RESUMEN
The McKittrick-Wheelock syndrome is a very rare complication of rectal villous adenoma, characterized by fluid and electrolyte hypersecretion from a rectal tumour, which can lead to acute renal failure. We present a case review of a 67-year-old male patient hospitalised for profuse secretory diarrhea, with electrolyte dysbalance and progressive renal failure. A rectoscopic finding of massive rectal adenoma contributed to establishing the correct diagnosis. Resection of the affected part of the rectum resulted in rapid restoration from mineral imbalance and improvement of renal functions. The reported case shows the necessity of interdisciplinar management and the importance of surgical treatment in patients with this rare diagnosis.
Asunto(s)
Adenoma Velloso/complicaciones , Diarrea/etiología , Neoplasias del Recto/complicaciones , Insuficiencia Renal/etiología , Desequilibrio Hidroelectrolítico/etiología , Anciano , Historia del Siglo XX , Humanos , Masculino , SíndromeRESUMEN
Risk factors, mortality and antimicrobial susceptibility of Pseudomonas aeruginosa bacteremias isolated from 148 patients from all University Hospitals in Slovakia were analyzed. Only 1.2% of 169 strains of P. aeruginosa were resistant to meropenem, 4.1% to piperacillin/tazobactam, 7.7% to ceftazidime as well as cefepime and 12% to amikacin. More than 30% of P. aeruginosa were resistant to ciprofloxacin. Our analysis of risk factors for antimicrobial resistance to the particular antimicrobials, indicated no difference in risk factors and outcome in cases infected with P. aeruginosa bacteremias resistant to amikacin, piperacillin/tazobactam or ceftazidime in comparison to episodes caused by P. aeruginosa due to susceptible isolates. When comparing risk factors for P. aeruginosa bacteremia in children vs. adults, cancer vs. non-cancer patients, several differences in risk factors were observed. Neither antimicrobial resistance to amikacin, ceftazidime or piperacillin/tazobactam, nor appropriateness of therapy according to two separate analyses were associated with better outcome.