ABSTRACT
Whipple's disease is an uncommon systemic disease which most often affects the intestine but may involve any other organ. The case of a woman who consulted for weight loss, fever of unknown origin, cutaneous eruptions and increase in the abdominal perimeter is presented. The ascitic fluid showed exudate infected by E. coli suggesting spontaneous bacterial peritonitis associated with chronic liver disease. Antibiotic treatment and diuretics were administered after which abdominal exploration demonstrated the presence of a mesogastric mass. Echographic and tomographic studies were unable determine the origin of the mass with the final diagnosis being achieved by exploratory laparotomy and biopsy.
Subject(s)
Abdomen , Granuloma, Plasma Cell/diagnosis , Whipple Disease/diagnosis , Abdominal Neoplasms/diagnosis , Adult , Diagnosis, Differential , Female , Humans , Sarcoidosis/diagnosis , Skin Diseases/diagnosisABSTRACT
The importance of atrial fibrillation (AF) as a risk factor (RF) for cerebral infarction (CI) is well-known. It is probably caused by cardiac embolism but other explanations can also justify this association. Our aim was to analyse the features of the patients with CI and AF and sinus rhythm (SR), as well as to form hypotheses as regards the pathogenesis. 250 patients with CI, 204 in RS and 46 in AF (31 non-valvular and 15 associated to a valvular disease) were studied, analysing the prevalence of RF and initial blood tests. The group of patients with valvular AF of probably embolic mechanism had a minor prevalence of RF (hypertension, diabetes, smoking, alcoholism) but higher mortality. The group with non-valvular AF, had a lower RF prevalence compared to the SR group (non-embolic mechanism), without statistical significance and with a similar mortality rate. We concluded that the atherothrombotic mechanism can be the cause of a considerable proportion of CI in patients with non-valvular AF.
Subject(s)
Atrial Fibrillation/complications , Cerebral Infarction/etiology , Aged , Atrial Fibrillation/blood , Cerebral Infarction/blood , Female , Humans , Hypertension/complications , Lipids/blood , Male , Middle Aged , Risk FactorsABSTRACT
A case of 54-year-old male who, during the development of a pulmonary fibrosis, showed extrapulmonary autoimmune symptoms (polyarthritis and hemolytic anemia), is presented. The antinuclear antibodies and rheumatoid factor positives have been described in up to 30% of the idiopathic pulmonary fibrosis, complicating the differential diagnosis with lung fibrosis caused by alterations of connective tissue. We discuss the prognosis and treatment of this difficult diagnosis.
Subject(s)
Autoimmune Diseases/diagnosis , Pulmonary Fibrosis/diagnosis , Antibodies, Antinuclear/blood , Autoimmune Diseases/drug therapy , Biopsy , Diagnosis, Differential , Drug Therapy, Combination , Humans , Lung/pathology , Male , Middle Aged , Pulmonary Fibrosis/drug therapy , Rheumatoid Factor/bloodABSTRACT
The prevalence of cerebrovascular disease risk factors and their immediate mortality prognostic value together with the initial analytical parameters are evaluated. 250 cases of cerebral infarction (CI), 150 cases of intracerebral hemorrhage (ICH) and 60 cases of transitory ischemic events (TIE) were studied and compared to a control group. A higher prevalence of arterial hypertension, cardiopathy, previous cerebrovascular disease and elevated hematocrit was found in the CI group. In the TIE group there was an increased prevalence of cardiopathy, previous cerebrovascular disease and high hematocrit. In the ICH group an increased prevalence of hypertension and left ventricular hypertrophy was found. We have to point out the importance of a global approach of the risk factors. The intrahospital mortality due to CI was associated with old age, low hematocrit, leukocytosis and high blood sugar at admission. ICH was associated with a higher systolic arterial pressure leukocytosis and elevated blood glucose at admission.
Subject(s)
Cerebrovascular Disorders/mortality , Adult , Aged , Cerebrovascular Disorders/blood , Cerebrovascular Disorders/etiology , Cross-Sectional Studies , Female , Humans , Ischemic Attack, Transient/mortality , Male , Middle Aged , Prognosis , Risk FactorsABSTRACT
450 patients who arrived at the emergency department with abdominal pain were studied. 71% arrived without having previously consulted another doctor. The most frequent diagnosis was reno ureteral pain, non-specific pain, gastroenteritis and in geriatric patients (hernia, biliar pathology) other pathology. 69 patients with non-specific pain were followed-up during a period of one year. The symptoms returned in 40% of patients. Only 3% required urgent medical treatment.
Subject(s)
Abdominal Pain/etiology , Adolescent , Adult , Aged , Emergencies , Emergency Service, Hospital , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Diabetic nephropathy is one of the most serious complications of diabetes mellitus because of the associated mortality and morbility. The proteinuria, together with hypertension and renal function, are the clinical features. It is linked with a major prevalence of the other late complications of the disease. In recent years progress has been made in the knowledge of the natural history of the disease, as well as, its predictive factors. We review the etiopathogenia, the actual therapeutic management with special emphasis on hypertension treatment and the controversial metabolic control.
Subject(s)
Diabetic Nephropathies , Diabetic Nephropathies/classification , Diabetic Nephropathies/pathology , Diabetic Nephropathies/physiopathology , Diabetic Nephropathies/therapy , HumansSubject(s)
Emergency Service, Hospital/statistics & numerical data , Patient Admission , Adolescent , Adult , Aged , Aged, 80 and over , Diagnosis-Related Groups , Female , Hospitals, General , Humans , Male , Middle Aged , SpainABSTRACT
The first reported Spanish family with autosomal dominant endosteal hyperostosis is presented and two members in two different generations studied. Neurological involvement with sensorineural hearing loss, chronic intracranial hypertension, and mild corticospinal tract abnormalities were found in one case with radiological evidence of progressive bone disease at follow-up. In addition to mild hydrocephalus, CT-scan of the head documented a reduction in size of the posterior fossa and encroachment of the foramen magnum. A pattern of selective increase in the bone fraction of serum alkaline phosphatase was also recorded. This family supports the view that severe forms of endosteal hyperostosis are not confined to the autosomal recessive variant, as individuals with the autosomal dominant form may also show relentless progression to neurological involvement during adulthood.
Subject(s)
Osteochondrodysplasias/genetics , Alkaline Phosphatase/blood , Facial Bones/abnormalities , Genes, Dominant , Humans , Nervous System Diseases/genetics , Osteochondrodysplasias/blood , Osteochondrodysplasias/complications , Osteochondrodysplasias/diagnostic imaging , Skull/abnormalities , Tomography, X-Ray ComputedSubject(s)
Electrolytes/metabolism , Liver/metabolism , Vitamin K/pharmacology , Animals , Liver/drug effects , Male , Rats , Rats, Inbred StrainsABSTRACT
Se realizaron una serie de experimentos en ratas machos Sprague Dowley para estudiar la importancia de la vitamina K3 en la distribución electrolítica hepática. En este sentido se evaluó el contenido hepático de Fe, Pi, Mg, Mn, Ca, Cu, Na, K, Zn y Cl en ratas tratadas con dosis crecientes de vitamina K3, y los datos se correlacionaron con los niveles obtenidos en el grupo control respectivo. La administración de dosis de 10 a 50 mg/kg de peso únicamente tuvo un efecto significativo en el incremento de Fe. No se observaron variaciones significativas de los demás electrólitos. Los resultados obtenidos permiten sugerir algunas posibilidades sobre la variación del contenido de hierro
