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PubMed · 6229761

[Mycobacterioses].

Abstract

Mycobacteriosis are opportunistic infections caused by atypical mycobacteria. These have microscopic features resembling those of tubercle bacillus but differ in their cultural and biochemical characteristics and above all, their resistance to antituberculous antibiotics. The lesions chiefly involve the lungs, the lymph nodes or the skin and usually mimick those of tuberculosis. The diagnosis rests on repeated isolation in pathological specimens of the same atypical mycobacterium with a sufficient number of colonies, or on its sole presence in effusion fluids, biopsies or surgical specimens. Treatment with antibiotics is disappointing, except for M. kansasii. Surgical treatment can only be considered in those exceptional cases when the patient is young, has limited lesions and is not immuno-depressed.

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J Grosset, C Sors. 1984-02-04. [Mycobacterioses].. https://pubmed.ncbi.nlm.nih.gov/6229761/

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Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard.

PURPOSE: To prospectively evaluate the relative accuracy of digital examination, anal endosonography, and magnetic resonance (MR) imaging for preoperative assessment of fistula in ano by comparison to an outcome-derived reference standard. MATERIALS AND METHODS: Ethical committee approval and informed consent were obtained. A total of 104 patients who were suspected of having fistula in ano underwent preoperative digital examination, 10-MHz anal endosonography, and body-coil MR imaging. Fistula classification was determined with each modality, with reviewers blinded to findings of other assessments. For fistula classification, an outcome-derived reference standard was based on a combination of subsequent surgical and MR imaging findings and clinical outcome after surgery. The proportion of patients correctly classified and agreement between the preoperative assessment and reference standard were determined with trend tests and kappa statistics, respectively. RESULTS: There was a significant linear trend (P < .001) in the proportion of fistula tracks (n = 108) correctly classified with each modality, as follows: clinical examination, 66 (61%) patients; endosonography, 87 (81%) patients; MR imaging, 97 (90%) patients. Similar trends were found for the correct anatomic classification of abscesses (P < .001), horseshoe extensions (P = .003), and internal openings (n = 99, P < .001); endosonography was used to correctly identify the internal opening in 90 (91%) patients versus 96 (97%) patients with MR imaging. Agreement between the outcome-derived reference standard and digital examination, endosonography, and MR imaging for classification of the primary track was fair (kappa = 0.38), good (kappa = 0.68), and very good (kappa = 0.84), respectively, and fair (kappa = 0.29), good (kappa = 0.64), and very good (kappa = 0.88), respectively, for classification of abscesses and horseshoe extensions combined. CONCLUSION: Endosonography with a high-frequency transducer is superior to digital examination for the preoperative classification of fistula in ano. While MR imaging remains superior in all respects, endosonography is a viable alternative for identification of the internal opening.

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