RESUMEN
Tuberculosis and its extrapulmonary manifestations are no longer on the decline in the United States. This is in part due to impaired immunity induced by HIV infection, immigration from countries with extremely high prevalence rates and earlier misdiagnosis with delay in treatment. This, combined with increasing drug resistance, poses a serious threat to public health. We report on a patient, a native of Washington D.C., who had no evidence of immunodeficiency and who developed Pott's disease. Cultures revealed Mycobacterium tuberculosis resistant to all first line chemotherapeutic drugs. Surgical drainage and appropriate use of alternative drugs ensured a gradual recovery. Pott's disease caused by multi-drug resistant M. tuberculosis has not been previously described (AU)
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Humanos , Tuberculosis de la Columna Vertebral/terapiaRESUMEN
Amyloidosis is a chronic disorder, characterized by accumulation of a fibrillar protein in the various organ systems, including the respiratory tract. Amyloid localized entirely to the respiratory tract is, however, a rare finding. Involvement of the airways (trachea and bronchi) leads to signs and symptoms of airway obstruction. Parenchymal amyloid occurs in two forms, diffuse and nodular, with the latter having a more benign natural history and a better prognosis. This disorder must be considered in the differential diagnosis and work-up of a solitary pulmonary nodule (AU)
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Humanos , AmiloidosisRESUMEN
We decided to use the technique of supraclavicular brachial block at the Georgetown Public Hospital on patients undergoing surgery on the upper limb. A total of sixty patients were studied from January, 1986 to August, 1986. A supraclavicular brachial block was done using 40cc of 1 percent lignocaine with 0.02 mg of epinephrine. The results obtained showed that supraclavicular block is as effective as the other methods and has minimal side-effects (AU)
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Humanos , Brazo , Plexo Braquial/efectos de los fármacos , Anestesia Local , GuyanaRESUMEN
Five hundred and four patients with suspected genital herpes simplex virus (HSV) infection were investigated in Jamaica between 1982 and 1984. Of these, 100 (19.8 percent) were virologically confirmed. There were 12 patients with primary/first episode, 45 recurrent and 6 "provoked' type of genital herpes simplex virus infections. Genital herpes in women was more severe than in men. Eighty-eight per cent of genital herpes was confirmed by virus isolation. Forty HSV isolates were identified as HSV type 2. There was a sero-response in 75 percent primary, 18 percent recurrent and 17 percent provoked type of genital herpes. Virus isolation is the most sensitive and specific test for the diagnosis of genital herpes simplex virus infection. The measurement of serum anti herpes simplex complement-fixing antibodies was not useful in the diagnosis of suspected patients with genital ulcers and their contacts. The infectiousness of the virus, clinical manifestations, complications such as neonatal herpes infections, psychosocial problems and methods of prevention are issues that clinicians should discuss with patients with genital herpes (AU)
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Herpes Genital/epidemiología , Herpes Genital/diagnóstico , Simplexvirus/clasificación , Serotipificación , JamaicaRESUMEN
The prevalence of genital herpes simplex infection is unknown in Jamaica and in other Caribbean countries. From November 1982 to October 1984, 504 patients with suspected genital herpes simplex virus infection were investigated in Jamaica. Of these 100 (19.8 percent) were virologically confirmed. The confirmation rate was 21.3 percent in patients attending the sexually transmitted disease clinic and 16.8 percent of patients referred from private practitioners. Of the virologically confirmed cases, there were 12 patients with primary/first episode, 45 recurrent and 6 provoked type of genital herpes simplex virus infection. In 35 patients, the type was unknown. Symptoms of genital herpes were more severe in women than men. Genital herpes in women was accompanied by systematic symptoms (53 percent), local pain (70 percent), itching (46 percent) and genital ulcers (100 percent). There was a serological response in 75 percent primary, 18 percent recurrent and 17 percent provoked type of genital herpes simplex infections. Twenty herpes virus isolates were identified as Herpes simplex type 2 by indirect immunofluorescent antibody test. No Herpes simplex type I isolates were made. Virus isolation is the most sensitive and specific test for the diagnosis of genital herpes simplex virus infection. The measurement of serum anti-herpes simplex complement fixing antibodies was not useful in the diagnosis of suspected genital ulcer patients and their contacts. The presence of genital herpes in Jamaica should alert clinicians to the possibility of unrecognised neonatal Herpes infections and aseptic meningitis (AU)