[Two cases of pulmonary Schizophyllum commune infection and literature review].
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Abstract:
本文分析2例肺部普通裂褶菌感染患者的临床资料，同时进行文献复习，总结肺部普通裂褶菌感染的临床表现、影像学特点和治疗方案等，以提高临床医生对该病的诊治水平。本组2例肺部普通裂褶菌感染者主要表现为咳嗽、咳痰，胸部CT影像学特点为肺部实变影、部分痰栓形成及肺部团块影，其中例1患者经支气管镜镜下清除痰栓，肺部病灶完全吸收。对有腐木等可疑接触史，伴有呼吸道症状，实验室检查示外周血嗜酸性粒细胞计数、总IgE水平升高，胸部影像学提示有痰栓改变，应考虑到该病的可能，积极完善支气管镜检查及病原学送检是关键。.Keywords:
Schizophyllum commune
Pulmonary infection
Urinary retention
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Objetive: Evaluate clinically and radiographically whether the presence and size of dural ectasia (ED) is associated
with low back pain in patients with Marfan syndrome (MS).
Material and method: 92 patients diagnosed with MS according to Ghent criteria were studied prospectively
for one year. Underwent a medical history, imaging tests, including a lumbar spine MRI volumetric and 3
questionnaires were given: SRS 22 (Scoliosis Research Society) and SF 36 v-2 and Oswestry Disability Index
subdivided according to the sample in group I (patients with moderate lower back pain and / or severe) and
group II (patients without pain).
Results: Multivariate analysis of variables related to low back pain, the ED reached statistical significance.
ED was present in 75.9% of patients in group I, and 49.2% in group II. The presence of ED is associated with
low back pain in patients with MS with an OR of 3.24 (1.21 to 8.68) p = 0.016 and the presence of vertebral
deformity (scalloping) with an OR of 129, 83 (16.1 to 1047.74) p <0.001.
Conclusion: The presence and size of ED was significantly associated with LBP in the SM but the «scalloping»
does not affect the increased intensity of pain.
Oswestry Disability Index
Back Pain
Ectasia
Univariate analysis
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Thirty-four hips (22 patients) with history and physical findings consistent with osteonecrosis of the femoral head were evaluated preoperatively by radiographs, bone scans and magnetic resonance images. All patients with Stage 0, I, or II disease by the Ficat and Arlet classification underwent core decompression using the same technique. Osteonecrosis was confirmed histologically in all 34 hips. Eighteen of 22 patients had prognostic factors traditionally associated with poor outcome including collagen vascular diseases and continued use of steroids. Followup averaged 4 years for 18 patients with 29 hips. Four patients died secondary to systemic illness. Twelve patients had good or excellent results using the Modified Harris Hip Score with 6 patients needing hip arthroplasty. In this group of patients previously associated with poor prognosis, no hip fractures were seen and 66% good to excellent results were obtained.
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Hip Arthroplasty
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Parotitis
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The current treatment of massive pulmonary embolism (PE) has been either thrombolysis or surgical embolectomy. Percutaneous rheolytic thrombectomy, however, has emerged as an alternative treatment in patients with contraindications to thrombolysis. This case illustrates the usefulness of the AngioJet(R) thrombectomy catheter in patients with contraindications to thrombolytics. Three-dimensional computed tomography imaging demonstrated the effectiveness of treatment in this patient with massive PE.
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A kidney transplanted patient developed a nosocomial pneumonia and pleural empyema due to Legionella pneumophila. Despite erythromycin and rifampin treatment the patient died. The diagnosis was made by direct fluorescent antibody staining of pleural fluid.
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Legionnaires' disease
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Tuberculosis of the ankle joint is relatively uncommon, and the treatment usually includes chemotherapy, immobilization and non-weight bearing protection. It is easily confused with pyogenic arthritis, which often leads to delayed diagnosis. We reviewed the records of 4 patients with ankle tuberculosis with advanced articular lesions without evidence of pulmonary tuberculosis. They took antituberculous agents for 5 to 6 months. Two of them had positive bacterial cultures, and all four had initially received surgical management under the impression of pyogenic osteomyelitis. Two patients underwent arthrodesis and the other two synovectomy with debridement. The clinical and radiologic results were better in the patients who underwent arthrodesis. We consider surgery with open biopsy of a painful swelling ankle to be helpful in the differential diagnosis of tuberculous and pyogenic arthritis. Arthrodesis in patients with severe osteoarticular destruction of the ankle provides a better prognosis and more stable joint than other treatment methods.
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Debridement (dental)
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