RESUMEN
Gastrointestinal bleedings caused by small intestinal tumors are rare and difficult to diagnose because they are not easy to access to the conventional endoscopy. We report two cases, one of them from proximal jejunum and the other one from ileal intestine complicated by intussusception. The two cases were admitted in the emergency department for hematochezia and melena, the diagnosis was established by enhanced helical computed tomography angiography.
Asunto(s)
Hemorragia Gastrointestinal/etiología , Neoplasias del Íleon/complicaciones , Neoplasias del Yeyuno/complicaciones , Anciano , Angiografía por Tomografía Computarizada , Hemorragia Gastrointestinal/diagnóstico , Humanos , Neoplasias del Íleon/diagnóstico , Intususcepción/complicaciones , Intususcepción/diagnóstico , Neoplasias del Yeyuno/diagnóstico , MasculinoRESUMEN
It is a rare synovium pseudotumor that mainly concerns the male adult, of unknown etiology, espe-cially observed in the knee, especially in the suprapatellar recess. The arboreal lipoma consists of hypertrophic synovial villi and contains fat in very large quantities, so that the mass has a lipoma-tous appearance. The diagnosis is based on an MRI that shows hypertrophy of synovial villi appear-ing as a fatty signal on all sequences. However the diagnosis is established after synovial biopsy.
Asunto(s)
Articulación de la Rodilla/patología , Lipoma/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico , Membrana Sinovial/patología , Biopsia , Diagnóstico Diferencial , Humanos , Lipoma/patología , Imagen por Resonancia Magnética , Masculino , Enfermedades Raras , Neoplasias de los Tejidos Blandos/patología , Adulto JovenAsunto(s)
Síndrome de Marfan , Dilatación Patológica , Duramadre , Humanos , Imagen por Resonancia MagnéticaRESUMEN
BACKGROUND: Mass azithromycin distribution reduces under-5 child mortality. Trachoma control programs currently treat infants aged 6 months and older. Here, we report findings from an infant adverse event survey in 1-5 month olds who received azithromycin as part of a large community-randomized trial in Niger. METHODS AND PRINCIPAL FINDINGS: Active surveillance of infants aged 1-5 months at the time of treatment was conducted in 30 randomly selected communities from within a large cluster randomized trial of biannual mass azithromycin distribution compared to placebo to assess the potential impact on child mortality. We compared the distribution of adverse events reported after treatment among azithromycin-treated versus placebo-treated infants. From January 2015 to February 2018, the caregivers of 1,712 infants were surveyed. Approximately one-third of caregivers reported at least one adverse event (azithromycin: 29.6%, placebo: 34.3%, risk ratio [RR] 0.86, 95% confidence interval [CI] 0.68 to 1.10, P = 0.23). The most commonly reported adverse events included diarrhea (azithromycin: 19.3%, placebo: 28.1%, RR 0.68, 95% CI 0.49 to 0.96, P = 0.03), vomiting (azithromycin: 15.9%, placebo: 21.0%, RR 0.76, 95% CI 0.56 to 1.02, P = 0.07), and skin rash (azithromycin: 12.3%, placebo: 13.6%, RR 0.90, 95% CI 0.59 to 1.37, P = 0.63). No cases of infantile hypertrophic pyloric stenosis were reported. CONCLUSIONS: Azithromycin given to infants aged 1-5 months appeared to be safe. Inclusion of younger infants in larger azithromycin-based child mortality or trachoma control programs could be considered if deemed effective. TRIAL REGISTRATION: ClinicalTrials.gov NCT02048007.
Asunto(s)
Antibacterianos/efectos adversos , Azitromicina/efectos adversos , Chlamydia trachomatis/efectos de los fármacos , Tracoma/tratamiento farmacológico , Factores de Edad , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Azitromicina/administración & dosificación , Azitromicina/uso terapéutico , Femenino , Humanos , Lactante , Mortalidad Infantil , Masculino , Niger/epidemiología , Tracoma/epidemiologíaRESUMEN
BACKGROUND: Prior to blindness, trachoma is thought to profoundly affect women's abilities to lead normal lives, but supporting evidence is lacking. To better understand the effects of trichiasis, we asked women to define quality of life, how trichiasis affects this idea and their perceptions of eyelid surgery. METHODS: Operated and unoperated women were purposively selected for in-depth interviews. These were audio-recorded and transcribed, and codes were identified and applied to the transcripts. Overarching themes, commonalities and differences were identified and matched to quotations. RESULTS: Twenty-three women were interviewed. Quality of life was defined as health, security, family, social status and religious participation. Trichiasis caused severe pain and loss of health, leading to loss of security. This affected social, economic and religious activities and caused burden on their families. Surgery improved quality of life, even in cases of surgical failure or recurrent disease. CONCLUSIONS: Trichiasis disables most women, even those reporting fewer or less-severe symptoms. While women in rural Niger often live in extreme poverty, trichiasis exacerbates the situation, making women unable to work and undermining their social status. It adds to family burden, as women lose the ability to meaningfully contribute to the household and require additional family resources for their care.
Asunto(s)
Calidad de Vida , Triquiasis/psicología , Actividades Cotidianas , Adulto , Ceguera , Costo de Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Niger , Investigación Cualitativa , Población Rural , Trastornos de la Visión/etiología , Adulto JovenRESUMEN
We conducted a survey in rural Niger to assess use, maintenance and acceptability of household latrines one year after a subsidized promotion project. Standard interviews were conducted with 200 randomly selected project participants and a visual latrine inspection. Before the project, 21.5% (43/200) of households had latrines. After the first year, 100% of these households had at least one latrine. Overall, 2577 household latrines were built in the 50 targeted villages. Latrines were 'always' used by 92.5% of adults and 55% of children in the households. The latrines were adequately maintained: superstructure 93%, covers 74.5%, clean 70%. The main perceived advantages of latrine ownership were proximity/easy access (59.5%) and privacy (22.5%). The project demonstrated that the implementation of a household latrine promotion project is acceptable and feasible in rural Niger. Future promotion projects may develop local sanitation expertise and focus on perceived benefits--proximity and privacy--rather than health.