Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Am J Trop Med Hyg ; 109(3): 587-588, 2023 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-37524329

RESUMO

Leptospirosis is a zoonotic disease that primarily affects people in tropical and subtropical areas worldwide. Owing to the temperate climate of Japan, leptospirosis is not endemic across the country. Domestic cases of leptospirosis have been mainly reported in Okinawa and the southwestern subtropical islands, but not in the other regions. Here, we describe a case of leptospirosis that developed and was diagnosed outside the domestically endemic region. Notably, disease onset occurred shortly after the patient experienced a flood after a typhoon disaster. With global warming, the international prevalence of leptospirosis may change. Physicians outside currently endemic areas must be aware of this tropical disease.


Assuntos
Tempestades Ciclônicas , Desastres , Leptospirose , Animais , Humanos , Japão/epidemiologia , Leptospirose/diagnóstico , Leptospirose/epidemiologia , Zoonoses/epidemiologia
3.
BMJ Case Rep ; 15(12)2022 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-36585049

RESUMO

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinicoradiologic syndrome diagnosed by temporary hyperintense lesion in the area, including the splenium of the corpus callosum, on diffusion-weighted imaging and neuropsychiatric symptoms that recover without sequelae. MERS is rare in adults, especially elderly people. We herein report a man in his 60s diagnosed with MERS caused by Legionella pneumonia. He completely recovered with only the administration of levofloxacin and azithromycin despite the risk factors of an advanced age, medical history of untreated hypertension, bilateral spontaneous pneumothoraxes, smoking and drinking habits and pulmonary emphysema. To our knowledge, this is the oldest case of MERS due to Legionella pneumonia and extremely old among total MERS cases. Our research revealed that Legionella species are the most common pathogens of adult-onset MERS, while viruses are the main causative factors in children. This case helps clarify the features of MERS in high-risk adults.


Assuntos
Encefalopatias , Encefalite , Legionella , Doença dos Legionários , Pneumonia , Masculino , Adulto , Criança , Humanos , Idoso , Encefalopatias/complicações , Encefalite/diagnóstico por imagem , Encefalite/etiologia , Doença dos Legionários/complicações , Doença dos Legionários/diagnóstico , Doença dos Legionários/tratamento farmacológico , Corpo Caloso/diagnóstico por imagem , Corpo Caloso/patologia , Pneumonia/complicações , Imageamento por Ressonância Magnética
4.
Clin Case Rep ; 9(3): 1791-1792, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33768941

RESUMO

Situs inversus may mimic the pain localization of acute abdomen. In patients with acute abdomen, especially elderly patients who are medically healthy, physicians should cautiously diagnose the etiology of acute abdomen in combination with imaging studies.

5.
Clin Case Rep ; 9(3): 1810-1811, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33768950

RESUMO

Physicians should be aware of the risk of malignancy in patients with toxic multinodular goiter. Radionuclide scan cannot be used to predict the malignant potential of thyroid nodules. A comprehensive evaluation of imaging studies is needed.

6.
J Anesth ; 27(1): 88-92, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22990527

RESUMO

PURPOSE: WHO's three step ladder sometimes cannot provide adequate pain relief for pancreatic cancer. Some patients develop terminal delirium (TD). The aim of this study was to test if the addition of a celiac plexus block (CPB) to pharmacotherapy could reduce the incidence of TD. METHODS: Pancreatic cancer patients under the care of our palliative-care team were investigated with regard to the duration and occurrence of TD, pain scores [numerical rating score (NRS)] and daily opioid dose. Between August 2007 to September 2008, 17 patients received only pharmacotherapy (control group). Then, we modified our guideline for analgesia, performing CPB 7 days after the first intervention of our team. Between October 2008 to September 2009, 19 patients received CPB. RESULTS: The opioid doses in CPB group were significantly lower both at 10 days after the first intervention (3 days after CPB) (27 ± 11 vs. 66 ± 82 mg; p = 0.029) and 2 days before death (37 ± 25 vs. 124 ± 117 mg; p = 0.009). NRS in the CPB group were significantly lower both at 10 days after the first intervention (0 [0-2] vs. 3 [2-5], p < 0.0001) and 2 days before death (1 [0-2] vs. 3 [1-4.5], p = 0.018). The occurrence and duration of TD in CPB group were both reduced (42 vs. 94 %, p = 0.019; and 1.8 ± 2.9 vs. 10.4 ± 7.5 days, p = 0.0003). CONCLUSION: The duration and occurrence of TD and the pain severity were significantly less in pancreatic cancer patients who underwent neurolytic CPB.


Assuntos
Plexo Celíaco , Delírio/etiologia , Delírio/prevenção & controle , Bloqueio Nervoso/métodos , Neoplasias Pancreáticas/complicações , Idoso , Delírio/psicologia , Feminino , Humanos , Hipotensão/etiologia , Avaliação de Estado de Karnofsky , Masculino , Pessoa de Meia-Idade , Bloqueio Nervoso/efeitos adversos , Medição da Dor , Dor Intratável/tratamento farmacológico , Dor Intratável/etiologia , Dor Intratável/terapia , Cuidados Paliativos , Neoplasias Pancreáticas/psicologia , Cirurgia Assistida por Computador , Assistência Terminal , Tomografia Computadorizada por Raios X
7.
J Anesth ; 24(3): 407-10, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20217150

RESUMO

PURPOSE: Painful neuropathic conditions of cancer pain often show little response to nonopioid and opioid analgesics but may be eased by antidepressants and anticonvulsants. Although gabapentin is effective in the treatment of neuropathic pain in patients with cancer, some patients experience intolerable side effects sufficient to warrant discontinuation. The aim of this study was to see whether low-dose gabapentin is effective in treating cancer-related neuropathic pain when combined with low-dose imipramine. METHODS: Fifty-two cancer patients diagnosed as having neuropathic pain were allocated into four groups: G400-I group took gabapentin 200 mg and imipramine 10 mg every 12 h orally; G400 group took gabapentin 200 mg every 12 h orally; G800 group took gabapentin 400 mg every 12 h orally; I group took imipramine 10 mg every 12 h orally. RESULTS: Low-dose gabapentin-imipramine significantly decreased the total pain score and daily paroxysmal pain episodes. Several patients developed mild adverse symptoms in the four groups, and three patients discontinued treatment due to severe adverse events in the G800 group. CONCLUSION: Low-dose gabapentin-antidepressant combination with opioids was effective in managing neuropathic cancer pain without severe adverse effects.


Assuntos
Aminas/uso terapêutico , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Imipramina/uso terapêutico , Neoplasias/complicações , Dor/tratamento farmacológico , Dor/etiologia , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/etiologia , Ácido gama-Aminobutírico/uso terapêutico , Idoso , Anti-Inflamatórios não Esteroides/uso terapêutico , Antidepressivos Tricíclicos/administração & dosagem , Quimioterapia Combinada , Feminino , Gabapentina , Humanos , Imipramina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Medição da Dor/efeitos dos fármacos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...