ABSTRACT
The authors present a 43-year-old woman with a yellow, swollen toe nail of the right foot. This nail was lesioned 20 years before. The proximal nail fold of the right hallux was erythematous and indurated. The medial half of the nail was thickened and yellowish, sharply demarcated from the unaffected half. This aspect is typical for onychomatricoma.
Subject(s)
Nail Diseases/diagnosis , Nails/pathology , Adult , Diagnosis, Differential , Female , Foot , Hallux , Humans , Nail Diseases/pathologyABSTRACT
We describe a case of cutaneous leishmaniasis with lymphadenopathy due to Leishmania donovani, which was successfully treated with oral miltefosine. Given the increased prevalence of travelling, patients presenting with lymph-node enlargement should have leishmaniasis included in the differential diagnosis even in the absence of typical ulceration.
Subject(s)
Facial Dermatoses/diagnosis , Leishmania donovani , Leishmaniasis, Cutaneous/diagnosis , Lymphatic Diseases/parasitology , Animals , Antiprotozoal Agents/therapeutic use , Facial Dermatoses/drug therapy , Female , Humans , Leishmaniasis, Cutaneous/complications , Leishmaniasis, Cutaneous/drug therapy , Lymphatic Diseases/drug therapy , Middle Aged , Phosphorylcholine/analogs & derivatives , Phosphorylcholine/therapeutic useABSTRACT
BACKGROUND: We aimed to evaluate the short- and long-term outcomes of treatment by insertion of a covered expandable modified Gianturco-Z endoprosthesis (Song stent) in patients with esophagogastric malignancies. METHODS: Consecutive patients with esophagogastric malignancies in whom a Song stent was inserted were included. Data were retrieved retrospectively. Dysphagia before and after stent placement was scored on a 5-point scale. Early (less than 30 days) and late complications (more than 30 days) were scored. RESULTS: Analysis included 164 stents in 153 patients. Indications for stent placement were dysphagia and/or fistulas/perforations. The dysphagia score improved from a mean of 3.7 to 2.2 after stent placement (p < 0.0001). Fistulas/perforations sealed in 87% of cases. Early complications after stent placement occurred in 29.9% of cases. These included stent migration (4.3%), stent obstruction (6. 1%), aspiration pneumonia (4.9%), bleeding (4.3%), perforation (1. 8%), and pain (15.9%). Late complications occurred in 27.8% of cases. These included stent migration (2.6%), stent obstruction (9.6%), aspiration pneumonia (2.6%), bleeding (7.0%), perforation (0.9%), and pain (12.2%). The 30-day mortality was 26%. Death related to stent placement occurred in 3.3%. CONCLUSION: Insertion of a Song expandable endoprosthesis in patients with esophagogastric malignancies significantly improves dysphagia, is successful in sealing fistulas/perforations, and is associated with acceptable morbidity and mortality rates.
