RESUMEN
INTRODUCTION: Thoracic endometriosis (TE) is a rare disorder affecting women during their reproductive years. Manifestations of TE include pneumothorax and haemothorax. Treatment is based on surgical and hormonal therapy that aims at eradicating existing endometrial thoracic plaques and to prevent reseeding from pelvic endometriosis. CASE REPORT: We report the case of a 36 year-old young woman presenting thoracic endometriosis revealed by a recurring spontaneous, large and isolated right haemothorax. Diagnosis, pathogeny and treatment are discussed. CONCLUSION: Thoracic endometriosis needs to be considered as a cause of haemothorax in women of childbearing age.
Asunto(s)
Endometriosis/diagnóstico , Hemotórax/diagnóstico , Enfermedades Torácicas/diagnóstico , Adulto , Endometriosis/complicaciones , Endometriosis/cirugía , Femenino , Hemotórax/etiología , Hemotórax/cirugía , Humanos , Enfermedades Pleurales/complicaciones , Enfermedades Pleurales/diagnóstico , Enfermedades Pleurales/cirugía , Neumotórax/diagnóstico , Neumotórax/etiología , Neumotórax/cirugía , Recurrencia , Enfermedades Torácicas/complicaciones , Enfermedades Torácicas/cirugíaRESUMEN
The fibromyalgia syndrome (FMS) is considered to result from the exposure of a genetically susceptible individual to various triggers, such as physical trauma, stress, viral infections etc. A possible role of vaccination in FMS etiology has been suspected. Our objective was to evaluate the efficacy and safety of influenza vaccination in FMS patients. Nineteen FMS patients underwent physical and dolorimetric examinations and answered the fibromyalgia impact questionnaire (FIQ), the widespread pain index (WPI) checklist and the symptoms severity scale (SSS), which are part of the 2010 diagnostic criteria. Thirty-eight healthy subjects were recruited as controls. All participants were vaccinated with the inactivated split virion influenza vaccine. Serum was collected for antibody titration. Six weeks after vaccination, sera were tested by hemagglutination (HI) against A/California (H1N1), A/Perth (H3N2) and B/Brisbane. Humoral response was defined as either a fourfold or greater increase in titer, or an increase from a non-protective baseline level of <1/40 to a level of 1/40. No severe vaccination reactions were observed. No significant change was observed between WPI, SSS and FIQ values before and after vaccination, indicating no worsening of FMS symptoms. Vaccine immunogenicity: Six weeks after vaccination, FMS patients showed a significant increase in geometric mean titers of HI antibody. The rates of sero-protection increased from 22.9% for H1N1 to 89.5% post-vaccination. A significant increase in HI antibody titers was also demonstrated among healthy controls. Influenza vaccination was both safe and effective in FMS patients. In view of these results, FMS patients should be encouraged to undergo influenza vaccination according to the standard WHO recommendations.
Asunto(s)
Fibromialgia/fisiopatología , Vacunas contra la Influenza/efectos adversos , Vacunación/efectos adversos , Adulto , Anticuerpos Antivirales/biosíntesis , Anticuerpos Antivirales/sangre , Progresión de la Enfermedad , Femenino , Humanos , Inmunogenicidad Vacunal , Subtipo H3N2 del Virus de la Influenza A/inmunología , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Vacunas de Productos InactivadosRESUMEN
Seronegative spondyloarthritis (SpA) represents a group of diseases that share certain genetic, clinical, and radiographic features. Enthesitis, inflammation at the site of tendon insertion into the bone, involving both the axial and the peripheral joints, is an important sign of SpA. Clinical diagnosis of enthesitis, however, is neither sensitive nor specific; thus, the diagnosis of enthesitis often relies on typical abnormalities in imaging studies. Due to its low costs and availability, ultrasound is emerging as the preferred technique for detection of enthesitis for both clinical and research purposes. Ultrasonographic features of enthesitis include tendon hypoechogenicity and thickening, calcifications, bone erosions, and Doppler signal. Several semi-quantitative scoring systems have been developed to quantify ultrasonographic abnormalities of the entheses. These methods have been used for early diagnosis and classification of SpA as well as for monitoring response to treatment.
Asunto(s)
Enfermedades Reumáticas/diagnóstico por imagen , Espondiloartritis/diagnóstico por imagen , Humanos , UltrasonografíaAsunto(s)
Hemangioma/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Adulto , Antineoplásicos/uso terapéutico , Benzamidas , Brucelosis/diagnóstico por imagen , Medios de Contraste , Femenino , Fluorodesoxiglucosa F18 , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/cirugía , Hemangioma/tratamiento farmacológico , Hemangioma/patología , Humanos , Mesilato de Imatinib , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/patología , Imagen por Resonancia Magnética , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Radiofármacos , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
BACKGROUND: Intentional selective occlusion of the arterial blood supply to tumors of abdominal organs is a well established therapeutic procedure. Several reports described gas accumulation at the infarcted sites. These gas collections are usually nonsuppurative; however, the differential diagnosis should include abscess formation. CASE REPORT: We present a 59-year-old patient in whom the splenic artery was accidentally ligated during gastrectomy surgery, with resultant splenic infarction. Gas accumulation was diagnosed by sonography and CT studies. To the best of our knowledge this is the first report ever published in the English medical literature describing nonsuppurative gas formation within an abdominal organ, caused by accidental ligation of its main arterial supply during surgery. SUMMARY: Possible theories regarding this noninfectious gas accumulation are discussed and the differential diagnosis between abscess formation and noninfectious gas accumulation is emphasized. Establishing the correct diagnosis is of big clinical importance as the treatment of choice is completely different in each one of these entities although the imaging features, in ultrasound as well as in CT, are somewhat similar.
Asunto(s)
Gases , Infarto del Bazo/diagnóstico , Diagnóstico Diferencial , Gastrectomía/efectos adversos , Humanos , Ligadura , Masculino , Errores Médicos , Persona de Mediana Edad , Arteria Esplénica/cirugíaRESUMEN
Reported herein is a 41-year-old male who presented for ultrasound due to two episodes of lower urinary tract infections within a period of 5 months. The sonographic examination revealed an elongated foreign body in the urethra extending into the urinary bladder. Self-insertion of foreign bodies into the urethra is usually done for erotic stimulation. However, foreign bodies can be inserted by children due to curiosity and by mentally retarded people, patients with psychiatric disorders as well as by intoxicated patients and in confusional states. Due to embarrassment, the patients seek medical help only when they are symptomatic and hence some of the foreign bodies are removed only several months after insertion. Detection might be either by plain abdominal films when the foreign bodies are radiopaque or by the use of contrast media. In the case presented by us, this was done by sonography. Endoscopic removal of these foreign bodies is considered the treatment of choice. Recurrent or chronic unexplained urinary tract infections should raise a high index of suspicion to the possible existence of a foreign body in the urethra and/or urinary bladder.
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Cuerpos Extraños/diagnóstico por imagen , Uretra/diagnóstico por imagen , Vejiga Urinaria/diagnóstico por imagen , Adulto , Humanos , Masculino , UltrasonografíaRESUMEN
Laparoscopic cholecystectomy is considered the procedure of choice for removing symptomatic, stone-containing gallbladders. It is estimated that in 30-40% of these operations stone(s) spill into the peritoneal cavity. It was assumed that these "dropped stones" are harmless and are dissolved and absorbed spontaneously. We present a 70-year-old woman in whom such a stone, dropped during laparoscopy, led to formation of an intraperitoneal abscess.
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Absceso/diagnóstico , Colecistectomía Laparoscópica , Complicaciones Intraoperatorias , Complicaciones Posoperatorias/diagnóstico , Anciano , Colelitiasis/diagnóstico por imagen , Colelitiasis/cirugía , Femenino , Humanos , Enfermedades Peritoneales/diagnóstico , Enfermedades Peritoneales/etiología , Radiografía , UltrasonografíaAsunto(s)
Drama/historia , Medicina en la Literatura , Médicos/historia , Francia , Historia del Siglo XVII , HumanosRESUMEN
The unique appearance of a midline prostatic cyst is reported. The cyst presented as a round-shaped filling defect at the base of the urinary bladder during an intravenous pyelography study. Transabdominal sonography showed the mass to be a midline prostatic cyst. The sonographic features of the mass and its location are the hallmark of a müllerian duct prostatic cyst. Midline prostatic cysts are discussed and the features differentiating müllerian duct cysts from utricle cysts are emphasized.