ABSTRACT
Nocardia farcinica is an infrequent infection that usually appears in patients with predisposing conditions, especially in immunosuppressed patients, although it has also been found in healthy individuals. Its importance as a new pathogen has been recognized only in recent years. Mainly, it affects the lung, indistinguishable from other types of pneumonia in the clinical and radiological characteristics. The main reason for detection is therapeutic failure.
Subject(s)
Nocardia Infections/complications , Pneumonia, Bacterial/complications , Pulmonary Disease, Chronic Obstructive/complications , Aged , Humans , MaleSubject(s)
Cough/etiology , Dyspnea/etiology , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Waldenstrom Macroglobulinemia/complications , Cough/diagnosis , Dyspnea/diagnosis , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/diagnostic imaging , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Middle Aged , Tomography, X-Ray Computed , Waldenstrom Macroglobulinemia/diagnostic imaging , Waldenstrom Macroglobulinemia/pathologyABSTRACT
OBJECTIVE: The aim of our work has been the study of CO diffusion capacity in mitral valve stenosis patients. METHOD: We have studied 15 control subjects and 15 patients with mitral valve stenosis. We performed spirometry study and CO pulmonary diffusion tests (DLCO) by single breath method to determine two components: pulmonary capillary blood volume (Vc) and membrane diffusion factor (Dm). In addition, in mitral valve stenosis patients we performed a ecocardiography-doppler study. RESULTS: The mitral valve stenosis group had higher values of DLCO and Vc and a lower ratio of Dm/Vc than the control group. There is a negative correlation between Vc and the mitral valve area (r = -0.63; p = 0.037). We do not find any another correlation between the rest of ecocardiography doppler parameters and lung function test variables that we have measured. We have not found any differences between both groups in Dm. CONCLUSIONS: Mitral valve stenosis patients present a increase of CO pulmonary diffusion capacity and pulmonary capillary blood volume without changes in membrane diffusion factor.
Subject(s)
Carbon Monoxide/metabolism , Mitral Valve Stenosis/physiopathology , Pulmonary Diffusing Capacity , Female , Humans , Male , Middle Aged , Mitral Valve Stenosis/metabolismABSTRACT
We describe the case of a 67-years-old man who underwent transurethral resection and immunotherapy with Calmette-Guérin bacillus solution (CGB) for superficial transitional carcinoma of the bladder. After a series of intravesical irrigations with CGB, the patient developed fever, asthenia and persistent anorexia and was hospitalized. After testing he was diagnosed of miliary tuberculosis due to CGB and died in spite of tuberculostatic therapy. Hematogenous dissemination, a rare but serious complication of vesical irrigation with CGB, is thought to be more common than previously suspected. It should be suspected in all patients receiving CGB when a compatible clinical picture presents. An understanding of this complication and early establishment of specific treatment is the only wat to improve prognosis.
Subject(s)
BCG Vaccine/adverse effects , Tuberculosis, Miliary/etiology , Administration, Intravesical , Aged , Carcinoma, Transitional Cell/therapy , Humans , Male , Urinary Bladder Neoplasms/therapyABSTRACT
We report here two cases presenting with visual symptoms secondary to choroidal metastases, without any other remarkable systemic symptom. After an exhaustive investigation in both patients the diagnosis was obtained of bronchoalveolar carcinoma as primary tumor responsible for such lesions. Bronchoalveolar carcinoma is a type of pulmonary adenocarcinoma which rarely begins with clinical symptoms attributable to metastases and even rarer of choroidal location. The presence of such choroidal lesions are usually associated with visual clinical symptoms and they are a diagnostic challenge when manifested as the presenting symptoms. Therapy is directed to the primary tumor usually associated with palliative radiotherapy of choroidal metastases. Their presence implies a poor survival rate.
Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar/diagnosis , Adenocarcinoma, Bronchiolo-Alveolar/secondary , Choroid Neoplasms/diagnosis , Choroid Neoplasms/secondary , Lung Neoplasms/diagnosis , Adenocarcinoma, Bronchiolo-Alveolar/complications , Adult , Choroid Neoplasms/complications , Fatal Outcome , Female , Humans , Lung Neoplasms/complications , Vision Disorders/diagnosis , Vision Disorders/etiology , Visual AcuityABSTRACT
The difference between exudates and transudates is the first question a clinician must solve when facing a pleural effusion. A great number of parameters have been tried without a definite efficacy of any of them. Cholesterol is an easy, useful determination for distinguishing exudates from transudates. In our series of 86 patients a cholesterol value of 50 mg/dl allowed us to correctly classify 94.2% of effusions. The ratio between pleural fluid cholesterol/serum cholesterol was more efficient because it permitted to correctly classify 97.7% of effusions, in one of those major groups which constitute the binomial exudate/transudate.
