RESUMO
A 75 year old man developed chronic flexor tenosynovitis in a finger, caused by Mycobacterium terrae. He had a history of diabetes mellitus and arteritis, but not of local trauma. However, triamcinolone had been injected into the tendon sheath on 3 occasions. Chemotherapy was instituted, but after 3 months amputation became mandatory. This is the fourth case reported in which M. terrae was involved, and it supports the responsibility of this organism as a human pathogen. Attention is drawn to the hazards of corticosteroid injections into tendon sheaths.
Assuntos
Dedos , Infecções por Mycobacterium não Tuberculosas/etiologia , Infecções por Mycobacterium/etiologia , Tenossinovite/microbiologia , Idoso , Humanos , Masculino , Infecções por Mycobacterium não Tuberculosas/terapia , Micobactérias não Tuberculosas/isolamento & purificação , Tenossinovite/terapia , Triancinolona/efeitos adversosRESUMO
A case of posttransfusional immunologic thrombocytopenia is reported in a 75-year-od PlA1-negative woman. This was the second episode of postoperative and posttransfusion thrombocytopenia in the same patient who had had only one pregnancy. Both thrombocytopenic episodes were subclinical and discovered by systematical hematologic study. A potent anti-PlA1-antibody (titer 1/128) was demonstrated by the platelet-indirect radioactive Coombs test which appeared more sensitive than other platelet immunological assays used. The very long duration of the thrombocytopenia is discussed as well as the therapeutic possibilities in such cases.
Assuntos
Púrpura Trombocitopênica/etiologia , Reação Transfusional , Idoso , Anticorpos , Plaquetas/imunologia , Testes de Fixação de Complemento , Teste de Coombs , Feminino , Humanos , Agregação Plaquetária , Fator Plaquetário 3 , Púrpura Trombocitopênica/imunologia , Serotonina/metabolismoRESUMO
Function incapacitation of the hand in rheumatoid arthritis was studied on 33 patients (54 hands). 35 were operated on. All cases had reached the stage of articular destructions. The authors emphasize the importance of preserved proximal inter-phalangeal joint for digito-palmar pinch. Thumb unstability was not severely disabling as long as the other digits were normal. However, when it was associated with hyperextension deformities of the other fingers, the hand became useless. Surgical indications in rheumatoid hand were detailed. The importance of restoring thumb function was pointed out.
