem causa importante de morbidade e mortalidade em doentes submetidos a transplante de medula óssea. Os testes de função pulmonar são utilizados rotineiramente na avaliação antes e no acompanhamento após o transplante. A revisão sistemática da literatura mostrou que a presença de alterações nos testes de função pulmonar antes do transplante de medula não esteve relacionada com maior incidência de complicações pulmonares pós-transplante. Entretanto, alterações destes testes após o transplante estiveram relacionadas com maior incidência de complicações respiratórias. Desta forma, embora as alterações dos testes de função pulmonar pré-transplante não tenham sido de valor preditivo positivo na detecção precoce de complicações respiratórias pós-transplante, os mesmos podem ser úteis na comparação com os testes realizados após o transplante e devem fazer parte da avaliação de doentes candidatos ao transplante de medula óssea.Rev Port Pneumol 2006; XII (1: 61-69 Abstract: The pulmonary function test plays an important role in the management of pulmonary complications after bone marrow transplantation. Although its utility in helping to predict the likelihood of developing post transplant pulmonary complications and mortality is not well established, current data indicate that pre-transplant pulmonary function tests are important as a reference for the interpretation of post transplant pulmonary function tests and for identifying patients at high risk of developing pulmonary complications and/or mortality after bone marrow transplantation.Rev Port Pneumol 2006; XII (1: 61-69 Palavras-chave: Transplante de medula óssea, testes de função pulmonar, revisão sistemática, Key-words: Bone marrow transplantation, respiratory function tests, systematic review

  19. Characteristics of masticatory muscles in children with unilateral posterior crossbite

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    Annicele da Silva Andrade

    2010-06-01

    Full Text Available The aim of this study was to detect possible differences in the EMG (electromiography activity, chewing rate (CR, cycle duration (CD and preferred chewing side (PCS between children with and without unilateral posterior crossbite. Thirty-seven children aged from 7 to 10 years were selected from the clinic of the Department of Pediatric Dentistry, Piracicaba Dental School, Brazil, and divided into two groups: unilateral posterior crossbite (UPCB group, n = 17, and normal occlusion (NOccl group, n = 20. The PCS was determined using a visual spot-checking method. The EMG activity was recorded during mastication, and two chewing sequences of 20 s were evaluated to establish each subject's CR (cycles/sec and CD. UPCB and NOccl groups did not have a PCS. The EMG activity and the cycle characteristics did not differ between the groups. The correlations between CD, CR and EMG activity were statistically significant for the masseter and anterior temporalis muscles only in the NOccl group, in which there was also a significant correlation between the EMG activity of masseter and anterior temporalis. In conclusion, these findings suggest that although children with and without UPCB presented a bilateral masticatory pattern with similar CR and CD, balanced EMG activity of masseter and anterior temporalis muscles was observed only in the NOccl group. These results indicate that in children, UPCB can alter the coordination of masticatory muscles during mastication.

  20. Transcanal labyrinthectomy for intractable vertigo after unilateral cochlear implantation.

    Science.gov (United States)

    Heidenreich, Katherine D; Basura, Gregory J; Zwolan, Teresa A; El-Kashlan, Hussam K; Telian, Steven A

    2011-10-01

    Document the use of transcanal labyrinthectomy to treat disabling attacks of vertigo after unilateral cochlear implantation. A 46-year-old woman with severe-profound bilateral sensorineural hearing loss secondary to enlarged vestibular aqueducts underwent cochlear implantation for her right ear with a Nucleus Freedom device. The surgery was uneventful, and postoperative imaging confirmed that the electrode was positioned properly. She developed episodic vertigo 10 to 14 days after the implant surgery, which failed to improve with aggressive vestibular rehabilitation therapy. Plugging of the round window for possible perilymphatic fistula did not relieve her symptoms. Right transcanal labyrinthectomy supplemented by filling the vestibule with gentamicin-soaked Gelfoam and then a customized vestibular rehabilitation program. Comparison of vestibular symptoms and cochlear implant performance before and after transcanal labyrinthectomy. The patient had immediate relief of symptoms, and the function of the cochlear implant was not adversely affected. Transcanal labyrinthectomy may be an effective method to ablate the vestibular end organ after unilateral cochlear implantation. It can offer relief of disabling vertigo without adversely affecting the performance of the implant.

  1. Functional significance of ipsilesional motor deficits after unilateral stroke.

    Science.gov (United States)

    Chestnut, Caitilin; Haaland, Kathleen Y

    2008-01-01

    To determine whether ipsilesional motor skills, which have been related to independent functioning, are present chronically after unilateral stroke and are more common in people with apraxia than in those without apraxia. Observational cohort comparing the performance of an able-bodied control group, stroke patients with left- or right-hemisphere damage matched for lesion volume, and left-hemisphere stroke patients with and without ideomotor limb apraxia. Primary care Veterans Affairs and private medical center. Volunteer right-handed sample; stroke patients with left- or right-hemisphere damage about 4 years poststroke; a control group of demographically matched, able-bodied adults. Not applicable. Total time to perform the (1) Williams doors test and the (2) timed manual performance test (TMPT), which includes parts of the Jebsen-Taylor Hand Function Test. Ipsilesional motor deficits were present after left- or right-hemisphere stroke when using both measures, but deficits were consistently more common in patients with limb apraxia only for the TMPT. These findings add to a growing literature that suggests that ipsilesional motor deficits may have a functional impact in unilateral stroke patients, especially in patients with ideomotor limb apraxia.

  2. Management of unilateral true vocal cord paralysis in children.

    Science.gov (United States)

    Setlur, Jennifer; Hartnick, Christopher J

    2012-12-01

    Historically, information gained from the treatment of unilateral true vocal cord paralysis (UVCP) in adults was the same used to treat children. Today, there is a growing body of literature aimed specifically at the treatment of this condition in children. It is an area of growing interest as UVCP can significantly impact a child's quality of life. Children with UVCP may present with stridor, dysphonia, aspiration, feeding difficulties, or a combination of these symptoms. Diagnosis relies on laryngoscopy, but other adjuncts such as ultrasound and laryngeal electromyography may also be helpful in making the diagnosis and forming a treatment plan. In many instances, there is effective compensation by the contralateral vocal fold, making surgical intervention unnecessary. Children who cannot compensate for a unilateral defect may suffer from significant dysphonia that can affect their quality of life because their ability to be understood may be diminished. In these patients, treatment in the form of medialization or reinnervation of the affected recurrent laryngeal nerve may be warranted. UVCP is a well recognized problem in pediatric patients with disordered voice and feeding problems. Some patients will spontaneously recover their laryngeal function. For those who do not, a variety of reliable techniques are available for rehabilitative treatment. Improved diagnostics and a growing understanding of prognosis can help guide therapy decisions along with the goals and desires of the patient and his or her family.

  3. Primary continuous unilateral headaches: a nosologic model for hemicrania continua.

    Science.gov (United States)

    Pareja, Juan A; Cuadrado, María-Luz; Fernández-de-las-Peñas, César; Montojo, Teresa; Álvarez, Mónica; López-de-Silanes, Carlos

    2012-04-01

    Hemicrania continua was originally described as a strictly unilateral, continuous headache with an absolute response to indomethacin. Recognition of an increasing number of patients with the same clinical features except for a lack of response to indomethacin has generated controversy about whether the responsive/non-responsive phenotypes belong to the same disorder. We suggest that the non-responsive phenotype should be differentiated from the original concept of hemicrania continua, because it probably indicates a separate type of headache of undetermined nature, i.e. hemicrania incerta. However, differentiating hemicrania incerta from hemicrania continua does not imply that the two headaches are unrelated. Both hemicranias may outline a continuum, giving rise to a broader diagnostic field. There seems to be a syndrome of 'primary continuous unilateral headache' with at least two distinctive categories: hemicrania continua and hemicrania incerta, which are differentiated by their respective response to indomethacin. This division means plurality but adds precision, and allows a clear-cut diagnosis of some controversial cases.

  4. The Computerized Table Setting Test for Detecting Unilateral Neglect.

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    Seok Jong Chung

    Full Text Available Patients with unilateral neglect fail to respond normally to stimuli on the left side. To facilitate the evaluation of unilateral spatial neglect, we developed a new application that runs on a tablet device and investigated its feasibility in stroke patients.We made the computerized table setting test (CTST to run on the tablet computer. Forty acute ischemic stroke patients (20 patients with right hemispheric infarction with neglect, 10 patients with right hemispheric infarction without neglect, and 10 patients with left hemispheric infarction and 10 healthy controls were prospectively enrolled to validate the CTST. The test requires subjects to set a table by dragging 12 dishes located below the table on the tablet screen. The horizontal deviation of the 12 dishes from the midline of the table, the selection tendency measured by the sequence of the dish selection, and the elapsed time for table setting were calculated automatically.Parameters measured by the CTST were correlated with the results of conventional neglect tests. The horizontal deviation was significantly higher in patients with right hemispheric infarction with neglect compared with the other groups. The selection tendency and elapsed time also were significantly different in patients with right hemispheric infarction with neglect compared with the left hemispheric infarction and control groups, but were similar to those with right hemispheric infarction without neglect.The CTST is feasible to administer and comparable with conventional neglect tests. This new application may be useful for the initial diagnosis and follow-up of neglect patients.

  5. A systematic review of left unilateral electroconvulsive therapy.

    Science.gov (United States)

    Kellner, C H; Farber, K G; Chen, X R; Mehrotra, A; Zipursky, G D N

    2017-08-01

    To systematically review the published clinical trials, case series, and case reports on left unilateral (LUL) electrode placement for clinical electroconvulsive therapy (ECT). PubMed, Ovid Medline, and the Cochrane Library were searched for articles concerning LUL ECT. Number of patients, efficacy, and cognitive outcomes were extracted from the papers that met our inclusion criteria. A total of 52 articles were included in this review, consisting of 33 clinical trials, seven case series, and 12 case reports. Overall, the efficacy of LUL electrode placement for the treatment of depression and psychosis is similar to that of right unilateral (RUL) and bilateral (BL) electrode placements. Patients receiving LUL ECT tend to experience more verbal memory impairment than patients receiving RUL ECT, but less verbal impairment than patients receiving BL ECT. In contrast, patients receiving LUL ECT tended to experience the least visual and nonverbal memory impairment, compared to patients receiving RUL or BL ECT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Unilateral Keratoconus after Chronic Eye Rubbing by the Nondominant Hand

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    Nathalie Bral

    2017-12-01

    Full Text Available Introduction: To report the development of unilateral keratoconus in a healthy male after persistent unilateral eye rubbing by the nondominant hand which was not needed for professional activities. Methods: Observational case report. Results: A 60-year-old male was first seen in our clinic due to decreased vision in his left eye. Slit-lamp biomicroscopy of the left eye revealed Vogt’s striae, stromal thinning, and a stromal scar. Corneal topography showed a stage 4 keratoconus. Clinical examination and corneal topography of the right eye were normal. Medical history revealed a habit of chronic eye rubbing only in the left eye because of the right hand being occupied for professional needs. During follow-up of 5 years, Scheimpflug images of the right eye stayed normal while the left eye showed a stable cone. Discussion: This case report supports the hypothesis of mechanical fatigue of the cornea due to repetitive shear stress on the surface caused by eye-rubbing.

  7. Bending of a nonlinear beam reposing on an unilateral foundation

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    Machalová J.

    2011-06-01

    Full Text Available This article is going to deal with bending of a nonlinear beam whose mathematical model was proposed by D. Y. Gao in (Gao, D. Y., Nonlinear elastic beam theory with application in contact problems and variational approaches,Mech. Research Communication, 23 (1 1996. The model is based on the Euler-Bernoulli hypothesis and under assumption of nonzero lateral stress component enables moderately large deflections but with small strains. This is here extended by the unilateralWinkler foundation. The attribution unilateral means that the foundation is not connected with the beam. For this problem we demonstrate a mathematical formulation resulting from its natural decomposition which leads to a saddle-point problem with a proper Lagrangian. Next we are concerned with methods of solution for our problem by means of the finite element method as the paper (Gao, D. Y., Nonlinear elastic beam theory with application in contact problems and variational approaches, Mech. Research Communication, 23 (1 1996 has no mention of it. The main alternatives are here the solution of a system of nonlinear nondifferentiable equations or finding of a saddle point through the use of the augmented Lagrangian method. This is illustrated by an example in the final part of the article.

  8. Unilateral Darier’s disease – case report

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    Jolanta Węgłowska

    2017-11-01

    Full Text Available Introduction . Darier’s disease (dyskeratosis follicularis, keratosis follicularis, Darier-White disease, Darier disease is a rare genodermatosis inherited in autosomal dominant manner, caused by a mutation in the ATP2A2 gene located on chromosome 12. The gene encodes SERCA2 ATPase, an enzyme responsible for the metabolism of calcium ions in the endoplasmic reticulum. Darier’s disease is characterized by small brown hyperkeratotic papules which appear already in childhood or early adolescence. Skin lesions are located primarily in seborrhoeic areas. In addition to typical skin eruptions, the clinical picture may include involvement of the nails and mucous membranes. The histopathological pattern is characterized by the coexistence of two abnormalities: acantholysis and dyskeratosis. Objective . To present and discuss a case of unilateral Darier’s disease diagnosed and treated at our medical centre. Case report . We present the case of a 46-year old woman with Darier’s disease manifesting as skin lesions in the form of typical hyperkeratotic papules localized on the left part of the trunk and on left-side limbs. The diagnosis was made on the basis of clinical features and histopathological findings. A good therapeutic effect was achieved after introducing treatment with acitretin at a dose of 25 mg/day. Conclusions . The case presented is interesting because of the rarity of unilateral Darier’s disease.

  9. Acute Unilateral Vestibular Failure Does Not Cause Spatial Hemineglect.

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    Julian Conrad

    Full Text Available Visuo-spatial neglect and vestibular disorders have common clinical findings and involve the same cortical areas. We questioned (1 whether visuo-spatial hemineglect is not only a disorder of spatial attention but may also reflect a disorder of higher cortical vestibular function and (2 whether a vestibular tone imbalance due to an acute peripheral dysfunction can also cause symptoms of neglect or extinction. Therefore, patients with an acute unilateral peripheral vestibular failure (VF were tested for symptoms of hemineglect.Twenty-eight patients with acute VF were assessed for signs of vestibular deficits and spatial neglect using clinical measures and various common standardized paper-pencil tests. Neglect severity was evaluated further with the Center of Cancellation method. Pathological neglect test scores were correlated with the degree of vestibular dysfunction determined by the subjective visual vertical and caloric testing.Three patients showed isolated pathological scores in one or the other neglect test, either ipsilesionally or contralesionally to the VF. None of the patients fulfilled the diagnostic criteria of spatial hemineglect or extinction.A vestibular tone imbalance due to unilateral failure of the vestibular endorgan does not cause spatial hemineglect, but evidence indicates it causes mild attentional deficits in both visual hemifields.

  10. EFFICACY OF BILATERAL SIMULTANEOUS HALLUX VALGUS CORRECTION COMPARED TO UNILATERAL

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    A. V. Boychenko

    2014-01-01

    Full Text Available The aim - to compare the results of simultaneous bilateral and unilateral surgical correction of hallux valgus and to create recommendations for treatment of the patients with this pathology. Material and methods. The authorse analyzed the data of 40 patients (60 feet who carried out an operative treatment of hallux valgus in SPb multiprofile city hospital N 2 since 2011 to 2013. Functional (AOFAS score and X-ray results were compared between groups with bilateral and unilateral correction. Mean AOFAS score in these 2 groups after 12 months after surgery was 85,6±6,2 and 85,5±6,9 (p>0,05, mean intermetatarsal angle - 8,4±0,5° and 8,8±0,8° (p>0,05 respectively. No statistically significant difference between these two groups was found. Conclusion. A bigger surgical trauma in case of simultaneous bilateral correction neither worsens functional and x-ray results nor increases a complication rate.

  11. Terapia celular em doenças pulmonares: existem perspectivas? Cell therapy in pulmonary diseases: are there perspectives?

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    João T. Ribeiro-Paes

    2009-05-01

    Full Text Available A terapia celular poderia ser conceituada de forma ampla e genérica como o emprego de células para tratamento de doenças. Apesar de um número não tão expressivo de relatos tendo o pulmão como objeto de estudo na terapia celular em pacientes humanos, há dados consistentes da literatura, tanto em humanos, quanto em modelos animais,que evidenciam a migração de células-tronco da medula óssea para o pulmão,em diferentes situações experimentais. Esses resultados forneceram o embasamento experimental para o emprego de células-tronco na regeneração do tecido pulmonar em modelos animais. Em nosso laboratório, vários projetos de pesquisa têm sido conduzidos com a finalidade de avaliar a resposta pulmonar (morfológica e funcional ao tratamento com células-tronco adultas em camundongos com doença pulmonar obstrutiva crônica (DPOC induzida experimentalmente. Os resultados obtidos, aliados àqueles de outros grupos de pesquisa, permitem aventar a possibilidade de aplicação, a curto prazo, da terapia celular em pacientes com DPOC. Em outra patologia pulmonar, fibrose cística (FC, cuja abordagem terapêutica com células-tronco apresenta aspectos particulares em relação às patologias pulmonares crônico-degenerativas, há avanços promissores e potencialmente interessantes; no entanto, os resultados podem ser considerados incipientes e deve-se assinalar, portanto, que a associação da terapia gênica e celular apresenta-se como uma alternativa possível, mas ainda muito distante quanto à sua consolidação e incorporação como opção terapêutica segura e eficaz em FC. Por outro lado, tendo por embasamento os resultados obtidos em modelos experimentais, é possível postular que a terapia celular com células-tronco hematopoéticas (ou de outras fontes encerra perspectivas consistentes de aplicação em diversas outras patologias pulmonares humanas, especialmente em DPOC.Cell therapy can be briefly described as the use of

  12. Auditory and language outcomes in children with unilateral hearing loss.

    Science.gov (United States)

    Fitzpatrick, Elizabeth M; Gaboury, Isabelle; Durieux-Smith, Andrée; Coyle, Doug; Whittingham, JoAnne; Nassrallah, Flora

    2018-03-13

    Children with unilateral hearing loss (UHL) are being diagnosed at younger ages because of newborn hearing screening. Historically, they have been considered at risk for difficulties in listening and language development. Little information is available on contemporary cohorts of children identified in the early months of life. We examined auditory and language acquisition outcomes in a contemporary cohort of early-identified children with UHL and compared their outcomes at preschool age with peers with mild bilateral loss and with normal hearing. As part of the Mild and Unilateral Hearing Loss in Children Study, we collected auditory and spoken language outcomes on children with unilateral, bilateral hearing loss and with normal hearing over a four-year period. This report provides a cross-sectional analysis of results at age 48 months. A total of 120 children (38 unilateral and 31 bilateral mild, 51 normal hearing) were enrolled in the study from 2010 to 2015. Children started the study at varying ages between 12 and 36 months of age and were followed until age 36-48 months. The median age of identification of hearing loss was 3.4 months (IQR: 2.0, 5.5) for unilateral and 3.6 months (IQR: 2.7, 5.9) for the mild bilateral group. Families completed an intake form at enrolment to provide baseline child and family-related characteristics. Data on amplification fitting and use were collected via parent questionnaires at each annual assessment interval. This study involved a range of auditory development and language measures. For this report, we focus on the end of follow-up results from two auditory development questionnaires and three standardized speech-language assessments. Assessments included in this report were completed at a median age of 47.8 months (IQR: 38.8, 48.5). Using ANOVA, we examined auditory and language outcomes in children with UHL and compared their scores to children with mild bilateral hearing loss and those with normal hearing. On most

  13. Impact of unilateral conductive hearing loss due to aural atresia on academic performance in children.

    Science.gov (United States)

    Kesser, Bradley W; Krook, Kaelyn; Gray, Lincoln C

    2013-09-01

    This study evaluates the effect of unilateral conductive hearing loss secondary to aural atresia on elementary school children's academic performance. Case control survey and review of audiometric data. One hundred thirty-two surveys were mailed to families of children with aural atresia, and 48 surveys were sent to families of children with unilateral sensorineural hearing loss (SNHL) to identify rates of grade retention, use of any resource, and behavioral problems. Audiometric data of the cohort were tabulated. Of the 40 atresia patients, none repeated a grade, but 65% needed some resources: 12.5% currently use a hearing aid, 32.5% use(d) a frequency-modulated system in school, 47.5% had an Individualized Education Plan, and 45% utilized speech therapy. Compared to the unilateral SNHL group and a cohort of children with unilateral SNHL in an earlier study, children with unilateral atresia were less likely to repeat a grade. Children in both unilateral atresia and SNHL groups were more likely to utilize some resource in the academic setting compared to the unilateral SNHL children in the prior study. Unilateral conductive hearing loss due to aural atresia has an impact on academic performance in children, although not as profound when compared to children with unilateral SNHL. The majority of these children with unilateral atresia utilize resources in the school setting. Parents, educators, and health care professionals should be aware of the impact of unilateral conductive hearing loss and offer appropriate habilitative services. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Effects of bilateral and unilateral locus coeruleus lesions on beam-walking recovery after subsequent unilateral sensorimotor cortex suction-ablation in the rat.

    Science.gov (United States)

    Goldstein, L B

    1997-01-01

    The recovery of beam-walking ability following a unilateral sensorimotor cortex lesion in the rat is hypothesized to be noradrenergically-mediated. We carried out two experiments to further test this hypothesis. In the first experiment, bilateral 6-hydroxydopamine locus coeruleus (LC) lesions or sham LC lesions were made 2 weeks prior to a right sensorimotor cortex suction-ablation lesion or sham cortex lesion. In the second experiment, unilateral left or right LC lesions or sham LC lesions were made 2 weeks prior to a right sensorimotor cortex lesion or sham cortex lesion. Beam-walking recovery was measured over the 12 days following cortex lesioning in each experiment. Bilateral, unilateral left, and unilateral right LC lesions resulted in impaired recovery. These data provide additional support for the hypothesis that beam-walking recovery after sensorimotor cortex injury is, at least in part, noradrenergically mediated.

  15. ERP effects of spatial attention and display search with unilateral and bilateral stimulus displays

    NARCIS (Netherlands)

    Lange, J.J.; Wijers, A.A.; Mulder, L.J.M.; Mulder, G.

    Two experiments were performed in which the effects of selective spatial attention on the ERPs elicited by unilateral and bilateral stimulus arrays were compared. In Experiment 1, subjects received a series of grating patterns. In the unilateral condition these gratings were presented one at a time,

  16. Motor Learning of a Bimanual Task in Children with Unilateral Cerebral Palsy

    Science.gov (United States)

    Hung, Ya-Ching; Gordon, Andrew M.

    2013-01-01

    Children with unilateral cerebral palsy (CP) have been shown to improve their motor performance with sufficient practice. However, little is known about how they learn goal-oriented tasks. In the current study, 21 children with unilateral CP (age 4-10 years old) and 21 age-matched typically developed children (TDC) practiced a simple bimanual…

  17. Nephron sparing surgery (NSS) for unilateral wilms tumor (UWT): the SIOP 2001 experience

    NARCIS (Netherlands)

    Wilde, Jim C. H.; Aronson, Daniel C.; Sznajder, Beata; van Tinteren, Harm; Powis, Mark; Okoye, Bruce; Cecchetto, Giovanni; Audry, Georges; Fuchs, Jörg; Schweinitz, Dietrich Von; Heij, Hugo; Graf, Norbert; Bergeron, Christophe; Pritchard-Jones, Kathy; van den Heuvel-Eibrink, Marry; Carli, Modesto; Oldenburger, Foppe; Sandstedt, Bengt; de Kraker, Jan; Godzinski, Jan

    2014-01-01

    Total nephrectomy (TN) remains the standard treatment of unilateral Wilms tumors (uWT). The SIOP WT-2001 protocol allowed Nephron Sparing Surgery (NSS) for polar or peripherally non-infiltrating tumors. Inventory of the current SIOP NSS-experience. 2,800 patients with a unilateral, localized or

  18. Unilateral mydriasis secondary to ipratropium bromide in a critically ill patient

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    Luciano Santana-Cabrera

    2012-01-01

    Full Text Available Unilateral dilated pupil in a critical patient under sedation is an important clinical sign that requires prompt evaluation. An exhaustive assessment must be performed, including neurological examination and imaging tests, and pharmacological causes must be ruled out. We describe a case of unilateral fixed dilated pupil secondary to the administration of a nebulized cholinergic antagonist, ipratropium bromide, in an unconscious patient.

  19. Determinants of Autobiographical Memory in Patients with Unilateral Temporal Lobe Epilepsy or Excisions

    Science.gov (United States)

    St-Laurent, Marie; Moscovitch, Morris; Levine, Brian; McAndrews, Mary Pat

    2009-01-01

    Patients with unilateral temporal lobe epilepsy from hippocampal origin and patients with unilateral surgical excision of an epileptic focus located in the medial temporal lobe were compared to healthy controls on a version of the Autobiographical Interview (AI) adapted to assess memory for event-specific and generic personal episodes. For both…

  20. Children with Mild Bilateral and Unilateral Hearing Loss: Parents' Reflections on Experiences and Outcomes

    Science.gov (United States)

    Fitzpatrick, Elizabeth; Grandpierre, Viviane; Durieux-Smith, Andrée; Gaboury, Isabelle; Coyle, Doug; Na, Eunjung; Sallam, Nusaiba

    2016-01-01

    Children with mild bilateral and unilateral hearing loss are now commonly identified early through newborn hearing screening initiatives. There remains considerable uncertainty about how to support parents and about which services to provide for children with mild bilateral and unilateral hearing loss. The goal of this study was to learn about…