ABSTRACT
Tuberculosis and cancer are two processes in relationship. The relation between both are studied. We analyzed retrospectively the culture-positive tuberculosis cases in from 1999 to 2002. We described the six cases with tuberculosis and cancer. One hundred and five cases of tuberculosis were observed, 6 cases (5.7%) had cancer. Four cases were pulmonary tuberculosis, one tuberculous pleurisy and other urinary tuberculosis urinary. The two cases with bronchogenic neoplasm had a diagnosis of tuberculosis at same time than cancer. The diagnosis of neoplasm was previous than tuberculosis in two cases (breast neoplasm and hypernephroma), and posterior in others two cases (breast and colon neoplasm). Half of theses patients died. In patients with neoplasm, the possibility of coexist tuberculosis is not depreciable, previous, concomitant or after the diagnosis of neoplasm.
Subject(s)
Neoplasms/complications , Tuberculosis/complications , Adult , Aged , Female , Hospitals, General , Humans , Male , Middle Aged , Retrospective Studies , SpainABSTRACT
Tuberculosis y cáncer son dos procesos que pueden aparecer interrelacionados. Se estudia la asociación entre ambas entidades. Se han revisado de forma retrospectiva los casos diagnosticados microbiológicamente de tuberculosis en el Hospital General Universitario de Elche desde 1999 a 2002. En seis pacientes coexistía neoplasia y tuberculosis. Se diagnosticaron 105 casos de tuberculosis, 6 de los cuales (5,7 por ciento) tenían una neoplasia. Cuatro tuvieron tuberculosis pulmonar, uno pleuropulmonar y otro urinaria. Los dos pacientes con carcinoma broncogénico tuvieron un diagnóstico sincrónico de tuberculosis pulmonar. El diagnóstico de la neoplasia previo al de tuberculosis fue en dos casos (cáncer de mama e hipernefroma), y posterior en otros dos (cáncer de mama y de colon). La mitad de los pacientes fallecieron. En los pacientes con neoplasia la posibilidad de coexistencia de tuberculosis no es despreciable, tanto previo al diagnóstico, concomitantemente, o tras el mismo (AU)
Subject(s)
Male , Middle Aged , Humans , Female , Adult , Aged , Tuberculosis , Spain , Retrospective Studies , Hospitals, General , NeoplasmsSubject(s)
Hyperparathyroidism/complications , Hypothyroidism/complications , Aged , Female , HumansABSTRACT
Leydig cell tumor is a testicular tumor with a low incidence characterized by a high estrogens secretion from the tumoral cells. Its more frequent clinical presentation is a testicular nodule with or without other endocrine manifestations due to estrogenic hypersecretion. We're reporting a case of a Leydig cell tumor with high plasmatic levels of estradiol, gynecomastia and inferior cava vein thrombosis, which hasn't been described among its clinical features up to now. Vascular thrombotic phenomenons have already been reported in other clinical situations with hiperestrogesism and they could also be associated with these tumors. Patients with Leydig cell tumors could be at a higher risk of developing thromboembolic phenomenons because of tumoral hyperestrogenism and could present thrombotic complications among the clinical findings.
Subject(s)
Gynecomastia/complications , Leydig Cell Tumor/complications , Testicular Neoplasms/complications , Vena Cava, Inferior , Venous Thrombosis/complications , Adult , Estrogens/metabolism , Gynecomastia/metabolism , Humans , Leydig Cell Tumor/metabolism , Male , Testicular Neoplasms/metabolism , Venous Thrombosis/etiologyABSTRACT
El tumor de células de Leydig es un tumor testicular de baja incidencia caracterizado por la secreción de estrógenos por las células tumorales. Sus manifestaciones clínicas más frecuentes son la presencia de un nódulo testicular acompañado o no de manifestaciones endocrinas secundarias a la hipersecreción estrogénica. Comunicamos un caso de tumor de células de Leydig con elevadas concentraciones plasmáticas de estradiol, ginecomastia y trombosis de la vena cava inferior, que no ha sido descrita como manifestación de estos tumores hasta la actualidad. Los fenómenos trombóticos vasculares se han descrito en otras situaciones clínicas de hiperestrogenismo y también podrían presentarse asociados a estos tumores. Los pacientes con tumores de células de Leydig podrían tener un mayor riesgo de desarrollar fenómenos tromboembólicos secundarios al hiperestrogenismo de origen tumoral y podrían presentar complicaciones trombóticas como manifestación clínica (AU)
Subject(s)
Adult , Male , Humans , Vena Cava, Inferior , Venous Thrombosis , Leydig Cell Tumor , Estrogens , Gynecomastia , Testicular NeoplasmsABSTRACT
A point prevalence study to document oral yeast carriage was undertaken. Risk factors for the development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients were investigated with a case-control design. Cases included all patients with fluconazole-resistant strains (MIC> or =64 microg/ml), and controls were those with susceptible (MIC< or =8 microg/ml) or susceptible-dependent-upon-dose (MIC 16-32 microg/ml) strains. One hundred sixty-eight Candida strains were isolated from 153 (88%) patients, 28 (16%) of whom had oropharyngeal candidiasis. Overall, 19 (12%) of the patients harbored at least one resistant organism (MIC > or = 64 microg/ml). Among patients with resistant strains, tuberculosis (P<0.001), esophageal candidiasis (P = 0.001), clinical thrush (P<0.001), and a CD4 + cell count < 200/mm3 (P = 0.03) were more frequent. These patients had also been treated more commonly with antituberculous drugs (adjusted odds ratio [OR] 6.13; 95% confidence interval [CI] 2.11-17.80), ciprofloxacin (OR 6.0; 95% CI 1.23-29.26), fluconazole (OR 4.59; 95% CI 1.55-13.52), and steroids (OR 4.13; 95% CI 1.11-15.39). Multivariate analysis showed that the determinants for fluconazole resistance were therapy with antituberculous drugs (OR 3.61; 95% CI 1.08-12.07; P=0.03) and one of the following: previous tuberculosis (OR 3.53; 95% CI 1.08-14.57; P=0.03) or fluconazole exposure (OR 3.41; 95% CI 1.10-10.54). Findings from this study indicate that treatment with antituberculous drugs, previous tuberculosis, and fluconazole exposure are the strongest determinants for development of oropharyngeal colonization or infection by fluconazole-resistant Candida strains in HIV-infected patients.
