ABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Mycobacterium marinum/pathogenicity , Infections , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/physiopathology , Colitis, Ulcerative/complications , Colitis, Ulcerative/drug therapy , Metabolic Syndrome , InfliximabABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Crohn Disease/drug therapy , Methotrexate/adverse effects , Pneumonia/chemically induced , Crohn Disease/complications , Lymphadenopathy/diagnostic imaging , Pneumonia/diagnosis , Pneumonia/drug therapy , Thorax/diagnostic imaging , Thorax/abnormalities , Granuloma/complications , Granuloma/diagnostic imagingSubject(s)
Antirheumatic Agents/adverse effects , Colitis, Ulcerative/complications , Infliximab/adverse effects , Metabolic Syndrome/complications , Mycobacterium Infections, Nontuberculous/etiology , Mycobacterium marinum/isolation & purification , Opportunistic Infections/etiology , Skin Diseases, Bacterial/etiology , Alcoholism/complications , Antirheumatic Agents/therapeutic use , Antitubercular Agents/therapeutic use , Colitis, Ulcerative/drug therapy , Diabetes Mellitus, Type 2/complications , Disease Susceptibility , Humans , Infliximab/therapeutic use , Male , Middle Aged , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/microbiology , Obesity/complications , Opportunistic Infections/drug therapy , Opportunistic Infections/microbiology , Skin Diseases, Bacterial/drug therapy , Skin Diseases, Bacterial/microbiologyABSTRACT
Tuberculosis (TB) remains a cause of illness and death across the world, especially in developing countries and vulnerable population groups. In 2013, 1.5 million died from the disease worldwide. In Argentina, the largest proportion of TB-related deaths occurred in the northern provinces. Several international studies reported that TB mortality was related to the presence of certain comorbidities and socio-demographic characteristics. Our aim was to investigate the main risk factors associated with TB mortality in adults from six provinces in Argentina, especially those with higher TB mortality rates. A retrospective case-control study was conducted. It included all patients of =18 years with clinical and/or bacteriological TB diagnosis who underwent treatment from January 1st, 2012 to June 30th, 2013. Socio-demographic, clinical and bacteriological variables were surveyed. Information on 157 cases and 281 controls was obtained. Patients reported as deceased to the TB Control Program were considered cases, and those whose treatment result was reported as successful in the same time period were considered controls. For 111 deaths, the average time elapsed between the start of treatment and death was 2.3 months; median: 1. TB-related mortality was associated with poor TB treatment adherence (OR: 3.7 [1.9-7.3], p: 0.000), AIDS (OR: 5.29 [2.6-10.7], p: 0.000), male gender (OR: 1.7 [1.1-2.5], p: 0.009), belonging to indigenous people (OR: 7.2 [2.8-18.9], p:0. 000) and age = 50 (OR: 2.2 [1.4-3.3], p: 0.000). By multivariate analysis the two first associations were confirmed. This study sets up the basis for planning inter-program and inter-sector work to accelerate the decline in the inequitable TB mortality.
Subject(s)
Tuberculosis/mortality , Adult , Aged , Aged, 80 and over , Argentina/epidemiology , Case-Control Studies , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Young AdultABSTRACT
Tuberculosis (TB) remains a cause of illness and death across the world, especially in developing countries and vulnerable population groups. In 2013, 1.5 million died from the disease worldwide. In Argentina, the largest proportion of TB-related deaths occurred in the northern provinces. Several international studies reported that TB mortality was related to the presence of certain comorbidities and socio-demographic characteristics. Our aim was to investigate the main risk factors associated with TB mortality in adults from six provinces in Argentina, especially those with higher TB mortality rates. A retrospective case-control study was conducted. It included all patients of =18 years with clinical and/or bacteriological TB diagnosis who underwent treatment from January 1st, 2012 to June 30th, 2013. Socio-demographic, clinical and bacteriological variables were surveyed. Information on 157 cases and 281 controls was obtained. Patients reported as deceased to the TB Control Program were considered cases, and those whose treatment result was reported as successful in the same time period were considered controls. For 111 deaths, the average time elapsed between the start of treatment and death was 2.3 months; median: 1. TB-related mortality was associated with poor TB treatment adherence (OR: 3.7 [1.9-7.3], p: 0.000), AIDS (OR: 5.29 [2.6-10.7], p: 0.000), male gender (OR: 1.7 [1.1-2.5], p: 0.009), belonging to indigenous people (OR: 7.2 [2.8-18.9], p:0. 000) and age = 50 (OR: 2.2 [1.4-3.3], p: 0.000). By multivariate analysis the two first associations were confirmed. This study sets up the basis for planning inter-program and inter-sector work to accelerate the decline in the inequitable TB mortality.
En 2013, 1.5 millones de personas murieron por tuberculosis (TB) en el mundo, especialmente en países en desarrollo y grupos de población vulnerables. En Argentina, la mayor proporción de muertes asociadas con TB ocurrió en las provincias del norte. Estudios internacionales observaron que la mortalidad por TB estaba relacionada con comorbilidades y características sociodemográficas. Este estudio pretendió investigar cuáles eran los principales factores de riesgo asociados con la mortalidad por TB en adultos de seis provincias argentinas, especialmente aquellas con mayores tasas de mortalidad por TB. Se realizó un estudio retrospectivo casos-controles, incluyendo todos los pacientes = 18 años con diagnóstico clínico y/o bacteriológico de TB en tratamiento entre el 1° de enero de 2012 y el 30 de junio de 2013. Se obtuvo información de 157 casos y 281 controles, considerándose casos los pacientes notificados como fallecidos al Programa de TB y controles aquellos cuyo resultado de tratamiento fue notificado como éxito o curado en el mismo período de tiempo. El tiempo transcurrido entre el comienzo del tratamiento y la muerte fue 2.3 meses; mediana: 1. Las muertes relacionadas con TB estuvieron asociadas con: escasa adherencia al tratamiento (OR: 3.7 [1.9-7.3], p: 0.000), sida (OR: 5.29 [2.6-10.7], p: 0.000), género masculino (OR: 1.7 [1.1-2.5], p: 0.009), pertenencia a pueblos originarios (OR: 7.2 [2.8-18.9], p: 0.000) y edad = 50 (OR: 2.2 [1.4-3.3], p: 0.000). Por análisis multivariado, se confirmaron las dos primeras asociaciones. Este estudio sienta las bases para planificar acciones destinadas a acelerar el descenso de la mortalidad por TB.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Tuberculosis/mortality , Argentina/epidemiology , Case-Control Studies , Retrospective Studies , Risk FactorsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Colitis/diagnosis , Cysts/diagnosis , Gastrointestinal Hemorrhage/etiology , Intestinal Mucosa/pathology , Rectal Neoplasms/diagnosis , Diagnosis, Differential , Follow-Up StudiesSubject(s)
Colitis/diagnosis , Colorectal Neoplasms/diagnosis , Cysts/diagnosis , Diagnostic Errors , Adolescent , Colitis/drug therapy , Colitis/pathology , Colitis/surgery , Colitis, Ulcerative/complications , Cysts/drug therapy , Cysts/pathology , Cysts/surgery , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Humans , Immunosuppressive Agents/therapeutic use , Male , Mesalamine/therapeutic use , Middle Aged , Rectal Diseases/etiology , Recurrence , Unnecessary ProceduresABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Pleural Effusion/diagnosis , Pancreatic Fistula/diagnosis , Pancreatitis, Chronic/complications , Dyspnea/etiology , Asymptomatic DiseasesSubject(s)
Pancreatic Fistula/complications , Pancreatitis, Chronic/complications , Pleural Diseases/complications , Pleural Effusion/etiology , Respiratory Tract Fistula/complications , Asymptomatic Diseases , Calcinosis/diagnostic imaging , Calcinosis/etiology , Cholangiopancreatography, Endoscopic Retrograde , Cholangiopancreatography, Magnetic Resonance , Constriction, Pathologic , Humans , Male , Middle Aged , Pancreatic Ducts/pathology , Pancreatic Ducts/surgery , Pancreatic Pseudocyst/etiology , Pancreatitis, Chronic/diagnostic imaging , Pleural Effusion/diagnostic imaging , Stents , Tomography, X-Ray ComputedABSTRACT
Polycystic liver disease (PLD) is a hereditary disease inherited by autosomal dominant trait that occurs as a frequent extrarenal manifestation of autosomal dominant polycystic kidney disease (ADPKD). We report a case of a 59-year-old woman diagnosed with ADPKD associated with PLD. End-stage chronic renal failure with a secondary Budd-Chiari syndrome developed during the patient's clinical course. She underwent combined liver and kidney transplantation, with a successful response over a 9-year follow-up period.
ABSTRACT
Inflammatory pseudotumor (IPT) of the liver is a rare benign tumor of unknown origin, it has the appearance of a malignant tumor but has a benign histology and clinical course. We report a case of a 63-year-old man diagnosed of IPT of the liver and followed for 10 years. During the clinical course, he developed a secondary Budd-Chiari syndrome, with a successful response to a transjugular intrahepatic portosystemic shunt over a 5-year follow-up period.
Subject(s)
Budd-Chiari Syndrome/etiology , Granuloma, Plasma Cell/complications , Liver Diseases/complications , Follow-Up Studies , Humans , Male , Middle Aged , Time FactorsABSTRACT
El pseudotumor inflamatorio (PTI) hepático es una entidad rara, de origen desconocido y aunque puede tener apariencia maligna, su naturaleza es benigna. Presentamos el caso de un varón de 63 años diagnosticado de PTI hepático en seguimiento durante 10 años. En su evolución desarrolló un síndrome de Budd-Chiari, con buena respuesta tras la colocación de una derivación porto-sistémica transyugular, a los cinco años (AU)
Inflammatory pseudotumor (IPT) of the liver is a rare benign tumor of unknown origin, it has the appearance of a malignant tumor but has a benign histology and clinical course. We report a case of a 63-yearold man diagnosed of IPT of the liver and followed for 10 years. During the clinical course, he developed a secondary Budd-Chiari syndrome, with a successful response to a transjugular intrahepatic portosystemic shunt over a 5-year follow-up period (AU)
Subject(s)
Humans , Male , Middle Aged , Budd-Chiari Syndrome/complications , Budd-Chiari Syndrome/diagnosis , Cholangiocarcinoma/complications , Cholangiocarcinoma/diagnosis , Laparotomy/methods , Laparotomy , Biopsy/methods , Budd-Chiari Syndrome/physiopathology , Budd-Chiari Syndrome/surgery , Budd-Chiari Syndrome , Immunoglobulins/analysis , Immunoglobulins/isolation & purification , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methodsABSTRACT
Primary sclerosing cholangitis is an infrequent extraintestinal manifestation of ulcerative colitis. Damage to bile ducts is irreversible and medical therapies to prevent progression of the disease are usually ineffective. We describe a patient with long-standing ulcerative colitis, which was refractory to corticosteroid therapy who developed primary sclerosing cholangitis (biochemical stage II/IV) in the course of his pancolitis. Treatment with infliximab (5 mg/kg as an induction dose followed by maintenance doses every two months) was indicated because of steroid-dependent disease associated to primary sclerosing cholangitis as well as sacroiliitis and uveitis and previous episode of severe azathioprine-related hepatic toxicity. At present, after two years of follow-up, the patient is asymptomatic with normal liver tests and complete resumption of daily life activities. This case draws attention to the usefulness of anti-tumor necrosis factor-alpha therapy for the management of primary sclerosing cholangitis as extraintestinal manifestation of inflammatory bowel disease.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Cholangitis, Sclerosing/drug therapy , Colitis, Ulcerative/drug therapy , Drug Resistance , Immunosuppressive Agents/therapeutic use , Steroids/therapeutic use , Aged , Cholangitis, Sclerosing/diagnosis , Cholangitis, Sclerosing/etiology , Colitis, Ulcerative/complications , Colitis, Ulcerative/diagnosis , Humans , Infliximab , Male , Treatment OutcomeABSTRACT
Ulcerative colitis is a chronic inflammatory bowel disease of unknown etiopathogenesis and increasing incidence in recent years. Perianal complications of ulcerative colitis are rare and seem to be associated with higher extent of inflammation and a more severe course of the disease. The cases of two male patients with severe corticoid-dependent ulcerative colitis of protracted clinical course who developed perianal fistulas and abscesses successfully treated with infliximab are reported. Treatment with infliximab was followed by perianal fistula closure with marked improvement in the quality of life over 2-year follow-up period.
Subject(s)
Anti-Inflammatory Agents/adverse effects , Antibodies, Monoclonal/adverse effects , Colitis, Ulcerative/drug therapy , Pneumocystis carinii , Pneumonia, Pneumocystis/chemically induced , Anti-Inflammatory Agents/administration & dosage , Antibodies, Monoclonal/administration & dosage , Humans , Infliximab , Infusions, Intravenous , Male , Middle Aged , Treatment OutcomeABSTRACT
Se realizó un estudio retrospectivo observacional de las biopsias hepáticas realizadas en el Instituto Superior de Medicina Militar Dr Luis Días Soto en un periodo de 3 años, y se descartó mediante un estudio minucioso de las historias clínicas la presencia de causas de daño hepático graso secundario (vírales, tóxicas, quirúrgicas y por alteraciones congénitas del metabolismo). Se encontró que el 36 por ciento de las biopsias correspondía con el diagnóstico de hígado graso no alcohólico. En todas sus formas histológicas se observó que el 52 por ciento de los sujetos mayores de 45 años mostraron las formas evolutivas histológicas más severas (tipo III, IV). Se evidenció que existe estrecha relación entre el hígado graso no alcohólico con los estados que conforman el denominado síndrome de resistencia a la insulina (obesidad, hiperlipidemia, diabetes e hipertensión) y que la enfermedad tiene una evolución silente .Se concluye que el hígado graso no alcohólico resulta una entidad prevalente en este medio, y como se espera un crecimiento proporcional de los hábitos que condicionan su génesis, resulta necesario tener en cuenta dicho diagnóstico y la realización de la biopsia hepática en aquellos casos de riesgo, con vistas a tomar una conducta terapéutica que se dirija al control de los factores que lo condicionan(AU)
Subject(s)
Fatty Liver/epidemiology , BiopsyABSTRACT
Se realizó un estudio retrospectivo observacional de las biopsias hepáticas realizadas en el Instituto Superior de Medicina Militar Dr Luis Días Soto en un periodo de 3 años, y se descartó mediante un estudio minucioso de las historias clínicas la presencia de causas de daño hepático graso secundario (vírales, tóxicas, quirúrgicas y por alteraciones congénitas del metabolismo). Se encontró que el 36 por ciento de las biopsias correspondía con el diagnóstico de hígado graso no alcohólico. En todas sus formas histológicas se observó que el 52 por ciento de los sujetos mayores de 45 años mostraron las formas evolutivas histológicas más severas (tipo III, IV). Se evidenció que existe estrecha relación entre el hígado graso no alcohólico con los estados que conforman el denominado síndrome de resistencia a la insulina (obesidad, hiperlipidemia, diabetes e hipertensión) y que la enfermedad tiene una evolución silente .Se concluye que el hígado graso no alcohólico resulta una entidad prevalente en este medio, y como se espera un crecimiento proporcional de los hábitos que condicionan su génesis, resulta necesario tener en cuenta dicho diagnóstico y la realización de la biopsia hepática en aquellos casos de riesgo, con vistas a tomar una conducta terapéutica que se dirija al control de los factores que lo condicionan
Subject(s)
Biopsy , Fatty Liver/epidemiologyABSTRACT
Se presentó una paciente de 15 años de edad, de la raza blanca, cuyo inicio clínico era sugestivo de una hepatitis vírica aguda de tipo colestásico. En evolución posterior se presenta un franco deterioro de la función hepática, donde predominan los elementos de hipertensión portal, y fallece en un cuadro de sangramiento digestivo alto por várices esofágicas. El estudio posmortem mostró alteraciones hepáticas compatibles con una cirrosis hepática por déficit de alfa 1 antitripsina. Resultó de interés destacar lo infrecuente de esta entidad, su evolución clínica extremadamente grave y la forma clínica en que se presentó, la cual resultó indistinguible clínicamente de una hepatitis vírica aguda(AU)
Subject(s)
alpha 1-Antitrypsin DeficiencyABSTRACT
Se presentó una paciente de 15 años de edad, de la raza blanca, cuyo inicio clínico era sugestivo de una hepatitis vírica aguda de tipo colestásico. En evolución posterior se presenta un franco deterioro de la función hepática, donde predominan los elementos de hipertensión portal, y fallece en un cuadro de sangramiento digestivo alto por várices esofágicas. El estudio posmortem mostró alteraciones hepáticas compatibles con una cirrosis hepática por déficit de alfa 1 antitripsina. Resultó de interés destacar lo infrecuente de esta entidad, su evolución clínica extremadamente grave y la forma clínica en que se presentó, la cual resultó indistinguible clínicamente de una hepatitis vírica aguda