RESUMO
BACKGROUND: The aim of this study was to investigate the incidence and clinical characteristics of intravenous (IV) or inhaled (IH) colistin-associated acute kidney injury (AKI) using the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria. METHODS: From 2010 to 2014, 160 patients were treated with IV or IH colistin. Of these, we included 126 patients who received colistin for > 72 hours for the treatment of pneumonia and compared the incidence and clinical characteristics of patients in the IV (n = 107) and IH (n = 19) groups. RESULTS: The patients included 104 men and 22 women, with a mean age of 69 years (range, 24–91 years). The mortality rate was 45%, and AKI occurred in 75 (60%) patients. At the end of therapy, the bacteriologic cure rate was 66%. There were no differences in the clinical characteristics between the IV and IH groups except for age. In comparison with patients in the IV group, the patients in the IH group were older (74 ± 8 vs. 68 ± 12 years, P = 0.026). The incidence of AKI was not different between the 2 groups (62 vs. 47%, P = not significant), and there was no difference in the severity of AKI according to the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria. Of the 83 patients with AKI, 6 and 1 patients underwent renal replacement therapy, respectively. CONCLUSION: The incidence of AKI in patients with colistin therapy is 60% in our center. It seems that IH colistin therapy could not be better in safety than IV colistin therapy.
Assuntos
Feminino , Humanos , Masculino , Injúria Renal Aguda , Colistina , Incidência , Falência Renal Crônica , Mortalidade , Nebulizadores e Vaporizadores , Pneumonia , Terapia de Substituição RenalRESUMO
BACKGROUND: To analyze the result of 18F-FDG positron emission tomography (PET) in patients with a concomitant malignancy and tuberculoma in a tuberculosis (TB)-endemic area. METHODS: Twelve patients with a concomitant malignancy and tuberculoma, who underwent whole-body 18F-FDG PET, were evaluated retrospectively. The maximal standardized uptake values (SUVmax) of the malignancy and tuberculoma were compared. In 6 patients, 18F-FDG PET was repeated during the anti-TB treatment and the changes in SUVmax were analyzed. RESULTS: Of the 12 patients, 10 were male. The mean age was 67.2+/-7.9 years. Tuberculomas were located in the lung (n=10) and lymph nodes (n=2), and tumors were located in the lung (n=6), colon (n=3), stomach (n=1), ovary (n=1) and liver (n=1). Although the mean SUVmax of malignant lesions was higher than that of tuberculomas (5.2+/-3.2 vs 3.5+/-2.0), the difference was not significant. In 4 patients, the SUVmax was higher in the tuberculoma than the tumor. After anti-TB treatment in 6 patients, the mean SUVmax of the tuberculomas decreased significantly, from 3.5+/-2.0 to 1.6+/-0.9 (p=0.028). CONCLUSION: In patients with a concomitant malignancy and tuberculoma, SUVmax alone could not differentiate between them. However, 18F-FDG PET may be useful in monitoring the response to anti-TB treatment.
Assuntos
Feminino , Humanos , Masculino , Colo , Elétrons , Fluordesoxiglucose F18 , Fígado , Pulmão , Linfonodos , Ovário , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos , Estômago , Tuberculoma , TuberculoseRESUMO
An endoscopic mucosal resection (EMR) is considered to be a potential alternative to surgery for a gastrointestinal tumor on account of it being an improved technique. Since its introduction in Japan in the early 1980s, it is now an accepted modality for removing precancerous lesions or early gastric cancer from the GI tract because it is minimally invasive and preserves the patient's quality of life. The major complications of EMR is bleeding and perforation. The treatment guidelines for iatrogenic perforation after EMR have not been established. Herein, we report a successful case of EMR induced gastric perforation with fluid collection that was successfully treated with non-surgical management.
Assuntos
Trato Gastrointestinal , Hemorragia , Japão , Qualidade de Vida , Neoplasias GástricasRESUMO
BACKGROUND: Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyoud just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD accordint to patient's smoking habits. METHOD: To evaluate the differences in the smoking patterens of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). RESULT: The patients with emphysema smoked earlier and had a higher smoking history(ie, more pachyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of ingalation was also significantly higher in the emphysema patients after taking into account age, cumulative cagarette consumption and the type of cigarette smoked. CONCLUSION: Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.
