RESUMO
We report 3 patients on maintenance hemodialysis who developed a fulminant, disseminated and fatal form of mucormycosis. The diagnosis was made by microscopy and culture in 1 case, yielding Rhizopus rhizopodiformis, and by post-mortem microscopy in the two other cases. These patients were receiving desferrioxamine (DFO) for aluminum overload and had no iron-overload. Ten similar patients, all (with only one possible exception) receiving DFO, have been reported from American centers. The mechanism by which DFO could precipitate mucormycosis is unsettled. The explanation might be that DFO acts as a siderophore to the Mucorales fungi. High serum levels of DFO in renal failure could enhance this mechanism. Epidemiological data, provided from an inquiry in 25 Flemish dialysis centers, support the association between DFO treatment and dialysis-associated mucormycosis.
Assuntos
Desferroxamina/efeitos adversos , Falência Renal Crônica/terapia , Mucormicose/etiologia , Diálise Renal/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RhizopusAssuntos
Tendão do Calcâneo , Anti-Infecciosos/efeitos adversos , Transplante de Rim , Tendinopatia/induzido quimicamente , Anti-Infecciosos/uso terapêutico , Fluoroquinolonas , Humanos , Imunossupressores/uso terapêutico , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Ruptura Espontânea/induzido quimicamenteAssuntos
Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Campylobacter jejuni , Claritromicina/uso terapêutico , Diálise Peritoneal Ambulatorial Contínua , Peritonite/microbiologia , Doença Aguda , Administração Oral , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/análise , Antibacterianos/sangue , Campylobacter jejuni/efeitos dos fármacos , Claritromicina/administração & dosagem , Claritromicina/análise , Claritromicina/sangue , Soluções para Diálise/análise , Humanos , Masculino , Peritonite/tratamento farmacológicoRESUMO
This report describes the current financial, technical and medical status of nephrology, dialysis and renal transplant services in these countries with the hope of helping our colleagues there to upgrade their standards of care. The general impression is that physicians as well as administrators in these countries are eager to improve conditions of patient care despite a disastrous economical climate. Our view is that we can help by providing literature, textbooks, journals, travel funds, by offering visiting fellowships to individual physicians, and by forming partnerships between nephrology centres.
Assuntos
Atenção à Saúde/economia , Atenção à Saúde/normas , Falência Renal Crônica/terapia , Terapia de Substituição Renal , Humanos , Lituânia , Terapia de Substituição Renal/economia , República de Belarus , Federação Russa , Resultado do TratamentoRESUMO
Three cases of dilated abdominal left paraaortic lymphatic duct are described. The diagnosis was established by means of sonography and confirmed with lymphography in all three patients. A sonographically guided puncture of the lymphatic duct was performed in one patient. Dilatation of these lymphatic ducts was possibly the consequence of previous upper abdominal surgery in two patients and a coronary bypass operation in one.
Assuntos
Sistema Linfático/patologia , Espaço Retroperitoneal , Ultrassonografia , Abdome , Diagnóstico Diferencial , Dilatação Patológica , Feminino , Humanos , Linfonodos/patologia , Doenças Linfáticas/diagnóstico , Metástase Linfática/diagnóstico , Masculino , Pessoa de Meia-IdadeRESUMO
A 61-yr-old woman presented with acute severe pain in the upper abdomen. Within a few hours after admission, diagnosis of partial splenoportal and superior mesenteric venous thrombosis was made by ultrasonography. This thrombosis appeared to be the first sign of a previously unsuspected essential thrombocythemia. Early sonographic diagnosis made possible the prompt institution of conservative treatment. Total thrombosis of the splenoportal system could be prevented. Major surgery was avoided and the outcome was uneventful.