Subject(s)
Cardiac Resynchronization Therapy/adverse effects , Electrocardiography/methods , Heart Failure , Hospitalization/statistics & numerical data , Long Term Adverse Effects , Adult , Aged , Cardiac Resynchronization Therapy/methods , Female , Heart Failure/diagnosis , Heart Failure/epidemiology , Heart Failure/physiopathology , Heart Failure/therapy , Humans , Long Term Adverse Effects/diagnosis , Long Term Adverse Effects/etiology , Long Term Adverse Effects/mortality , Long Term Adverse Effects/physiopathology , Malaysia/epidemiology , Male , Middle Aged , Registries/statistics & numerical data , Severity of Illness Index , Statistics as Topic , Stroke Volume , Survival Analysis , Ventricular RemodelingABSTRACT
Disseminated cryptococcosis mainly occurs in patients with impaired cell mediated immunity. We present a case of disseminated cryptococcosis in a non-HIV patient with nephrotic syndrome who never received immunosuppression. Cultures of bone marrow aspirate, cerebrospinal fluid analysis and histology of skin lesions were all consistent with Cryptococcus neoformans infection. Treatment with amphotericin B followed by fluconazole was successful and in the course of two months when, the skin nodules disappeared.
Subject(s)
Cryptococcosis/microbiology , Cryptococcus neoformans/isolation & purification , Nephrotic Syndrome/complications , Adult , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Bone Marrow/microbiology , Cerebrospinal Fluid/microbiology , Cryptococcosis/diagnosis , Cryptococcosis/pathology , Fluconazole/therapeutic use , Forearm/microbiology , Forearm/pathology , Humans , Male , Skin/microbiology , Skin/pathology , Treatment OutcomeABSTRACT
Iodine-123 (159 keV, T1/2 = 13.3 hr) has been proposed for renal investigations, as opposed to I-131 (364 keV, T1/2 = 8.06 days), because of its more practical photon energy and lower radiation dose to the patient. The cyclotron production method 124Te (p,2n) 123I for I-123 results in contamination with I-124 (T1/2 = 4.5 days). The latter emits high-energy photons whose relative abundance increases with time after end of bombardment (EOB). This paper is an evaluation of the effects of photon penetration, scatter, and attenuation on the phantom calibration measurements required for determining relative renal uptake using I-123. Measurements using I-131 were performed for comparison. Parameters investigated included: (a) the relationship between the integrated count and ROI size, (b) the magnitude of the "cross-talk" in counts between the kidneys, and (c) the attenuation corrections for source (kidney) depth. Phantom results obtained for I-123 suggest that this radionuclide will allow a better measurement of the activity in individual kidneys. Collimator penetration effects were greater for I-131 than for I-123. With I-123 for example, a higher fraction of the counts due to the activity in the kidney phantom were observed within the ROI enclosing its image. However, the attenuation corrections for source depth for I-123 were dependent on both the size of the ROI and time after EOB.
