Damián Palafox

Poster 1011: Potential immunogenetic associations between atopy and metabolic syndrome in children

Background Recently, immunogenetic studies have demonstrated a potential association between atopy and metabolic syndrome in children. Several susceptibility genes have been linked between obesity, diabetes and atopy, such as CTLA4 (CD28-ICOS), IL12b, ADRB2, TNFa and LTA4. It has also been noted that obese atopic patients have different clinical manifestation compared to those not obese, for instance, systemic inflammation is often more severe and bronchial hyperreactivity tends to be more acute. On the other hand, pulmonary function, quality of life in terms exercise tolerance and involvement in recreational activities is poorer.

Ascending necrotizing mediastinitis secondary to emphysematous pyelonephritis

Mediastinal infections usually originate from postoperative complications or in a descending manner from a cervical infectious process; few reports have emerged describing an ascending trajectory. A 56-year-old woman with a Huang class 1 left emphysematous pyelonephritis was referred due to a progression of an ascending necrotizing mediastinitis. A left posterolateral thoracotomy was performed, drainage and thorough lavage were carried out with a successful outcome. We believe this is the first reported case of ascending necrotizing mediastinitis secondary to an emphysematous renal infection.

Malformación arteriovenosa de alto flujo en el cuello

We present the case of a 17-year-old female patient that came for consultation because of a pulsatile mass in the left lateral side of the neck. The physical examination revealed that she was neurologically intact. An increase of volume confined to the region and a pulsatile mass accompanied by fremitus were felt. Slight exophthalmos could also be seen, with preservation of visual and auditory acuity. The

Poster 2002: Transfer factor may provide immunomodulation in cutaneous tuberculosis

Methods We tested transfer factor in a 1 year old and 3 months patient diagnosed with Ganglionar Tuberculosis. 1 week after the administrarion of the Bacillus Calmette-Guerin vaccination, the present developed fever, cervical, submandibular, supraclavicular, inguinal and axillary lymphadenopathy. Later on the patient devoloped cutaneous clinical manifestations of tuberculosis such as scrofuloderma, fistulas, hypertrophic scars and ultimately, queloids. The patient had previously undergone short-term strictly supervised treatment for tuberculosis with very poor results. When the treatment was first administered, the patient had the following data: Total White Blood Count 12.9 Lymphocytes: 29% (12–46) CD3: 26.3% (59–90) T helper Cells (CD3/CD4) 21.6% (42–58) Cytotoxic T cells (CD3/CD8) 5.1% (17–33) Natural Killer Cells (CD56) 2.1% (3–7) B cells (CD19) 67.6 % (0–10).

Timectomia toracoscópica bem sucedida em um lactente

Minimally invasive surgery is gaining worldwide acceptance for the treatment of mediastinal tumors in children. It has been shown to have several advantages over conventional open surgical approaches. For instance, Lawal et al. showed that thoracoscopy, in comparison with thoracotomy, was associated with significantly fewer midterm musculoskeletal sequelae and a better cosmetic outcome.Minimally invasive surgery is gaining worldwide acceptance for the treatment of mediastinal tumors in children. It has been shown to have several advantages over conventional open surgical approaches. For instance, Lawal et al. showed that thoracoscopy, in comparison with thoracotomy, was associated with significantly fewer midterm musculoskeletal sequelae and a better cosmetic outcome. The authors also found that chest asymmetry in the horizontal plane was significantly less frequent after video-assisted thoracic surgery (VATS) than after conventional surgery (mean relative difference, Another group of authors demonstrated that undesirable comorbidities, such as rib fusion, deformities of the thorax, and scoliosis, can be avoided using thoracoscopic procedures. For anterior mediastinal masses in children, less invasive approaches are preferred, because of the wide spectrum of clinical manifestations associated with such masses. Here, we present the case of an eighteen-month-old infant who underwent thoracoscopic thymectomy, which proved to be safe and provided a satisfactory clinical outcome. We believe that it is of the utmost importance that the thoracoscopic approach be promoted to pediatric pulmonologists and thoracic surgeons. An eighteen-month-old male infant presented with a six-month history of recurrent respiratory infections. He had previously been diagnosed with bronchiolitis, which had been treated with bronchodilators and symptomatic management. However, poor results had been obtained. There was no record of any previous hospitalization, and no imaging studies had been performed before he was referred to our facility. He was hospitalized during an acute episode of severe dyspnea. Simple X-rays showed a widened mediastinum and a mass in the anterior mediastinum. Therefore, CT was performed. The presence of an anterior mediastinal mass was confirmed. The mass was solid, without any cystic or calcified areas. The results of all laboratory tests were normal, including those for tumor markers. We decided to perform elective surgery based on his history of infections and progressive dyspnea. Other causes of enlarged mediastinum and dyspnea, such as bronchogenic cysts, were ruled out. We decided to use a thoracoscopic approach. The tumor was found to be thymus-dependent and the surgery therefore consisted of thoracoscopic thymectomy. The patient was anesthetized, and a double-lumen endotracheal tube was used in order to perform single-lung ventilation, which has been shown to be a safe procedure. (4) We used a left-sided approach. The surgical technique was performed in accordance with one of our previous reports. In brief, the surgical technique involves the use of three ports; one is placed in the …

Leiomiomatosis benigna pulmonar metastatizante

Resumen La leiomiomatosis benigna metastatizante se caracteriza por la presencia de lesiones leiomiomatosas pulmonares, en ausencia de criterios clinicos, radiologicos e histopatologicos de malignidad. Nos centraremos en una paciente con antecedente de leiomiomatosis uterina. Se trata de una enfermedad poco comun que debe ser considerada en el diagnostico diferencial de tumores benignos pulmonares. Debido a que el abordaje en el manejo de este tipo de pacientes constituye un reto para el medico responsable de atender patologia respiratoria, presentamos a continuacion un caso de una mujer con antecedente de histerectomia secundaria a miomatosis uterina y a quien se realizo el diagnostico de leiomiomatosis benigna metastatizante siendo tratada satisfactoriamente.