1/6. Efficacy of hemodiafiltration in a child with severe lactic acidosis due to thiamine deficiency.We report the case of a child in whom severe lactic acidosis (LA) and hyperammonemia developed after twenty days of total parenteral nutrition (TPN) for diffuse esophageal damage due to caustic ingestion. The revision of TPN preparation revealed that thiamine was never included and the hypothesis of thiamine deficiency was later confirmed measuring the serum thiamine level. Because severe metabolic acidosis the dialytic treatment with hemodiafiltration (HDF) and bicarbonate infusion were performed: the patient very quickly recovered with dramatic reestablishment of the acid-basic balance. Thiamine administration restored lactate metabolism. We emphasize that HDF is a useful and prompt treatment for LA to get over the critical phase of neurological and cardiological damage.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/6. Uncommon serious complications in stevens-johnson syndrome: a clinical case.We present an extremely serious clinical case of stevens-johnson syndrome, the evolution of which has been followed for 3 years. The etiology was unknown, although it was related with the administration of amoxicillin. We found a type III immunity mechanism involving immune complexes. The serious complications affected the skin, mucosae and internal organs. The present sequelae are: esophageal stenosis, pneumopathy with a 50% deficit of pulmonary perfusion and bilateral trichiasis.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/6. Lichen ruber mucosae with esophageal involvement.The clinical course of a 50-year-old woman with oral lichen ruber planus (Irp) and prolonged dysphagia is described. The swallowing problems of this patient were related to an inflammatory lesion of the middle third of the esophagus, leading to stenosis. Distal to this area, the esophagus was covered with mucosa of the cardia type, as seen in endobrachyesophagus. Apart from reflux disease, the Irp may have accounted for the stenosis of the mid-esophagus. The mucosal lesions disappeared after administration of etretinate (Tigason). After endoscopic dilatation the patient was able to swallow normally again.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/6. Effects of neutralizing agents on esophageal burns caused by disc batteries.The sequelae associated with ingested disc batteries that lodge in the esophagus may include tracheoesophageal fistula, esophageal perforation, stricture formation, or death. The focus of the current investigation is on whether medical therapy can arrest or lessen the severity of the injury during the time required to transport the patient to a center for treatment. A case of esophageal damage from the ingestion of a 1.5-V manganese dioxide disc battery in a 3-year-old boy is reported also. A two-phase study was completed in which the initial phase was an in vitro experiment to identify potable solutions that might neutralize the alkali contained in disc batteries. An in vivo study in 24 cats was undertaken to determine if bolus administration of these solutions would arrest or lessen the severity of the esophageal injury. None of the solutions tested demonstrated a significant difference in the degree of gross or histologic esophageal damage when compared to controls.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/6. Severe chronic mucocutaneous candidiasis. Favourable response to oral therapy with ketoconazole.Severe, early-onset, chronic mucocutaneous candidiasis was associated with bronchiectasis, oesophageal stricture, short stature and delayed puberty in a male aged 18 years. Topical treatment with antifungal agents, and several courses of intravenously administered transfer factor, amphotericin, and miconazole achieved only minor or transient improvement in the patient's condition. Correction of iron deficiency anaemia did not lead to alleviation of candidiasis. skin reactivity to candida antigen was absent and t-lymphocytes, which responded normally to phytohaemagglutinin (PHA), poke-weed mitogen and concanavalin a, had negative macrophage-inhibiting factor (MIF) and blastogenic responses to candida antigen. Treatment with the orally effective imidazole derivative, ketoconazole, produced improvement within three days and clearing of mucosal lesions within five weeks. The patient then entered puberty spontaneously at the age of 20 years. After 18 months of treatment with ketoconazole, without side effects, the clinical manifestations of mucocutaneous candidiasis have not recurred. Because of the possibility of continuous, long-term administration, ketoconazole represents the best currently available agent for the treatment of chronic mucocutaneous candidiasis.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/6. Esophageal stricture secondary to candidiasis without underlying disease.candidiasis of the esophagus progressing to stricture formation in a 74-year-old male is reported. Esophageal candidiasis develops in the presence of various predisposing conditions such as long-standing administration of antibiotics or corticosteroids, and malignancy. The first endoscopic examination of this patient revealed unusual multiple black plaques in the esophagus. Despite intensive exploration, no predisposing factors were found. The stricture was progressive, despite the administration of adequate antifungal therapy, and its presence necessitated several attempts at dilatation. case reports of esophageal candidiasis without underlying disease are very rare.- - - - - - - - - - ranking = 2keywords = administration (Clic here for more details about this article) |