Giovanni GasbarriniOlga RickardsCristina Martínez-LabargaElsa Pacciani...
5300-5304页
查看更多>>摘要：We recently presented the case of a first century AD young woman,found in the archaeological site of Cosa,showing clinical signs of malnutrition,such as short height,osteoporosis,dental enamel hypoplasia and cribra orbitalia,indirect sign of anemia,all strongly suggestive for celiac disease (CD).However,whether these findings were actually associated to CD was not shown based on genetic parameters.To investigate her human leukocyte antigen (HLA) class Ⅱ polymorphism,we extracted DNA from a bone sample and a tooth and genotyped HLA using three HLA-tagging single nucleotide polymorphisms for DQ8,DQ2.2 and DQ2.5,specifically associated to CD.She displayed HLA DQ 2.5,the haplotype associated to the highest risk of CD.This is the first report showing the presence of a HLA haplotype compatible for CD in archaeological specimens.
Gilton Marques FonsecaAndré Luis MontagniniManoel de Souza RochaRosely Antunes Patzina...
5305-5308页
查看更多>>摘要：Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities,trunk,head and neck,retroperitoneum,mediastinum,pelvis,and peritoneum.However,it can arise in the gastrointestinal tract,including biliary tract.We present a 24-year-old male patient with obstructive jaundice,whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct,difficult to differentiate with hilar adenocarcinoma.He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection.The patient recovered well without signs of recurrence of the lesion after 12 mo.We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar.Resection is the treatment of choice for such cases and the tumor did not recur in any of the resected cases.
查看更多>>摘要：Herein,we present a case of pneumoaorta and aortoduodenal fistula (ADF) caused by an endoluminal aortic prosthesis infection.An 82-year-old man underwent endovascular aneurysm repair with a stent graft to exclude a 5.1-cm abdominal aortic aneurysm.Three months after the index procedure,the patient was taken to the emergency department at a medical university hospital.He presented with a 2-d history of bloody diarrhea.An endoluminal aortic stent graft infection was diagnosed,and an ADF was identified.The patient died of septic shock despite emergency surgery and intensive care.When encountered,stent graft infections require appropriate antibiotics and graft explantation.The diagnosis of an ADF is important,and surgery remains the most effective management if septic shock presents despite conservative treatment.
查看更多>>摘要：Penicillium marneffei (P.marneffei) infection usually occurs with skin,bone marrow,lung or hepatic involvement.However,no cases of P.marneffei infection with chylous ascites have been reported thus far.In this report,we describe the first case of acquired immune deficiency syndrome (AIDS) which has been complicated by a P.marneffei infection causing chylous ascites.We describe the details of the case,with an emphasis on treatment regimen.This patient was treated with amphotericin B for 3 mo,while receiving concomitant therapy with an efavirenz-containing antiretroviral regimen,but cultures in ascitic fluid were persistently positive for P.marneffei.The infection resolved after treatment with high-dose voriconazole (400 mg every 12 h) for 3 mo.P.marneffei should be considered in the differential diagnosis of chylous ascites in human immunodeficiency virus patients.High-dose voriconazole is an effective,well-tolerated and convenient option for the treatment of systemic infections with P.marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.
查看更多>>摘要：Fatty liver,including non-alcoholic fatty liver disease,is closely associated with metabolic syndrome (MS).Thus,the presence of fatty liver without MS in some conditions may be clinically important.Many studies have shown that compared with no or occasional alcohol intake,moderate alcohol consumption is associated with lower prevalence rates of hypertension and type 2 diabetes,and lower levels of circulating C-reactive protein,a valuable marker for MS and insulin resistance.Considering these findings,light to moderate alcohol consumption has theoretical benefits on fatty liver and MS.Fatty liver,including non-alcoholic fatty liver disease,may be more clinically important than MS,particularly in non-obese individuals,because fatty liver can develop before MS in several conditions,such as regular alcohol consumers.Furthermore,most of the currently used MS criteria are unable to detect "true MS" because of variations in multiple factors such as age,height,medications,and complications.
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