Mesotherapy is a treatment method devised for controlling pain syndromes or diseases by subcutaneous microinjections given at or around the involved areas at short intervals of time. Different adverse effects have been described due to this modality of treatment. This report describes 3 patients with cutaneous infection caused by Mycobacterium fortuitum after mesotherapy. Three women, aged 24, 27 and 44 years, presented with similar clinical features, consisting of painful nodules located at the points where mesotherapy had been applied. A smear from a skin biopsy revealed the presence of acid-fast bacilli in all 3 cases. The specimen was cultured and eventually identified as M. fortuitum. A multidrug long-term regimen (combinations of 3 drugs from the following: ciprofloxacin, cotrimoxazole, clarithromycin and amoxicillin-clavulanic acid) was needed to achieve resolution of the lesions. After 15, 25 and 26 months of follow-up, no patient relapsed. Mycobacterium fortuitum is a rapidly growing mycobacterium that can lead to cutaneous infection after minor surgical procedures when aseptic measures are not adequate. Multiple drugs for several months are usually needed to treat this disease successfully.

Adult↗

PubMedDate not supplied

[Pneumonia due to varicella zoster virus in adults: a review of 13 cases].

Pneumonia due to varicella-zoster virus is a complication of chickenpox that appears almost solely in adults. The clinical picture ranges from varieties with few symptoms to those with severe respiratory insufficiency. This retrospective study of adult varicella pneumonia cases treated at our hospital over a seven-year period enrolled 13 patients (9 men and 4 women) whose diagnosis of varicella pneumonia was based on clinical and radiologic criteria during the course of disease. Three patients were immunodepressed (two with HIV infection and one with systemic lupus) and one patient was in her third month of pregnancy. Seventy-seven percent of the patients were active smokers. The most common symptoms apart from skin rash and fever were coughing and dyspnea. All had extensive bilateral nodular patterns visible on the chest film, with no pleural involvement or mediastinal adenopathy. All received intravenous acyclovir and outcome was good in all but one HIV-infected patient, who died. The pregnant patient required intensive care.

Acyclovir↗

PubMedDate not supplied

[Experience of a renal function test unit].

The activity developed during one year in a Renal Function Tests Unit was studied prospectively. Six hundred pharmacological tests (50 tests per month) were done to 453 patients, children and adults. Abnormal tests results were found in 38.4% of the patients. 49.7% of the tests were performed in patients affected with nephrolithiasis or carriers of metabolic anomalies predisposing to renal stones, mainly idiopathic hypercalciuria. The tests were also frequently done to other group of patients affected with urinary tract infection, mitochondrial disease, vesicoureteral reflux, osteoporosis and primary Sjögren's syndrome. The urinary concentrating capacity after desmopressin (37.2%) was the most frequent performed isolated test, although the group of tests to study the renal acidification capacity (58.5%) were the most frequent requested ones.

Adolescent↗

PubMedDate not supplied

Influence of tumor localization on the prognostic value of P53 protein in colorectal adenocarcinomas.

BACKGROUND: The prevalence of genetic alterations is different in primary carcinomas from the proximal colon when compared with carcinomas from the distal colorectum. The objective of this work was to explore the existence of possible differences in the informative weight of the risk of tumor recurrence provided by p53 immunostaining depending on the localization of the neoplasm. PATIENTS AND METHODS: Nuclear immunohistochemical expression of p53 protein was determined in formalin-fixed paraffin-embedded archival tumor tissue samples from 190 primary colorectal adenocarcinomas. The relative prognostic importance on the risk of recurrence of each variable was assessed in a Cox's proportional hazard regression analysis. Multiplicative interaction terms between p53 and tumor site were included in the multivariate models in order to test their joint effect on survival. RESULTS: One hundred and one patients (53.1%) manifested nuclear accumulation of the protein. P53 overexpression was more frequent in distal than in proximal tumors (58.5% ve s 41.7%) (p = 0.03). Disease-free survival was lower in p53-positive cases (75% versus 38%) (p = 0.006), but significance of the association varied according to the localization of the tumor (p = 0.004 in proximal carcinomas and p = 0.049 in distal carcinomas). Multivariate analysis identified p53 positivity and distal tumor localization as the factors significantly associated with a high risk of recurrence Interaction between p53 expression and localization was present. P53 exhibited different prognostic value in distal and proximal colon. While adjusted hazard ratio for positive p53 was 1.99 in distal cancers, it was 8.04 for proximal tumors. CONCLUSION: The prognostic with value of tumor recurrence associated overexpression of p53 protein is influenced by the location of the tumor. The negative predictive weight is significantly higher in proximal than in distal cancers.

Adenocarcinoma↗

PubMedDate not supplied