Gaceta Medica de Bilbao最新文献

Cranial idiopathic hypertrophic pachymeningitis is a rare disorder characterized by chronic inflammation causing thickening of the dura mater. Headache, multiple cranial neuropathy and magnetic resonance images showing GD-DTPA-enhanced thickened dura can aid diagnosis.

We report the autopsy case of a 69-year-old man with chronic headache and visual loss due to optic nerve damage developing over a 3-month period, who was diagnosed with hypertrophic pachymeningitis. Cerebrospinal fluid showed inflammatory changes. The sample of hypertrophied dura mater revealed chronic granulomatous inflammation without signs of vasculitis or infectious or neoplastic processes.

Idiopathic hypertrophic pachymeningitis is an exclusion diagnosis. Exhaustive tests (both bacteriological and histopathological) to identify the cause of dural thickening in our patient proved unsuccessful.

A total of 390 inguinal herniorrhaphies were performed with an ambulatory method in three hospitals of Gambia. The patients were aged between 13 and 100 years old (mean age: 72.6 years). The male:female ratio was 14.4:1. The most common form of hernia was right inguinal hernia (64.3% of the patients) followed by indirect hernia (69.2% of the patients). The Condon technique was used in 25.6% of the patients and acute urinary retention was found in nine patients.

The presence of white papules with reticular pattern is one of the most common findings in oral pathology. Classically, these lesions have been generically called oral lichen planus (OLP). This entity is a chronic inflammatory disease with an immunological basis and unknown etiology that has a predilection for perimenopausal females. The premalignant potential of OLP has been –and still is– controversial. Most studies report that malignancy occurs in less than 1% of cases. Recently, certain lesions, called oral lichenoid lesions (OLL) are considered to be those with an increased risk of malignant transformation. Consequently, knowledge of the different features of oral lichenoid disease (OLD) and its distinct subtypes is essential. In this review, we provide an update of the main clinicopathological and prognostic features of this common and controversial oral mucosal disease.

We report the case of a 72-year-old woman with an epidermoid carcinoma of the cervix who had been treated with radiotherapy and who presented with diarrhea for the previous 2 years. We provide a review of radiation-induced enteritis and the various treatment strategies of this rare but potentially fatal illness.

Thyrotoxic crisis, or thyroid storm, is a severe manifestation of hyperthyroidism. Although uncommon, this condition is life-threatening. Thyrotoxic crisis complicates 1–2 % of cases of hyperthyroidism, and mortality ranges from 20–30 %. The cause may be a sudden increase of circulating thyroid hormones or an increase in their bioavailability. Clinical recognition, diagnosis, and early treatment are crucial to reduce the high associated morbidity and mortality. We provide a retrospective review of the clinical presentation, treatment, and outcome of two patients recently diagnosed with thyrotoxic crisis in our hospital.

Introduction

The aim of this study was to examine the treatment and results of Lisfranc fracture-dislocations treated at our department from 1995 to 2009.

Material and methods

We retrospectively reviewed 20 cases in 19 patients. The lesions were classified according to Hardcastle's criteria. Most cases were due to high-energy trauma, and nine cases were associated with other lesions. Eighteen cases were treated surgically (16 with closed reduction and fixation with wires and two with open reduction and internal fixation).

Results

Patients who underwent surgery had an average AOFAS score of 85.43 and an average VAS score of 8. Radiologically, anatomic reduction was achieved in 14 cases. The most frequent long-term complication was tarsometatarsal arthritis.

Conclusion

Closed reduction and fixation with Kirschner wires for Lisfranc fracture-dislocation provides good clinical and radiological outcomes.