ABSTRACT
SETTING: The relationship between myasthenia gravis (MG) and tuberculosis (TB) has not been determined. OBJECTIVE: To evaluate the relationship between MG and TB. DESIGN: A national survey conducted between 2000 and 2006 included 2317 patients with MG identified from the Taiwan National Health Insurance database. The incidence rate ratio of TB in these patients was compared with those in 23 170 randomly selected age-, sex- and comorbidity-matched controls without MG. RESULTS: The risk of TB was higher in the MG cohort (adjusted hazard ratio [aHR] 1.96, 95% confidence interval [CI] 1.22-3.16, P = 0.005), mainly due to an excess risk of pulmonary TB (aHR 2.10, 95%CI 1.27-3.47, P = 0.004). Age ≥60 years (HR 4.99, 95%CI 2.06-12.10, P < 0.001) and the use of corticosteroids (HR 1.12, 95%CI 1.07-1.17, P < 0.001) were risk factors for developing TB in the MG cohort. Patients with MG who developed TB had a lower 5-year survival rate than those who did not (89.4% vs. 96.0%, P = 0.032). CONCLUSION: The incidence of pulmonary TB is significantly higher in patients with MG. Careful screening strategies for TB should be considered among high-risk patients with MG.
Subject(s)
Myasthenia Gravis/complications , Tuberculosis/complications , Tuberculosis/epidemiology , Adult , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Risk Factors , Young AdultABSTRACT
To study the potential utility of magnetic resonance (MR) imaging in staging colorectal tumors, 15 resected colonic segments containing 17 elevated lesions were examined on a 1.5- or 1.9-T superconductive MR system. The whole intestinal wall was apparent as three or five layers on images obtained with a short repetition time (TR) and short echo time (TE) and as six or eight distinct layers, including the intestinal wall proper as well as an adherent mucus layer and an outer layer of pericolonic fat, on the long TR/TE images. In cases of colonic carcinoma, MR images correlated well with the pathologic findings, including the macroscopic growth pattern, depth of mural invasion, and the presence of foci of calcific tumor necrosis and pools of extracellular mucin (colloid). These features suggest that MR imaging may be valuable in the clinical evaluation of colorectal tumors.
Subject(s)
Adenocarcinoma/diagnosis , Colorectal Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Colon/pathology , Humans , In Vitro Techniques , Intestinal Mucosa/pathology , Rectum/pathologyABSTRACT
A case of beta-thalassemia with an unusual focus of extramedullary hematopoiesis is reported. The presacral area was involved producing a significant mass effect on the rectum.
