共查询到20条相似文献,搜索用时 15 毫秒
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Rodolfo J. Oviedo 《Methodist DeBakey Cardiovascular Journal》2012,8(3):49-Sep;8(3):49
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Atsushi Komatsuda Hideki Wakui Masaru Togashi Ken-Ichi Sawada 《The American journal of the medical sciences》2010,339(5):486-490
A 35-year-old Japanese man developed systemic lymphadenopathy during the course of immunosuppressive therapy for IgA nephropathy associated with cutaneous nodules, polyclonal hypergammaglobulinemia, and persistent increased serum C-reactive protein of unknown cause. Lymph node examination showed the plasmacytic type of Castleman disease (CD). A skin biopsy showed specific pathologic findings of CD cutaneous involvement. Considering the involvement of interleukin-6 in CD, we treated the patient with humanized anti-interleukin-6 receptor antibody. Thereafter, his symptoms and abnormal laboratory findings were improved. Cutaneous CD has rarely been described in Asian population, and renal complications in CD are uncommon and heterogeneous. To our knowledge, this is the first case of IgA nephropathy associated with multicentric CD with cutaneous involvement. 相似文献
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Farzan Irani Hussam Elkambergy Kalpana Naraharisetty Raheel Jamal 《The American journal of the medical sciences》2009,337(6):470-472
Propylthiouracil (PTU) can effectuate antineutrophil cytoplasmic antibodies (ANCA)–positive vasculitis. We report a case of severe, PTU-induced leucocytoclastic vasculitis with diffuse pulmonary hemorrhage within a month of initiating PTU. Emergent plasmapheresis was initiated with excellent clinical response. A clinical suspicion for this potential side effect coupled with early cessation of the drug is generally adequate. Clinical manifestations, posited pathogenetic mechanisms, and therapeutic strategies, including the role of plasmapheresis, are discussed. 相似文献
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This is a detailed single-case presentation of a 70-year-old Caucasian, married woman suffering from multiple sclerosis and significant chronic depression. Her presentation was complicated by traumatic events during childhood and a recent decline in physical abilities due to multiple sclerosis. Cognitive behavioral therapy was used and excellent outcomes were achieved. This article describes how cognitive behavioral therapy was effectively adapted to treat this patient whose longstanding physical disability was progressively intruding into the patient's quality of life and her interactions with others, particularly her husband. In writing this account of how therapy was delivered, the authors pay particular attention to the need for flexibility so that the cognitive behavioral therapy met this patient's individual needs. 相似文献
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Eric M. Mortensen Luci Leykum Brandy Nakashima Marcos I. Restrepo Sean Garcia Antonio Anzueto 《The American journal of the medical sciences》2010,339(3):239-243
BackgroundPrevious research has shown that hypoglycemia is associated with worse outcomes for the elderly, in sepsis, and in children with pneumonia. The purpose of this study was to examine whether hypoglycemia (< 70 mg/dL) is associated with increased 30-day mortality, after adjusting for potential confounders, for adults hospitalized with pneumonia.MethodsA retrospective cohort study conducted at 2 tertiary teaching hospitals. Eligible subjects were admitted with a diagnosis of, and had a chest x-ray consistent with, community-acquired pneumonia. Our primary analysis was a multivariable logistic regression with the dependent variable of 30-day mortality and with independent variable of hypoglycemia, diabetes, severity of illness determined using the pneumonia severity index, and pneumonia-related processes of care.ResultsData were abstracted on 787 subjects at the 2 hospitals. Mortality was 8.1% at 30 days. At presentation, 55% of subjects were at low risk, 33% were at moderate risk, and 12% were at high risk. In our cohort, 2.8% (n = 22) had hypoglycemia at presentation. Unadjusted mortality for those who were hypoglycemic was 27.3% versus 8.6% for those who were not (P = 0.0003). In the multivariable analysis, hypoglycemia (odds ratio: 4.1, 95% confidence interval: 1.4–11.7) was significantly associated with 30-day mortality.ConclusionsAfter adjusting for severity of illness and other potential confounders, hypoglycemia is significantly associated with 30-day mortality for patients hospitalized with pneumonia. Patients with hypoglycemia should be placed in closely monitored settings even when by pneumonia specific risk systems they would normally be discharged. 相似文献
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Anemia in Children With Cancer Is Associated With Decreased Erythropoietic Activity and Not With Inadequate Erythropoietin Production 总被引:4,自引:4,他引:4
Corazza Francis; Beguin Yves; Bergmann Pierre; Andre Marie; Ferster Alina; Devalck Christine; Fondu Pierre; Buyse Marc; Sariban Eric 《Blood》1998,92(5):1793-1798