Since new ways of radiodiagnostic exploration of the adrenal glands are now performed, it is important to take stock upon the complications of adrenal angiography. These complications are very different according to the fact that we explore pheochromocytomas or not. The complications of stimulation, of hypertensive accident or collapsus are quite specially observed during the angiography of pheochromocytomas. They must be prevented by a selection of the indications and a reanimation pre and per angiography. Lesions of glandular destruction that lead to a hormonal insufficiency (sometimes therapeutic) are observed outwards pheochromocytomas. Because they depend upon the explored adrenal lesion and specially of the angiographic conditions of the exploration, these complications must be prevented by a rigorous technic.
Summary Respiratory diseases are common in children with esophageal atresia (EA), leading to an increased morbidity and mortality in the first months of life. Objective Assess the prevalence of hospitalizations linked to a respiratory disease and of maintenance inhaled therapy at the age of 1 year in French children. Methods Population based-study using data from the French national EA register. We included all children born between 2010 and 2015 with data available at birth and at follow-up at one year of age. Results A total of 981 patients born with EA were included in the register, 75 of them (8%) being deceased at the age of 1 year. Data were missing for 60 patients, thus 846 children (86%) were retained for analysis. EAs were type III of Ladd classification in 89% and type I in 7%. Rate of prematurity was 37% while 51% presented associated malformations. At 1 year of age, 1297 hospitalizations were reported for 508 patients (60%), at least one hospitalization for a respiratory disease for 251 children (51%). Factors significantly associated with respiratory hospitalizations were longer median length of oxygen supplementation (P < 10−2) and noninvasive ventilation in the neonatal period (P = 0.02), gastrostomy tube (P < 10−2), esophageal anastomosis dilation (P < 10−2). At 1 year of age, 29% had an inhaled maintenance treatment, and 85% inhaled corticosteroids. Factors significantly associated with inhaled maintenance treatment were male gender (P = 0.04), advanced older median age at gastrostomy tube insertion (P < 10−3), enteral feeding at one year of age (P < 10−3). Conclusion This study shows a high rate of respiratory problems responsive of frequent hospitalizations and inhaled maintenance treatment in children born with EA in the first year of life.
The accessory soleus muscle is a supernumerary leg muscle that is rare and usually clinically silent. The best diagnostic strategy is not agreed on. We report two cases in which magnetic resonance imaging contributed significantly to the diagnosis and to the pretreatment evaluation.
A 26-year-old pregnant woman was hospitalized in an emergency setting for a skin eruption. She had developed pustules distributed on round patch-like areas of rash localized at the umbilicus and the larger skin folds. She was given calcitriol and calcium with good results. Systemic steroids are usually given for exanthematic pustulosis of pregnancy but with variable efficacy. Few cases of successful treatment with calcium and vitamin D have been reported. We suggest this alternative treatment could be useful in other cases.
