[Menetrier disease of the child: a case report].
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Biomedical subjects
Publications and source records attributed to V Novara.
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Lipoid pneumonia. Recovery after treatment with intravenous immunoglobulins, steroids, cephalosporins. A case of lipoid pneumonia is described, due to accidental inhalation of cosmetic oil occurred in an infant 11 months old, which caused severe clinical and radiological features. The patient was treated with antibiotics, corticosteroids and intravenous immunoglobulins. Clinical and radiological recovery was achieved within 5 months and persisted at 9 and 20 months follow-up.
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CDU was used in 11 children with intussusception. Demonstration of vascular images within the "pseudokidney" mass was possible in none of 11 cases. Of them, eight could be treated by hydrostatic reduction. In the remaining case, marked edema of the bowel wall did not allow reduction, and surgery had to be performed: no necrosis was observed in the surgical specimen. Both patients in whom CDU failed to demonstrate vascular signals had necrosis at surgery, and bowel resection was performed. Because of the limited number of patients examined at this time, no firm conclusions can be drawn from our experience. However, CDU seems a promising technique in detecting vascular changes occurring in intussusception, with a possible role as a predictive tool of bowel necrosis.
Color-Doppler US was performed on 20 patients with sub-clinic hypothyroidism which had been confirmed by laboratory tests. In all cases, color-Doppler US showed increased parenchymal flow, whose semiology was similar to the one known as "thyroid inferno" and currently associated, in the literature, with diffuse hyperfunction conditions. Quantitative measurements yielded no further element for differential diagnosis, while showing high flow speeds which were similar to those in hyperfunction. On the basis of consequent physiopathologic considerations, hypervascularization, as observed in hypothyroidism, is likely to be referred to the hypertrophic action of TSH, which was reported as high in all patients. In conclusion, the color-Doppler "thyroid inferno" pattern, which has been to date considered as specific of thyroid hyperfunction, has lost part of its diagnostic specificity, and further investigation--e.g. hormonal titers, scintigraphy--is needed for an unquestionable diagnosis to be made.
After premising the value of qualitative color-Doppler analysis in the characterization of the main thyropathies through the identification of 4 main reference patterns, the authors investigate whether the quantitative information obtained by means of spectral analysis can improve the predictive value of color-Doppler US. One-hundred and seventy-six patients were examined and divided into 4 groups according to qualitative color-Doppler patterns, as reported in the literature. For each patient, flowmetry included the peak systolic frequency shift and the diastolic frequency shift. The Doppler shift was seen to differ greatly within each semiology class, with overlap of values between the various qualitative classes and between the different diseases. In conclusion, flowmetry provides no more useful diagnostic information than color-Doppler US in nodular or diffuse thyroid diseases.
One-hundred and sixty-six patients affected with thyroid diseases were examined, together with 41 healthy volunteers, by means of color-Doppler US. Four main reference patterns were identified: no appreciable glandular flow (I); presence of signal in perinodular location (II); peri- and intranodular flow (III); increased vascularization (IV). In 72 cases, parenchymal and nodular goiters, with no signs of thyroid hyperfunction, were characterized as belonging to pattern III, while pattern II was observed in 57 nodular lesions; only in 7 patients was pattern III detected. Hyperfunctioning autonomous nodules exhibited pattern III in 10/11 cases and the same pattern was followed by the six carcinomas. Pattern IV resulted peculiar to Basedow disease and to glandular hyperplasia related to high values of circulating thyroid hormone (6 cases). When color-Doppler specificity in typifying the major thyreopathies can be confirmed, the possibility is actually in sight of reducing, in the near future, the number of thyroid scintigraphies and of US-guided needle biopsies.
The antidepressant and anxiolytic effects of alprazolam were compared to those of desipramine, diazepam and buspirone in the forced swim test. Subchronic alprazolam induced a reduction in immobility similar to that of desipramine in 'non-pretested' and 'pretested' rats. In 'non-pretested' rats, the anti-immobility effect of desipramine was potentiated by diazepam and alprazolam, given before subchronic desipramine, while the anti-immobility effect of subchronic alprazolam was counteracted by diazepam. Diazepam, administered before the pretest session, counteracted, 24 h later, the anti-immobility effect of subchronic desipramine and alprazolam; alprazolam counteracted the anti-immobility effect of alprazolam but not of desipramine, buspirone at the highest doses tested potentiated the anti-immobility effect of subchronic desipramine but not of alprazolam. These data provide further support for the hypothesis that the GABA/benzodiazepine/Cl complex is directly implicated in the action of antidepressants and that systems other than the GABA system are involved in the antidepressant and anxiolytic effects of alprazolam.
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The effects of chlordiazepoxide (CDP, 5 mg/kg i.p.), the sodium salt of valproic acid (VPA, 200 mg/kg i.p.) and naloxone (Nx, 1 mg/kg s.c.) alone and CDP-Nx, VPA-Nx association on schedule controlled behaviour with signalled unpunished and punished periods, were investigated. Our results show that CDP and VPA under both the unemotional (variable ratio reinforcement schedule 20%) and the emotional (continuous reinforced schedule associated with electric shock) components significantly increase responding in the Skinner box. Nx, on the multiple schedule, non-significantly reduces responding under both components. With CDP-Nx association the increase in responding under the unemotional component is less than in the case of the benzodiazepine alone, while under the emotional component the increase in responding is not appreciably affected. With the VPA-Nx association the responding rate is lower than that of the control under the unemotional component while under the emotional component the increase in responding is reduced compared to the VPA alone. The higher rates of unemotional and emotional responding with both CDP and VPA depend on the dipsogenic and disinhibiting effects by both drugs. The different rate of emotional and unemotional responding with CDP-Nx and VPA-Nx associations indicates a specific influence on GABAergic and other systems by CDP and VPA.
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