Medicina
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Congenital metabolic diseases are considered as rare diseases because of their low incidence and their clinical symptoms at onset. Sometimes they can just begin in the neonatal period. Their progressive knowledge and the availability of specific and sensitive biochemical procedures allow us to diagnose many congenital metabolic diseases, which were not recognized some years ago. ⋯ In the first steps, the neuroimaging was less orientative, even if it allow the exclusion of other diseases. More than half of the patients with inborn errors of metabolism with onset in the neonatal period died within the first two years of life. It is really important to suspect these diseases in the neonatal period so as to achieve an early diagnosis and prompt therapy, specially with cofactors, that can reduce the morbimortality.
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Candida spondylodiscitis associatd with epidural abscess is rarely seen. We present a patient with Hodgkin lymphoma who received chemotherapy and developed systemic Candida infection, which was complicated by Candida spondylodiscitis and epidural abscess.
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An experimental model was devised to study the effects of a sustained insufflation maneuver on the immediate response to exogenous surfactant administration and the effects of baseline pulmonary volume subsequently used in 20 adult albino rats. Lung-injury was induced by repeated lavages with saline solution. Gas exchange, hemodynamic status, lung mechanics and histopathology were assessed. ⋯ Increased PaO2 associated to high functional residual capacity (FRC) (Group 1 p = 0.0001; Group 2 p = 0.0001), regardless of sustained insufflation, was observed. The use of sustained insufflation prior to surfactant administration along with high FRC ventilation was associated with polymorphonuclear infiltrates beneath the bronchiolar epithelium (p = 0.008). Our results do not advocate the use of sustained insufflation prior to the administration of exogenous surfactant.