scholarly journals The Role of a Rapid Prevention of Ralstonia pickettii Growth during Dialysis in a Frail Patient

Reports ◽  
2021 ◽  
Vol 4 (4) ◽  
pp. 39
Author(s):  
Manuela Colosimo ◽  
Maria Lucia Citraro ◽  
Cinzia Donato ◽  
Filippo Luciani ◽  
Luca Gallelli ◽  
...  

Ralstonia pickettii is an opportunistic bacillus found in Pseudomonas species, with the ability to induce systemic infections. We report the case of a 69-year-old man, with a clinical history of myeloma, Type IIdiabetes, renal failure (grade IV), and colon cancer, that developed a severe bacterial infection, with acute asthenia and a fever, that appeared at the end of dialysis. Using theMALDI-TOF technology, the bacillus Ralstonia pickettii was identified, and an antimicrobial treatment was quickly started with a rapid microbiological remission.

2017 ◽  
Vol 5 (3) ◽  
pp. 397-398
Author(s):  
Anastasiya Atanasova Chokoeva ◽  
Georgi Tchernev

A 28-year-old male patient, presented with a one-week history of pain and itching on the skin of the left upper leg. Erythematous indurated, warm and painful on palpation, subcutaneous plaques and nodules were clinically observed, affecting the skin of the left upper leg, within a recent black-wolf tattoo. The diagnosis of traumatic panniculitis with superposed bacterial infection, provoked by a wolf tattoo was made.  The patient underwent 7-days systemic antibiotic treatment regimen and topical application of iodine povidone unguent under occlusion for 7 days. Significant alleviation of the subjective complaints was achieved within the first week, with a total clinical resolution of the symptoms. The role of the procedure as a source of trauma for subcutaneous inflammation (traumatic panniculitis) and the contamination of the equipment or the staff (infective panniculitis) in simultaneously triggering of the pathogenetic chain of the reported Wolf’s panniculitis could be present.


1996 ◽  
Vol 105 (9) ◽  
pp. 694-700 ◽  
Author(s):  
Joseph B. Jacobs ◽  
Barry A. Shpizner ◽  
Eugenie Brunner ◽  
Richard A. Lebowitz ◽  
Roy A. Holliday

Agger nasi cells contribute to nasofrontal duct (NFD) obstruction and chronic frontal sinus disease. To investigate this relationship, we conducted a review of the surgical outcome and computed tomographic imaging in 26 patients with chronic frontal sinusitis. Coronal and sagittal images were used to delineate the anatomic variability and mucosal disease in the NFD and frontal sinus region. Data from coronal and sagittal images were compared. The results were also correlated with the outcome of frontal sinus surgery in patients with a clinical history of chronic frontal sinus disease. Our data suggest that agger nasi cell pneumatization with narrowing of the frontal sinus outflow tract is a significant cause of persistent frontoethmoid pain and chronic frontal sinusitis. Sagittal reformatted images are more capable than coronal images of demonstrating agger nasi cell encroachment on the NFD, as well as NFD mucosal disease. Endoscopic frontal sinusotomy is an effective treatment for chronic frontal sinus disease.


2021 ◽  
pp. 41-49
Author(s):  
Shubhabrata Das ◽  
Tanmoy Pal

Most cases of post-traumatic meningitis (PTM) occur following immediate head trauma or neurosurgical procedures. Hence, internists do not often come across these patients. However, closed-head trauma can be associated with community-acquired meningitis (CAM), and this history can often be missed especially if it is remote or trivial in nature. Therefore, meticulous clinical assessment is necessary to identify cases of community-acquired PTM. Knowledge about pathophysiological, anatomical, and microbiological context of community-acquired PTM is required in order to manage these patients. The role of internist is to provide holistic management in these patients which includes not only antimicrobial treatment but also timely referral to surgical specialties if required as well as vaccination to prevent further episodes. Here, we present a case of CAM with remote history of close head trauma and cerebrospinal fluid rhinorrhea for years who was found to have base of skull (BOS) defect on imaging of skull. He was treated with antibiotics and referred to surgical specialties for repair of BOS defect as well as given pneumococcal vaccine to prevent further episodes of meningitis.


Author(s):  
Gustavo Aroca Mart ◽  
Ra Garc ◽  
Andr Cadena Bonfanti ◽  
Marco Anaya Taboada ◽  
Lucia Mercedes Ni ◽  
...  

Se designa con el nombre de amiloidosis a un grupo de enfermedades poco frecuentes, que se caracterizan por el depósito extracelular de un material proteico fibrilar denominado amiloide. La afectación renal en la amiloidosis sistémica es frecuente, por lo que se le asocia un pronóstico desfavorable, al ser la falla renal la segunda causa de muerte en los pacientes que la presentan. El objetivo de este trabajo consistió en presentar el caso de un hombre de 55 años, hipertenso de novo, con cuadro clinico de 7 meses de evolución de edema progresivo asociado a disnea, oliguria y hematuria, documentándose síndrome nefrótico en paraclínicos. El reporte histopatológico reveló acumulación de material eosinofílico rojo congo positiva a nivel glomerular, e inmunofluoresencia positiva para cadenas livianas en patrón mesangial, compatible con amiloidosis renal. La amiloidosis sigue siendo un desafío para los clínicos, en cuanto a su diagnóstico y tratamiento, y el pronóstico empeora a medida que se comprometen más órganos. La principal causa de muerte de los pacientes con amiloidosis obedece a trastornos cardiacos, siendo la segunda causa la falla renal.ABSTRACTA group of rare diseases are called amyloidosis. It is characterized by extracellular fibrillar protein material named amyloid deposit. Renal involvement in systemic amyloidosis is often, giving an unfavorable prognostic, being this one the second death cause in these kind of patients. It aims to show a 55 years old man, hypertensive with a clinical history of 7 months with a progressive edema associated with dyspnea, oliguria and hematuria, reporting nephrotic syndrome in paraclinical patients. The histopathological report reveals accumulation of Congo red coloured material positive in glomerular level and positive iimmune-fluorescence for light chains in mesangial pattern associated with renal Amyloidosis. Amyloidosis is still a challenge for clinical patients. based on its diagnosis and treatment. The prognosis is even worst as more organs are committed. It should be considered that the main cause of death of an amyloidosis patient is cardiac disorders, being renal failure the second cause of death.


2015 ◽  
Vol 33 (16) ◽  
pp. 1721-1728 ◽  
Author(s):  
Elena M. Stoffel

Genetic and epigenetic alterations identified in tumors of different cancer types can provide insights regarding the roles played by different cell signaling pathways in carcinogenesis. Somatic mutation profiles of GI tumors are used to guide choice of chemotherapy and can facilitate identification of individuals whose cancers arise in the setting of genetic predisposition. This review provides a framework for how clinical history, family history of cancer, and tumor genomic phenotype can be used to screen patients with colorectal, gastric, or pancreatic cancer for hereditary cancer syndromes. Early identification of individuals who carry germline mutations can affect clinical care not only for patients with cancer but also for their at-risk relatives.


2020 ◽  
Author(s):  
Suci Indriani ◽  
Suko Adiarto ◽  
Hananto Andriantoro ◽  
Ismoyo Sunu ◽  
Taofan Siddiq ◽  
...  

Abstract Background This study aims to identify risk factors associated with in-hospital and 30-days mortality in patients with acute limb ischemia (ALI). Methods This study was a single-centered cohort enrolling a total of 160 consecutive patients with a diagnosis of ALI. The ALI diagnosis was based on clinical history, physical examination, and Doppler studies of the extremities. The main outcome of this study is in-hospital and 30-days mortality. Results There were a total of 170 patients involving 192 limbs with the diagnosis of ALI. Intra-aortic balloon pump (IABP) insertion (HR 3.4; 95% CI 1.0-11.3, p = 0.042), no vitamin E treatment (HR 5.6; CI 1.7–18.3, 0.004), arrhythmia (HR 12.00; CI 3.8–37.7, p < 0.001), and acute renal failure (HR 6.70; CI 1.88–24.3, p = 0.003) were an independent predictor of intra-hospital mortality. For 30-days mortality, the independent predictors were menopause (HR 3.2; CI 1.16–8.85, p = 0.02); IABP insertion (HR 4.51; CI 1.14–17.92, p = 0.03); arrhythmia (HR 0.11; CI 0.04–0.32, p < 0.001); bleeding requiring transfusion (HR 3.77; CI 0.10-14.28, p = 0.05); and acute renal failure (HR 5.5; CI 1.79–16.95, p = 0.003). Conclusion In-hospital mortality in patients with ALI remains high in our center. Several factors contributing to mortality were arrhythmia, renal failure, no vitamin E supplementation, and a history of recent cardiac operation.


2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
E. C. Cashman ◽  
M. J. Donnelly

Globus pharyngeus is a common disorder and accounts for 5% of all ENT referrals.Objectives. To evaluate the role of barium swallow and endoscopy in these patients, to ascertain the incidence, if any, of aerodigestive tract malignancy in this group and to assess the natural evolution of globus pharyngeus.Materials and Methods. Seventy-nine patients underwent barium swallow and rigid oesophagoscopy for globus pharyngeus between January 2005 and October 2008. Fifty-five patients were contacted by phone on average 5 years and 3 months after intervention and asked if their symptoms still persisted. Twenty-four patients were uncontactable or lost to followup, three patients were deceased, two of cardiac related disease and one of renal failure.Results. The majority of patients, 36 of 55 (65%), had a normal barium swallow. Forty-five of 55 (82%) of patients had normal rigid endoscopies. Thirty-one of 55 (56%) patients were at an average followup time of 5 years and 3 months. No patient developed a malignant lesion.Conclusion. Globus pharyngeus is a relatively common but benign condition of indeterminate origin. Our study demonstrates that many of these patients spontaneously improve with time.


2009 ◽  
Vol 11 (4) ◽  
pp. 326-329 ◽  
Author(s):  
Luca Aresu ◽  
Renato Zanatta ◽  
Paola Pregel ◽  
Diego Caliari ◽  
Massimiliano Tursi ◽  
...  

Renal dysplasia is defined as a condition of disorganised development of renal parenchyma due to abnormal differentiation. The case of a 5-month-old intact male Norwegian Forest Cat with a history of polyuria and polydipsia is reported. Ultrasonographic examination showed a slight enlargement of kidneys. Biochemical parameters, haematological examinations and clinical signs were compatible with chronic renal failure (CRF). Histological examination was correlated with a primary tubular disorganisation and modification of glomerular compartment. The clinical history together with the histological lesions is consistent with bilateral juvenile renal dysplasia in this cat. To our knowledge, feline renal dysplasia has been reported in fetal infections with panleukopenia virus; no reports indicate the idiopathic origin in feline dysplastic lesions.


2010 ◽  
Vol 3 (1) ◽  
pp. 31-35
Author(s):  
Jiaming Yao ◽  
Kathleen Hickey

Long QT syndrome (LQTS) is a hereditary disorder in which the majority of affected individuals present with QT prolongation on electrocardiograms (ECGs), arising from delayed ventricular repolarization. This commonly arrhythmia-associated genetic syndrome can lead to sudden cardiac death (SCD) and increased propensity for arrythmogenic syncope. The authors describe the case of a young patient who presented with episodes of syncope, prolonged QTc interval on ECG, and family history of SCD. He subsequently received an ICD for protection against SCD based on his prior clinical history. The article discusses the clinical manifestations, electrocardiographic (ECG) findings, management of LQTS, and role of the clinician in testing, teaching, and counseling the affected patients and families.


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