Spontaneous retropharyngeal hematoma is an uncommon entity that is difficult to diagnose and may progress rapidly to airway obstruction. We report a case of a 53-year-old man with acute onset of retropharyngeal pain, dysphonia, and dysphagia after vomiting. On CT, a nonspecific retropharyngeal collection was seen. MR imaging demonstrated blood products, suggesting a diagnosis of retropharyngeal hematoma, and the patient was managed conservatively. MR imaging allowed specific diagnosis of a rare condition that is otherwise difficult to diagnose without surgical intervention.

Airway Obstruction↗

PubMedDate not supplied

[Hypothalamic-hypophyseal-gonadal axis in patients with liver cirrhosis of alcoholic origin].

Plasma levels of testosterone, 17-beta-oestradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone were estimated in 19 males with alcoholic cirrhosis and in 10 healthy age matched controls in basal conditions and after administration of clomiphene citrate. The gonadal hormone response is normal in the cirrhotic group after stimulation with clomiphene citrate, suggesting a normal functional reserve of the gonad of the cirrhotic patients. It is emphasized the direct damage that the alcohol produces in the Leydig cell.

Clomiphene↗

PubMedDate not supplied

[Homocystinuria in adults (report of 2 cases].

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Adult↗

PubMedDate not supplied

Dialysis-related infections.

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Arteriovenous Shunt, Surgical↗

PubMedDate not supplied

[Celiac disease and HLA in a hospital population of Uruguay].

Since the description of the association of HLA-B8 antigen with celiac disease, it has been confirmed by many authors. The incidence of HLA-B8 antigen is higher in adults and children when it is compared to apparently healthy controls. Some authors found a reduction on the incidence of HLA-B7 antigen and others suggested that a higher incidence of HLA-B12 antigen in patients HLA-B8 antigen negative, is associated with celiac disease. We studied 19 unrelated patients with celiac disease and 64 controls. Their ages range from 18 months to 18 years old, onset of the disease was during childhood. We determined twelve antigens of the HLA-A locus and thirteen antigens of the HLA-B locus. We used the NIH Microlymphocytotoxicity Technique. The degree of association was computed by the relative risk and the results were statistically evaluated by the X2. The statistically significant increase in frequency was shown only for HLA-A29 The results did not show neither the higher incidence for HLA-B8 found by other authors, nor the higher incidence for HLA-B12; however HLA-B7 was not detected in our patients. The final decision on the association of HLA-A29 antigen with celiac disease in our population will require examination of a broader panel of probands.

Adolescent↗

PubMedDate not supplied

[Thrombophlebitis of the cavernous sinus secondary to polysinusitis. Report of a new case].

Cavernous sinus thrombophlebitis syndrome is uncommon nowadays. Despite the wide range of antimicrobial agents it carries a high mortality. The disease frequently arises from infection of face, mouth, nose and paranasal sinuses, reaching the cavernous sinus by venous spread. Involvement of adjacent anatomic structures accounts for most of the clinical findings. Meningeal involvement, bilateral orbital edema and ocular cranial nerves palsy are very helpful in the differential diagnosis. Streptococcus spp., Staphylococcus spp., Haemophilus influenzae and anaerobic organisms are considered to be the most frequent etiological agents. In the present paper we report a case of cavernous sinus thrombophlebitis following left side polysinusitis. The patient presented with the main clinical features of the syndrome along with Streptococcus equisimilis and Fusobacterium necrophorum bacteremia. Urgent surgery of infected sinuses and appropriate antibiotic therapy led to a favorable outcome. The patient made and excellent progress and was discharged completely recovered two weeks after admission.

Adult↗

PubMedDate not supplied

[Chylous ascites in cirrhotic and non-cirrhotic patients].

Chylous ascites is an accumulation of lymph in the abdominal cavity. The diagnosis is established when the concentration of triglycerides in plasma is greater than in ascitic fluid over a level of 200 mg/dl. The clinical and biochemical characteristics of 22 patients with chylous ascites (11 cirrhotics and 11 non cirrhotics) were studied in order to assess differences between patients with and without hepatic cirrhosis. The cirrhotic patients with chylous ascites showed lower protein (1.3 +/- 0.74 mg/dl, p = 0.002) and cholesterol concentration (46.0 +/- 45.2 mg/dl, p = 0.02) in ascitic fluid than non cirrhotic patients (3.1 +/- 1.09 mg/dl, and 100.85 +/- 41.7 mg/dl, respectively). In addition, the cellularity in the ascitic fluid was also lower in cirrhotic patients (209.09 +/- 113.96 cel/mm3) versus (831.8 +/- 945.08 cel/mm3; p < 0.05). Four patients (18.18%) presented high adenosine deaminase levels (ADA) in the ascitic fluid in the absence of tuberculous peritonitis. The authors conclude that the biochemical differences observed in the ascitic fluid of the cirrhotic patients with chylous ascites may be explained by a dilutional mechanism due to the combination of "clear" ascites secondary to portal hypertension and chylous ascites. Furthermore, chylous ascites could be the cause of an elevation in ADA in the absence of tuberculous peritonitis.

Adenosine Deaminase↗