ABSTRACT
Autoimmune thyroid diseases (AITD) are postulated to develop as a result of a complex interplay between several genetic and environmental influences. The pathogenesis of AITD is still not clearly defined. However, among the implicated triggers (e.g. iodine, infections, medications), more recent data confirmed strong associations of AITD with the hepatitis C virus (HCV) infection and interferon-α (IFNα) therapy. Moreover, it is likely that HCV and IFN act in synergism to trigger AITD in patients. Indeed, approximately 40% of HCV patients develop either clinical or subclinical disease while receiving IFNα. Interferon induced thyroiditis (IIT) can manifest as non-autoimmune thyroiditis (presenting as destructive thyroiditis, or non-autoimmune hypothyroidism), or autoimmune thyroiditis [presenting with clinical features of Graves' disease (GD) or Hashimoto's thyroiditis (HT)]. Although not yet clearly understood, it is thought that IFNα can induce thyroiditis via both immune stimulatory and direct toxic effects on the thyroid. In view of the high frequency of IIT, routine screening and surveillance of HCV patients receiving IFNα is recommended to avoid the complications, such as cardiac arrhythmias, associated with thyrotoxicosis. In summary, IIT is a common clinical problem that can be readily diagnosed with routine thyroid function screening of HCV patients receiving IFN. The treatment of IIT consists of the standard therapy for differing clinical manifestations of IIT such as GD, HT, or destructive thyroiditis. However, anti-thyroid medications are not recommended in this setting since they can potentially be hepatotoxic.
Subject(s)
Environment , Hepatitis C/complications , Interferon-alpha/physiology , Thyroiditis/etiology , Animals , Genetic Predisposition to Disease , Hepatitis C/genetics , Humans , Interferon-alpha/adverse effects , Models, Biological , Thyroiditis/diagnosis , Thyroiditis/genetics , Thyroiditis/therapyABSTRACT
The aim of the study was to review the literature of tympanosclerosis especially its pathogenesis, to study the general incidence of tympanosclerosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis. Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected. The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 20-40 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap > 40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent. The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type.
Subject(s)
Ear, Middle/pathology , Otitis Media, Suppurative/complications , Adolescent , Adult , Child , Child, Preschool , Cholesteatoma/complications , Chronic Disease , Female , Hearing Loss, Conductive/etiology , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Sclerosis/epidemiologyABSTRACT
Sixty-three patients were studied after renal transplantation to determine whether infection associated with use of the urethral catheter could be diagnosed reliably with catheter tip cultures. Catheter tip cultures correlated poorly with urine cultures aspirated from the catheter and follow-up voided urine cultures. Postoperative infectious complications did appear to be related to catheter contamination.
Subject(s)
Escherichia coli Infections/etiology , Urinary Catheterization/adverse effects , Urinary Tract Infections/etiology , Escherichia coli Infections/diagnosis , Humans , Kidney Transplantation , Methods , Postoperative Complications/diagnosis , Urinary Tract Infections/diagnosisABSTRACT
Twenty-five children with meningomyelocele have been managed by clean unsterile intermittent catheterization (UIC). There were 17 satisfactory results, three total failures, and three partial failures under this regimen. Experience, problems, and causes of failure are discussed. UIC offers a definitive form of management for some types of neurogenic bladder.
Subject(s)
Meningomyelocele/complications , Spinal Dysraphism/complications , Urinary Incontinence/therapy , Adolescent , Child , Female , Humans , Male , Urinary Catheterization , Urinary Incontinence/etiologyABSTRACT
A case of Salmonella lithiasis in a 60-year-old woman is presented and the relevant literature is discussed. Nephrectomy instead of lyelolithotomy was undertaken to eliminate the carrier state, and cholecystectomy and exploration of the common bile duct were required.
Subject(s)
Kidney Calculi/complications , Salmonella Infections/complications , Urinary Tract Infections/complications , Carrier State/therapy , Chloramphenicol/therapeutic use , Cholecystectomy , Common Bile Duct/pathology , Female , Humans , Kidney Calculi/surgery , Middle Aged , Nephrectomy , Salmonella Infections/drug therapyABSTRACT
A case of squamous cell carcinoma of the shaft of the penis leading to auto-amputation is presented. Despite delay in treatment, a good result was obtained following surgical excision.
