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Tuberculosis peritoneal en una adulta joven
Guerra Macías,Ileana; Rizo Revé,Rafael; Hernández Cobos,Salvador;
MEDISAN , 2009,
Abstract: the clinical case of a undernourished 24-year-old patient of the republic of djibouti who lived in a rural region is described. she was attended in the emergency department of surgery due to a fixed, continuous and stabbing hypogastric pain, which was intensified progressively besides nauseas and bilious vomiting. a very painful adnexal mass of almost 8 cm was palpated in the right side with a bimanual exploration. examinations confirmed the presence of a bent ovaric cyst and a possible peritoneal tuberculosis, which was proven with intraoperative diagnosis. she made a good progress and was transferred to the medicine service for antibacillary treatment.
Tuberculosis ganglionar en un adulto joven Lymph node tuberculosis in a young adult  [cached]
Joaquín López González,Sahily Quintero Salcedo,Odalis García Gómez,Haydée Marrero Rodríguez
MEDISAN , 2011,
Abstract: Se expone el caso clínico de un recluso de 34 a os de edad, de procedencia rural, quien fue atendido por especialistas de neumología a causa de cuadro febril crónico, astenia, pérdida de peso, inapetencia y aumento de volumen no doloroso en la región lateral derecha del cuello. Los exámenes complementarios mostraron imágenes de adenomegalias en hilio hepático y epigastrio. La muestra extraída del ganglio cervical para biopsia reveló necrosis caseosa de origen tuberculoso, por lo cual se diagnosticó tuberculosis ganglionar con afectación de cadenas ganglionares superficiales y profundas; enfermedad muy poco frecuente con esas características en el territorio. The case of 34 year-old prisoner is reported, who lived in a rural area and was attended by pulmonologists because of chronic feverishness, asthenia, weight loss, loss of appetite and painless enlargement in the right lateral region of the neck. Complementary tests revealed lymphadenopathies in porta of liver and epigastrium. Cervical node biopsy revealed tuberculous caseous necrosis, thus diagnosing as lymph node tuberculosis with involvement of superficial and deep lymph node chains; an infrequent disease with these characteristics in the territory.
Peritoneal tuberculosis
K. Mimidis, K. Ritis, G. Kartalis
Annals of Gastroenterology , 2007,
Abstract: Tuberculosis (TB) can involve any part of the gastrointestinal tract and is the sixth most frequent site of extrapulmonary involvement. Both the incidence and severity of abdominal tuberculosis (AT) are expected to increase with increasing incidence of HIV infection. Peritoneal tuberculosis (PT), a form of AT, occurs in three forms: wet type with ascites, dry type with adhesions, and fibrotic type with omental thickening and loculated ascites. Clinically, PT is characterized by fever, abdominal pain, anorexia, weight loss, and ascites. However, none of these symptoms is specific for the disease, so it is commonly misdiagnosed, especially as carcinomatous peritonitis in the elderly. Early diagnosis of PT is of major importance in the control of the disease. Chest X-rays show evidence of concomitant pulmonary lesions in less than 25 per cent of cases. Laparoscopy with direct biopsy is an excellent diagnostic method and must be considered for every patient with unexplained ascites. A definitive diagnosis requires identification of bacilli in ascitic fluid or peritoneum tissue. However, acidfast staining is usually negative and cultures are positive in 30-40% of cases, making bacteriological confirmation of the disease very difficult. Recently, advances in molecular techniques have provided a new approach to the rapid diagnosis of tuberculosis by nucleic acid probes and polymerase chain reaction (PCR). Management is with conventional antitubercular therapy for at least six months. Key words: PCR, ascites, peritoneal tuberculosis
Adaptación psicométrica del inventario de Texas revisado de duelo (ITRD) en población militar espa ola joven adulta Psychometric Adaptation of Texas Revised Inventory of Grief (TRIG) in a Spanish young adult military population  [cached]
E. Samper Lucena
Sanidad Militar , 2011,
Abstract: Introducción: Las pérdidas que acompa an la condición humana suponen un proceso muy difícil de incorporar en la vida, según la literatura científica uno de los acontecimientos vitales más estresantes. En la actualidad se ha incrementado el interés por estos temas y su demanda social. En las Fuerzas Armadas la actuación diaria de los hombres y mujeres que la integran, especialmente durante su participación en las misiones en el exterior, es la razón de su prestigio entre nuestros conciudadanos, pero también se sufren pérdidas de personas y heridos allí donde prestan servicio, lo que afecta a compa eros, familiares y amigos. Objetivos: En este trabajo se trata de estudiar psicométricamente el inventario de Texas revisado de duelo (ITRD) de Faschingbauer y cols., en personal militar joven adulto, revisando algunas de las variables que se han asociado en la literatura científica con el proceso psicológico estudiado. Aportar información relevante de apoyo en la consulta especializada o en situaciones de emergencia o catástrofe para la ayuda a personas que han perdido a seres queridos. Metodología: Se ha confeccionado un cuestionario para recoger los datos. Se aplicó a una muestra de adultos jóvenes, miembros de las Fuerzas Armadas Espa olas, realizando el estudio psicométrico (análisis descriptivo, baremación mediante percentiles, y estudio factorial). Discusión: Se compararon los resultados obtenidos con los de otros estudios de autores tanto de la prueba original como de la versión utilizada en otras poblaciones de diferente origen. Conclusiones: La prueba utilizada es psicométricamente adecuada en población joven adulta de forma similar a lo encontrado en otros estudios con distinta población. Existen diferencias entre hombres y mujeres en el proceso de duelo. Que la clasificación de los baremos de la prueba se debe de adaptar a la población donde se aplica, clínica o no, diferentes grupos de edad, o diferentes orígenes culturales, ya que el proceso de duelo es distinto. El perfil de la persona con necesidades de apoyo especializado, en este estudio, es de una mujer sin tratamientos en salud mental y que ha perdido a un ser querido por una enfermedad. Se aporta un trabajo de interés para enriquecer los instrumentos diagnósticos psicológicos, en una población específica de las Fuerzas Armadas Espa olas. Introduction: The losses that accompany the human condition are a difficult process to come to terms with, and according to scientific literature one of the most stressful life events. Today there is an increased interest in these issues and their social dem
Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis  [PDF]
Mehmet Akce,Sarah Bonner,Eugene Liu,Rebecca Daniel
Case Reports in Medicine , 2014, DOI: 10.1155/2014/436568
Abstract: A 67-year-old male presented with fatigue, abdominal pain , and 30-pound weight loss over 3 months. Computerized tomography (CT) abdomen displayed ascites with thickening and enhancement of the peritoneum and mottled nodular appearing as soft tissue consistent with omental caking worrisome for peritoneal carcinomatosis. A paracentesis revealed white blood cell count of 2,500 with 98% lymphocytes and serum ascites albumin gradient of 0.9?g/L. No acid-fast bacilli were seen by microscopic exam and culture was negative. Purified protein derivative skin test (PPD) was negative and CXR did not reveal any infiltrates. Esophagogastroduodenoscopy (EGD) and colonoscopy were unrevealing. The patient underwent exploratory laparotomy with round ligament and peritoneal biopsies that revealed numerous necrotizing granulomas. Acid-fast bacteria Ziehl-Neelsen stain (AFB) of the biopsy specimen revealed single acid-fast bacilli. Treatment for M. tuberculosis was initiated and final culture revealed that mycobacterium tuberculosis was sensitive to Isoniazid, Rifampin, Ethambutol, and Pyrazinamide. After 6 months of treatment, the ascites and peritoneal carcinomatosis resolved. 1. Introduction Extrapulmonary tuberculosis (ETB) comprises 18.7% of all tuberculosis cases in the USA. Peritoneal tuberculosis, which is caused by mycobacterium tuberculosis, is an uncommon form of ETB and is seen only in 4.7% of all ETB cases [1]. Although both primary tuberculosis (PTB) and ETB cases have decreased over time in the USA, the slower decrease in ETB cases caused a relative increase in the ETB compared to PTB. Peritoneal involvement is the sixth most common site of ETB in the USA and usually is a result of hematogenous spread from a pulmonary focus or direct spread from adjacent organs. 2. Case Presentation A 67-year-old male presented with fatigue, anemia, and weight loss of 30 pounds in the last 3 months. He denied history of alcohol consumption and endorsed history of travel to Philippines. On physical examination he had pale conjunctiva bilaterally and shifting dullness on abdomen and rest of his physical examination was normal. Initial laboratory studies revealed Hb of 6.1?gm/dL, MCV 58 FL, creatinine 1.50?mg/dL, albumin 3.3?gm/dL, INR 0.77, normal ALT/AST/ALP, and total bilirubin. CXR did not reveal any infiltrates (Figure 1). CT abdomen showed moderate amount of ascites with diffuse thickening of peritoneal surfaces suggestive of peritoneal carcinomatosis (Figure 2). Due to these CT abdomen findings and history of recent weight loss, he underwent a work-up for malignancy with
Meningoencefalitis por Mycoplasma pneumoniae en un adulto joven Mycoplasma pneumoniae meningoencephalitis in a young adult  [cached]
Marcelo del Castillo,Carlos D'Giano,María Teresa Goicoechea
Medicina (Buenos Aires) , 2005,
Abstract: Las infecciones por Mycoplasma pneumoniae presentan complicaciones del sistema nervioso de distinto tipo, que si bien son infrecuentes pueden ser graves; habitualmente tienen evolución favorable pero pueden dejar secuelas permanentes. Se presenta una paciente adulta joven con una meningoencefalitis aguda que no dejó secuelas como complicación de una infección respiratoria baja. El diagnóstico se efectuó por detección de anticuerpos específicos. Mycoplasma pneumoniae infections have extrapulmonary complications that involve the nervous system. The neurologic manifestations are diverse. Although the prognosis is usually favorable, the patients can undergo severe permanent sequelae. We present a young female adult with acute meningoencephalitis as a complication of a lower respiratory infection, which followed a benign course without neurologic sequelae.
Peritoneal Tuberculosis: Diagnostic Options  [cached]
N. Lal,V. Soto-Wright
Infectious Diseases in Obstetrics and Gynecology , 1999, DOI: 10.1155/s1064744999000447
Abstract: Background: Extrapulmonary tuberculosis has vague symptoms and few signs. It is essential to recognize and diagnose this curable disease prior to performing definitive surgery. Newer tests such as DNA or RNA amplification allow for early diagnosis but have limitations.
CT and barium features of gastrointestinal and peritoneal tuberculosis  [cached]
Makanjuola Dorothy
Saudi Journal of Gastroenterology , 1997,
Abstract: The radiological features in barium gastrointestinal studies and computed tomographic (CT) examinations of 22 consecutive cases of proven peritoneal and/or intestinal tuberculosis were analyzed in order to highlight the radiological features which could provide ready identification of the disease. There were 15 cases of intestinal tuberculosis and 7 cases of peritoneal tuberculosis and 3 patients had both. The commonest location of intestinal tuberculosis was the ileocecal region (N=10) which occurred in association with colonic or ilea] disease. Bowel wall thickening in CT was largely asymmetrical but minimal and symmetrical wall thickening occurred with peritonitis. Luminal narrowing with or without mucosal tethering were seen in both CT and Barium studies. Peritoneal TB had either high density ascites with smudge or nodular omental surface with a thickened omental lining. Also detected was fibrinous dry peritonitis with thickened mesenteric tissue. Lymphadenopathy in the peripancreatic, mesenteric or paracaval were common to both intestinal or peritoneal tuberculosis (21 out of 22). Fifty percent of the patients showed some lymph nodes with necrotic centers. The differential diagnosis included malignant peritonitis and intestinal or mesenteric carcinoid. The study shows that a combination of barium gastrointestinal study and computed tomography can provide distinct features which could strongly suggest the diagnosis of intestinal or peritoneal tuberculosis.
Intestinal/Peritoneal Tuberculosis in Children: An Analysis of Autopsy Cases  [PDF]
Cecilia Ridaura-Sanz,Eduardo López-Corella,Ruy Lopez-Ridaura
Tuberculosis Research and Treatment , 2012, DOI: 10.1155/2012/230814
Abstract: Infection by Mycobacterium bovis is not infrequently identified in Mexico. Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract. The term “abdominal tuberculosis” includes peritoneal as well as primary and secondary intestinal tuberculosis. The clinical differentiation of these conditions is difficult. In this work, we reviewed the clinical and pathological features of 24 cases of children dying with tuberculosis in whom autopsy revealed abdominal disease in a referral hospital in Mexico City. We identified 8 cases of primary intestinal tuberculosis, with documentation of M. bovis in 6 of them, and 9 cases of secondary intestinal tuberculosis (primary pulmonary disease), all negative to M. bovis. Seven patients had peritoneal tuberculosis without intestinal lesions and with active pulmonary disease in 4 of them, and of the remaining three, two had mesenteric lymph node involvement suggesting healed intestinal disease. In this approach to abdominal tuberculosis, postmortem analysis was able to differentiate primary from secondary intestinal tuberculosis and to define the nature of peritoneal involvement. This discrimination gives rise to different diagnostic approaches and epidemiological and preventive actions, particularly in countries where tuberculosis is endemic and infection by M. bovis continues to be identified. 1. Introduction Tuberculosis continues to be a serious public health problem in Mexico, particularly for children. The incidence in 2007 was 13.49 cases/100 000 individuals and 5.077/100 000 in children under the age of 19 [1]. Around 16% of dairy cattle are infected with M. bovis, and 30% to 50% of their product is sold as nonpasteurized milk or cheese with a wide distribution [2]. Cheese consumption has been associated with cases of intestinal tuberculosis in Mexican children residing in New York City, and a similar situation was identified in Denver, Colorado, where most cases of tuberculosis caused by M. bovis occurred in Mexican residents [3, 4]. In a recent study in the vicinity of Mexico City, 13.8% of samples from symptomatic individuals with the tuberculosis complex corresponded by spoligotyping to M. bovis [2]. M. bovis is widely recognized as the causal agent of primary intestinal tuberculosis [5]. Tuberculosis infection in the abdominal cavity includes cases with involvement of the gastrointestinal tract, often with peritoneal extension, as well as cases of peritoneal infection without intestinal lesions. In a majority of publications, these conditions
Understanding health: a starting point in the healing focus when promoting health among young adult women La comprensión de la salud: punto de partida del enfoque sanológico en la promoción de la salud de la mujer adulta joven1  [cached]
PARDO TORRES MYRIAM PATRICIA,Nú?EZ GóMEZ NICOLáS ARTURO
Avances en Enfermería , 2007,
Abstract: Via an intervention study with a before and after design, we worked with a group of 100 women between 20 and 40 years who are residents of the area of the Fourth regional district of the Capital, i.e. Bogotá (San Cristóbal, specifically), with the purpose of identifying the understanding of health before and after an intervention when promoting health drives with a healing focus, and the transformation that is generated after such intervention. In order to explore the concept of health and the actions needed to preserve health before and after, we used the semi-structured interview instrument, as of the judgments issued by women. We identified criteria and defined categories in order to understand the health concept and its evolution. At the beginning of the intervention, half the women understood health in terms of the absence of illnesses; one fifth associated it with corporal care, psycho spiritual and environmental care and one third integrated complex elements close to the category comprehension of healing in ones health. After the interventions the majority of the judgments issued by participants included criteria in this latter category. As a conclusion it is shown that the intervention strategy of promoting health with a healing focus to adult young women favors self thinking and the evolution of health conception, towards the recognition by women of their definitive role in being healthy and in the need for social contributions to a life project. Através de un estudio de intervención con dise o antes-después, se trabajó con un grupo de 100 mujeres en-tre 20 y 40 a os residentes en la Localidad Cuarta del Distrito Capital de Bogotá (San Cristóbal), con el objetivo de identificar la comprensión de la salud antes de una intervención en promoción de la salud con enfoque sanológico, y la transformación que se genera después de la intervención. Para explorar el concepto de salud y las acciones para mantener la salud antes-después se utilizó como instrumento la entrevista semiestructurada, a partir de los juicios emitidos por las mujeres, se identificaron los criterios y se construyeron categorías para comprender el concepto de salud y su evolución. Al inicio de la intervención, la mitad de las mujeres comprendían la salud en términos de ausencia de enfermedad; un quinto la asociaba con el cuidado corporal, psicoespiritual y ambiental y un tercio integraba elementos complejos cercanos a la categoría comprensión sanológica de la salud. Posterior a la intervención, la mayoría de los juicios emitidos por las participantes incluían criterios de esta últim
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