Autologous blood transfusion: an easy way of avoiding unnecessary risks.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to R Ortega.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Pulmonary hypertension is a syndrome characterized by high pulmonary vascular resistance. It is a well described entity in newborn infants and children but almost unknown in the fetus. Therefore, this article focuses mainly on the former and then summarize how we diagnose and manage the problem in the fetus.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We retrospectively reviewed 16 children younger than 13 years with 17 fractures of the shafts of the radius or ulna or both who had undergone an open reduction-internal fixation (ORIF). ORIF was performed when a closed reduction was deemed unacceptable in 14 radius fractures and for three unstable open fractures of the radius. The average age was 9.4 +/- 2.3 years (range, 5.0-12.5). Of the 14 fractures with an unacceptable closed reduction, soft-tissue interposition was encountered in seven. Fixation was secured by plates and screws, percutaneous Steinmann pins, or intramedullary Steinmann pins. There were no delayed unions or nonunions, no infections, and no neurovascular injuries. The average follow-up was 12.3 months; all 17 fractures had excellent results (forearm rotation loss of < 10 degrees). Our study indicates that excellent results can be expected with no increased risk of complications if the treating physician elects to proceed with an ORIF in a pediatric forearm fracture with proper indications.
Heel pain is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft-tissue disorders. These disorders are classified on the basis of anatomic origin and predominant location of heel pain to foster a better understanding of this complaint. The disorders include plantar fascial lesions (fasciitis, rupture, fibromatosis, xanthoma), tendinous lesions (tendinitis, tenosynovitis), osseous lesions (fractures, bone bruises, osteomyelitis, tumors), bursal lesions (retrocalcaneal bursitis, retroachilleal bursitis), tarsal tunnel syndrome, and heel plantar fat pad abnormalities. With its superior soft-tissue contrast resolution and multiplanar capability, magnetic resonance (MR) imaging can help determine the cause of heel pain and help assess the extent and severity of the disease in ambiguous or clinically equivocal cases. Careful analysis of MR imaging findings and correlation of these findings with patient history and findings at physical examination can suggest a specific diagnosis in most cases. The majority of patients with heel pain can be successfully treated conservatively, but in cases requiring surgery (eg, plantar fascia rupture in competitive athletes, deeply infiltrating plantar fibromatosis, masses causing tarsal tunnel syndrome), MR imaging is especially useful in planning surgical treatment by showing the exact location and extent of the lesion.
INTRODUCTION: Lhermitte-Duclos disease is a rare disorder of the cerebellum of unknown origin in which dysplasic thickening of the cerebellar convolutions is seen. It usually occurs in young adults. Currently it is included in the phacomatosis group of disorders. CLINICAL CASE: A 19 year old woman attended the Emergency Department complaining of progressive orthostatic headache for the previous three months. On examination there were striking facial micronodular lesions suggestive of angiofibromas, a hypo-pigmented macula in the inframammary region and a hyperpigmented 'café-au-lait' macula in the right hypochondrium. On computerized tomography there was tetraventricular hydrocephalia. Cerebral magnetic resonance showed significant descent of the tonsils, hypertensive hydrocephalia and a lesion in the left cerebellum, apparently laminar hyperintensity in DP and T2, with thickening of some folia, not enhanced by intravenous contrast and suggestive of a dysplasic gangliocytoma. Laboratory investigations showed subclinical hypothyroidism. Other investigations were normal. The patient was treated by implanting a ventriculo-peritoneal shunt which has relieved the symptoms to date. CONCLUSIONS: Lhermitte-Duclos disease is probably not a single anatomo-clinical condition, assuming that it may be a cerebellar hamartoma associated with a phacomatosis with few clinical signs, whether it be Cowden's disease, tuberous sclerosis as in this case or an 'overlapping' syndrome. The magnetic resonance findings are necessary and sufficient for the diagnosis of Lhermitte-Duclos disease.
Explore the source record for details and available documents.
The function of the pancreatic B- and A- cell during a carbohydrate-rich meal was investigated in hyperthyroid patients, since these patients frequently present an altered handling of glucose. In basal conditions the plasma levels of glucose, immunoreactive insulin (IRI), C-peptide (CPR), proinsulin were higher in hyperthyroid patients than in normal subjects, whereas plasma glucagon was similar in the two groups. Hyperthyroid patients had high post-breakfast incremental areas of glucose and IRI and those of CPR and glucagon were normal. In post-breakfast plasma, the hyperthyroid patients had high proinsulin and normal insulin levels. The molar ratio between CPR and IRI was low throughout the test in the hyperthyroid group. In conclusion, in the hyperthyroid group the plasma levels of proinsulin were high and those of glucagon were normal; in response to the standard breakfast the levels of insulin and C-peptide were normal. These findings do not explain the altered glucose handling present in these patients.
Explore the source record for details and available documents.