RESUMEN
The aim of this study was to evaluate the occurrence of pulmonary embolism in returning travelers with hypoxemic pneumonia due to COVID-19. All returning travelers to Reunion Island with hypoxemic pneumonia due to COVID-19 underwent computed tomography pulmonary angiography (CTPA) and were included in the cohort. Thirty-five patients were returning travelers with hypoxemic pneumonia due to COVID-19 and had recently returned from one of the countries most affected by the COVID-19 outbreak (mainly from France and Comoros archipelago). Five patients (14.3%) were found to have pulmonary embolism and two (5.9%) were incidentally found to have deep vein thrombosis on CTPA. Patients with pulmonary embolism or deep vein thrombosis had higher D-dimer levels than those without pulmonary embolism or deep vein thrombosis (P = 0.04). Returning travelers with hypoxemic pneumonia due to COVID-19 should be systematically screened for pulmonary embolism.
Asunto(s)
Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Embolia Pulmonar/diagnóstico por imagen , Trombosis de la Vena/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Angiografía , Betacoronavirus , COVID-19 , Comoras , Infecciones por Coronavirus/complicaciones , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Francia , Humanos , Hipoxia/virología , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Embolia Pulmonar/virología , Reunión , SARS-CoV-2 , Tomografía Computarizada por Rayos X , Viaje , Trombosis de la Vena/virologíaAsunto(s)
Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Embolia Pulmonar/virología , Viaje , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/fisiopatología , Francia , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/fisiopatología , SARS-CoV-2 , Tomografía Computarizada por Rayos XAsunto(s)
Enfermedades Transmisibles Importadas/microbiología , Enfermedades Transmisibles Importadas/transmisión , Melioidosis/microbiología , Melioidosis/transmisión , Viaje , Adulto , Burkholderia pseudomallei/clasificación , Burkholderia pseudomallei/genética , Burkholderia pseudomallei/aislamiento & purificación , Enfermedades Transmisibles Importadas/diagnóstico , Enfermedades Transmisibles Importadas/epidemiología , Francia , Humanos , Masculino , Melioidosis/diagnóstico , Melioidosis/epidemiología , VietnamRESUMEN
Axitinib is an oral second-generation selective inhibitor of vascular endothelial growth factor receptors recently approved for the treatment of advanced renal cell carcinoma. Numerous cases of acute pancreatitis have been reported after treatment with nonselective tyrosine kinase inhibitors such as sorafenib and sunitinib. We present the first report of a patient under axitinib treatment presenting with acute pancreatitis for which no other etiology has been found. The patient was a 29-year-old woman treated for renal cell carcinoma. The patient had no history of chronic illness, gallstone-related disease, or alcohol consumption. She had been previously treated with sunitinib and everolimus. Four months after the onset of axitinib treatment she was hospitalized for acute pancreatitis. Symptoms and blood lipase levels normalized within a few days after axitinib was withheld. We believe that acute pancreatitis should be recognized as a potential axitinib-related adverse event.
Asunto(s)
Antineoplásicos/efectos adversos , Carcinoma de Células Renales/tratamiento farmacológico , Imidazoles/efectos adversos , Indazoles/efectos adversos , Neoplasias Renales/tratamiento farmacológico , Pancreatitis/inducido químicamente , Inhibidores de Proteínas Quinasas/efectos adversos , Enfermedad Aguda , Adulto , Antineoplásicos/uso terapéutico , Axitinib , Femenino , Humanos , Imidazoles/uso terapéutico , Indazoles/uso terapéutico , Inhibidores de Proteínas Quinasas/uso terapéuticoAsunto(s)
Aorta Abdominal , Enfermedades de la Aorta/complicaciones , Arteriopatías Oclusivas/complicaciones , Hipertensión Maligna/etiología , Obstrucción de la Arteria Renal/complicaciones , Trombosis/complicaciones , Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/fisiopatología , Aorta Abdominal/cirugía , Enfermedades de la Aorta/diagnóstico , Enfermedades de la Aorta/fisiopatología , Enfermedades de la Aorta/cirugía , Aortografía/métodos , Arteriopatías Oclusivas/diagnóstico , Arteriopatías Oclusivas/fisiopatología , Arteriopatías Oclusivas/cirugía , Presión Sanguínea , Circulación Colateral , Femenino , Humanos , Hipertensión Maligna/diagnóstico , Hipertensión Maligna/fisiopatología , Hipertensión Maligna/cirugía , Persona de Mediana Edad , Nefrectomía , Valor Predictivo de las Pruebas , Obstrucción de la Arteria Renal/diagnóstico , Obstrucción de la Arteria Renal/fisiopatología , Obstrucción de la Arteria Renal/cirugía , Trombosis/diagnóstico , Trombosis/fisiopatología , Trombosis/cirugía , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Injerto VascularRESUMEN
Amebiasis, the parasitic disease caused by Entamoeba histolytica, may result in extra-intestinal diseases among which liver abscess is the most common manifestation. We report two cases of amebic liver abscess illustrating the inequal sensitivity of serologic tests detecting anti-amebic antibodies.
Asunto(s)
Anticuerpos Antiprotozoarios , Drenaje/métodos , Entamoeba histolytica/inmunología , Absceso Hepático Amebiano , Metronidazol/administración & dosificación , Pruebas Serológicas/métodos , Adulto , Antiprotozoarios/administración & dosificación , Reacciones Falso Negativas , Humanos , Ictericia Obstructiva/etiología , Absceso Hepático Amebiano/complicaciones , Absceso Hepático Amebiano/diagnóstico , Absceso Hepático Amebiano/microbiología , Absceso Hepático Amebiano/fisiopatología , Absceso Hepático Amebiano/terapia , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
OBJECTIVE: Because prostate cancer local recurrences can be efficiently treated by salvage therapies, it becomes critical to detect them early. METHODS: The first alert is the rise of the prostate specific antigen (PSA) level after the post-treatment nadir, which can correspond to a distant recurrence, a local recurrence or both. This so-called biochemical failure (BF) is defined as PSA level > 0.2 ng/ml after radical prostatectomy (RP) and PSA level > nadir + 2 ng/ml after radiotherapy. There is no consensual definition of BF after cryotherapy, high-intensity focused ultrasound (HIFU) ablation or brachytherapy. RESULTS: Local recurrences after RP are treated by radiotherapy, those after radiotherapy by RP, cryotherapy, brachytherapy or HIFU ablation. Recurrences after cryotherapy or HIFU ablation can be treated by a second session or radiotherapy. Recurrences after brachytherapy are difficult to treat. In patients with BF, MRI can detect local recurrences, whatever the initial treatment was. Dynamic contrast-enhanced MRI seems particularly accurate. The role of spectroscopy remains controversial. Ultrasound-based techniques are less accurate, but this may change with the advent of ultrasonic contrast media. CONCLUSION: These recent advances in imaging may improve the outcome of salvage therapies (by improving patient selection and treatment targeting) and should open the way to focal salvage treatments in the near future.