Assuntos
Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Nepal/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Fatores de RiscoRESUMO
OBJECTIVES: Cell mediated immunity (CMI), cytokines and humoral immunity have been implicated in the pathogenesis of invasive amoebiasis. METHODS: The role of cytokines--tumour necrosis factor-alpha (TNF-alpha) and interleukin 2 (IL-2) in blood and pus aspirate was studied in 20 patients of amoebic liver abscess (ALA), before and after treatment and 10 controls. RESULTS: The mean TNF-alpha levels (pg/ml) in the controls and before treatment in the patients in serum and pus were 24.3 +/- 11.6, 28 +/- 14.5 and 161.2 +/- 81.3 (p < 0.002) respectively. The mean IL-2 levels (pg/ml) in the controls, serum and pus aspirate in the patients prior to treatment were 10.3 +/- 8.5, 39.2 +/- 26.1 and 117.0 +/- 65.9 respectively. The levels in the patients after therapy, increased to 47 +/- 25.7 (p < 0.001) and 134 +/- 59.4 (p < 0.01). CONCLUSIONS: The higher levels of TNF-alpha and IL-2 in the pus aspirate compared to blood pre treatment, supports the role of locally released cytokines in the target organ i.e. liver in amoebiasis. The rise in values observed after therapy are indicative of increased macrophage activity due to CMI occurring late in the course of the disease which may contribute to disease limitation and localisation in amoebiasis. The study suggests that locally released cytokines play an important role in the pathogenesis of ALA.
Assuntos
Adulto , Feminino , Humanos , Imunidade Celular/imunologia , Índia , Interleucina-2/sangue , Fígado/imunologia , Abscesso Hepático Amebiano/diagnóstico , Ativação de Macrófagos/imunologia , Masculino , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Granulomatous mediastinitis is a rare condition, and tuberculosis and fungal infections are the most important causes of this potentially lethal condition. Tuberculous mediastinitis usually presents with fever, cough, dyspnoea and rarely, florid features of obstruction to intra-thoracic structures are seen. A case of tuberculous mediastinitis presenting as a suprasternal lump, a rare presentation, is described here.
Assuntos
Granuloma/diagnóstico , Humanos , Masculino , Mediastinite/diagnóstico , Pessoa de Meia-Idade , Esterno/patologia , Tuberculose Pulmonar/diagnósticoRESUMO
We report a patient with an infected hepatic hydatid cyst, which spontaneously ruptured into the inferior vena cava, with resultant thrombosis of the inferior vena cava, and left renal, right common iliac and right external iliac veins.