RESUMO
INTRODUCTION: Extremity war-wounds present an elevated risk of infection and compromise reconstructive procedures. In a French military hospital, a multi-disciplinary meeting (MDM) was created to standardize the care given to soldiers with osteoarticular infection. The aim of this study was to evaluate the usefulness of MDM decisions. METHODS: An observational case study was performed including the French wounded at war treated for an osteoarticular infection between 2004 and 2016. They were separated into two groups according to their time of management: before (group A) or after (group B) the MDM creation in September 2010. Various operative and bacteriological parameters were analyzed retrospectively. A questionnaire was created to evaluate healthcare professionals' satisfaction toward the usefulness of the MDM on their practice. RESULTS: During the study period, 38 patients were included: 19 in group A and 19 in group B. Initial tests found an infection with one pathogen in 15 patients, an infection with 2 pathogens in 11 patients, and an infection with 3 or more pathogens in 12 patients. Enterobacter cloacae was the most common pathogen. Pseudomonas aeruginosa and Escherichia coli were also frequent. The mean number of samples taken to conduct the bacteriological tests per operating session was significantly higher for group B than for group A. Twelve of the 14 questioned healthcare professionals believed the MDM was very useful in their patient management. CONCLUSION: The MDM seems to have had a beneficial impact on orthopedic surgeon practices. A significant increase of the number of samples taken was the most obvious sign that the French recommended practices for osteoarticular infections were followed since the creation of MDM.
Assuntos
Militares/estatística & dados numéricos , Osteomielite/terapia , Adulto , França/epidemiologia , Humanos , Masculino , Osteomielite/epidemiologia , Osteomielite/microbiologia , Estudos Retrospectivos , Guerra/estatística & dados numéricosRESUMO
We report the case of a 20 years old woman with unusual acute myeloid leukemia t(8;21). Cytological, phenotypic and cytogenetic investigations showed a divergence from those of the literature as well as data for the last 12 LA to t(8;21) supported in the service.
Assuntos
Cromossomos Humanos Par 21 , Cromossomos Humanos Par 8 , Leucemia Mieloide Aguda/diagnóstico , Translocação Genética , Citodiagnóstico , Feminino , Humanos , Imunofenotipagem , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/imunologia , Leucemia Mieloide Aguda/patologia , Adulto JovemRESUMO
We report the first case of light-chain escape from plateau phase occurring after 7 years of evolution of multiple myeloma in a patient who had never received new molecules. A very good partial response was obtained.
Assuntos
Cadeias kappa de Imunoglobulina/análise , Fatores Imunológicos/análise , Mieloma Múltiplo/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Feminino , Seguimentos , Humanos , Imunoglobulina G/análise , Mieloma Múltiplo/tratamento farmacológico , Indução de RemissãoRESUMO
We describe a case of a patient hospitalized in haematology unit for treatment to blastic plasmacytoid dendritic cell neoplasm. Apart skin lesions found at diagnosis in 83% of patients, few elements suggest the diagnosis. Cytology is not characteristic and no cytogenetic abnormality is specific to the LpDC, the karyotype shows generally at least three cytogenetic abnormalities. Definitive diagnosis rests to identification of a blastic population with immunophenotype CD4+ CD56+. This leukemia is chemosensitive but the relapse rate is important and the survival time is 16 months.
Assuntos
Células Dendríticas/patologia , Leucemia/diagnóstico , Leucemia/patologia , Doença Aguda , Idoso , Dorso , Células da Medula Óssea/patologia , Feminino , Humanos , Infiltração Leucêmica/diagnóstico , Infiltração Leucêmica/patologia , Pele/patologia , TóraxAssuntos
Linfócitos B/imunologia , Mononucleose Infecciosa/complicações , Linfonodos/patologia , Linfocitose/complicações , Idoso de 80 Anos ou mais , Linfócitos B/patologia , Diagnóstico Diferencial , Humanos , Mononucleose Infecciosa/diagnóstico , Mononucleose Infecciosa/imunologia , Linfocitose/diagnóstico , Linfocitose/imunologia , MasculinoRESUMO
A strain of Nocardia was isolated from a pulmonary abscess of a human immunodeficiency virus-infected patient in France. Comparative 16S rRNA gene sequence analysis revealed that the isolate represented a strain of Nocardia beijingensis. Antimicrobial susceptibility testing was essential to guide the clinicians to successfully treat this infection.