Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 5 Articles
Pulmonary renal syndrome (PRS) is a high mortality, rare disorder presenting\nwith diffuse alveolar hemorrhage and progressive acute glomerulonephritis.\nThis syndrome is often caused by autoimmune entities, the most frequent\nbeing ANCA positive vasculitis and anti-GBM disease. We report a case of a\n34-year-old Chilean woman, who initially presents with anemia and after a\nfew days of inpatient management, starts with progressively worsening dyspnea,\ndecrease in renal function and hematuria. The patient is initially diagnosed\nwith pneumonia, but further evaluation using Thorax CT scan and\nrenal biopsy confirms the suspicion of PRS. The case is of particular interest\ndue to the lack of extensive bibliography on anti-GBM and ANCA negative\npulmonary-renal syndrome, an uncategorized subtype of this syndrome with\nunknown optimal management....
Background. Tuberculosis is a major public health problem and extrapulmonary tuberculosis (EPTB) accounts for a significant\nproportion of tuberculosis cases worldwide. Objective. To determine the magnitude of EPTB, associated risk factors, and agreement\nof diagnostic techniques at Dessie Referral Hospital. Methods. A cross-sectional study was conducted on consecutive presumptive\nEPTB cases from March 1 to June 30, 2017. Sociodemographic characteristics and other variables were collected using a structured\nquestionnaire. Clinical specimens were collected and processed using fluorescent microscopy and Gene Xpert assay. Data was\nanalyzed using SPSS version 20. Chi-square test and logistic regression were done and a P value of ..... was taken as statistically\nsignificant. Results. From a total of 353 presumptive EPTB cases the overall prevalence of Gene Xpert assay and smear confirmed\npatients was 8.8% and 2.5%, respectively. Tuberculosis lymphadenitis was the predominant (33.3%) type followed by pleural (11.9%) and peritoneal (6.7%) tuberculosis. Previous history of pulmonary tuberculosis was significantly associated with extrapulmonary\ninfection (AOR:2.8; 95%CI: 1.05-7.54; p=0.04); however, other variables such as age, residence, sex,marital status, occupation, level\nof education, andmonthly income did not show any association. Conclusion. High proportions (71%) ofGene Xpert assay confirmed\nEPTB patientswere smear-negative. Sensitivity of microscopy should be enhanced in resource limited countries like Ethiopia where\nGene Xpert machine is not easily accessible....
An immunocompetent 82-year-old female was admitted to our hospital due to fever\nwithout clear origin and hyponatremia. In the following days, an acute and bilateral pulmonary\ninfiltrate appeared with a progressive worsening in respiratory function. Chest x-ray and CT\n(Computed tomography) showed bilateral reticulonodular infiltrates. Bronchoscopic aspiration\nand bronchoalveolar lavage (BAL), and transbronchial lung biopsy (TBBX) studies did not reveal\nmicrobiological and histopathological diagnosis. Broad-spectrum antibiotics were non-effective,\nand the patient died due to respiratory failure. Necropsy study revealed a miliary tuberculosis\naffecting lungs, liver, bone marrow, spleen, kidney, arteries, pancreas, and adrenal glands.\nSome weeks after the patient´s death, mycobacterial cultures from sputum, BAL and TBBX samples\nwere positive for Mycobacterium tuberculosis....
Pneumonia causes the deaths of over a million people worldwide each year, with most\noccurring in countries with limited access to expensive but effective diagnostic methods,\ne.g., chest X-rays. Physical examination, the other major established method of diagnosis, suffers from\nseveral drawbacks, most notably low accuracy and high interobserver error. We sought to address this\ndiagnostic gap by developing a proof-of-concept non-invasive device to identify the accumulation\nof fluid in the lungs (consolidation) characteristic of pneumonia. This device, named Tabla after\nthe percussive instrument of the same name, utilizes the technique of auscultatory percussion;\na percussive input sound is sent through the chest and recorded with a digital stethoscope for analysis.\nTabla analyzes differences in sound transmission through the chest at audible frequencies as a marker\nfor lung consolidation. This paper presents preliminary data from five pneumonia patients and eight\nhealthy subjects. We demonstrate 92.3% accuracy in distinguishing between healthy subjects and\npatients with pneumonia after data analysis with a K-nearest neighbors algorithm. This prototype\ndevice is low cost and simple to implement and may offer a rapid and inexpensive method for\npneumonia diagnosis appropriate for general use and in areas with limited medical infrastructure....
Transforming growth factor (TGF) .. is an evolutionarily conserved pleiotropic factor that\nregulates a myriad of biological processes including development, tissue regeneration, immune\nresponses, and tumorigenesis. TGF... is necessary for lung organogenesis and homeostasis as evidenced\nby genetically engineered mouse models. TGF... is crucial for epithelial-mesenchymal interactions\nduring lung branching morphogenesis and alveolarization. Expression and activation of the three TGF... ligand isoforms in the lungs are temporally and spatially regulated by multiple mechanisms. The lungs\nare structurally exposed to extrinsic stimuli and pathogens, and are susceptible to inflammation, allergic\nreactions, and carcinogenesis. Upregulation of TGF... ligands is observed in major pulmonary diseases,\nincluding pulmonary fibrosis, emphysema, bronchial asthma, and lung cancer... regulates\nmultiple cellular processes such as growth suppression of epithelial cells, alveolar epithelial cell\ndifferentiation, fibroblast activation, and extracellular matrix organization. These effects are closely\nassociated with tissue remodeling in pulmonary fibrosis and emphysema. TGF... is also central to T\ncell homeostasis and is deeply involved in asthmatic airway inflammation. TGF... is the most potent\ninducer of epithelial-mesenchymal transition in non-small cell lung cancer cells and is pivotal to\nthe development of tumor-promoting microenvironment in the lung cancer tissue. This review\nsummarizes and integrates the current knowledge of TGF... relevant to lung health\nand disease....
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