Biomedical subjects
Publications and source records attributed to P A Hogan.
Previous reports of Pseudomonas folliculitis in children identified heated pools, hot tubs or spa baths as the source of the infection. This report presents a 4-year-old female with Pseudomonas folliculitis acquired from the family bath tub. The source of the infection was contaminated bath toys and bath plug.
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Atopic eczema in infants and children usually responds to a management programme involving patient education, the avoidance of environmental irritants, the regular use of emollients and the application of topical steroids. If a child fails to respond to this management programme, the dermatologist should initially ensure that the diagnosis is correct and exclude a coexistent disease process (for example, infection or immunodeficiency) that may be hampering response to treatment. The next step is to ensure that environmental irritants have been identified and eliminated from the child's environment and that prescribed medication is being used as instructed. Allergy assessment and ancillary therapy are reserved for those infants and children with severe disease not responding to basic therapy.
Viral exanthems can be classified as erythematous vesicular and papular. The majority are erythematous with the most common viral causes being non polio enteroviruses, respiratory viruses, acute. Epstein-Barr virus, human herpes viruses 6 and 7, and parvovirus B-19. Measles, rubella, mumps, acute GMV, hepatitis viruses. HIV seroconversion, Ross River and Barmah Forest viruses are less commonly seen. The differential diagnosis includes drug eruption, erythematous bacterial exanthems and Kawasaki's syndrome.
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26 patients admitted with clinical pictures consistent with meso-diencephalic infarction were studied using computerized axial tomography, magnetic resonance imaging and angiography. All of the patients presented symptoms in two of three major categories which comprise the "top of the basilar" syndrome. Lesions in the territory of the basilar-communicating artery were demonstrated in 22 of them. The remaining patients died before adequate neuroimaging documentation was obtained. Overall prognosis appeared relatively good since 80% of the patients recovered completely or incompletely from the ictus. Meso-diencephalic infarction is a very important and not uncommon subtype of cerebrovascular disorder.
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The term "top of the basilar" has been used in reference to a group of signs and symptoms of midbrain, diencephalic, and posteroinferior hemispheric dysfunction. It has been attributed to ischemia in the territory of second- and third-order vessels that arise from the uppermost portion of the basilar artery. We report our experience with four patients who had alteration of consciousness, confusion, and vertical gaze paresis accompanied by other physical abnormalities. Extensive evaluation did not help in documenting the lesions or in understanding their pathogenesis. The top of the basilar syndrome is a not uncommon form of stroke and carries a variable prognosis. Treatment by anticoagulation may prevent further infarction in selected patients who are seen early.
A case of ischemic infarction in a young woman who also had angiographic findings consistent with "Moya Moya" disease is presented. Unusual features of the case, such as the presentation as an infarction rather than subarachnoid hemorrhage and the unilaterality of the angiographic abnormalities, are discussed. The literature is reviewed and emphasis is directed to the importance of the inclusion of this entity in the differential diagnosis of cerebral ischemic events in young adults, owing to the possible therapeutic implications.
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