Abdominal tuberculosis: CT evaluation

The computed tomography (CT) scans of 27 patients with abdominal tuberculosis were reviewed retrospectively to determine the range of abdominal involvement. Most patients had been at increased risk because of intravenous drug abuse, alcoholism, acquired immunodeficiency syndrome (AIDS), cirrhosis, or steroid therapy. The etiologic agent was Mycobacterium tuberculosis in 23 patients and M. avium-intracellulare in four patients with AIDS. In five patients, tuberculosis was limited to the abdomen. CT findings included adenopathy, splenomegaly, hepatomegaly, ascites, bowel involvement, pleural effusion, intrasplenic masses, and intrahepatic masses. Characteristic features were a tendency for adenopathy to prominently involve peripancreatic and mesenteric compartments, low-density centers within enlarged nodes, complex nature of the ascites, and adenopathy adjacent to sites of gastrointestinal tract involvement. Recognition of these manifestations and maintenance of an index of suspicion, especially in patients at risk, should help optimize the correct diagnosis and management of intraabdominal tuberculosis.     

Livedo reticularis associated with interferon α therapy in two melanoma patients

We report two patients who developed intense livedo reticularis clearly related to the administration of interferon alpha 2b as an adjuvant therapy for melanoma. Histological studies showed scattered perivascular infiltrates without vasculitis. Laboratory tests excluded any underlying condition. Resolution of the symptoms was observed in both patients when interferon alpha was withdrawn. These cases highlight the occurrence of livedo reticularis as an uncommon side-effect of interferon alpha treatment.     

Pulsed dye laser in the treatment of 325 calculi of the urinary tract

The pulsed dye laser (Candela) has been used from February 1988 to September 1989 in order to treat 325 stones in 278 patients. A total of 285 endoscopies has been performed. The pulsed laser has helped to achieve the fragmentation of 318 stones. Laser fragmentation has not induced any complication at all. The main failures can be attributed to the nature and shape of the stone. Thanks to the thin laser fiber, the use of small diameter ureteroscopes has increased the reliability of ureteroscopy. The use of this technique combined to extracorporeal shock wave lithotripsy (ESWL) has reduced the rate of open surgery for ureteral stones down to less than 1%.     

Paediatric burn injuries in New England, USA

The authors analysed a subset of data from the New England Regional Burn Program (NERBP) to describe the epidemiology of burn injuries for children aged from birth to 19 years in the six-state New England area of the USA. The subset of the NERBP data analysed pertained to residents of the six New England states who were admitted to hospital for the treatment of a burn injury sustained between 1 July 1978 and 30 June 1979. Analysis of the data revealed that 1128 (41 per cent) of the 2742 hospitalized burns identified occurred to persons between the ages of birth and 19 years, yielding an overall burn incidence rate of 30.7 burns per 100,000 person-years. Children aged from birth to 2 years sustained a higher burn rate, 96.7 burns per 100,000 child-years, than did children in any other age category. The burn rate for males was higher than the rate for females in each age category, as were the rates for black children compared to white children. Children in Massachusetts experienced the highest overall burn rate among the six New England states; the lowest rate occurred in New Hampshire. Overall, 63 per cent of the burns occurred in a residential setting. The most common activities related to burn injury were food preparation and food consumption, which accounted for 471 (42 per cent) of the burn injuries.