Thoracic Computed Tomographic Manifestations of Tuberous Sclerosis in Adults

The purpose of this article is to illustrate the various manifestations that can be encountered on thoracic computed tomography of tuberous sclerosis in adults. The pulmonary findings include lymphangioleiomyomatosis and multifocal micronodular pneumocyte hyperplasia. The extrapulmonary manifestations are divided into cardiac, vascular, mediastinal, osseous, and upper abdominal findings.     

Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections

ABSTRACT: Central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Recently, bisphosphonates have been used to treat central giant cell lesions. A case of a 36-year-old male with a central giant cell lesion crossing the mandibular midline was treated with intralesional corticosteroids combined with alendronate sodium for the control of systemic bone resorption. The steroid injections and the use of bisphosphonates were stopped after seven months when further needle penetration into the lesion was not possible due to new bone formation. After two years, the bony architecture was near normal, and only minimal radiolucency was present around the root apices of the involved teeth. The patient was followed up for four years, and panoramic radiography showed areas of new bone formation. Thus far, neither recurrence nor side effects of the medication have been detected.     

Phlebotomine fauna in the Ponta Porã city: epidemiological importance in border line between Brazil and Paraguay

ObjectiveTo identify the urban phlebotomine sandfly fauna in Ponta Porã, Mato Grosso do Sul State, Brazil.MethodsThe captures were undertaken from April 2009 to March 2010 with CDC light traps in 14 ecotopes (intra and peridomicile) in different areas of the city, Shannon traps being used in areas with abundant vegetation.ResultsA total of 707 specimens were captured with CDC light traps (565 males and 142 females) and 155 specimens (112 males and 43 females) with Shannon traps, a total of 862 phlebotomines. The specimens captured belonged to eight species: Lutzomyia longipalpis (Lutz & Neiva, 1912), Evandromyia cortelezzii (Brethes, 1923), Sciopemyia sordelli (Shannon & Del Ponte, 1927), Pintomyia pessoai (Coutinho & Barretto, 1940); Pintomyia monticola (Costa Lima, 1932); Brumptomyia brumpti (Larousse, 1920); Nyssomyia whitmani (Antunes & Coutinho, 1939) and Psathyromyia shannoni (Dyar, 1929). Lutzomyia longipalpis, the main vector of Leishmania (Leishmania) chagasi, was the species most frequently captured (97.03%) and also the most abundant according to the standardized abundance index (SAI)=0.86.ConclusionsThe highest species richness was captured, with CDC light traps, inside the domiciles and the species diversity and evenness in the peridomicile, clearly indicating a preference for anthropic environments.     

(In)accuracy of blood pressure measurement in 14 Italian hospitals

OBJECTIVES:: The diagnosis and control of hypertension depend on accurate measurement of blood pressure (BP). The literature on the accuracy of BP recording by health professionals is, however, limited, and no study directly interviewed patients in the hospital setting. This multicenter cross-sectional study aimed at evaluating the compliance to current recommendations on BP measurement by health professionals directly from patients and to investigate potential predictors of higher quality in BP recording. METHODS:: A trained nurse interviewed a random sample of adult patients hospitalized for an ordinary admission (except in the emergency room) lasting more than one night, without mental disorder, who had their BP routinely measured by the hospital personnel less than 3?h before. The questionnaire contained 15 items on the main procedures that are common to current guidelines. RESULTS:: Fourteen public hospitals from seven regions of Italy participated, and 1334 questionnaires were collected. Nine of the recommended practices were followed in the majority (>70%) of BP recordings, whereas some others were infrequent or rare: in 98.6, 82.2 and 81.1% of the participants, respectively, the arm circumference was never recorded, BP was measured only once, and BP was never recorded in both arms. Overall, 10 or more recommended procedures were followed during 33.4% recordings. At multivariate analysis, physicians were less likely than nurses to provide a more accurate BP measurement. CONCLUSIONS:: The operator's compliance to some recommendations in BP measurement is unacceptably low. This survey provides detailed indications for medical directors on the procedures and settings to prioritize in educational programs, which are definitely needed.