Subject(s)
Familial Mediterranean Fever/diagnosis , Carrier Proteins/genetics , Colchicine/therapeutic use , Cryopyrin-Associated Periodic Syndromes/diagnosis , Cryopyrin-Associated Periodic Syndromes/genetics , Diagnosis, Differential , Familial Mediterranean Fever/drug therapy , Humans , Interleukin 1 Receptor Antagonist Protein/therapeutic use , Male , Middle Aged , NLR Family, Pyrin Domain-Containing 3 Protein , Polyradiculoneuropathy/etiology , Prednisone/therapeutic useSubject(s)
Familial Mediterranean Fever/genetics , Adult , Colchicine/therapeutic use , Cytokines/blood , Cytoskeletal Proteins/genetics , DNA Mutational Analysis , Exons/genetics , Familial Mediterranean Fever/blood , Familial Mediterranean Fever/diagnosis , Familial Mediterranean Fever/drug therapy , Familial Mediterranean Fever/epidemiology , Genes, Recessive , Humans , Male , Mutation, Missense , Point Mutation , PyrinSubject(s)
Chlorthalidone/adverse effects , Diuretics/adverse effects , Hypokalemia/chemically induced , Aged , Female , Humans , Time FactorsSubject(s)
Pneumonia, Bacterial/etiology , Typhus, Endemic Flea-Borne/complications , Adult , Anti-Bacterial Agents/therapeutic use , Biopsy , Bronchoalveolar Lavage Fluid , Doxycycline/therapeutic use , Humans , Male , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/diagnostic imaging , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/surgery , Thoracotomy , Tomography, X-Ray Computed , Typhus, Endemic Flea-Borne/drug therapyABSTRACT
The remitting seronegative symmetrical synovitis with pitting edema of the elderly patient with edema and fovea (RS3PE), characterizes for the appearance of one polyarthritis symmetrical with fovea in the back of the hands, and negative reumatoideal factor. The association to tuberculosis had not been described before. One presents the case of a 89-year-old patient who consulted for anorexia of month and a half of evolution accompanied of edema in hands and feet, with negative reumatoideal factor. He was presenting a pulmonary infiltrated, which microbiological study revealed the infection for Mycobacterium tuberculosis.
Subject(s)
Edema/etiology , Synovitis/etiology , Tuberculosis, Pulmonary/complications , Aged, 80 and over , Humans , MaleABSTRACT
Pericarditis is an unusual manifestation of gigantic cell arteritis. The following essay describes the case of a female patient who had been diagnosed, three years earlier, with several types of rheumatic myalgia, and because of this, she had had periodical tests in which no complications at all had been observed. At the age of 69, this female patient consulted the doctor for mild fever, dry cough, anorexia and diffuse abdominal pain. The echocardiography showed pericardium discharge and complementary explorations ruled out infectious or neoplasia processes. A corticoid treatment was started and the symptomatology improved in a few days, the pericardium discharge being solved in 3 months.
Subject(s)
Giant Cell Arteritis/complications , Pericarditis/etiology , Aged , Female , Giant Cell Arteritis/drug therapy , Humans , Pericarditis/drug therapySubject(s)
Blister/etiology , Tuberculin Test/adverse effects , Adult , Blister/pathology , Female , HumansSubject(s)
Carcinoma/secondary , Lung Neoplasms/secondary , Thyroid Neoplasms/pathology , Aged , Aged, 80 and over , Female , Humans , Time FactorsSubject(s)
Lung Neoplasms/pathology , Lymphoma, B-Cell/pathology , Aged , Disease Progression , Female , Humans , Time FactorsABSTRACT
The aim of this study was to determine the etiologic diagnosis of nosocomial pneumonia in hospitalized patients outside the intensive care unit. The study was carried out prospectively at the University Hospital Arnau de Vilanova in Lerida (Spain) from 1 May 1994 through 28 February 1996, during which 103 cases were diagnosed. Transthoracic needle aspiration (TNA) was chosen as the most useful diagnostic procedure, given its high specificity and low rate of complications. Sixty-seven TNA procedures were carried out; 10 (14.9%) were positive. Sputum was cultured for 62 patients and true positives were observed in 6 (9.7%). Pleural liquid was cultured for 35 patients and germs were isolated for 2 (5.7%). Bronchial brushing with a telescoping catheter was performed in 4 patients and brush culture provided 2 additional positives. Blood samples from 51 patients were cultured provided 4 additional diagnoses (7.8%). The most commonly found germs were P. aeruginosa (13.33%), S. aureus (13.3%), C. pneumoniae (10%) and L. pneumophila (10%). Disease was polymicrobial in 33.3%. Complications were observed, in the form of pneumothorax, in 2 cases (3%), one of which required drainage. We conclude that TNA, which is highly specific and has a low rate of complication, is a useful procedure for diagnosing nosocomial pneumonia in patients who are not being mechanically ventilated.
Subject(s)
Cross Infection/diagnosis , Cross Infection/microbiology , Pneumonia/diagnosis , Pneumonia/microbiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Needles , Prospective Studies , Suction/methods , ThoraxABSTRACT
OBJECTIVE: To know the incidence and risk's factors of nosocomial pneumonia (NN) in patient entered in hospital with age more of 14 years-old. The study was not performed in patients of Unit Care. Also, morbility and mortality are showed and the relation between bacterial agent and inmunologic answer of the patients. By other hand, we reported about specific clinical predictors for NN. MATERIALS AND METHODS: During a period of twenty-two months, 103 cases of NN were diagnosed what supposed 0.34% of the patients entered in this period of time. The study has been carried out in the University Arnau of Vilanova Hospital in Lleida (HUAV), with a capacity of 435 beds. Factors of the patients' risk of NN were valued. Multivariate analysis has been carried out by means of the pattern Cox's regression for proportional risks. RESULTS: About 66.99% of the patients had followed previous antibiotic treatment to the pneumonia episode, but only were significants those that had been treated with amoxicillin-clavulanic acid (28.15%, p = 0.0191). Blocking of the channels of the calcium were administered to 14.56% (p = 0.0030), and treatment with sedative drugs in 27.18% (p = 0.0397). Aerosol therapy was performed in 29 patients (28.15%, p = 0.0030). Nasogastric tube was performed in 19.41% of the patients (p = 0.0132). Creatinine was elevated in 31.42% (p < 0.05). The attributable mortality to the NN was of 33.9%, having a rate of higher mortality that the patients without NN. The agent etiologic was isolated in 23.3% of cases. The NN was polymicrobial in 8 cases with P. aeruginosa and S. aureus as the most frequents. CONCLUSION: In patients with several pathologies and treatments could be changed the immunologic answer and these patients are more predisposed to suffer NN. The mortality is associate to the age and others illness of the patient.
