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41.
Mohammed A.R. Chamsi-Pasha M.B.B.S. ‡ Ashraf M. Anwar M.D. Ibrahim Al-Nasser M.D. † Youssef F. M. Nosir M.D. Ph.D. Aref Ajam M.R.C.P. Hassan Chamsi-Pasha F.R.C.P.I. F.A.C.C. 《Echocardiography (Mount Kisco, N.Y.)》2009,26(5):581-585
Primary cardiac tumors are rare at all ages, and especially so in childhood, where the most prevalent type of benign cardiac masses are rhabdomyomas followed by fibromas, both of which have a predilection for ventricular septum. We report an unusual case of a tumor involving the ventricular septum in an asymptomatic 17-year-old adolescent who has been known to have this tumor for 10 years. The use of multiple imaging included myocardial contrast two-dimensional echocardiography, real time three-dimensional echocardiography (with and without myocardial contrast), and magnetic resonance imaging supported the diagnosis of cardiac rhabdomyoma. 相似文献
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OBJECTIVES: The objective of this case report is to describe a femoral nerve injury after a psoas compartment block (PCB) and to discuss the probable mechanisms of injury and neuron regeneration. To date, this is the first report of severe femoral nerve injury after PCB. CASE REPORT: A 60-year-old, American Society of Anesthesiologists II woman underwent right total knee replacement under general anesthesia and continuous PCB for postoperative analgesia. Postoperatively, she showed signs of severe femoral nerve injury. A physical therapy program and muscle electrical stimulation were instituted and continued for 6 months. The patient recovered completely with no residual motor or sensory deficit and had no other complication. CONCLUSIONS: Severe nerve injuries after regional anesthesia techniques remain infrequent and probably unreported. Our case report suggests that severe femoral nerve injury should be added to the list of reported complications during PCB. This case report is also encouraging because it shows the possibility of a good recovery after such injury. 相似文献
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Al-Nasser F Duncan A Sharma R O'Sullivan C Coats AJ Anker SD Henein MY 《International journal of cardiology》2002,86(2-3):199-205
BACKGROUND: In a small but significant group of elderly patients who present with breathlessness, dynamic left-ventricular outflow tract obstruction (DLVOTO) may be responsible for symptom generation. The aim of our study was to investigate the effect of beta-blockade on ventricular physiology and symptoms in patients with DLVOTO. METHODS: We performed a pilot study in 15 patients (age 76+/-10 years, mean+/-S.D., 14 female) with symptoms of exercise intolerance (New York Heart Association, NYHA, class 2.7+/-0.5). All patients had normal resting left ventricular (LV) systolic function together with DLVOTO based on the presence of basal septal hypertrophy and the development of high outflow tract velocities on stress echocardiography. All were commenced on oral atenolol (mean dose 45+/-19 mg), but this could not be tolerated in four patients due to a deterioration in clinical status. RESULTS: In the remaining 11 patients who could tolerate atenolol therapy, the rate pressure product was significantly lower (23%, P=0.028) and there was a marked reduction in LV outflow tract velocity (23%, P=0.001) following beta-blockade. Patient symptoms improved significantly following atenolol therapy, with a reduction in mean NYHA class from 2.8+/-0.4 to 1.5+/-0.5 (P<0.0001). CONCLUSIONS: Beta-blockade may represent a beneficial therapeutic approach in selected patients with DLVOTO as identified by stress echocardiography. 相似文献
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Summary Very few data on the frequency and diversity of haematological abnormalities occurring in brucellosis in children have been reported. In the present study 110 children (56 boys and 54 girls; age range, 2 months to 14 years) with proven brucellosis were investigated to determine the haematological changes during the active course of this infection. Anaemia was detected in 48 (44%) patients, of whom four had evidence of haemolysis. Leukopenia occurred in 33% of the cases, with neutropenia and/or lymphopenia being the most striking features encountered. Thrombocytopenia was found in six (5%) patients and pancytopenia in 15 (14%) patients, of whom one developed disseminated intravascular coagulation. Clinically detectable bleeding occurred in five (4.5%) patients whose platelet counts were significantly low. Hypersplenism, haemophagocytosis and granulomatous lesions of the bone marrow appear to play a fundamental role in producing these abnormalities of the peripheral blood. Brucellosis may be considered in patients whose blood picture reveals haemolytic anaemia, leukopenia, thrombocytopenia or pancytopenia, particularly when the disease is epidemiologically suspected.
Hämatologische Manifestationen der Brucellose im Kindesalter
Zusammenfassung Zur Häufigkeit und Vielfalt pathologischer hämatologischer Befunde bei Brucellose im Kindesalter liegen nur wenige Berichte vor. Die folgende Studie umfaßt 110 Kinder (56 Knaben, 54 Mädchen im Alter von 2 Monaten bis 14 Jahren) mit gesicherter Brucellose, bei denen die hämatologischen Veränderungen während des akuten Krankheitsverlaufes verfolgt wurden. Bei 48 Kindern (44%) trat eine Anämie, in vier Fällen mit Zeichen der Hämolyse auf. Bei 33% der Patienten bestand eine Leukopenie mit Neutropenie und/oder Lymphopenie. Sechs Patienten (5%) hatten eine Thrombozytopenie und 15 (14%) eine Panzytopenie, in einem Fall mit diffuser intravaskulärer Gerinnung, entwickelt. Bei fünf Kindern mit niedrigen Thrombozytenzahlen traten Blutungen auf. Für die Entstehung der Veränderungen im peripheren Blut sind im wesentlichen Hypersplenismus, Hämophagozytose und granulomatöse Läsionen im Knochenmark verantwortlich. Bei Patienten mit hämolytischer Anämie, Leukopenie, Thrombozytopenie oder Panzytopenie sollte an eine Brucellose gedacht werden, vor allem wenn eine entsprechende epidemiologische Situation besteht.相似文献
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