ABSTRACT
Thromboembolic complications during the course of inflammatory bowel disease are infrequent but are mainly found in young patients and are associated with a high morbimortality. The etiopathogenesis of these complications has been widely debated and the existence of coagulation alterations and fibrinolysis have been suggested. Nonetheless, the mechanism must be complex since not only do not all the patients with these alterations present this complication but neither do all the patients with thromboembolism have recognized coagulation disorders. The most common clinical presentation is deep vein thrombosis with pulmonary embolism with arterial thrombosis being rare. Five patients with Crohn's disease and two with ulcerative colitis who presented a total of new thromboembolic episodes, six arterial (1 in primitive iliac artery, 1 in common femoral artery, 1 in humeral-axillary artery, 2 in internal carotid and 1 in superior mesenteric artery) and three of venous localization (1 in brachyocephalic-subclavian trunk, 1 axillary and 1 iliac-femoral/pulmonary thromboembolism) are reported. An updated review of the etiopathogenesis, presentation, treatment and prophylaxis of the thromboembolic complications of inflammatory bowel disease is presented.
Subject(s)
Inflammatory Bowel Diseases/complications , Thromboembolism/etiology , Adult , Female , Humans , Male , Middle AgedABSTRACT
The study reported here, seeking to develop a simple, practical, sensitive, and inexpensive technique for microbial diagnosis of tuberculosis, used a combination of biphasic media and microculture techniques to augment the sensitivity of traditional culture methods. A total of 540 sputum samples (5 mL each) were obtained from 180 patients with suspected tuberculosis in Mexico City. These samples were treated with Hanks reagent, neutralized with 25% HCl, and centrifuged. In each case the resulting residue was combined with liquid media (Sula medium or a phosphate-buffered control solution) and was inoculated into a bottle containing a solid medium (Löwenstein-Jensen-Holm or Middlebrook). A silicone-coated slide appropriate for culture of hydrophobic mycobacteria was inserted in each bottle, and the cultures (examined weekly) were incubated at 37 degrees C until the first macroscopic bacterial growth was detected or for up to eight weeks if none was detected. When such growth was detected, or at the end of eight weeks, each slide was withdrawn from the bottle, sterilized, stained by Kinyoun's method, and examined microscopically. Following 2-4 weeks of incubation, macroscopic bacterial growth was detected in 71 bottles and was confirmed by microscopic examination of the corresponding slides. No macroscopic bacterial growth was found in any of the remaining 469 bottles, but microscopic growth was observed on 77 of the slides examined after eight weeks. The authors conclude that this method represents a noteworthy improvement over standard culture methods in terms of bacterial isolation and suggest that its case, economy, and practicality make it suitable for application in developing countries.
Subject(s)
Cell Culture Techniques/methods , Mycobacterium tuberculosis/isolation & purification , Silicon , Cell Culture Techniques/economics , Culture Media , Humans , Sensitivity and Specificity , Statistics, NonparametricABSTRACT
We report the case of a 27-year-old man with alcoholic acute pancreatitis, who developed an acute loss of visual acuity; a bilateral Purtscher's retinopathy, a rare complication of acute pancreatitis, was confirmed by ophthalmoscopy.
Subject(s)
Pancreatitis, Alcoholic/complications , Retinal Diseases/etiology , Adult , Humans , Male , Retinal Hemorrhage/etiology , Vision Disorders/etiology , Visual AcuityABSTRACT
Sarcoidosis is a granulomatous disease of unknown origin with a variable clinical presentation. Although involvement of every organ has been described, the pulmonary system is most frequently involved. Isolated extrapulmonary disease is rare. Hepatic manifestations include granulomatous hepatitis and hilar lymphadenopathy. We describe a case of sarcoidosis initially presenting as extrahepatic jaundice.
