Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged/statistics & numerical data , Cognition Disorders/epidemiology , Polypharmacy , Geriatric Assessment , Cognition Disorders/prevention & control , Drug-Related Side Effects and Adverse Reactions/diagnosis , Education, Medical , Inappropriate Prescribing/adverse effects , Movement Disorders/diagnosisABSTRACT
The diagnosis of neuroendocrine tumors of the small intestine is usually challenging. They are infrequent, and the clinical course is insidious with nonspecific manifestations. Routine endoscopic and abdominal imaging studies are more often unremarkable. Therefore, distant metastases are frequently detected at the time of diagnosis. The tumor markers chromogranin A, synaptophysin, and neuron-specific enolase, and capsule endoscopy, and device-assisted enteroscopy are useful resources to establish a diagnosis. The aim was to present a case of neuroendocrine tumor of small intestine diagnosed with base in findings of the capsule endoscopy and further open surgery.
El diagnóstico de tumores neuroendocrinos del intestino delgado suele ser un desafío. Son infrecuentes y el curso clínico es insidioso con manifestaciones inespecíficas. Los estudios de imágenes endoscópicos y abdominales de rutina suelen ser anodinos. Por tanto, las metástasis a distancia se detectancon frecuencia en el momento del diagnóstico. Los marcadores tumorales cromogranina A, sinaptofi-sina y enolasa neuronal específica, y la cápsula endoscópica y la enteroscopía asistida por dispositivo son recursos útiles para establecer un diagnóstico. El objetivo de este trabajo fue presentar un caso de tumor neuroendocrino de intestino delgado diagnosticado con base en hallazgos de la cápsula endoscópica y de una nueva cirugía abierta.
Subject(s)
Humans , Female , Middle Aged , Case Reports , Neuroendocrine Tumors , Capsule Endoscopy , General Surgery , Diagnosis , Gastrointestinal Neoplasms , Intestine, SmallABSTRACT
Lymphangiomas are rare and correspond to 0.7% to 4.0% of mediastinal tumors, and isolated mediastinal location occurs in 1% of cases. They are benign tumors that originate from a congenital malformation of the lymphatic vessels and are diagnosed more frequently in children less than 2 years of age. Chylous ascites is a clinical manifestation of thoracic duct lymphangioma and is composed of lymph accumulation caused by dilation of this lymphatic channel. It appears milky in the peritoneal cavity, containing triglyceride levels higher than 200 mg/dl. We report the case of a young patient with chylous ascites and lymphangioma of the thoracic duct, who was conservatively treated with octreotide and a low-fat diet with medium-chain triglycerides.
Subject(s)
Humans , Female , Adult , Chylous Ascites/therapy , Lymphangioma/therapy , Abdominal Neoplasms/therapy , Thoracic Duct/pathology , OctreotideSubject(s)
Humans , Female , Pregnancy , Adolescent , Ascaridida Infections/diagnosis , Head and Neck Neoplasms/diagnosis , Thiabendazole/therapeutic use , Biopsy , Levamisole/therapeutic use , Ascaridida Infections/surgery , Ascaridida Infections/pathology , Ascaridida Infections/drug therapy , Rare Diseases/diagnosis , Rare Diseases/parasitology , Diagnosis, Differential , Drug Therapy, Combination , Anthelmintics/therapeutic use , Neck/pathologyABSTRACT
Abstract Urinary tract infection is a serious public health issue that predominantly affects women. In men, it is more often associated with prostatic hyperplasia and bladder catheterization. Urogenital tuberculosis presents with nonspecific with nonspecific symptoms and the diagnosis can be made in the presence of sterile leukocyturia and recurrent infection with acid urine. Non-tuberculous mycobacteria or other non-tuberculosis mycobacteria are opportunistic pathogens that inhabit the soil, water or environment surfaces, and usually cause diseases in immunocompromised individuals. Mycobacterium abscessus is an agent that causes lung, skin and soft tissue hospital infections. Urinary tract infections by this pathogen are rare.
Resumo Infecção do trato urinário é um sério problema de saúde pública que acomete predominantemente as mulheres. Em homens, está mais relacionada com hiperplasia prostática e cateterismo vesical. A tuberculose urogenital cursa com sintomas inespecíficos e o diagnóstico pode ser aventado na presença de leucocitúria estéril, e infecção recorrente com urina ácida. Micobactérias não tuberculosas ou mycobacteria other than tuberculosis são patógenos oportunistas que habitam o solo, a água ou superfícies do meio ambiente, e geralmente causam doenças em imunodeprimidos. Mycobacterium abscessus é um agente que causa infecções nosocomiais, pulmonares, de pele e de tecidos moles. Infecção urinária decorrente desse patógeno é considerada rara.
Subject(s)
Humans , Male , Middle Aged , Urinary Tract Infections/diagnosis , Mycobacterium abscessus/isolation & purification , Mycobacterium Infections, Nontuberculous/diagnosis , Urinary Tract Infections/microbiology , Urinary Tract Infections/drug therapy , Amikacin/administration & dosage , Follow-Up Studies , Treatment Outcome , Clarithromycin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium Infections, Nontuberculous/drug therapyABSTRACT
This case study describes a 71-year-old man with signet-ring cell gastric adenocarcinoma and malignant sigmoidal polyp; and typical features of Saint's triad and Heyde syndrome. He had digestive bleeding, two types of hernia, diverticulosis, arterial hypertension, malignant polyp, and antecedent of smoking, lung tuberculosis, and surgical correction of aortic valve stenosis. There is a hypothetical inverse relationship between herniosis and development of malignancy; however, the patient herein described presented gastric and sigmoidal cancers. Gastrointestinal malignancies are sometimes associated with paraneoplastic entities, isolated or manifested as syndromes, but neither Saint's triad or Heyde syndrome have been included. This patient persisted clinically stable during the preoperative period, but suddenly died; Trousseau's syndrome would be the most probable mechanism of sudden death in this setting. Case reports can stimulate further studies to get additional knowledge about unusual entities.
Este estudio de caso describe un hombre de 71 años de edad, con adenocarcinoma gástrico con células en anillo de sello y un pólipo maligno sigmoideo; y características típicas de la tríada de Saint y del síndrome de Heyde. Tuvo una hemorragia digestiva, dos tipos de hernias, divertículos, hipertensión arterial, y pólipo maligno; con antecedente de tabaquismo, tuberculosis pulmonar, y corrección quirúrgica de estenosis de la válvula aórtica. Hay una hipotética relación inversa entre hernioses y el desarrollo de malignidades; sin embargo, el paciente que se describe en el presente documento presentó cánceres gástrico y sigmoideo. Neoplasias gastrointestinales se asocian a veces con entidades para neoplásicas aisladas o manifiestan síndromes, pero ni la tríada de Saint ni el síndrome de Heyde se ha incluido. Este paciente persistió clínicamente estable durante el período preoperatorio, pero de repente murió; síndrome de Trousseau sería el mecanismo más probable de muerte súbita en esta situación. Los informes de casos pueden estimular más estudios para obtener un conocimiento adicional sobre esas entidades inusuales.
Subject(s)
Aged , Humans , Male , Aortic Valve Stenosis/complications , Sigmoid Neoplasms/complications , Stomach Neoplasms/complications , Cholelithiasis/complications , Colonic Polyps/complications , Diverticulum/complications , Carcinoma, Signet Ring Cell/complications , Gastrointestinal Hemorrhage/etiology , Hernia, Hiatal/complications , Neoplasms, Multiple Primary/complications , Syndrome , Thrombophlebitis/etiology , Angiodysplasia/etiology , Fatal Outcome , Anemia, Iron-Deficiency/etiology , Death, Sudden , Models, BiologicalABSTRACT
Comentários sobre o artigo de Rabahi e Alcântara, sob o título "Tendência temporal da endemia do tabagismo no Brasil", no qual os autores analisaram o papel desse grave problema de saúde pública na morbimortalidade por doenças respiratórias, cardiovasculares e neoplásicas. (AU)
Comments about the article by Rabahi and Alcântara, entitled "The temporal trend of the smoking endemic disease in Brazil", in which the authors analised the role of this severe problem of public health on the morbidity and mortality by respiratory, cardiovascular and neoplastic diseases. (AU)
Subject(s)
Letter , Respiratory Tract Diseases , Nicotiana , SmokingABSTRACT
The aim of the present report is to alert health care workers about a 64yearold patient diagnosed with adenocarcinoma in the right lung treated with pemetrexed disodium, cisplatin and dexamethasone. He evolved with prolonged neutropenia, symptoms of lower airways infection, and recent pulmonary infiltrate in the radiographic image. The cultures for bacteria and mycobacteria in the blood and sputum were negative. Because of the lack of response to treatment with broad spectrum antibiotics and maintenance of neutropenia, a transbronchial biopsy was performed, which demonstrated infection by Aspergillus fumigatus. The patient was treated.
O objetivo do presente relato é alertar os profissionais de saúde sobre o caso de um paciente de 64 anos de idade com diagnóstico de adenocarcinoma no pulmão direito tratado com pemetrexede dissódico, cisplatina e dexametasona. Ele evoluiu com neutropenia prolongada, sintomas de infecção de vias aéreas inferiores e infiltrado pulmonar recente na imagem radiográfica. As culturas para bactérias e micobactérias no sangue e escarro foram negativas. Por falha na resposta ao tratamento com antibióticos de largo espectro e manutenção da neutropenia, foi realizada biópsia transbrônquica que demonstrou infecção por Aspergillus fumigatus e o paciente foi tratado.
Subject(s)
Humans , Male , Middle Aged , Aspergillus , Immunosuppression Therapy , Pulmonary Aspergillosis , Neutropenia , Pneumonia , Dexamethasone/therapeutic use , Adenocarcinoma , Cisplatin/therapeutic use , Pemetrexed/therapeutic use , Lung NeoplasmsABSTRACT
A 62-year-old Brazilian man who lived in endemic areas of tropical diseases had an episode of hematemesis associated with portal hypertension. He used to swim in natural ponds during childhood and developed the hepatosplenic form of schistossomiasis with moderate ascites, in addition to the characteristic features of abdominal Caput Medusae. The aim of the report is highlight the role of chronic liver disease and schistossomiasis
Un hombre natural de Brasil de 62 años de edad que vivía en zonas endémicas de enfermedades tropicales presentó un episodio de hematemesis asociada con hipertensión portal. Frecuentemente se bañaba en los estanques naturales durante la infancia y desarrolló la forma hepatosplénica de la esquistosomiasis con ascitis moderada, además de los rasgos abdominales característicos de la Cabeza de Medusa. El objetivo del informe es poner de relieve el papel de la enfermedad hepática crónica y de la esquistosomiasis