ABSTRACT
Primary Sjögren s syndrome is a multisystemic inflammatory disorder that mainly affects the exocrine glands and usually presents as dryness of the mouth and eyes. The wide clinical spectrum of the disease also includes general symptoms, extraglandular manifestations and lymphoma. It is frequently associated with renal diseases. Interstitial nephritis is the most common renal manifestation, but glomerular involvement and acute renal failure may also (rarely) occur. We describe a case of a female patient with primary Sjögren s syndrome complicated by severe acute renal failure due to cryoglobulinemic glomerulonephritis. Treatment with steroids, cyclophosphamide, plasma exchange and rituximab successfully led to recovery from acute renal failure.
Subject(s)
Acute Kidney Injury/etiology , Postoperative Complications/etiology , Sjogren's Syndrome/complications , Dental Implantation/adverse effects , Female , Humans , Middle AgedABSTRACT
Se presenta el caso de un paciente con intoxicación paralítica por ingesta de moluscos que cursó con insuficiencia respiratoria grave y requirió ventilación mecánica durante48 horas. Se trata de una intoxicación muy rara en nuestro entorno y puede ocasionarla muerte por parálisis de los músculos respiratorios si no se atiende adecuadamente (AU)
We report the case of a man with paralytic poisoning caused by eating mollusks. The patient presented with severerespiratory failure and required mechanical ventilation for 48 hours. This syndrome, which is very rare in Spain, can befatal if the respiratory muscles are affected and proper treatment is not provided (AU)
Subject(s)
Humans , Male , Middle Aged , Shellfish/adverse effects , Foodborne Diseases/diagnosis , Respiratory Paralysis/chemically induced , Dinoflagellida/pathogenicity , Saxitoxin , TetrodotoxinABSTRACT
Describimos un caso de hematoma epidural agudo en un varón de 16 años que evoluciona hacia la resolución espontánea en las primeras 10 horas siguientes al traumatismo. La resolución espontánea precoz es un hecho poco frecuente, como lo demuestra la escasa bibliografía al respecto (AU)
Subject(s)
Adolescent , Male , Humans , Remission, Spontaneous , Hematoma, Epidural, Cranial/physiopathology , Tomography, Emission-Computed/methods , Craniocerebral Trauma/complicationsABSTRACT
Two hundred and sixty three patients with a diagnosis of brucellosis between January 1984 and December 1987 were studied prospectively. Sixty five patients (25%) developed osteoarticular complications. These patients had a more prolonged course than those with no complications. Spondylitis in 38 (58%) and sacroiliitis in 29 (45%) were the most prevalent. There were no significant laboratory, serological, or bacteriological differences between patients with and without osteoarticular complications. At diagnosis 47 patients (72%) showed radiographic abnormalities, commonly in axial sites but rarely in peripheral sites. Radionuclide bone scan was positive with no radiographic abnormalities in 17 (26%) of cases. Fifty seven patients received medical treatment alone, 51 (89%) being cured with a single course of treatment. Treatment failed or there was a relapse in six patients (11%), of whom five had spondylitis. Eight of the 65 patients (12%), all of whom had spondylitis and paravertebral or epidural abscesses, also required surgical treatment.
Subject(s)
Brucellosis/complications , Osteoarthritis/etiology , Adolescent , Adult , Aged , Brucellosis/drug therapy , Brucellosis/pathology , Doxycycline/therapeutic use , Drug Therapy, Combination , Female , Humans , Joints/pathology , Male , Middle Aged , Osteoarthritis/drug therapy , Osteoarthritis/pathology , Prospective Studies , Rifampin/therapeutic use , Sacroiliac Joint/pathology , Spine/pathology , Streptomycin/therapeutic useABSTRACT
The socio-economic cost of human brucellosis is analyzed. One hundred and seven patients are included in this study, 75 males (70.09%) and 32 females (29.91), diagnosed of brucellosis in the Internal Medicine Department of the Regional Hospital "Carlos Haya" in Málaga from the 1st of October 1984 to the 31st of December 1986. Thirty seven patients (34.57%) presented some kind of complication. Seventy eight cases (72.89%) were admitted to the hospital resulting in a total of 1.005 hospital admissions with a mean hospital stay of 12.88 days. The total economic cost was 30.724.962 pesetas with a mean patient cost of 287.149 pesetas. The total number of work absence days was 5.291 with a mean 101.7 days per patient and with an accumulated cost in this respect of 49.053.151 pesetas. The total money loss was 84.307.488 pesetas with a mean of 787.920 pesetas per patient. This high cost, together with the high incidence of the disease throughout most of our national territory, clearly justify the need for aggressive preventive measures.
Subject(s)
Brucellosis/economics , Absenteeism , Adolescent , Adult , Aged , Female , Humans , Length of Stay/economics , Male , Middle Aged , Socioeconomic FactorsABSTRACT
Effectiveness and therapeutic value of the doxycycline plus streptomycin and doxycycline plus rifampin schedules of treatment of human brucellosis have been assessed by carrying out a prospective study on 111 patients randomly distributed into two groups. Patients in group A were treated with doxycycline plus streptomycin sulphate and those in group B with doxycycline plus rifampin. The temperature of all patients reverted to normal, and 54 patients from group A (91.6%) and 45 from group B (86.5%) achieved total recovery with a single therapeutic cycle. Two therapeutic failures and 3 relapses in group A (8.4%) and 7 relapses in group B (13.46%) were observed. The tolerance to both regimens was good. Although the combination doxycycline plus rifampin offers a more convenient oral administration, in the light of these results, until more extensive research is carried out, it should be considered as an alternative rather than a first choice in the treatment of human brucellosis.