RESUMO
A 63-year-old man with rheumatoid arthritis presented with pain and swelling of his right buttock. Imaging and tissue biopsy revealed a diffuse large B-cell, non-Hodgkin's lymphoma. The disease-modifying drugs he was taking, cyclosporin and methotrexate, were stopped, and the lymphoma resolved spontaneously without the use of chemotherapy.
Assuntos
Artrite Reumatoide/tratamento farmacológico , Ciclosporina/administração & dosagem , Imunossupressores/administração & dosagem , Linfoma de Células B/patologia , Linfoma Difuso de Grandes Células B/patologia , Metotrexato/administração & dosagem , Artrite Reumatoide/complicações , Nádegas , Ciclosporina/efeitos adversos , Quimioterapia Combinada , Humanos , Imunossupressores/efeitos adversos , Linfoma de Células B/complicações , Linfoma de Células B/diagnóstico , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/diagnóstico , Masculino , Metotrexato/efeitos adversos , Pessoa de Meia-Idade , Neoplasias Musculares/complicações , Neoplasias Musculares/patologia , Músculo Esquelético/patologia , Remissão EspontâneaRESUMO
We used computer-generated dot maps to examine the spatial distribution of 94 Toxoplasma gondii infections associated with an outbreak in British Columbia, Canada. The incidence among patients served by one water distribution system was 3.52 times that of patients served by other sources. Acute T. gondii infection among 3, 812 pregnant women was associated with the incriminated distribution system.
Assuntos
Gráficos por Computador , Surtos de Doenças , Toxoplasma/isolamento & purificação , Toxoplasmose/epidemiologia , Abastecimento de Água , Doença Aguda , Adolescente , Adulto , Animais , Colúmbia Britânica/epidemiologia , Métodos Epidemiológicos , Feminino , Humanos , Incidência , Mapas como Assunto , Pessoa de Meia-Idade , GravidezRESUMO
The world's largest outbreak of waterborne toxoplasmosis occurred in a municipality in the western Canadian province of British Columbia. When drinking water emerged as a possible source of infection during the outbreak investigation, a laboratory method was needed to attempt detection of the parasite, Toxoplasma gondii. The method developed was based on the current U.S. Environmental Protection Agency method for detection of Cryptosporidium oocysts. Collection of large-volume drinking water samples and cartridge filter processing were unchanged, although identification of Toxoplasma oocysts in the filter retentate was carried out by using a previously described rodent model. Validation of the method developed was tested by using oocysts from a well-characterized Toxoplasma strain.
Assuntos
Toxoplasma/isolamento & purificação , Água/parasitologia , Animais , Colúmbia Britânica/epidemiologia , Estudos de Casos e Controles , Surtos de Doenças , Reservatórios de Doenças , Métodos Epidemiológicos , Feminino , Humanos , Camundongos , Gravidez , Toxoplasmose/epidemiologia , Toxoplasmose Congênita/epidemiologia , Abastecimento de ÁguaRESUMO
The anatomy of 54 pairs of lumbosacral nerve roots was described in nine fresh adult cadaver specimens, with particular attention given to the fixation of the nerve roots to surrounding skeletal and ligamentous structures in the lumbar spine. Dural ligaments were identified fixing the dura and nerve roots at their exit from the main dural sac to the posterior longitudinal ligament and vertebral body periosteum proximal to the intervertebral disc. Distal fixation occurs at the intervertebral foramen where the epineural sheath of the spinal nerve is attached. The overall arrangement is one which tends to hold the exiting nerve root anteriorly in the spinal canal. Mechanical analysis of this anatomical arrangement explains how pressure can be applied to the extrathecal nerve root by a disc protrusion without compression of the nerve root against the posterior elements. The possible role of the dural ligaments in the pathogenesis of the sciatica syndrome is discussed.
