ABSTRACT
Subcutaneous sarcoidosis is a rare variant of this disease, whose relationship with systemic disease is still controversial. Our objective was to describe the clinical characteristics of a series of patients with subcutaneous sarcoidosis and to investigate the relationship between these skin lesions and the disease's activity, severity, and prognosis. Nineteen patients with biopsy-confirmed subcutaneous sarcoidosis between 2009 and 2019 were selected. Mean age at diagnosis was 53 years. Lung involvement was detected in 10 patients (52.6%), mainly in stages I and II. Only two patients (10.5%) had additional systemic signs and five patients (26%) suffered from other autoimmune diseases simultaneously. Six patients (31.6%) had elevated angiotensin-converting enzyme levels (mean level 174.5 U/L). Eight patients (42%) received treatment, mainly systemic corticosteroids, and all patients except for one had a favorable clinical outcome. Subcutaneous sarcoidosis is frequently associated with a mild form of systemic disease, and the prognosis seems favorable regardless of treatment. Sarcoid nodules could be an early finding of systemic disease, allowing for less invasive procedures for histological confirmation.
Subject(s)
Sarcoidosis/pathology , Skin Neoplasms/pathology , Subcutaneous Tissue/pathology , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Angiotensin-Converting Enzyme 2/blood , Angiotensin-Converting Enzyme 2/metabolism , Autoimmune Diseases/complications , Biopsy , Female , Humans , Lymphadenopathy/epidemiology , Male , Middle Aged , Polymerase Chain Reaction , Prevalence , Retrospective Studies , Sarcoidosis/complications , Sarcoidosis/diagnosis , Skin Diseases/pathology , Skin Neoplasms/complicationsABSTRACT
On 2 November 1999, one of the main hospital façades adjoining cardiovascular surgery collapsed in a 900-bed teaching hospital in Santander, Spain. The purpose of this study was to determine whether the accident affected the safety of patients by increasing the risk for nosocomial and surgical site infections (SSI). Measures for the prevention of nosocomial infections were immediately reinforced. A total of 217 consecutive patients were operated on before 2 November 1999, with another 296 after this date. Patients in both study periods showed similar severity of illness, complexity of surgical procedure and length of hospital stay. The overall rate of nosocomial infection before and after the accident was 28.1% and 24.7%, respectively (P=0.381). The rates of respiratory infection, urinary infection and bacteraemia were also similar. A statistically significant reduction in the SSI rate in the second period was observed (14.8% vs 4.4%, P=0.008). The collapse of the façade was not associated with any increase in nosocomial infection rates, but there was a significant reduction of SSI rates in relation to intensive infection control measures implemented after the collapse.
Subject(s)
Cross Infection/epidemiology , Surgical Wound Infection/epidemiology , Thoracic Surgery , Aged , Bacteremia/epidemiology , Female , Hospitals, Teaching , Humans , Length of Stay , Male , Prevalence , Respiratory Tract Infections/epidemiology , Severity of Illness Index , Spain , Urinary Tract Infections/epidemiologyABSTRACT
Cardiomyopathies are a clinically and genetically heterogeneous group of cardiac diseases in which the myocardium is primarily involved. Mitochondrial DNA point mutations have been identified in a broad spectrum of mitochondrial disorders, which are associated with neurological diseases. However, they also have been reported in patients with cardiomyopathy, either alone or as part of a multisystem disorder. A patient who presented with severe heart failure and was diagnosed as having a mitochondrial A3243G mutation is described.
Subject(s)
Heart Failure/diagnosis , MELAS Syndrome/diagnosis , DNA, Mitochondrial/genetics , Disease Progression , Female , Follow-Up Studies , Heart Failure/genetics , Humans , Middle Aged , MutationSubject(s)
Corynebacterium Infections/diagnosis , Corynebacterium Infections/microbiology , Lumbar Vertebrae/microbiology , Lung Neoplasms/diagnosis , Osteomyelitis/diagnosis , Osteomyelitis/microbiology , Urinary Bladder Neoplasms/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Anti-Infective Agents/therapeutic use , Carcinoma, Transitional Cell/complications , Carcinoma, Transitional Cell/diagnosis , Community-Acquired Infections/diagnosis , Community-Acquired Infections/microbiology , Corynebacterium Infections/complications , Corynebacterium Infections/drug therapy , Diagnosis, Differential , Humans , Low Back Pain/microbiology , Lung Neoplasms/complications , Male , Middle Aged , Osteomyelitis/complications , Osteomyelitis/drug therapy , Treatment Outcome , Urinary Bladder Neoplasms/complicationsSubject(s)
Hypercalcemia/etiology , Liver Neoplasms/complications , Lymphoma/complications , Aged , Calcitriol/blood , Fatal Outcome , Humans , Hypercalcemia/blood , Hypercalcemia/diagnosis , Liver Neoplasms/blood , Liver Neoplasms/diagnosis , Lymphoma/blood , Lymphoma/diagnosis , Male , Middle AgedABSTRACT
Consumers of adulterated drugs may present with talc-induced interstitial lung disease. A transbronchial biopsy specimen showing granulomas with intracellular talc crystals is necessary to confirm this diagnosis. In patients infected with HIV, such a condition can be indistinguishable at first glance from opportunistic infections or other pulmonary diseases. A case is presented of a seropositive patient whose chest radiographs showed a diffuse interstitial pattern.
Subject(s)
Granuloma, Foreign-Body/etiology , Granuloma, Respiratory Tract/etiology , HIV Infections/complications , Lung Diseases, Interstitial/etiology , Talc/adverse effects , Adult , Diagnosis, Differential , Fatal Outcome , Granuloma, Foreign-Body/diagnostic imaging , Granuloma, Foreign-Body/pathology , Granuloma, Respiratory Tract/diagnostic imaging , Granuloma, Respiratory Tract/pathology , Humans , Lung Diseases, Interstitial/diagnostic imaging , Lung Diseases, Interstitial/pathology , Male , RadiographySubject(s)
Endocarditis, Bacterial/diagnosis , Enterobacter cloacae , Enterobacteriaceae Infections/diagnosis , Heart Valve Prosthesis/adverse effects , Prosthesis-Related Infections/diagnosis , Aged , Combined Modality Therapy , Endocarditis, Bacterial/therapy , Enterobacteriaceae Infections/therapy , Humans , Male , Mitral Valve , Prosthesis-Related Infections/therapyABSTRACT
No disponible
Subject(s)
Middle Aged , Aged , Male , Female , Humans , Transplantation Immunology , Arthroplasty, Replacement, Knee , Arthroplasty, Replacement, Hip , Transplantation, Homologous , Surgical Wound Infection , Blood Transfusion , Blood Coagulation DisordersABSTRACT
No disponible