scholarly journals A Case of Sarcoidosis with Unusual Radiographic Findings that Developed 5 Years after Silicone Augmentation Mammoplasty Complicated by Miliary Tuberculosis during Corticosteroid Treatment

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Tomoko Miyashita ◽  
Katsunobu Yoshioka ◽  
Tomoyuki Nakamura ◽  
Keiko Yamagami

A 54-year-old woman with a past history of silicone augmentation mammoplasty was admitted with fever and dyspnea with diffuse interstitial shadows on computed tomography (CT). Although radiological findings were atypical, we diagnosed sarcoidosis by laboratory, microbiological, and bronchoalveolar lavage fluid analysis. Corticosteroids ameliorated the condition, but she had recurrent of fever and CT revealed miliary nodules while interstitial shadows disappeared. Liver biopsy showed that noncaseating granuloma and Ziehl-Neelsen stain was positive. We diagnosed miliary tuberculosis which developed during corticosteroid therapy. Antituberculotic therapy resulted in favorable outcome. Possibility exists that onset of sarcoidosis was induced by mammoplasty, namely, human adjuvant disease.

2017 ◽  
Vol 5 (2) ◽  
pp. 135-138
Author(s):  
Md Mahabub Morshed ◽  
AKM Ferdous Rahman ◽  
Syed Tariq Reza ◽  
Muhammad Asaduzzaman ◽  
Mohammad Selim ◽  
...  

Background: Guillain-Barré syndrome is an acquired polyradiculo-neuropathy, often preceded by an antecedent event. It is a monophasic disease but a recurrence rate of 1–6 % is documented in a subset group of patients.Case presentation: Thirty-five-years-old female with past history of near complete recovery following Guillain-Barré syndrome 17 years back presented with acute, ascending symmetrical flaccid quadriparasis extending to bulbar muscles and respiratory compromise needing mechanical ventilation. Nerve conduction study revealed AMAN variant of Guillain-Barré syndrome. Cerebrospinal fluid analysis done after 1 weeks during recurrent episode revealed albuminocytologic dissociation. She was treated with intravenous immunoglobulin resulting in a remarkable recovery.Conclusion: Recurrence of Guillain-Barré syndrome can occur in a subset of patients with Guillain-Barré syndrome even after many years of asymptomatic period. Most patients with recurrent GBS respond favourably to treatment with plasmapheresis or IVIG.Bangladesh Crit Care J September 2017; 5(2): 135-138


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. Benkalfate ◽  
S. Dirou ◽  
P. Germaud ◽  
C. Defrance ◽  
A. Cavailles ◽  
...  

Abstract Background Allergic bronchopulmonary aspergillosis (ABPA) is a bronchopulmonary disease caused by a complex hypersensitivity to Aspergillus and is usually associated with underlying respiratory diseases such as asthma or cystic fibrosis. Mucus plugging can lead to segmental or lobar atelectasis, but complete lung atelectasis has been exceptionally reported in the literature, making it difficult to diagnose. The diagnosis of ABPA may however be suggested in patients without known predisposing respiratory disorder, even in the absence of other relevant radiographic findings. Case presentation We report five cases of total unilateral lung collapse secondary to ABPA in 70–81-year-old women. Two of them had a past history of ABPA, while total unilateral lung collapse was the first sign of the disease in the other three patients, contributing to the initial misdiagnosis. Flexible bronchoscopy was initially performed to remove mucus plugs from the obstructed airways but was inefficient in four cases. Corticosteroid and/or antifungal treatment was needed. Conclusion ABPA can cause total unilateral lung collapse even in patients without known underlying chronic respiratory disease, making the diagnosis difficult. Flexible bronchoscopy should be considered when lung collapse is associated with respiratory distress but corticosteroids are the mainstay treatment for ABPA.


2010 ◽  
Vol 17 (5) ◽  
pp. e102-e105 ◽  
Author(s):  
Elif Kupeli ◽  
Demet Karnak ◽  
Serpil Dizbay Sak ◽  
Oya Kayacan

Hypersensitivity pneumonitis (HP) is a nonimmunoglobulin E-related immune-mediated parenchymal lung disease. A 45-year-old woman who was a lifelong nonsmoker with a six-month history of frequent episodes of cough and dyspnea was admitted to hospital. She had been working as a money counter for 20 years at a central bank. Bibasilar crackles on lung auscultation, ground-glass opacities and a mosaic pattern on high-resolution computed tomography, restrictive abnormality on pulmonary function tests and mild hypoxemia were the prominent findings. Bronchoalveolar lavage fluid analysis revealed a predominance of CD4-positive T cells, and she tested positive on her natural challenge test. She was diagnosed with subacute HP based on established criteria. She was advised to discontinue counting fresh banknotes. Prednisolone was commenced, then tapered to discontinue in the ensuing six months. Clinical and radiological improvement was achieved within two months. To the authors’ knowledge, the present report is the first to describe ‘hard cash HP’, possibly caused by chipping dust or printing dye.


2014 ◽  
pp. 140-152
Author(s):  
Manh Hoan Nguyen ◽  
Ngoc Thanh Cao

Background and Objective: HIV infection is also a cause of postpartum depression, however, in Vietnam, there has not yet the prevalence of postpartum depression in HIV infected women. The objective is to determine prevalence and related factors of postpartum depression in HIV infected women. Materials and Methods: From November 30th, 2012 to March 30th, 2014, a prospective cohort study is done at Dong Nai and Binh Duong province. The sample includes135 HIV infected women and 405 non infected women (ratio 1/3) who accepted to participate to the research. We used “Edinburgh Postnatal Depression Scale (EPDS) as a screening test when women hospitalized for delivery and 1 week, 6weeks postpartum. Mother who score EPDS ≥ 13 are likely to be suffering from depression. We exclude women who have EPDS ≥ 13 since just hospitalize. Data are collected by a structural questionaire. Results: At 6 weeks postpartum, prevalence of depression in HIV infected women is 61%, in the HIV non infected women is 8.7% (p < 0.001). There are statistical significant differences (p<0.05) between two groups for some factors: education, profession, income, past history of depression, child’s health, breast feeding. Logistical regression analysis determine these factors are related with depression: late diagnosis of HIV infection, child infected of HIV, feeling guilty of HIV infected and feeling guilty with their family. Multivariate regression analysis showed 4 factors are related with depression: HIV infection, living in the province, child’s health, past history of depression. Conclusion: Prevalence of postpartum depression in HIV infected women is 61.2%; risk of depression of postnatal HIV infected women is 6.4 times the risk of postnatal HIV non infected women, RR=6.4 (95% CI:4.3 – 9.4). Domestic women have lower risk than immigrant women from other province, RR=0.72 (95% CI:0.5 – 0.9). Past history of depression is a risk factor with RR=1.7 (95% CI:1.02 – 0.9. Women whose child is weak or die, RR=1.7(95% CI:0.9 – 3.1). Keywords: Postpartum depression, HIV-positive postpartum women


Author(s):  
Bahram Mashhoon

A postulate of locality permeates through the special and general theories of relativity. First, Lorentz invariance is extended in a pointwise manner to actual, namely, accelerated observers in Minkowski spacetime. This hypothesis of locality is then employed crucially in Einstein’s local principle of equivalence to render observers pointwise inertial in a gravitational field. Field measurements are intrinsically nonlocal, however. To go beyond the locality postulate in Minkowski spacetime, the past history of the accelerated observer must be taken into account in accordance with the Bohr-Rosenfeld principle. The observer in general carries the memory of its past acceleration. The deep connection between inertia and gravitation suggests that gravity could be nonlocal as well and in nonlocal gravity the fading gravitational memory of past events must then be taken into account. Along this line of thought, a classical nonlocal generalization of Einstein’s theory of gravitation has recently been developed. In this nonlocal gravity (NLG) theory, the gravitational field is local, but satisfies a partial integro-differential field equation. A significant observational consequence of this theory is that the nonlocal aspect of gravity appears to simulate dark matter. The implications of NLG are explored in this book for gravitational lensing, gravitational radiation, the gravitational physics of the Solar System and the internal dynamics of nearby galaxies as well as clusters of galaxies. This approach is extended to nonlocal Newtonian cosmology, where the attraction of gravity fades with the expansion of the universe. Thus far only some of the consequences of NLG have been compared with observation.


2021 ◽  
pp. 194589242198916
Author(s):  
Henry D. Zheng ◽  
Jeffrey C. Mecham ◽  
Yassmeen Abdel-Aty ◽  
Devyani Lal ◽  
Michael J. Marino

Background The histopathology and microbiology associated with silent sinus syndrome (SSS) have not been well described. Objective This study details the histopathological and microbiological characteristics in addition to radiographic findings of SSS in comparison to those of chronic maxillary sinusitis (CRS). Methods 42 patients diagnosed with SSS at Mayo Clinic Hospital in Arizona were identified. Paranasal computed tomography scans of the 42 SSS patients as well as 42 matched CRS patients were analyzed in order to assess differences in the prevalence of septal spurs/deviation. 20 of the SSS patients and 19 of the matched CRS patients also had histopathology and microbiology reports, which were compiled and summarized. Additionally, 19 SSS and 19 matched CRS patients were contacted via phone survey for a more complete patient history regarding maxillary dental disease/surgery. Results SSS patients have a significantly higher prevalence of septal spurs/deviation than CRS patients. The microbiomes of SSS patients more closely resemble those of healthy controls than those of CRS patients. Analysis of the histopathology of SSS reveals chronic, non-specific inflammation similar to that seen in non-eosinophilic CRS without polyps. SSS patients were significantly more likely to have a history of maxillary dental disease requiring surgery. Conclusion These data support the hypothesis that the pathogenesis of SSS is more likely due to anatomical/mechanical factors than inflammatory/microbiological factors.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S163-S164
Author(s):  
K G Manjee ◽  
W G Watkin

Abstract Introduction/Objective Cervical biopsy is performed following an abnormal pap smear or positive HPV testing in an attempt to uncover clinically significant lesions [HSIL/invasive carcinoma (HSIL+)]. An excisional procedure is considered if biopsy confirms HSIL+. When preceded by pap smear of LSIL, ASCUS, NILM/HPV+ or persistent HPV, continued surveillance is recommended for biopsies showing no SIL or LSIL. In our laboratory, cervical biopsies are routinely sectioned at 3 levels. Deeper levels are often ordered when initial sections are non-diagnostic. p16 immunohistochemistry, with or without deeper levels, is often ordered to confirm HSIL, or to differentiate HSIL from mimics. In this study, we examine whether and in what clinical situations does obtaining additional levels uncover clinically significant lesions. Methods 430 cervical biopsies between January-May 2018, with recent cytology of LSIL, ASCUS or NILM/HPV+ were identified in the pathology database. HPV status (if known), final biopsy diagnosis and past history of LSIL/HSIL were recorded. For each biopsy, orders for additional levels and/or p16 immunohistochemistry were recorded resulting in 4 categories: C1-no additional levels or p16, C2-deeper only, C3-deeper+p16 and C4-p16 only. Final diagnoses were divided into HSIL+, LSIL and no SIL. Results There was no significant difference in prior history of LSIL/HSIL and HPV status between all categories. Biopsy results were as follows: HSIL+: 11/222 (5%) C1; 1/78 (1%) C2; 7/43 (16%) C3; 15/87 (17%) C4 LSIL: 91/222 (41%) C1; 7/78 (9%) C2; 16/43 (37%) C3; 35/87 (40%) C4 No SIL: 120/222 (54%) C1; 70/78 (90%) C2; 20/43 (46%) C3; 37/87 (42%) C4 The average number of additional levels in C2 and C3 was 3.8 and 1.8, respectively. Conclusion Deeper levels alone did not enhance the detection of HSIL+. Almost all LSIL/HSIL were detected when initial levels were diagnostic or suspicious and supported by p16 immunohistochemistry. 3 levels are adequate to detect clinically significant lesions.


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