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2.
J Indian Soc Pedod Prev Dent ; 38(3): 319-322, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004733

RESUMO

Melanotic neuroectodermal tumor is a rare benign congenital neoplasm involving the head-and-neck region found in infants <1 year of age. The lesion most commonly affects the maxilla. We report the case of a 4-month-old male child with a tumor involving the anterior region of the maxilla along with a brief review of literature, differential diagnosis, and treatment.


Assuntos
Tumor Neuroectodérmico Melanótico , Criança , Diagnóstico Diferencial , Humanos , Lactente , Masculino , Maxila , Tumor Neuroectodérmico Melanótico/diagnóstico , Tumor Neuroectodérmico Melanótico/diagnóstico por imagem , Tumor Neuroectodérmico Melanótico/cirurgia
3.
Curr Opin Ophthalmol ; 31(6): 521-531, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33009085

RESUMO

PURPOSE OF REVIEW: Ocular sarcoidosis is one of the most common causes of uveitis worldwide. The diagnosis and treatment of patients with ocular sarcoidosis remains challenging in some cases. It is important for clinicians to keep up to date with new diagnostic and treatment tools for this disease. RECENT FINDINGS: The International Workshop on Ocular Sarcoidosis diagnostic criteria were first proposed in 2009 and revised in 2017. The new criteria contained two parts: ocular presentation and systemic investigation. The diagnostic value of liver enzymes was reduced in the new criteria, whereas the value placed of lymphopenia and the CD4/CD8 ratio in bronchoalveolar lavage fluid were increased. Despite not being included in the criteria, recent studies have also highlighted the diagnostic value of serum soluble interleukin-2 receptors. Recent ophthalmologic imaging also provides useful insights for the differential diagnosis.Many new treatments for ocular sarcoidosis have been developed in recent years. The introduction of biological immunomodulatory agents for uveitis treatment represents a big improvement. Antitumor necrosis factor-alpha antibodies, including adalimumab, have been proven to be effective for treating ocular sarcoidosis. Many studies have also suggested that other biological agents could be effective and well tolerated. Newer intravitreal dexamethasone and fluocinolone implants have been developed. Patients treated with these implants have experienced good and sustained control of their intraocular inflammation. SUMMARY: Diagnosis and treatment options for ocular sarcoidosis have changed over time. However, challenges still exist in some difficult patients. Future studies should focus on finding more sensitive biomarkers and developing more effective immunomodulatory treatments with longer efficacy and less side effects.


Assuntos
Oftalmopatias/diagnóstico , Oftalmopatias/tratamento farmacológico , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Biomarcadores/análise , Diagnóstico Diferencial , Endoftalmite/diagnóstico , Humanos
4.
Rev Assoc Med Bras (1992) ; 66(9): 1277-1282, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027458

RESUMO

INTRODUCTION: Microcytic anemias are very common in clinical practice, with iron deficiency anemia (IDA) and thalassemia minor (TT) being the most prevalent. Diagnostic confirmation of these clinical entities requires tests involving iron metabolism profile, hemoglobin electrophoresis, and molecular analysis. In this context, several discriminant indices have been proposed to simplify the differential diagnosis between IDA and TM. OBJECTIVE: The aim of this paper was to demonstrate the clinical relevance of the use of discriminant indices in individuals with microcytic anemia to simplify the differential diagnosis between iron deficiency anemia and minor thalassemia. METHODS: A bibliographic and cross-sectional search was performed in the PubMed, SciELO and LILACS databases, using the following descriptors: iron deficiency anemia, thalassemia minor, and differential diagnosis. RESULTS: More than 40 mathematical indices based on erythrocyte parameters have been proposed in the hematological literature in individuals with microcytosis. Green & King indexes (IGK), Ehsani index, and erythrocyte count (RBC) had excellent performances, especially when their efficacy was observed in adults and children. CONCLUSIONS: Confirmatory tests for differential diagnosis between IDA and TM require time-consuming and costly methods. Despite the excellent performances of IGK, Ehsani index, and RBC, none of them presented sufficient sensitivity and specificity to establish a diagnosis. However, they can provide a powerful additional tool for diagnostic simplification between IDA and TM.


Assuntos
Anemia Ferropriva , Talassemia beta , Anemia Ferropriva/diagnóstico , Estudos Transversais , Diagnóstico Diferencial , Índices de Eritrócitos , Humanos , Talassemia beta/diagnóstico
5.
Stomatologiia (Mosk) ; 99(5): 92-95, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034184

RESUMO

The article presents a clinical case of an immunohistochemical study of a rare disease: necrotizing sialometaplasia in the hard palate. Due to the complexity of the differential diagnosis between necrotizing sialometaplasia and squamous cell carcinoma, an immunohistochemical method was used with antibodies to proteins Ki-67, P53, P63 and cytokeratins-7 and Immunohistochemical study established low proliferative activity of glandular cells in excretory ducts and metaplastic squamous epithelium for Ki-67 protein, significant expression of protein P63 was detected both in the ductal epithelium nuclei and in metaplastic areas and expression of the mutant protein P53 was approximately absent. Marked expression of cytokeratin-7 in the ducts cells and weak expression in necrotic acini of the glands and metaplastic epithelium was noted. It was shown that cytokeratin-15 homogeneously stains the peripheral zone of metaplastic epithelium, which is characteristic of a benign lesion. Thus, the panel of antibodies to proteins Ki-67, P53 and cytokeratins-7 and 15 allows to verify necrotizing sialometaplasia.


Assuntos
Carcinoma de Células Escamosas , Sialometaplasia Necrosante , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Epitélio , Humanos , Palato Duro , Sialometaplasia Necrosante/diagnóstico
6.
BMJ Case Rep ; 13(10)2020 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-33012721

RESUMO

We present a case of non-convulsive status epilepticus in a 57-year-old woman with a schizoaffective disorder, without an antecedent seizure history, with two possible aetiologies including SARS-CoV-2 infection and clozapine uptitration. We discuss the presentation, investigations, differential diagnosis and management. In particular, we focus on the electroencephalogram (EEG) findings seen in this case and the electroclinical response to antiepileptic medication. We review the literature and discuss the relevance of this case to the SARS-CoV-2 global pandemic. We emphasise the importance of considering possible neurological manifestations of SARS-CoV-2 infection and highlight seizure disorder as one of the possible presentations. In addition, we discuss the possible effects of clozapine on the electroclinical presentation by way of possible seizure induction as well as discuss the possible EEG changes and we highlight that this needs to be kept in mind especially during rapid titration.


Assuntos
Antipsicóticos/efeitos adversos , Betacoronavirus , Clozapina/efeitos adversos , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Transtornos Psicóticos/tratamento farmacológico , Estado Epiléptico/etiologia , Clozapina/uso terapêutico , Diagnóstico Diferencial , Eletroencefalografia/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Pandemias , Estado Epiléptico/fisiopatologia
7.
Arch Pathol Lab Med ; 144(10): 1162-1163, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33002155
9.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1689-1693, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067975

RESUMO

OBJECTIVE: To evaluate the efficiency of red blood cell indices and fomulas for the differential diagnosis of the thalassemia trait (TT) and iron deficiency anemia (IDA) for children in Shenzhen area of Guangdong Province in China. METHODS: A total of 849 child patients from Shenzhen were enrolled, including 536 cases of TT and 313 cases of IDA. The sensitivity (SEN), specificity (SPE), positive predictive values (PPV), negative predictive value (NPV), and Youden's indices (YI) were analyzed using five red blood cell indices ï¼»including red blood cell count, average red blood cell volune(MCV), average amount of red blood cell hemoglobin(CMH), red blood hemoglobin cancentration(MCHC), red blood cell distribution width(RDW)ï¼½ and 10 red blood cell paramter formulas including Mentzer, Green and King, Srivastava, Ricerca, RDWI, Sirdah, Huber-Herklotz, Ehsani, Shine and Lal, and England and Fraser. Receiver operating characteristic (ROC) curve was drawn. RESULTS: Green and King was the most reliable index, as it had the highest YI (63.7%) and area under ROC curve (AUC) (0.875), the SEN and SPE was 82.5% and 81.2%. The YI, SEN, SPE, and AUC for RDWI were 62.8%, 79.1%, 83.7%, and 0.870, respectively. CONCLUSION: The formulas of Green and King and RDWI can be used for the differential diagnosis of TT and IDA, suitable for chidren in Shenzhen, China.


Assuntos
Anemia Ferropriva , Anemia Ferropriva/diagnóstico , Criança , China , Diagnóstico Diferencial , Índices de Eritrócitos , Eritrócitos , Humanos
10.
Medicine (Baltimore) ; 99(40): e22350, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019411

RESUMO

BACKGROUND: Ultrasonography is the first choice for clinical diagnosis and differentiation of thyroid cancer Currently. However, due to the complexity and overlapping nature of the thyroid nodule sonograms, it remains difficult to accurately identify nodules with atypical ultrasound characteristics. Previous studies showed that superb microvascular imaging (SMI) can detect tumor neovascularization to differentiate benign from malignant thyroid nodules. However, the results of these studies have been contradictory with low sample sizes. This meta-analysis tested the hypothesis that SMI is accurate in distinguishing benign and malignant thyroid nodules. METHODS: We will search PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from their inceptions to the August 20, 2020, without language restrictions. Two authors will independently carry out searching literature records, scanning titles and abstracts, full texts, collecting data, and assessing risk of bias. Review Manager 5.2 and Stata14.0 software ((Stata Corp, College Station, TX) will be used for data analysis. RESULTS: This systematic review will determine the accuracy of SMI in distinguishing thyroid nodules. CONCLUSION: Its findings will provide helpful evidence for the accuracy of SMI in in distinguishing thyroid nodules.Systematic review registration: INPLASY202080084.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/patologia , Ultrassonografia/métodos , Diagnóstico Diferencial , Neovascularização Patológica/patologia , Projetos de Pesquisa , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem
11.
Medicine (Baltimore) ; 99(40): e22488, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019444

RESUMO

RATIONALE: Some acute myeloid leukemia (AML) patients present with features mimicking the classical hypergranular subtype of acute promyelocytic leukemia (APL) but without the typical promyelocytic leukemia/retinoic acid receptor α (PML/RARα) rearrangement. Herein, we report an AML patient resembling APL but with nucleoporin 98/retinoid acid receptor gamma gene (NUP98/RARG) fusion transcript and Runt-related transcription factor 1 (RUNX1) mutation. PATIENT CONCERNS: An 18-year-old male presented at the hospital with a diagnosis of AML. DIAGNOSES: The patient was diagnosed with bone marrow examination. Bone marrow smear displayed 90.5% promyelocytes. Fluorescence in situ hybridization analysis failed to detect the PML/RARα fusion transcript or RARα amplification. While real-time polymerase chain reaction showed positivity for the NUP98/RARG fusion transcript. G-banding karyotype analysis showed a normal karyotype. INTERVENTIONS: The patient showed resistance to arsenic trioxide and standard 3 + 7 chemotherapy, but eventually achieved complete remission through the Homoharringtonine, Cytarabine, and Aclarubicin chemotherapy. OUTCOMES: These measures resulted in a rapid response and disease control. LESSONS: Acute myeloid leukemia with the NUP98/RARG fusion gene and the RUNX1 mutation may be a special subtype of AML and may benefit from the alkaloid-based regimen.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Adolescente , Subunidade alfa 2 de Fator de Ligação ao Core/genética , Diagnóstico Diferencial , Humanos , Leucemia Mieloide Aguda/diagnóstico , Leucemia Promielocítica Aguda/diagnóstico , Masculino , Complexo de Proteínas Formadoras de Poros Nucleares/genética , Receptores do Ácido Retinoico/genética
12.
Artigo em Russo | MEDLINE | ID: mdl-33081445

RESUMO

OBJECTIVE: To improve the algorithm of differential diagnosis and complex treatment of patients with CR. MATERIAL AND METHODS: Forty-two patients with CR were divided into 2 groups. Patients of the first group (n=21) received basic treatment (NSAID, myorelaxants, local injections with glucocorticoids (on demand), B vitamins and non-pharmacological methods) and the anticholinesterase drug ipidacrine. The second group (n=21) had only basic treatment. The total duration of the study was 45 days. The effectiveness of treatment was evaluated with VAS, NDI, GROC and total duration of disability period. RESULTS: A battery of tests for the diagnosis of CR that included Spurling test, motor strength deficiency, ULTT, pain pattern, shoulder adduction test (diagnostic complex SPASIBO), has been developed. A positive result of all 5 tests guarantees the 94.7% accuracy of CR diagnosis. The application of ipidacrine has allowed a significant (p<0.05) reduction of pain, enhancement of daily living activities and subjective improvement of well-being of patients after 1 month of treatment and mostly after 45 days. Besides, there was a considerable (p<0.05) reduction of the disability period in the first group of patients compared to the control one. CONCLUSION: The diagnostic complex SPASIBO should be used in diagnosis of CR. It is highly recommended to include ipidacrine in the complex treatment of CR.


Assuntos
Radiculopatia , Atividades Cotidianas , Diagnóstico Diferencial , Humanos , Dor , Radiculopatia/diagnóstico , Radiculopatia/tratamento farmacológico
13.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(5): 594-597, 2020 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-33085248

RESUMO

Infantile myofibromatosis is a rare benign childhood myofibroblastoma. A case of infantile myofibromatosis of the left mandible was reported, and relevant literature was reviewed to discuss the clinical characteristics, pathogenesis, imaging characteristics, pathological characteristics, differential diagnosis, and the treatment of the tumor to improve the understanding of the tumor.


Assuntos
Miofibromatose , Neoplasias de Tecido Muscular , Criança , Diagnóstico Diferencial , Humanos , Mandíbula , Miofibromatose/diagnóstico
14.
Chron Respir Dis ; 17: 1479973120961843, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000640

RESUMO

The spread of the SARS-CoV-2 infection among population has imposed a re-organization of healthcare services, aiming at stratifying patients and dedicating specific areas where patients with suspected COVID-related respiratory disease could receive the necessary health care assistance while waiting for the confirmation of the diagnosis of COVID-19 disease. In this scenario, the pathway defined as a "grey zone" is strongly advocated. We describe the application of rules and pathways in a regional context with low diffusion of the infection among the general population in the attempt to provide the best care to respiratory patients with suspected COVID-19. To date, this process has avoided the worst-case scenario of intra-hospital epidemic outbreak.


Assuntos
Infecções por Coronavirus , Procedimentos Clínicos/tendências , Controle de Infecções/métodos , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Doenças Respiratórias/diagnóstico , Idoso , Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Diagnóstico Diferencial , Feminino , Humanos , Itália/epidemiologia , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/organização & administração , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Prevalência
15.
Tohoku J Exp Med ; 252(2): 109-119, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33028754

RESUMO

Coronavirus disease 2019 (COVID-19) is associated with various symptoms and changes in hematological and biochemical variables. However, clinical features, which can differentiate COVID-19 from non-COVID-19, are not clear. We therefore examined the key clinical features of COVID-19 and non-COVID-19 patients. This study included 60 COVID-19 patients and 100 non-COVID-19 patients, diagnosed by PCR, and no significant differences in the age and sex were seen between the two groups. The frequencies of fatigue, loose stool, diarrhea, nasal obstruction, olfactory dysfunction, taste dysfunction, underlying hyperlipidemia, and the prescription of angiotensin II receptor blocker (ARB) were significantly higher in COVID-19 patients than those in non-COVID-19 patients. The counts of leucocytes, neutrophils, lymphocytes, eosinophils, monocytes, and basophils and the levels of chloride and calcium in blood of COVID-19 patients were significantly lower than those of non-COVID-19 patients. The frequencies of atypical lymphocytes and the levels of lactate dehydrogenase (LDH) and potassium were significantly higher in COVID-19 than those in non-COVID-19. The C-reactive protein (CRP) level in COVID-19 patients was significantly lower than that in non-COVID-19 patients, when we compared CRP levels among patients with elevated CRP. This study is the first to indicate that electrolyte levels and the frequency of atypical lymphocytes in COVID-19 are significantly different from those in non-COVID-19. Fatigue, loose stool, diarrhea, nasal obstruction, olfactory dysfunction, and taste dysfunction were the key symptoms of COVID-19. Furthermore, hyperlipidemia and ARB may be risk factors of COVID-19. In conclusion, leucocytes, leucocyte fractions, CRP, LDH, and electrolytes are useful indicators for COVID-19 diagnosis.


Assuntos
Infecções por Coronavirus/diagnóstico , Eletrólitos/sangue , Linfócitos/virologia , Pneumonia Viral/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Proteína C-Reativa/análise , Criança , Diagnóstico Diferencial , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/virologia , Pandemias , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Avaliação de Sintomas , Distúrbios do Paladar/virologia , Adulto Jovem
16.
Medicine (Baltimore) ; 99(40): e22583, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019474

RESUMO

INTRODUCTION: Henoch-Schönlein purpura (HSP) is an extremely rare condition in patients with pulmonary tuberculosis, with only a few reported cases. Compared to patients with typical clinical symptoms, it is difficult to make a definitive diagnosis when HSP presents as an initial manifestation in pulmonary tuberculosis patients. Herein, a case of pulmonary tuberculosis that showed HSP at first was reported, and the related literatures were reviewed. PATIENT CONCERNS: A 24-year-old man presented with palpable purpura on the extremities, accompanied by abdominal pain, bloody stools, and knee pain. DIAGNOSES: The patient was diagnosed with pulmonary tuberculosis based on the results of interferon gamma release assays, purified protein derivative test, and computed tomography. INTERVENTIONS: The patient was treated with vitamin C and chlorpheniramine for 2 weeks, and the above-mentioned symptoms were relieved. However, 3 weeks later, the purpura recurred with high-grade fever and chest pain during the inspiratory phase. The patient was then treated with anti-tuberculosis drugs, and the purpura as well as the high fever disappeared. OUTCOMES: The patient recovered well and remained free of symptoms during the follow-up examination. CONCLUSION: Pulmonary tuberculosis presenting with HSP as an initial manifestation is not common. Therefore, it is difficult to clinically diagnose and treat this disease. When an adult patient shows HSP, it is important to consider the possibility of tuberculosis to avoid misdiagnosis and delayed treatment.


Assuntos
Antituberculosos/uso terapêutico , Púrpura de Schoenlein-Henoch/etiologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Assistência ao Convalescente , Ácido Ascórbico/uso terapêutico , Clorfeniramina/uso terapêutico , Diagnóstico Diferencial , Febre/diagnóstico , Febre/etiologia , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Testes de Liberação de Interferon-gama/métodos , Masculino , Púrpura de Schoenlein-Henoch/tratamento farmacológico , Resultado do Tratamento , Tuberculina , Tuberculose Pulmonar/sangue , Tuberculose Pulmonar/diagnóstico por imagem , Vitaminas/uso terapêutico , Adulto Jovem
17.
Medicine (Baltimore) ; 99(40): e22619, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019483

RESUMO

RATIONALE: Xanthogranuloma of the sellar region is exceedingly rare, and described in only a handful of case reports. Herein, we present a case of xanthogranuloma of the sellar region to improve our knowledge for the diagnosis and management of this unusual disease. PATIENT CONCERNS: A 50-year-old female presented with the symptoms of intermittent vomiting, occasional head discomfort, and diabetes insipidus of 1 month duration. DIAGNOSES: Magnetic resonance imaging showed a large well-defined, vase-like, heterogeneous mass in the sellar region. The lesion showed mixed signal with hierarchical signal presentation. Fluid-fluid level sign can be found within the lesion. The upper part of the lesion was hyperintense, and the lower part was hypointense on both T1-weighted images and T2-weighted images. The lesion showed no enhancement following the intravenous administration of gadolinium. The normal pituitary tissue was not clearly visible. Optic chiasm was compressed and displaced by the lesion. Initial diagnosis of pituitary macroadenoma with hemorrhage in the sellar region was made before surgery. Final diagnosis of sellar xanthogranuloma was confirmed by histopathological examination after surgical resection. INTERVENTIONS: Gross total resection of the lesion was achieved using the microscope through endonasal transsphenoidal approach. OUTCOMES: The patient recovered well with improved binocular vision and no symptom of diabetes insipidus, and was discharged 5 days after operation. LESSONS: Sellar xanthogranuloma should receive diagnostic consideration for the lesion that is a heterogeneously mixed mass with a degree of T1-weighted images hyperintense in the sellar region.


Assuntos
Diabetes Insípido/etiologia , Granuloma/cirurgia , Sela Túrcica/patologia , Xantomatose/patologia , Xantomatose/cirurgia , Diagnóstico Diferencial , Feminino , Gadolínio/administração & dosagem , Granuloma/patologia , Cefaleia/etiologia , Humanos , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico , Sela Túrcica/diagnóstico por imagem , Resultado do Tratamento , Vômito/etiologia
18.
Ann Biol Clin (Paris) ; 78(5): 499-518, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026346

RESUMO

The French society of clinical biology "Biochemical markers of COVID-19" has set up a working group with the primary aim of reviewing, analyzing and monitoring the evolution of biological prescriptions according to the patient's care path and to look for markers of progression and severity of the disease. This study covers all public and private sectors of medical biology located in metropolitan and overseas France and also extends to the French-speaking world. This article presents the testimonies and data obtained for the "Overseas and French-speaking countries" sub-working group made up of 45 volunteer correspondents, located in 20 regions of the world. In view of the delayed spread of the SARS-CoV-2 virus, the overseas regions and the French-speaking regions have benefited from feedback from the first territories confronted with COVID-19. Thus, the entry of the virus or its spread in epidemic form could be avoided, thanks to the rapid closure of borders. The overseas territories depend very strongly on air and/or sea links with the metropolis or with the neighboring continent. The isolation of these countries is responsible for reagent supply difficulties and has necessitated emergency orders and the establishment of stocks lasting several months, in order to avoid shortages and maintain adequate patient care. In addition, in countries located in tropical or intertropical zones, the diagnosis of COVID-19 is complicated by the presence of various zoonoses (dengue, Zika, malaria, leptospirosis, etc.).


Assuntos
Serviços de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Saúde Global/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Medicina de Viagem/organização & administração , Adulto , África/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Bélgica/epidemiologia , Betacoronavirus/fisiologia , Biomarcadores/análise , Biomarcadores/sangue , Camboja/epidemiologia , Criança , Serviços de Laboratório Clínico/organização & administração , Serviços de Laboratório Clínico/estatística & dados numéricos , Busca de Comunicante/métodos , Busca de Comunicante/estatística & dados numéricos , Infecções por Coronavirus/transmissão , Diagnóstico Diferencial , Feminino , França/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Recém-Nascido , Ilhas/epidemiologia , Idioma , Laos/epidemiologia , Louisiana/epidemiologia , Masculino , Pessoal de Laboratório Médico/organização & administração , Pessoal de Laboratório Médico/estatística & dados numéricos , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/transmissão , Estudos Retrospectivos , Inquéritos e Questionários , Análise de Sobrevida , Medicina de Viagem/métodos , Medicina de Viagem/estatística & dados numéricos , Doença Relacionada a Viagens , Clima Tropical , Medicina Tropical/métodos , Medicina Tropical/organização & administração , Medicina Tropical/estatística & dados numéricos , Vietnã/epidemiologia
19.
BMJ Case Rep ; 13(10)2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028570

RESUMO

In March 2020, a 74-year-old man affected by end-stage renal disease and on peritoneal dialysis was referred to an emergency room in Modena, Northern Italy, due to fever and respiratory symptoms. After ruling out COVID-19 infection, a diagnosis of chronic obstructive pulmonary disease exacerbation was confirmed and he was thus transferred to the nephrology division. Physical examination and blood tests revealed a positive fluid balance and insufficient correction of the uraemic syndrome, although peritoneal dialysis prescription was maximised. After discussion with the patient and his family, the staff decided to start hybrid dialysis, consisting of once-weekly in-hospital haemodialysis and home peritoneal dialysis for the remaining days. He was discharged at the end of the antibiotic course, after an internal jugular vein central venous catheter placement and the first haemodialysis session. This strategy allowed improvement of depuration parameters and avoidance of frequent access to the hospital, which is crucial in limiting exposure to SARS-CoV-2 in an endemic setting.


Assuntos
Infecções por Coronavirus , Falência Renal Crônica , Pandemias , Diálise Peritoneal/métodos , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Diálise Renal/métodos , Idoso , Antibacterianos/administração & dosagem , Betacoronavirus , Terapia Combinada/métodos , Terapia Combinada/tendências , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Diagnóstico Diferencial , Unidades Hospitalares de Hemodiálise , Humanos , Controle de Infecções/métodos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Exacerbação dos Sintomas
20.
BMJ Case Rep ; 13(10)2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028572

RESUMO

A 13-year-old boy presented to hospital with 3-day self-limited fever, followed by dry cough, persistent asthenia and impaired general condition of 2 weeks' duration. Blood analyses showed a severe inflammatory status and chest X-ray images were consistent with bilateral COVID-19 pneumonia. He developed an acute respiratory failure that required paediatric intensive care admission and non-invasive ventilation. A targeted COVID-19 treatment was initiated with hydroxicloroquine, corticosteroids, enoxaparine and a single dose of tocilizumab. Repeated serological tests and real-time reverse transcription PCR for SARS-CoV-2 were negative. Other infectious pathogens were also ruled out. Thoracic high resolution CT showed an intense bilateral pulmonary dissemination with lytic vertebral bone lesions. After diagnostic investigations, Ewing's sarcoma with metastatic pulmonary dissemination was diagnosed. Nowadays, in the context of SARS-CoV-2 community pandemic, we cannot forget that COVID-19 clinical presentation is not specific and other entities can mimic its clinical features.


Assuntos
Infecções por Coronavirus/diagnóstico , Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Pneumonia Viral/diagnóstico , Sarcoma de Ewing , Tomografia Computadorizada por Raios X/métodos , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica , Exame de Medula Óssea/métodos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/sangue , Infecções por Coronavirus/fisiopatologia , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/fisiopatologia , Neoplasias Pulmonares/secundário , Masculino , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/patologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/fisiopatologia , Tomografia Computadorizada de Emissão de Fóton Único/métodos
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