ABSTRACT
Nocardiosis is a life-threatening infection usually affecting immunocompromised patients. Very rarely it presented with intracranial abscesses and pleuro-parenchymal infections. We herein report a very challenging case of a 34-year-old obese and diabetic man affected by disseminated nocardiosis with multiple brain abscesses and pleural empyema. Despite rare, this entity should be taken into account by the pathologists and urgently communicated to clinicians in order to promptly start an effective treatment.
Subject(s)
Brain Abscess/diagnostic imaging , Diabetes Mellitus/diagnostic imaging , Empyema, Pleural/diagnostic imaging , Nocardia Infections/diagnostic imaging , Opportunistic Infections/diagnostic imaging , Adult , Brain Abscess/complications , Brain Abscess/pathology , Diabetes Complications , Diabetes Mellitus/pathology , Empyema, Pleural/complications , Empyema, Pleural/pathology , Humans , Immunocompromised Host , Male , Nocardia Infections/complications , Nocardia Infections/pathology , Opportunistic Infections/complications , Opportunistic Infections/pathologyABSTRACT
INTRODUCTION: Quality of life is affected during any illness, especially chronic diseases, such as renal failure. OBJECTIVE: To evaluate the quality of life after kidney transplantation. METHODS: One hundred patients were interviewed (60 men, 40 women, mean age 36 +/- 10.4 years, median 35 years) from July to October 2000 using the multidimensional questionnaire WHOQL-Bref. RESULTS: Eighty-eight percent of patients were satisfied/very satisfied with their general health condition. Seventy-seven percent manifested a good capacity to carry out daily activities, and 75% considered themselves satisfied with their work capacity. Quality of life was considered "very good" or "good" among 80%, and "neither good nor bad" in 20%. None considered quality of life in general as "bad" or "very bad." Most (87%) were satisfied with their current condition and with themselves after the kidney transplant. CONCLUSION: Patients perceive kidney transplant as capable of improving their quality of life. The most important finding in this study is that the results of the physical and psychological domains did not show any significant difference. It was possible to conclude that the quality of life for most subjects is related to reduction or disappearance of the symptoms caused by the previous disease.
Subject(s)
Kidney Transplantation/physiology , Quality of Life , Adult , Female , Follow-Up Studies , Humans , Interpersonal Relations , Kidney Transplantation/psychology , Male , Perception , Surveys and Questionnaires , Time FactorsABSTRACT
Living donor liver transplantation (LDLT) for children and adults has gained widespread acceptance due to the severe organ shortage. LDLT provides potential recipients with timely transplantation, but this procedure engenders a potentially significant risk to the donor. This study analyzed medical, functional, and psychological donor outcomes after LDLT. Nineteen donors (mean age 33.9 +/- 12 years), who underwent hepatectomy for LDLT (13 right lobectomy for adult LDLT) from March 1998 to November 2002, were interviewed at a median of 13 months after donation (range, 2 to 58 months). According to the Clavien System classification, major complications occurred in three donors (16%), and minor in four (21%). The mean length of hospital stay was 5.7 +/- 1.6 days. Five patients (27%) needed rehospitalization. Complete recovery was achieved at a mean time of 8.5 +/- 3.5 weeks. All 19 donors were able to return to predonation activities. The donor's relationship to the recipient and to their families was improved after donation in all cases; 12 (63%) cited a positive psychological impact on their lives. About 90% would donate again and 84% would recommend donation to someone contemplating it. In conclusion, all donors are alive and well after donation and were able to return to their predonation occupation. Most of them felt that this experience changed their lives for the better and would donate again. Donor safety and quality of life should remain the priority in all donation processes.
Subject(s)
Liver , Living Donors/psychology , Quality of Life , Adolescent , Adult , Female , Hepatectomy/methods , Humans , Interviews as Topic , Liver Transplantation , Male , Middle Aged , Time Factors , Tissue and Organ Harvesting/methodsABSTRACT
OBJECTIVE: To investigate lower urinary tract function in ambulatory children with myelomeningocele. PATIENTS AND METHODS: The urological course of 45 children with myelomeningocele who walked either independently (19 children) or with ankle-foot orthotics (26 children) was reviewed. Follow-up ranged from 9 months to 13.5 years (mean 4.75 years). RESULTS: A normal pattern of voiding was observed both clinically and during urodynamic evaluation in only three of the 45 children, with the remainder displaying neurogenic lower urinary tract dysfunction. The independent walkers and those with orthotics did not differ in the spectrum of lower urinary tract dysfunction or other variables. Those patients with persistent incontinence underwent an initial urodynamic evaluation when older (mean 3.7 years versus 6.4 weeks in those who were continent). CONCLUSION: Ambulatory children with myelomeningocele suffer the full spectrum of lower urinary tract dysfunction. Given the potential danger of untreated lower urinary tract dysfunction, ambulatory children with myelomeningocele should receive the same diagnostic and therapeutic attention as their peers with more overt neurological deficits.
