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1

Recurrent lupus miliaris disseminatus faciei: a case report  

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Full Text Available Lupus miliaris disseminatus faciei (LMDF is a granulomatous eruption characterized by monomorphic, reddishbrown papules and nodules predominantly localized on the face. A 43 years old lady presented with multiple, painful, papulo-pustules over face 6 years back. Biopsy showed showed large foci of suppurative granulomatous dermatitis with a large central area of suppuration surrounded by histiocytes and occasional giant cells. Epidermis is not disrupted. Perifollicular and perivascular lymphocytic infiltrates were also seen. The lesions were healed with atrophic scars. She is now presented with multiple asymptomatic papules over bilateral periorbital regions of the face.

Zonunsanga

2015-01-01

2

Miliary pulmonary blastomycosis  

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Five patients with proved blastomycosis had a diffuse miliary nodular pattern seen on chest radiographs. These cases are presented to emphasize that blastomycosis may be the cause of a miliary pattern in an endemic area. Documentation requires recovery of the organism from body fluids or tissue since skin and serologic testing are unreliable indicators of active disease. With prompt diagnosis and appropriate treatment, the patient may recover from this form of endogenous disseminated reinfection that otherwise may be fatal, particularly in the immunocompromised host.

Stelling, C.B.; Woodring, J.H.; Rehm, S.R.; Hopper, D.W.; Noble, R.C.

1984-01-01

3

Miliary pulmonary blastomycosis  

International Nuclear Information System (INIS)

Five patients with proved blastomycosis had a diffuse miliary nodular pattern seen on chest radiographs. These cases are presented to emphasize that blastomycosis may be the cause of a miliary pattern in an endemic area. Documentation requires recovery of the organism from body fluids or tissue since skin and serologic testing are unreliable indicators of active disease. With prompt diagnosis and appropriate treatment, the patient may recover from this form of endogenous disseminated reinfection that otherwise may be fatal, particularly in the immunocompromised host

4

Leber's miliary aneurysms.  

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Leber's disease is a form of primary retinal telangiectasia characterized by the presence of abnormalities in the retinal vasculature. It is an idiopathic, unilateral condition with male predilection. It is not associated with any other systemic or ocular disease. The disease has a very slow progression and can be complicated by vascular dilatations, neovascularizations, thromboses, retrovitreal hemorrhages, and macular changes. We present a case of Leber's miliary aneurysms in an asymptomatic 22-year-old male patient. His fundus examination showed aneurysmal dilatations with lipid exudation. Intravenous fluorescein angiography showed early and late leakage as well as capillary dropout with late hypofluorescence. In this case, the patient was treated with laser photocoagulation of the retina. PMID:24082673

Alturkistany, Walaa; Waheeb, Saad

2013-05-01

5

Endobronchial Involvement in Miliary Tuberculosis  

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SUMMARY. Endobronchial tuberculosis (EBTB) is the tuberculous infection of the tracheobronchial tree. It has been reported in patients with parenchymal infiltrations and cavities in the lung and intrathoracic tuberculous lymphadenopathy. The occurrence of bronchial lesions in miliary tuberculosis is most likely to be a result of hematogenous dissemination of tubercle bacilli. We report six patients with endobronchial involvement in miliary tuberculosis. Bronchoscopic examination with histopat...

Imran Ozdemir, Md; Nihal Bayar, Md; Seza Tetikkurt, Md; Cuneyt Tetikkurt, Md

2010-01-01

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Endobronchial Involvement in Miliary Tuberculosis  

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Full Text Available SUMMARY. Endobronchial tuberculosis (EBTB is the tuberculous infection of the tracheobronchial tree. It has been reported in patients with parenchymal infiltrations and cavities in the lung and intrathoracic tuberculous lymphadenopathy. The occurrence of bronchial lesions in miliary tuberculosis is most likely to be a result of hematogenous dissemination of tubercle bacilli. We report six patients with endobronchial involvement in miliary tuberculosis. Bronchoscopic examination with histopathological evidence is essential to exclude or confirm endobronchial involvement in miliary tuberculosis. Chest computed tomography (CT may be a useful diagnostic adjunct for evaluating bronchial stenosis, but does not show the mucosal changes of endobronchial inflammation if the lesions are superficial or mild. Local steroid injection appears to be useful for the treatment of superficial mucosal lesions involving less than one quarter of the bronchial lumen, but for advanced inflammatory lesions local treatment is ineffective. Local steroid injection for the treatment of bronchial narrowing is contraindicated by the finding of significant bronchial or segmental stenosis on CT scan. The evolution of airway involvement in miliary tuberculosis indicates that hematogenous dissemination of the bacilli is the primary mechanism for endobronchial tuberculosis. Pneumon 2010, 23(2:135-140.

Imran Ozdemir, MD

2010-01-01

7

Comparison of high-resolution CT findings between miliary metastases and miliary tuberculosis  

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To compare the findings of high-resolution computed tomography (HRCT) between patients with miliary metastases and miliary tuberculosis. Between May 1998 and April 2002, 11 patients with miliary metastases and 18 with miliary tuberculosis underwent HRCT, and we reviewed the findings. In miliary metastases, the primary lesions were adenocarcinoma of the lung (n=2), stomach (n=1), or pancreas (n=1), or unknown origin (n=5), and papillary carcinoma of the thyroid (n=2). Two radiologists blinded to the clinical and pathologic data reached a consensus regarding nodule size and margin, their distribution and coalescence, interstitial involvement, and other ancillary HRCT findings. Data were analyzed using the chi-square test. CT scans showed numerous 1 to 5-mm nodules randomly distributed throughout both lungs of all patients. Nodules larger than 1.5 mm in diameter were more often seen in miliary metastases (81.9%). In six (54.5%) patients with miliary metastases and in three (16.7%) with miliary tuberculosis, nodule size varied (p<0.05). Pleural effusion occurred in three (27.3%) patients with miliary metastases and three (16.7%) with miliary tuberculosis. Interlobular septal thickening (100%) and peribronchovascular thickening (63.6%) were more common in miliary metastases than in miliary tuberculosis (p<0.01). Lymph node enlargement was seen in 11 (100%) patients with miliary metastases and five (27.8%) with miliary tuberculosis (P<0.001). At HRCT, lymph node enlargement and both interlobular and peribronchovascular thickening are more commonly observed in miliary metastases than in miliary tuberculosis.

Kim, Chan Sung; Lee, Ki Nam; Lee, Jin Hwa [Dong-A University College of Medicine, Pusan (Korea, Republic of)

2003-02-01

8

67Gallium Scan Findings in Miliary Tuberculosis  

International Nuclear Information System (INIS)

Miliary Tuberculosis is an illness produced by acute dissemination of tubercle bacilli via the blood stream. In chest roentgenogram, a diffuse 'miliary' infiltrates are usually seen, but normal or suspicious ground glass pattern also can be seen in early manifestation. Ten patients of miliary tuberculosis who underwent whole-body 67Ga-citrate scintigraphy were evaluated retrospectively to study usefulness of Ga-scan for early diagnosis of miliary Tbc and evaluation of disease activity. All of ten patients demonstrated significantly diffuse bilateral pulmonary uptakes on 48 hours image. All of three patients of ground-glass pattern in chest roentgemogram also demonstrated increased uptakes. In the statistical analysis, the severity of chest roentgenographic findings showed positive correlation with the activity on Ga-scan. These results suggest that Gallium scan is useful for diagnosis of early miliary tuberculosis and for evaluation of disease activity on follow-up examination of miliary tuberculosis of lung.

9

Pediatric tinea faciei in southern Spain: a 30-year survey.  

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Tinea faciei (TF) is a common clinical form of tinea in children that is frequently misdiagnosed and treated with corticosteroids. No large case series of TF focusing on children have been published. The aim of this study was to analyze the main epidemiologic, clinical, and microbiologic features of TF in children over a period of 30 years and compare these features with those of other tineas. We undertook a retrospective study of 818 cases of tinea in children at a referral hospital in southern Spain, diagnosed between 1977 and 2006, concentrating for this study on TF. Of the 73 cases of TF diagnosed, 50.7% were in girls. Most children (46.6%) were 4 to 9 years old. At the time of diagnosis, 29.2% of the cases had been treated with topical steroids. The most frequently isolated dermatophyte was Trichophyton mentagrophytes, which was isolated significantly more frequently in TF than in the other tineas. Cases of TF in children were not extremely unusual, emphasizing that TF must be considered in children with inflammatory facial eruptions. This consideration and the more-frequent use of mycologic tests can help achieve the correct diagnosis, when present. PMID:21995701

del Boz, Javier; Crespo, Vicente; de Troya, Magdalena

2012-01-01

10

[Job's syndrome and miliary tuberculosis].  

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The hyper Immunoglobulin E syndrome, also known as Job's syndrome, is a rare primary immunodeficiency, its mechanisms of inheritance maybe recessive or dominant autosomal. It is characterized by high levels of IgE, eosinophilia, skin abscesses, eczema, chronic mucocutaneous candidiasis and recurrent pulmonary infections all of which contribute to the development of pneumatoceles and bronchiectasis. The most frequently isolated bacteria is Staphylococcus aureus. Currently, despite the highest survival of patients, lymphomas and other opportunistic infections have been reported. There are few reports of patients with Mycobacterium tuberculosis infection associated with hyper IgE syndrome. Therefore it is relevant that we report a case history of a patient with pulmonary tuberculosis, presenting miliary tuberculosis and severe respiratory compromise, who responded positively to standard anti-tuberculous treatment with first line drugs. PMID:25188660

Gamberale, Ana; Moreira, Ileana; Bartoletti, Bruno; Cruz, Víctor; Bezrodnik, Liliana; Alberti, Federico; Catro Zorrilla, Liliana; Palmero, Domingo

2014-01-01

11

Miliary tuberculosis developing after cured Hodkin's disease  

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A case of miliary lung tuberculosis was suggested in a patient at the age 19 which was developed after steady remission of Hodgkins's disease (3 stage). The patient was subjected to polychemotherapy and irradiation with integral focal dose of 20-40 Gy. But miliary tuberculosis with the lesion of lungs, liver and spleen was developed from the immune supression. Tuberculous intoxication and respiratory insufficiency were the reason for death

12

Erythromelanosis follicularis faciei et colli: Relationship with keratosis pilaris  

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Erythromelanosis follicularis faciei et colli (EFF) is an unusual condition characterized by the triad of hyperpigmentation, follicular plugging and erythema of face and neck. This is less common in women and familial case reports are few. We report EFF in three siblings in an Indian family, two of whom are females. The possibility of this condition being genetically related to keratosis pilaris as well as being a variant of keratosis rubra pilaris is also discussed.

Augustine M; Jayaseelan E

2008-01-01

13

Miliary tuberculosis: HRCT findings in 14 patients  

International Nuclear Information System (INIS)

To evaluate high-resolution CT(HRCT) findings of the miliary tuberculosis and their significance. We retrospectively studied clinical records, HRCT and chest radiographs of 14 patients with miliary tuberculosis. On HRCT, nodules were seen in all 14 cases, 10 of them evenly, and 4 were irregularly distributed. The size of each nodule was less than 1 mm in 7 cases, 1 - 2 mm in 6 cases, and 3 mm or more in 1 case. The ground - glass opacity was accompanied in 8 cases, and fine reticular opacity was also noted in 8 cases. Other associated findings were pleural effusion (n=4), hilar and mediastinal lymphadenopathy (n=3), consolidation of the exudative tuberculosis (n=4). HRCT findings of miliary tuberculosis are diffusely distributed micro nodules of variable size, less than 5 mm in diameter. The ground-glass opacity can be combined

14

Tinea faciei due to microsporum canis in children: a survey of 46 cases in the District of Cagliari (Italy).  

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Dermatophytoses are frequent in children, but involvement of the facial skin has peculiar aspects that should be considered a separate entity: tinea faciei. Microsporum canis infection in tinea faciei has not been widely documented. To review cases of tinea faciei due to M. canis in children diagnosed at the Dermatology Clinic, University of Cagliari. Between 1990 and 2009, all children with dermatophyte infections of the facial skin were recruited for the study after parental consent. Diagnosis was made through direct microscopic and cultural examination. Age, sex, clinical form, illness duration, identified dermatophyte, source of infection, and treatment were recorded. Forty-six cases of tinea faciei due to M. canis in children aged 11 months to 15 years (29 male/17 female) were diagnosed. In 42 (91.3%) children, the illness was the result of contact with pets, and 4 (8.7%) cases resulted from contact with children affected by tinea capitis due to M. canis. Clinical manifestations were typical ringworm in 34 (74%) patients, whereas in 12 (26%) cases, atypical forms mimicking atopic dermatitis, impetigo, lupus erythematosus, and periorificial dermatitis were observed. In 18 (39%) cases, involvement of the vellus hair follicle was documented as ectothrix invasion. Topical or systemic antifungal therapy was effective in all patients. Tinea faciei shows a complex spectrum of differential diagnosis and age-related variations with respect to other superficial dermatophytosis. M. canis is the main organism responsible in children residing in Cagliari, capitol city of Sardinia, Italy. Close collaboration with veterinary and educational programs within infant communities are required for adequate prevention. PMID:22011084

Atzori, Laura; Aste, Natalia; Aste, Nicola; Pau, Monica

2012-01-01

15

A case report of multiple miliary osteoma  

International Nuclear Information System (INIS)

The author observed a multiple miliary osteoma which was found in the 70-year-old male patient at routine dental examination and obtained the following features; 1. The osteomas are situated in the buccal cheeks of both side, but overlying skin shows normal. 2. The small osteomas range from 0.5 mm to 2.0 mm in diameter. 3. The osteomas appeared in proximity to the surface at a special radiograph which made with the tube directed parallel to the surface of the face when the cheek is being blown outwardly. 4. Each osteoma appears as a small doughnut-shaped shadow with a radiolucent center.

16

Hypercalcaemia: atypical presentation of miliary tuberculosis.  

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We report an unusual case of miliary tuberculosis in a 77-year-old Filipino man with hypertension, diabetes mellitus, nephrolithiasis status-post left nephrectomy, presenting with 1 month of fever, generalised weakness and weight loss. Laboratory data were significant for anaemia, hypercalcaemia and acute kidney injury. Chest radiograph showed ground glass opacities and interstitial infiltrates. Extensive workup was performed to evaluate fever and hypercalcaemia. Malignancy, hormonal and septic workup were all unremarkable. Tuberculin skin test was negative. Sputum, pleural fluid, bronchoalveolar lavage and cerebrospinal fluid were acid-fast bacilli (AFB) smear negative. Remarkably, urine AFB smear was positive. Caseating granulomas were seen on transbronchial biopsy. Antituberculosis therapy was initiated which lead to defervescence and initial clinical improvement. However, hospital course became complicated by small bowel obstruction and respiratory failure. He subsequently developed pulseless electrical activity and expired. An autopsy confirmed the presence of tuberculosis in multiple organs including his remaining kidney. PMID:24569260

So, Edison; Bolger, Dennis Thomas

2014-01-01

17

Disseminated (miliary) abdominal tuberculosis after laparoscopic gastric bypass surgery  

OpenAIRE

The development of disseminated (miliary) abdominal tuberculosis (TB) in patients following operations which affect their immunity, such as laparoscopic gastric bypass, is rare. The authors report the case of middle aged woman, who a few months after undergoing laparoscopic gastric bypass surgery for morbid obesity (body mass index 49), presented with generalised fatigability and abnormal liver function. A CT scan of the abdomen was suggestive of miliary TB. The patient developed acute abdome...

Alhajri, Khalid; Alzerwi, Nasser; Alsaleh, Khalid; Yousef, Hussam Bin; Alzaben, Mohamed

2011-01-01

18

Bilateral Miliary Shadowing on Chest X-ray  

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A patient presented with recent onset of increasing shortness of breath, weight loss and low-grade fever. His chest X-ray revealed bilateral miliary shadowing. He was investigated with CT-scanning of thorax. Later, a biopsy from supra-clavicular node and its immunocytochemistry studies confirmed metastasis from primary lung cancer. Primary lung cancer with miliary pulmonary metastases is a rare happening and is mostly associated with lung adenocarcinoma. (author)

19

Disseminated histoplasmosis simulating miliary tuberculosis: a case report  

International Nuclear Information System (INIS)

Histoplasmosis is a disease caused by inhalation of the fungus Histoplasma capsulatum. In rare cases the disease affects immunocompetent individuals. Disseminated and severe disease is seen in immunocompromised patients. We report a case of a 45 year old immunocompromised patient presenting with weight loss and abdominal pain. Chest x-ray and computerized tomography examinations showed interstitial infiltrate and diffuse micro nodules. The initial diagnosis was miliary tuberculosis. However, the definitive diagnosis of miliary histoplasmosis was made later on. (author)

20

Asymptomatic pons tuberculoma in an infant with miliary tuberculosis  

International Nuclear Information System (INIS)

Miliary tuberculosis is caused by the hematogenous spread of Mycobacterium tuberculosis and consists of 1.5% of all tuberculosis cases. It is seen mostly in infants because of the immature immune system, and central nervous system CNS involvement is not rare. Tuberculomas are rarely seen in the localized form of CNS tuberculosis, and only 4% are localized in the brain stem. We report a 4.5-month-old infant who deteriorated during follow-up with the diagnosis of cytomegalovirus pneumonia, and afterwards received the diagnosis of miliary tuberculosis. Although the baby had no neurologic abnormality and cerebrospinal fluid findings were normal, cranial MRI revealed contrast enhanced nodular lesions in pons, cerebellum, and right parietal region. The case is presented to intensify the importance of CNS investigation even if the patient with miliary tuberculosis has no neurologic finding. (author)

 
 
 
 
21

Action of ?-radiation on bioluminescence of Noctiluca miliaris  

International Nuclear Information System (INIS)

Results of the study in the action of various doses of irradiation on the bioluminescence of Noctiluca miliaris are presented. The doses are found that stimulate the bioluminescence and the dose - effect curves are obtained. It has been shown that stimulation of Noctiluca luminescence by ?-radiation is not of a constant character and extinguishes after a period of time determined by a dose rate

22

A case of anxiety associated with miliary tuberculosis  

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Full Text Available Fahad D Alosaimi,1 Feras A Alkharboush,2 Maram H Altuwariqi11Department of Psychiatry, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2College of Medicine, King Saud University, Riyadh, Kingdom of Saudi ArabiaAbstract: Miliary tuberculosis (TB is a serious infection with various presentations that can perplex even the most experienced clinicians. To our knowledge, there is a lack of published reports that link psychiatric symptoms directly with miliary TB (either alone or co-occurring with other medical symptoms. Mental health workers may, therefore, not consider, and consequently miss, this important diagnosis. Here we are reporting a case of cyclical anxiety occurring in a 67-year-old patient. For 3 years prior to admission, the patient failed to respond to multiple courses of different antianxiety medications. The patient required hospital admission as he deteriorated and had a reduced level of consciousness. A chest X-ray revealed bilateral nodules and a magnetic resonance imaging scan showed multiple enhancing tuberculous lesions in the cerebral white matter, brain stem, and cerebellum. A diagnosis of miliary TB was finally made. Several characteristics of this case suggest that the diagnosed anxiety disorder was due to miliary TB. However, we cannot exclude the possibility that generalized anxiety disorder preceded the onset of miliary TB or that both diseases were coincidental. The report serves as a reminder that organic causes for psychiatric symptoms always need to be considered, particularly if they follow an atypical pattern or fail to improve with usual psychiatric medications.Keywords: anxiety disorder, elderly, psychosomatic, case report, Saudi Arabia

Alosaimi FD

2014-06-01

23

BIO-CONVENTIONAL BLEACHING OF KRAFT-AQ PULP OF A. CADAMBA BY CRUDE XYLANASES FROM COPRINELLUS DISSEMINATUS MLK-03 AND EFFECT OF RESIDUAL ENZYME ON EFFLUENT LOAD  

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Full Text Available A new thermo-alkali-tolerant crude xylanase from Coprinellus disseminatus decreased kappa number by 34.38% and improved brightness and viscosity by 1.6 and 6.47% respectively after XE1-stage during prebleaching of Anthocephalus cadamba kraft-AQ pulp. At 2.4% chlorine demand, crude xylanase in a XECEHH (X= enzymatic prebleaching stage, E= extraction stage, C= chlorination stage, H= hypochlorite stage bleaching sequence improved pulp brightness, tensile index, burst index, and double fold numbers by 3.66%, 4.78%, 6.38%, and 11.11%, respectively with a reduction in viscosity (10.59% and tear index (10.77% compared to the control. Combined bleach effluent of the XECEHH sequence mitigated adsorable organic halides (AOX by 21% and increased chemical oxygen demand (COD, bio-chemical oxygen demand (BOD, and colour by 67.18%, 84.78%, and 97.53%, respectively, compared to the control. Residual enzymes that entered during enzymatic prebleaching stage decreased AOX, COD, BOD, and colour of combined effluent of the XECEHH bleaching sequence progressively and on 6th day, and these were reduced by 23.78%, 0.04%, 15.00%, and 0.61%, respectively, compared to the control.

Mohan Lal

2011-04-01

24

Miliary osteoma cutis of the face: A case report  

OpenAIRE

Introduction: Miliary osteoma cutis (OC) of the face is a rare benign extra skeletal bone formation. For our knowledge, only 23 cases have been reported in the English literature. These lesions may be primary or secondary. They cause diagnostic, therapeutic and cosmetic concern especially in women who are usually concerned. Our purpose is to present a case which is completely documented with the clinical, histological and radiological findings. We also report a possible pathogenic theory acco...

Saadia Bouraoui; Mona Mlika; Rim Kort; Fayka Cherif; Ahlem Lahmar; Sabeh Mzabi-Regaya

2012-01-01

25

High-resolution CT findings of miliary pulmonary tuberculosis  

International Nuclear Information System (INIS)

This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluated the usefulness of HRCT by comparison with chest radiographs. High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. On HRCT, characteristic 1-2 mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n = 5), pleural effusion (n = 4), mediastinal lymphadenopathy (n = 6) and ARDS (n = 1) were also opathy (n = 6) and ARDS (n = 1) were also associated. HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs

26

A case of Legionella pneumophila pneumonia complicated by miliary tuberculosis.  

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A 47-year-old woman was admitted to hospital with severe Legionella pneumonia. The respiratory symptoms improved dramatically and the X-rays revealed a decrease in the diffuse chest infiltrates after treatment with erythromycin and rifampicin. However, chest CT scans showed that the reticulonodular opacities persisted for several weeks after the onset of pneumonia. Two months after admission, the chest X-rays showed the progression of small nodules in both lungs and there was increasing respiratory distress. A diagnosis of miliary tuberculosis was confirmed. The present case should alert physicians to this potentially confusing combination of respiratory pathogens. PMID:12753545

Uchida, Kou; Aoike, Nozomi; Yoshida, Kanako; Koya, Ai; Takai, Yujiro; Tateda, Kazuhiro; Yamaguchi, Keizo

2003-06-01

27

Miliary osteoma cutis of the face: A case report  

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Full Text Available Introduction: Miliary osteoma cutis (OC of the face is a rare benign extra skeletal bone formation. For our knowledge, only 23 cases have been reported in the English literature. These lesions may be primary or secondary. They cause diagnostic, therapeutic and cosmetic concern especially in women who are usually concerned. Our purpose is to present a case which is completely documented with the clinical, histological and radiological findings. We also report a possible pathogenic theory according to our histologic findings.Case Report: We report a case of a multiple miliary OC of the face in a 45-year-old woman which suffered from gravidarum acne. These lesions were treated by focal surgical treatment. Conclusions: Based on our histological findings, an osteoblastic metaplasia seems to be a possible pathogenic theory. This metaplasia seems to be secondary to a chronic inflammation. Concerning therapeutic procedures, they are non consensual and debated and are based on surgical or medical treatment. More reports are needed in order to assess the therapeutic management of this disease and its inducing factors.

Saadia Bouraoui

2012-01-01

28

Multidrug resistant miliary tuberculosis and Pott's disease in an immunocompetent patient.  

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In a high tuberculosis TB prevalence country, mortality due to miliary TB is not unknown but the treatment outcome in general is good. We describe a previously healthy man with miliary TB who did not respond to 2-months antituberculous therapy with 4 drugs. Persistent complaints of backache, which antedated chest symptoms, resulted in a diagnosis of Pott's disease. Culture of bronchial aspirate yielded multidrug resistant Mycobacterium tuberculosis that responded slowly to streptomycin, ethionamide, cycloserine, clofazimine, ofloxacin, paraaminosalicylic acid and isoniazid. The association of multidrug resistant miliary TB with Pott's disease in an immunocompetent patient is yet to be highlighted.

Ashok Shah

2004-10-01

29

Oropharyngeal and miliary pulmonary tuberculosis without respiratory symptom.  

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Tuberculosis is an important cause of morbidity and mortality world-wide. We report the case of a 52-year-old man who presented with a two month history of sore throat without other general or respiratory symptoms. Oral ex- amination revealed ulcerative and granulomatous lesions on the soft palate and tonsils. Histological examination of the lesions showed granulomatous tissue with caseaous necrosis consistent with tuberculosis. A chest x-ray and computed to- mography of the chest showed miliary tuberculosis of both lungs. The oral lesions improved with antituberculous medication by one month. Tuberculosis should be considered in the differential diagnosis of oral lesions which do not respond to appropriate antibiotic therapy. Pulmonary tuberculosis should also be considered in patients with oral tuberculosis even if they do not have respiratory symptoms. PMID:25507605

Chang, Jung Hyun; Kim, Jung Hyun; Kang, Ju Wan; Kim, Jeong Hong

2014-07-01

30

Miliary tuberculosis in Qatar: A review of 32 adult cases  

International Nuclear Information System (INIS)

This study was conducted to define the demographic, clinical andlaboratory features, methods of diagnosis and outcome, in patients withmilitary tuberculosis (TB) in Qatar, and compare the findings with otherreported studies. A retrospective review of 32 cases of military TB treatedat the Hamad Medical Corporation during a seven year period (1992 to 1998)was undertaken. The 32 patients comprised 24 males and 8 females, and theirmean age was 33.3 years. The majority (90%) were expatriates. The clinicalfeatures of the patients were similar to those of previously reported series.The most common presenting symptoms were fever, cough, night sweats, weightloss and sputum production. Fever, rales, lymphadenopathy, alerted mentalstatus and hepatomegaly were the most common signs. Chest radiograph wasabnormal in 94% of patients, and showed a military pattern in 69%. Sputum,cerebrospinal fluid, bronchial washings and urine smears for acid-fastbacilli were rarely positive, however, cultures for Mycobacteriumtuberculosis were positive in 54.8%, 37.5%, 33% and 25% respectively. Thediagnoses in the majority of patients were made on the basis of the clinicalpresentation and supported by a military pattern on chest radiograph. Inthose whom chest radiograph did show the classic military pattern,transbranchial biopsy was diagnostic in 1 of 2 patients (50%), bone marrowbiopsy in 5 of 11 (45%), liver biopsy in 1 of 2 (50%) and lymph node biopsyin all 7 patients (100%). Thirty patients werall 7 patients (100%). Thirty patients were treated with a four-drugregimen consisting of isoniazid, rifampin, pyrazinamide and streptomycin orethambutol. Mortality due to miliary TB was 3%. Miliary TB is common inQatar, especially among expatriates. Because the clinical features of thedisease are nonspecific, a high index of suspicion is essential for earlydiagnosis in order to avoid delays in therapy and poor outcome. (author)

31

Multidrug resistant miliary tuberculosis and Pott's disease in an immunocompetent patient.  

OpenAIRE

ABSTRACT In a high tuberculosis TB prevalence country, mortality due to miliary TB is not unknown but the treatment outcome in general is good. We describe a previously healthy man with miliary TB who did not respond to 2-months antituberculous therapy with 4 drugs. Persistent complaints of backache, which antedated chest symptoms, resulted in a diagnosis of Pott's disease. Culture of bronchial aspirate yielded multidrug resistant Mycobacterium tuberculosis tha...

Ashok Shah; Chandramani Panjabi; Vikas Maurya; Puneet Khanna

2004-01-01

32

Locating Noctiluca Miliaris in the Arabian Sea: An Optical Proxy Approach  

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Coincident with shifting monsoon weather patterns over India, the phytoplankter Noctiluca miliaris has recently been observed to be dominating phytoplankton blooms in the northeastern Arabian Sea during the winter monsoons. Identifying the exact environmental and/or ecological conditions that favor this species has been hampered by the lack of concurrent environmental and biological observations on time and space scales relevant to ecologic and physiologic processes. We present a bio-optical proxy for N. miliaris measured on highly resolved depth scales coincident with hydrographic observations with the goal to identify conducive hydrographic conditions for the bloom. The proxy is derived from multichannel excitation chlorophyll a fluorescence and is validated with microscopy, pigment composition, and spectral absorption. Phytoplankton populations dominated by either diatoms or other dinoflagellates were additionally discerned. N. miliaris populations in full bloom were identified offshore in low-nutrient and low-N : P ratio surface waters within a narrow temperature and salinity range. These populations transitioned to high-biomass diatom-dominated coastal upwelling populations. A week later, the N. miliaris blooms were observed in declining phase, transitioning to very-low-biomass populations of non-N. miliaris dinoflagellates. There were no clear hydrographic conditions uniquely associated with the N. miliaris populations, although N. miliaris was not found in the upwelling or extremely oligotrophic waters. Taxonomic transitions were not discernible in the spatial structure of the bloom as identified by the ocean color Chl imagery, indicating that in situ observations may be necessary to resolve community structure, particularly for populations below the surface.

Thibodeau, Patricia S.; Roesler, Collin S.; Drapeau, Susan L.; Matondkar, S. G. Prabhu; Goes, Joaquim I.; Werdell, P. Jeremy

2014-01-01

33

[Acute miliary tuberculosis or Isambert disease: a case report].  

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Pharynx tuberculosis consists in a set of active lesions in granulomatous-type mucosa, resulting from Mycobacterium tuberculosis infection. In an endemic context, this diagnosis should be raised in cases of head and neck disease. A recent observation of a case of acute miliary tuberculosis gave us the opportunity to conduct a literature review of this disorder. This 9-year-old girl presented with dysphagia associated with pharyngeal discomfort, snoring, and hoarseness lasting for 8 months. This pharyngeal syndrome occurred in the context of an impaired general condition. Clinical examination found a diffuse mucosal granulation aspect in the oropharynx. The workup showed an inflammatory syndrome with a strong positive intradermal tuberculin reaction. The biopsy found an aspect of giant cell granuloma with caseous necrosis. The course was favorable on antituberculous chemotherapy. Tuberculosis is a chronic bacterial infection caused by a bacterium belonging to the M. tuberculosis complex. Pharyngeal tuberculosis remains a rare disease, but several epidemiological parameters show an upsurge of this disease, prompting us to report this observation. PMID:23266174

Ziad, T; Nouri, H; Adny, A; Rochdi, Y; Aderdour, L; Raji, A

2013-01-01

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Diagnosis and management of miliary tuberculosis: current state and future perspectives  

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Full Text Available Sayantan Ray, Arunansu Talukdar, Supratip Kundu, Dibbendhu Khanra, Nikhil SonthaliaDepartment of Medicine, Medical College and Hospital, Kolkata, West Bengal, IndiaAbstract: Tuberculosis (TB remains one of the most important causes of death from an infectious disease, and it poses formidable challenges to global health at the public health, scientific, and political level. Miliary TB is a potentially fatal form of TB that results from massive lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli. The epidemiology of miliary TB has been altered by the emergence of the human immunodeficiency virus (HIV infection and widespread use of immunosuppressive drugs. Diagnosis of miliary TB is a challenge that can perplex even the most experienced clinicians. There are nonspecific clinical symptoms, and the chest radiographs do not always reveal classical miliary changes. Atypical presentations like cryptic miliary TB and acute respiratory distress syndrome often lead to delayed diagnosis. High-resolution computed tomography (HRCT is relatively more sensitive and shows randomly distributed miliary nodules. In extrapulmonary locations, ultrasonography, CT, and magnetic resonance imaging are useful in discerning the extent of organ involvement by lesions of miliary TB. Recently, positron-emission tomographic CT has been investigated as a promising tool for evaluation of suspected TB. Fundus examination for choroid tubercles, histopathological examination of tissue biopsy specimens, and rapid culture methods for isolation of M. tuberculosis in sputum, body fluids, and other body tissues aid in confirming the diagnosis. Several novel diagnostic tests have recently become available for detecting active TB disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. A high index of clinical suspicion and early diagnosis and timely institution of antituberculosis treatment can be lifesaving. Response to first-line antituberculosis drugs is good, but drug-induced hepatotoxicity and drug–drug interactions in HIV/TB coinfected patients create significant problems during treatment. Data available from randomized controlled trials are insufficient to define the optimum regimen and duration of treatment in patients with drug-sensitive as well as drug-resistant miliary TB, including those with HIV/AIDS, and the role of adjunctive corticosteroid treatment has not been properly studied. Research is going on worldwide in an attempt to provide a more effective vaccine than bacille Calmette–Guérin. This review highlights the epidemiology and clinical manifestation of miliary TB, challenges, recent advances, needs, and opportunities related to TB diagnostics and treatment.Keywords: Mycobacterium tuberculosis, human immunodeficiency virus, diagnostic tests, biomarkers, antituberculosis drugs, vaccine

Ray S

2013-01-01

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Miliary Tuberculosis with Concurrent Brain and Spinal Cord Involvement: A Case Report  

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Central nervous system involvement by tuberculosis is rare, and intramedullary involvement is even more rare. A patient that developed intermittent amnesia during anti-tuberculous therapy underwent brain CT and MRI and spine MRI. The latter showed multiple small enhancing nodules in the brain and spinal cord. The patient was treated with anti-tuberculous medication and steroids under the suspected diagnosis of miliary tuberculosis. Follow-up CT showed decreased nodule size and number. We report a case of miliary tuberculosis in the brain and spinal cord and present a review of the literature related to similar cases.

Sung, Chang Keun; Na, Hyoung Il; Yu, Hyeon; Byun, Jun Soo; Youn, Young Chul; Seo, Jae Seung; Kim, Gi Hyeon [Chung-Ang University, Seoul (Korea, Republic of)

2008-11-15

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X-ray findings in patients with miliary appearance of metallic mercury after suicide attempt  

International Nuclear Information System (INIS)

This case report evaluates X-ray findings in patients with miliary accumulation of mercury observed after parenteral application of metallic mercury in a suizide attempt. There are certain discrepancies between clinical symptoms and the X-ray findings. A clear demonstration of mercury in coronary blood vessels is possible by fluoroscopy. (orig.)

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Varicella Vaccination During Early Pregnancy: A Cause of in utero Miliary Fetal Tissue Calcifications and Hydrops?  

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Full Text Available Background: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation.

Anthony Al-Khan

2002-01-01

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X-ray findings in patients with miliary appearance of metallic mercury after suicide attempt  

Energy Technology Data Exchange (ETDEWEB)

This case report evaluates X-ray findings in patients with miliary accumulation of mercury observed after parenteral application of metallic mercury in a suizide attempt. There are certain discrepancies between clinical symptoms and the X-ray findings. A clear demonstration of mercury in coronary blood vessels is possible by fluoroscopy.

Bonse, G.; Neuhaus, R.; Gunkel, L.V.

1985-03-01

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Miliary brain metastasis presenting with calcification in a patient with lung cancer: a case report  

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Full Text Available Abstract Introduction Miliary brain metastasis is an extremely rare form of brain metastasis which can present with atypical imaging findings. We report the case of a patient with miliary brain metastasis of lung cancer showing calcification in metastatic lesions. Case presentation A 68-year-old Japanese woman was diagnosed with lung adenocarcinoma. Brain computed tomography revealed multiple small calcified lesions in both cerebral hemispheres. Mutation of the epidermal growth factor receptor gene (exon 21, L858R in lung cancer cells was detected, and treatment with gefitinib was initiated. A partial response was observed; however, the patient was readmitted to our hospital because of regrowth of the primary lesion and complaints of nausea, headache, and difficulty walking. Brain magnetic resonance imaging revealed scattered tiny nodules enhanced by gadolinium. A diagnosis of leptomeningeal carcinomatosis was made on the basis of cerebrospinal fluid cytology. The patient’s general status worsened, and she died 356?days after the day of first medical examination. Upon autopsy, the brain was found to be edematous and swollen. Lung carcinoma cells were diffusely disseminated on the meningeal surface. Metastatic foci of small nodular form, accompanied by calcifications, were also found in the brain parenchyma. We diagnosed miliary metastasis of lung carcinoma. Conclusions To the best of our knowledge, this is the third report of calcified miliary brain metastasis confirmed by autopsy. We describe calcified lesions that increased in size during the clinical course of nine months. Brain computed tomography findings that reveal multiple small calcified lesions in patients with malignancy should raise suspicion of miliary brain metastasis.

Inomata Minehiko

2012-09-01

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Miliary Pulmonary Tuberculosis That Can Be Confused with Pump-Lung Syndrome After Heart Surgery  

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Full Text Available Miliary pulmonary tuberculosis is a rare condition following open heart surgery. Tuberculosis is a more common entity in Asia and Africa. Following an increase in international travels globalizing world, the possibility of the occurrence of this entity has increased worldwide. The patient, without a history of previous tuberculosis was admitted to our department with a clinical condition that mimics heart failure. After routine laboratory tests, cardiologists and cardiovascular surgeons easily established the diagnosis of pump lung disease. The condition of patient did not respond to the treatments, untill the right diagnosis established with consultations. The patient responded to treatment following the diagnosis of miliary pulmonary tuberculosis 35 days after coronary bypass surgery, and is still on maintenance therapy.

Sevinç Sannav

2012-12-01

 
 
 
 
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[A miliary tuberculosis case without lung involvement difficult to distinguish from autoimmune hepatitis exacerbation].  

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A 48-year-old female with a past history of systemic lupus erythematosus had developed autoimmune hepatitis (AIH) at the age of 45 years, and administration of PSL 30 mg/day was initiated. However, AIH exacerbation was suspected based on elevation of hepatic and biliary tract enzymes such as ALP (1207U/L) with a fever of 38 degrees C after tapering off the steroids to PSL 7.5 mg daily, and she was thus hospitalized. A liver biopsy was recommended, but she refused. Thus, we suspected concomitant AIH and autoimmune cholangitis (AIC). Although high-dose steroid treatment including steroid pulse therapy was administered, there was no improvement. We performed a liver biopsy on the 66th hospital day, after obtaining the patient's consent. Epithelioid granuloma was detected in the liver leaflet as the background of the AIH and AIC findings. In addition, acid fast bacteria were detected with auramine and Ziehl-Neelsen staining, raising the possibility of tuberculosis. Additionally, granuloma was also seen in her bone marrow, and miliary tuberculosis was suspected. Anti-tuberculous therapy with isoniazid, rifampicin, ethambutol and pyrazinamide was initially administered, but the regimen was changed to levofloxacin, ethambutol, and streptomycin due to the side effects of the earlier medications. Liver functions improved and the inflammatory reaction became negative. The patient was discharged on the 138th hospital day. Ultimately, no acid fast bacteria were detected with culture, PCR of her bone marrow, or liver biopsy. However, miliary tuberculosis was definitively diagnosed from the pathological findings and her clinical course. AIH was an underlying disease, and the discrimination from AIH exacerbation was difficult. Consequently, the diagnosis was miliary tuberculosis without the lung involvement and the main lesion was in the liver. It is important to take account of miliary tuberculosis in the differential diagnosis of fevers of unknown origin with elevation of hepatic and biliary tract enzymes, and to make a definitive diagnosis with a liver biopsy. PMID:25199380

Yamashita, Hiroyuki; Ueda, Yo; Takahashi, Yuko; Mimori, Akio

2014-07-01

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Varicella Vaccination During Early Pregnancy: A Cause of in utero Miliary Fetal Tissue Calcifications and Hydrops?  

OpenAIRE

BACKGROUND: It is the purpose of this article to describe a suspected association of inadvertent vaccination with varicella vaccine during early pregnancy with the subsequent development of in utero miliary fetal tissue calcifications and fetal hydrops detected by sonogram at 15 weeks of gestation. CASE: This is a case presentation of a pregnant patient who received varicella vaccination during the same menstrual cycle that she became pregnant, and is supplemented by a literary review. The fe...

Anthony Al-Khan; Leslie Iffy; Vijaya Ganesh; Joseph Apuzzio

2002-01-01

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Predictors and outcome of patients with acute respiratory distress syndrome caused by miliary tuberculosis: a retrospective study in Chongqing, China  

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Full Text Available Abstract Background Miliary tuberculosis (TB is an uncommon cause of acute respiratory distress syndrome (ARDS with a high mortality. The aim of the present study was to evaluate the clinical characteristics, predictors and outcome of patients with ARDS caused by miliary TB. Methods A retrospective study was conducted among patients with a diagnosis of ARDS with miliary TB in four hospitals from 2006 to 2010. Medical records and laboratory examinations of these patients were taken during the first 24 h of admission. Results Eighty-five patients with miliary TB developed ARDS, 45 of whom survived (52.9%. The median age was 36.6?±?12.5 years with 38 males (44.7%. Diabetes mellitus (DM was the most common underlying disease (18.8%.ICU mortality was 47.1%. The time from admission to anti-tuberculosis therapy was 4.5?±?2.0 days. Mean duration of mechanical ventilation was 8.5?±?3.0 days in all patients. Duration of time to diagnosis, time from diagnosis to mechanical ventilation, and time to anti-tuberculosis therapy were significantly shorter in survivors than those in non-survivors. Diabetes mellitus (OR 5.431, 95%CI 1.471-20.049; P?=?0.005, ALT (70-100U/L, OR 10.029, 95%CI 2.764-36.389; P?=?0.001, AST (>94U/L,OR 8.034, 95%CI 2.200-29.341; P?=?0.002, D-dimer (>1.6mg/L, OR 3.167, 95%CI 0.896-11.187; P?=?0.042, hemoglobin ( Conclusions Accurate diagnosis, early initiation of anti-tuberculosis therapy and mechanical ventilation are important for the outcome of patients with ARDS caused by miliary TB. DM, ALT, AST, D-dimer, hemoglobin, and albumin are independent predictors of ARDS development in patients with miliary TB.

Deng Wang

2012-05-01

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Reproductive ecology and behavior of Thoropa miliaris (Spix, 1824) (Anura, Leptodactylidae, Telmatobiinae) / Ecologia e Comportamento Reprodutivo de Thoropa miliaris (Spix, 1824) (Anura, Leptodactylidae, Telmatobiinae)  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Ecologia e Comportamento Reprodutivo de Thoropa miliaris (Spix, 1824) (Anura, Leptodactylidae, Telmatobiinae). As espécies de Thoropa estão distribuídas no sul e sudeste do Brasil e têm girinos semiterrestres em ambientes rochosos. Aqui apresentamos dados complementares sobre reprodução, cuidado pat [...] ernal e canibalismo por girinos em T. miliaris. Machos guardiões foram testados quanto a perturbações às suas desovas. As desovas foram postas em faixas de umidade na rocha; os ovos foram postos em camada única e estavam aderidos à superfície da rocha, raízes e uns aos outros. Os girinos eclodiram entre quatro e seis dias após a oviposição. O número de ovos em duas desovas foi 750 e 1190; os ovos eram cinza e a porção vitelínica mediu cerca de 1,7 mm em diâmetro; 2,3 mm com a cápsula gelatinosa. Foram observadas interações agressivas entre os machos. Os machos permaneceram com suas desovas durante a noite e reagiram agressivamente às perturbações experimentais. Girinos em estágios tardios foram vistos canibalizando ovos. Uma desova em uma faixa de umidade recém formada morreu por desidratação. As faixas de umidade na rocha são os únicos locais onde os ovos e os girinos podem se desenvolver e representam um fator limitante para a reprodução porque são raras. Para as fêmeas, a seleção de faixas úmidas recém formadas deve representar um balanço entre as vantagens em ocupar lugares livres de girinos canibais e/ou competidores e os riscos de perda de prole por desidratação. Nossos resultados não apóiam Cycloramphinae como um táxon válido, indicando que as similaridades morfológicas e comportamentais entre as espécies de Thoropa e Cycloramphus devem ser interpretadas como convergência. Abstract in english Thoropa species are distributed in southern and southeastern Brazil and have semiterrestrial tadpoles on rocky environments. Herein, we provide further data on reproduction, paternal care and tadpole cannibalism in T. miliaris. Guarding males were tested for disturbances in their egg masses. Egg mas [...] ses were laid in stripes of wet rock; eggs were in a single layer and were adhered to the rock surface, roots, and to one another. The tadpoles hatched between four and six days. The egg number in two egg masses was 750 and 1190; eggs were gray and the yolk were about 1.7 mm in diameter; 2.3 mm with the jelly capsule. Aggressive interactions were observed between males. Males remained with their egg masses during the night and reacted aggressively to the experimental disturbances. Late stage tadpoles were found cannibalizing eggs. An egg mass in a recently formed wet stripe died from drought. The strips of wet rock are the only places where eggs and tadpoles can develop and represent a limiting factor for reproduction because they occur in short supply. For the females, the selection of newly formed wet strips may represent a trade-off between the advantages of using places free of cannibalistic and/or competitive tadpoles and the risks of losing offspring by drought. Our results do not support Cycloramphinae as a valid taxon, indicating that the morphological and behavioral similarities between Thoropa and Cycloramphus species should be interpreted as convergence.

Ariovaldo Antonio, Giaretta; Kátia Gomes, Facure.

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Tuberculosis miliar en paciente inmunocompetente como causa rara de fiebre nosocomial MILIARY TUBERCULOSIS AN UNCOMMON CAUSE OF NOSOCOMIAL FEVER IN AN IMMUNOCOMPETENT PATIENT  

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Full Text Available La tuberculosis ha disminuido su incidencia en los últimos años en Chile, siendo considerado actualmente como un país con baja incidencia de tuberculosis (A progresive decrease of tuberculosis incidence has been shown in the last years in Chile. Presently Chile is considered as a country with a low incidence of tuberculosis (< 20 cases per 10(5 inhabitants. Miliary tuberculosis is an uncommon form of tuberculosis in immunocompetent patients. Miliary tuberculosis is tipically observed in immunocompromised patients. It is an infrequent cause of nosocomial fever. We report a case of miliary tuberculosis in an immunocompetent patient, that caused intrahospitalary fever, in the course of a long term hospitalization.

Alcides Zambrano F.

2004-07-01

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Salmonella Infection Superimposed on Letterer-Siwe's Disease Resembling Miliary Tuberculosis  

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Full Text Available A 2 ½-year old boy in presented with a history of purulent otitis media and cutaneous abscesses in the frontal and occipital region since one year prior to admission. Later, hepatosplenomegaly, adenopathies and skin lesions developed. X-rays showed osteolysis of the skull over the abscess and military image of the lungs as well as a small lytic defect in the proximal left humerus. With respect to the high occurrence of Tuberculosis in this country an antituberculosis therapy was started without any noticeable effect. A skin biopsy revealed histiocytosis X and in cultures from abscesses grew Salmonella typhi B. Thus, Letterer-Siwes disease was diagnosed on which a Salmonella infection was superimposed mimicking miliary Tuberculosis.

M Ghorbanian

1986-07-01

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MRI of the brain in patients with miliary pulmonary tuberculosis without symptoms or signs of central nervous system involvement  

International Nuclear Information System (INIS)

MRI was performed on patients with miliary pulmonary tuberculosis to look for brain involvement and to study the features sequentially, during treatment. We studied seven patients with typical radiographic tuberculosis, and no symptoms or signs of central nervous system involvement. Conventional spin-echo (SE) imaging, including contrast enhanced images, was performed in all cases. All patients showed brain involvement: four patients showed lesions mainly less than 3 mm in diameter, better seen on contrast-enhanced images. These patients showed oedema around the lesions after 2 months of treatment, with subsequent regression on follow-up. The remaining three patients had multiple lesions, 3 mm or more in diameter, which showed a gradual decrease on follow-up. We conclude that the brain may commonly be involved in miliary pulmonary tuberculosis. The response to treatment depends on the stage of the granuloma and shows a definite pattern of healing on follow-up. (orig.). With 2 figs., 1 tab

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Diurnal observations on the behavioral ecology of Gymnothorax moringa (Cuvier) and Muraena miliaris (Kaup) on a Caribbean coral reef  

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Activities of muraenids, primarily Gymnothorax moringa and Muraena miliaris, were observed on a Caribbean coral reef with a view to further understanding their role in the reef ecosystem. Other muraenid species included in the total of 198 sightings were Echidna catenata, Enchelycore nigricans, and an unidentified brown moray. The five species were unequally distributed among three basic habitats (sand, coral head, reef rock) available on the reef. Nine particular holes accounted for 52.5% of the total sightings, although hundreds of other seemingly appropriate sites were available. The eels (except M. miliaris) were transient with respect to given holes and particular sections of the reef. While some G. moringa were sighted in the same holes for several consecutive days, M. miliaris individuals remained in the same coral heads throughout the 6-week study period. Muraenids observed in this study showed high tolerances for and were tolerated by other fishes (including other morays) and invertebrates on the reef. They appeared to be opportunistic, roving predators and were not strictly nocturnal. Distinct behavioral interactions and displays between muraenids and reef fish were observed.

Abrams, R. W.; Abrams, M. D.; Schein, M. W.

1983-09-01

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Tuberculosis congénita asociada con tuberculosis materna miliar diseminada Congenital tuberculosis associated with maternal disseminated miliary tuberculosis  

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Full Text Available La tuberculosis sin tratamiento en mujeres gestantes es un riesgo definido para la transmisión de la enfermedad al recién nacido y para resultados adversos, obstétricos y perinatales. La tuberculosis en mujeres gestantes y la tuberculosis congénita son afecciones infrecuentes y de difícil diagnóstico por la falta de especificidad de las manifestaciones clínicas.
Se presenta el caso de una mujer primigestante con tuberculosis miliar diseminada, con inicio de las manifestaciones en el puerperio inmediato, diagnóstico en el segundo mes del puerperio y desenlace fatal. Además, se presenta el caso de su hijo prematuro con manifestaciones desde el nacimiento, evidencia de complejo pulmonar primario, atelectasia persistente por obstrucción bronquial por las adenopatías e infección por citomegalovirus; recibió tratamiento estándar con mejoría.Untreated tuberculosis during pregnancy presents a serious risk for transmission of disease to the newborn and can result in adverse perinatal and obstetrical outcomes. Tuberculosis during pregnancy and congenital tuberculosis are infrequent conditions and are difficult to diagnose due the non-specificity of the symptoms. A case report is presented of a woman who had no children previously with disseminated miliary tuberculosis. Tuberculosis symptoms appeared immediately after birth of the first child, with a clinical diagnosis on the second month after childbirth, whereupon the patient died. The son, a premature infant, showed disease symptoms from the first day, with primary pulmonary complex and persistent atelectasis due to bronchial obstruction. The obstruction was due to thoracic lymphadenitis and coinfection with cytomegalovirus. The infant received standard treatment and his condition improved.

Julio César Mantilla

2007-12-01

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Miliary tuberculosis occurred after immunosuppressive drug in PNH patient with completely cured tuberculosis; a case report  

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Full Text Available Abstract Paroxysmal nocturnal hemoglobinuria (PNH is a clonal disorder that presents with hemolytic anemia, marrow failure and thrombophilia. During acute attacks, corticosteroid can alleviate the hemolytic paroxysm, but the prolonged administration induces serious toxicity including immunosuppression. So American thoracic society (ATS for tuberculosis (TB recommends prophylactic anti-TB medication in patients with a long-term steroid therapy. However, in the patient who was treated for active TB in the past, there are no guidelines of the test for determining patients who have latent TB infection (LTBI and no recommendations of TB prophylaxis if there is no evidence of reactivation at present. A 40-year-old male patient presented with fever and aggravated weakness for a week. He was diagnosed with PNH a month ago and took corticosteroid for 3 weeks. In the past, he was diagnosed with pulmonary TB and completely cured after treatment. According to guideline, he was not indicated with TB prophylaxis. However, he caught miliary TB, progressed to acute respiratory distress syndrome. We experience this embarrassing case, and emphasize the need to investigate multicentral TB prevalence and to make the guidelines of anti-TB medication in subgroups of hematologic diseases including PNH.

Lee Jihyun

2012-05-01

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Tuberculosis congénita asociada con tuberculosis materna miliar diseminada / Congenital tuberculosis associated with maternal disseminated miliary tuberculosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish La tuberculosis sin tratamiento en mujeres gestantes es un riesgo definido para la transmisión de la enfermedad al recién nacido y para resultados adversos, obstétricos y perinatales. La tuberculosis en mujeres gestantes y la tuberculosis congénita son afecciones infrecuentes y de difícil diagnóstic [...] o por la falta de especificidad de las manifestaciones clínicas. Se presenta el caso de una mujer primigestante con tuberculosis miliar diseminada, con inicio de las manifestaciones en el puerperio inmediato, diagnóstico en el segundo mes del puerperio y desenlace fatal. Además, se presenta el caso de su hijo prematuro con manifestaciones desde el nacimiento, evidencia de complejo pulmonar primario, atelectasia persistente por obstrucción bronquial por las adenopatías e infección por citomegalovirus; recibió tratamiento estándar con mejoría. Abstract in english Untreated tuberculosis during pregnancy presents a serious risk for transmission of disease to the newborn and can result in adverse perinatal and obstetrical outcomes. Tuberculosis during pregnancy and congenital tuberculosis are infrequent conditions and are difficult to diagnose due the non-speci [...] ficity of the symptoms. A case report is presented of a woman who had no children previously with disseminated miliary tuberculosis. Tuberculosis symptoms appeared immediately after birth of the first child, with a clinical diagnosis on the second month after childbirth, whereupon the patient died. The son, a premature infant, showed disease symptoms from the first day, with primary pulmonary complex and persistent atelectasis due to bronchial obstruction. The obstruction was due to thoracic lymphadenitis and coinfection with cytomegalovirus. The infant received standard treatment and his condition improved.

Luis Miguel, Sosa; Luz Libia, Cala; Julio César, Mantilla.

2007-12-01

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Development of miliary tuberculosis during the course of adult-onset Still’s disease: Case report  

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Full Text Available Adult-onset Still’s disease (AOSD is a rare systemic inflammatory disease with unknown etiology. Here, a 30-year-old man who developed miliary tuberculosis during the course of AOSD was presented due to very rare coincidence of these two diseases. The diagnosis of military tuberculosis was documented by bone marrow biopsy and culture. The patient’s clinical findings improved with anti-tuberculosis treatment and steroids. J Microbiol Infect Dis 2011;1(1:38-41.

Murat Turgay1, Halil Kurt2, Ali ?ahin1, Orhan Küçük?ahin1

2011-06-01

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Multidrug-Resistant Tuberculosis Presenting as Miliary Tuberculosis without Immune Suppression: A Case Diagnosed Rapidly with the Genotypic Line Probe Assay Method  

OpenAIRE

Miliary tuberculosis (TB) is a rare extrapulmonary form of TB, and there have been only two reports of miliary TB associated with infection with multidrug-resistant (MDR)-TB pathogen in an immunocompetent host. A 32-year-old woman was referred to our hospital because of abnormal findings on chest X-ray. The patient was diagnosed with MDR-TB by a line probe assay and was administered proper antituberculous drugs. After eight weeks, a solid-media drug sensitivity test revealed that the pathogen...

Ko, Yousang; Lee, Ho Young; Lee, Young Seok; Song, Junwhi; Kim, Mi-yeong; Lee, Hyun-kyung; Shin, Jeong Hwan; Choi, Seok Jin; Lee, Young-min

2014-01-01

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Retreived bacteria from Noctiluca miliaris (green) bloom of the northeastern Arabian Sea  

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In recent years, seasonal blooms of the dinoflagellate Noctiluca miliaris have appeared in the open-waters of the northern Arabian Sea (NAS). This study provides the first characterization of bacteria from a seasonal bloom of green Noctiluca of NAS (20°N-17°N and 64°E-70°E), during the spring-inter-monsoon cruise of Sagar Sampada 253, in March 2007. Bacterial growth as assessed by most-probable number (MPN) and plate counts, revealed `variable-physiotypes' over a wide range of salinities (0%-25% w/v NaCl), pH levels (5-8.5), and organic nutrient strengths, in comparison to non-bloom waters. MPN indices of bacteria in surface waters of bloom stations *DWK and *PRB, corresponded to (3.08-4.41)×103 cells/mL at 3.5% NaCl (w/v), and (2.82-9.49)×102 cells/mL at 25% (w/v) NaCl in tryptone-yeast extract broth (TYE). Plate counts were (1.12-4)×106 CFU/mL at 0% (w/v) NaCl, (1.28-3.9)×106 CFU/mL at 3.5% (w/v) NaCl, and (0.4-7)×104 CFU/mL at 25% NaCl (w/v) on TYE. One-tenth-strength Zobell's gave (0.6-3.74)×105 CFU/mL at pH 5 to (3.58-7.5)×105 CFU/mL at pH 8.5. These bacteria were identified to the genera Bacillus, Cellulomonas, Staphylococcus, Planococcus, Dietzia, Virgibacillus, Micrococcus, Sporosarcinae, Leucobacter, and Halomonas. The identity of three strains (GUFBSS253N2, GUFBSS253N30, and GUFBSS253N84) was confirmed through 16S rDNA sequence homology as Bacillus cohnii, Bacillus flexus, and Bacillus cereus. The ˜2-3-fold higher plate counts of culturable bacteria from the open-waters of the NAS indicate that these bacteria could critically determine the biogeochemical dynamics of the bloom and its milieu. The role of these bacteria in sustaining/terminating the bloom is under evaluation.

Basu, Subhajit; Matondkar, S. G. Prabhu; Furtado, Irene

2013-01-01

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Fatal paradoxical cryptic miliary tuberculosis and immune reconstitution disease in a young non-HIV immunocompromised male patient: case report with autopsy findings.  

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Non-HIV immunocompromised patients may develop immune reconstitution inflammatory syndrome (IRIS) as an abnormal response to invading microorganisms, such as Mycobacterium tuberculosis (MTB). IRIS consists in a sudden change in the dominant T-helper responses to inflammation, which is not balanced by anti-inflammatory response, playing a critical role in microbial pathogenesis. A patient with restoration of host immunity during anti-tuberculosis treatment can become gravely ill with a paradoxical severe form of tuberculosis (TB) disease named TB immune reconstitution disease (IRD).The diagnosis of acute cryptic miliary TB is difficult and requires an accurate histopathology. We report a fatal association between a generalized lymphadenitis tuberculosis and IRD in a 34-year-old male patient, non-smoker, non-HIV immunocompromised, but with a previously co-morbid diabetes mellitus (DM) type I. The purpose of this report is to describe an unusual and rare case of a progressive extrapulmonary TB disease to a liver involvement, mimicking a hepatotoxicity secondary to anti-tuberculosis therapy. The diagnosis of disseminated miliary TB with cryptic pulmonary was confirmed later after performing necropsy. Formalin-fixed paraffin-embedded pulmonary and extrapulmonary miliary foci were processed for histology and stained with Hematoxylin and Eosin. This rare entity of cryptic miliary involvement of the lungs is described more in elderly than in young individuals. In the reported case, IRD induced a paradoxical progressive dissemination of TB lesions leading to death in a patient with an apparent uncomplicated form of lymphadenitis TB. PMID:24970001

Man, Milena Adina; Arghir, Oana Cristina; Man, Sorin; Streba, Costin Teodor; Olteanu, Mihai; Nitu, Mimi

2014-01-01

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[A case of miliary tuberculosis complicated by disseminated intravascular coagulation and acute respiratory distress syndrome successfully treated with recombinant human soluble thrombomodulin].  

Science.gov (United States)

A 67-year-old woman was referred to our hospital for persistent fever and dyspnea. Chest X-ray revealed diffuse reticulonodular shadows and high-resolution computed tomography showed randomly distributed small nodules. Examination of sputum and urine revealed acid-fast bacilli, which were later confirmed as Mycobacterium tuberculosis sensitive to all drugs. Laboratory tests revealed thrombocytopenia, an elevated concentration of fibrin degradation products, and severe hypoxemia. We therefore diagnosed her with miliary tuberculosis complicated by acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). After admission, her status rapidly worsened and she required mechanical ventilation. Treatment with recombinant human soluble thrombomodulin (rTM) and high-dose methylprednisolone was started in addition to the antituberculosis chemotherapy. The patient's condition gradually improved and she was weaned from ventilation on day 30. She was discharged on day 92. It is generally thought that prognosis of miliary tuberculosis complicated by DIC and ARDS is very poor. A recent report suggested that rTM is effective for DIC and ARDS secondary to sepsis. This is the first report of miliary tuberculosis complicated by DIC and ARDS successfully treated with rTM. PMID:23350518

Shiraishi, Sachiko; Futami, Shinji; Kurahara, Yu; Tsuyuguchi, Kazunari; Hayashi, Seiji; Suzuki, Katsuhiro

2012-12-01

57

Differential adaptations between cold-stenothermal environments in the bivalve Lissarca cf. miliaris (Philobryidae) from the Scotia Sea islands and Antarctic Peninsula  

Science.gov (United States)

The cold stenothermal nature of the Southern Ocean, and highly adapted fauna living within, raises the question of how much intra-specific variation there is among invertebrate populations, and how variation may have a role in speciation processes through ecological divergence, natural selection, and reproductive isolation. Despite decades of collecting biological material, this question remains largely unanswered, and many studies compare ‘populations' of pooled material from wide geographic ranges to compensate for sampling constraints. In this study, variations in ecophysiological traits are explored by measuring growth, reproduction, and shell morphology among six populations of the small bivalve Lissarca cf. miliaris (Philippi, 1845) from the Southern Ocean, which experience subtle differences in temperature, disturbance, and food availability. There are significant differences in shell morphology and growth among different populations and slower growth rates at higher latitude populations. Prodissoconch sizes show an inverse ‘U' shaped relationship with latitude, and are correlated with egg size at South Georgia and King George Island's Potter Cove. Higher brood sizes at the South Georgia population represent a trade-off with lower egg size, and correlate with shell morphology by offering lower internal capacity to brood young. Lower investment into offspring and morphological variations in L. cf. miliaris highlight the importance of local scale environmental variations on species' ecology. These variations in physical traits appear to be underestimated in the Southern Ocean, but may be important drivers of ecological divergence and speciation, which should be considered in future genetic investigations on different invertebrate populations.

Reed, Adam J.; Linse, Katrin; Thatje, Sven

2014-04-01

58

Significance of localized miliary subdiaphragmatic seeding and size of initial postsurgical residual in patients with epithelial ovarian cancer  

International Nuclear Information System (INIS)

Objective: Despite multimodality treatment regimens the survival rates for patients with stage III epithelial ovarian cancer have shown minor improvement in the last decade and remain poor. An analysis of the results of our trimodality treatment regimens was undertaken to identify prognostic factors for progression-free survival (PFS) and to correlate these with patterns of failure. Materials and Methods: Between May 1985 and December 1994, 52 patients with FIGO stage III ovarian cancer underwent maximum cytoreductive surgery, followed by chemotherapy (1-10 cycles, median: 6) and external beam irradiation. Radiation treatment consisted of whole abdominal irradiation (30 Gy), pelvic boosts (21,6 Gy), diaphragmatic boosts (12 Gy) and paraaortic nodal boosts (12 Gy) if the latter were involved. Patient age ranged from 31-79 years (median: 59). Follow-up for all patients was from 1-127 months (median: 25) and 38-127 months (median: 76) for patients at risk. Factors analysed for their impact on PFS and patterns of failure included postsurgical size and site of residual tumor, age, tumor grade, unilateral or bilateral ovarian involvement, presence of ascites, number of cycles of chemotherapy, and completion of radiotherapy. Results: Actuarial survival and PFS rates at 5 years were 30% and 29%. The presence of localized miliary seeding at the dome of the right diaphragm (MDS; 14 patients) as well as residual disease >2 cm after surgical debulking (6 patients) strongly influecal debulking (6 patients) strongly influenced PFS. Patients with MDS or >2 cm residual disease had a PFS of 0% with a median survival of 6 and 8 months, respectively. These results were significantly worse (p=0.0006) than those obtained for the 16 patients with no macroscopic tumor or the 15 patients with macroscopic residuals 2 cm residual (67%) compared with patients who had no or 2 cm) were found to be strongly prognostic and are associated with a high incidence of distant failure. If our finding of the prognostic significance of MDS can be confirmed, it is suggested that Taxol containing chemotherapy regimens be employed in the treatment of such patients as are now being utilized in the treatment of patients with suboptimal debulked disease

59

Macrofaunal involvement in the sublittoral decay of kelp debris: The sea urchin Psammechinus miliaris (Gmelin) (Echinodermata: Echinoidea)  

Science.gov (United States)

Psammechinus miliaris occurs in the Clyde Sea area in large numbers (<18 individuals per 100 g -1 weed dry wt) on sublittoral beds of detached Laminaria saccharina. Its rôle in weed decomposition has been examined by comparing its responses (behavioural choice, growth rate, absorption efficiencies of both carbon and protein, gut retention times and rate of faecal output) to fresh and rotting weed. Younger urchins grew faster than older individuals on a diet of rotting weed but not on fresh weed. Large seasonal variation existed, however, with fast growth occurring in June-August and little, or no, growth in December-February, irrespective of diet. Starved controls did not grow. Correcting for seasonality, rotting kelp still promoted faster growth of young urchins than did fresh weed. Larger (older) individuals showed no difference. Urchins fed fresh weed had significantly longer gut retention times. Protein absorption efficiency was higher on fresh than rotting weed, varying with weed protein content and size of urchin. Very young individuals can only digest high protein weed efficiently, eg. material derived from near the frond meristem. Organic carbon content of rotting weed was significantly lower than fresh weed. Carbon absorption efficiencies were significantly higher on fresh weed which related to organic carbon content. Standard-sized urchins fed rotting weed produced larger dry weights of faeces per day, reflecting increased ingestion rate. In closed-system choice experiments urchins preferred rotting weed kinetically. Size-frequency analysis of field populations suggested that weed beds are principally colonized by larval settlement from the plankton. Mature Psammechinus have evolved different 'strategies' for exploiting fresh and rotting weed. Fresh weed is relatively difficult to digest and long gut retention times allow high protein absorption efficiencies to be attained. Rotting weed has microbial protein in quantities and a lower organic carbon fraction. Some bacterial protein is seemingly unavailable though and lower protein absorption efficiencies result. Thus gut retention time is shortened and more food passed through the gut. Growth remains equivalent. Substratum digestion is of paramount importance for Psammechinus feeding on either fresh or rotting weed, cf. the 'classical' microbe-stripping detritivore of Fenchel.

Bedford, A. P.; Moore, P. G.

1985-01-01

60

Culturable bacterial flora associated with the dinoflagellate green Noctiluca miliaris during active and declining bloom phases in the Northern Arabian Sea.  

Science.gov (United States)

A massive algal bloom of the dinoflagellate Noctiluca miliaris (green) was located in the Northern Arabian Sea by IRS-P4-2 (OCM-II) for microbiological studies, during two consecutive cruises of February-March 2009. Culturable bacterial load during bloom were ? 2-3-fold higher in comparison to non-bloom waters and ranged from 3.20 × 10(5) to 6.84 × 10(5) cfu ml(-1). An analysis of the dominant heterotrophs associated with Noctiluca bloom resulted in phylogenetic and a detailed metabolic characterization of 70 bacterial isolates from an overlapping active and declining bloom phase location near north-central Arabian Sea. The active phase flora was dominated by Gram-positive forms (70.59 %), a majority of which belonged to Bacillus (35.29 %) of Firmicutes. As the bloom declined, Gram-negative forms (61.11 %) emerged dominant, and these belonged to a diverse ?-proteobacterial population consisting of Shewanella (16.67 %) and equal fractions of a Cobetia-Pseudomonas-Psychrobacter-Halomonas population (36.11 %). A Unifrac-based principal coordinate analysis of partial 16S rDNA sequences showed significant differences among the active and declining phase flora and also with reported endocytic flora of Noctiluca (red). A nonparametric multidimensional scaling (NMDS) of antibiogram helped differentiation among closely related strains. The organic matter synthesized by N. miliaris appears to be quickly utilized and remineralized as seen from the high efficiency of isolates to metabolize various complex and simple C/N substrates such as carbohydrates, proteins/amino acids, lipids, sulfide production from organic matter, and solubilize phosphates. The ability of a large fraction of these strains (50-41.67 %) to further aerobically denitrify indicates their potential for nitrogen removal from these high-organic microniches of the Noctiluca bloom in the Arabian Sea, also known for high denitrification activity. The results indicate that culturable euphotic bacterial associates of Noctiluca are likely to play a critical role in the biogeochemical ramifications of these unique seasonally emerging tropical open-water blooms of the Northern Arabian Sea. PMID:23280496

Basu, Subhajit; Deobagkar, Deepti D; Matondkar, S G Prabhu; Furtado, Irene

2013-05-01

 
 
 
 
61

Aneurisma miliar de Leber associado à síndrome de tração vítreomacular: relato de caso / Leber's miliary aneurysms associated with vitreomacular traction syndrome: case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Telangiectasias retinianas são anormalidades vasculares primárias e idiopáticas caracterizadas por dilatações irregulares e incompetência dos vasos retinianos com variados graus de exsudação intra e sub-retiniana. O objetivo desse relato é documentar uma rara associação entre aneurisma miliar de Leb [...] er e síndrome de tração vítreomacular bem caracterizada à angiofluoresceinografia e tomografia de coerência óptica. O tratamento realizado foi fotocoagulação com laser de argônio nos aneurismas perimaculares e cirurgia de vitrectomia posterior via pars plana, o que resultou em melhora consistente da acuidade visual. O caso relatado confirma a importância da tomografia de coerência óptica em estudar a interface vítreorretiniana e suas alterações, o que permitiu abordagem completa da doença em questão. Abstract in english Retinal telangiectasias are idiopatic vascular abnormalities of the retina characterizad by irregular dilatation of the retinal vessels, intraretinal and subretinal exsudation. The aim of this article is to describe the uncommon association of Leber's miliary aneurysms and vitreomacular traction syn [...] drome in a female patient. The diagnosis was established with angiofluoresceinography and optic coherence tomography. The patient was treated with focal photocoagulation with argon green laser directed to the perimacular aneurysms and pars plana posterior vitrectomy. The visual acuity showed great improvement after a four-month follow-up. The present report supports the importance of optic coherence tomography in cases where the vitreoretinal interface must be evaluated, including vascular pathologies, which allowed us to offer a better treatment to this patient.

Luciano Sólia, Násser; Herbert Paulo de, Almeida; Leandro Cabral, Zacarias; Suel, Abujamra; André Marcelo Vieira, Gomes.

2007-10-01

62

Tuberculosis miliar, ganglionar, pancreática y costal: Presentación clínica y revisión bibliográfica / Miliary, ganglionar, pancreatic and costal tuberculosis: Clinical presentation and bibliography review  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Se presenta un paciente de 42 años que ingresa en nuestro hospital con fiebre, dolor abdominal y patrón radiológico miliar. Tenía un aumento de amilasemia y amilasuria y de la lipasa sérica. El mantoux era negativo. En el estudio de TAC había engrosamiento costal, lesiones hepáticas focales múltiple [...] s y adenopatías necrosadas en zona peripancreática. Las biopsias transbronquiales y la punción pancreática mostraron lesiones granulomatosas necrotizantes, cultivándose M. tuberculosis complex en el broncoaspirado. El tratamiento específico normalizó todas las alteraciones pulmonares, costales y pancreáticas. Abstract in english A 42-year-old man was admitted to the hospital with fever, abdominal pain and miliary radiological pattern.The amylase and lipase in serum, and the amylase in urine were increased. The tuberculin skin test was negative. The thoracic and abdominal CT scan showed costal afectation, multiple focal hepa [...] tic lesions and large necrosing peripancreatic lymphadenopathies. The transbronchial biopsy and the pancreatic punction demostrated granulomatous necrotic lesions, and M. tuberculosis growed in the bronchial washing culture. The specific treatment normalized the pulmonary, costal and pancreatic lesions.

I., Inchaurraga Álvarez; A., Herrejón Silvestre; P., Plaza Valía; R., Blanquer Olivas.

2001-09-01

63

Miliary pulmonary metastases of well-differentiated thyroid carcinoma (medullary excluded) about 10 cases; Les metastases pulmonaires micronodulaires de type miliaire dans le cancer thyroidien bien diff encie (medullaires exclus) a propos de dix cas  

Energy Technology Data Exchange (ETDEWEB)

Thyroid cancer is relatively a rare cancer; about 1% from all cancers: between 10 and 1591 of patients with differentiated thyroid cancer develop micro or macro-nodular pulmonary metastases. In this study we examined the characteristics and evolution after treatment of 10 patients with micro-nodular or miliary metastases of well-differentiated thyroid carcinoma. Total body scintigraphy with 131 iodine, chest X-ray or CT scan, and thyroglobulin assay were performed for all patients. The treatment was iodine 131 (3. 7 GBq). therapeutic 131 iodine scan was done for all patients seven days after the 131 administration. The effect of 131 iodine treatment was evaluated by means of changes in the number and size of lung metastases on the total body scintigraphy with 131 iodine and by serum thyroglobulin levels six months after 131 iodine ablation, they all received L-thyroxine (2,4 {mu}g/kg/j). The minimum duration of follow-up was 12 months. There were six females and four males within a range of 13-70 years old. Eight had papillary and two follicular thyroid cancer. These 10 patients benefited 131 iodine therapy. The effect of 131 iodine treatment and the prognostic values of the following variables mere examined: age at the time of 131 iodine. treatment and histological findings. The miliary was rarely diagnosed on the initial investigation. only in to o cases by 131 iodine scar. alter surgery. two cases by chest X-ray, and two cases by CT scan, the initial thyroglobulin levels was very high in seven cases, between 10 and 40 ng/ml in one case and less than 10 ng/ml in two cases. These results indicate that age, 131 iodine uptake. histological findings and the presence of other metastases are important factors in predicting the effects of 131 treatment for pulmonary metastases of well-differentiated thyroid carcinoma. Among all the variables studied. the best prognosis for survival was demonstrated by increased 131 uptake in pulmonary metastases and by early diagnosis during post surgery 131 iodine scanning of radiologically non-apparent metastases. (authors)

Ennibi, G. [Hopital Hassan-2, Service de Medecine Nucleaire, Agadir (Morocco); Ben Rais, N. [Centre Hospitalier Universitaire IBN Sina, Service de Medecine Nucleaire, Rabat (Morocco)

2007-03-15

64

Percutaneous breast implant herniation: a rare complication of miliary TB.  

Science.gov (United States)

We describe the case of a 46-year-old female patient treated for disseminated tuberculosis (TB) infection involving the lungs, urinary tract and skin. Following initiation of antituberculous therapy, the patient's right breast implant eroded through the overlying skin and was seen to be herniating through the resulting defect. The breast implant was removed under local anaesthetic and histological analysis of the resected tissue demonstrated granuloma formation consistent with periprosthetic TB. Wound healing following implant removal was poor and future breast augmentation surgery was only considered following completion of 12?months anti-TB treatment. This case constitutes the first report in the literature of percutaneous breast implant herniation resulting from periprosthetic infection with TB. A high index of suspicion is required to ensure early detection and timely management of TB and, in cases where periprosthetic pus aspirate is sterile, mycobacterial infection must be actively excluded. PMID:25568276

Dale, Adam P; Dedicoat, Martin J; Saleem, Tausif; Moran, Ed

2015-01-01

65

"Scleroderma linearis: hemiatrophia faciei progressiva (Parry-Romberg syndrom) without any changes in CNS and linear scleroderma "en coup de sabre" with CNS tumor  

OpenAIRE

Abstract Background Hemifacial atrophy (Parry-Romberg syndrome) is a relatively rare disease. The etiology of the disease is not clear. Some authors postulate its relation with limited scleroderma linearis. Linear scleroderma "en coup de sabre" is characterized by clinical presence of most commonly one-sided linear syndrome. In a number of patients, neurological affection is the medium of the disease. The treatment of both scleroderma varieties is similar to the treatment of ...

Brzezi?ska-Wcis?o Ligia; Lis-?wi?ty Anna; Bergler-Czop Beata

2009-01-01

66

Tuberculosis congénita asociada con tuberculosis materna miliar diseminada Congenital tuberculosis associated with maternal disseminated miliary tuberculosis  

OpenAIRE

La tuberculosis sin tratamiento en mujeres gestantes es un riesgo definido para la transmisión de la enfermedad al recién nacido y para resultados adversos, obstétricos y perinatales. La tuberculosis en mujeres gestantes y la tuberculosis congénita son afecciones infrecuentes y de difícil diagnóstico por la falta de especificidad de las manifestaciones clínicas.
Se presenta el caso de una mujer primigestan...

Julio César Mantilla; Luz Libia Cala; Luis Miguel Sosa

2007-01-01

67

Clinical and radiological deterioration in a patient with AIDS  

Energy Technology Data Exchange (ETDEWEB)

Paradoxical clinical deterioration of miliary tuberculosis, characterized by pulmonary and abdominal manifestations, is reported in a patient with the acquired immunodeficiency syndrome, after initiation of treatment with highly active antiretroviral therapy. Paradoxical reaction was attributed to partial restoration of cell-mediated immunity related to highly effective antiretroviral therapy. Because tuberculosis has a high prevalence in HIV patients and tuberculosis is often characterized by miliary spreading of disease in these patients, it is important to recognize this phenomenon. (orig.)

Backer, A.I. de [General Hospital Sint-Lucas, Department of Radiology, Ghent (Belgium); Mortele, K.J. [Brigham and Women' s Hospital, Harvard Medical School, Department of Radiology, Division of Abdominal Imaging and Intervention, Boston, MA (United States); Bomans, P.; Vanschoubroeck, I.J. [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Internal Medicine, Antwerp (Belgium); Keulenaer, B.L. de [Royal Darwin Hospital, Intensive Care Unit, Tiwi, NT (Australia); Kockx, M.M. [Ziekenhuisnetwerk Antwerpen, Stuivenberg, Department of Pathology, Antwerp (Belgium)

2005-11-01

68

Clinical and radiological deterioration in a patient with AIDS  

International Nuclear Information System (INIS)

Paradoxical clinical deterioration of miliary tuberculosis, characterized by pulmonary and abdominal manifestations, is reported in a patient with the acquired immunodeficiency syndrome, after initiation of treatment with highly active antiretroviral therapy. Paradoxical reaction was attributed to partial restoration of cell-mediated immunity related to highly effective antiretroviral therapy. Because tuberculosis has a high prevalence in HIV patients and tuberculosis is often characterized by miliary spreading of disease in these patients, it is important to recognize this phenomenon. (orig.)

69

Atrophoderma vermiculatum: a case report and review of the literature on keratosis pilaris atrophicans.  

Science.gov (United States)

Atrophoderma vermiculatum (AV) is a rare follicular disorder primarily affecting children with reticular or honeycomb atrophy of the cheeks and forehead. Along with keratosis pilaris atrophicans faciei (KPAF) and keratosis follicularis spinulosa decalvans (KFSD), AV falls within the broader spectrum of keratosis pilaris atrophicans (KPA). Although these 3 variants of KPA have unique presentations and associations, they can all be frustratingly difficult to treat. We describe a sporadic case of AV that presented in late adolescence, a relatively late age of onset. PMID:19326693

Luria, Rebecca B; Conologue, Theresa

2009-02-01

70

Molecular epidemiology of dermatophytosis in Tehran, Iran, a clinical and microbial survey.  

Science.gov (United States)

In the framework of a survey on dermatophytoses, 14,619 clinical specimens taken from outpatients with symptoms suggestive of tinea and referred to a Medical Mycology laboratory in Tehran, Iran, were analyzed by direct microscopy and culture. In total, 777 dermatophyte strains recovered in culture were randomly identified by a formerly established RFLP analysis method based on the rDNA ITS regions. For confirmation of species identification, 160 isolates representing the likely entire species spectrum were subjected to ITS-sequencing. Infection was confirmed in 5,175 collected samples (35.4%) by direct microscopy and/or culture. Tinea pedis was the most prevalent type of infection (43.4%), followed by tinea unguium (21.3%), tinea cruris (20.7%), tinea corporis (9.4%), tinea manuum (4.2%), tinea capitis (0.8%) and tinea faciei (0.2%). Trichophyton interdigitale was the most common isolate (40.5%) followed by T. rubrum (34.75%), Epidermophyton floccosum (15.6%), Microsporum canis (3.9%), T. tonsurans (3.5 %) and M. gypseum (0.5%). Other species included M. ferrugineum, T. erinacei, T. violaceum, T. schoenleinii, and a very rare species T. eriotrephon (each one 0.25%). The two strains of T. eriotrephon isolated from tinea manuum and tinea faciei are the second and third reported cases worldwide. Application of DNA-based methods is an important aid in monitoring trends in dermatophytosis in the community. PMID:22587730

Rezaei-Matehkolaei, Ali; Makimura, Koichi; de Hoog, Sybren; Shidfar, Mohammad Reza; Zaini, Farideh; Eshraghian, Mohammadreza; Naghan, Parvaneh Adimi; Mirhendi, Hossein

2013-02-01

71

COMPARISON OF DIET AND USE OF BROMELIADS BETWEEN A BROMELICOLOUS AND A BROMELIGENOUS ANURAN AT AN INSELBERG IN THE SOUTHEASTERN OF BRAZIL  

OpenAIRE

Anurans from an inselberg in southeastern Brazil were studied using a sample ofsixty tank of bromeliads Alcantharea sp. We found 153 tadpoles of S. arduous, 21adults of S. arduous, 30 adults of T. miliaris, and two adults of Scinax x-signatus,which were not considered in our analyses. Tadpoles of S. arduous were present in35% of the analyzed plants. Adults of S. arduous (bromeligeneous) occurred in 25%of analyzed plants, while adults of T. miliaris (bromelicolous) occurred in 30%.Apparently t...

PERTEL WESLEI; TEXEIRA ROGEIRO; FERREIRA RODRIGO

2010-01-01

72

GenBank blastn search result: AK059019 [KOME  

Lifescience Database Archive (English)

Full Text Available AK059019 001-021-B02 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 2e-12 Plus Plus ...

73

GenBank blastx search result: AK058686 [KOME  

Lifescience Database Archive (English)

Full Text Available AK058686 001-019-A10 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 4e-16 +3 ...

74

GenBank blastx search result: AK059228 [KOME  

Lifescience Database Archive (English)

Full Text Available AK059228 001-024-D11 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 2e-13 +3 ...

75

GenBank blastn search result: AK240854 [KOME  

Lifescience Database Archive (English)

Full Text Available AK240854 J065021E17 V01143.1 PMHIS7 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A ... , containing many sequence gaps). (see also ... for allelic sequence.). INV 5e-42 1 -1 ...

76

GenBank blastx search result: AK059098 [KOME  

Lifescience Database Archive (English)

Full Text Available AK059098 001-022-C07 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 1e-19 +2 ...

77

GenBank blastx search result: AK061605 [KOME  

Lifescience Database Archive (English)

Full Text Available AK061605 001-030-C05 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 2e-27 +1 ...

78

GenBank blastx search result: AK058436 [KOME  

Lifescience Database Archive (English)

Full Text Available AK058436 001-015-F07 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 3e-15 +1 ...

79

GenBank blastx search result: AK058913 [KOME  

Lifescience Database Archive (English)

Full Text Available AK058913 001-009-A01 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 7e-29 +1 ...

80

GenBank blastx search result: AK058540 [KOME  

Lifescience Database Archive (English)

Full Text Available AK058540 001-017-B06 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 1e-28 +1 ...

 
 
 
 
81

GenBank blastn search result: AK119240 [KOME  

Lifescience Database Archive (English)

Full Text Available AK119240 001-120-A04 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 4e-17 Plus Plus ...

82

GenBank blastx search result: AK059019 [KOME  

Lifescience Database Archive (English)

Full Text Available AK059019 001-021-B02 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 7e-16 +2 ...

83

GenBank blastx search result: AK059228 [KOME  

Lifescience Database Archive (English)

Full Text Available AK059228 001-024-D11 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 4e-26 +3 ...

84

GenBank blastx search result: AK058741 [KOME  

Lifescience Database Archive (English)

Full Text Available AK058741 001-019-G08 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 5e-16 +2 ...

85

GenBank blastx search result: AK059159 [KOME  

Lifescience Database Archive (English)

Full Text Available AK059159 001-023-D03 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 6e-12 +3 ...

86

GenBank blastx search result: AK104901 [KOME  

Lifescience Database Archive (English)

Full Text Available AK104901 001-046-D02 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 6e-67 +3 ...

87

GenBank blastx search result: AK058913 [KOME  

Lifescience Database Archive (English)

Full Text Available AK058913 001-009-A01 V01144.1 Sea urchin (P. miliaris) gene for histones H1, H4, H2B, H3 and H2A ... (in that order, with many gaps). (see also ... for allelic sequence.).|INV INV 1e-13 +1 ...

88

GenBank blastn search result: AK105816 [KOME  

Lifescience Database Archive (English)

Full Text Available AK105816 001-203-C11 V01143.1 Sea urchin (P. miliaris) gene for histones H4, H2B, H3, H2A and H1 ... , containing many sequence gaps). (see also ... for allelic sequence.).|INV INV 3e-17 Plus Plus ...

89

[Fever of unknown origin in 74-year-old multimorbid man].  

Science.gov (United States)

A 74-year-old multimorbid man was admitted with fever of unknown origin. Over time the fever ceased spontaneously. The patient developed signs of a right heart failure without evidence of a primarily cardiac pathogenesis and died of acute right heart failure. Miliary tuberculosis that had lead to pulmonary artery hypertension was diagnosed at autopsy. PMID:25301026

Fuchs, A; Elezkurtaj, S; Hortig, P; Ignatius, R; Gross, U; Schneider, T

2014-12-01

90

Pulmonary alveolar microlithiasis with the absence of technetium-99m MDP uptake of lungs  

International Nuclear Information System (INIS)

The authors report a patient with alveolar microlithiasis who was treated for miliary tuberculosis eight years earlier and whose Tc-99m MDP scan revealed absent lung uptake. Diagnosis was established by bronchoalveolar lavage. Both the roentgenogram and computed tomography of the chest confirmed alveolar microlithiasis

91

Pulmonary alveolar microlithiasis  

OpenAIRE

Pulmonary alveolar microlithiasis is a rare disease of unknown cause. We report a case in a young boy who presented with history of failure to thrive and chest X-ray finding suggestive of miliary mottling. Open lung biopsy revealed pulmonary alveolar microlithiasis.

Gayathri Devi, H. J.; Mohan Rao, K. N.; Prathima, K. M.; Das, Jayanth K.

2011-01-01

92

Pulmonary alveolar microlithiasis with the absence of technetium-99m MDP uptake of lungs  

Energy Technology Data Exchange (ETDEWEB)

The authors report a patient with alveolar microlithiasis who was treated for miliary tuberculosis eight years earlier and whose Tc-99m MDP scan revealed absent lung uptake. Diagnosis was established by bronchoalveolar lavage. Both the roentgenogram and computed tomography of the chest confirmed alveolar microlithiasis.

Turktas, H.; Ozturk, C.; Guven, M.; Ugur, P.; Erzen, C.

1988-12-01

93

Tuberculosis of the Gallbladder  

OpenAIRE

Analysis of 5 patients with gallbladder tuberculosis who had open cholecystectomy and review of literature have shown that, although still rare it presents as a part of systemic miliary tuberculosis, abdominal tuberculosis, isolated gallbladder tuberculosis and as acalculus cholecystitis in anergic patients. There are no pathognomonic signs, the diagnosis depends on suspicion of tuberculosis, peroperative findings and histological examination.

Kumar, K.; Ayub, M.; Kumar, Mohan; Keswani, N. K.; Shukla, H. S.

2000-01-01

94

Dicty_cDB: Contig-U04955-1 [Dicty_cDB  

Lifescience Database Archive (English)

Full Text Available Contig-U04955-1 no gap 530 4 4861622 4861092 MINUS 1 1 U04955 0 0 0 0 0 0 1 0 0 0 0 0 0 0 Show C ... miliaris ... 44 5.3 1 ( BV281582 ) S232P6488RF4.T0 Beagle ... Canis familiaris STS genom... 44 5.3 1 ( AL807801 ...

95

Mature ovarian teratoma with gliomatosis peritonei - A case report  

Directory of Open Access Journals (Sweden)

Full Text Available Gliomatosis peritonei (GP, a rare condition related to ovarian teratomas, is characterized by miliary implants of mature glial tissues on the peritoneum or omentum. We report herein a case of mature teratoma of the ovary with GP with imaging features and pathological correlation

Das C

2005-01-01

96

Pulmonary Strongyloides stercoralis infection  

Science.gov (United States)

The 17-year-old male patient presented with fever, weakness, dyspnea and weight loss. His chest radiography demonstrated diffuse reticulonodular density, and high-resolution lung tomography indicated diffuse micronodules and prevalent ground-glass pattern. The findings were consistent with miliary involvement. The patient underwent examinations for rheumatology, immunology, cytology and infectious conditions. His immune system was normal and had no comorbidities or any history of immunosuppressive treatment. Strongyloides stercoralis larvae were noted upon direct inspection of the feces. Clinical and radiological improvement was achieved with albendazole 400 mg/day. This case is being presented since miliary involvement in the lungs caused by S. stercoralis infection in an individual with intact immune system is rare and difficult to diagnosis.

Dogan, Canan; Gayaf, Mine; Ozsoz, Ayse; Sahin, Birsen; Aksel, Nimet; Karasu, Isil; Aydogdu, Zekiye; Turgay, Nevin

2014-01-01

97

Disseminated Mycobacterium avium complex infection in an immunocompetent pregnant woman  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Disseminated mycobacterium avium complex (MAC occurs mainly in immunocompromised hosts, which is associated with abnormal cellular immunity. Case presentation A 26-year-old pregnant woman presented with fever and general weakness. Miliary lung nodules were noted on chest X-ray. Under the impression of miliary tuberculosis, anti-tuberculosis medication was administered. However, the patient was not improved. Further work-up demonstrated MAC in the sputum and placenta. The patient was treated successfully with clarithromycin-based combination regimen. Conclusion This appears to be the first case of disseminated MAC in an otherwise healthy pregnant woman. Clinicians should be alert for the diagnosis of MAC infection in diverse clinical conditions.

Kim Woo

2006-10-01

98

[Tuberculosis induced by Bacillus Calmette-Guerin immuno-prophylaxis -- case study].  

Science.gov (United States)

We describe a case of miliary tuberculosis induced by Bacillus Calmette-Guerin (BCG) as a complication of an infection after BCG-instillation therapy into the bladder because of bladder carcinoma. Bacilli surely entered blood circulation via an urethral lesion because of a difficult catheterisation. The 60 year old patient was administered to the hospital with septic temperature 4 four days after BCG instillation. CT showed a miliary patten and the diagnosis was confirmed by bronchoscopy: transbronchial biopsy showed granulomatous infiltration and an acid-fast rod-bacterium was detected in bronchial slime. Symptoms vanished after a consequent antituberculous triple therapy regime and the patient left hospital in a good general state of health. PMID:15534773

Frickmann, H; Jungblut, S; Hanke, P; Bargon, J

2004-11-01

99

Uma nova espécie de Thoropa da Serra do Cipó, Minas Gerais, Brasil (Amphibia, Leptodactylidae)  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese [...] Abstract in english Thoropa megatympanum, sp. n., is described from the Serra do Cipó, Minas Gerais, Southeastern Brasil. The new species is related to T. miliaris (Spix), from which it is readily distinguished by its smaller size, broader head, larger tympanum, shorter legs, and dorsal pattern mottled. The eggs and th [...] e tadpole are also described.

Ulisses, Caramaschi; Ivan, Sazima.

100

FOLLICULITIS ET PERIFOLLICULITIS CAPITIS ABSCEDENS ET SUFFODIENS CONTROLLED WITH A COMBINATION THERAPY: SYSTEMIC ANTIBIOSIS (METRONIDAZOLE PLUS CLINDAMYCIN), DERMATOSURGICAL APPROACH, AND HIGH-DOSE ISOTRETINOIN  

OpenAIRE

Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology. It is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. The condition is also known as ‘acne necrotica miliaris’ or ‘Proprionibacterium’ folliculitis. Most often the disease affects men of African-American or African-Caribbean descent between 20 and 40 years of age. The clinical picture is determined by fluctuating p...

Tchernev, Georgi

2011-01-01

 
 
 
 
101

Tuberculosis ganglionar con afectación cutánea (escrofulodermia) en paciente inmunocompetente. Reporte de un caso  

OpenAIRE

Tuberculosis (TB) infection is most prevalent in the world and its frequency continues to increase, being endemic in Paraguay. TB disease is defined by the presence of clinical symptoms and signs depending on the location of the disease. The most common primary site is the lung. But there are other less common locations such as pleural, pericardial, lymph nodes, miliary, meningeal, osteoarticular, gastrointestinal, renal, pancreatic, breast, skin, eye and genitourinary tract.We report the cas...

Martinez Braga Gabriela; Di Martino Ortiz Beatriz; Rodriguez Masi Mirtha; Knopfelmacher Oilda; Bolla de Lezcano Lourdes

2011-01-01

102

Paradoxical increase in uric acid level with allopurinol use in pyrazinamide-induced hyperuricaemia.  

Science.gov (United States)

We report the case of a 36-year-old man with psoriatic arthritis and miliary tuberculosis, whose serum uric acid (SUA) level increased after the initiation of antituberculosis treatment, which included pyrazinamide. Most strikingly and paradoxically, the patient's SUA level increased after treatment with allopurinol. On cessation of allopurinol, his SUA level decreased substantially, and complete normalisation was observed following the discontinuation of pyrazinamide treatment. PMID:23677428

Gerdan, Vedat; Akkoc, Nurullah; Ucan, Eyup Sabri; Bulac Kir, Serpil

2013-06-01

103

Hepatic capillariasis in a Cape ground squirrel (Xerus inaurus) : short communication  

OpenAIRE

We report, for the first time, an incidental finding of Calodium hepaticum infestation in a sub-adult female Cape ground squirrel (Xerus inaurus). Post mortem examination of the squirrel revealed severe haemoperitoneum, splenomegaly and hepatomegaly with miliary white spots distributed diffusely throughout the hepatic parenchyma. Histologically the portal tracts in the liver showed granulomatous inflammation with fibrosis and numerous giant cells. Occasional adult worms were identified and th...

Mitchell, B.; Mitchell, D.; Wilson, W. A.; Meyer, L. C. R.; Hetem, R. S.; Fick, L. G.; Witt, B. A.; Erlwanger, K. H.

2012-01-01

104

Tuberculous abscess of the pancreas presenting as obstructive jaundice: a case report  

Energy Technology Data Exchange (ETDEWEB)

Pancreatic tuberculosis is very rare, though dissemination to the gastrointestinal tract and mesenteric lymph nodes is common. We describe a case of pancreatic tuberculosis presenting as a cystic mass in the pancreatic head, with biliary obstruction, in a patient with miliary pulmonary tuberculosis. Surgery for the curative treatment of jaundice was performed, and the histopathologic findings indicated that a pancreatic abscess with caseous necrosis was present, consistent with tuberculosis.

Yoo, Dong Kyun; Cho, June Sik; Shin, Kyung Sook; Kang, Dae Young [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)

2002-06-01

105

Pulmonary Strongyloides stercoralis infection  

OpenAIRE

The 17-year-old male patient presented with fever, weakness, dyspnea and weight loss. His chest radiography demonstrated diffuse reticulonodular density, and high-resolution lung tomography indicated diffuse micronodules and prevalent ground-glass pattern. The findings were consistent with miliary involvement. The patient underwent examinations for rheumatology, immunology, cytology and infectious conditions. His immune system was normal and had no comorbidities or any history of immunosuppre...

Dogan, Canan; Gayaf, Mine; Ozsoz, Ayse; Sahin, Birsen; Aksel, Nimet; Karasu, Isil; Aydogdu, Zekiye; Turgay, Nevin

2014-01-01

106

Production of tumor necrosis factor-alpha by alveolar macrophages from patients with pulmonary tuberculosis.  

OpenAIRE

In order to ascertain the role of TNF-alpha in pulmonary tuberculosis, we determined the TNF-alpha productivity of alveolar macrophages(AMs) obtained by bronchoalveolar lavage(BAL), along with the level of TNF-alpha in the serum of patients with tuberculosis including pulmonary, miliary, and endobronchial tuberculosis, healthy controls, and pulmonary diseases such as diffuse interstitial lung disease (DILD) and pneumonia. AMs from patients with pulmonary tuberculosis did not produce a larger ...

Kim, S. J.; Kim, H. I.; Lee, Y. H.; Kim, S. K.

1991-01-01

107

Magnetic resonance imaging in acute intractional tuberculosis  

International Nuclear Information System (INIS)

We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. All patients had native and contrast enhanced CT and MRI scans. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis. (orig.)

108

COMPARISON OF DIET AND USE OF BROMELIADS BETWEEN A BROMELICOLOUS AND A BROMELIGENOUS ANURAN AT AN INSELBERG IN THE SOUTHEASTERN OF BRAZIL  

Directory of Open Access Journals (Sweden)

Full Text Available Anurans from an inselberg in southeastern Brazil were studied using a sample ofsixty tank of bromeliads Alcantharea sp. We found 153 tadpoles of S. arduous, 21adults of S. arduous, 30 adults of T. miliaris, and two adults of Scinax x-signatus,which were not considered in our analyses. Tadpoles of S. arduous were present in35% of the analyzed plants. Adults of S. arduous (bromeligeneous occurred in 25%of analyzed plants, while adults of T. miliaris (bromelicolous occurred in 30%.Apparently the presence of toe pads in S. arduous allow them to occupy the centerportion of bromeliads, while T. miliaris, which lack pads on their toes, were foundon the base of the plant axils. The number of anuran species and the abundance ofindividuals found were low. This may be a result of the high altitude of our studiedsite or a restriction imposed by the saxicolous environment, such as high temperaturesand low humidity during the day. Both species can be considered generalist feedersdue to their wide variety of ingested prey. Formicidae was their main prey but wasabsent segregation in the bromeliads. Blattodea was very common inside the bromeliadaxils and represented the most signifi cant prey by weight in both frog species. Weconclude that both anurans forage inside and outside of bromeliads. Trophic nichebreadth in S. arduous was larger than in T. miliaris. Even both species being commoninhabitants of the same environment, they demonstrated a marked spatial segregationin the bromeliads. Based on their diet, however, there may be disputes for territoryoutside of the bromeliads.

PERTEL WESLEI

2010-06-01

109

Multiple intestinal perforations as a primary manifestation of abdominal tuberculosis in a HIV-infected patient  

Directory of Open Access Journals (Sweden)

Full Text Available Abdominal tuberculosis (TB is the sixth commonest extra-pulmonary TB form after lymphatic, genitourinary, bone and joint, miliary and meningeal tuberculosis. Perforation is a serious and uncommon complication of abdominal tuberculosis which can occur even during the treatment. A 30-year-old man was admitted with a three-day history of abdominal pain who had emergency surgery for multiple perforations of the distal ileum.

Amir Hossein Sarrami

2010-12-01

110

BIODIVERSIDAD DE MACROHONGOS DE LA RESERVA NACIONAL MAGALLANES BIODIVERSITY OF MACROFUNGI OF THE MAGALLANES NATIONAL RESERVE  

Directory of Open Access Journals (Sweden)

Full Text Available El presente estudio entrega antecedentes cuantitativos sobre la riqueza y abundancia de macrohongos existentes en comunidades vegetales de la Reserva Nacional Magallanes. Se realizó entre los meses de enero a mayo de 2005 sobre cuatro comunidades vegetales (bosque de lenga, bosque de coigüe, murtillar y pastizal húmedo. En cada una se delimitaron parcelas permanentes, en las cuales mediante cuadrantes aleatorios se evaluó la riqueza y abundancia de macrohongos periódicamente cada 14 días. Paralelamente se realizaron muéstreos intensivos, lo que permitió complementar la lista de especies. En total se identificó un total de 40 especies considerando ambos muéstreos. El estudio de diversidad demostró que la mayor riqueza y abundancia de macrohongos se presenta en comunidades boscosas, siendo superior en las parcelas relevadas en coigüe. En el matorral no se registraron individuos. La especie más abundante fue Russula nothofaginea. Por otro lado, Coprinus disseminatus fue la especie presente en mayor cantidad de ambientes. Un análisis de la variación estacional de las fructificaciones permite concluir que la mayor diversidad de macromicetes se presenta en el mes de mayo. Los resultados validan la hipótesis que los bosques de coigüe presentan la mayor abundancia de macrohongos comparados con otras comunidades vegetales. Sin embargo, en los muéstreos intensivos, considerando bosques mixtos y diversos ambientes, aumenta la riqueza de especies en las cuencas de árboles caducifolios. Por otro lado, se estima que las condiciones climáticas extremas presentadas en este estudio (nevazones tempranas y temperaturas congelantes pudieron afectar la diversidad de macrohongos en las distintas comunidades.The present study delivers qualitative precedents on the richness and abundance of macro- fungi existing in plant communities of the National Reserve Magallanes. It was realized between January to May 2005 on four plant communities (forest of lenga, forest of coigüe, murtillar and humid grassland. In every community there were delimited permanent plots, in which by means of random quadrants the richness and abundance of macrofungi were evaluated from time to time every 14 days. Parallel intensive sampling realized what allowed to complement the list of species. In whole there was identified a whole of 40 species considering both samplings. The study demonstrated that la major richness and abundance of macrofungi appears in forest communities, being superior in the plots relieved in coigüe. In the bushes did not register individuáis. The most abundant species was Russula nothofaginea. On the other hand, Coprinus disseminatus was the present species in major quantity of environments. An analysis of the seasonal variation of the fructifications allows to conclude that the major diversity of macromicetes appears in May. The results valídate the hypothesis that the forests the forests of coigüe present the major abundance of macro fungicompared with other plant communities. Nevertheless, the intensive samplings, considering mixed forests and diverse environments, the richness of species increases in the trees caducifolios basins. On the other hand, it estimates that the climatic extreme conditions presented in this study (snow early and temperatures cool could affect the diversity of macro fungi in the different communities.

Verónica Mancilla

2008-01-01

111

COMPARISON OF DIET AND USE OF BROMELIADS BETWEEN A BROMELICOLOUS AND A BROMELIGENOUS ANURAN AT AN INSELBERG IN THE SOUTHEASTERN OF BRAZIL / Comparación de la dieta y el uso de bromelias entre anuros en un afloramiento rocoso en el sudeste de Brasil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: English Abstract in spanish Se estudiaron los anuros que usan las rosetas de 60 bromelias del género Alcantharea, en un afloramiento rocoso del sudeste de Brasil. Se encontraron 153 larvas y 21 adultos de Scinax arduous, 30 adultos de Thoropa miliaris, y dos individuos de Scinax x-signatus, éstos últimos no se incluyeron en lo [...] s análisis. Las larvas de S. arduous se encontraron en el 35% de las plantas analizadas. Los adultos de S. arduous se presentaron en el 25% de las plantas estudiadas, mientras que los adultos de T. miliaris se encontraron en el 30% de las plantas. Aparentemente, la presencia de ventosas en las patas de S. arduous permite que los individuos de esta especie ocupen la porción central de las bromelias, en tanto que los individuos de T. miliaris, los que carecen de dichas ventosas en sus patas, ocupan las axilas inferiores de las hojas de las bromelias. El número de especies de anuros y la abundancia de individuos fue relativamente baja. Esto puede ser el resultado de la apreciable altitud del área estudiada o por las restricciones impuestas por el ambiente saxícola del área investigada, la cual se caracteriza por presentar elevadas temperaturas y baja humedad durante el día. Ambas especies pueden ser consideradas como consumidores generalistas. Los formícidos constituyeron la principal presa en número, aunque éstos no se registraron en las rosetas de las bromelias. Por su parte, los Blattodea fueron muy comunes dentro de las bromelias, los cuales representaron una presa más importante en peso para las dos especies de anuros. Se puede concluir que ambas especies de anuros forrajean en la parte interna como en la externa de las bromelias. El nicho trófico de S. arduous demostró ser más amplio. Aunque ambas especies de anuros son habitantes comunes del mismo ambiente, éstas presentan una marcada segregación espacial en las bromelias. No obstante, teniendo como base su dieta, las dos especies de anuros disputan territorio por fuera de las bromelias. Abstract in english Anurans from an inselberg in southeastern Brazil were studied using a sample of sixty tank bromeliads Alcantharea sp. We found 153 tadpoles of S. arduous, 21 adults of S. arduous, 30 adults of T. miliaris, and two individuals of Scinax x-signatus, which were not considered in our analyses. Tadpoles [...] of S. arduous were present in 35% of the analyzed plants. Adults of S. arduous (bromeligeneous) occurred in 25% of analyzed plants, while adults of T. miliaris (bromelicolous) occurred in 30%. Apparently the presence of toe pads in S. arduous allows them to occupy the center portion of bromeliads, while T. miliaris, which do not have pads on their toes, used the base of the plant axils for residency. The number of anuran species and the abundance of individuals found were low. This may be a result of the high altitude of our studied site or a restriction imposed by the saxicolous environment, such as high temperatures and low humidity during the day. Both species can be considered generalist feeders due to their wide variety of ingested prey. Formicidae was their main prey but was absent inside the bromeliads. Blattodea was very common inside the bromeliad axils and represented the most significant prey by weight in both frog species. We can conclude that both anurans forage inside and outside of bromeliads. The trophic niche breadth in S. arduous was larger than in T. miliaris. Even though both species are common inhabitants of the same environment, they demonstrated a marked spatial segregation in the bromeliads. Based on their diet, however, there may be disputes for territory outside of the bromeliads.

WESLEI, PERTEL; ROGÉRIO L., TEIXEIRA; RODRIGO B., FERREIRA.

2010-06-30

112

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer  

Energy Technology Data Exchange (ETDEWEB)

To investigate the impact of PET and PET/CT scanning on decision-making in management planning and to identify the optimal setting for selecting candidates for surgery in suspicious recurrent ovarian cancer. A retrospective chart review was performed in patients with possible recurrent ovarian cancer after primary optimal cytoreduction and taxane/carboplatin chemotherapy who had undergone FDG PET or FDG PET/CT scans from July 2002 to August 2008 to help make treatment decisions. The analysis included 44 patients who had undergone a total of 89 PET scans. The positive PET scans were classified as follows. (1) localized (one or two localized sites of FDG uptake), (2) multiple (three or more sites of FDG uptake), (3) diffuse (extensive low-grade activity outlining serosal and peritoneal surfaces). Of the 89 PET scans, 52 (58.4 %) led to a change in management plan. The total number of patients in whom cytoreductive surgery was selected as the treatment of choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2 % of those receiving surgery. Miliary disseminated disease was detected in 6 of the 12 patients with recurrent disease whose treatment-free interval (TFI) was <12 months, whereas none of those with a TFI of ?12 months had such disease (P = 0.0031). PET or PET/CT is useful for selecting candidates for cytoreductive surgery among patients with recurrent ovarian cancer. To avoid surgical attempts in those with miliary dissemination, patients with a TFI of ?12 months are the best candidates for cytoreductive surgery. (orig.)

Ebina, Yasuhiko; Yamada, Hideto [Kobe University Graduate School of Medicine, Department of Obstetrics and Gynecology, Kobe (Japan); Watari, Hidemichi; Kaneuchi, Masanori; Takeda, Mahito; Hosaka, Masayoshi; Kudo, Masataka; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan)

2014-03-15

113

The pathology of tuberculosis caused by Mycobacterium tuberculosis in a herd of semi-free-ranging springbok (Antidorcas marsupialis  

Directory of Open Access Journals (Sweden)

Full Text Available The first detailed description of the pathology of tuberculosis, caused by Mycobacterium tuberculosis, in springbok is reported. The springbok were part of a semi-free-ranging herd kept on the grounds of iThemba Laboratory for Accelerator Based Science (LABS in the Kuils River district of the Western Cape Province, South Africa. Mycobacterium tuberculosis was isolated from three animals out of a total of 33 sampled, with two animals showing tuberculosis lesions. The index case was an adult ewe that showed advanced miliary tuberculosis with marked macroscopic and microscopic lesions in the lungs, pleura and respiratory lymph nodes, and numerous acid-fast bacilli. Six healthy rams were sampled nine months later and a pilot study indicated miliary tuberculosis lesions in one ram, which again were macroscopically most prominent in the lungs, pleura and respiratory lymph nodes. Macroscopic lesions were also noted in the sternal, iliac, prefemoral and retropharyngeal lymph nodes. Microscopy in this animal revealed lesions in the macroscopically affected organs as well as numerous other lymph nodes, and suspected lesions occurred in the testicle and colon. Acid-fast bacilli were scarce to moderate in affected organs. Because of the miliary nature of the lesions in both affected animals, the route of infection could not be established conclusively. The lesions in most affected organs of both animals resembled classical tuberculous granulomas. A main study conducted on healthy animals 19 months after the pilot study failed to find any animal with tuberculosis lesions in the group of 25 sampled, and all were negative for mycobacteria via mycobacterial culture.

M.C. Williams

2010-09-01

114

The pathology of tuberculosis caused by Mycobacterium tuberculosis in a herd of semi-free-ranging springbok (Antidorcas marsupialis).  

Science.gov (United States)

The first detailed description of the pathology of tuberculosis, caused by Mycobacterium tuberculosis, in springbok is reported. The springbok were part of a semi-free-ranging herd kept on the grounds of iThemba Laboratory for Accelerator Based Science (LABS) in the Kuils River district of the Western Cape Province, South Africa. Mycobacterium tuberculosis was isolated from three animals out of a total of 33 sampled, with two animals showing tuberculosis lesions. The index case was an adult ewe that showed advanced miliary tuberculosis with marked macroscopic and microscopic lesions in the lungs, pleura and respiratory lymph nodes, and numerous acid-fast bacilli. Six healthy rams were sampled nine months later and a pilot study indicated miliary tuberculosis lesions in one ram, which again were macroscopically most prominent in the lungs, pleura and respiratory lymph nodes. Macroscopic lesions were also noted in the sternal, iliac, prefemoral and retropharyngeal lymph nodes. Microscopy in this animal revealed lesions in the macroscopically affected organs as well as numerous other lymph nodes, and suspected lesions occurred in the testicle and colon. Acid-fast bacilli were scarce to moderate in affected organs. Because of the miliary nature of the lesions in both affected animals, the route of infection could not be established conclusively. The lesions in most affected organs of both animals resembled classical tuberculous granulomas. A main study conducted on healthy animals 19 months after the pilot study failed to find any animal with tuberculosis lesions in the group of 25 sampled, and all were negative for mycobacteria via mycobacterial culture. PMID:21344792

Gous, T A; Williams, M C

2009-12-01

115

Sensitivity of Ocean Reflectance Inversion Models for Identifying and Discriminating Between Phytoplankton Functional Groups  

Science.gov (United States)

The daily, synoptic images provided by satellite ocean color instruments provide viable data streams for observing changes in the biogeochemistrY of marine ecosystems. Ocean reflectance inversion models (ORMs) provide a common mechanism for inverting the "color" of the water observed a satellite into marine inherent optical properties (lOPs) through a combination of empiricism and radiative transfer theory. lOPs, namely the spectral absorption and scattering characteristics of ocean water and its dissolved and particulate constituents, describe the contents of the upper ocean, information critical for furthering scientific understanding of biogeochemical oceanic processes. Many recent studies inferred marine particle sizes and discriminated between phytoplankton functional groups using remotely-sensed lOPs. While all demonstrated the viability of their approaches, few described the vertical distributions of the water column constituents under consideration and, thus, failed to report the biophysical conditions under which their model performed (e.g., the depth and thickness of the phytoplankton bloom(s)). We developed an ORM to remotely identifY Noctiluca miliaris and other phytoplankton functional types using satellite ocean color data records collected in the northern Arabian Sea. Here, we present results from analyses designed to evaluate the applicability and sensitivity of the ORM to varied biophysical conditions. Specifically, we: (1) synthesized a series of vertical profiles of spectral inherent optical properties that represent a wide variety of bio-optical conditions for the northern Arabian Sea under aN Miliaris bloom; (2) generated spectral remote-sensing reflectances from these profiles using Hydrolight; and, (3) applied the ORM to the synthesized reflectances to estimate the relative concentrations of diatoms and N Miliaris for each example. By comparing the estimates from the inversion model to those from synthesized vertical profiles, we were able to identifY those bio-optical conditions under which the inversion model performs both well and poorly.

Werdell, P. Jeremy; Ooesler, Collin S.

2012-01-01

116

Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer  

International Nuclear Information System (INIS)

To investigate the impact of PET and PET/CT scanning on decision-making in management planning and to identify the optimal setting for selecting candidates for surgery in suspicious recurrent ovarian cancer. A retrospective chart review was performed in patients with possible recurrent ovarian cancer after primary optimal cytoreduction and taxane/carboplatin chemotherapy who had undergone FDG PET or FDG PET/CT scans from July 2002 to August 2008 to help make treatment decisions. The analysis included 44 patients who had undergone a total of 89 PET scans. The positive PET scans were classified as follows. (1) localized (one or two localized sites of FDG uptake), (2) multiple (three or more sites of FDG uptake), (3) diffuse (extensive low-grade activity outlining serosal and peritoneal surfaces). Of the 89 PET scans, 52 (58.4 %) led to a change in management plan. The total number of patients in whom cytoreductive surgery was selected as the treatment of choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2 % of those receiving surgery. Miliary disseminated disease was detected in 6 of the 12 patients with recurrent disease whose treatment-free interval (TFI) was <12 months, whereas none of those with a TFI of ?12 months had such disease (P = 0.0031). PET or PET/CT is useful for selecting candidates for cytoreductive surgery among patients with recurrent ovarian cancer. To avoid surgical attempts in those with miliary dissemination, patients with a TFI of ?12 months are the best candidates for cytoreductive surgery. (orig.)

117

Tuberculosis ganglionar con afectación cutánea (escrofulodermia en paciente inmunocompetente. Reporte de un caso  

Directory of Open Access Journals (Sweden)

Full Text Available Tuberculosis (TB infection is most prevalent in the world and its frequency continues to increase, being endemic in Paraguay. TB disease is defined by the presence of clinical symptoms and signs depending on the location of the disease. The most common primary site is the lung. But there are other less common locations such as pleural, pericardial, lymph nodes, miliary, meningeal, osteoarticular, gastrointestinal, renal, pancreatic, breast, skin, eye and genitourinary tract.We report the case of a 21 years old male patient, immunocompetent, with extrapulmonary tuberculosis (lymph node with secondary skin involvement (scrofuloderma.

Martinez Braga Gabriela

2011-07-01

118

CT appearances of abdominal tuberculosis  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.

Lee, W.-K., E-mail: leewk33@hotmail.com [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Van Tonder, F.; Tartaglia, C.J.; Dagia, C. [Department of Medical Imaging, St Vincent' s Hospital, University of Melbourne, Fitzroy, Victoria (Australia); Cazzato, R.L. [Department of Radiology, Universita Campus Bio-Medico di Roma, Rome (Italy); Duddalwar, V.A. [Department of Radiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California (United States); Chang, S.D. [Department of Medical Imaging, Vancouver General Hospital, University of British Columbia, British Columbia (Canada)

2012-06-15

119

Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta from Tuberculous Aortitis: CT Findings and Treatment with an Endovascular Stent Graft  

Energy Technology Data Exchange (ETDEWEB)

Tuberculous pseudoaneurysms of the aorta are rare entities that have been reported as fatal complications requiring early diagnosis and treatment. Here, we describe a case of a tuberculous pseudoaneurysm of the descending thoracic aorta in a patient with miliary tuberculosis. The computed tomography findings of a tuberculous pseudoaneurysm and outcomes of treatment with endovascular stent graft are described. Tuberculous pseudoaneurysms of the descending thoracic aorta were treated with endovascular stent graft. However, perigraft recurrence of tuberculosis after cessation of antituberculous drugs led to surgical treatment.

Yoon, Ji Younbg; Lee, In Jae; Jeon, Eui Yong; Kim, Min Jeong; Lee, Kwan Seop; Lee, Yul [Dept. of Radiology, Hallym University College of Medicine, Chuncheon (Korea, Republic of)

2011-12-15

120

Bilateral atypical optic neuritis associated with tuberculosis in an immunocompromised patient  

OpenAIRE

A 27 year-old lady, presented with sudden loss of vision in the right eye for a week. It was followed by poor vision in the left eye after 3 days. It involved the whole entire visual field and was associated with pain on eye movement. She was diagnosed to have miliary tuberculosis and retroviral disease 4 months ago. She was started on anti-TB since then but defaulted highly active anti-retroviral therapy (HAART). On examination, her visual acuity was no perception of light in the right eye a...

Jaafar, Juanarita; Hitam, Wan Hazabbah Wan; Noor, Raja Azmi Mohd

2012-01-01

 
 
 
 
121

Synthesis of sperm and late histone cDNAs of the sea urchin with a primer complementary to the conserved 3' terminal palindrome: evidence for tissue-specific and more general histone gene variants.  

OpenAIRE

We have cloned histone cDNAs from total RNA isolated from testis and from gastrula-stage embryos of the sea urchin Psammechinus miliaris. The reverse transcription of histone mRNAs was specifically primed with an oligonucleotide that is complementary to the conserved palindromic sequence present at the 3' end of nonpolyadenylated histone mRNAs. Two sperm H2B, two late H2B, and three late H2A variant cDNA clones were isolated and characterized by DNA sequence analysis. These cDNA clones were u...

Busslinger, M.; Barberis, A.

1985-01-01

122

Genomic resources notes accepted 1 August 2014-30 September 2014.  

Science.gov (United States)

This article documents the public availability of (i) transcriptome sequence data, assembly and annotation, and single nucleotide polymorphisms (SNPs) for the cone snail Conus miliaris; (ii) a set of SNP markers for two biotypes from the Culex pipiens mosquito complex; (iii) transcriptome sequence data, assembly and annotation for the mountain fly Drosophila nigrosparsa; (iv) transcriptome sequence data, assembly and annotation and SNPs for the Neotropical toads Rhinella marina and R. schneideri; and (v) partial genomic sequence assembly and annotation for 35 spiny lizard species (Genus Sceloporus). PMID:25424247

Arthofer, Wolfgang; Banbury, B L; Carneiro, Miguel; Cicconardi, Francesco; Duda, Thomas F; Harris, R B; Kang, David S; Leaché, A D; Nolte, Viola; Nourisson, Coralie; Palmieri, Nicola; Schlick-Steiner, Birgit C; Schlötterer, Christian; Sequeira, Fernando; Sim, Cheolho; Steiner, Florian M; Vallinoto, Marcelo; Weese, David A

2015-01-01

123

Central Nervous System Tuberculosis: An Imaging-Focused Review of a Reemerging Disease  

Science.gov (United States)

Central nervous system (CNS) tuberculosis is a potentially life threatening condition which is curable if the correct diagnosis is made in the early stages. Its clinical and radiologic manifestations may mimic other infectious and noninfectious neurological conditions. Hence, familiarity with the imaging presentations of various forms of CNS tuberculosis is essential in timely diagnosis, and thereby reducing the morbidity and mortality of this disease. In this review, we describe the imaging characteristics of the different forms of CNS tuberculosis, including meningitis, tuberculoma, miliary tuberculosis, abscess, cerebritis, and encephalopathy. PMID:25653877

Sanei Taheri, Morteza; Karimi, Mohammad Ali; Haghighatkhah, Hamidreza; Samadian, Mohammad; Delavar Kasmaei, Hosein

2015-01-01

124

Tuberculosis Can Mimic Lung Cancer: A Case Series  

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Full Text Available Tuberculosis can mimic all pathological considerations of the lung and can present in many various forms and appearances. Most common radiographic appearances are cavitary, fibroproductive, exudative, acinary, micro and macronodular and miliary types. Six patients (5 men; ages ranging from 38 to 74 years who presented at our clinic during previous years were evaluated. In this case series report we discussed the consideration that, very rarely, post- primary lung tuberculosis presenting with large nodular and mass-like forms in a chest X-ray or tomography scan, can be considered as having a neoplastic pattern.

Levent Dalar

2013-03-01

125

Clinical/usefulness of gallium-67 lung scan in diffuse interstitial lung diseases of various etiology  

International Nuclear Information System (INIS)

Gallium-67 lung scan was performed in fourty four patients with diffuse interstitial lung diseases of various etiology to investigate clinical usefulness of this examination. The series included cryptogenic fibrosing alveolitis (13), pneumonitis due to collagen disease (5), sarcoidosis (4), hypersensitivity pneumonitis (4), lymphangitis carcinomatosa (4), drug-induced pneumonitis (4), pneumoconiosis (3), miliary tuberculosis (2), eosinophylic granuloma (1) and others (4). In twenty five cases pathologic findings of specimens obtained by transbronchial lung biopsy were compared with gallium scan findings. Diffuse lung diseases characterized by granuloma formation such as hypersensitivity pneumonitis, sarcoidosis and miliary tuberculosis were associated with prominent 67Ga accumulation. All patients with lymphangitis carcinomatosa showed abnormal 67Ga scan. In nine out of thirteen patients with cryptogenic fibrosing alveolitis 67Ga accumulation was observed in the lung region where, roentgenologically, micronodular or ground-glass shadow was present. On the other hand, the lung region with honeycomb appearance was not associated with 67Ga accumulation. There was no close correlation between pathologic findings and Ga-study in general, however, most of the cases whose specimens had inflammatory cells more than grade +2 showed abnormal Ga-study. The follow-up study of the scan was useful for the assesment of the effect of therap for the assesment of the effect of therapy. (author)

126

Evaluation of three-dimensional distribution of foci of diffuse lung diseases with computed tomography  

Energy Technology Data Exchange (ETDEWEB)

Three-dimensional distribution of foci of diffuse lung disease was evaluated by CT image, and it was examined whether each lung disease could be diagnosed by different distribution. Subjects were 120 cases (idiopathic interstitial pneumonia 15 cases, sarcoidosis 23 cases, miliary tuberculosis 10 cases, diffuse panbronchiolitis 7 cases, chronic pulmonary emphysema 6 cases, pulmonary metastasis 9 cases, SLE 6 cases, PSS 8 cases, dermatomyositis (DM) 6 cases, RA 7 cases, SjS 9 cases and others 14 cases). CT image was obtained from apex to base of lung with 10 mm gapless. The image was divided into three parts in both head-tail direction and back-front direction, and two parts in cortex medulla direction, and the ratio of foci to whole in each part was evaluated in five phases, and the part with the highest ratio was determined as the predominant side. In idiopathic interstitial pneumonia, sarcoidosis, miliary tuberculosis, diffuse panbronchiolitis, chronic pulmonary emphysema, pulmonary metastasis, PSS and DM, the predominant side was confirmed, respectively, and usefulness of differential diagnosis was recognized. Constant distribution wasn't recognized in SLE, RA and SjS, because the state of disease was not always same in the foci of these diseases. (K.H.)

Niwa, Masamitsu [Nagoya City Univ. (Japan). Medical School

1998-11-01

127

Pulmonary tuberculosis  

International Nuclear Information System (INIS)

Dissemination of the tubercle bacillus is of three types: bronchogenic, hematogenous, and lymphangitic. Bronchogenic dissemination occurs when exudate from a cavity or small area of caseation drains into a bronchus and is aspirated into previously uninfected areas either on the same or on the opposite side. This type of spreading occurs frequently after bleeding and when there is a cavity emptying into a bronchus. Hematogenous dissemination leads to miliary tuberculosis and to extrapulmonary lesions throughout the body. Acute massive hematogenous spread causes miliary tuberculosis, while chronic spread in smaller amounts usually results in the chronic extrapulmonary foci. Lymphangitic dissemination is common in primary infection. It is responsible for involvement with subsequent enlargement of hilar and mediastinal nodes that is often seen in children and in young black adults. The reaction to M. tuberculosis depends on the presence or absence of immunity to tuberculoprotein. In individuals having no tissue hypersensitivity or immunity, primary tuberculosis results. In those with immunity produced by previous infection or BCG vaccination, the reactivation (reinfection) disease may develop

128

Imaging diagnosis of pulmonary tuberculosis in immunocompromised patients  

International Nuclear Information System (INIS)

Objective: To evaluate CT and X-ray features of pulmonary tuberculosis in diabetic patients, patients post kidney transplantation, and patients with acquired immunodeficiency syndrome (AIDS). Methods: The authors reviewed CT scans in 20 patients with diabetic patients, X-ray films in 10 cases after kidney transplantation, and CT scans in 2 patients with AIDS. Results: CT features of pulmonary tuberculosis in diabetic diseases included larger confluent consolidation (10 cases ), multiple small cavities within any given lesion (9 cases ) and non-segmental distribution (2 cases). Satellite lesions were found in most films. The X-ray appearances of pulmonary tuberculosis post kidney transplantation included patch and larger confluent consolidation (6 cases), and miliary tuberculosis(4 cases). The CT findings of pulmonary tuberculosis with AIDS were enlarged mediastinal lymph nodes (1 case), pulmonary infiltration (1 case), and extra chest lesions(2 cases) such as enlarged neck lymph nodes and post-peritoneal lymph nodes. Conclusion: The Main radiological findings of pulmonary tuberculosis in immunocompromised patients appear larger confluent consolidation, multiple small cavities within a given lesion, miliary tuberculosis, enlarged mediastinal lymph nodes, and extra chest enlarged lymph nodes

129

Tuberculosis among atomic bomb survivors  

International Nuclear Information System (INIS)

Effects of atomic bomb on tuberculosis among atomic bomb survivors necropsied after 1956 when Atomic Bomb Hospital was opened were observed statistically and the following results were obtained. The morbidity of tuberculosis in the group exposed within 2 km from the hypocenter was higher than that of the control group, but there was not a significant difference between the both groups. The morbidity of all types of tuberculosis was significantly higher in the group exposed within 2 km from the hypocenter than in the control group. The morbidity of tuberculosis tended to decrease in both exposed and non-exposed groups with time. However, the morbidity of miliary or active tuberculosis has tended to rise in the exposed since 1975. The morbidity in young a-bomb survivors exposed within 2 km was higher than that in those of other groups, but there was not a difference in the morbidity among the aged. The higher the rate of complication of active tuberculosis with stomach cancer or acute myelocytic leukemia or liver cirrhosis, the nearer the places of exposure were to the hypocenter. Out of 26 patients with miliary tuberculosis, 6 were suspected to have leukemia while they were alive and were suggested to have leukemoid reaction by autopsy. They all were a-bomb survivors, and 4 of them were exposed within 2 km from the hypocenter. (Tsunoda, M.)

130

Ultrasonic diagnosis of hepatic metastases in patients with stomach cancer and colon cancer  

International Nuclear Information System (INIS)

To assess the value of hepatic ultrasound in cancer patients, a prospective evaluation was performed by comparing the preoperative ultrasound report and surgeon's diagnosis at the time of operation in 86 patients with stomach cancer and 26 patients with colon cancer. In a total of 112 patients considered to have a metastasis free liver on ultrasound scanning 10 patients were turned out to have had hepatic metastasis at the time of laparotomy. Among these, 4 patients had miliary metastasis, 4 patients had nodular metastasis at the dome of the right hepatic lobe, and 2 patients had surface metastasis or direct invasion from the primary tumor. These observations suggest that false negative preoperative hepatic ultrasound scanning is 9% had this is considered due to small size of the metastatic lesions, and lesions roundabout the dome of the right hepatic lobe or surface metastasis. Thus one should keep in mind the possibility of miliary metastasis in cancer patient was has coarse hepatic echotexture. In addition, the hepatic dome as well as hepatic surfaces should be searched carefully as the lesions in these areas tend to be easily neglected by ultrasound

131

Infecção por Salmonella typhimurium de origem hídrica em garça gigante (Casmerodius albus egretta), em sua vida livre no Estado do Rio de Janeiro  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese De uma mortandade de garças de vida livre, no Estado do Rio de Janeiro, Brasil, foi isolada Salmonella typhimurium por hemocultura de material proveniente de uma ave que se mostrava enferma e que à necrópsia não apresentavam lesões a na tomopa tológicas. A Salmonella typhimurium foi também isolada d [...] e água de um lago existente no Jardim Zoológico do Rio de Janeiro, onde as aves tinham acesso permanente. Durante a mortandade das aves foi observada uma hepatite necrótica na qual havia colônias bacterianas, tesões atribuídas a esta salmonelose. Abstract in english In a fatal dissease among wild herons (Casmerodius albus egretta), the authors isolated Salmonella typhimurium from tissues. The observations were made in the city of Rio de Janeiro and the infected fowls showed depression (Fig. 1 and 2). The principal gross lesions ocurred in the liver where hepato [...] megalia and miliary necrosis were observed (Fig. 3). The microscopic examination of the liver showed miliary necrosis centrally occupied by colonies of bacteria (Fig. 4 and 5). The authors isolated also Salmonella typhimurium from waterofa lake where the fowls had access every day. This is the first observation of infection by Salmonella typhimurium in herons (Casmerodius albus egretta) according the literature consulted.

Maria do Amparo Queiroz de, Freitas; Jefferson Andrade dos, Santos; Amaury Romeiro, Pires; Edwaldo, Nascimento.

1977-10-01

132

Infecção por Salmonella typhimurium de origem hídrica em garça gigante (Casmerodius albus egretta, em sua vida livre no Estado do Rio de Janeiro  

Directory of Open Access Journals (Sweden)

Full Text Available De uma mortandade de garças de vida livre, no Estado do Rio de Janeiro, Brasil, foi isolada Salmonella typhimurium por hemocultura de material proveniente de uma ave que se mostrava enferma e que à necrópsia não apresentavam lesões a na tomopa tológicas. A Salmonella typhimurium foi também isolada de água de um lago existente no Jardim Zoológico do Rio de Janeiro, onde as aves tinham acesso permanente. Durante a mortandade das aves foi observada uma hepatite necrótica na qual havia colônias bacterianas, tesões atribuídas a esta salmonelose.In a fatal dissease among wild herons (Casmerodius albus egretta, the authors isolated Salmonella typhimurium from tissues. The observations were made in the city of Rio de Janeiro and the infected fowls showed depression (Fig. 1 and 2. The principal gross lesions ocurred in the liver where hepatomegalia and miliary necrosis were observed (Fig. 3. The microscopic examination of the liver showed miliary necrosis centrally occupied by colonies of bacteria (Fig. 4 and 5. The authors isolated also Salmonella typhimurium from waterofa lake where the fowls had access every day. This is the first observation of infection by Salmonella typhimurium in herons (Casmerodius albus egretta according the literature consulted.

Maria do Amparo Queiroz de Freitas

1977-10-01

133

Mycology - an update. Part 1: Dermatomycoses: causative agents, epidemiology and pathogenesis.  

Science.gov (United States)

Dermatomycoses are caused most commonly by dermatophytes. The anthropophilic dermatophyte Trichophyton rubrum is still the most frequent causative agent worldwide. Keratinolytic enzymes, e.g. hydrolases and keratinases, are important virulence factors of T. rubrum. Recently, the cysteine dioxygenase was found as new virulence factor. Predisposing host factors play a similarly important role for the development of dermatophytosis of the skin and nails. Chronic venous insufficiency, diabetes mellitus, disorders of cellular immunity, and genetic predisposition should be considered as risk factors for onychomycosis. A new alarming trend is the increasing number of cases of onychomycosis - mostly due to T. rubrum - in infancy. In Germany, tinea capitis is mostly caused by zoophilic dermatophytes, in particular Microsporum canis. New zoophilic fungi, primarily Trichophyton species of Arthroderma benhamiae, should be taken into differential diagnostic considerations of tinea capitis, tinea faciei, and tinea corporis. Source of infection are small household pets, particularly rodents, like guinea pigs. Anthropophilic dermatophytes may be introduced by families which immigrate from Africa or Asia to Europe. The anthropophilic dermatophytes T. violaceum, T. tonsurans (infections occurring in fighting sports clubs as "tinea gladiatorum capitis et corporis") and M. audouinii are causing outbreaks of small epidemics of tinea corporis and tinea capitis in kindergartens and schools. Superficial infections of the skin and mucous membranes due to yeasts are caused by Candida species. Also common are infections due to the lipophilic yeast fungus Malassezia. Today, within the genus Malassezia more than 10 different species are known. Malassezia globosa seems to play the crucial role in pityriasis versicolor. Molds (also designated non-dermatophyte molds, NDM) are increasingly found as causative agents in onychomycosis. Besides Scopulariopsis brevicaulis, several species of Fusarium and Aspergillus are found. PMID:24533779

Nenoff, Pietro; Krüger, Constanze; Ginter-Hanselmayer, Gabriele; Tietz, Hans-Jürgen

2014-03-01

134

Dermatophyte Infections in Primorsko-Goranska County, Croatia: a 21-year Survey.  

Science.gov (United States)

This study examined the frequency of dermatophytoses in the Primorsko-Goranska County, a north-western part of Croatia, over a period of 21 years (1988-2008). All fungal samples were microscopically examined with 20% potassium hydroxide (KOH) solution. Fungal infections were confirmed in 26.9% cases. Out of these, dermatophytes were isolated in 38.3%, Candida spp. infection in 55.1% cases, while non-dermatophyte molds were identified in 6.6% isolates. The most frequently isolated dermatophyte was Trichophyton (T.) mentagrophytes var. interdigitalis (55.4%), followed by Mycrosporum (M.) canis (36.9%), T. violaceum (3.2%), M. gypseum (2.2%), and T. verrucosum (1.3%). Epidermophyton (E.) floccosum (0.9%) and T. rubrum (0.1%) were identified only sporadically. The most common dermatophytosis diagnosed in the 21-year period was tinea pedis (26.2%) followed by tinea capitis (21.8%) and tinea corporis (20.1%). Toenail onychomycosis (14.5%) was more common than fingernail onychomycosis (2.0%). T. mentagrophytes var. interdigitalis was the major pathogen causing tinea pedis (86.6%) as well as toenail onychomycosis (93.9%), while M. canis was most frequently isolated in tinea capitis (98.6%), tinea corporis (62.1%), and tinea faciei (40.2%). With regard to age and sex, T. mentagrophytes var. interdigitalis infections were predominant in middle-aged men. M. canis affected mostly children up to 9 years with a slight predominance in girls. Data from epidemiological trend analysis such as presented in our study are important for evidence-based public health measures for the prevention and control of dermatophytoses. PMID:25230057

Kaštelan, Marija; Utješinovi?-Gudelj, Vesna; Prpi?-Massari, Larisa; Brajac, Ines

2014-01-01

135

A Molecular Epidemiological Survey of Clinically Important Dermatophytes in Iran Based on Specific RFLP Profiles of Beta-tubulin Gene  

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Full Text Available Background: Surveillance of dermatophytosis is essential to determine the likely changes in etiological trends and distribution profile of this infection. In this study beta tubulin gene (BT2, was used as the first time in a PCR-RFLP format to clarify the distribution of dermatophytosis agents in some parts of Iran.Methods: A total of 603 clinical isolates was obtained from 500 patients in Tehran, Isfahan, Mazandaran and Guilan provinces. The isolates were identified using macro/micro-morphological criteria and electrophoretic patterns of PCR amplicons of BT2after digestion with each of the restriction enzymes FatI, HpyCH4V, MwoI and Alw21I.Results: Among the patients, 59.2% were male and 40.8% female. The most prevalent clinical form was tinea pedis (42.4%, followed by tinea cruris (24.2%, tinea unguium (12.3%, tinea corporis (10.8%, tinea faciei (4%, tinea manuum (3.14%, tinea capitis (3% and tinea barbae (0.16%, respectively. Trichophyton interdigitale ranked the first, followed by T. rubrum, Epidermophyton floccosum, Microsporum canis, T. tonsurans, T. erinacei and T. violaceum (each 0.49% and the less frequent species were T. schoenleinii, M. gypseum and T. anamorph of Arthroderma benhamiae (each 0.16%. A case of scalp infection by E. floccosum was an exceptional event in the study. No case of T. verrucosum was found.Conclusion: Trichophyton species and E. floccosum are yet the predominant agents of infection in Iran, while Microsporum species are decreasing. T. interdigitale and Tinea pedis remain as the most causal agent and clinical form of dermatophytosis, respectively. It seems that BT2 can be a useful genetic marker for epidemiological survey of common pathogenic dermatophytes.

Mahdi Abastabar

2013-09-01

136

Epidemiological survey of dermatophytosis in Tehran, Iran, from 2000 to 2005  

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Full Text Available Background: Cutaneous fungal infections are common in Tehran, Iran, and causative organisms include dermatophytes, yeasts and non-dermatophyte molds. The prevalence of superficial mycosis infections has risen to such a level that skin mycoses now affect more than 20-25% of the world?s population, making them the most frequent form of infection. Aims: Our aim was to determine the prevalence of superficial cutaneous fungal infections especially dermatophytosis in our Medical Mycology Laboratory in the Pasteur Institute of Iran, Tehran. Methods: A total of 17,573 specimens were collected from clinically suspected tinea corporis, tinea cruris, tinea capitis, tinea faciei, tinea pedis, tinea manuum and finger and toe onychomycosis from 2000 to 2005. Patients were referred to our laboratory for direct examination, fungal culture and identification. The incidence of each species was thus calculated. Results: Dermatophytes remain the most commonly isolated fungal organisms, except from clinically suspected finger onychomycosis, in which case Candida species comprise> 7% of the isolates. Epidermophyton floccosum remains the most prevalent fungal pathogen and increased incidence of this species was observed in tinea cruris. Trichophyton tonsurans continues to increase in incidence. Conclusion: This study identifies the epidemiologic trends and the predominant organisms causing dermatophytosis in Tehran, Iran. These data can be used to ascertain the past and present trends in incidence, predict the adequacy of our current pharmacologic repertoire and provide insight into future developments. Consideration of the current epidemiologic trends in the incidence of cutaneous fungal pathogens is of key importance to investigational effort, diagnosis and treatment.

Bassiri-Jahromi Shahindokht

2009-01-01

137

Snakes from coastal islands of State of São Paulo, Southeastern Brazil / Serpentes das ilhas costeiras do Estado de São Paulo, Sudeste do Brasil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Há poucos estudos sobre a fauna de serpentes em ilhas costeiras do Estado de São Paulo, Sudeste do Brasil e um baixo número de espécies depositadas em coleções zoológicas. No Brasil, pela primeira vez, foi realizado um inventário em 18 ilhas do litoral paulista a partir de pesquisa de registros nas [...] coleções herpetológicas do Sudeste do Brasil. Também foram realizadas coletas de campo em onze ilhas. Trinta e seis espécies de quatro famílias foram registradas: uma espécie de Boidae, trinta de Colubridae, uma de Elapidae e quatro de Viperidae. Os dados de campo apresentaram treze ocorrências novas de espécies sem registro nas coleções. Para estimar a raridade das espécies utilizaram-se categorias de abundância relativa: comum, não-freqüente e rara. Das espécies amostradas, 44,4% foram consideradas raras. As espécies mais comuns foram Micrurus corallinus, presente em doze ilhas; Bothrops jararaca e Liophis miliaris, presentes em onze ilhas, B. jararacussu e Chironius bicarinatus, presentes em 10 ilhas. Foram efetuados sete novos registros para a Ilha do Cardoso (25° 05’ S e 47° 59’ W): C. bicarinatus, C. multiventris, Dipsas petersi, Echinanthera bilineata, E. cephalostriata, Helicops carinicaudus e Xenodon neuwiedii; três para Ilha Comprida (24° 54’ S e 47° 48’ W): B. jararacussu, C. bicarinatus e H. carinicaudus; um para Ilha Anchieta (23° 32’ S e 45° 03’ W): Spilotes pullatus; um para a Ilha das Couves (23° 25’ S e 44° 52’ W): L. miliaris; um para a Ilha dos Porcos (23° 23’ S e 44° 54’ W): B. jararaca. B. alcatraz e B. insularis, endêmicos à Ilha de Alcatrazes e à Ilha da Queimada Grande, respectivamente, são considerados criticamente em perigo segundo IUCN. Foi registrada a extinção da fauna de serpentes na Ilha Monte de Trigo. Os ecossistemas insulares, mais vulneráveis que os continentais, carecem de uma proteção mais efetiva. A maioria destas espécies (cerca de 52%) preda anfíbios, reforçando a necessidade de conservação das florestas. Abstract in english There are relatively few studies on snake fauna from coastal islands of the State of São Paulo (SSP), Southeastern Brazil and the number of species housed in Brazilian institutional zoological collections is relatively limited. In Brazil, for the first time, a snake inventory for eighteen islands of [...] coastal SSP is presented. Here we record data from sampling on eleven islands as well information on vouchered species in the main herpetological collections. Thirty-six species from four families: one Boidae, thirty Colubridae, one Elapidae and four Viperidae from eighteen islands are listed as well as the thirteen new island records for snakes. Relative abundance categories were used for species rarity: common, infrequent and rare; 44.4% of the snakes with voucher specimens were considered rare. The most common species in twelve of the eighteen islands was Micrurus corallinus; in eleven of the eighteen islands were Bothrops jararaca and Liophis miliaris; in ten of the eighteen islands were B. jararacussu and Chironius bicarinatus. The most common snake species on coastal islands were Micrurus corallinus which was found in twelve of the eighteen islands, followed by Bothrops jararaca and Liophis miliaris found on eleven of the eighteen islands and B. jararacussu and Chironius bicarinatus which were found in ten of the eighteen islands studied. There are seven new records of snake species for Cardoso Island (25° 05’ S and 047° 59’ W): C. bicarinatus, C. multiventris, Dipsas petersi, Echinanthera bilineata, E. cephalostriata, Helicops carinicaudus and Xenodon neuwiedii; three new records for Comprida Island (24° 54’ S and 47° 48’ W): B. jararacussu, C. bicarinatus and H. carinicaudus; one for Anchieta Island (23° 32’ S and 045° 03’ W): Spilotes pullatus; one for Couves Island (23° 25’ S and 44° 52’ W): L. miliaris; one for Porcos Island (23° 23’ S and 44° 54’ W), B. jararaca. The endemi

Paulo José Pyles, Cicchi; Marco Aurélio de, Sena; Denise Maria, Peccinini-Seale; Marcelo Ribeiro, Duarte.

138

Indications, diagnostic yields and complications of transbronchial biopsy over 5 years in the State of Qatar  

International Nuclear Information System (INIS)

To review the indications, diagnostic yields and complications of transbronchial biopsy (TBB) in a tertiary hospital in the State of Qatar. A retrospective review of our records revealed 1006 adult flexible fibre optic bronchoscopies (FFB) at Hamad General Hospital, State of Qatar between January 1999 and December 2003. A total of 85 (8.4%) TBB were performed, but complete data were available for 71/85 (83.5%), which were reviewed for indications, diagnostic yields and complications. Adequate samples were obtained in 58/71 TBBs (81.7%), while 13/71 TBBs (18.3%) yielded mucosa. The main indications in 16/71 (22.5%) TBBs for radiographic localized pulmonary diseases were to rule out (TB) in 13 cases, and malignancy in 3 cases. Tuberculosis was verified in 3 (23%) of 13 cases with localized disease. 45 out of 71 (77.5%) TBBs were performed for radiographic diffuse pulmonary disease: 16/55 (29%) for miliary shadows, while 39/55 (70.9%) were carried out for reticular /reticulonodular infiltrates. Histopathology showed granulomatous lesions consistent with TB in 10/16 (62.5%) cases of miliary shadow. In other pattern of diffuse disease, the histopathological diagnosis were obtained in 25/39 (64%) cases. It showed non-specific pulmonary fibrosis in 13 cases, sarcoidosis in 4 cases, connective tissue disease associated interstitial fibrosis in 4 cases, bronchiolitis obliterans organizing pneumonia (BOOP) in one case, eosinophilic pneumonia in one case, amiodarone toxicity in monia in one case, amiodarone toxicity in one case and lymphangitis carcinomatosis in one case. The main complications were minor bleeding <50 cc in 17 cases (23.9%) pneumothorax in 7 cases (9.8%) and one case has sepsis. Our experience substantiates previous reports of the value and safety of transbronchial biopsy in rapid diagnosis smear-negative miliary TB. In diffuse lung diseases of a non-infectious nature, other than sarcoidosis, lymphangitis carcinomatosis and few other conditions, a pathological diagnosis are much less likely to be reliably made on small pieces of tissue such as those provided by TBB . (author)

139

CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities  

International Nuclear Information System (INIS)

Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities. CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies. Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance. (orig.)

140

The snake community of Serra do Mendanha, in Rio de Janeiro State, southeastern Brazil: composition, abundance, richness and diversity in areas with different conservation degrees / A comunidade de serpentes da Serra do Mendanha, Estado do Rio de Janeiro, Sudeste do Brasil: composição, abundância, riqueza e diversidade em áreas com diferentes graus de conservação  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Estudamos e comparamos parâmetros da comunidade de serpentes da Serra do Mendanha, Estado do Rio de Janeiro, Brasil (22º 48'-22º 51' S e 43º 28'-43º 31' W), tais como: distribuição de abundância, riqueza e diversidade de espécies e biomassa total, entre áreas florestadas, áreas em regeneração e área [...] s agrícolas (bananais); para obter informações sobre a história natural e facilitar o desenvolvimento de futuros estudos. Para a captura dos animais foram usadas armadilhas de queda (pitfalls) com cercas-guia e procura visual (diurna e noturna) ao longo de quatro transectos por ambiente. As serpentes capturadas foram identificadas, medidas com trena e paquímetro, pesadas com dinamômetro e sexadas com uso de cateter. Um exemplar por espécie foi fixado e depositado como material testemunho no Museu Nacional, Rio de Janeiro. Os demais indivíduos coletados foram marcados (com corte de escamas ventrais) e soltos. Empreendemos um esforço de cerca de 840 h/homem, resultando na captura de 207 serpentes pertencentes a 25 espécies (Colubridae 80,2%, Elapidae 12,6%, Viperidae 6,3% e Boidae 0,9%). As três espécies mais abundantes foram Liophis miliaris (n = 33), Micrurus corallinus e Chironius fuscus (ambas com n = 26), sendo as três menos abundantes Elapomorphus quinquelineatus, Siphlophis compressus e Tropidodryas serra (todas com n = 1). Contribuíram com a maior biomassa Spilotes pullatus (7.925 g), Chironius laevicollis (4.694 g), Liophis miliaris (3.675 g) e Pseustes sulphureus (3.050 g). As que menos contribuíram foram Siphlophis compressus, Tropidodryas serra (ambas com 4 g) e Elapomorphus quinquelineatus (3 g). Encontramos diferenças significativas nos parâmetros estudados entre os três tipos de ambientes amostrados na Serra do Mendanha (mata pouco perturbada, mata secundária e monocultura de bananeiras). Os resultados indicaram uma acentuada redução na abundância, riqueza, diversidade e biomassa de serpentes quando a floresta nativa é substituída pela monocultura de bananeiras. Abstract in english We studied and compared parameters of the snake community of the Serra do Mendanha, Rio de Janeiro State, southeastern Brazil (22º 48'-22º 51' S and 43º 31'-43º 28' W), such as: abundance distribution, richness, species diversity and biomass, between forested areas, areas under regeneration and agri [...] culture areas (banana plantations); to obtain information about the natural history and facilitate the development of future research. For capturing the snakes we used: pitfall traps, drift-fences and visual search (diurnal and nocturnal) along four transects for each habitat. The captured snakes were measured with a tape and caliper, weighed with dynamometers and sexed with the use of a catheter. The animals marked (with ventral scales cut) were released for posterior recapture. One individual per species was fixed and deposited at the Museu Nacional, Rio de Janeiro. We undertook an effort of 840 man/hour, and captured a total of 207 snakes belonging to 25 species (Colubridae 80.2%, Elapidae 12.6%, Viperidae 6.3% and Boidae 0.9%). The most abundant were: Liophis miliaris (n = 33), Micrurus corallinus and Chironius fuscus (both with n = 26); the least abundant: Elapomorphus quinquelineatus, Siphlophis compressus and Tropidodryas serra (all with n = 1). The species that contributed the greatest biomass were Spilotes pullatus (7,925 g), Chironius laevicollis (4,694 g), Liophis miliaris (3,675 g) and Pseustes sulphureus (3,050 g); those that contributed the lowest biomass were: Siphlophis compressus, Tropidodryas serra (both with 4 g) and Elapomorphus quinquelineatus (3 g). We found significant differences between the sampled habitats at the Serra do Mendanha (undisturbed forest, secondary forest and banana plantations). The results showed that a great reduction in the abundance, richness, diversity and biomass of the snakes occurs when the native forest is replaced by banana plantations.

JAL., Pontes; RC., Pontes; CFD., Rocha.

2009-08-01

 
 
 
 
141

Two Polynomial-Time Algorithms for Dual Scheduling Problems  

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Full Text Available Scheduling problems with mutiple objectives play increasing important roles in solving complicated problems apparing in the fields of economy, management , engineering, miliary affairs and society etc. In this paper, we give two polynomial-time algorithms when all tardy jobs are given for the two binary NP-hard problems 1 **and **. For the problem 1 **, schedule job k last , where **, and ** is the set of jobs which are not tardy even when processed last , L is set of tardy jobs; For the problem 1 **, schedule job k last , where ** if M is empt; else choose any job in M. In the end, we give prooves of the schedule which got from the polynomial-time algorithm is an optimal solution for the scheduling problemwith weighted agreeable condition respretively.(* Indicates a formula, please see the full text

TANG Guo-chun

2010-03-01

142

Calorific and carbon values of marine and freshwater Protozoa  

Science.gov (United States)

Calorific and carbon values were determined for a variety of marine and freshwater Protozoa ( Noctiluca miliaris, Euplotes sp., Eufolliculina sp. respectively Tetrahymena pyriformis, Paramecium caudatum), their food sources (Bacteria, Dunaliella primolecta, Ceratium hirundinella), and for Protozoa-dominated plankton samples. Most calorific values lie close to the centre of the range covering organisms in general. Low values in some marine samples probably resulted from the retention of bound water in the dried material. When all results were combined with data selected from the literature, the dependence of calorific value on carbon content was highly significant. This relationship is probably also adequately described by an energy-carbon regression through the variety of organic compounds commonly found in organisms. Calorific value expressed per unit carbon is shown to vary little in Protozoa (mean conversion factor 46 J [mg C]-1) or throughout the range of biological materials considered in this study (45 J [mg C]-1).

Finlay, B. J.; Uhlig, G.

1981-12-01

143

Encefalitis carcinomatosa / Carcinomatous encephalitis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Se comunica un caso de encefalitis carcinomatosa, en un paciente con diagnóstico de adenocarcinoma de pulmón y síndrome confusional. Esta entidad es poco conocida en relación a otras afecciones neurológicas relacionadas al cáncer. Se discute su presentación clínica, se destaca la necesidad de sospec [...] harla aun luego de obtener una tomografía computada normal y sus típicas imágenes miliares en resonancia magnética. Abstract in english We report a case of carcinomatous encephalitis in a patient with lung adenocarcinoma and confusional syndrome. This is a rare form of brain metastases. We discuss its clinical picture, the importance of suspecting it after a normal computed tomography scan and the miliary typical images at magnetic [...] resonance.

Flavio, Sánchez; Marcelo, Zylberman; Shigeru, Kozima; Gabriela, Tossen; Nebil, Larrañaga; Reinaldo, Chacon.

2004-12-01

144

Recognition of Pneumocystis carinii in foals with respiratory distress  

International Nuclear Information System (INIS)

Five 3-month-old foals presenting with fever and respiratory disease were found to have pulmonary abscesses with patchy to diffuse alveolar and interstitial pneumonia on post-mortem examination. All affected foals had evidence of Rhodococcus equi infection and had few to abundant Pneumocystis carinii cysts in the sections of affected lung. Of the 5 foals examined radiographically, 3 had a distinct reticulonodular (miliary) pattern which may aid in the ante-mortem diagnosis of P. carinii pneumonia (PCP). Leukocyte counts of foals with PCP were significantly greater than in the control group of foals with uncomplicated bacterial pneumonia. Foals with PCP tended to be more tachypnoeic than the control foals and 4 of the 5 PCP+ foals appeared dyspnoeic before death. The ante-mortem recognition of PCP may be expedited by bronchoalveolar lavage and successful treatment of foals with PCP may require the administration of adequate levels of potentiated sulphonamides

145

[Spontaneus abortion caused by Listeria monocytogenes--report of three cases].  

Science.gov (United States)

This paper describes three cases of spontaneous abortion caused by Listeria monocytogenes which were diagnosed during the outbreak of listeriosis in late 2006. Both clinical and morphological features were highly consistent. The abortion between 19 and 20 weeks of gestation was preceded by high maternal fever. The fetal disease was miliary widespread with involvement of adrenals, liver and lungs in particular. There was always present a pustular rash. Histological examination of the placentas revealed acute chorioamnionitis with massive growth of gram-positive rods in the amnion in all cases. Acute villitis and intervillous microabscesses were additionally noted in one case. The diagnosis in all reported cases was not established until fetal autopsy. The final diagnosis was confirmed by microbiological examination using samples submitted during the autopsy examination. PMID:18783138

Jezová, M; Múcková, K; Koukalová, P

2008-07-01

146

The radiographic findings in diagnosis of pulmonary lymphoma  

International Nuclear Information System (INIS)

Objective: To study the radiographic findings in the diagnosis of pulmonary lymphoma and pseudo lymphoma. Methods: Eight patients with pulmonary lymphoma and 2 with pseudo lymphoma were examined by X-ray film, tomography, and CT. Results: Single or multiple nodules or masses were observed in 8 patients with pulmonary lymphoma, shaggy borders or halo of ground-glass attenuation in 7 patients, 2 patients had multiple patchy infiltrates bilaterally, 2 had diffuse interstitial infiltrates and 1 had miliary nodules. Multiple consolidations with air bronchogram and without hilar and mediastinal lymphadenopathy were observed in 2 patients with pulmonary pseudo lymphoma. Conclusion: Radiographic findings of pulmonary lymphoma were varied, the most common findings were the nodules or masses with shaggy borders or halo of ground-glass attenuation. The specific findings of pulmonary pseudo lymphoma were multiple consolidations with air bronchogram and without hilar and mediastinal lymphadenopathy. The final diagnosis relied on pathology

147

Bayesian estimation of streptomycin pharmacokinetics.  

Science.gov (United States)

Streptomycin dose requirements were determined in an 83-year-old man with renal impairment who was being treated for miliary tuberculosis. Concentration measurements were interpreted using a Bayesian parameter estimation program. Estimated creatinine clearance (1.1 L/h) was used as a starting value for streptomycin clearance, and volume was initially assumed to be 0.3 L/kg. Bayesian estimates of clearance were close to the starting value and declined from 1.4 L/h to 0.9 L/h during the course of therapy. Volume was higher than the initial estimate (0.4-0.5 L/kg), possibly due to the patient having a low albumin and being underweight. Satisfactory concentrations were maintained for several weeks with doses of 500 mg every 36-48 h. PMID:1485376

Thomson, A H; Coote, J; MacPherson, L; Gordon, J

1992-12-01

148

Cáncer tiroideo: una causa infrecuente de obstrucción de vía aérea superior en niños: Caso clínico Thyroid carcinoma as a cause of upper airway obstruction in children: Case report  

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Full Text Available Upper airway obstruction (UAO can be a severe medical condition with a high mortality in children. We report a 10 year-old girl with UAO due to papillary thyroid carcinoma. The study confirmed a thyroid cancer. The patient was referred to our centre for the evaluation of dyspnea and hoarseness. She was admitted in severe respiratory distress. Her chest X-ray revealed a critical narrowing of the cervical trachea and extensive infiltration of the lung with a miliary pattern; CT scan revealed a thyroid mass with bilateral pulmonary dissemination. An early surgical approach with total thyroidectomy and tracheotomy was performed. The study revealed a thyroid carcinoma. The patient was then referred to a specialized centre to receive chemotherapy. Recognition of thyroid carcinoma in children requires a high suspicion index. An early CT scan and fiberoptic assessment could show UAO in many unsuspected lesions

Lisbeth Platzer M

2006-06-01

149

Cáncer tiroideo: una causa infrecuente de obstrucción de vía aérea superior en niños: Caso clínico / Thyroid carcinoma as a cause of upper airway obstruction in children: Case report  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Upper airway obstruction (UAO) can be a severe medical condition with a high mortality in children. We report a 10 year-old girl with UAO due to papillary thyroid carcinoma. The study confirmed a thyroid cancer. The patient was referred to our centre for the evaluation of dyspnea and hoarseness. She [...] was admitted in severe respiratory distress. Her chest X-ray revealed a critical narrowing of the cervical trachea and extensive infiltration of the lung with a miliary pattern; CT scan revealed a thyroid mass with bilateral pulmonary dissemination. An early surgical approach with total thyroidectomy and tracheotomy was performed. The study revealed a thyroid carcinoma. The patient was then referred to a specialized centre to receive chemotherapy. Recognition of thyroid carcinoma in children requires a high suspicion index. An early CT scan and fiberoptic assessment could show UAO in many unsuspected lesions

Lisbeth, Platzer M; Luis E, Vega-Briceño; Hernán, González D; Fernando, Iñiguez O; Cyntia, Escobar F; Francisco, Prado A.

2006-06-01

150

Chylous effusions  

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Full Text Available This paper presents 4 patients with chylothorax, and one patient with bilateral chylothorax and chyloperitoneum. The chylous effusions were of benign etiology, developed as a complication of miliary tuberculosis (1 patient, after L-2 vertebral body fracture (1 patient, and idiopathic (2 patients. The diagnosis was confirmed by the presence of chylomicrons and high content of triglycerides in the effusion, ranged 11,9-29,1 mmol/l. Lymphangiography showed multiple abnormalites of lymphatic system, the obstruction of ductus thoracicus, dilatation and convulsion of lymphatic channels, but the site of lymphatic leak was not detected. The treatment included an extended period of pleural and peritoneal drainage with total parenteral nutrition (1 patient, pleurodesis using Corynebacterium parvum (2 patients, and surgical partial parietal pleurectomy with continous drainage (1 patient. The treatment was successful in all patients.

Tomi? Ilija

2003-01-01

151

CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities  

Energy Technology Data Exchange (ETDEWEB)

Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities. CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies. Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance. (orig.)

Lucas, Susan; Andronikou, Savvas [Faculty of Health Sciences, University of the Witwatersrand, Department of Radiology, Johannesburg (South Africa); Goussard, Pierre; Gie, Robert [Stellenbosch University, Department Paediatrics, Stellenbosch (South Africa)

2012-08-15

152

Tuberculous peritonitis during pegylated interferon plus ribavirin combination therapy in a patient with chronic hepatitis C.  

Science.gov (United States)

A woman in her 70s with fever and abdominal distension was referred to our hospital for investigation. She had just finished a course of pegylated interferon and ribavirin combination therapy for chronic hepatitis C. Abdominal computed tomography revealed peritoneal thickening and ascites. QuantiFERON(®)-TB Gold was positive, ascitic adenosine deaminase was high, and fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) showed diffuse accumulation in the peritoneum. Although these findings suggested tuberculous peritonitis, we did not detect Mycobacterium tuberculosis in any bacterial cultures, ascites, or other specimens. However, laparoscopic peritoneal biopsy demonstrated a large number of miliary white nodules in the parietal and visceral peritonea. Pathological examination of these nodules revealed epidermoid granuloma with giant Langhans' cells and caseous necrosis. Finally, the diagnosed of tuberculous peritonitis was established. It is important to consider tuberculosis in patients presenting with new symptoms while receiving interferon therapy. PMID:25482910

Fukuba, Ryohei; Kawaratani, Hideto; Kubo, Takuya; Kaya, Daisuke; Aihara, Yosuke; Morioka, Chie; Noguchi, Ryuichi; Mitoro, Akira; Yoshiji, Hitoshi; Fukui, Hiroshi

2014-12-01

153

Sepsis tuberculosa gravissima: Una presentación infrecuente en paciente con tratamiento inmunosupresor / Severe disseminated tuberculosis in a patient on immunosuppressive treatment: Report of one case  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish [...] Abstract in english Patients on immunosuppressive therapy are at increased risk of developing tuberculosis. We report a 39-year-old female with an ulcerative colitis receiving prednisone, azathioprine and azulfidine that was admitted to hospital due to fever, anemia, diarrhea and hematochezia. A chest CT scan showed mu [...] ltiple miliary micronodular images diffusely distributed and mediastinal enlarged lymph nodes with central necrosis, suggestive of disseminated tuberculosis. Antituberculous treatment was started but discontinued and the patient was treated as a bronchiolitis obliterans with methylprednisolone pulses and discharged. She was readmitted in shock one week later and died. After her death cultures for Mycobacterium tuberculosis were informed as positive. The clinical picture of the patient is known as sepsis tuberculosa gravissima.

Rafael, Silva; Juan, Jara; Tulio, Soto; Pedro, Sepúlveda.

2011-06-01

154

Hepatic capillariasis in a Cape ground squirrel (Xerus inaurus : short communication  

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Full Text Available We report, for the first time, an incidental finding of Calodium hepaticum infestation in a sub-adult female Cape ground squirrel (Xerus inaurus. Post mortem examination of the squirrel revealed severe haemoperitoneum, splenomegaly and hepatomegaly with miliary white spots distributed diffusely throughout the hepatic parenchyma. Histologically the portal tracts in the liver showed granulomatous inflammation with fibrosis and numerous giant cells. Occasional adult worms were identified and there were multiple C. hepaticum eggs distributed diffusely throughout the portal tracts and the parenchyma. The spleen also contained C. hepaticum eggs. The genus Rattus is the primary host and reservoir of C. hepaticum, but C. hepaticum infections have been reported previously in other Sciuridae. Based on our findings, people should be cautious of the zoonotic potential of C. hepaticum, when they come into contact with the Cape ground squirrel.

B. Mitchell

2012-05-01

155

A case of calcified intracranial tuberculoma presenting unique MRI findings  

International Nuclear Information System (INIS)

A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T1 weighted inversion recovery sequence and heterogenously low intensity using the T2 weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed. (author)

156

Cerebral angiography of moyamoya's disease  

International Nuclear Information System (INIS)

Objective: To study the diagnostic method and bleeding mechanism of the hemorrhagic moyamoya disease. Methods: Head CT, cerebral arteriography for all and partial lumbar CSF (cerebral spinal fluid) centesis was undertaken in 67 cases of intracranial hemorrhage. Results: 67 cases of hemorrhagic moyamoya disease always involved unilateral or bilateral internal carotid and/or vertebral arterial branches with abnormal hyperplasia of small vessels at the same area. CT scan showed intracranial hemorrhagic foci in different parts clearly. Vasculitis caused by immunologic effect led to cerebral arterial stenosis or occlusion with compensatory small vascular hyperplasia. The mechanism of thinning of these vascular walls enlargement of vascular lumen, rupture of miliary or cystic aneurysms and infraependymal infarctions were due to bleeding and rebleeding. Conclusion: Percutaneous pancerebral arteriography is the main diagnostic method for Moyamoyas disease

157

An radiography study of pediatric pulmonary cryptococcosis  

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Cryptococcosis is a cosmopolitan mycotic disease caused by a yeast like fungus, Cryptococcus neoformans. Respiratory tract, as portal of entry, is the initial focus of infection. Initial pulmonary lesion may heal with or without dissemination of the disease. Authors reviewed 8 cases of confirmed cryptococcosis during Jan. 1973 to June 1981 at Seoul National University Hospital. The results are as follows: Majority of the cases are below 5 years old. The most common symptoms are fever, abdominal pain and distension, and respiratory symptoms in only 2 cases. The involved organs are liver, lymph node, spleen, meninges, and skin in the order of frequency. Chest P-A roentgenograms show both hilar enlargement with perihilar and basilar, linear and small nodular infiltrations. Miliary nodular lesions and mediastinal lymphadenopathy were also noted.

Yeon, Kyung Mo; Kim, In One [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1981-12-15

158

An radiography study of pediatric pulmonary cryptococcosis  

International Nuclear Information System (INIS)

Cryptococcosis is a cosmopolitan mycotic disease caused by a yeast like fungus, Cryptococcus neoformans. Respiratory tract, as portal of entry, is the initial focus of infection. Initial pulmonary lesion may heal with or without dissemination of the disease. Authors reviewed 8 cases of confirmed cryptococcosis during Jan. 1973 to June 1981 at Seoul National University Hospital. The results are as follows: Majority of the cases are below 5 years old. The most common symptoms are fever, abdominal pain and distension, and respiratory symptoms in only 2 cases. The involved organs are liver, lymph node, spleen, meninges, and skin in the order of frequency. Chest P-A roentgenograms show both hilar enlargement with perihilar and basilar, linear and small nodular infiltrations. Miliary nodular lesions and mediastinal lymphadenopathy were also noted

159

Lung deposits of Lipiodol in normal and cirrhotic rats  

International Nuclear Information System (INIS)

The distribution of Lipiodol in the liver and lungs following arterial or portal injection was studied in normal (n=55) and cirrhotic rats (n=20). Using magnified xeroradiography and radioisotope labeled tracers, it was found that Lipiodol was deposited mainly in the liver and lung after either arterial or portal administration. In control rats after arterial injection, deposits in the lung peaked after 2 hours and gradually declined over 48 hours; whereas after portal injection, the deposit steadily increased for 48 hours. Twenty-five percent of cirrhotic rats demonstrated a Lipiodol-induced miliary pattern in the lung. An increased number of portosystemic shunts in cirrhotic rats was also noted. These results suggest that cirrhosis of the liver may be a potential risk factor for developing pulmonary complications after Lipiodol administration. (orig.)

160

Lung deposits of Lipiodol in normal and cirrhotic rats  

Energy Technology Data Exchange (ETDEWEB)

The distribution of Lipiodol in the liver and lungs following arterial or portal injection was studied in normal (n=55) and cirrhotic rats (n=20). Using magnified xeroradiography and radioisotope labeled tracers, it was found that Lipiodol was deposited mainly in the liver and lung after either arterial or portal administration. In control rats after arterial injection, deposits in the lung peaked after 2 hours and gradually declined over 48 hours; whereas after portal injection, the deposit steadily increased for 48 hours. Twenty-five percent of cirrhotic rats demonstrated a Lipiodol-induced miliary pattern in the lung. An increased number of portosystemic shunts in cirrhotic rats was also noted. These results suggest that cirrhosis of the liver may be a potential risk factor for developing pulmonary complications after Lipiodol administration. (orig.).

Chiang, J.H.; Cheng, H.C.; Yang, M.C.M.; Lo, J.G.; Chi, C.W.; Lui, W.Y.; Liu, R.S.; Chang, T. (Veterans General Hospital, Taipei (Taiwan). Dept. of Radiology Veterans General Hospital, Taipei (Taiwan). Dept. of Medical Research Veterans General Hospital, Taipei (Taiwan). Dept. of Surgery Veterans General Hospital, Taipei (Taiwan). Dept. of Nuclear Medicine National Tsing Hua Univ., Hsinchu (Taiwan). Inst. of Nuclear Science)

1991-11-01

 
 
 
 
161

Radiodiagnosis of pulmonary lesions in a severe closed chest trauma  

International Nuclear Information System (INIS)

The results of X-ray examination of 548 persons with a severe closed chest trauma were summed up. Urgent chest X-ray examination included panoramic roentgenography or electroroentgenography of the chest in two projections performed mostly in a special wheelchair without resetting and turning the patients. Dynamic X-ray control was used afterwards. Pulmonary lesions developed most frequently in a closed chest trauma. Roentgenosemiotics of lung contusion was characterized by a variety of symptoms and determined by the nature of a contusion syndrome. Infiltrate like, cavitary, miliary and peribronchial forms of lung contusion should be distinguished by an X-ray picture. In lung rupture, pneumothorax was detected in 33%, pneumohemothorax in 56%, emphysema of the chest soft tissues in 28%, mediastinal emphysema in 4% of the cases

162

Radiologic observation of renal tuberculosis  

International Nuclear Information System (INIS)

Radiographic findings of thirty eight cases of renal tuberculosis treated at this hospital during last 4 years were analysed with following results. The cases examined were 24 male and 14 female patients. Age distribution was broad and evenly distributed ranging from 2nd decades to 5th decades. Main symptoms complained were urinary frequency, hematuria, dysuria and flank pain. Findings of physical examination revealed tenderness of costovertebral angle, palpable mass on flank area and epididymal indutration. The simple chest films showed pulmonary tuberculosis in 22 cases including 6 cases of active military type. Thirty one cases showed increased ESR, 8 cases showed AFB positive in urine and 12 cases showed bilateral renal tuberculosis. Through urographic findings nonvisualization, cyceopelviectasis, motheaten appearance of minor calyx, contracted bladder, delayed visualization, ureteral stricture and beading were observed in order of frequency. Five cases with miliary tuberculosis showed advanced renal lesion on urogram

163

June 2013 imaging case of the month  

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Full Text Available No abstract available. Article truncated after first page. Clinical History A 42-year-old woman complained of cough and intermittent wheezing with shortness of breath. Her previous medical history was unremarkable. Frontal and lateral (Figures 1A and B chest radiography was performed. Figure 1. Frontal (Panel A and lateral (Panel B chest x-ray. Which of the following statements regarding the chest radiograph is most accurate? 1.The chest radiograph shows no abnormalities 2.The chest radiograph shows bilateral, basal reticulation suggesting fibrotic lung disease 3.The chest radiograph shows medial left lower lobe opacities 4.The chest radiograph shows large lung volumes associated with faint cystic change 5.The chest radiograph shows numerous small nodules suggesting a miliary pattern

Gotway MB

2013-06-01

164

Tuberculosis complications after BCG treatment for urinary bladder cancer.  

Science.gov (United States)

Bacillus Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis that has been effectively used in the treatment of non-muscle invasive bladder carcinoma. The complications of this treatment are uncommon, and the causes of dissemination are still discussed. We report a case of disseminated tuberculosis in a 66-year-old smoking man without a history of pulmonary diseases, who underwent immunotherapy with BCG after the initial surgical treatment of bladder cancer. After the last BCG instillation, he developed a fever. The diagnosis of sepsis was not confirmed, and miliary pulmonary tuberculosis was suspected. The diagnosis was confirmed by clinical manifestation, computed tomography of the lungs, and histological examination. PMID:23455890

Naudži?nas, Albinas; Juškait?, R?ta; Žiaugryt?, Indr?; Unikauskas, Alvydas; Varanauskien?, Egl?; Mašanauskien?, Edita

2012-01-01

165

Sepsis tuberculosa gravissima: Una presentación infrecuente en paciente con tratamiento inmunosupresor Severe disseminated tuberculosis in a patient on immunosuppressive treatment: Report of one case  

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Full Text Available Patients on immunosuppressive therapy are at increased risk of developing tuberculosis. We report a 39-year-old female with an ulcerative colitis receiving prednisone, azathioprine and azulfidine that was admitted to hospital due to fever, anemia, diarrhea and hematochezia. A chest CT scan showed multiple miliary micronodular images diffusely distributed and mediastinal enlarged lymph nodes with central necrosis, suggestive of disseminated tuberculosis. Antituberculous treatment was started but discontinued and the patient was treated as a bronchiolitis obliterans with methylprednisolone pulses and discharged. She was readmitted in shock one week later and died. After her death cultures for Mycobacterium tuberculosis were informed as positive. The clinical picture of the patient is known as sepsis tuberculosa gravissima.

Rafael Silva

2011-06-01

166

Post-kala-azar dermal leishmaniasis associated with AIDS  

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Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

Bittencourt Achiléa

2002-01-01

167

Post-kala-azar dermal leishmaniasis associated with AIDS  

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Full Text Available Post-kala-azar dermal leishmaniasis (PKDL is rarely reported in South America. In spite of the fact that there are many reports about the association of visceral leishmaniasis and AIDS, PKDL is very uncommon in HIV-positive patients, and so far only four cases have been documented in the literature. We present another case with unusual clinicopathological aspects. The patient, a 28-year-old male, from Salvador, Bahia (an endemic area presented with clinical manifestations of visceral leishmaniasis three years after the diagnosis of AIDS. During treatment for visceral leishmaniasis he developed disseminated miliary papules. Microscopically, the skin biopsy showed a "saw-tooth" pattern with a lichenoid mononuclear infiltrate simulating lichen planus. The histopathological diagnosis was achieved through the finding of amastigotes. The authors discuss the clinicopathological aspects of this case based on a review of the specific literature.

Bittencourt Achiléa

2003-01-01

168

Isolation and Identification of Cellulolytic Bacteria from the Gut of Three Phytophagus Insect Species  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The cellulolytic bacteria from the gut of three different phytophagous insects were studied to isolate novel cellulolytic organism for biofuel industry. Among the threse, gut of P. quatuordecimpunctata larvae contained both highest no of total bacterial count (6.8x107 CFU/gut) and cellulolytic bacte [...] ria (5.42x103 CFU/gut). Fifteen different isolates were obtained from the gut of O. velox, A. miliaris and P. quatuordecimpunctata. All the isolates produced clear zone in CMC medium staining with Congo red. The isolates included Gram positive Enterococcus, Microbacterium and Gram negative Aeromonas, Erwinia, Serretia, Flavobacterium, Acenitobacter, Klebsiella, Yersinia, Xenorhabdus, Psedomonas and Photorhabdus. Out of the fifteen isolated and identified bacterial species, twelve bacterial species were novel being reported for first time as having cellulase activity.

Rajib Kumar, Shil; Suman, Mojumder; Faozia Faleha, Sadida; Myn, Uddin; Dwaipayan, Sikdar.

2014-12-01

169

Criptococose palpebral: relato de caso Palpebral cryptococcosis: case report  

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Full Text Available Relata-se o caso de uma paciente portadora de síndrome da imunodeficiência adquirida empiricamente tratada com esquema tríplice para tuberculose miliar. Durante a evolução clínica a paciente cursou com lesões comprometendo a pálpebra e conjuntiva tarsal à direita. A hipótese diagnóstica inicial foi de tuberculose ocular com comprometimento conjuntival e palpebral. A biópsia da lesão conjuntival mostrou presença do Criptococcus neoformans. Após o início do tratamento específico com anfotericina B, a paciente apresentou melhora das lesões cutâneas.This paper is about a patient with acquired immunodeficiency syndrome empirically treated for miliary tuberculosis. During the clinical evolution the patient presented lesions compromising the right eyelid and tarsal conjunctiva. The initial diagnostic hypothesis was ocular tuberculosis with conjunctival and eyelid involvement. The biopsy of the conjuctival lesion identified an encapsulated yeast-like fungus: Criptococcus neoformans. After starting treatment with B anfotericin, the cutaneus lesions cleared.

Murilo Barreto Souza

2006-04-01

170

Radiodiagnostic errors by X-ray pictures of the chest taken at bed resting patients  

International Nuclear Information System (INIS)

The roentgenological findings of 383 cases have been compared with the anatomical and pathological diagnosis of the autopsy report. In 29% the radiodiagnosis was incorrect. About 70% of the X-ray examinations had to be carried out succenturiately at bed side in bedridden patients. The error rate of the interpretation of these examinations was higher than in examinations under standardized conditions. Especially, carcinomatous lymphangiosis, miliary tuberculosis and pulmonary embolism can be diagnosed badly in those incomplete X-ray pictures caused by the clinical situation of the bed resting patients. The publication analyses the most common errors in the diagnosis of cardiac and pulmonary diseases, and they will be demonstrated in examples. (orig.)

171

Ultrasonographic and CT findings of hepatosplenic tuberculosis  

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To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis Materials and Methods: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12 patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions of the liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement of tuberculosis were analyzed. Results : There were three cases of hepatic tuberculosis, seven of splenic tuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CT findings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low density mass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonary tuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis such as lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervical lymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. Conclusion : Ultrasonography and CT were valuable in the detection and diagnosis of hepatosplenic tuberculosis.

Moon, Un Hyeon; Lee, Jeong Seok; Ko, Kang Seok; Park, Byung Ran; Yang, Dong Cheol; Im, Ju Hyeon [Kwangju Christian Hospital, Kwangju (Korea, Republic of); Kang, In Young [Kwangju Green Cross Hospital, Kwangju (Korea, Republic of)

1998-08-01

172

Technetium-99m tetrofosmin single photon emission computed tomography to detect metastatic papillary thyroid carcinoma in patients with elevated human serum thyroglobulin levels but negative I-131 whole body scan  

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AIM: The aim of this study was to evaluate the effectiveness of technetium-99m tetrofosmin (Tc-99m TF) single photon emission computed tomography (SPECT) of the neck and chest to detect metastatic lesions in papillary thyroid carcinoma (PTC) after near total thyroidectomy and radioiodine (I-131) treatment in patients who present with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). MATERIALS AND METHODS: Twenty patients with PTC treated by near total thyroidectomy and I-131 treatments were included in this study. All 20 patients had negative I-131 WBS results and elevated hTg levels (hTg 2.0 {mu}IU/ml) under thyroid-stimulating hormone (TSH) stimulation (TSH 30 {mu}IU/ml). Nineteen of the 20 cases were confirmed to have metastases by operation/biopsy histopathological findings or clinical follow-up longer than 1 year by additional morphological imaging techniques. The remaining patient has been followed up closely and has been disease free for 10 months. Tc-99m TF SPECT was performed to detect metastatic lesions. RESULTS: Tc-99m TF SPECT demonstrated lesions in 11/19 patients; a sensitivity of 57.9%. Tc-99m TF SPECT failed to demonstrate lesions in eight patients including smaller lymph nodes and miliary lung metastases. CONCLUSIONS: We conclude that Tc-99m TF SPECT is a useful additional tool to detect metastatic lesions in PTC with elevated hTg but negative I-131 WBS. However, smaller lymph nodes and miliary lung metastases may be missed.

Wu, H.-S.; Liu, F.-Y.; Huang, W.-S.; Liu, Y.-C.; Chang, C.-T.; Kao, C.-H. E-mail: d10040@www.cmch.org.tw

2003-10-01

173

Unusual radiological findings of adult-onset pulmonary tuberculosis  

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Usual chest radiographic findings in pulmonary tuberculosis are well described in radiologic literatures for both primary and postprimary phases of disease. During the last decade, many authors have enumerated the unusual manifestations of pulmonary tuberculosis in adult population. These unusual findings usually have been involved in the frequent failure of both radiologist and clinician to recognize that tuberculosis could be the cause of a abnormal chest radiograph in patients who are finally and surprisingly proven to have tuberculosis. Authors have evaluated 249 patients who were admitted and newly proven to have adult-onset pulmonary tuberculosis at Chung-Ang University Hospital from January, 1985 to December, 1986. Unusual findings were noted in 76 (30.5%) of the 249 patients with adult-onset pulmonary tuberculosis. These unusual findings most frequently could be seen in 3rd decades and showed no sex difference in incidence. A broad spectrum of abnormal findings including usual and unusual abnormalities were procedure by adult-onset pulmonary tuberculosis. The unusual radiographic findings were arbitrarily classified. Pleural effusion without parenchymal disease (10.0%), unusual location of infiltrate (5.6%) and atelectasis (3.2%) were relatively common. Hilar and / or mediastinal lymphnode enlargement (1.6%), cavity without parenchymal infiltrates (1.6%), septic lung-like infiltrates (1.6%), completely clear lungs (1.2%), miliary infiltrates (1.2%), fibrocalci%), miliary infiltrates (1.2%), fibrocalcific scar-like infiltrates (1.2%), masslike density (1.2%) and rheumatoid lung-like infiltrates (1.2%) were occasionally noted. Pneumothorax without parenchymal disease (0.4%) and bron chocutaneous fistula (0.4%) are. The recognition of these unusual findings could further improve the detection and diagnosis of adult-onset pulmonary tuberculosis

174

Cavitary Lesions and Nodular Infiltration Patterns in Multi-Drug Resistant TB and Non-Tuberculosis Mycobacterium: Comparison of Chest CT  

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Full Text Available Background/Objective: By increasing of HIV frequency, MDRTB has also increased. Clinical and laboratory findings of multi-drug resistant TB (MDRTB and non-tuberculosis mycobacterium (NTM are very similar. Maybe imaging findings help early differentiation before culture result. This study has compared cavitary lesions and nodular infiltration patterns in the chest CT of MDRTB and NTM."nPatients and Methods: A retrospective study was performed on 66 hospitalized patients (43 MDRTB and 23 NTM in Masih Daneshvari Hospital (from 2006-2009. Lung CT scans were evaluated by a radiologist and two radiology residents without any information about the culture result. Nodular infiltrations were classified into 6 patterns (tree in bud, scattered nodule, lobar nodular infiltration, cavitary nodule, macronodule, miliary pattern and cavitary lesions to thick and thin, single and multiple with lobar distribution and satellite nodule adjacent to cavity. Chi-square statistics analysis was performed."nResult: Respectively in NTM and MDRTB: Mean age (51.5%-44.8%, sex (34.8% M and 65.2 F, 58.1% M and 41.9% F, treatment history (56.5%,83.7%, scattered nodular infiltration (47.8%, 60.5%, lobar nodular infiltration (13%, 9.3%, TIB (47.8%, 46.5%, miliary pattern (0%, 0%, cavitary nodule (21.7%, 27.9%, macro nodule (nodule?10mm (43.5%, 25.6%, cavity (69.6%, 76.7%, thin wall cavity (65.2%, 46.5%, thick wall cavity (26.1%, 58.1%, satellite nodule adjacent to cavity (39.1%, 9.3%, single cavity (13%, 14%, lobar distribution of single cavity: RUL (8.7%, 4.7%, RML (0%, 0%, RLL (0%, 0%, LUL (4.3%, 4.7%, lingual (0%, 0%, LLL (0%, 4.7%, multiple cavity (56.5%, 60.5%, lobar distribution of multiple cavity: RUL (26.1%, 51.2%, RML (21.7%, 9.3%, RLL (26.1%, 23.3%, LUL (47.8%, 44.2%, lingual (26.1%, 18.6%, LLL (30.4%, 16.3%."nConclusion: Treatment history (p=0.016, satellite nodule adjacent to cavity (p=0.004, thick wall cavity (p=0.013 and multiple cavity in RUL (p=0.05 are more common in NTM with significant difference. Frequency difference in other variables was not significant (p>0.05.

Shahram Kahkouee

2010-05-01

175

Alterações fundoscópicas e sua associação clínica empacientes com tuberculose, no Distrito Federal Posterior eye lesions and their clinical association in patients with tuberculosis, in the Federal District, Brazil  

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Full Text Available OBJETIVO: Avaliar a incidência de lesões de fundo de olho em pacientes com tuberculose no Distrito Federal e identificar fatores de risco para o aparecimento dessas lesões. MÉTODOS: Em estudo prospectivo, foi realizada oftalmoscopia binocular indireta em 292 pacientes com tuberculose sistêmica. Estes pacientes foram avaliados em cinco diferentes Hospitais Regionais do Distrito Federal, entre 1ºde agosto de 1997 e 30 de julho de 1998. Análise multivariada foi aplicada para identificar associações entre a variável "lesão de fundo de olho" e as variáveis "sexo, idade, baciloscopia, HIV, localização da tuberculose, internação dos pacientes, tempo de sintomas, procedência e experiência anterior com tratamento". RESULTADOS: Os resultados deste estudo mostraram incidência de 5,5% de lesões fundoscópicas em pacientes com tuberculose. Análise multivariada mostrou que a co-infecção pelo HIV, internação dos pacientes e tuberculose miliar foram fatores de risco para a presença de lesões de fundo de olho. Quando essas características estiveram presentes simultaneamente, a probabilidade de um indivíduo apresentar estas lesões foi de 66%. CONCLUSÕES: Na avaliação da incidência de lesões de fundo de olho em pacientes com tuberculose, devem ser levadas em consideração certas características individuais, visto que fatores de risco como a co-infecção pelo HIV, tuberculose miliar, e internação, influenciaram na presença destas lesões.PURPOSE: To evaluate the incidence of eye posterior lesions in patients with tuberculosis in the Federal District, Brazil, and to identify the risk factors for the appearance of these lesions. METHODS: In a prospective study, indirect binocular ophthalmoscopy was performed in 292 patients with systemic tuberculosis. These patients were examined in five different Regional Hospitals of the Federal District, between August 1st, 1997 and July 30th, 1998. A multiple analysis was applied to identify associations between the variable "eye posterior lesion" and the variables "sex, age, bacilloscopy, HIV, tuberculosis site, patient hospitalization, duration of symptoms, origin of the patient and previous experience with treatment. RESULTS: The results showed a 5,5% incidence of posterior lesions in patients with tuberculosis. A multiple analysis showed that HIV co-infection, patient hospitalization and miliary tuberculosis were risk factors for the presence of eye posterior lesions. When these characteristics were simultaneously present, the probability of a patient to present these lesions was 66%. CONCLUSIONS: In the evaluation of the incidence of eye posterior lesions in patients with tuberculosis, certain individual characteristics should be taken in to account, since risk factors, such as HIV co-infection, miliary tuberculosis, and hospitalization, influenced the presence of these lesions.

Gustavo Federici Mendes

2003-06-01

176

Unilateral milia-type intradermal tophi associated with underlying urate subcutaneous deposition: an uncommon cutaneous presentation of gout.  

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Tophi develop during the most advanced clinical stage of gout, and are usually located on or around the joints. However, unusual skin features caused by intradermal and/or subcutaneous deposition of tophaceous material at locations other than articular regions have been reported. We present the case of a patient with a condition that has been recently termed 'miliarial gout'. which is only the second such case, to our knowledge. A 51-year-old woman, who had a chronic joint disease that had been diagnosed and treated as psoriatic arthritis, presented with multiple asymptomatic, yellowish-white, firm papules (1-3 mm in size) on erythematous areas on the outside of her left leg. On histological examination of a skin biopsy, uric acid crystals were seen in the dermis and subcutis. The patient also had a raised level of serum urate, consistent with a diagnosis of gout. Treatment with allopurinol led to rapid improvement. Intake of corticosteroids and diuretics was a possible triggering factor for the development of cutaneous tophi in this patient. PMID:23837935

Aguayo, R S; Baradad, M; Soria, X; Abal, L; Sanmartín, V; Egido, R; Gallel, P; Casanova, J M; Martí, R M

2013-08-01

177

Clinical and high-resolution computed tomographic findings in five patients with pulmonary tuberculosis who developed respiratory failure following chemotherapy  

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AIM: The purpose of this study was to describe the clinical and high-resolution computed tomographic (HRCT) findings in patients with pulmonary tuberculosis who developed respiratory failure after starting chemotherapy. MATERIALS AND METHODS: The clinical records, chest radiographs, and HRCT findings in five patients with non-miliary pulmonary tuberculosis who developed respiratory failure after starting chemotherapy were reviewed. RESULTS: Chest radiographs taken early in the course of acute respiratory failure showed progression of the original lesions with (n = 4) or without (n = 1) new areas of opacity away from the site of the original lesions. HRCT demonstrated widespread ground-glass attenuation with a reticular pattern as well as segmental or lobar consolidation with cavitation and nodules, consistent with active tuberculous foci in all five cases. Prominent interlobular septal thickening was seen in two cases. Four of the five patients had received corticosteroids. Of these five, two died and three recovered with continued corticosteroid therapy. Transbronchial biopsy in three cases showed evidence of acute alveolar damage. CONCLUSION: In selected patients with tuberculosis who develop respiratory failure following the initiation of antituberculous therapy, HRCT may be a helpful adjunct to clinical evaluation in differentiating hypersensitivity reactions (presumed to be due to the release of mycobacterial antigens) from other pulmonary complications. Akira, Mom other pulmonary complications. Akira, M. and Sakatani, M. (2001)

178

Folliculitis et perifolliculitis capitis abscedens et suffodiens controlled with a combination therapy: systemic antibiosis (metronidazole plus clindamycin), dermatosurgical approach, and high-dose isotretinoin.  

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Folliculitis et perifolliculitis capitis abscedens et suffodiens is a rare disease of unknown etiology. It is a suppurative process that involves the scalp, eventually resulting in extensive scarring and irreversible alopecia. The condition is also known as 'acne necrotica miliaris' or 'Proprionibacterium' folliculitis. Most often the disease affects men of African-American or African-Caribbean descent between 20 and 40 years of age. The clinical picture is determined by fluctuating painful fistule-forming conglomerates of abscesses in the region of the occipital scalp. The cause of scalp folliculitis is not well understood. It is generally considered to be an inflammatory reaction to components of the hair follicle, particularly the micro-organisms. These include: bacteria (especially Propionibacterium acnes, but in severe cases, also Staphylococcus aureus), Yeasts (Malassezia species) and mites (Demodex folliculorum). The initial histopathologic finding is an exclusively neutrophilic infiltration followed by a granulomatous infiltrate. The treatment of the disease is usually difficult and often disappointing. Successful treatment with isotretinoin 1 mg/kg body mass could be achieved only after regular systematic administration in the course of 3-4 months. Here we describe a patient with eruptive purulent form of the disease, which has been controlled with combination therapy: systemic antibiosis with metronidazole and clindamycin, dermatosurgical removal of single nodular formations, and isotretinoin 1 mg/kg body mass for 3-5 months. PMID:21772598

Tchernev, Georgi

2011-05-01

179

Inoperable bronchial carcinoma complicated by pulmonary tuberculosis  

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The records of 165 patients with lung cancer complicated by pulmonary tuberculosis for the period 1964-1977 were analysed. Adenocarcinoma originating in scars was relatively frequent; squamous cell carcinoma growing in caviting lesions were also found. Advanced cancer (T3 and T4) was present in 124 persons. In 130 patients lung cancer was associated with inactive fibrotic pulmonary tuberculosis, and in 35 with an active tuberculous process, with a positive sputum in 23 patients. Treatment was by radiotherapy with high energy electrons of 35-45 MeV. In 139 the tuberculous lesions was located on the same side as the irradiation fields. Prophylactic chemotherapy on account of inactive tuberculosis was given to 96 patients and withheld from 34. Patients with active tuberculosis received individually dosed intensive chemotherapy starting with a combination of three drugs. There was no manifest difference as regarded tumour regression and survival time between cases of lung cancer with tuberculosis and those without tuberculosis. The same also applied to radiosensitivity. Bacteriologically (and autoptically) confirmed re-activation of an inactive tuberculous process occured in 6 patients who had not received prophylactic chemotherapy; one of them died of acute miliary tuberculosis, four were successfully treated. There was no case of reactivation in patients who had been given prophylactic chemotherapy. (orig./AJ)AJ)

180

Development of a clinical scoring system for the diagnosis of smear-negative pulmonary tuberculosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english This study developed a clinical score based on clinical and radiographic data for the diagnosis of smear-negative pulmonary tuberculosis (SNPT). SNPT was defined as a positive culture in Ogawa in a patient with two negative sputum smears. Data from patients admitted to the emergency ward with respir [...] atory symptoms and negative acid-fast bacilli (AFB) smears was analyzed by means of logistic regression to develop the predictive score.Two hundred and sixty two patients were included. Twenty patients had SNPT. The variables included in the final model were hemoptysis, weight loss, age > 45 years old, productive cough, upper-lobe infiltrate, and miliary infiltrate. With those, a score was constructed. The score values ranged from -2 to 6. The area under the curve for the ROC curve was 0.83 (95% CI 0.74-0.90). A score of value 0 or less was associated with a sensitivity of 93% and a score of more than 4 points was associated with a specificity of 92% for SNPT. Fifty-two point twenty-nine percent of patients had scores of less than one or more than four, what provided strong evidence against and in favor, respectively, for the diagnosis of SNPT. The score developed is a cheap and useful clinical tool for the diagnosis of SNPT and can be used to help therapeutic decisions in patients with suspicion of having SNPT.

Alonso, Soto; Lely, Solari; Juan, Agapito; Carlos, Acuna-Villaorduna; Marie-Laurence, Lambert; Eduardo, Gotuzzo; Patrick Van der, Stuyft.

2008-04-01

 
 
 
 
181

Demographic And Risk Factors Related To Military Tuberculosis  

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Full Text Available Background and Aim: Tuberculosis is one the major health care problems in developing countries. Miliary tuberculosis is induced by blood dissemination of multiple tubercle bacilli, the paramount importance of accurate diagnosis of military tuberculosis is because of its dismal outcome if untreated and the chance of cure if diagnosis happens early in the course of the disorder. In this study we describe the demographic and risk factors related to military tuberculosis, which enables us to control and reduce the incidence of military tuberculosis. This ultimately reduces the mortality and morbidity consistent with this disorder. Materials and Methods: we conducted a retrospective case control study, which compares 28 patients with military tuberculosis and 56 patients with pulmonary tuberculosis as control. We reviewed all the patients' documents registered between years 1994-2004, after extracting raw data we analyzed them with chi-square and Fisher exact tests. Results and Conclusion: We found that HIV (P< 0.05 infection and lack of BCG vaccination (P< 0.05 increases the number of military tuberculosis among our patients. In addition we did not find any other significant risk factor.

M. Rasolinejad

2006-05-01

182

Tuberculosis in patients infected with the human immunodeficiency virus.  

Science.gov (United States)

A retrospective study of tuberculosis was undertaken among 125 patients infected with human immunodeficiency virus (HIV) who attended our regional infectious disease unit between 1986 and 1989. Nine TB-positive patients (five English, three Africans, one Indian) were identified. In three patients who presented with pyrexia of unknown origin and no objective evidence of any organ involvement, the diagnosis of TB was established from examination of sputum induced by nebulized hypertonic saline. Four other patients had extrapulmonary disease while another two had only pulmonary manifestations of TB. Chest radiographs from five patients were normal, while the other four showed cavities with consolidation, pleural effusion, miliary opacities and hilar enlargement, respectively. All but two mycobacterial isolates were fully sensitive to standard first-line chemotherapeutic drugs. Response to treatment was rapid and only complicated in one patient. There were no relapses following treatment without maintenance therapy after a mean follow-up of 22.2 months (range 9-48). Three patients died, of causes unrelated to TB. Tuberculosis may occur at any stage of HIV disease and is an important cause of fever in HIV-infected British patients, even when chest radiographs are normal and previous BCG vaccination has been performed. PMID:1946941

Ong, E L; Mandal, B K

1991-07-01

183

Increased incidence of tuberculosis in patients of systemic sclerosis on dexamethasone pulse therapy: A short communication from Kashmir  

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Full Text Available Background: Systemic sclerosis is a multi-systemic autoimmune disorder affecting predominantly the skin, lungs, gut and kidneys. Purpose: To report the increased incidence of tuberculosis in patients of systemic sclerosis on dexamethasone pulse (DP therapy. Methods: Forty-seven patients of systemic sclerosis were included in the study. After taking a complete history and doing a detailed physical examination, the patients were submitted to a battery of investigations including complete hemogram(CBC with erythrocyte sedimentation rate (ESR(F, Chest X-ray CXR (PA view Mantoux test and urine analysis. CBC, ESR and urine examination was done monthly and CXR were repeated six-monthly. Findings: Seven patients on DP therapy developed genitourinary tuberculosis. Four had pulmonary tuberculosis. One patient developed tubercular lymphadenitis, one patient succumbed to miliary tuberculosis. Conclusion: There is an increased incidence of tuberculosis amongst patients of systemic sclerosis on DP therapy. Limitation of the Study: There was no control group of systemic sclerosis patients not on DP therapy to rule out the confounding effect of the disease per se predisposing to tuberculosis as all our patients as a matter of routine were put on steroid pulse. Also, the increased incidence of tuberculosis was detected incidentally while on monthly follow-up.

Ahmad Qazi

2008-01-01

184

Disseminated mycobacteriosis in a stranded loggerhead sea turtle (Caretta caretta).  

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A loggerhead sea turtle (Caretta caretta) was found stranded alive along the Adriatic coast close to Ancona, Italy, displaying obtundation, tachypnea, and increased respiratory effort. It died a few hours after admission, and a postmortem examination was immediately performed. Miliary yellowish nodules were evident in the liver, and a lower number in the heart, stomach, and gut wall. Hundreds of whitish nodules were scattered in the lungs, with the majority of the pulmonary parenchyma being replaced by the lesions. Histologically, all nodular lesions consisted of a small central area of necrosis with acid-fast bacilli surrounded by epithelioid cells, macrophages, and lymphocytes. Giant cells were found in the spleen and the liver. Kidneys, lungs, liver, spleen, brain, and skin lesions were inoculated aseptically onto general isolation media and selective isolation media for mycobacteria. The isolate showed a restriction pattern identical to Mycobacterium chelonae by polymerase chain reaction-restriction fragment length polymorphism. To the best of the authors' knowledge, this is the first description of a disseminated infection caused by a potentially pathogenic mycobacteria in a stranded, free-ranging loggerhead sea turtle. Veterinary staff and biologists who handle sea turtles with suspected mycobacterial disease should protect themselves appropriately. PMID:25000698

Nardini, Giordano; Florio, Daniela; Di Girolamo, Nicola; Gustinelli, Andrea; Quaglio, Francesco; Fiorentini, Laura; Leopardi, Stefania; Fioravanti, Maria Letizia

2014-06-01

185

Thoracic CT findings of behcet disease  

International Nuclear Information System (INIS)

Objective: To illustrate the thoracic CT findings of Behcet disease and to assess the CT diagnostic role in patients with Behcet disease. Methods: Thoracic CT images and medical records were retrospectively reviewed in 13 patients with thoracic Behcet disease. The diagnosis was based on the criteria set by the international study group for Behcet disease. Results: Of 13 patients, subpleural patchy consolidations were showed in 3, bilateral diffuse ground glass opacities in 3, left low lobe collapse with a right small nodule in 1, subpleural solitary pulmonary nodule in 1, bilateral pleural effusion in 2, mediastinal lymphoadenopathy in 2, diffuse bilateral miliary lung nodules in 1 during treatment. Thoracic vascular involvement was presented in 8 patients, two with superior vena cava thrombosis, one with left subclavicle artery aneurysm, one with left low pulmonary artery aneurysm and mural thrombosis, one with bilateral low pulmonary arteries and left basilar artery aneurysm, three with right pulmonary artery thrombosis in which there were two with left pulmonary artery occlusion and one with left basilar artery branch aneurysm. Conclusions: Thoracic CT findings of Behcet disease are variable and nonspecific. Contrast-enhanced CT scan can be helpful by showing thrombosis of the superior vena cava and pulmonary artery as well aneurysm of the pulmonary artery. (authors)

186

Abnormal chest shadow on CT in immunosuppressed patients  

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An abnormal chest shadow was observed on CT scans in 25 cases of 23 immunosuppressed patients. Pulmonary disease was pathologically confirmed to be pneumocystis carinii pneumonia (PC pneumonia) in four patients, cytomegalovirus pneumonia (CMV pneumonia) in one, bacterial pneumonia in seven, fungal infection in three, miliary tuberculosis in one, leukemic infiltration in two, lymphangitis carcinomatosa in three, drug-induced pneumonitis in three, and ARDS in one. In almost all patients, especially those with infectious diseases such as PC pneumonia, CMV pneumonia, and bacterial pneumonia, the abnormal shadow was wide and visible in the bilateral lung fields. We presumed that such findings as lobular shadow, centrilobular shadow, and mosaic pattern reflected the extension of disease via the respiratory tract, and that those findings are typical of infectious diseases. Because such findings as abnormal linear shadow and swelling of a broncho-vascular bundle were very frequently recognized in patients with lymphangitis carcinomatosa and frequently recognized in those with drug-induced pneumonitis, these diseases may be distinguished from other diseases. An area of slightly increased density was frequently recognized in patients with PC pneumonia, bacterial pneumonia, and drug-induced pneumonitis. Such lesions were pathologically confirmed to be located in the interstitium and/or alveolus. CT was extremely useful in comprehending the character and extension of particular diseases among various diseases. As the number of patients studied was small, the utility of CT in immunosuppressed patients requires further investigation in a larger number of patients. (author).

Tanaka, Nobuyuki; Matsumoto, Tsuneo; Nakamura, Hiroshi (Yamaguchi Univ., Ube (Japan). School of Medicine) (and others)

1992-12-01

187

Abnormal chest shadow on CT in immunosuppressed patients  

International Nuclear Information System (INIS)

An abnormal chest shadow was observed on CT scans in 25 cases of 23 immunosuppressed patients. Pulmonary disease was pathologically confirmed to be pneumocystis carinii pneumonia (PC pneumonia) in four patients, cytomegalovirus pneumonia (CMV pneumonia) in one, bacterial pneumonia in seven, fungal infection in three, miliary tuberculosis in one, leukemic infiltration in two, lymphangitis carcinomatosa in three, drug-induced pneumonitis in three, and ARDS in one. In almost all patients, especially those with infectious diseases such as PC pneumonia, CMV pneumonia, and bacterial pneumonia, the abnormal shadow was wide and visible in the bilateral lung fields. We presumed that such findings as lobular shadow, centrilobular shadow, and mosaic pattern reflected the extension of disease via the respiratory tract, and that those findings are typical of infectious diseases. Because such findings as abnormal linear shadow and swelling of a broncho-vascular bundle were very frequently recognized in patients with lymphangitis carcinomatosa and frequently recognized in those with drug-induced pneumonitis, these diseases may be distinguished from other diseases. An area of slightly increased density was frequently recognized in patients with PC pneumonia, bacterial pneumonia, and drug-induced pneumonitis. Such lesions were pathologically confirmed to be located in the interstitium and/or alveolus. CT was extremely useful in comprehending the character and extension of particular dhe character and extension of particular diseases among various diseases. As the number of patients studied was small, the utility of CT in immunosuppressed patients requires further investigation in a larger number of patients. (author)

188

Disseminated aspergillosis in two dogs in Israel.  

Science.gov (United States)

Aspergillus terreus, normally a soil or plant saprophyte, causes disseminated systemic infection, involving primarily the skeletal and the cardiopulmonary system in humans and dogs.(1, 2) We describe two cases of German shepherd dogs that were referred to Koret School of Veterinary Medicine Teaching Hospital with a history of anorexia and weakness. Case 1 suffered from neurological deficits, paraparesis and lumbar pain whereas case 2 suffered from unilateral uveitis and exophthalmus. Both dogs were treated symptomatically, but deteriorated progressively despite therapy and were therefore euthanised. Necropsy revealed disseminated aspergillosis, and numerous organs had multiple, miliary, white-yellow foci. Microscopically, these were identified as granulomas, containing fungal hyphae. Affected tissue included brain, heart, kidneys, spleen, lymph nodes and bones (case 2). Aspergillus terreus was isolated from different organs and from urine culture. We suggest that disseminated aspergillosis should be considered as a differential diagnosis in German shepherd dogs presenting with ocular disease, neurological deficits, spinal column pain, urinary system disorders, and radiographic evidence of skeletal and/or respiratory pathology. PMID:16466447

Bruchim, Y; Elad, D; Klainbart, S

2006-03-01

189

Comparison of Clinical and Radiology Manifestation of Pulmonary Tuberculosis in Younger and Elderly Patients  

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Full Text Available To study the differences of presentation pulmonary tuberculosis related with age. This study is a retrospective as case-control match in one hundred patients with pulmonary tuberculosis in Iran for five years. All patients had pulmonary tuberculosis divided in two group, younger (age<50 as control and older (age?50 as case group. Data was collected included; clinical presentation and radiology manifestation. Data were analyzed with chi-square and student's t test and p<0.05 levels were significant. In here showed that 46 patients in control (mean age 28.6±6.8 and 54 patients in case (mean age was 67.5±8 were evaluated. In case group fever and cough were less than control (p<0.005. Fibrosis was more (p<0.005 and miliary was less in case group than control group (p<0.01. In conclusion, absence of fever and cough and increase of fibrosis should not be delayed diagnosis of pulmonary tuberculosis in elderly and physicians need to have a high level suspicion of unusual manifestation of tuberculosis in elderly patients.

Ghorbani Gholamali

2007-01-01

190

Macrofaunal involvement in the sublittoral decay of kelp debris: the detritivore community and species interactions  

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The fauna associated with sea-bed accumulations of decomposing Laminaria saccharina has been studied by year-round SCUBA diving at two sites in the Clyde Sea area. Seasonal changes in density of 64 species are reported. In the autumn, large quantities of kelp are detached by storms. This weed carries with it to the sea bed a large part of its normal fauna. Additional species settle onto the weed from the plankton whilst others migrate onto it from the surrounding sea bed. Peak densities of associated species were recorded in autumn. Litter bag experiments in situ showed that, except during the summer, weed is lost from sea-bed accumulations at a faster rate when macrofaunal animals are excluded. The macrofauna therefore inhibits decomposition. The relative importance of interactive cropping by three macrodetritivores, Psammechinus miliaris (Echinodermata), Platynereis dumerilii (Polychaeta) and Gammarus locusta (Amphipoda) was studied by in situ containment of different species combinations. The presence of Gammarus with Psammechinus resulted in less weed being lost than when Psammechinus was isolated. This is because Gammarus selectively crops rotting weed, retarding frond disintegration by microbes. Platynereis retards microbial colonization of frond tissues ruptured during its feeding by repeated cropping of the same region. Weed would decompose very rapidly were it not for macrofaunal cropping. Macroalgal decay thus differs profoundly from that of vascular plants.

Bedford, A. P.; Moore, P. G.

1984-01-01

191

Invertebrate bioassays with North Sea water samples. I. Structural effects on embryos and larvae of serpulids, oysters and sea urchins  

Science.gov (United States)

Structural effects of bottom and surface water samples from two dumping grounds in the inner German Bight on the development of three meroplanktonic organisms (Pomatoceros triqueter: Polychaeta, Psammechinus miliaris: Echinodermata and Crassostrea gigas, Mollusca) were investigated. The titaniumdioxide dumping site was sampled immediately after dumping (within the visible waste trail 1 km behind the vessel), and 10 h after dumping. Samples were taken in the sewage sludge deposition area in the intervals between the usual dumping activities, regardless of the exact dumping schedule. The preserved bioassay test organisms were inspected microscopically to count percentages of “normal” larval hatch in test water samples, reference water samples and laboratory aged control water samples (5 to 10 replicates). The relative water quality at various dumping sites was expressed in terms of “net risk”-values (Woelke, 1972) compared to hatching rates observed in the controls. Larval development of P. triqueter was significantly suppressed (up to -22 % “net risk”) in trail water of the titanium dioxide dump site while the development of sea urchin larvae was still affected in the 10 h surface samples. Hatching of all test organisms in bottom-water samples from the centre of the sewage sludge dump site was affected to different degrees when compared to reference areas about 4 km north or 6 km northwest of the dumping area. The general usefulness of standardized bioassay procedures in pollution monitoring programmes is discussed. The results presented here call for further verification to minimize experimental background variability and to enlarge the catalogue of suitable effects criteria.

Klöckner, K.; Rosenthal, H.; Willführ, J.

1985-03-01

192

Case of calcified intracranial tuberculoma presenting unique MRI findings  

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A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflexia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25 mm in diameter, at the left frontal base. In MRI, the mass showed isointensity using the T/sub 1/ weighted inversion recovery sequence and heterogenously low intensity using the T/sub 2/ weighted spin echo sequence. Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors. Histologically, they consisted of calcified caseous tissue and thick collagen capsule, suggesting old calcified tuberculomas. Postoperative course was uneventful and did not result in meningitis. Antituberculous therapy of streptmycin, isoniazid and rifapicin was given for 2 weeks, started on the operative day. MRI findings were presented in detail and the guideline of antituberculous therapy to the tuberculoma was discussed.

Kinjo, Toshihiko; Mukawa, Jiro; Miyagi, Kouichi; Takara, Eiichi; Mekaru, Susumu; Ishikawa, Yasunari

1988-05-01

193

[Diagnosis delay of pleural and pulmonary tuberculosis].  

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Tuberculosis (TB) is still being endemic in our country. Time until management determines both evolution and prognosis of this condition. The aim of this work is to evaluate the delay in diagnosis of TB in a respiratory unit from a university hospital series. The authors conducted a cross-sectional study including patients with pulmonary TBC and/or pleural. An evaluation of time management was conducted from the beginning of symptoms and various consultations with reference to the date of hospitalization and treatment set up. One hundred patients were included (pulmonary TB: 68 cases, pleural TB 23 cases, miliary pulmonary TB: 4 cases, pulmonary TB associated with other extrathoracic locations: 5 cases). The mean time of patient delay and total delay institution were respectively 43.6, 25.7 and 69.3 days. Variables responsible for long delays were: number of consultations more than 3 before hospitalization, empirical antibiotic therapy, of a regional hospital first consultation and the presence of extra-respiratory impairment. The patient delay was considered long. A reorganization of the TB control program, in particular by partial decentralization of care and health education is imperative in order to improve the quality of tuberculosis management in our country. PMID:24874402

Cherif, J; Mjid, M; Ladhar, A; Toujani, S; Mokadem, S; Louzir, B; Mehiri, N; Béji, M

2014-08-01

194

Avian mycobacteriosis in psittacines: a retrospective study of 123 cases.  

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One hundred and twenty-three cases of mycobacterioses were diagnosed in psittacine birds from a total of 9,241 submissions for necropsy examination or histopathology made to the California Animal Health and Food Safety Laboratory System between 1990 and 2007. The species affected most commonly were Amazon parrots (Amazona spp.)(n = 32; 26%) and grey-cheeked parakeets Brotogeris pyrrophterus (n = 23; 18.7%). The main gross findings on necropsy examination were enlarged and mottled pale livers and spleens and thickening of the small intestinal wall with numerous pale miliary nodules on the mucosa. Microscopical examination revealed infiltration of foamy macrophages and giant cells containing acid-fast bacteria in various organs. The gene encoding mycobacterial 65 kDa heat shock protein (hsp65) was amplified by nested polymerase chain reaction (PCR) from DNA extracted from 22 cases. The species of Mycobacterium involved was determined by analysis of restriction endonuclease patterns of the PCR products. Mycobacterium genavense was detected in 19 cases and Mycobacterium avium in two cases. One parrotlet (Touit spp.) had a mixed infection of both species of mycobacteria. It is concluded that M. genavense is the primary cause of mycobacteriosis in psittacine birds and the potential for zoonotic disease should be considered, especially for immunocompromised owners. PMID:22884283

Palmieri, C; Roy, P; Dhillon, A S; Shivaprasad, H L

2013-02-01

195

[Case of sarcoidosis with myelodysplastic syndrome in an elderly woman].  

Science.gov (United States)

An 85-year-old woman, who had been given a diagnosis of myelodysplastic syndrome with refractory anemia 2 years previously and required blood transfusion once a month, was admitted with complaints of fever, general fatigue, and dry cough. A chest X-ray film showed multiple small nodules in bilateral lung fields which were not observed 1 month previously. Although smear and culture tests for acid-fast bacilli in her bronchoalveolar lavage fluid, urine, and bone marrow aspiration fluid were all negative, miliary tuberculosis was strongly suspected. Antituberculosis drugs were administered, but neither her symptoms nor chest X-ray findings improved. Five months later, right oculomotor nerve palsy, followed by left abducens nerve paralysis occurred. Lumber puncture examination revealed lymphocytosis, and increased protein and ACE levels, suggesting neurosarcoidosis. A transbronchial lung biopsy specimen demonstrated non-caseating epithelioid granulomas. Oral administration of 30 mg/day prednisolone improved her symptoms as well as the chest X-ray findings. PMID:21226301

Horie, Masafumi; Noguchi, Satoshi; Tanaka, Wakae; Yoshihara, Hisanao; Kawakami, Masaki; Suzuki, Masaru; Sakamoto, Yoshio; Oka, Teruaki

2010-12-01

196

Cytogenetical studies in five Atlantic Anguilliformes fishes  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english The order Anguilliformes comprises 15 families, 141 genera and 791 fish species. Eight families had at least one karyotyped species, with a prevalence of 2n = 38 chromosomes and high fundamental numbers (FN). The only exception to this pattern is the family Muraenidae, in which the eight species ana [...] lyzed presented 2n = 42 chromosomes. Despite of the large number of Anguilliformes species, karyotypic reports are available for only a few representatives. In the present work, a species of Ophichthidae, Myrichthys ocellatus (2n = 38; 8m+14sm+10st+6a; FN = 70) and four species of Muraenidae, Enchelycore nigricans (2n = 42; 6m+8sm+12st+16a; FN = 68), Gymnothorax miliaris (2n = 42; 14m+18sm+10st; FN = 84), G. vicinus (2n = 42; 8m+6sm+28a; FN = 56) and Muraena pavonina (2n = 42; 6m+4sm+32a; FN = 52), collected along the Northeastern coast of Brazil and around the St Peter and St Paul Archipelago were analyzed. Typical large metacentric chromosomes were observed in all species. Conspicuous polymorphic heterochromatic regions were observed at the centromeres of most chromosomes and at single ribosomal sites. The data obtained for Ophichthidae corroborate the hypothesis of a karyotypic diversification mainly due to pericentric inversions and Robertsonian rearrangements, while the identification of constant chromosome numbers in Muraenidae (2n = 42) suggests a karyotype diversification through pericentric inversions and heterochromatin processes.

Antonio Jales Moraes, Vasconcelos; Wagner Franco, Molina.

197

Utility of bone marrow aspiration in extrapulmonary tuberculosis  

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Full Text Available This study was undertaken to look for evidence of acid fast bacilli (AFB in bone marrow (BM in patients of extrapulmonary tuberculosis. Fifty cases suspected of extrapulmonary tuberculosis underwent bone marrow aspiration from sternum/illiac crest and were put on a therapeutic trial of antituberculosis therapy. All cases taken in the study responded to the therapy. The pattern of involvement were – abdominal (20, CNS (19, pericardial involvement (5, cervical lymphadenopathy (2, PUO (2, spinal (1 and miliary (1. 52% cases showed evidence of AFB in BM (on Ziehl Neelsen’s (ZN staining whereas only 4% of cases showed evidence of AFB in any other body fluid (CSF/pericardium/peritonium. Besides this, cytomorphological changes of BM showed evidence of lymphocytosis (22%, increased plasma cells (80% and prominence of macrophages (88%, thus signifying infective pathology with macrophage overactivity. So we conclude that bone marrow aspiration has a definite diagnostic value and may prove useful when other investigations are unrewarding. (Med J Indones 2002; 11: 148-52 Keywords: bone marrow aspiration, acid fast bacilli, extrapulmonary tuberculosis

H. Singh

2002-08-01

198

Múltiplos tuberculomas intracerebrais na vigência de terapia específica para tuberculose pulmonar: a propósito de um caso Intracranial tuberculomas developing during treatment of pulmonary tuberculosis: case report  

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Full Text Available A forma clássica de apresentação da neurotuberculose é a meningite. Os tuberculomas cerebrais são formas raras de neurotuberculose e resultam da disseminação hematogênica de focos distantes de infecção pelo Mycobacterium tuberculosis. Aproximadamente 1% dos pacientes com tuberculose do sistema nervoso central desenvolve tuberculomas intracranianos, poucas semanas ou meses após o início da quimioterapia tuberculostática. A involução das lesões é lenta e não necessariamente significa resistência medicamentosa ou falta de aderência ao tratamento. Descrevemos o caso, diagnosticado e tratado na 25ª Enfermaria da Santa Casa da Misericórdia do Rio de Janeiro, de um paciente imunocompetente que apresentou meningite e tuberculomas múltiplos do sistema nervoso central, durante o tratamento específico de tuberculose miliar. A literatura é revisada e o diagnóstico, terapêutica e possíveis mecanismos imunológicos são discutidos.The classical presentation of neurotuberculosis is meningitis. Intracranial tuberculomas are a rare manifestation of neurotuberculosis and are due to hematogenous dissemination of distant focuses of Mycobacterium tuberculosis infection. Around 1% of patients with central nervous system tuberculosis develop intracranial tuberculomas some weeks or months after the beginning of the specific treatment with tuberculostatic chemotherapy. The involution of the lesions is slow and does not mean drug resistance nor lack of adequate treatment. We describe the case, diagnosed and treated at the 25th Infirmary of Santa Casa da Misericórdia do Rio de Janeiro, of an immunocompetent male patient who developed meningitis and multiple intracranial tuberculomas during the specific treatment of miliary tuberculosis. The literature is revised and the diagnosis, treatment and possible immunological mechanisms are discussed.

MARIA LÚCIA VELLUTINI PIMENTEL

2000-06-01

199

[Tuberculosis in children in Romania].  

Science.gov (United States)

According to the World Health Organization and Stop TB Partnership, tuberculosis among children often remains undiagnosed, the main reported causes being lack of access to health services or because health professionals unrecognizing the signs and symptoms of tuberculosis in this age group. In Romania, consistent with TB endemic levels, the overall incidence progressively decreased from 142.2%ooo in 2002 to 82.8%ooo in 2011, incidence of TB in children 0-14 years dropped steadily from 47.2 %ooo (1784 cases) in the same "peak year"2002 to 23.6% ooo (766 cases) in 2011. The distribution of TB disease in children by counties shows variations between these, the explanations may be related both to differences in offer of the bacilli between different areas (prevalence of pulmonary patients smear and/or culture positive) and by deficiencies in the detection of cases and lack of rigor in diagnosis (variation in the incidence of TB in 0-14 years from 2.S%ooo in S?laj county up to 53.2%ooo in Maramures county in 2011). The number of serious cases of TB in children (meningoencephalitis, miliary, cavitary) still maintains a constant high annual rate (65 cases in 2011), which demonstrates the severity of endemic TB in our country. Prompt assurance of TB diagnostic and also the accurate management of TB treatment constitute the guarantee of the decrease of this disease, goal applies to all age groups. PMID:23781566

Didilescu, Cristian; Cioran, Nicoleta; Chiotan, Domnica; Popescu, Gilda

2013-01-01

200

A preliminary investigation of tuberculosis and other diseases in African buffalo (Syncerus caffer in Queen Elizabeth National Park, Uganda  

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Full Text Available A survey to determine the prevalence of bovine tuberculosis caused by Mycobacterium bovis and certain other infectious diseases was conducted on 42 free-ranging African buffaloes, (Syncerus caffer from May to June 1997 in the Queen Elizabeth National Park, Uganda. Using the gamma interferon test, exposure to M. bovis was detected in 21.6 % of the buffaloes. One dead buffalo and an emaciated warthog (Phacochoerus aethiopicus that was euthanased, were necropsied; both had miliary granulomas from which M. bovis was isolated. None of the buffaloes sampled in Sector A of the park, which has no cattle interface, tested positive for bovine tuberculosis (BTB exposure. The prevalence and distribution of BTB does not appear to have changed significantly since the 1960s, but this may be due to fluxes in the buffalo population. Serological testing for foot-and-mouth disease (FMD demonstrated positive exposure of 57.1% of the buffaloes sampled, with types A, O and SAT 1-3, which is the first known report of FMD antibodies to A and O types in free ranging African buffaloes. Foot-and-mouth disease virus types SAT 1 and SAT 3 were isolated from buffalo probang samples. Two percent of the buffaloes had been exposed to brucellosis. None of the buffaloes tested had antibodies to rinderpest, leptospirosis or Q fever.

A.L. Michel

2010-09-01

 
 
 
 
201

Tc-99m erythromycin lactobionate inhalation scintigraphy in parenchymal lung diseases  

International Nuclear Information System (INIS)

We have investigated Technetium 99m erythromycin lactobionate (Tc 99m EL) clearance from the lungs after inhalation, in the presence of an alveolitis. Eighteen patients (6 sarcoidosis, 7 idiopathic fibrosis, and 5 miliary tuberculosis) were imaged after the patients inhaled 1,110 MBq of Tc 99m EL. Clearance half time for the first 45 min, for 24 h, and retention at 24 h correlated with percentage of lymphocytes in bronchoalveolar lavage fluid (BAL) (r=.729, r=.883, and r=.826, respectively). There was a positive correlation between peripheral penetration (PP) and forced expiratory volume in 1 s (FEV1) (r=.806) and forced vital capacity (FVC) (r=.781). Retention was more marked in sarcoidosis compared with tuberculosis (0.025< p?0.05). Radioaerosol lung imaging may reflect the pulmonary function impairment in parenchymal lung diseases. Retention of Tc 99m EL may be related to number of BAL cells or presence of a lymphocytic alveolitis. Long residency time of Tc 99m EL in the lungs implies that erythromycin can also be administered by inhalation for therapeutic purposes

202

Tc-99m erythromycin lactobionate inhalation scintigraphy in parenchymal lung diseases  

Energy Technology Data Exchange (ETDEWEB)

We have investigated Technetium 99m erythromycin lactobionate (Tc 99m EL) clearance from the lungs after inhalation, in the presence of an alveolitis. Eighteen patients (6 sarcoidosis, 7 idiopathic fibrosis, and 5 miliary tuberculosis) were imaged after the patients inhaled 1,110 MBq of Tc 99m EL. Clearance half time for the first 45 min, for 24 h, and retention at 24 h correlated with percentage of lymphocytes in bronchoalveolar lavage fluid (BAL) (r=.729, r=.883, and r=.826, respectively). There was a positive correlation between peripheral penetration (PP) and forced expiratory volume in 1 s (FEV{sub 1}) (r=.806) and forced vital capacity (FVC) (r=.781). Retention was more marked in sarcoidosis compared with tuberculosis (0.025

Durak, Hatice E-mail: hdurak@kordon.deu.edu.tr; Aktogu, Serir; Degirmenci, Berna; Sayit, Elvan; Ertay, Tuerkan; Dereli, Sevket

1999-08-01

203

Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis  

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Full Text Available Perinatal tuberculosis (TB is rarely reported, because the clinical manifestations are not specific and there is a problem in its laboratory and radiology examination which caused undiagnosed. Perinatal TB is the preferred description that encompasses TB acquired either intra uterine, during or post delivery in early newborn period. A-3- month old baby was transferred to Pediatric Emergency Hasan Sadikin Hospital because of prolong fever and unable to breastfeed. There was no problem with delivery. Lethargic, fever, tachypnea, and hepatosphlenomegali were found on physical examination. Ziehl Neelsen smear of gastric lavage yielded positive acid fast bacilli. Tuberculine test was non reactive, chest x-ray showed a miliary pattern, and cerebral spinal fluid analysis gave tuberculous meningitis interpretation. By active finding, his father and grandfather were detected as a source of TB transmission. In additon to oral antituberculosis regimen, antibiotics and prednison were also given. Septic shock and disseminated intravascular coagulation were occurred during his illness and the baby died. Staphylococcus haemolyticus was identified from blood culture. In conclusion, although there were no problems during labor, active investigation of perinatal TB possibility is required on the family with a source of TB. Caution on TB in pregnant women is necessary at developing country with high rates of TB.

Heda Melinda D. Nataprawira

2014-10-01

204

Tuberculosis in patients with myelodysplastic syndromes  

International Nuclear Information System (INIS)

AIM: The purpose of our study was to describe radiological manifestations of tuberculosis in patients with myelodysplastic syndromes. MATERIALS AND METHODS: Chest radiographs and CTs of 12 patients with tuberculosis among 195 consecutive patients with myelodysplastic syndrome, proved by bone marrow biopsy, were reviewed. Six of the 12 patients presented with tuberculosis and were subsequently found to have myelodysplastic syndrome. RESULTS: Chest radiographs and CTs revealed pulmonary tuberculosis in all 12 patients and extrapulmonary tuberculous involvement in six (50%). Initial chest radiographic findings of pulmonary tuberculosis included a primary pattern (n = 6), a post-primary pattern (n = 3), a miliary pattern (n = 1), atypical infiltrates (n = 1) and normal radiograph (n = 1). Tuberculosis involved extrathoracic lymph nodes (n = 5), liver (n = 2), spleen (n = 2), kidney (n 2), bowel (n = 2), pericardium (n = 2) peritoneum (n = 1) and rib (n = 1). CONCLUSION: Tuberculosis is a relatively common cause of infection in patients with myelodysplastic syndromes. The radiological appearance of pulmonary tuberculosis in myelodysplastic syndromes is often a primary pattern, and there is frequently extrapulmonary involvement. Kim, H-C. et al. (2002)

205

Tuberculosis in patients with myelodysplastic syndromes  

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AIM: The purpose of our study was to describe radiological manifestations of tuberculosis in patients with myelodysplastic syndromes. MATERIALS AND METHODS: Chest radiographs and CTs of 12 patients with tuberculosis among 195 consecutive patients with myelodysplastic syndrome, proved by bone marrow biopsy, were reviewed. Six of the 12 patients presented with tuberculosis and were subsequently found to have myelodysplastic syndrome. RESULTS: Chest radiographs and CTs revealed pulmonary tuberculosis in all 12 patients and extrapulmonary tuberculous involvement in six (50%). Initial chest radiographic findings of pulmonary tuberculosis included a primary pattern (n = 6), a post-primary pattern (n = 3), a miliary pattern (n = 1), atypical infiltrates (n = 1) and normal radiograph (n = 1). Tuberculosis involved extrathoracic lymph nodes (n = 5), liver (n = 2), spleen (n = 2), kidney (n 2), bowel (n = 2), pericardium (n = 2) peritoneum (n = 1) and rib (n = 1). CONCLUSION: Tuberculosis is a relatively common cause of infection in patients with myelodysplastic syndromes. The radiological appearance of pulmonary tuberculosis in myelodysplastic syndromes is often a primary pattern, and there is frequently extrapulmonary involvement. Kim, H-C. et al. (2002)

Kim, Hyo-Cheol; Goo, Jin Mo; Kim, Hyun Beom; Lee, Joon Woo; Seo, Joon Beom; Im, Jung-Gi

2002-05-01

206

Organizing safety: conditions for successful information assurance programs.  

Science.gov (United States)

Organizations must continuously seek safety. When considering computerized health information systems, "safety" includes protecting the integrity, confidentiality, and availability of information assets such as patient information, key components of the technical information system, and critical personnel. "High Reliability Theory" (HRT) argues that organizations with strong leadership support, continuous training, redundant safety mechanisms, and "cultures of high reliability" can deploy and safely manage complex, risky technologies such as nuclear weapons systems or computerized health information systems. In preparation for the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Office of the Assistant Secretary of Defense (Health Affairs), the Offices of the Surgeons General of the United States Army, Navy and Air Force, and the Telemedicine and Advanced Technology Research Center (TATRC), US Army Medical Research and Materiel Command sponsored organizational, doctrinal, and technical projects that individually and collectively promote conditions for a "culture of information assurance." These efforts include sponsoring the "P3 Working Group" (P3WG), an interdisciplinary, tri-service taskforce that reviewed all relevant Department of Defense (DoD), Miliary Health System (MHS), Army, Navy and Air Force policies for compliance with the HIPAA medical privacy and data security regulations; supporting development, training, and deployment of OCTAVE(sm), a self-directed information security risk assessment process; and sponsoring development of the Risk Information Management Resource (RIMR), a Web-enabled enterprise portal about health information assurance. PMID:15650526

Collmann, Jeff; Coleman, Johnathan; Sostrom, Kristen; Wright, Willie

2004-01-01

207

Pulmonary benign metastasizing leiomyoma: a case report and literature review.  

Science.gov (United States)

Benign metastasizing leiomyoma (BML) is a rare condition that occurs in all age groups and that is particularly prevalent among women of late childbearing age. All patients have a history of uterine leiomyoma and/or myomectomy, often associated with distant metastases from the uterus, which commonly occurs in the lung. We report the case of a 32-year-old young woman suffering from chest stuffiness, labored respiration and weakness after a myomectomy performed one month earlier. The chest CT showed a diffuse miliary shadow in both sides of her lungs, but serum tumor markers such as CA125, CA199, carcinoembryonic antigen (CEA), neuron specific enolase (NSE), and CYFRA21-1 were normal. The patient underwent a lung biopsy by thoracoscopic surgery after four weeks of anti-TB treatment; there were no significant changes in the chest CT. H&E staining showed that the tumor cells had characteristics of smooth muscle cell differentiation. Immunohistochemical staining showed a low tumor cell proliferation index, which indicated that the likelihood of a malignancy was not high. There was no expression of CD10, indicating a diagnosis of pulmonary benign metastasizing leiomyoma (PBML). Smooth muscle actin (SMA) and desmin as specific markers of smooth muscle and the estrogen receptor (ER) and progesterone receptor (PR) were all strongly positive, which is characteristic of PBML. The patient was given the anti-estrogen tamoxifen for 3 months. With no radiological evidence of disease development and further distant metastasis, the patient will continue to be followed. PMID:24977035

Chen, Shi; Liu, Rui-Ming; Li, Tian

2014-06-01

208

Disseminated tuberculosis after extracorporeal shock-wave lithotripsy in an AIDS patient presenting with urosepsis.  

Science.gov (United States)

Haematogenous dissemination of undiagnosed urinary tuberculosis after performing extracorporeal shock-wave lithotripsy (ESWL) is extremely rare. Herein, we report a 41-year-old male who presented with urosepsis to the emergency room; catheterization was performed and retention resolved. He had a tattoo on his left arm and a five-year history of intravenous drug use. Blood tests indicated anaemia, leukocytosis, elevated CRP and ESR and mild hyponatraemia; haematuria, moderate bacteriuria and 2+ proteinuria on urinanalysis were observed. Chest X-ray revealed lesions suggestive of miliary tuberculosis, which was confirmed by chest CT scan. Brain CT and MRI suggested brain involvement in the setting of tuberculosis. On further investigations, HIV infection and hepatitis C seropositivity were detected and the patient remained in a coma for five days with a Glasgow Coma Scale of 6/15. Finally, the diagnosis of haematogenous dissemination of tuberculosis following lithotripsy was established. Anti-tuberculosis and anti-retroviral therapy were prescribed and monthly follow-up visits were scheduled. In conclusion, in a patient diagnosed with ureterolithiasis, a thorough history and physical examination, with specific attention to HIV and tuberculosis predisposing factors, should be carried out and preoperative screening tests considering the possibility of urinary tuberculosis are required. Finally, if urinary tuberculosis is detected, ESWL must be postponed until after appropriate treatment of tuberculosis. PMID:23970650

Tourchi, Ali; Ebadi, Maryam; Hosseinzadeh, Alireza; Shabaninia, Mahsa

2014-03-01

209

Effectiveness of BCG Vaccination in Prevention of Childhood Tuberculosis: A Prospective Study from Kishanganj, Bihar  

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Full Text Available Introduction: BCG vaccine has shown consistently high efficacy against childhood tubercular meningitis and miliary tuberculosis and other mycobacterial diseases. It is considered to be a safe vaccine with a low incidence of adverse effects. Efficacy of BCG vaccine found in different clinical trials is variable in different geography. Objectives: Study was done to assess the efficacy of BCG vac-cine. Materials and Methods: All the children who were less than three years of age and were previously BCG vaccinated and not-vaccinated, were included in this study. A total of sixty (60 vaccinated children and sixty non-vaccinated children were selected. These children were followed up prospectively for 24 months, at the end of which, it was seen whether they developed tuberculosis or not. Results: Out of these 60 children in both the cases and control groups, total number of BCG vaccinated children who developed TB were 4 (i.e. 6.6% and total number of Non-BCG vaccinated children who developed TB were 12 (i.e. 20%. Thus, the efficacy of BCG vaccine calculated in our study was 67%. Conclusion: Most studies in different parts of the world have shown that the efficacy of BCG vaccine varies from zero to eigh-ty percent. This study favors the efficacy of BCG vaccine. This vaccination strategy will be favorable for our children. Creation of awareness among the parents and family members for an early administration of BCG vaccine after child birth can be recom-mended.

Kashif Shahnawaz, Goutam Sarkar, Palash Das, Mausumi Basu, Biman Roy

2013-01-01

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Radiological patterns of childhood pulmonary tuberculosis in Khartoum state  

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This hospital based study was undertaken to determine the commonest radiological features of childhood pulmonary tuberculosis in Khartoum, and to correlate these features with the clinical symptoms and laboratory investigations. A total of hundred patients were selected from referred clinics and the paediatric wards (inpatients) of three teaching hospitals in Khartoum, during the period february 95 to april 96. Almost all the families were from low socio economic status. The peak age incidence was at (7, 8, 10) years; 50% of children had received BCG vaccination and history of contact with TB was positive in 35%. Mantoux test was positive in 79% and four cases had smear-positive sputum for AAFB. The most frequent lesion on chest radiography was lemphadenopathy in 67% of cases followed by multiple lesions which were present in 65% of cases. Consolidation was present in 49 cases , 38 showed unilateral changes, while 11 showed bilateral changes. The right and particularly the right middle and lower lobes were more frequently affected. Seven patients had pleural effusion which was sided in five, left sided in one and bilateral in one. Cavitation was present in eight cases, broncho-pneumonic changes in three and only one case had miliary mottling. Positive mantoux test and chest x-ray were present in 72 patients, while all cases with negative mantoux and negative sputum smear showed significant radiological findings. (Author)

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Pulmonary Pathology: LC22-1 PATHOLOGICAL DIVERSITY OF PULMONARY TUBERCULOSIS.  

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Tuberculosis (TB), a multi-systemic disease with myriad presentations and variable manifestations, is endemic in almost every part of the world and continues to remain the most common cause of infectious diseaserelated mortality and morbidity. The infection occurs most often via the pulmonary route through aerosols, producing pulmonary and/or extra-pulmonary disease. A remarkable feature of the organism M. tuberculosis is its ability to lie dormant within alveolar macrophages/granulomas that leads to active disease in 5-10% of immune-competent individuals; the endogenous reactivation usually causes abnormalities in the upper lobes of one or both lungs. Now, there has been a rise of progressive disease due to overt immune-suppression and emergence of drug-resistant strains. In the recent years, at autopsy, we have noted a definite affinity of the organisms for the intra-parenchymal bronchial tree with prominent or sole broncho-centric inflammation. The bronchial spread is often associated with consolidations (often in the lower lobes) and vasculitis. Many of the cases of miliary lesions are associated with diffuse alveolar damage and organizing pneumonia. PMID:25188153

Vaideeswar, Pradeep

2014-10-01

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[Cowpox virus infection in an alpaca (Vicugna pacos) - clinical symptoms, laboratory diagnostic findings and pathological changes].  

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Orthopoxvirus infections appear to be rare in South American Camelids, because only a few cases have been reported in the literature. Based on a generalized infection with cowpox virus in an alpaca, the clinical symptoms, laboratory diagnostic findings and the pathological changes are described. The case history showed a long treatment because of chronic skin lesions. The main clinical symptom was miliary papules over the entire skin. Furthermore, a bilateral mucopurulent conjunctivitis occurred as well as excessive salivation due to a severe erosive-ulcerative stomatitis. Although the animal received intensive treatment, it died 8 days after admission to the clinic. During necropsy, an erosive-ulcerative laryngitis as well as a necrotising pneumonia and lymphadenitis were observed. Histopathological examination of representative organ samples led to the diagnosis of a suspected orthopoxvirus infection. Electron microscopy and quantitative polymerase chain reaction (qPCR) of tissue samples confirmed this diagnosis. The virus could be isolated in tissue culture and a PCR with subsequent nucleotide sequencing identified cowpox virus as the causative agent for this generalised infection. PMID:24920091

Goerigk, D; Theuß, T; Pfeffer, M; Konrath, A; Kalthoff, D; Woll, D; Vahlenkamp, T W; Beer, M; Starke, A

2014-01-01

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The chest radiological manifestation in psittacosis  

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Objective: To summarize the clinical characteristics and imaging features of psittacosis. Methods: The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed. Results: The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dissociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of neutrophils might be increased. The chest X-ray and CT scan showed air-space consolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were also present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittaci. Erythromycin was effective in all 3 patients. Conclusion: Although the appearance of psittacosis on clinical findings and chest X-ray and CT scan is not characteristic, psittacosis can be diagnosed with the combination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging features of psittacosis is helpful in differential diagnosis. (authors)rs)

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Parameters from the community of leaf-litter frogs from Estação Ecológica Estadual Paraíso, Guapimirim, Rio de Janeiro State, southeastern Brazil  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Estudamos a comunidade de anuros de folhiço da EstaçãoEcológica Estadual Paraíso, em Guapimirim, estado do Rio de Janeiro, no sudeste do Brasil. Combinamos três métodosde amostragem (plots, transectos e armadilhas de queda) para apresentar dados sobre a composição de espécies, riqueza,abundância rel [...] ativa e densidade. A assembleia local foi composta por 14 espécies de anuros, pertencentes a nove famílias. Haddadus binotatus, espécie de desenvolvimento direto, foi a mais abundante durante o estudo. A densidade de anuros de folhiço estimada com base na amostragem por plots foi de4,3 ind/100m². Haddadus binotatus apresentou a maior densidade (1,1 ind/100m²). Os anuros foram registrados predominantemente durante a noite. Thoropa miliaris apresentou os maiores valores de CRC (39,0 ± 10,3 mm). As menores espécies foram Euparkerella brasiliensis (16,7 ± 2,2 mm) e E. cochranae (16,0 ± 2,7mm). Rhinella ornata apresentou a maior massa corporal média (12,1 ± 7,5 g) e E. cochranae (0,4 ± 0,2 g) a menor. A massa média total foi de 938,6 g/ha. Nossos resultados corroboram com a tendência de maiores densidades de anuros de folhiço na região Neotropical quando comparado com áreas Tropicais do Velho Mundo, tendendo a serem maiores na América Central do que na América do Sul. Abstract in english We studied the leaf-litter frog community of Estação Ecológica Estadual Paraíso, in Guapimirim, Rio de Janeiro State, southeastern Brazil. Herein we combined three sampling methods (large plots, visual encounter surveys and pit-fall traps) to present data on species composition, richness, relative a [...] bundance and densities. The local assemblage of frogs associated to the leaf-litter was composed by 14 species, belonging to nine families. Haddadus binotatus, a direct-developing frog, was the most abundant species in the community. The estimated density of the local leaf-litter frog assemblage based on plot sampling was 4.3 frogs/100 m². Haddadus binotatus had the highest density (1.1 ind/100 m²). Frogs were predominantly found at night. Thoropa miliaris had the largest values of SVL (39.0 ± 10.3 mm), whereas the smallest species were Euparkerella brasiliensis (16.7 ± 2.2 mm) and E. cochranae (16.0 ± 2.7 mm). Rhinella ornata had the highest mean body mass (12.1 ± 7.5 g), and E. cochranae the lowest (0.4 ± 0.2 g). The overall frog mass was 938.6 g/ha. Our data support that higher densities of leaf-litter frogs tend to occur in the Neotropical region compared to the OldWorld tropics, tending to be higher in Central America than in South America.

Carlos F.D., Rocha; Davor, Vrcibradic; Mara C., Kiefer; Carla C., Siqueira; Mauricio, Almeida-Gomes; Vitor N.T., Borges Júnior; Fábio H., Hatano; Angélica F., Fontes; Jorge A.L., Pontes; Thais, Klaion; Lívia O., Gil; Monique Van, Sluys.

1259-12-01

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Fiebre, derrame pleural y lesión osteolítica en paciente con infección por VIH / Fever, pleural effusion and osteolytic lesion in a patient with HIV infection  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Presentamos el caso de una paciente de 28 años que consultó por fiebre de hasta 40,8ºC, dolor pleurítico en costado derecho y aparición de una masa dolorosa en la extremidad inferior izquierda de cuatro días de evolución. Mediante tomografía axial computerizada (TAC) se objetivó la existencia de una [...] condensación en el lóbulo medio del pulmón derecho con derrame pleural asociado y patrón miliar bilateral. El estudio ecográfico de la extremidad inferior izquierda mostró una masa de partes blandas de aspecto quístico con destrucción de la cortical del peroné y destrucción ósea. La resonancia magnética confirmó la presencia de osteomielitis en el peroné izquierdo y de un absceso de partes blandas asociado. En el material obtenido por punción del citado absceso así como en tres muestras de esputo se aisló Mycobacterium tuberculosis, estableciéndose el diagnóstico de tuberculosis diseminada con afectación pulmonar miliar, osteomielitis peronea y absceso tuberculoso de partes blandas. Se inició tratamiento antituberculoso (rifampicina, isoniacida y pirazinamida) seguido, dos semanas después, de tratamiento antirretroviral (AZT, 3TC y NVP). La paciente desarrolló un cuadro de erupción cutánea generalizada que desapareció tras la sustitución de la rifampicina por etambutol. Ante la persistencia de la masa de partes blandas, tras cinco semanas de tratamiento antituberculoso se procedió al drenaje quirúrgico del absceso. La evolución posterior fue favorable, permaneciendo la paciente asintomática al mes de ser dada de alta. Abstract in english We present the case of a 28 year old patient who came for consultation on a fever of up to 40.8º C, pleuritic pain on the right side and the appearance of a painful mass in the lower left extremity of four days evolution. Computerised axial tomography (CAT) showed the existence of a condensation in [...] the middle lobe of the right lung with associated pleural effusion and bilateral miliary pattern. The echographic study of the lower left extremity showed a mass of soft parts with a cystic aspect with destruction of the cortical of the fibula and osseous destruction. Magnetic resonance confirmed the presence of osteomyelitis in the left fibula and of an abscess; Mycobacterium tuberculosis was also isolated in three samples of sputum that led to a diagnosis of disseminated tuberculosis with miliary lung affectation, peroneous osteomyelitis and tuberculous abscess of the soft parts. Anti-tuberculosis treatment was started (riphampicine, isoniacide and pirazinamide) followed, two weeks later, with antiretroviral treatment (AZT, 3TC and NVP). The patient developed a clinical picture of generalised cutaneous eruption that disappeared following the replacement of the riphampicine by etambutol. Due to the persistence of the mass of soft parts following five weeks of anti-tuberculosis treatment, we proceeded to surgical draining of the abscess. The subsequent evolution was favourable, with the patient remaining asymptomatic one month after hospital discharge.

J.I., Aláez; J., Repáraz; J., Castiello; J., Úriz; M., Barber; J., Sola.

2007-08-01

216

Fiebre, derrame pleural y lesión osteolítica en paciente con infección por VIH Fever, pleural effusion and osteolytic lesion in a patient with HIV infection  

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Full Text Available Presentamos el caso de una paciente de 28 años que consultó por fiebre de hasta 40,8ºC, dolor pleurítico en costado derecho y aparición de una masa dolorosa en la extremidad inferior izquierda de cuatro días de evolución. Mediante tomografía axial computerizada (TAC se objetivó la existencia de una condensación en el lóbulo medio del pulmón derecho con derrame pleural asociado y patrón miliar bilateral. El estudio ecográfico de la extremidad inferior izquierda mostró una masa de partes blandas de aspecto quístico con destrucción de la cortical del peroné y destrucción ósea. La resonancia magnética confirmó la presencia de osteomielitis en el peroné izquierdo y de un absceso de partes blandas asociado. En el material obtenido por punción del citado absceso así como en tres muestras de esputo se aisló Mycobacterium tuberculosis, estableciéndose el diagnóstico de tuberculosis diseminada con afectación pulmonar miliar, osteomielitis peronea y absceso tuberculoso de partes blandas. Se inició tratamiento antituberculoso (rifampicina, isoniacida y pirazinamida seguido, dos semanas después, de tratamiento antirretroviral (AZT, 3TC y NVP. La paciente desarrolló un cuadro de erupción cutánea generalizada que desapareció tras la sustitución de la rifampicina por etambutol. Ante la persistencia de la masa de partes blandas, tras cinco semanas de tratamiento antituberculoso se procedió al drenaje quirúrgico del absceso. La evolución posterior fue favorable, permaneciendo la paciente asintomática al mes de ser dada de alta.We present the case of a 28 year old patient who came for consultation on a fever of up to 40.8º C, pleuritic pain on the right side and the appearance of a painful mass in the lower left extremity of four days evolution. Computerised axial tomography (CAT showed the existence of a condensation in the middle lobe of the right lung with associated pleural effusion and bilateral miliary pattern. The echographic study of the lower left extremity showed a mass of soft parts with a cystic aspect with destruction of the cortical of the fibula and osseous destruction. Magnetic resonance confirmed the presence of osteomyelitis in the left fibula and of an abscess; Mycobacterium tuberculosis was also isolated in three samples of sputum that led to a diagnosis of disseminated tuberculosis with miliary lung affectation, peroneous osteomyelitis and tuberculous abscess of the soft parts. Anti-tuberculosis treatment was started (riphampicine, isoniacide and pirazinamide followed, two weeks later, with antiretroviral treatment (AZT, 3TC and NVP. The patient developed a clinical picture of generalised cutaneous eruption that disappeared following the replacement of the riphampicine by etambutol. Due to the persistence of the mass of soft parts following five weeks of anti-tuberculosis treatment, we proceeded to surgical draining of the abscess. The subsequent evolution was favourable, with the patient remaining asymptomatic one month after hospital discharge.

J.I. Aláez

2007-08-01

217

Tuberculose associada à AIDS: situação de região do Nordeste brasileiro Tuberculosis associated with AIDS: the position in a Northeastern region of Brazil  

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Full Text Available OBJETIVO: Investigar os principais aspectos da co-infecção pelo HIV e o Mycobacterium tuberculosis nos pacientes adultos assistidos pelo hospital de referência para doenças infecciosas do Estado do Ceará, Brasil, responsável pela notificação de 89,3% dos casos registrados no Estado, entre 1986-92. METODOLOGIA: Foram coletados dados de prontuários de pacientes maiores de 15 anos, com diagnóstico de AIDS, atendidos em hospital de referência estadual, região Nordeste do Brasil. A análise dos dados seguem o critério do Ministério da Saúde, para definição dessa doença. RESULTADOS: A tuberculose apresentou-se em 30,6% dos pacientes estudados (151/493 e foi diagnosticada até o primeiro ano após o diagnóstico da AIDS em 76,8% dos casos. Observou-se um tendência crescente na proporção de casos de tuberculose entre pacientes com AIDS conforme decresce o nível de escolaridade (INTRODUCTION: The main aspects of the HIV and Mycobacterium tuberculosis coinfection in the adult patients attended by the main reference hospital for infectious diseases in the State of Ceará, Brazil, responsible for the notification of 89.3% of the cases registered in the state between 1986 and 1992 were investigated. METHODOLOGY: Data were collected from the case histories of patients of more than 15 years of age with a diagnosis of AIDS, attended in a state reference hospital in Northeastern Brazil. The analysis of the data obeys the criteria of the Ministry of Health for the definition of this disease. RESULTS: Tuberculosis had been present in 30.6% of the patients studied (151/493 and it was diagnosed by the first year after the AIDS diagnosis in 76.8% of the cases. The proportion of AIDS cases with tuberculosis is significantly greater (p=0,032 among men (94.7% than among women (88.3%. An increased linear trend in the proportion of cases with tuberculosis was noticed in the AIDS cases according to the decrease in level of schooling (p<0,001. The direct baciloscopy of the sputum although considered a high priority exam, was made in only 72.9% of the patients, presenting positive results in 28.3% of these. The extrapulmonary form was detected in 23.9% of the cases and, among those, the miliary form in 25% and the meningitis in 16.7%. These results differ in a significant way (p<0,001 for all from the cases with tuberculosis without HIV infection in adults registered in the state in 1992 (9.8% extrapulmonary, 7.2% miliary and 3.3% meningitis. In most cases, death occurred in the presence of tuberculosis (52.3%, and only 10.6% managed to recover from the tuberculosis. CONCLUSIONS: The premature development of tuberculosis in AIDS patients, the presence of a high percentage of extrapulmonary forms and the high lethality are indicators that the prevention and control measures of these two pathologies cannot be considered separately in this State.

Ligia R. S. Kerr-Pontes

1997-08-01

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Habitat selection by anurofauna community at rocky seashore in coastal Atlantic Forest, Southeastern Brazil / Selecao de habitat por uma comunidade de anuros em um costao rochoso na Mata Atlantica costeira, sudeste do Brasil  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Costões rochosos são morros graníticos distribuídos ao longo da costa do sudeste brasileiro, com vegetação xeromórfica devido ao seu solo raso. O conhecimento sobre comunidades de anfíbios e seus padrões reprodutivos é especialmente reduzido neste tipo de ambiente. Neste estudo, nós apresentamos os [...] resultados de dois anos de monitoramento de uma comunidade de anfíbios em um costão rochoso localizado na área protegida do Parque Estadual da Serra da Tiririca, município de Niterói, estado do Rio de Janeiro, Brasil. Nós fizemos buscas diurnas e noturnas para encontrar anuros em bromélias-tanque, superfície rochosa e vegetação arbustiva. O padrão anual de atividade reprodutiva também foi estimado. Indivíduos da bromélia-tanque mais abundante no local, Alcantarea glaziouana, foram coletados e tiveram diversas variáveis mensuradas a fim de se entender a seleção de bromélias por anuros. Verificamos a influência das condições ambientais sobre a abundância dos anfíbios, e a associação entre as medidas das bromélias e a capacidade de estocar água no seu tanque. Diferenças na utilização de microhábitats e na ocupação de bromélias pelos anuros também foram investigadas, assim como também foi testada a influência das variáveis das bromélias sobre a ocorrência dos anuros nestas plantas. Foram registradas as seguintes espécies: Scinax aff. x-signatus; S. cuspidatus; S. littoreus; Thoropa miliaris e Gastrotheca sp. As bromélias foram o habitat preferido pelos anuros. O hábito noturno foi predominante para todas as espécies. Durante buscas diurnas, os espécimes foram encontrados abrigados nas axilas das folhas das bromélias. O número de machos vocalizando, assim como a abundância de anfíbios, foi associado com o período mais quente e chuvoso. Machos adultos de T. miliaris foram observados vocalizando especialmente na estação chuvosa. A precipitação e a temperatura combinadas foram positivamente correlacionadas com o número total de anfíbios capturados. Entretanto, individualmente, a precipitação não foi significativamente correlacionada, enquanto que a temperatura foi positivamente correlacionada com a abundância de anfíbios. A capacidade de armazenamento de água pelas bromélias está correlacionada com as características e tamanho da planta. Na estação chuvosa, a altura da planta e o seu diâmetro foram correlacionados com a ocorrência de anfíbios, enquanto que durante o período seco não existiu correlação entre variáveis e o uso da bromélia pelos anfíbios. As espécies registradas estão fortemente associadas ao domínio da Floresta Atlântica. Entretanto, a ocupação dos costões rochosos por anuros pode estar mais associado com modos reprodutivos especializados apresentados pelas espécies, já que não existem riachos ou poças d'água permanentes disponíveis no local. Abstract in english Rocky seashores are low granitic hills distributed along the southeastern Brazilian coast with xeric-like vegetation due to the shallow soil. Knowledge on amphibian communities and their reproductive patterns is especially reduced on this kind of environment. Herein, we present a framework of two ye [...] ars monitoring an amphibian community at a rocky seashore environment located at the protected area of Parque Estadual da Serra da Tiririca, municipality of Niterói, state of Rio de Janeiro, Brazil. We conducted diurnal and nocturnal searches for frogs in tank bromeliads, rocky surface and shrubby vegetation. Annual pattern of breeding activity of anurans was also estimated. Individuals of the most abundant tank-bromeliad, Alcantarea glaziouana were collected and measured according to several variables to understanding the selection of bromeliads by frogs. We checked the influence of the environmental conditions on amphibian abundance, association between the bromeliads measures, and the water storage in the tank. We recorded the species: Scinax aff. x-signatus; S. cuspidatus; S.

RC., Pontes; RT., Santori; FC. Goncalves e, Cunha; JAL., Pontes.

2013-08-01

219

Correlación entre linfocitos CD4 y carga viral en pacientes infectados por el virus de la inmunodeficiencia humana con tuberculosis / Correlation between CD4 lymphocytes and viral load in HIV-TB patients  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Analizar, retrospectivamente, la correlación entre los linfocitos CD4 y la carga viral en 16 pacientes (14 hombres y 2 mujeres) infectados por el virus de la inmunodeficiencia humana (VIH) con tuberculosis activa. Material y métodos: Se organizaron los siguientes grupos o formas clínicas d [...] e presentación en relación con la(s) localización(es) de la enfermedad tuberculosa: pulmonares distinguiendo entre típicas y atípicas según el patrón radiológico; extrapulmonares; mixtas, pulmonar y extarpulmonar; y tuberculosis miliar. Resultados: En 7 casos (44%) la afectación era exclusivamente pulmonar, todas ellas atípicas, en 6 (38%) extrapulmonar, en 2 (12%) mixta y en 1 (6%) miliar. La media de linfocitos CD4 fue de 111,1 (rango 5-360), en 11 (69%) los recuentos era inferiores a 200 cels/mm³. El menor recuento de CD4 se obtuvo en las formas mixtas con una media de 45 cels/mm³ mientras que el mayor recuento se obtuvo en las pulmonares con una media de 128,3 cels/mm³. La media de la carga viral fue de 4.82 log (rango, 0-5,93) siendo el título más elevado el de las formas mixtas, con una media de 5,69 log y el más bajo el de las pulmonares con una media de 4.19 log, sin hallarse correspondencia estadísticamente significativa entre ambos parámetros: linfocitos CD4 y carga viral (coeficiente de correlación - 0,1163) Conclusiones: Aunque no hemos hallado significación estadística, por lo regular, aquellos casos con CD4 más elevados presentaron una menor carga viral y los que tienen CD4 bajos una mayor carga viral. Abstract in english Objective: A retrospective study of the correlation between CD4 lymphocytes and the viral load in 16 HIV-patients with tuberculosis. Material and methods: The clinical forms of presentation of tuberculosis were classified according to the location/s of the disease into: pulmonary, distinguishing bet [...] ween typical pulmonary and atypical according to the radiological pattern; extrapulmonary; mixed forms: pulmonary and extrapulmonary; and miliary tuberculosis. Results: Tuberculosis was exclusively pulmonary in 7 cases (44%), all were atypical; extrapulmonary 6 (38%); mixed 2 (12%); and miliary 1 (6%). The mean CD4 lymphocyte count was 111. 1 (range 5-360), in 11 (69%) the counts were below 200 cells/mm³. The lowest CD4 count was in the mixed forms with a mean of 45 cells/ mm³ whilst the highest was obtained in pulmonary forms with a mean of 128.3 cells/mm³. The mean viral load was 4.82 log (range, 0-5.93), the highest load was for mixed forms with a mean 5.69 log, whereas the lowest load was for pulmonary forms with a mean of 4.19 log. No significant correlation was observed between CD4 lymphocytes and viral load (correlation coefficient - 0.1163), Conclusions: Though no significant correlation was observed, a high CD4 was associated to a low viral load and inversely a low CD4 with a high viral load.

F. L., Lado Lado; A., Prieto Martínez; E., Losada Arias; A., Cabarcos Ortiz de Barrón; A., Aguilera Guirao; M. L., Pérez del Molino.

2001-12-01

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Tuberculosis en pacientes ancianos: Formas de presentación / Tuberculosis in elderly patients: Forms of presentation  

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Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Objetivo: Analizar la distribución de las formas de presentación de tuberculosis (FPT) en pacientes de edad avanzada. Material y métodos: Se revisaron los casos de tuberculosis registrados en la Unidad de Prevención y Control de la Tuberculosis del Área Sanitaria de Santiago de Compostela en un perí [...] odo de seis años. Clasificamos las FPT en: formas pulmonares (P), definida por localización exclusivamente pulmonar; Formas extrapulmonares (FE), caracterizada por una localización extrapulmonar; Formas mixtas (FM), localización pulmonar y extrapulmonar; Formas diseminadas (FD), dos o más localizaciones extrapulmonares; y TB miliares, definida por patrón radiológico miliar y/o enfermedad diseminada en necropsia. Resultados: Se registraron un total de 278 tuberculosis, 156 (56,2%) eran varones y 122 (43,8%) mujeres. La edad media fue de 75,3 años (rango, 65-95). La distribución de FPT resultó ser: 155 (55,8%) pulmonares; 66 (23,7%) FE de las cuales 27 (41,0%) eran de localización ganglionar, 12 (18,2%) osteoarticular, 8 (12,1%) intestinal, 6 (9,1%) peritoneal, 5 (7,6%) meningea y 8 (12,0%) otras localizaciones; FM 47 casos (16,9%); TB miliares 7 casos (2,5%) y FD 3 casos (1,1%). No se observó ningún caso de pacientes infectados por el virus de la inmunodeficiencia humana. Conclusiones: En estos pacientes, se comprueba una elevada prevalencia de tuberculosis extrapulmonar. Ello nos sugiere, un cambio en la presentación clásica de la enfermedad y una extrema sensibilidad en el diagnóstico localizatorio de la enfermedad. Abstract in english Objetive: To analyse the distribution of the forms of presentation of tuberculosis (TPF) in elderly patients. Material and methods: The medical records of patients diagnosed with tuberculosis attending the Tuberculosis Prevention and Control Unit of the Santiago Health District were reviewed over of [...] six years period. The classification of TPF was: pulmonary forms (P), disease confined to the lung; extrapulmonary forms (EF), disease outside the lung; mixed forms (MF), the presence of both pulmonary and extrapulmonary tuberculosis; disseminated forms (DF), the pressence of two or more extrapulmonary locations; and miliary TB, which was definied by a diffuse pulmonary radiographic pattern or diagnosis was undertaken by necropsy. Results: A total of 278 tuberculosis infected patients were observed, 156 (56.2%) were men and 122 (43.8%) women, their mean age was 75.3 years (range 65-95). The distribution of TPF was: 155 (55.8%) P forms; 66 (23.7%) EF, of which 27 (41.0%) were ganglionary location, 12 (18.2%) bone and joint, 8 (12.0%) intestinal, 6 (9.1%) peritoneal, 5 (7.6%) meningeal, and other locations 8 (12.1%); MF 47 cases (16.9%); miliary TB 7 cases (2.5%) and. DF 3 cases (1.1%). None case was observed of HIV infected patient. Conclusions: Our findings confirm high incidence of extrapulmonary TB in elderly patients. Our experience shows a modification to the classical presentation of the disease, and thus the need for sensitivity in locating the disease.

F. L., Lado Lado; V., Tuñez Bastida; A. L., Golpe Gómez; A., Cabarcos Ortiz de Barrón; M. L., Pérez del Molino.

2002-03-01

 
 
 
 
221

Acute renal failure after rifampicin / Insuficiência renal aguda por rifampicina  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Apresentamos um paciente com tuberculose miliar a partir de um foco crônico urogenital. Em sua entrada no hospital tinha uma função renal limítrofe e desenvolveu franca insuficiência renal na vigência da terapêutica específica constituída por RMP, INH e EMB. Bióp-sia renal realizada no 3° dia de ure [...] mia revelou necrose tubular recente, com inflamação intersticial aguda, permeada por granulomas. As formações granulomatosas foram altamente sugestivas de reação alérgica à droga devido à ausência de paliçadas, alta incidência de neutrófilos e o não encontro de bacilos-álcool-ácido-resistentes. Esta é a primeira descrição de nefrite intersticial granulomatosa provavelmente causada pela RMP. São discutidos os principais aspectos fisiopatogênicos da insuficiência renal causada pela tuberculose acrescida dos efeitos nefrotóxicos da RMP. Abstract in english A patient with miliary tuberculosis and a chronic urogenital focus is described, who had a borderline renal function at diagnosis and developed overt renal failure upon daily treatment with rifampin (RMP), isoniazid (INH) and ethambutol (EMB). This is the first Brazilian report of BMP induced renal [...] damage. A renal biopsy taken on the third day of oliguria showed recent tubular necrosis with acute interstitial inflammation and granuloma formation. The aspect of the granulomatous lesion hightly suggested drug etiology because of the lack of palisading, high incidence of neutrophils and absence of facid-fast bacilli. This is the first presentation of an acute granulomatous interstitial nephritis probably due to RMP. Furthermore the pathogenesis of the renal damage caused by tuberculosis and RMP are discussed.

Adriana, Weinberg; A., Barone; Luis B., Saldanha; Mario, Shiroma.

1984-12-01

222

The role of FDG-PET/CT in the detection of recurrent colorectal cancer  

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The conventional diagnostic techniques used to assess recurrence of colorectal cancer (CRCR) often yield unspecific findings. Integrated FDG-PET/CT seems to offer promise for the differential diagnosis of benign and malignant lesions. The aim of this study was to compare the value of FDG-PET and PET/CT in the detection of CRCR subsequent to colonic resection or rectal amputation. The population for this retrospective study comprised 84 patients with suspected CRCR. The sensitivity, specificity and accuracy of PET and PET/CT were calculated for (a) intra-abdominal extrahepatic recurrences, (b) extra-abdominal and/or hepatic recurrences and (c) all recurrences, and tumour marker levels were analysed. The sensitivity, specificity and overall accuracy of PET in detecting intra-abdominal extrahepatic CRCR were 82%, 88% and 86%, respectively, compared with 88%, 94% and 92%, respectively, for PET/CT. The corresponding figures for detection of extra-abdominal and/or hepatic CRCR were 74%, 88% and 85% for PET and 95%, 100% and 99% for PET/CT. Considering the entire population, the sensitivity, specificity and overall accuracy of PET were 80%, 69% and 75%, respectively, compared with 89%, 92% and 90%, respectively, for PET/CT. FDG-PET/CT examination correctly detected 40 out of a total of 45 patients with CRCR. Two of five patients with falsely negative FDG-PET/CT findings had local microscopic recurrences and one had miliary liver metastases. Of 39 patients without CRCR, threestases. Of 39 patients without CRCR, three showed false positive FDG-PET/CT results. Two of these cases were due to increased accumulation in inflammatory foci in the bowel wall, while one was due to haemorrhaging into the adrenal gland. FDG-PET/CT appears to be a very promising method for distinguishing a viable tumour from fibrous changes, thereby avoiding unnecessary laparotomy. (orig.)

223

The role of FDG-PET/CT in the detection of recurrent colorectal cancer  

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The conventional diagnostic techniques used to assess recurrence of colorectal cancer (CRCR) often yield unspecific findings. Integrated FDG-PET/CT seems to offer promise for the differential diagnosis of benign and malignant lesions. The aim of this study was to compare the value of FDG-PET and PET/CT in the detection of CRCR subsequent to colonic resection or rectal amputation. The population for this retrospective study comprised 84 patients with suspected CRCR. The sensitivity, specificity and accuracy of PET and PET/CT were calculated for (a) intra-abdominal extrahepatic recurrences, (b) extra-abdominal and/or hepatic recurrences and (c) all recurrences, and tumour marker levels were analysed. The sensitivity, specificity and overall accuracy of PET in detecting intra-abdominal extrahepatic CRCR were 82%, 88% and 86%, respectively, compared with 88%, 94% and 92%, respectively, for PET/CT. The corresponding figures for detection of extra-abdominal and/or hepatic CRCR were 74%, 88% and 85% for PET and 95%, 100% and 99% for PET/CT. Considering the entire population, the sensitivity, specificity and overall accuracy of PET were 80%, 69% and 75%, respectively, compared with 89%, 92% and 90%, respectively, for PET/CT. FDG-PET/CT examination correctly detected 40 out of a total of 45 patients with CRCR. Two of five patients with falsely negative FDG-PET/CT findings had local microscopic recurrences and one had miliary liver metastases. Of 39 patients without CRCR, three showed false positive FDG-PET/CT results. Two of these cases were due to increased accumulation in inflammatory foci in the bowel wall, while one was due to haemorrhaging into the adrenal gland. FDG-PET/CT appears to be a very promising method for distinguishing a viable tumour from fibrous changes, thereby avoiding unnecessary laparotomy. (orig.)

Votrubova, Jana; Belohlavek, Otakar; Jaruskova, Monika [Na Homolce Hospital, PET Centre, Prague (Czech Republic); Oliverius, Martin [Institute of Clinical and Experimental Medicine, Prague (Czech Republic); Lohynska, Radka [University Hospital Motol, Department of Radiotherapy and Oncology, Prague (Czech Republic); Trskova, Kristina [Na Homolce Hospital, Department of Oncology, Prague (Czech Republic); Sedlackova, Eva [General Teaching Hospital and 1st Faculty of Medicine, Department of Oncology, Prague (Czech Republic); Lipska, Ludmila [Thomayer' s Teaching Hospital and 1st Faculty of Medicine, Department of Surgery, Prague (Czech Republic); Stahalova, Vladimira [Na Bulovce Teaching Hospital, Institute of Radiation Oncology, Prague (Czech Republic)

2006-07-15

224

Radiographic Findings of Pulmonary Tuberculosis in Tehran in Comparison with Other Institutional Studies  

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Full Text Available Background/Objective: Tuberculosis (TB is one of the most common worldwide infections, especially in developing countries. Early diagnosis is very important for prevention of the chronic form of the disease and sequel formation. Chest x-ray (CXR is an easy, feasible, non-expensive and quick tool for the diagnosis of pulmonary tuberculosis. "nPatients and Methods: We retrospectively evaluated 200 chest x-rays of secondary pulmonary TB cases in university-affiliated hospitals. These cases were all proved by a positive sputum smear or culture for mycobacterium tuberculosis. "nResults: In this study, we correlated CXR findings of 100 male and 100 female patients. The peak age of involvement in both groups was 61-80 years. None of the chest x-rays were normal. The main radiographic findings were consolidation-infiltration, fibrosis, pleural effusion, cavitation, pleural thickening and bronchiectasis. Mediastinal lymphadenopathy was detected in 9% of the cases. Pulmonary infiltration with consolidation was the most common finding (55%. Miliary shadowing, atelectasis and pneumomediastinum were the least common presentations. Lymphadenopathy was more common in 40 to 60-year-old women. Right lung involvement was more common than the left side and the upper zones were involved in most cases. The most common underlying diseases were hypertension and diabetes mellitus. Infiltration in diabetic patients and fibrotic appearances in hypertensive patients were common findings. "nConclusion: There was no significant difference between our data and the other studies carried out in Iran. The patients were younger in the studies from other countries. However, cavitary lesions were more common in other studies than this study, which seems to be due to the higher prevalence of underlying diseases such as HIV or diabetes.

A. Jamzad

2009-11-01

225

Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation  

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Full Text Available SciELO Brazil | Language: English Abstract in english PURPOSE: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. MATERIALS AND METHODS: 80 patients (56 males, 70%; median age 34 years; age range 12 to 75) with urogenital tuberculosis were retrospectively reviewed. The patient [...] s were divided in seven groups: 1) Bilateral parenchymatous renal lesions; 2) No or minimal changes on radiographic examination; 3) Unilateral renal tuberculosis; 4) Contracted bladder; 5) Contracted bladder with renal failure; 6) Tuberculosis on a transplanted kidney; 7) Isolated genital tuberculosis. RESULTS: 1) Seven (8.8%) patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2) Six (7.5%) cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3) Twelve (15%) patients had unilateral renal tuberculosis with partial (1 case) or total non-function kidney. 4) Thirty-seven (46.3%) patients had contracted bladder associated with unilateral partial (1 case) or total non-function kidney. 5) Ten (12.5%) patients had end stage renal disease due to tuberculosis with contracted bladder. 6) Four (5.0%) patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7) Four (5.0%) patients had prostate or epididymis tuberculosis without associated renal lesion. CONCLUSIONS: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic presentation. A classification according to similar patterns correlating with disease stage is feasible although early diagnosis is the only prevention of the most severe forms.

Andre A., Figueiredo; Antonio M., Lucon; Cristiano M., Gomes; Miguel, Srougi.

2008-08-01

226

Urogenital tuberculosis: patient classification in seven different groups according to clinical and radiological presentation  

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Full Text Available PURPOSE: To describe and classify 80 cases of urogenital tuberculosis in seven groups of similar clinical and radiological presentation. MATERIALS AND METHODS: 80 patients (56 males, 70%; median age 34 years; age range 12 to 75 with urogenital tuberculosis were retrospectively reviewed. The patients were divided in seven groups: 1 Bilateral parenchymatous renal lesions; 2 No or minimal changes on radiographic examination; 3 Unilateral renal tuberculosis; 4 Contracted bladder; 5 Contracted bladder with renal failure; 6 Tuberculosis on a transplanted kidney; 7 Isolated genital tuberculosis. RESULTS: 1 Seven (8.8% patients had multiple bilateral parenchymatous renal lesions with fever and malaise, characteristic of miliary tuberculosis. Three of these patients had AIDS. 2 Six (7.5% cases had an early diagnosis, with minimal or no radiographic lesions. Two did not have any urologic symptoms. 3 Twelve (15% patients had unilateral renal tuberculosis with partial (1 case or total non-function kidney. 4 Thirty-seven (46.3% patients had contracted bladder associated with unilateral partial (1 case or total non-function kidney. 5 Ten (12.5% patients had end stage renal disease due to tuberculosis with contracted bladder. 6 Four (5.0% patients had tuberculosis on a transplanted kidney, with graft loss in half the cases. 7 Four (5.0% patients had prostate or epididymis tuberculosis without associated renal lesion. CONCLUSIONS: Urogenital tuberculosis is a destructive disease of the urogenital tract with variable clinical and radiographic presentation. A classification according to similar patterns correlating with disease stage is feasible although early diagnosis is the only prevention of the most severe forms.

Andre A. Figueiredo

2008-08-01

227

Scrotal inflammation: characteristic US patterns  

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During the last 3 years (1987-1990) the authors have performed 562 ultrasound studies of the scrotum in patients ranging 6 months to 76 years of age. All patients were referred with a non-specific clinical suspicion of scrotal pathologies. Only 214/562 patients presenting with signs and symptoms of scrotal inflammation were considered for this study. Among this group of 214 patients, 34 cases of tubercolous epididymo-orchitis were identified. The remaining 180 patients were classified as follows: non specific inflammation 141, other non inflammatory pathology 39. In the group with findings of tubercolosis, all stages of disease were identified, including miliary forms as well as nodular forms. The patients were closely followed during medical terapy or until surgery was performed to study the course of the disease. For each form of disease specific US findings and differential diagnostic criteria were recognized and will be illustrated in this paper. All diagnosis of tubercolosis were confirmed either at surgery or on the basis of successful response to specific chemoterapy. US diagnosis based on the morphologic and echo texture criteria allowed high diagnostic accuracy: in fact in the whole group of 214 patients with inflammatory disease there were only 1 false positive and 1 false negative diagnosis with a sensitivity of 96.9%, a specificity of 89.9% and a diagnostic accuracy of 98.85%. The paper also stresses the importance of US in the short- and long-term follow- of US in the short- and long-term follow-up of the patients undergoing medical therapy

228

Papulonecrotic tuberculid. A clinical, histopathological, and immunohistochemical study of 15 patients.  

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We report 10 women and five men with papulonecrotic tuberculid, an uncommon form of cutaneous tuberculosis (TB). The mean age was 22.6 years (range, 2 1/2-35 years) at presentation. The Mantoux test was strongly positive in 13 patients. Five patients showed presumptive evidence of associated TB; in one case, the presence of TB was proven by culture. Response to anti-TB was dramatic in all cases. Clinical findings were similar to those previously published. We emphasize the simultaneous occurrence of erythema induratum, associated Takayasu's disease, possible associated phlebitic tuberculid, and clinical mimicry of acute bacterial endocarditis. The main histopathological findings obtained from 27 biopsy specimens included dermal necrosis (26 of 27 cases), a poorly formed granulomatous infiltrate (27 of 27 cases), vasculitis (11 of 27 cases), perivascular spongy edema (11 of 27 cases), and follicular necrosis or suppuration (five of 27 cases). A Ziehl-Neelsen stain was negative in all biopsy specimens. Immunohistochemical labeling revealed a preponderance of T-lymphocytes (UCHL-1+), monocytes-macrophages (S-100+), and Langerhans cells (ACT+), indicative of a type IV hypersensitivity reaction. B-lymphocytes (L26+) were sparse. Conditions that may be confused with PNT on clinical or histopathological ground include pityriasis lichenoides et varioliformis acuta, papular urticaria, papulopustular syphilide, miliary TB, septicemia, perforating granuloma annulare, chondrodermatitis nodularis, reactive perforating collagenosis, allergic granulomatosis, suppurative folliculitis, and infectious causes of palisading granulomas. Papulonecrotic tuberculid has distinct clinical, histopathological, and immunohistochemical features. Awareness of this entity is important since an appropriate diagnosis is necessary for the institution of timely curative treatment. PMID:7802163

Jordaan, H F; Van Niekerk, D J; Louw, M

1994-10-01

229

Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation  

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Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallied a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases

230

Cinco diferentes tipos de imágenes gammagráficas tiroideas en pacientes con enfermedad de graves tratados con 131I en el Paraguay.  

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Full Text Available Thyroid disease is frequent in Paraguay, a country with a prevalence of goiter 48,6% in general population located in the center of South America.Grave’s disease constitutes the most common thyroid hyperfunction observed whose treatment can be carried out with medication (propiltiouracil, metimazol, etc., surgery or iodine 131(131IWe analyzed 70 patients this type of hyperthyroidism treated with the 131I, in its clinical aspect pre and post treatment, ultrasound and nuclear scan findings of the gland thyroid, the hormonal respond Ft4, T3, TSH, thyroid antibodies TPOab, TGab, TRab.Besides the diffuse classic image observed in the thyroid scan and by ultrasonography of the gland, in Grave’s disease, 4 types of images were identified with nodules (multinodular, hot nodule, cold nodule and miliar. The group with diffuse increase in size form was the most numerous (50% continued by the variety multinodular (30%, Marin-Lenhart’s Sx (hot nodule 14%, miliary 3%, and cold nodule 3%.Three months after the treatment with the radioiodine was observed the decrease of the size and thyroid volume in 68% of the patients, thyroid uptake with 131I diminished in 75%. All patients had an increase of weight of 20% and 87% of then were feminineThe signs and symptoms were normalized in 88,5% of the patients. The levels of FT4 were normalized in 73, 8%, T3 in 66%, TSH in 47,7%, TPOab in 83%, TGab in 90%, and TRab in 84%.A received a single dose of 131I was used it in 93% of the patient The cost of the 131I in the Clinic Hospital was half of the cost of the surgery, and at private level the fourth part but cheap.

Jara Yorg J.A.

2006-10-01

231

Distribution and contrast enhanced CT appearance of abdominal tuberculous lymphadenopathy  

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To clarify the contrast enhanced CT features and anatomic distribution of the disseminated vs non-disseminated tuberculosis (TB) involving abdominal lymph nodes. The contrast enhanced CT findings of abdominal lymphadenopathy in 25 patients, including disseminated TB associated with miliary TB of the lung (n=5) and non-disseminated TB (n=20), were retrospectively evaluated in a blind review to assess our criteria of morphology, density and location of the involved lymphadenopathy. The enhancement patterns of disseminated TB were not different from those of non-disseminated TB. Ninety-six percent of the patients had peripheral rim enhancement, and 60% showed a multilocular appearance. The enlarged lymph nodes of TB were less than 4 cm in diameter. Lymphadenopathy caused by hematogenous dissemination often accompanied splenic involvement showing multiple low-density foci in the spleen. The predominant sites of lymphadenopathy of disseminated TB were hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric, and both upper and lower portions of the retroperitoneal lymph nodes, whereas non-disseminated TB mainly involved hepatoduodenal ligamentous, hepatogastric ligamentous, mesenteric and upper retroperitoneal lymph nodes, excluding the lower retroperitoneal lymph nodes. By combining contrast enhancement patterns and the anatomic distribution of lymphadenopathy shown on the contrast enhanced CT images, reviewers made a correct diagnosis of tuberculosis in 94%, of rect diagnosis of tuberculosis in 94%, of cases, with a specificity of 95% and sensitivity of 92%. Contrast enhanced CT patterns correlate well with the pathologic features of tuberculous lymphadenopathy. A different anatomic distribution between disseminated and non-disseminated TB involving the lower retroperitoneal lymph nodes was recognized in this study. (author)

232

Lung nodule detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography in patients with papillary thyroid cancer, negative 131I whole body scan, and undetectable serum-stimulated thyroglobulin levels: two case reports  

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Full Text Available Abstract Introduction When a pulmonary nodular lesion is detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography in a patient with post-surgical papillary thyroid carcinoma with undetectable serum-stimulated thyroglobulin levels and negative 131I whole body scan, diagnosis and management of the nodule may be confusing. Case presentation We describe two post-surgical patients with papillary thyroid carcinoma who showed pulmonary nodular lesions detected by F-18 fluorodeoxyglucose positron emission tomography-computed tomography. In both cases serum-stimulated thyroglobulin levels were undetectable and nodular lesions were not detected by 131I whole body scan. In the first case, a 64-year-old Asian woman showed one focal increased fluorodeoxyglucose uptake lesion in the right lower lobe of one of her lungs. Based on the histologic study, the pulmonary nodular lesion was diagnosed as a solitary pulmonary metastasis from papillary thyroid carcinoma. In the second case, a 59-year-old Asian woman showed a new pulmonary nodule in the right lower lobe. The computed tomography scan of her chest revealed a 9mm nodule in the anterior basal segment and another tiny nodule in the posterior basal segment of the right lower lobe. Six months later, both nodules had increased in size and miliary disseminated nodules were also seen in both lungs. Based on their histology, the pulmonary nodular lesions were considered to be primary lung adenocarcinoma. Conclusions The present cases emphasize that physicians should be cautious and make efforts for an accurate diagnosis of pulmonary nodules detected on F-18 fluorodeoxyglucose positron emission tomography-computed tomography in patients with papillary thyroid carcinoma with no evidence of metastasis such as negative 131I whole body scan and undetectable stimulated serum thyroglobulin levels.

Jung Chan-Hee

2012-10-01

233

Chest X-rays and associated clinical parameters in pulmonary Tubercolosis cases from the National Tubercolosis Program, Mumbai, India  

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Full Text Available The study was carried out in pulmonary tuberculosis (PTB patients from the local Tuberculosis control programme, Mumbai, India. It examined features of chest X-rays and their correlation with clinical parameters for possible application in suspected multidrug resistant TB (MDRTB and to predict outcome in new and treatment failure PTB cases. X-ray features (infiltrate, cavitation, miliary shadows, pleural effusion, mediastinal lymphadenopathy and extent of lesions were analyzed to identify associations with biological/clinical parameters through univariate and multivariate logistic regression. Failures demonstrated associations between extensive lesions and high glycosylated hemoglobin (GHb levels (P=0.028 and male gender (P=0.03. An association was also detected between cavitation and MDR (P=0.048. In new cases, bilateral cavities were associated with MDR (P=0.018 and male gender (P=0.01, low body mass index with infiltrates (P=0.008, and smoking with cavitation (P=0.0238. Strains belonging to the Manu1 spoligotype were associated with mild lesions (P=0.002. Poor outcome showed borderline significance with extensive lesions at onset (P=0.053. Furthermore, amongst new cases, smoking, the Central Asian Strain (CAS spoligotype and high GHb were associated with cavitation, whereas only CAS spoligotypes and high GHb were associated with extensive lesions. The study highlighted associations between certain clinical parameters and X-ray evidence which support the potential of X-rays to predict TB, MDRTB and poor outcome. The use of Xrays as an additional tool to shorten diagnostic delay and shortlist MDR suspects amongst nonresponders to TB treatment should be explored in a setting with limited resources coping with a high MDR case load such as Mumbai.

Anirvan Chatterjee

2012-01-01

234

The clinical utility of camera-based FDG PET in patients with papillary thyroid cancers  

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We evaluated the usefulness of F-18 FDG gamma camera based PET (CoDe-PET) in patients papillary thyroid cancers (PTC). Twenty patients with PTC (7 males, 13 females and mean age of 44 ranging 19-71) underwent CoDe-PET of the neck and chest using a dual-head gamma camera equipped with coincidence detection circuitry. There were two groups of patients studied. First group, 17 athyrotic patients with PTC underwent CoDe-PET for elevated thyroglobulin and negative I-131 whole body diagnostic scan after total thyroidectomy. Second group, 3 patients with PTC performed CoDe-PET preoperatively. Neck and chest images were obtained and attenuation correction was not made. CoDe-PET images were evaluated visually and compared with the anatomical images or posttherapy I-131 scans if performed. The results of CoDe-PET was positive in 10 of 17. In 3 cases, abnormal FDG uptake were histologically confirmed. One patient underwent radical neck dissection and the other two patients received I-131 ablation therapy. Of the remaining 14 patients, seven were CoDe-PET positive and the other seven were negative. A total of 11 patients received subsequent I-131 ablation therapy, in whom only three have concordant CoDe-PET results with post-therapy I-131 scans. Two with military pulmonary metastases failed to concentrate FDG but neck diseases were detected. In the 2nd group consisting of patients before total thyroidectomy, CoDe-PET detected thyroid cancers in two patients but failed in one in which the size of cancer was 0.5 cm in diameter. In the follow-up of patients with papillary thyroid cancer, CoDe-PET appears useful in detecting residual or recurrent lesions in the neck of patients with elevated serum thyroglobulin levels but negative diagnostic iodine scans. However, CoDe-PET was insensitive in detecting miliary pulmonary metastases and small lesions in the neck.

Hwang, K. H.; Park, Chan H.; Soh, E. Y.; Yoon, S. N.; Joh, C. W.; Lee, M. H. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

2001-07-01

235

Asociación entre tuberculosis infantil grave e inmunización previa con BCG en un hospital de referencia nacional, Perú 1990-2000 Association between severe tuberculosis in children and previous BCG immunization in a national referral Hospital, Peru 1990-2000  

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Full Text Available El objetivo del estudio fue determinar la asociación entre la inmunización con BCG y tuberculosis grave (TB. Se realizó un estudio retrospectivo, se incluyó fichas de pacientes atendidos en el servicio de neumología del Instituto Nacional de Salud del Niño de Perú, entre los años 1990-2000. Se revisaron un total de 2106 casos de TB entre los que había 259 casos graves (TB miliar o meningoencefalitis por TB. Del total, 497 casos no tenían antecedente de inmunización con BCG; 202 tenían TB grave y 295 TB no grave (OR= 0,05; IC 95%= 0,03-0,07. En conclusión, los niños con diagnóstico de TB y que han sido inmunizados con BCG, tienen 94% menos riesgo de desarrollar TB grave, en comparación a los niños con diagnóstico no inmunizados con BCG.The objective of the study was to determine the association between BCG immunization and severe tuberculosis (TB. We performed a retrospective study, including medical records from patients of the pneumology department at the National Children’s Institute in Peru, between the years 1990-2000. A total of 2106 TB cases were reviewed, from them 259 patients were severe (miliary TB or meningoencephalitic TB. From all, 497 cases did not have history of BCG vaccination, 202 had severe TB and 295 non-severe TB (OR = 0.05, 95% CI = 0.03 to 0.07. In conclusion, children diagnosed with TB and who have been immunized with BCG, has 94% lower risk of developing severe TB, compared to children with TB non-immunized with BCG.

Félix Llanos-Tejada

2012-03-01

236

Thoracic radiographic features of silicosis in 19 horses  

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Clinical records and thoracic radiographs of 19 horses with a confirmed pathologic diagnosis of silicosis were reviewed. These horses had histories of varying degrees of chronic weight loss, exercise intolerance, and respiratory distress. At the time of presentation, two horses were asymptomatic. Ten horses were geldings and nine were female. The mean age of the 19 horses was 10.7 +/- 5.5 years. Fourteen horses were identified as being from the Monterey-Carmel Peninsula of midcoastal California. An abnormal, structured interstitial pulmonary pattern was identified on thoracic radiographs in each horse. The interstitial pulmonary changes were classified as miliary (13 horses), reticulonodular (4), or linear interstitial (2), and were best visualized dorsally and caudodorsally. In addition to the abnormal interstitial pulmonary pattern, areas of pulmonary consolidation were evident caudodorsally in seven horses. Other thoracic radiographic features included: hilar lymphadenopathy (4 horses), pleural effusion/thickening (4), cranial mediastinal lymphadenopathy (2), hyperinflation (1), and a discrete pulmonary mass (1). Necropsy findings in eight horses and results of lung biopsies in an additional five horses showed a diffuse, multifocal, granulomatous pneumonia with areas of pulmonary fibrosis. Cellular infiltrates included predominantly macrophages with intracellular and/or extracellular crystalline material, occasional lymphocytes, and giant cells. Similar cellular changes were also identified, during necropsy, in the hilar and tracheobronchial lymph nodes in each of the eight horses, although gross enlargement of the lymph nodes was present in only six horses. The radiographic and pathologic findings of these 19 horses are consistent with chronic or the accelerated forms of silicosis that are recognized in humans

237

Application of photosensitive devices to bioluminescence studies  

Energy Technology Data Exchange (ETDEWEB)

A brief review is given of some results obtained by the application of image intensification to studies of bioluminescence. The system consists of an image intensifier placed at the output of a suitable microscope, so that the image from the microscope falls on the intensifier cathode. The photon gain of the intensifier can be varied from a few thousand to one million. The output of the intensifier is recorded either on film or, in most applications to date, by means of a TV vidicon. The TV system permits display on a monitor in real time and simultaneous recording on magnetic tape for subsequent playback and analysis. It also provides time resolution for dynamic studies. Results are summarized for in vivo observations on Noctiluca miliaris, Obelia, Renilla, and Mnemiopsis leidyi. Utilization of the luminescence of aequorin in the presence of Ca/sup 2 +/ has been directed to observations on amoebae and the egg of the Medaka fish. Studies at the molecular level have been made by means of the spectral distribution of the output light. In these, the output of a fast input lens grating spectrometer is focused on the image intensifier cathode. Thus the entire visible spectrum of an in vivo bioluminescent flash can be intensified and recorded on film by photographing the output. The film is then analyzed by means of a digitized densitometer, and a computer program corrects the observed spectrum for system non-linearities and non-uniformities. In this way, the in vivo spectra of 15 bioluminescent species have been recorded.

Reynolds, G.T.

1978-01-01

238

[Evaluation of the management of tuberculosis in children in Madagascar. Results of a multicentric study].  

Science.gov (United States)

In Madagascar, tuberculosis remains an important cause of morbidity and letality with a Risk of Annual Tubercular Infection about 1% in 1996 in spite of a vaccination rate of 82.6% and tubercular drugs free of charge. In 1995, the National Tubercular Control Program detected 7,000 cases of pulmonary tuberculosis and expected more than 12,000 cases per year. This study was carried out in order to review the management and the treatment of the child tuberculosis in Madagascar. This retrospective study was conducted in four pediatric units of the General hospital of Befelatanana (A and B), Ambohimiandra Hospital and Regional Hospital Centre of Toliara for a twenty four months period from January 1997 to December 1998. All the less than 15-year-old children medical files were consulted. 214 cases were suspected of tuberculosis. 133 of them were treated upon clinical presumption basis and/or radiological exams (33 bacteriological and/or histopathological exams were only realized). 56% of the cases were vaccinated by BCG vaccine. Respiratory diseases with fever motive 46% of hospitalization. The majority of these children are living in poor conditions and 38% of them had malnutrition. Were found as clinical manifestations: 47% of pulmonary tuberculosis (among them 20% were smear-positive pulmonary tuberculosis), 12% had ganglionar tuberculosis, 10% peritoneal tuberculosis, 8% a tubercular meningitis, 5% a Pott-disease and 2% a miliary-disease. Mortality increases with suffocation. 18% of cases died, especially infants and in tubercular meningitis. The authors conclude that management and treatment of tuberculosis need an early diagnosis. But the diagnosis is difficult in front of non specific clinical manifestations in children and due to lack of means and national agreement which settle up diagnosis and therapy. A scoring system based upon clinical signs in agreement with complementary medical tests is desirable. PMID:12478966

Rasamoelisoa, J M; Tovone, X G; Razoeliarinoro, H V; Rakotoarimanana, D R

1999-01-01

239

Extrapulmonary tuberculosis in Peninsular Malaysia: retrospective study of 195 cases.  

Science.gov (United States)

During a 2-year retrospective study, 195 non-HIV-infected patients with extrapulmonary tuberculosis (EPT) were diagnosed at the National Tuberculosis Center, Kuala Lumpur, representing 10% of all patients with tuberculosis. Their mean age was 39 (+/- SD) 14 years old (range 14-81). The largest age group was 25-34 years, while 78.5% were less than 50 years of age. The subjects were mainly female (50.3%), Malay (49.2%), married (61.5%), resided in Kuala Lumpur (51.0%), and were unemployed (50.3%). Regarding risk factors, they were smokers and/or alcohol users (21.0%), and injecting drug users (IDUs) (5.1%); they also had history of tuberculosis (3.6%) and contact with TB patients (9.2%). Lymphadenopathy was the most common sign (45.6%) shown in the medical records. 42% of x-ray findings (chest, spine, and hip) showed signs consistent with tuberculosis, while histopathology was the most useful diagnostic tool (52.3%) and lymph node was the most frequent specimen used (35.0%) in this study. The three main sites of involvement were lymph nodes (42.6%), miliary and disseminated (19.5%), and pleura (12.8%). The outcome of this study showed 72.8% of these patients had completed treatment for at least 6 months, whilst, only 4.6% of patients were still undergoing treatment, and unfortunately, 22.6% of them showed non-adherence to anti-tubercular therapy at a duration of less than 6 months. However, no MDR-TB or death cases were reported or registered in this study. PMID:15906632

Nissapatorn, V; Kuppusamy, I; Rohela, M; Anuar, A Khairul; Fong, M Y

2004-01-01

240

First reported outbreak of severe spirorchiidiasis in Emys orbicularis, probably resulting from a parasite spillover event.  

Science.gov (United States)

The importance of disease-mediated invasions and the role of parasite spillover as a substantial threat to the conservation of global biodiversity are now well known. Although competition between invasive sliders Trachemys scripta elegans and indigenous European turtles has been extensively studied, the impact of this invasive species on diseases affecting native populations is poorly known. During winter 2012-2013 an unusual event was detected in a population of Emys orbicularis (Linnaeus, 1758) inhabiting a pond system in Galicia (NW Spain). Most turtles were lethargic and some had lost mobility of limbs and tail. Necropsies were performed on 11 turtles that were found dead or dying at this site. Blood flukes belonging to the species Spirorchis elegans were found inhabiting the vascular system of 3 turtles, while numerous fluke eggs were trapped in the vascular system, brain, lung, heart, liver, kidney, spleen, and/or gastrointestinal tissues of all necropsied animals. Characteristic lesions included miliary egg granulomas, which were mostly found on serosal surfaces, particularly of the small intestine, as well as endocarditis, arteritis, and thrombosis. The most probable cause of death in the 3 turtle specimens which were also examined histologically was a necrotic enteritis with secondary bacterial infection associated with a massive egg embolism. The North American origin of S. elegans, the absence of prior recorded epizootics in the outbreak area, and the habitual presence of its type host, the highly invasive red-eared slider, in this area suggest a new case of parasite spillover resulting in a severe emerging disease. PMID:25667339

Iglesias, Raúl; García-Estévez, José M; Ayres, César; Acuña, Antonio; Cordero-Rivera, Adolfo

2015-02-10

 
 
 
 
241

Radiographic findings of pulmonary tuberculosis in non-AIDS immunocompromised adult patients: comparison with immunocompetent adult patients  

International Nuclear Information System (INIS)

To compare chest radiographic findings of pulmonary tuberculosis in non-AIDS immunocompromised adult patients with those in immunocompetent patients. Eighty six patients who had pulmonary tuberculosis were included in the study. Of these, 41 were non-AIDS immunocompromised adult patients and 45 were immunocompetent adult patients. Chest radiographs obtained from 86 patients were retrospectively evaluated with regard to the followings; the anatomic distribution and extent of tuberculous lesions, typical or atypical patterns of radiographic findings. We then compared the results in non-AIDS immunocompromised adult patients with those in immunocompetent adult patients. The characteristic manifestation of pulmonary tuberculosis was a tendency of pulmonary lesions to localize in the apico-posterior segments of the upper lobe and the superior segment of the lower lobe in both groups but more wide distribution such as the anterior segment and the lingular segment of the upper lobe and the basal segments of the lower lobe was frequently identified in non-AIDS immunocompromised adult patients, and also bilateral, multi segmental and multi lobular extents were common findings. In immunocompetent adult patients, more common findings were in local exudative and productive lesions and several cavities in preferential sites. Atypical plain radiographic findings were more common in non-AIDS immunocompromised adult patients, and which were multiple cavitary lesions, wide extent of brltiple cavitary lesions, wide extent of bronchogenic spread and tuberculous pneumonia, and miliary disseminations and mass like lesions. Pulmonary tuberculosis in non-AIDS immunocompromised adult patients is characterized by frequent bilateral distribution, wide pulmonary extent, and atypical radiographic findings

242

Immunization with excreted-secreted antigens reduces tissue cyst formation in pigs.  

Science.gov (United States)

It has been demonstrated that tachyzoite-pooled excreted-secreted antigens (ESAs) of Toxoplasma gondii are highly immunogenic and can be used in vaccine development. However, most of the information regarding protective immunity induced by immunization with ESAs is derived from studies using mouse model systems. These results cannot be extrapolated to pigs due to important differences in the susceptibility and immune response mechanisms between pigs and mice. We show that the immunization of pigs with ESAs emulsified in Freund's adjuvant induced not only a humoral immune response but also a cellular response. The cellular immune response was associated with the production of IFN-? and IL-4. The humoral immune response was mainly directed against the antigens with molecular masses between 34 and 116 kDa. After intraperitoneal challenge with 10(7) T. gondii of the Gansu Jingtai strain (GJS) of tachyzoites, the immunized pigs remained clinically normal except for a brief low-grade fever (?40.5 °C), while the control pigs developed clinical signs of toxoplasmosis (cough, anorexia, prostration, and high fever). At necropsy, visible lesions were found at multiple locations (enlarged mesenteric lymph nodes, an enlarged spleen with focal necrosis, and enlarged lungs with miliary or focal necrosis and off-white lesions) in all of the control pigs but not in the pigs that had been immunized. We also found that immunization with ESAs reduced tissue cyst formation in the muscle (P < 0.01). Our data demonstrate that immunization with ESAs can trigger a strong immune response against T. gondii infection in pigs. PMID:23949245

Wang, Yanhua; Zhang, Delin; Wang, Guangxiang; Yin, Hong; Wang, Meng

2013-11-01

243

Production of tumor necrosis factor-alpha by alveolar macrophages from patients with pulmonary tuberculosis.  

Science.gov (United States)

In order to ascertain the role of TNF-alpha in pulmonary tuberculosis, we determined the TNF-alpha productivity of alveolar macrophages(AMs) obtained by bronchoalveolar lavage(BAL), along with the level of TNF-alpha in the serum of patients with tuberculosis including pulmonary, miliary, and endobronchial tuberculosis, healthy controls, and pulmonary diseases such as diffuse interstitial lung disease (DILD) and pneumonia. AMs from patients with pulmonary tuberculosis did not produce a larger amount of TNF-alpha than did those from the healthy control subjects. However, among the patients with pulmonary tuberculosis, the AMs from the fresh and reactivated groups produced a larger amount of TNF-alpha than those from the inactive group. AMs from patients showing positivity in culture produced a larger amount of TNF-alpha than those showing negativity. The average level of serum TNF-alpha in patients with pulmonary tuberculosis was slightly higher than that of the healthy control group. Among patients with pulmonary tuberculosis, significantly increased levels of serum TNF-alpha were noted in the reactivated group compared to those of the fresh and inactive group. Patients with moderate to far-advanced infiltration on their chest X-rays, showed a significantly higher level of serum TNF-alpha than those with minimal involvement on the chest X-ray. Smokers from the healthy control group showed a significantly higher level of serum TNF-alpha than non-smokers from the same group. These results suggest that an increase in the production of TNF-alpha may correspond with the severity of pulmonary tuberculosis. PMID:1888449

Kim, S. J.; Kim, H. I.; Lee, Y. H.; Kim, S. K.

1991-01-01

244

Uptake of iodine-123-a-methyl-l-tyrosine (IMT) in primary bone and soft-tissue tumours  

International Nuclear Information System (INIS)

Full text: The aim f this study was to determine the suitability of 123I-IMT for (i) visualising primary bone and soft tissue tumours, (ii) distinguishing between benign and malignant tumours and (iii) grading primary bone and soft tissue tumours. The measurement of the regional uptake of IMT provides information on the rate of amino acid transport, in rapidly growing tissues. It has been mainly studied in brain tumours. 8 patients (5 males and 3 females) and aged between 33-88yrs were recruited into the pilot study. 4 with benign bony lesions, 2 with low grade chondrosarcomas and 2 with high-grade neoplasms (one bone and one soft tissue). All underwent planar +/- SPECT imaging commencing 15 minutes post-injection of IMT and the results were compared with standard imaging studies and the histological findings. No abnormal uptake was seen in any of the 4 benign tumours, while intense uptake was seen in the 2 high-grade tumours. Presumed miliary lung metastases in one of these patients were not visualised with IMT. One of the low-grade chondrosarcomas had subtle uptake while the other was normal. Of the seven patients who had Thallium imaging, the IMT results were concordant in 6 and discordant in one with low-grade chondrosarcoma that was mildly positive on IMT and negative on thallium. IMT allows confident differentiation between high grade and low grade or benign bone or soft tissue tumours but does not appear to differentiate between benign and low-grade lesions or e between benign and low-grade lesions or offer any significant advantage over conventional thallium imaging for bone and soft tissue tumours in this pilot study. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

245

Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation  

Energy Technology Data Exchange (ETDEWEB)

Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases.

Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

1985-05-01

246

Prophylactic cranial irradiation in patients with small cell lung cancer. A retrospective study of recurrence, survival and morbidity.  

DEFF Research Database (Denmark)

BACKGROUND: Prophylactic cerebral irradiation (PCI) is a standard treatment for all small cell lung cancer (SCLC) patients with response to chemotherapy. The aims of this study were: to evaluate patients undergoing PCI with regard to cerebral recurrence rate, site of recurrence, and overall survival (OS) and to investigate the influence of steroid dose on acute toxicity. MATERIALS AND METHODS: From 2007 to 2010 a total of 118 consecutive patients underwent PCI (25 Gray in 10 fractions). In total, 114/118 received full PCI dose, all 118 were included in the study. Data were analyzed retrospectively with regard to disease stage, treatment, date of PCI, steroid dose during PCI, toxicity, time to recurrence, site of recurrence and time of death. The median follow up time was 16.6months (range 3-54months). RESULTS: Of the 118 patients undergoing PCI, 74 had limited disease (LD-SCLC) and 44 had extensive disease (ED-SCLC). The median age was 65years (range 46-80years). The median overall survival of all patients from the time of diagnosis was 16.0months (CI 95% 13.0-19.0), in LD-SCLC it was 24.0months (CI 95% 19.6-28.3), and in ED-SCLC it was 12.0months (CI 95% 9.6-14.4). Twenty-one patients (17.8%) were diagnosed with cerebral recurrence. Five of these presented with metastatic disease within the limbic system. Of these five patients, four had miliary cerebral disease and one had non-oligometastatic disease. The time from PCI to cerebral recurrence ranged from 4 to 27months. Prednisolone administration varied from 0 to 100mg/day. Forty-eight patients were not treated with steroids, 64.6% of these patients reported acute toxicity. Of the 36 patients receiving 50mg prednisolone, only 22.2% had side effects. The most common symptoms during PCI were nausea and headache. CONCLUSIONS: Twenty-one patients out of 118 developed brain metastases after PCI: five of the twenty-one had metastases located in the limbic system. The study showed that prophylactic steroid use might reduce acute toxicity to PCI. Survival data and recurrence rates are comparable to other clinical studies.

Ramlov, Anne; Tietze, Anna

2012-01-01

247

Adiaspiromicose humana. Relato de um caso tratado com cetoconazol  

Directory of Open Access Journals (Sweden)

Full Text Available É descrito um caso de adiaspiromicose humana, da forma pulmonar disseminada, no qual se empregou o cetoconazol. O paciente, oriundo de Goianésia, GO, referia tosse produtiva, dispnéia e emagrecimento. Doente há dois meses, já fizera uso do esquema tríplice tuberculostático, devido a um radiograma do tórax ter acusado lesões sugestivas de tuberculose miliar. Esse tratamento não surtiu o efeito esperado, pelo que foi ele submetido a uma biópsia pulmonar a céu aberto. A medida permitiu o reconhecimento da natureza fúngica da doença. Passou-se, então, ao emprego do cetoconazol, quando o processo já completara três meses de evolução. Dois meses depois, foi o paciente novamente visto, para controle do tratamento: todas as manifestações respiratórias haviam cessado e um novo radiograma mostrou regressão completa das alterações pulmonares. Apesar disso, é discutida a eficácia do cetoconazol contra C. parvum var crescens, tendo-se em conta o fato de o microrganismo não se reproduzir no hospedeiro.A case of human disseminated pulmonary adiaspiromycosis is reported. The patient, from Goianesia, GO, was admitted to the Brasilia University Hospital, in November 1992, with wet cough, dyspnea and weight loss3/4manifestations that had appeared two months before. Prior to admission, he had been treated for a suspected miliary tuberculosis, because a chest roentgenogram had shown a diffuse reticulonodular infiltrate in both lungs. This therapy brought no improvement to the patient status. An open chest biopsy was then performed, and the microscopic examination of the lung tissue revealed the fungal nature of the disease. Ketoconazole, 400mg/day, was started and the patient discharged from the hospital. He was seen again two months later: the respiratory manifestations had disappeared and a new chest roentgenogram showed complete resolution of the pulmonary lesions. The usefulness of ketoconazole is, however, questioned, since, as there is no multiplication of the fungus in the host organism3/4adiaspiromycosis. is believed to be, usually, a self-healing disease -, the efficacy of this imidazole derivative against the agent in animal tissues remains to be confirmed.

Ricardo Luiz M. Martins

1997-12-01

248

Tuberculosis Frequency in Patients Taking TNF-alpha Blokers  

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Full Text Available Objective: To evaluate tuberculosis frequency in patients who take tumor necrosis factor alpha (TNF-? inhibitors for Collagen Vascular Disease (CVD.Materials and Methods: Patients who actively use or were planned to use TNF-? inhibitors for CVD between June 2007-February 2010 were prospectively included in the study.All patients had a physical examination, chest x-ray and the Tuberculin Skin Test (TST. Sputum smear and culture for acid fast bacilli (AFB was performed in patients with a suspicious lesion on chest x-ray. During follow-up, physical examination, chest x-ray and sputum smear for AFB in indicated cases were performed every 3 months. Tuberculosis was diagnosed with microbiological, radiological and histopathological methods.In case of pulmonary or extrapulmonary tuberculosis,TNF-? inhibitor medication was stopped and anti-tuberculosis therapy was began.Results: A total of 179 patients were included in the study, 91 were female and 88 were male wth a mean age of 42.8±12.0. In 141 patients, TNF-? inhibitor therapy was begun in the study although 38 were taking TNF-? inhibitor medication at the beginning of the study. The median follow-up period was 17 months and 2 (1.1% patients were diagnosed to have active tuberculosis during the study period. The TST was found to be 5-9 mm in 15% and >10 mm in 53.3% of the patients.There was a successful tuberculosis therapy history in 5 patients and at least 1 BCG scar was seen in 67 patients.In our series, 70.9% of the patients had chemoprophylaxis during the study period and new tuberculosis was diagnosed in 2 patients, consisting of one miliary tuberculosis and one pleural tuberculosis. Tuberculosis was diagnosed in 1.1% of TNF-alpha taking patients in our series. Conclusion: It is recomended that the patients taking anti TNF treatment should be evaluated and followed up regularly for tuberculosis during the treatment.

Co?kun Do?an

2012-08-01

249

Satellite and ship studies of phytoplankton in the Northeastern Arabian during 2000—2006 period  

Science.gov (United States)

Sequence of the images from IRS P4 / OCM satellite and extensive shipboard sampling programme are used to understand the seasonal variation of phytoplankton abundance and types in the Northeastern (NE) Arabian Sea and Lakshadweep Sea. An appreciable degree of spatial and temporal variability is observed in chlorophyll a distribution from November to April months, as well as coastal and offshore stations, indicating marked seasonality in phytoplankton distribution in NE Arabian Sea. During November month (fall intermonsoon) average chlorophyll a (Chl a) by fluorometer was (0.799 mgm^-3) and by OCM it was 0.584 mgm^-3. The higher chlorophyll a observed was due to Trichodesmium (cyanobacteria) blooms. During December the average chlorophyll a was 0.34 mgm^-3 also due to Trichodesmium filaments in water column. During January onwards winter cooling led to increase in nutrients which enhanced chlorophyll a value to 0.64 mgm^-3 due to growth of flagellates (as seen by high chlorophyll b besides chlorophyll a) in water column. February, March and April supported moderately high chlorophyll value (0. 3 to 0.5 mgm^-3) due to growth of prasinophytes (as seen by pigment prasinoxanthin) and blooms of the Noctiluca miliaris. Time series monitoring of Noctiluca bloom was also conducted using OCM based chlorophyll images in NE Arabian Sea. During February chlorophyll a retrieved by OCM was 0.3 to 0.9 mgm^-3. Pigment analysis of water samples indicated the equal important of accessory pigment like zeaxanthin, prasinoxanthin, beta-carotene. The relevance of these pigments estimated by HPLC like zeaxanthin (cyanobacteria), fucoxanthin (diatoms), peridinin (dinoflagellates) is presented and discussed. Similarly, exercise is conducted in Lakshadweep waters where Trichodesmium related peak in chlorophyll a was observed during March onwards in OCM data. The average chlorophyll a in NE Arabian Sea at surface during November was (0.726 mgm^-3), December (0.34 mgm^-3), January (0.723 mgm^-3), February (0.344 mgm^-3), March (0.963 mgm^-3) and April 0.665 mgm^-3. Similar trend was observed in primary productivity estimates. The attempt is made to work out seasonality in the productivity of the Arabian Sea using OCM derived chlorophyll and relation of enhancement in productivity due to development of winter blooms in the Arabian Sea. The environmental conditions (temperature, wind, nutrients and mixed layer depth) affecting these blooms responsible for year to year variation in bloom biomass and productivity is also presented in detail.

Matondkar, S. G. P.; Dwivedi, R. M.; Parab, Sushma; Pednekar, Suraksha; Desa, E. S.; Mascarenhas, A.; Raman, Mini; Singh, S. K.

2006-12-01

250

The clinical utility of camera-based FDG PET in patients with papillary thyroid cancers  

International Nuclear Information System (INIS)

We evaluated the usefulness of F-18 FDG gamma camera based PET (CoDe-PET) in patients papillary thyroid cancers (PTC). Twenty patients with PTC (7 males, 13 females and mean age of 44 ranging 19-71) underwent CoDe-PET of the neck and chest using a dual-head gamma camera equipped with coincidence detection circuitry. There were two groups of patients studied. First group, 17 athyrotic patients with PTC underwent CoDe-PET for elevated thyroglobulin and negative I-131 whole body diagnostic scan after total thyroidectomy. Second group, 3 patients with PTC performed CoDe-PET preoperatively. Neck and chest images were obtained and attenuation correction was not made. CoDe-PET images were evaluated visually and compared with the anatomical images or posttherapy I-131 scans if performed. The results of CoDe-PET was positive in 10 of 17. In 3 cases, abnormal FDG uptake were histologically confirmed. One patient underwent radical neck dissection and the other two patients received I-131 ablation therapy. Of the remaining 14 patients, seven were CoDe-PET positive and the other seven were negative. A total of 11 patients received subsequent I-131 ablation therapy, in whom only three have concordant CoDe-PET results with post-therapy I-131 scans. Two with military pulmonary metastases failed to concentrate FDG but neck diseases were detected. In the 2nd group consisting of patients before total thyroidectomy, CoDe-PET detected thyroid cancers in two patients but failed in one in wers in two patients but failed in one in which the size of cancer was 0.5 cm in diameter. In the follow-up of patients with papillary thyroid cancer, CoDe-PET appears useful in detecting residual or recurrent lesions in the neck of patients with elevated serum thyroglobulin levels but negative diagnostic iodine scans. However, CoDe-PET was insensitive in detecting miliary pulmonary metastases and small lesions in the neck

251

Clinical manifestation of HIV/AIDS patients: differences between public and private hospitals in Jakarta  

Directory of Open Access Journals (Sweden)

Full Text Available The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective -descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital and Medistra Hospital (private hospital, Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method. Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects, consist of 59 male (89.4% and 7 female (10.6%. Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%, homosexual (13.6%, heterosexual (21.1%, transfusion (1.5% and maternal-child (perinatal (1.5%. The clinical symptoms mainly present as acute fever (56.2%, weight loss (39.4%, cough (38.8%, shortness of breath (27.2%, chronic diarrhea (22.8%, prolong fever (19.7%, loss of conciousness (15.3%, anorexia (15.3%. Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%, oral trush (22.6%, anemia (56.5%, leucopenia (32.3%, lymphopenia (55.9%, elevated AST/ALT (66.1%, hypoalbuminemia (46.9%, limphadenopathy (10.6%, brain space occuping lesion (7.6%, encephalopathy (6.0%, pulmonary tb and pleural effusion (10.6%. The opportunistic and co-infections present were candidiasis (25.8%, chronic hepatitis C (24.2%, chronic hepatitis B and C (4.5%, pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea, fatique, oral trush, anemia, leucopenia, lymphopenia. Patients admitted in private hospital had varied complain; and patients that admitted in public hospital had more severe and advance condition. (Med J Indones 2004; 13: 232-6Keywords: HIV, AIDS, Clinical Manifestation

Herdiman T. Pohan

2004-11-01

252

Postmortem Investigations Following Human Immunodeficiency Virus Infection  

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Full Text Available Background: HIV/AIDS is a global disease and despite intensive research it is one of the main causes of human death. Postmortem studies have proven accurate in determining the various pathologies in these patients. Aims & Objectives: Our aim was to analyze the post mortem results of individuals who died after HIV infection in the same geographical region. We evaluated the most frequent opportunistic diseases and their clinical and morphological outcomes. Methods: We studied case reports and autopsy research data from 32 patients who died after HIV infection in Smolensk, Russian Federation, between 2003 and 2008. All patients had been diagnosed with HIV infection before death, using HIV-specific enzyme linked immunosorbent assay (ELISA and immunoblotting. Autopsy specimens of various organs were examined histologically and microbiologically. Findings: The mean survival period from the moment of detection of seropositivity in all the patients was less than five years. Twelve patients had a parenteral mode of contact, six had been infected by sexual contact, and 14 patients had unknown modes of infection. Most patients (69% had chronic hepatitis C. The main causes of death were various infectious diseases. The most common were generalized miliary tuberculosis and progressive secondary tuberculosis of the lungs. Three (9% patients had tuberculosis of the meninges and five (16% had peritoneal infections, but tuberculous peritonitis had not been diagnosed before death. Six patients had pulmonary tuberculosis and bacterial pneumonia simultaneously. Two (6% patients died from bacterial sepsis as a result of cervical lymphadenitis, and eight (12.5% from abscess-forming pneumonia. The opportunistic infections revealed were Pneumocystis carinii pneumonia (eight patients, cytomegaloviral pneumonia (three, bronchopulmonary aspergillosis (one and mucosal candidiasis (three. In three patients, the causes of death were advanced neoplastic processes: two cases of leukemia and one case of cervical cancer. Conclusions: Tuberculosis was the most widespread among the opportunistic infections, which often had affected the entire lung and had a destructive form. In the morphological picture of tuberculous inflammation, alterative and exudative changes dominated. Moreover, HIV infection had a characteristically broad spectrum of causative agents of pneumonia, including bacteria, viruses, fungi, and protozoa.

Andrey V. Bychkov

2009-04-01

253

Adiaspiromicose humana. Relato de um caso tratado com cetoconazol  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese É descrito um caso de adiaspiromicose humana, da forma pulmonar disseminada, no qual se empregou o cetoconazol. O paciente, oriundo de Goianésia, GO, referia tosse produtiva, dispnéia e emagrecimento. Doente há dois meses, já fizera uso do esquema tríplice tuberculostático, devido a um radiograma do [...] tórax ter acusado lesões sugestivas de tuberculose miliar. Esse tratamento não surtiu o efeito esperado, pelo que foi ele submetido a uma biópsia pulmonar a céu aberto. A medida permitiu o reconhecimento da natureza fúngica da doença. Passou-se, então, ao emprego do cetoconazol, quando o processo já completara três meses de evolução. Dois meses depois, foi o paciente novamente visto, para controle do tratamento: todas as manifestações respiratórias haviam cessado e um novo radiograma mostrou regressão completa das alterações pulmonares. Apesar disso, é discutida a eficácia do cetoconazol contra C. parvum var crescens, tendo-se em conta o fato de o microrganismo não se reproduzir no hospedeiro. Abstract in english A case of human disseminated pulmonary adiaspiromycosis is reported. The patient, from Goianesia, GO, was admitted to the Brasilia University Hospital, in November 1992, with wet cough, dyspnea and weight loss3/4manifestations that had appeared two months before. Prior to admission, he had been trea [...] ted for a suspected miliary tuberculosis, because a chest roentgenogram had shown a diffuse reticulonodular infiltrate in both lungs. This therapy brought no improvement to the patient status. An open chest biopsy was then performed, and the microscopic examination of the lung tissue revealed the fungal nature of the disease. Ketoconazole, 400mg/day, was started and the patient discharged from the hospital. He was seen again two months later: the respiratory manifestations had disappeared and a new chest roentgenogram showed complete resolution of the pulmonary lesions. The usefulness of ketoconazole is, however, questioned, since, as there is no multiplication of the fungus in the host organism3/4adiaspiromycosis. is believed to be, usually, a self-healing disease -, the efficacy of this imidazole derivative against the agent in animal tissues remains to be confirmed.

Ricardo Luiz M., Martins; Clarice G. F., Santos; Filomena Rita F.C., França; Mário A.P., Moraes.

1997-12-01

254

Effects of tissue handling and processing steps on PCR for detection of Mycobacterium tuberculosis in formalin-fixed paraffin-embedded samples / Efeitos das etapas de tratamento e processamento do tecido na PCR para detecção de Mycobacterium tuberculosis em amostras fixadas em formalina e incluídas em parafina  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O desenvolvimento e a padronização de métodos confiáveis para a detecção de Mycobacterium tuberculosis em amostras clínicas é um objetivo importante nos laboratórios de todo o mundo. Neste trabalho, fragmentos de pulmão e baço de paciente que morreu com o diagnóstico de tuberculose miliar foram usad [...] os para avaliar a influência do tipo de fixador e dos protocolos de fixação e inclusão em parafina na performance da PCR. Fragmentos de tecido foram fixados por quatro h a 48 h, usando formalina não tamponada a 10% ou formalina tamponada a 10% e incluídos em parafina pura ou misturada a cera de abelha. As amostras foram submetidas a PCR para amplificação do gene da beta-actina humana e, separadamente, para amplificação da sequência de inserção IS6110, específica do complexo M. tuberculosis. O resultado da amplificação do gene da beta-actina foi positivo em todas as amostras. Não foram gerados amplicons na PCR-IS6110 em amostras de tecido pulmonar fixadas usando formalina não tamponada a 10% e incluídas em parafina com cera de abelha. Em conclusão, fatores inibitórios combinados interferiram na detecção de M. tuberculosis em material de arquivo. É importante controlar estes fatores inibitórios para poder implementar o diagnóstico molecular em laboratórios de patologia. Abstract in english Development and standardization of reliable methods for detection of Mycobacterium tuberculosis in clinical samples is an important goal in laboratories throughout the world. In this work, lung and spleen fragments from a patient who died with the diagnosis of miliary tuberculosis were used to evalu [...] ate the influence of the type of fixative as well as the fixation and paraffin inclusion protocols on PCR performance in paraffin embedded specimens. Tissue fragments were fixed for four h to 48 h, using either 10% non-buffered or 10% buffered formalin, and embedded in pure paraffin or paraffin mixed with bee wax. Specimens were submitted to PCR for amplification of the human beta-actin gene and separately for amplification of the insertion sequence IS6110, specific from the M. tuberculosis complex. Amplification of the beta-actin gene was positive in all samples. No amplicons were generated by PCR-IS6110 when lung tissue fragments were fixed using 10% non-buffered formalin and were embedded in paraffin containing bee wax. In conclusion, combined inhibitory factors interfere in the detection of M. tuberculosis in stored material. It is important to control these inhibitory factors in order to implement molecular diagnosis in pathology laboratories.

Denise, Barcelos; Marcello F., Franco; Sylvia Cardoso, Leão.

2008-12-01

255

Effects of tissue handling and processing steps on PCR for detection of Mycobacterium tuberculosis in formalin-fixed paraffin-embedded samples Efeitos das etapas de tratamento e processamento do tecido na PCR para detecção de Mycobacterium tuberculosis em amostras fixadas em formalina e incluídas em parafina  

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Full Text Available Development and standardization of reliable methods for detection of Mycobacterium tuberculosis in clinical samples is an important goal in laboratories throughout the world. In this work, lung and spleen fragments from a patient who died with the diagnosis of miliary tuberculosis were used to evaluate the influence of the type of fixative as well as the fixation and paraffin inclusion protocols on PCR performance in paraffin embedded specimens. Tissue fragments were fixed for four h to 48 h, using either 10% non-buffered or 10% buffered formalin, and embedded in pure paraffin or paraffin mixed with bee wax. Specimens were submitted to PCR for amplification of the human beta-actin gene and separately for amplification of the insertion sequence IS6110, specific from the M. tuberculosis complex. Amplification of the beta-actin gene was positive in all samples. No amplicons were generated by PCR-IS6110 when lung tissue fragments were fixed using 10% non-buffered formalin and were embedded in paraffin containing bee wax. In conclusion, combined inhibitory factors interfere in the detection of M. tuberculosis in stored material. It is important to control these inhibitory factors in order to implement molecular diagnosis in pathology laboratories.O desenvolvimento e a padronização de métodos confiáveis para a detecção de Mycobacterium tuberculosis em amostras clínicas é um objetivo importante nos laboratórios de todo o mundo. Neste trabalho, fragmentos de pulmão e baço de paciente que morreu com o diagnóstico de tuberculose miliar foram usados para avaliar a influência do tipo de fixador e dos protocolos de fixação e inclusão em parafina na performance da PCR. Fragmentos de tecido foram fixados por quatro h a 48 h, usando formalina não tamponada a 10% ou formalina tamponada a 10% e incluídos em parafina pura ou misturada a cera de abelha. As amostras foram submetidas a PCR para amplificação do gene da beta-actina humana e, separadamente, para amplificação da sequência de inserção IS6110, específica do complexo M. tuberculosis. O resultado da amplificação do gene da beta-actina foi positivo em todas as amostras. Não foram gerados amplicons na PCR-IS6110 em amostras de tecido pulmonar fixadas usando formalina não tamponada a 10% e incluídas em parafina com cera de abelha. Em conclusão, fatores inibitórios combinados interferiram na detecção de M. tuberculosis em material de arquivo. É importante controlar estes fatores inibitórios para poder implementar o diagnóstico molecular em laboratórios de patologia.

Denise Barcelos

2008-12-01

256

Radiographic findings in adult pulmonary tuberculosis  

International Nuclear Information System (INIS)

During the period from March, 1980 to February, 1981 in the Department of Radiology, Jeonbug National University Hospital, we reviewed the radiologic findings of 879 cases newly diagnosed pulmonary tuberculosis and 56 cases diagnosed tuberculous pleural effusion without lung parenchymal lesion on initial chest P-A film in the adult (older than 16 years). The results were as follows. 1. Sex distribution of pulmonary tuberculosis was 668 cases (76%) in male, 211 cases (24%) in female, the average age 44.6, and the highest incidence in the third and sixth decade with similarity. 2. The incidence of pulmonary tuberculosis was highest in the springtime (29.5%) and its peak particularly in May. 3. Classifying the extent of pulmonary tuberculosis into minimal, moderately advanced and far advanced pulmonary tuberculosis, their ratio was 6 : 1.5 : 1 with the concrete date of 553 cases (70.8%), 136 cases (17.4%) and 92 cases (11.8%) respectively. 4. In the case of minimal pulmonary tuberculosis the location of TB-lesion incidence were right upper, left upper and both upper lobes in the ratio of 45 : 27 :28 (%) 5. The radiological findings of pulmonary tuberculosis appeared various, but the ill-defined patchy density of exudative reaction signifying an initial lesion were than the most (35%). 6. As an unusual type of tuberculosis, cavitary TB was 38 cases (4.3%), among them, in 3 cases (7.9%) there appeared air-fluid level. Miliary TB was 8 cases (0.9%), mostly abundant in the ys 8 cases (0.9%), mostly abundant in the youngsters (esp. in the third decade), and female immensely outnumbered male. Tuberculoma was 10 cases (1.4%), female preceded male in the ratio of 7 : 3, and in right upper lobe in the incidence was highest (50%). 7. Without lung parenchymal lesion, the cases to have caused an tuberculous pleural effusion were 56 (6.0%), and in the years of 16 to 29 it was the most frequent with 26 cases (46.4%). 8. With complicated pulmonary tuberculosis, 78 cases (9.5%) showed to combine with other diseases. Among them pleural effusion was 14 cases (1.7%) and pneumothorax 14 cases (1.7%), which were the most frequent. 9. Spread of tuberculosis beyond the lung to other organ was 28 cases (3.1%) and frequent in female characteristically. Among them, bone and joint TB was 16 cases and the most abundant in number, in particular, spine TB was the most frequent with 10 cases (36%)

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Bacillus Calmette-Guérin (BCG) infection following intravesical BCG administration as adjunctive therapy for bladder cancer: incidence, risk factors, and outcome in a single-institution series and review of the literature.  

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Bacillus Calmette-Guérin (BCG) is the most effective intravesical immunotherapy for superficial bladder cancer. Although generally well tolerated, BCG-related infectious complications may occur following instillation. Much of the current knowledge about this complication comes from single case reports, with heterogeneous diagnostic and therapeutic approaches and no investigation on risk factors for its occurrence. We retrospectively analyzed 256 patients treated with intravesical BCG in our institution during a 6-year period, with a minimum follow-up of 6 months after the last instillation. We also conducted a comprehensive review and pooled analysis of additional cases reported in the literature since 1975. Eleven patients (4.3%) developed systemic BCG infection in our institution, with miliary tuberculosis as the most common form (6 cases). A 3-drug antituberculosis regimen was initiated in all but 1 patient, with a favorable outcome in 9/10 cases. There were no significant differences in the mean number of transurethral resections prior to the first instillation, the time interval between both procedures, the overall mean number of instillations, or the presence of underlying immunosuppression between patients with or without BCG infection. We included 282 patients in the pooled analysis (271 from the literature and 11 from our institution). Disseminated (34.4%), genitourinary (23.4%), and osteomuscular (19.9%) infections were the most common presentations of disease. Specimens for microbiologic diagnosis were obtained in 87.2% of cases, and the diagnostic performances for acid-fast staining, conventional culture, and polymerase chain reaction (PCR)-based assays were 25.3%, 40.9%, and 41.8%, respectively. Most patients (82.5%) received antituberculosis therapy for a median of 6.0 (interquartile range: 4.0-9.0) months. Patients with disseminated infection more commonly received antituberculosis therapy and adjuvant corticosteroids, whereas those with reactive arthritis were frequently treated only with nonsteroidal antiinflammatory drugs (p BCG regimen was resumed in only 2 of 36 patients with available data (5.6%), with an uneventful outcome. In the absence of an apparent predictor of the development of disseminated BCG infection after intravesical therapy, and considering the protean variety of clinical manifestations, it is essential to keep a high index of suspicion to initiate adequate therapy promptly and to evaluate carefully the risk-benefit balance of resuming intravesical BCG immunotherapy. PMID:25398060

Pérez-Jacoiste Asín, María Asunción; Fernández-Ruiz, Mario; López-Medrano, Francisco; Lumbreras, Carlos; Tejido, Angel; Juan, Rafael San; Arrebola-Pajares, Ana; Lizasoain, Manuel; Prieto, Santiago; Aguado, José María

2014-10-01

258

Disseminated tuberculosis in a pregnant woman presenting with numerous brain tuberculomas: case report Tuberculose disseminada em uma paciente grávida apresentando múltiplos tuberculomas cerebrais: relato de caso  

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Full Text Available Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has the pulmonary form as the most common presentation. Dissemination of the disease is common in immunocompromised patients, but immunodeficiency related to pregnancy severe enough to cause dissemination of the Mycobacteria is exceedingly rare. When dissemination occurs, any organ may be affected and in central nervous system, the infection presents as meningitis and single brain parenchyma tuberculomas. We report the case of a 17 year-old woman at the 34th week of pregnancy with respiratory and high intracranial pressure symptoms. On the day before admission she had a sudden onset of paraparesis and urinary retention and ten hours after the delivery she presented with paraplegia . The chest X-ray and CT scan were compatible with miliary tuberculosis. The cranial CT scan revealed numerous rounded hypodense lesions located at cerebral and cerebellar hemispheres, which presented ring-like enhancement after contrast injection. The patient underwent a craniotomy with biopsy of the lesions confirming the diagnosis of brain tuberculomas. The three-drug regimen was started and the cranial CT scan performed a year after diagnosis showed no brain lesions. We emphasize the aggressive dissemination of the disease in this case associated with pregnancy and the importance of early diagnosis and institution of therapy resulting in regression of the lesions.A tuberculose é doença infecciosa causada pelo Mycobacterium tuberculosis e tem na forma pulmonar a sua apresentação mais comum. A disseminação da doença é comum em pacientes imunodeprimidos. Entretanto, imunodeficiência relacionada à gravidez suficientemente severa para causar disseminação da micobactéria é rara. Quando a disseminação ocorre, qualquer órgão pode ser afetado e, quando ela se faz para o sistema nervoso central, apresenta-se mais comumente como meningite ou tuberculoma único. Relatamos o caso de uma paciente de 17 anos na 34ª semana de gestação com sintomas pulmonares e hipertensão intracraniana. No dia anterior ao internamento a paciente apresentou episódio súbito de paraparesia e retenção urinária. A paciente evoluiu para parto normal e dez horas após apresentou paraplegia. A radiografia simples e a tomografia de tórax foram compatíveis com tuderculose miliar. A tomografia de crânio mostrou múltiplas lesões hipodensas arredondadas nos hemisférios cerebrais e cerebelares, as quais apresentaram realce anelar após injeção de contraste. A paciente foi submetida à craniotomia com biópsia de uma das lesões, que confirmou o diagnóstico de tuberculoma. Iniciou-se tratamento com regime tríplice e a tomografia de crânio realizada um ano após o diagnóstico foi normal.

Emerson L. Gasparetto

2003-09-01

259

Disseminated tuberculosis in a pregnant woman presenting with numerous brain tuberculomas: case report / Tuberculose disseminada em uma paciente grávida apresentando múltiplos tuberculomas cerebrais: relato de caso  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese A tuberculose é doença infecciosa causada pelo Mycobacterium tuberculosis e tem na forma pulmonar a sua apresentação mais comum. A disseminação da doença é comum em pacientes imunodeprimidos. Entretanto, imunodeficiência relacionada à gravidez suficientemente severa para causar disseminação da micob [...] actéria é rara. Quando a disseminação ocorre, qualquer órgão pode ser afetado e, quando ela se faz para o sistema nervoso central, apresenta-se mais comumente como meningite ou tuberculoma único. Relatamos o caso de uma paciente de 17 anos na 34ª semana de gestação com sintomas pulmonares e hipertensão intracraniana. No dia anterior ao internamento a paciente apresentou episódio súbito de paraparesia e retenção urinária. A paciente evoluiu para parto normal e dez horas após apresentou paraplegia. A radiografia simples e a tomografia de tórax foram compatíveis com tuderculose miliar. A tomografia de crânio mostrou múltiplas lesões hipodensas arredondadas nos hemisférios cerebrais e cerebelares, as quais apresentaram realce anelar após injeção de contraste. A paciente foi submetida à craniotomia com biópsia de uma das lesões, que confirmou o diagnóstico de tuberculoma. Iniciou-se tratamento com regime tríplice e a tomografia de crânio realizada um ano após o diagnóstico foi normal. Abstract in english Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has the pulmonary form as the most common presentation. Dissemination of the disease is common in immunocompromised patients, but immunodeficiency related to pregnancy severe enough to cause dissemination of the Mycoba [...] cteria is exceedingly rare. When dissemination occurs, any organ may be affected and in central nervous system, the infection presents as meningitis and single brain parenchyma tuberculomas. We report the case of a 17 year-old woman at the 34th week of pregnancy with respiratory and high intracranial pressure symptoms. On the day before admission she had a sudden onset of paraparesis and urinary retention and ten hours after the delivery she presented with paraplegia . The chest X-ray and CT scan were compatible with miliary tuberculosis. The cranial CT scan revealed numerous rounded hypodense lesions located at cerebral and cerebellar hemispheres, which presented ring-like enhancement after contrast injection. The patient underwent a craniotomy with biopsy of the lesions confirming the diagnosis of brain tuberculomas. The three-drug regimen was started and the cranial CT scan performed a year after diagnosis showed no brain lesions. We emphasize the aggressive dissemination of the disease in this case associated with pregnancy and the importance of early diagnosis and institution of therapy resulting in regression of the lesions.

Emerson L., Gasparetto; Priscilla, Tazoniero; Arnolfo de, Carvalho Neto.

2003-09-01

260

Tuberculous biliary strictures: uncommon cause of obstructive jaundice  

International Nuclear Information System (INIS)

Tuberculous biliary stricture is a very rare cause of obstructive jaundice. A case of a man who had had pulmonary tuberculosis 20 years ago is reported. He now presented with obstructive jaundice due to multiple strictures just below the confluence of the hepatic ducts and in the right hepatic duct. At surgery, these turned out to be tuberculous in origin. There was also tuberculous involvement of the gall bladder and cystic duct. The commonest differential diagnosis in such cases is cholangiocarcinoma (as in the present case). Imaging helps in defining the extent of bile duct obstruction. Suspicion of the disease and establishing a tissue diagnosis is very important in treating this potentially curable condition, especially with the worldwide resurgence of tuberculosis. Imaging modalities such as US and CT may be useful in demonstrating the dilated bile ducts. As there are no specific radiological features of tuberculous biliary strictures, the radiologist should search for any associated findings in abdominal imaging, especially focal hepatic lesions, abdominal lymphadenopathy and abdominal calcification. Tuberculous hepatic involvement can have miliary, nodular and solitary abscess forms. Solitary tuberculous abscesses may be readily detected by sectional imaging such as US, CT or MRI. Ultrasound appearances encountered include well-defined hypoechoic lesions, mixed hyper/hypoechoic masses or almost solid masses. On CT, tuberculous liver abscesses have been describerculous liver abscesses have been described as having a rosette appearance or being a hypodense mass. Magnetic resonance imaging of a tuberculous solitary mass has been described as hypointense on T1-weighted images and iso- or hypointense on T2-weighted images. However, none of these findings are specific or diagnostic of tuberculous origin and, therefore, the lesions have to be sampled percutaneously to arrive at the correct diagnosis. Abdominal lymphadenopathy (mainly periductal, hepatoduodenal ligament and at the porta hepatis) can be seen in up to 35% of cases of hepatobiliary tuberculosis. Finding calcification on abdominal X-ray is another important observation which is reported to be present in 50% of cases of hepatobiliary tuberculosis. The patterns described are 'chalky' and confluent hepatic calcifications or nodal-type calcifications along the course of the CBD. It is also important to examine a recent chest X-ray as associated chest X-ray abnormalities may be seen in up to 65% of cases of hepatobiliary tuberculosis. The likelihood of having a positive yield of AFB in bile aspirate cytology from ERCP is low. Of the total 12 cases of biliary tuberculosis reported, bile cytology was done in seven, of which only two were positive for AFB. Only one of these 12 cases showed associated hepatic calcification. Copyright (2001) Blackwell Science Pty Ltd

 
 
 
 
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Vacina BCG contra tuberculose: efeito protetor e políticas de vacinação BCG vaccine against tuberculosis: its protective effect and vaccination policies  

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Full Text Available OBJETIVO: A vacina BCG é utilizada desde 1921, embora ainda apresente controvérsias e aspectos não esclarecidos. O objetivo do artigo foi analisar aspectos relacionados ao efeito protetor da primeira e segunda doses da vacina BCG e as políticas de vacinação adotadas. MÉTODOS: Foi realizada revisão sistemática da literatura publicada em inglês e espanhol, abrangendo o período compreendido entre 1948 e 2006, na base PubMed. Os principais descritores utilizados foram BCG vaccine, BCG efficacy, BCG e tuberculosis. Os estudos foram agrupados por tipo de desenho, apresentando-se separadamente os principais resultados de ensaios clínicos, estudos de caso-controle e metanálises. RESULTADOS: O efeito protetor da primeira dose da vacina BCG contra a tuberculose na forma miliar ou na meningite é elevado. No entanto, os resultados são discordantes em relação à forma pulmonar, variando de ausência de efeito a níveis próximos a 80%. Estão sendo conduzidas pesquisas sobre novas vacinas candidatas a substituir a BCG ou serem utilizadas como reforço. CONCLUSÕES: Há evidências de que a segunda dose da BCG não aumenta o seu efeito protetor. Apesar de seus limites e da expectativa futura de nova vacina para tuberculose, a vacina BCG mantém-se como importante instrumento no controle dos efeitos danosos da doença, sobretudo em países com taxas de incidência médias e elevadas.OBJECTIVE: The BCG vaccine has been in use since 1921, but still arouses controversy and uncertainties. The objective was to analyze the protective effect of the BCG vaccine in its first and second doses and the accompanying vaccination policies. METHODS: A systematic review of the literature in both English and Spanish was carried out, covering the period 1948 to 2006, using the PubMed database. The main search terms used included BCG vaccine, BCG efficacy, BCG and tuberculosis. The studies were grouped by design, with the main results from the clinic tests, case-control studies and meta-analyses presented separately. RESULTS: The protective effect of the first dose of the BCG vaccine against tuberculosis in its miliary and meningeal forms is high. However, the results vary in relation to the pulmonary form of the disease, with some indicating zero effect and others levels of nearly 80%. Research is being carried out to develop new vaccines that could substitute the BCG or be used as a booster. CONCLUSIONS: There are evidences that the protective effect of the BCG vaccine does not increase with a second dose. In spite of its limitations and the expectation that a new tuberculosis vaccine will be developed in the future, the BCG vaccine remains an important tool in controlling the harmful effects of tuberculosis, particularly in countries with medium or high incidence levels of the disease.

Susan M Pereira

2007-09-01

262

Clinical application of PET/CT imaging in search of the primary carcinoma  

International Nuclear Information System (INIS)

Full text: To explore the clinical value of PET/CT scanning in search of the primary carcinoma, we selected 4 patients who were subjected to PET/CT examination during Oct. 2002 to Dec. 2002. The primary lesion in all these patients was not detected. One of them had metastasis to liver, one had metastases in both lungs and the other two were having metastases to the bones. 18F-FDG in doses of 5.55MBq / kg body weight was injected to a fasting patient (at least 6 hours). PET/CT whole body examination was done using Discovery LS-PET/CT (GE Medical System, U.S.A.) 40-60 minutes later. In the first patient with metastasis to liver, primary lesion was localized in the transverse colon near the liver. The PET/CT showed multiple high radioactive uptake lesions of different sizes in the liver. No obvious change in position of the colon uptake was seen on the delayed images. After PET/CT, barium examination showed thinned cavity of the colon near the liver with coarse ankylosis of colon wall just like saw tooth. The mucous membrane was destroyed. Of the two patients with metastases in the bone, first - a 31 years old, was diagnosed to have primary lung cancer with multiple metastases to the liver and the bones. PET/CT showed high radioactive uptake in the inferior left lobe near the hilum with irregular shaped uneven distribution. A round high radioactive uptake area of 1.82 x 1.84 x 1.46cm size was also seen in the right lobe of the liver having clear edge and uneven distributver having clear edge and uneven distribution. The destroyed bones (L-10, L-11, L-12, T-1 and ala ossis i lii) showed high radioactive uptake. Second patient, 57-year male was diagnosed to have malignant lymphoma. PET/CT fusion showed high radioactive uptake in the marrow of whole body. Few destroyed parts of bones were also seen on CT images. Several cervical and the thoracic vertebrae as well as the ninth rib showed irregular radioactive accumulation with clear edges and well-distributed tracer raising the possibility of multiple myeloma or some other blood system disease. The histopathology from the ninth rib showed diffuse cell malignant lymphoma. Fourth patient with metastasis in the lungs was diagnosed to have primary carcinoma of bronchus. PET/CT showed high radioactive uptake in left supraclavicular and upper mediastinal lymph nodes. Miliary focus of high radioactive accumulation was also seen in both lung, especially in the inferior lobe and the lateral basal segment of the left lung. No other abnormal radioactive accumulation was found in the images. PET/CT whole body scan and fusion images give easy diagnosis of primary carcinoma and metastases than PET alone. Meanwhile, we must possess abundant clinical knowledge and analyze every patient systematically, only then we can expand the clinical value of this new modality. (author)

263

Neurotuberculosis: Hallazgos intracraneanos en RM / Neurotuberculosis: Intracranial MRI findings  

Scientific Electronic Library Online (English)

Full Text Available SciELO Argentina | Language: Spanish Abstract in spanish Objetivos. Mostrar nuestra casuística de pacientes con diagnóstico de tuberculosis intracraneana y describir los diferentes tipos de lesiones documentadas en Resonancia Magnética (RM) que caracterizan a esta entidad. Materiales y Métodos. Para el presente trabajo fueron seleccionados, de forma retro [...] spectiva, 20 pacientes con hallazgos positivos de tuberculosis intracraneana. Doce eran de sexo masculino y 8 de sexo femenino, con un rango etario de 8 meses a 49 años de edad (edad media: 21 años). El diagnóstico clínico fue realizado con punción lumbar y cultivo de LCR. Once pacientes presentaron serología positiva para VIH. Las RM fueron realizadas en resonadores de 0.5T y 1.5T, complementadas en dos casos con Tomografía Computada (TC) de cerebro. A dos pacientes se les realizó difusión (DWI) y a un paciente espectroscopía. Resultados. Del total de pacientes (n=20), 14 presentaron compromiso subaracnoideo en la convexidad y 13 compromiso subaracnoideo cisternal basal (afectación leptomeníngea). En 13 se observaron tuberculomas y 11 presentaron angeítis de grandes vasos; mientras que 7 tuvieron angeítis de pequeños vasos, 7 hidrocefalia, 6 infartos parenquimatosos y 1 afectación paquimeníngea. Quince pacientes tenían lesiones combinadas. Conclusión. La localización más frecuente de neurotuberculosis en esta serie fue meníngea con compromiso leptomeníngeo (14 pacientes con afectación subaracnoidea, seguido de afectación cisternal en 13 pacientes) y sólo en un caso fue paquimeníngea. La manifestación parenquimatosa más frecuente fue el tuberculoma (granulomas tuberculosos) con 13 casos. De estos, 5 presentaron un patrón miliar y sólo uno comportamiento pseudotumoral. Abstract in english Purposes. To report our case series of patients with a diagnosis of intracranial tuberculosis and to describe the different types of lesions characterizing this entity on Magnetic Resonance Imaging (MRI). Materials and Methods. For the present study, we retrospectively selected 20 patients with posi [...] tive MRI findings of intracranial tuberculosis. Twelve of them were males and 8 were females, with an age range of between 8 months and 49 years (mean age: 21years). Clinical diagnosis was obtained by lumbar puncture and cerebrospinal fluid (CSF) culture. Eleven patients presented positive HIV serology. MRIs were performed using 0.5T and 1.5 T scanners and computed tomography (CT) of the brain was also performed in two patients. Diffusion-weighted technique was performed in two patients and spectroscopy in one patient. Results. Of the total patients studied (n=20), 14 presented convexity subarachnoid involvement and 13 subarachnoid basal cystern involvement (leptomeningeal involvement), 13 presented tuberculomas, 11 large-vessel angiitis, 7 smallvessel angiitis, 7 hydrocephalia, 6 parenchymatous infarction and one pachymeningeal involvement. Combined lesions were observed in 15 patients. Conclusion. The most frequent location of neurotuberculosis in this series was meningeal with leptomeningeal involvement (14 patients with subarachnoid involvement, followed by cysternal involvement in 13 patients), and only one patient had pachymeningeal involvement. The most frequent parenchymatous finding of tuberculosis was tuberculoma in 13 patients, 5 with a miliary pattern and only one with pseudo-tumoral behavior.

Jorge, Docampo; Carolina, Mariluis; Nadia, González; Carlos, Morales; Claudio, Bruno.

2012-06-01

264

Neurotuberculosis: Hallazgos intracraneanos en RM Neurotuberculosis: Intracranial MRI findings  

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Full Text Available Objetivos. Mostrar nuestra casuística de pacientes con diagnóstico de tuberculosis intracraneana y describir los diferentes tipos de lesiones documentadas en Resonancia Magnética (RM que caracterizan a esta entidad. Materiales y Métodos. Para el presente trabajo fueron seleccionados, de forma retrospectiva, 20 pacientes con hallazgos positivos de tuberculosis intracraneana. Doce eran de sexo masculino y 8 de sexo femenino, con un rango etario de 8 meses a 49 años de edad (edad media: 21 años. El diagnóstico clínico fue realizado con punción lumbar y cultivo de LCR. Once pacientes presentaron serología positiva para VIH. Las RM fueron realizadas en resonadores de 0.5T y 1.5T, complementadas en dos casos con Tomografía Computada (TC de cerebro. A dos pacientes se les realizó difusión (DWI y a un paciente espectroscopía. Resultados. Del total de pacientes (n=20, 14 presentaron compromiso subaracnoideo en la convexidad y 13 compromiso subaracnoideo cisternal basal (afectación leptomeníngea. En 13 se observaron tuberculomas y 11 presentaron angeítis de grandes vasos; mientras que 7 tuvieron angeítis de pequeños vasos, 7 hidrocefalia, 6 infartos parenquimatosos y 1 afectación paquimeníngea. Quince pacientes tenían lesiones combinadas. Conclusión. La localización más frecuente de neurotuberculosis en esta serie fue meníngea con compromiso leptomeníngeo (14 pacientes con afectación subaracnoidea, seguido de afectación cisternal en 13 pacientes y sólo en un caso fue paquimeníngea. La manifestación parenquimatosa más frecuente fue el tuberculoma (granulomas tuberculosos con 13 casos. De estos, 5 presentaron un patrón miliar y sólo uno comportamiento pseudotumoral.Purposes. To report our case series of patients with a diagnosis of intracranial tuberculosis and to describe the different types of lesions characterizing this entity on Magnetic Resonance Imaging (MRI. Materials and Methods. For the present study, we retrospectively selected 20 patients with positive MRI findings of intracranial tuberculosis. Twelve of them were males and 8 were females, with an age range of between 8 months and 49 years (mean age: 21years. Clinical diagnosis was obtained by lumbar puncture and cerebrospinal fluid (CSF culture. Eleven patients presented positive HIV serology. MRIs were performed using 0.5T and 1.5 T scanners and computed tomography (CT of the brain was also performed in two patients. Diffusion-weighted technique was performed in two patients and spectroscopy in one patient. Results. Of the total patients studied (n=20, 14 presented convexity subarachnoid involvement and 13 subarachnoid basal cystern involvement (leptomeningeal involvement, 13 presented tuberculomas, 11 large-vessel angiitis, 7 smallvessel angiitis, 7 hydrocephalia, 6 parenchymatous infarction and one pachymeningeal involvement. Combined lesions were observed in 15 patients. Conclusion. The most frequent location of neurotuberculosis in this series was meningeal with leptomeningeal involvement (14 patients with subarachnoid involvement, followed by cysternal involvement in 13 patients, and only one patient had pachymeningeal involvement. The most frequent parenchymatous finding of tuberculosis was tuberculoma in 13 patients, 5 with a miliary pattern and only one with pseudo-tumoral behavior.

Jorge Docampo

2012-06-01

265

Pulmonary tuberculosis: relationship between sputum bacilloscopy and radiological lesions Tuberculose pulmonar: relação entre baciloscopia do escarro e lesões radiológicas  

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Full Text Available OBJECTIVES: To determine the frequency of radiological manifestations of chest tuberculosis among the tuberculosis outpatients at the Santa Casa de Misericórdia de São Paulo Hospital, and to correlate these radiological findings with the sputum bacilloscopy. SAMPLE AND METHODS: A review was made of the medical record cards and chest X-rays of all patients attended between January 1996 and December 1998. Patients with a diagnosis of tuberculosis who presented intrathoracic manifestations of the disease and negative anti-HIV serology were selected. RESULTS: The selection included 153 patients, with an average age of 37.5 years, who were predominantly male (60.8% and white (56.9%. Pulmonary lesions were present in 121 (79.9% and extrapulmonary lesions in 32 (20.1%. Parenchymal-infiltrate lesions appeared in 56 patients (36.6%, cavity lesions in 55 (36.0%, pleural effusion in 28 (18.3%, isolated nodules in 6 (3.9%, mediastinal enlargement in 4 (2.6% and miliary pattern in 4 (2.6%. Cavities were present in 45.5% of the patients with pulmonary lesions, generally in association with the parenchymal-infiltrate lesions. Parenchymal infiltrate was present in 86.8% of the patients with pulmonary lesions. There was significant presence of alcohol-acid resistant bacillus in the sputum of patients with cavities (76.4%, in comparison with those without cavities (50% (p = 0.003. CONCLUSIONS: Parenchymal-infiltrate lesions are the most frequent radiological manifestation of pulmonary tuberculosis, and they are generally associated with cavities. There is a relationship between the presence of acid fast bacilli in sputum and pulmonary cavity lesions.OBJETIVOS: Determinar a freqüência das manifestações radiológicas da tuberculose nos pacientes do Ambulatório de Tuberculose do Departamento de Medicina da Santa Casa de Misericórdia de São Paulo, e correlacionar a manifestação radiológica e a baciloscopia direta do escarro. CASUÍSTICA E MÉTODOS: Foram revisados os prontuários e as radiografias de tórax de todos os doentes atendidos entre janeiro/1996 e dezembro/1998. Foram selecionados os doentes com diagnóstico de tuberculose e que apresentavam manifestação intratorácica da doença e sorologia anti-HIV negativa. RESULTADOS: Foram incluídos 153 doentes, média de 37,5 anos, predominância do sexo masculino (60,8% e da raça branca (56,9%. Lesões pulmonares estavam presentes em 121 (79,1%; no restante ocorreu envolvimento torácico sem comprometimento pulmonar. Alterações do tipo infiltrado pulmonar ocorreram em 56 (36,6%, cavidade em 55 (36,0%, derrame pleural em 28 (18,3%, nódulo isolado em 6 (3,9%, linfonodomegalia mediastinal em 4 (2,6% e padrão miliar em 4 (2,6%. Excetuando-se as lesões extrapulmonares, cavidades estiveram presentes em 45,5% dos doentes com lesões pulmonares. Considerando o infiltrado pulmonar que acompanhou a lesão cavitária, em 105 (68,6% o infiltrado esteve presente. Excluindo-se aqueles com lesões extrapulmonares, o infiltrado apareceu em 86,8% dos doentes com lesões pulmonares. Baciloscopia foi positiva em 76,4% dos doentes com cavidade e em 50,0% dos sem cavidade (p = 0,003. CONCLUSÕES: O infiltrado pulmonar constitui-se na manifestação radiográfica mais freqüente da tuberculose pulmonar, estando a cavidade geralmente associada às lesões do tipo infiltrado pulmonar. Existe relação entre a presença de BAAR no escarro e as lesões cavitárias pulmonares.

Mauro Gomes

2003-10-01

266

Fase aguda da esquistossomose mansoni  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O A. faz um estudo panorâmico sobre a fase aguda da esquistossomose mansoni, abordando o quadro clínico e seu diagnóstico, os exames subsidiários, o diagnóstico diferencial, a terapêutica e os aspectos evolutivos. As manifestações clinicas dos períodos de incubação, de estado e de supressão são abor [...] dados. O diagnóstico da fase aguda é baseado em dado epidemiológico, 110 exame fisico e em exames subsidiários. O dado epidemiológico. em geral, é positivo, com menção a banho infectante, comumente 30 a 40 dias antes do início do quadro clínico e ao exame físico, encontramos hipertermia (38 - 4G°C), prostração, micropoliadenia hepatomegalia dolorosa em 95%, dos casos e esplenomegalia em 70% dos casos. Os exames prioritários para o diagnóstico são o exame parasiiológico de fezes seriado, que é positivo para ovos viáveis de S. mansoni e o leucograma seriado, que, geralmente, acusa leucocitose com eosinofilia. Em caso de dúvida ou para complementação diagnostica, podemos recorrer à endoscovia retal, ao oograma e á biópsia hepática. A endoscopia acusa, comumente, mucosa hiperêmica, edemaciada, friável, granulosa, com pontos hemorrágicos e o exame colhido por punção biópsia revela, entre outros achados, granulomas na fase necrótica-exsudativa. O diagnóstico diferencial deve ser feito com as seguintes entidades clínicas: gastroenterites. febre tifóide, disenteria bacilar, amebíase aguda, salmonelose septicêrnica prolongada, devendo, ainda, figurar a tuberculose miliar, abdome agudo, a G.N.D.A., a mononucleose infecciosa, a leptospirose, a hepatite e as poaneurites. A terapeutica é baseada nos cuidados gerais, na córticoterapia e na terapêutica específica. Observamos regressão dramática do quadro toxinfeccioso. nas primeiras 24 a 48 horas com a córticoterapia (prednisona) que tem duração aproximada de 7 a 10 dias. A terapêutica específica (derivado nitrotiazolico = ambilhar e derivado hidroximetílico do miracil D = hycanthone) é empregada após remissão do quadro toxiinfeccioso ou em plena fase aguda; nesta eventualidade os sintomas gerais e os distúrbios intestinais desaparecem a partir do 5.° dia de terapêutica. Quando empregamos ambilhar ou hycanthone, em apenas um esquema terapêutico, observamos 40% de cura; esta cifra atinge a 80-90%, quando repetimos a medicação específica, após verificarmos recidiva. Abstract in english In this panoramic study about the acute phase of schistosomiasis mansoni the author describe its clinical picture and diagnosis, the complementary tests, the author describes its clinical picture and diagnosis, the complementary tests, ical pictures of the incubation, fastigium and suppression perio [...] ds are described. The diagnosis of the acute phase is based on epidemiologic data are often positive, there being mention to an infective bath, usually 30 to 40 days prior to the onset of the disease. Fever (38-40°C) is noticed at the physical examination, as well as prostation and microlymphadenopathy. Enlargement and tenderness of the liver are found in 95 percent and splenomegaly in 70 per cent of the cases. The most important laboratory tests for the diagnosis are: repeated direct examination in stool specimens for the detection of viable S. mansoni eggs, and repeated leukocyte count that generally shows leukocytosis and eosinophilia. When in doubt or for diagnostic complementary one may always recourse to the rectal endoscopy, the ocgrama and the liver biopsy. The endoscopy usually reveals hyperemic, edematous, friable and granulous mucosa with bleeding points. The needle-biopsy of the liver followed by the histopathologic examination of the hepatic tissue discloses granulomas in the necrotic-exudative phase, among other findings. The differential diagnosis must be made with diseases as follows: gastroenteritis, typhoid fever, bacilar disentery, acute amebiasis, and prolonged septicaemic salmonellosis, although one should also include miliary tub

Edward, Tonelli.

1972-10-01

267

[Progress in management of severe tuberculosis or tuberculosis with severe complication].  

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The management and therapy of miliary tuberculosis: Nobuharu OHSHIMA (Asthma and Allergy Center, National Hospital Organization Tokyo National Hospital). Treatment and management of severe pulmonary tuberculosis: Yuta HAYASHI, Kenji OGAWA (Department of Respiratory Medicine, National Hospital Organization Higashi Nagoya National Hospital). Death of a young (non-elderly) patient may become a large psychological burden not only for patient's family but also for medical staff. We analyzed non-elderly cases with severe pulmonary tuberculosis by comparing 13 patients who died of tuberculosis in the hospital (death group) and 31 patients who survived and were discharged from hospital (survivor group). The mean age was older and there were more patients who were out of employment in the death group compared to the survivor group. Among the factors related to the general condition evaluated on the admission, disturbance of consciousness, respiratory insufficiency, impairment in the ADL, poor dietary intake, and decubitus ulcer were more observed in the death group. Chest X-ray finding was not a predictive factor of poor prognosis. Among the laboratory findings, the numbers of peripheral blood lymphocytes, red blood cells, and thrombocytes significantly decreased in the death group. Serum level of total cholesterol, cholinesterase, and albumin were also significantly lower in the death group, indicating that malnutrition was related to the death of severe tuberculosis. Further studies are needed to establish the optimal nutritional management and evaluate the effectiveness of adjunctive use of steroid for severe tuberculosis patients. Invasive fungal infection complicated with pulmonary tuberculosis: Akira WATANABE, Katsuhiko KAMEI (Division of Clinical Research, Medical Mycology Research Center, Chiba University). Among the invasive mycoses, chronic pulmonary aspergillosis (CPA) is the most frequent disease as a sequel to pulmonary tuberculosis. However, identifying CPA early in patient with persistent pulmonary shadows from pulmonary tuberculosis is difficult. Serum microbiological tests such as Aspergillus precipitans (principally for Aspergillus IgG antibodies) are useful but sensitivity and specificity of this test are not high. Even treated, CPA has a case mortality rate of 50% over a span of 5 years. Morbidity is marked by both systemic and respiratory symptom and hemoptysis. Loss of lung function and life-threatening hemoptysis are common. As invasive pulmonary aspergillosis, early diagnosis and treatment of CPA might improve the outcome. Regarding the treatment, concomitant use of some anti-tubercular agents and antifungals is contradicted. Treatment and management for pulmonary tuberculosis complicated with COPD and interstitial pneumonia: Shinji TAMAKI, Takashi KUGE, Midori TAMURA, Sayuri TANAKA, Eiko YOSHINO, Mouka TAMURA (National Hospital Organization Nara Medical Center), Hiroshi KIMURA (Second Department of Internal Medicine and Respiratory Medicine, Nara Medical University) Recently, patients of pulmonary tuberculosis have many complications especially in the elderly population. It is recognized that patients with COPD and interstitial pneumonia (IP) have an increased risk for developing active tuberculosis. The aim of this report is to describe the clinical findings of pulmonary tuberculosis complicated with COPD and IP. We reviewed 327 patients who were diagnosed as pulmonary tuberculosis. Twenty-six cases were complicated with COPD. All patients were male, and had smoking history. Cavitary lesions were observed only in 5 cases. Acute exacerbation of COPD occurred in one fatal case. Ten cases were complicated with IP. Cavitary lesions were observed in 3 cases. Acute exacerbation of IP were observed in 7 cases, and 4 patients died during the anti-tuberculosis treatment. Careful evaluation and treatment are necessary for tuberculosis patients complicated with COPD and IP. PMID:24979949

Kimura, Hiroshi; Imaizumi, Kazuyoshi

2014-05-01

268

[Tuberculosis Annual Report 2011--(2) Childhood and elderly tuberculosis].  

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In 2011, the number of newly notified childhood tuberculosis (TB) cases (tuberculosis patients aged 0-14 years) in Japan was 84, which corresponds to a notification rate of 0.50 per 100,000. The annual notified numbers and rates (per 100,000 population) of childhood TB cases decreased steadily until 2006, when the number became less than 100, after which the numbers have since remained stable. Among the 84 childhood TB patients who were notified in 2011, 33 (39.3%) were aged 0-4 years, 20 (23.8%) were aged 5-9 years, and 31 (36.9%) were aged 10-14 years. The proportion of TB patients aged 10-14 years was higher in 2011 than in previous years. In 2011, one TB meningitis case and two miliary TB cases were reported in children. Further, 23 symptomatic patients (27.4%) were identified at medical institutions and 45 patients (53.6%) were identified by contact investigation of household members. Together, these groups of patients accounted for nearly 80% of the cases of childhood TB that were detected, which was similar to the percentage in previous years. Since 1999, the notification rates of TB patients aged 85 years and above have been consistently higher among those aged 65 years and above in Japan. The annual rate of reduction in the notification rates of TB patients aged 65-79 years has accelerated from 12,625 in 2000 to 6,427 in 2011. The proportion of TB patients aged 65 years and above has consistently increased, reaching up to more than 60% in 2011; notably, the proportion of TB patients aged 80 years and above has increased to more than 30%. The proportion of bacteriologically positive TB cases among pulmonary TB (PTB) cases was higher in those aged 65 years and above than those aged 15-64 years. The proportion of PTB patients with only nonrespiratory symptoms increased with age, reaching 28.9% in those aged 85 years and above. The proportion of TB cases associated with a patient delay of two months or longer was much less in the patients aged 65 years and above than those aged 15-64 years (14.5% vs. 25.8%), whereas the proportion of TB cases associated with a doctor delay of one month or longer was slightly higher in the patients aged 65 years and above than those aged 15-64 years (24.2% vs. 20.0%). Of the newly notified TB patients in 2010 whose treatment outcomes are available as of writing, 28.5% died within a year after the initiation of TB treatment; of these, 16.3% died within three months. The proportion of deaths within three months after the initiation of the TB treatment among the patients aged 65 years and above showed substantial increase with age from 3.6% in 65-69 years old to 17.0% in 90 years and above. PMID:23986943

2013-07-01

269

 

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Full Text Available SciELO Brazil and Public Health | Language: Portuguese Abstract in portuguese OBJETIVO: A vacina BCG é utilizada desde 1921, embora ainda apresente controvérsias e aspectos não esclarecidos. O objetivo do artigo foi analisar aspectos relacionados ao efeito protetor da primeira e segunda doses da vacina BCG e as políticas de vacinação adotadas. MÉTODOS: Foi realizada revisão s [...] istemática da literatura publicada em inglês e espanhol, abrangendo o período compreendido entre 1948 e 2006, na base PubMed. Os principais descritores utilizados foram BCG vaccine, BCG efficacy, BCG e tuberculosis. Os estudos foram agrupados por tipo de desenho, apresentando-se separadamente os principais resultados de ensaios clínicos, estudos de caso-controle e metanálises. RESULTADOS: O efeito protetor da primeira dose da vacina BCG contra a tuberculose na forma miliar ou na meningite é elevado. No entanto, os resultados são discordantes em relação à forma pulmonar, variando de ausência de efeito a níveis próximos a 80%. Estão sendo conduzidas pesquisas sobre novas vacinas candidatas a substituir a BCG ou serem utilizadas como reforço. CONCLUSÕES: Há evidências de que a segunda dose da BCG não aumenta o seu efeito protetor. Apesar de seus limites e da expectativa futura de nova vacina para tuberculose, a vacina BCG mantém-se como importante instrumento no controle dos efeitos danosos da doença, sobretudo em países com taxas de incidência médias e elevadas. Abstract in english OBJECTIVE: The BCG vaccine has been in use since 1921, but still arouses controversy and uncertainties. The objective was to analyze the protective effect of the BCG vaccine in its first and second doses and the accompanying vaccination policies. METHODS: A systematic review of the literature in bot [...] h English and Spanish was carried out, covering the period 1948 to 2006, using the PubMed database. The main search terms used included BCG vaccine, BCG efficacy, BCG and tuberculosis. The studies were grouped by design, with the main results from the clinic tests, case-control studies and meta-analyses presented separately. RESULTS: The protective effect of the first dose of the BCG vaccine against tuberculosis in its miliary and meningeal forms is high. However, the results vary in relation to the pulmonary form of the disease, with some indicating zero effect and others levels of nearly 80%. Research is being carried out to develop new vaccines that could substitute the BCG or be used as a booster. CONCLUSIONS: There are evidences that the protective effect of the BCG vaccine does not increase with a second dose. In spite of its limitations and the expectation that a new tuberculosis vaccine will be developed in the future, the BCG vaccine remains an important tool in controlling the harmful effects of tuberculosis, particularly in countries with medium or high incidence levels of the disease.

Susan M, Pereira; Odimariles Maria Souza, Dantas; Ricardo, Ximenes; Mauricio L, Barreto.

2007-09-01

270

[Tuberculosis annual report 2012 --(2) Childhood and elderly tuberculosis].  

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In 2012, there were 63 newly notified childhood tuberculosis (TB) patients (patients aged 0-14 years) in Japan, corresponding to a notification rate of 0.38 per 100,000. The annual number of notified childhood TB patients was less than 100 in 2006, since then the numbers and rates (per 100,000 population) decreased steadily. Of the 63 patients with childhood TB notified in 2012, 30 (47.6%) were aged 0-4 years, 12 (19.0%) were aged 5-9 years, and 21 (33.3%) were aged 10-14 years. Thus, the proportion of TB patients aged 0-4 years was the highest among children. In 2012, only one patient of TB meningitis and no patient of miliary TB were reported in children. On the point of case detection, similar to percentages reported in previous years, 22 patients (34.9%) were identified at medical institutions and 32 patients (50.8%) were detected by contact investigation of household members. Since 1999, the notification rates of TB in Japan have been consistently higher among patients aged 85 years and above than among those aged 65-84 years in Japan. The annual rate of reduction in the notification rates of TB patients aged 65 years and above in 2012 (13,307 cases) was 3.3%, compared to 2011 (13,756 cases). The proportion of TB patients aged 65 years and above has consistently increased, reaching up to 62.5% in 2012; notably, the proportion of TB patients aged 80 years and above has increased to 34.0%. The proportion of bacteriologically positive TB patients among pulmonary TB (PTB) patients was higher among those aged 65 years and above than among those aged 15-64 years. The proportion of PTB patients with only non-respiratory symptoms increased with age, reaching 27.6% among those aged 85 years and above. The proportion of TB patients associated with patient delay of two months or longer was lower among the patients aged 65 years and above than among those aged 15-64 years (14.5% vs. 26.7%), whereas the proportion of TB patients associated with doctor delay of one month or longer was slightly higher among patients aged 65 years and above than among those aged 15-64 years (22.9% vs. 20.2%). Of the newly notified TB patients aged 65 years and above in 2011 whose treatment outcomes were available at the time of reporting, 31.3% died within a year after the initiation of TB treatment; of these, 18.4% died within three months. The proportion of deaths within three months after the initiation of TB treatment among patients aged 65 years and above increased substantially with age from 8.1% in the 65-69 years age group to 31.9% in the 90 years and above age group. PMID:25195303

2014-07-01

271

Aspectos tomográficos da tuberculose pulmonar em pacientes adultos com AIDS / Computed tomography findings of pulmonary tuberculosis in adult AIDS patients  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Este trabalho tem como finalidade descrever os achados tomográficos da tuberculose pulmonar em pacientes adultos com AIDS atendidos no serviço de radiologia de um hospital de referência em doenças infecciosas, procurar associações desses achados e a contagem de CD4. MATERIAIS E MÉTODOS: Fo [...] ram estudados 45 pacientes por meio de tomografia computadorizada de tórax durante quatro anos. RESULTADOS: Foram encontrados linfonodomegalia mediastinal e/ou hilar em 31 (68,8%) dos casos, derrame pleural em 29 (64,4%), nódulos centrolobulares de distribuição segmentar em 26 (57,7%), consolidação em 24 (53,3%), confluência de micronódulos em 17 (37,7%), nódulos mal definidos com distribuição centrolobular em 16 (35,5%), padrão de "árvore em brotamento" em 13 (28,9%), espessamento de parede brônquica em 12 (26,6%), cavidade de parede espessa em 10 (22,2%), nódulos miliares em 9 (20%) e bronquiectasias cilíndricas em 6 (13,3%). Dos 45 pacientes, 35 (77,8%) apresentaram CD4 200 cel/mm³. CONCLUSÃO: Concluímos que neste estudo, diversamente do descrito na literatura, linfonodomegalia mediastinal e/ou hilar e consolidação foram significativamente mais frequentes em pacientes com CD4 > 200 cel/mm³. No entanto, linfonodos com centro hipodenso foram mais frequentemente observados em pacientes com severa imunodepressão, ou seja, CD4 Abstract in english OBJECTIVE: The present study is aimed at describing computed tomography findings pulmonary tuberculosis in adult AIDS patients assisted at a radiology unit of a reference infectious diseases hospital, in an attempt to establish the association between such findings and CD4 count. MATERIALS AND METHO [...] DS: Forty-five patients were evaluated by chest computed tomography over a four-year period. RESULTS: Mediastinal and/or hilar lymph node enlargement was found in 31 (68.8%) cases, pleural effusion in 29 (64.4%), centrilobular nodules with segmental distribution in 26 (57.7%), consolidation in 24 (53.3%), confluent micronodules in 17 (37.7%), poorly defined nodules with centrilobular distribution in 16 (35.5%), tree-in-bud pattern in 13 (28.9%), bronchial wall thickening in 12 (26.6%), thick-walled cavity in 10 (22.2%), miliary nodules in 9 (20%), and cylindrical bronchiectasis in 6 (13.3%). Among the 45 patients, 35 (77.8%) presented CD4 count 200 cel/mm³. CONCLUSION: Differently from reports in the literature, the authors conclude that mediastinal and/or hilar lymph node enlargement and consolidation were significantly most frequent in patients with CD4 count > 200 cel/mm³. However, lymph nodes with hypodense center were most often observed in severely immunosuppressed patients with CD4 count

Lanamar Aparecida de, Almeida; Mario Flores, Barba; Fernando Alves, Moreira; Sidney, Bombarda; Sebastião André de, Felice; Edenilson Eduardo, Calore.

2011-02-01