[Graves-Basedow disease in a child. Apropos of a case treated with lithium carbonate].
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Adolescent↗
Biomedical subjects
C Valls
Publications and source records attributed to C Valls.
Duodenal gallstone ileus producing Boerhaave's syndrome.
A case of duodenal obstruction by biliary calculus associated with esophageal rupture is described. CT demonstrated air in the gallbladder, an impacted gallstone in the duodenum, pneumomediastinum, and hydropneumothorax. The present report describes the CT findings of these two rare conditions in the same patient.
Aged↗
Intrahepatic peripheral cholangiocarcinoma: CT evaluation.
BACKGROUND: The purpose of our study was to evaluate the imaging features and patterns of contrast enhancement in peripheral cholangiocarcinomas with computed tomography (CT) and correlate these features with histologic findings when available. METHODS: We reviewed the CT scans of 24 patients with 25 peripheral cholangiocarcinomas proved by orthotopic liver transplantation (n = 1), liver resection (n = 7), percutaneous needle biopsy (n = 10), and fine needle aspiration biopsy (n = 6). Incremental dynamic nonhelical CT was performed in four cases and helical CT in 21 cases. Portal venous phase images were obtained in all 25 cases. Fourteen patients underwent helical CT during arterial and portal phases. Delayed images were obtained in 20 patients. RESULTS: The size of the tumors ranged from 1.2 to 17 cm. Bile duct dilatation was present in 13 patients (52%), and regional lymph node enlargement was observed in six patients (24%). Retraction of the liver capsule was present in nine patients (36%). In eight patients (32%), satellite nodules were also detected. All tumors were globally hypodense during the portal phase. In 14 patients (70%), delayed images disclosed hyperattenuating tumors. Rimlike contrast enhancement was the most frequent pattern observed in either arterial (57% of patients) or portal (60% of patients) phase imaging. Portal venous encasement was seen in 10 patients (40%). CONCLUSION: In the proper clinical setting, detection of a hypodense hepatic lesion with peripheral enhancement, biliary dilatation, and contrast enhancement on delayed images are highly suggestive of peripheral intrahepatic cholangiocarcinoma.
Adult↗
Torsion of a wandering accessory spleen: CT findings.
Torsion of an accessory spleen is a rare entity that can have a variable clinical presentation. We report the computed tomographic (CT) findings of an acute torsion of an accessory spleen in a 13-year-old girl. CT disclosed a hypodense mesenteric mass with peripheral inflammatory changes.
Acute Disease↗
[Radiofrequency ablation of hepatic tumors].
This article aims to review the state of the art in ablation techniques for hepatic lesions. In addition to discussing the indications, outcomes, and potential complications of the technique, we illustrate the spectrum of imaging findings after treatment. Recent years have seen the development of a wide variety of minimally invasive techniques to treat liver cancer. These include ethanol injection, and thermal ablation using radiofrequency, laser, microwaves, or cryosurgery. Percutaneous radiofrequency ablation is one of the most promising non-surgical treatments for hepatic neoplasms. The results of several studies show that radiofrequency ablation enables adequate local control of tumors with few complications, achieving acceptable survival rates. Radiofrequency ablation can be performed using any imaging technique, although it is most commonly performed under ultrasound guidance. CT and MRI show the degree of tumor necrosis better and are more frequently employed in follow up. This article reviews the indications and contraindications for the procedure, potential complications, long-term outcome, and imaging findings for percutaneous radiofrequency ablation of hepatic tumors.
Carcinoma, Hepatocellular↗
Bisphosphonates, a new treatment for glucocorticoid-induced osteoporosis in children.
BACKGROUND: Long-term corticoids used as a treatment for rheumatic diseases are the most frequent cause of osteoporosis in the pediatric population. Bisphosphonates have been proved to be useful in treating osteoporosis. OBJECTIVE: To investigate the efficacy of pamidronate in corticoid-induced osteoporosis in children. PATIENTS AND METHODS: Ten children affected with rheumatic diseases and osteoporosis underwent biannual cycles of intravenous pamidronate (4 to 12 cycles). Complete clinical, radiological, biochemical and densitometric follow-up was performed at every treatment cycle. RESULTS: Good clinical and radiological evolution was observed in most of our patients; no new vertebral fractures were reported. Good densitometric evolution has been linked to the onset of puberty (rise in IGF-I levels) and low values for inflammatory activity markers (ESR and CRP). Self-limited hyperthermia and mild abdominal pain were observed during pamidronate infusion, but no other side effects were reported. CONCLUSIONS: Pamidronate is a safe and useful treatment for corticoid-induced osteoporosis in the pediatric population.
Adolescent↗
[Assistance quality program in intensive care units. Analysis of the effectiveness of correcting measures].
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Humans↗
Chondroblastoma of the temporal bone: CT and MR appearance.
The authors report a case of chondroblastoma in the unusual location of the temporal bone. CT findings do not differ dramatically from other reports: the lesion appeared as a soft-tissue density mass in the right temporal bone, with bony destruction and thinning of cortical margins. MR findings are more rare: on coronal T1-weighted images the lesion appeared as a mass, isointense to gray matter, centered in the right petrous bone; on axial T2-weighted images, as a mixed-intensity signal mass. They conclude that MR is an accurate indicator of the location and extension of the tumor, but that CT gives more specific information regarding bone involvement.
Chondroblastoma↗
[Control of respiratory monitoring in the critical patient].
This study of the safety of patients undergoing mechanical ventilation was undertaken to ensure correct ventilation and to find quality-control elements for patients and nursing staff. Differences in mode programming and ventilation parameters and their registry at the change of nursing shifts, and correct programming of the sensitivity and minimum minute volume alarms and maximum airway pressure alarms were examined. In a two-month period, 8 cross-sectional studies were made of G1 prevalence in each of three nursing shifts. The status of the alarms and sensitivity were recorded when incorrect, as well as whether the ventilation mode and parameters coincided with the change of nursing shift. An analysis was made of: FiO2, PEEP, respiratory rate, minute volume, tidal volume, support pressure level, and control pressure level depending on the ventilation mode. Corrective measures were applied for a month. The effectiveness of these measures was evaluated by making 8 new G2 cross-sectional studies of the same type. Two hundred forty-eight G1 and 250 G2 recordings were made. The G2 studies revealed a generalized reduction in errors for all parameters. We concluded that the corrective measures were effective so these indicators were included in the monitoring of risk areas in the unit quality control program.
Critical Care↗