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Tuberculosis of the temporomandibular joint: a rare case report and review of the literature 颞下颌关节结核:罕见病例报告和文献综述
IF 0.7 Q4 Medicine Pub Date : 2024-01-10 DOI: 10.18332/pne/175442
Evgenia Papathanassiou, Christos Kampolis, Efstathios Zogakis, C. Moschos, A. Papavasileiou, A. Loukeri
Head and neck tuberculosis represents a rare form of extrapulmonary tuberculosis and usually concerns the cervical lymph nodes. Involvement of the temporomandibular joint (TMJ) is extremely rare and only reported at a level of case report forms. A 20-year-old female patient of African origin presented with pain in the mandible and swelling at the left masticator since one month ago. Head and brain CT scan revealed multiple hyperdense lesions with peripheral enhancement and surrounding swelling. These findings were consistent with multiple abscesses. Moreover, severe impairment and the presence of fluid was observed at the left temporomandibular joint, the mandible and the left masseter muscle. Chest CT scan revealed centrilobular nodules in both upper lung lobes. Treatment with common antibiotics was initiated but the patient did not improve. During hospitalization, the patient experienced an episode of generalized tonic-clonic convulsion. Therefore, a surgical drainage of the mandibular abscess was performed. The AFB smear and the molecular test (XPERT MTB/RIF) were positive for Mycobacterium tuberculosis sensitive to rifampicin. The patient was treated with isoniazid, high dose rifampicin (900 mg), pyrazinamide, ethambutol and moxifloxacin. The patient received treatment for 12 months and improved significantly clinically and radiologically. Diagnosis of tuberculosis in the temporomandibular joint is challenging but should be included in the differential diagnosis when a compatible history of exposure and other organ involvement exist.
头颈部结核是一种罕见的肺外结核,通常累及颈部淋巴结。颞下颌关节(TMJ)受累极为罕见,仅在病例报告中有所报道。一名 20 岁的非洲裔女性患者自一个月前开始出现下颌骨疼痛和左侧咀嚼肌肿胀。头部和脑部 CT 扫描显示多发高密度病变,周围强化,周围肿胀。这些结果与多发性脓肿一致。此外,左侧颞下颌关节、下颌骨和左侧咀嚼肌也出现严重损伤和积液。胸部 CT 扫描显示,患者的两个上肺叶均有中心叶状结节。患者开始接受普通抗生素治疗,但病情未见好转。住院期间,患者出现全身强直阵挛性抽搐。因此,对下颌骨脓肿进行了手术引流。AFB 涂片和分子检测(XPERT MTB/RIF)结果均为对利福平敏感的结核分枝杆菌阳性。患者接受了异烟肼、大剂量利福平(900 毫克)、吡嗪酰胺、乙胺丁醇和莫西沙星治疗。患者接受了 12 个月的治疗,临床和影像学情况均有明显改善。颞下颌关节结核的诊断极具挑战性,但如果有相应的接触史和其他器官受累史,则应将其纳入鉴别诊断。
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引用次数: 0
Determinants of tobacco use patterns and predictorsof quit among older women in India: Findings fromthe study on global aging and adult health 印度老年妇女烟草使用模式的决定因素和戒烟预测:全球老龄化与成人健康研究结果
IF 0.7 Q4 Medicine Pub Date : 2024-01-05 DOI: 10.18332/pne/175144
Vansh Maheshwari, Baani Sodhi, Retisha Sharma, Saurav Basu
and predictors of quit among older women in India. METHODS Cross-sectional and nationally representative data from the first and second wave of WHO's Study on global Ageing and Adult Health (SAGE 2007 and 2015) were analyzed. Outcome variables included smoking and SLT use, with quit status assessed, while explanatory variables encompassed sociodemographic characteristics like age, education level, marital status, body mass index, religion, ethnicity, residence, wealth quintiles, and mother tongue. RESULTS We observed a reduction in the prevalence of tobacco use in any form among women from 34.17% (SAGE-1) to 18.17% (SAGE-2). The prevalence of current tobacco use in any form was 9.89% (n=352; 95% CI: 8.74–11.17), tobacco smoking was 9.42% (n=331; 95% CI: 8.29–10.69), while the prevalence of current SLT use was 12.3% (n=454; 95% CI: 10.99– 13.72). Muslim women had significantly higher odds of using SLT compared to Hindu women (AOR=1.86; 95% CI: 1.24–2.69). Successful quit after initiation to SLT use was reported in only 7.62% of the women. Women from scheduled caste ethnicity were less likely to achieve a successful quit (AOR=0.70; 95% CI: 0.09–5.81) compared to other caste groups. CONCLUSIONS Approximately one in five older women used tobacco, with higher prevalence than GATS data, underscoring the need for continued surveillance and focused public health efforts. Furthermore, quit rates in female SLT users continue to be very low suggesting the need for strengthening access, availability, and affordability of tobacco cessation services to promote successful quitting behavior.
和印度老年妇女戒烟的预测因素。方法 分析了世界卫生组织全球老龄化与成人健康研究(SAGE,2007 年和 2015 年)第一波和第二波的横截面全国代表性数据。结果变量包括吸烟和使用 SLT,并对戒烟情况进行了评估,而解释变量则包括年龄、教育水平、婚姻状况、体重指数、宗教、种族、居住地、财富五分位数和母语等社会人口特征。结果 我们观察到,妇女中任何形式的吸烟率从 34.17%(SAGE-1)降至 18.17%(SAGE-2)。目前使用任何形式烟草的流行率为 9.89% (n=352; 95% CI: 8.74-11.17),吸烟的流行率为 9.42% (n=331; 95% CI: 8.29-10.69),而目前使用 SLT 的流行率为 12.3% (n=454; 95% CI: 10.99-13.72)。与印度教妇女相比,穆斯林妇女使用 SLT 的几率明显更高(AOR=1.86;95% CI:1.24-2.69)。仅有 7.62% 的妇女在开始使用 SLT 后成功戒烟。与其他种姓群体相比,在册种姓妇女成功戒烟的可能性较低(AOR=0.70;95% CI:0.09-5.81)。结论 约有五分之一的老年妇女使用烟草,吸烟率高于 GATS 数据,这说明有必要继续开展监测并集中开展公共卫生工作。此外,女性 SLT 用户的戒烟率仍然很低,这表明有必要加强戒烟服务的可及性、可用性和可负担性,以促进成功戒烟行为。
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引用次数: 0
Bronchial atresia mimicking Swyer–James syndrome 支气管闭锁模仿斯威-詹姆斯综合征
IF 0.7 Q4 Medicine Pub Date : 2023-12-05 DOI: 10.18332/pne/175441
Sophia Papathanasiou, Garyfallia Perlepe, E. Karetsi, Euaggelia Sdroulia, I. Gerogianni, Dimitrios Papadopoulos, Konstantinos I. Gourgoulianis
). The correlation of CT and bronchoscopic findings established the diagnosis of congenital bronchial atresia. Bronchial atresia is a rare congenital abnormality in which the bronchus lacks central airway communication 1 . It is hypothesized to occur as focal bronchial interruption due to intrauterine ischemia after the 16th week of gestation 2 . Chest x-ray findings typically show hyperlucency, hilar mass, or both. CT is the gold standard for its diagnosis and the main findings are bronchocele, hyperinflation of the distal lung, and hypovascularity 3,4 . The main characteristic of bronchoceles is the mucoid impaction of atretic segment. Hyperinflation can be explained by collateral ventilation through the pores of Kohn, bronchoalveolar channels of Lambert, or via air-trapping due to check valve mechanism 5 . Despite these almost pathognomonic findings, it is necessary to differentiate unilateral hyperlucency from Swyer-James syndrome. It describes an acquired condition that usually develops during childhood as a sequel of post-infectious bronchitis obliterans, leading to the dilation and destruction of lung parenchyma with air trapping 1 and underdevelopment of the peripheral pulmonary vessels. The CT finding of a normal distal bronchial branch pattern without a connection between the distal and central airways is essential to differentiate bronchial atresia from Swyer-James syndrome 1 . Other congenital situations that should be included in differential diagnosis are congenital lobar emphysema, pulmonary sequestration and congenital cystic adenomatoid malformation, as there are possible common pathogenic pathways. During adulthood, the surgical treatment is meant for patients who present repeated infections 6 .
). CT与支气管镜检查结果的相关性确定了先天性支气管闭锁的诊断。支气管闭锁是一种罕见的先天性异常,支气管缺乏中央气道通讯。假设发生于妊娠16周后由于宫内缺血引起的局灶性支气管中断2。胸部x线表现典型为透光度高、肺门肿块或两者兼而有之。CT是其诊断的金标准,主要表现为支气管膨大、远端肺高充血、低血流量3,4。支气管的主要特征是闭锁段的黏液阻塞。恶性充气可以通过Kohn孔、Lambert支气管肺泡通道或通过止回阀机制引起的空气捕获来解释5。尽管这些几乎是典型的表现,但有必要将单侧透光症与Swyer-James综合征区分。它描述的是一种获得性疾病,通常发生在儿童时期,是传染性闭塞性支气管炎的后遗症,导致肺实质扩张和破坏,伴有空气潴留1和周围肺血管发育不全。CT发现正常的远端支气管分支模式,没有远端和中央气道之间的连接,是鉴别支气管闭锁和Swyer-James综合征的关键1。其他应纳入鉴别诊断的先天性情况包括先天性叶性肺气肿、肺隔离和先天性囊性腺瘤样畸形,因为它们可能有共同的致病途径。在成年期,手术治疗适用于反复感染的患者。
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引用次数: 0
Right atrial strain during prone ventilation in acuterespiratory distress syndrome 急性呼吸窘迫综合征患者俯卧通气时的右心房应变
IF 0.7 Q4 Medicine Pub Date : 2023-12-05 DOI: 10.18332/pne/174365
Aimilianos N. Kalogeris*, T. Ntaidou, A. Koroneos, Anastasia Kotanidou, I. Siempos
, the blood pressure 150/70 mm Hg, the heart rate 80 beats per minute, his breathing labored and the oxygen saturation was 89% at rest while breathing ambient air. There was no peripheral edema. Chest radiography revealed bilateral ground glass opacities. His laboratory findings were unremarkable. The patient was admitted to the hospital and received prophylactic enoxaparin, remdesivir, dexamethasone, ceftriaxone and moxifloxacin on top of his regular medications. During his hospitalization in the ward, his hypoxemia worsened and after a failed trial of high flow ABSTRACT Although prone ventilation is widely used in acute respiratory distress syndrome (ARDS), its effects on right heart function, assessed by state-of-the-art echocardiography, are not well studied. We report the effect of prone ventilation on right atrial strain in severe ARDS after optimization of lung recruitment and hemodynamics using esophageal pressure and pulmonary artery catheter measurements, respectively. A 66-year-old obese man with ischemic heart failure was intubated due to ARDS. Before, during and after his first prone session, pulmonary, hemodynamic and echocardiographic (using two-dimensional transthoracic speckle tracking echocardiography) parameters were measured. Prone ventilation sustainably improved lung recruitment and right atrial strain. Combining detailed physiological and advanced echocardiographic assessment provides insights into the effect of prone ventilation in ARDS.
血压150/70 mm Hg,心率80次/分,呼吸困难,静息时血氧饱和度89%。无外周水肿。胸片显示双侧磨玻璃影。他的实验室发现并不引人注目。患者入院后,在常规药物治疗的基础上,接受预防性依诺肝素、瑞德西韦、地塞米松、头孢曲松和莫西沙星治疗。虽然俯卧位通气在急性呼吸窘迫综合征(ARDS)中广泛应用,但其对右心功能的影响,通过最先进的超声心动图评估,尚未得到很好的研究。我们报道了俯卧位通气对重度ARDS患者右心房劳损的影响,分别通过食道压和肺动脉导管测量优化肺招募和血流动力学。66岁肥胖男性缺血性心力衰竭因急性呼吸窘迫综合征插管治疗。在第一次俯卧之前、期间和之后,测量肺部、血流动力学和超声心动图(使用二维经胸斑点跟踪超声心动图)参数。俯卧位通气可持续改善肺功能恢复和右心房劳损。结合详细的生理和高级超声心动图评估,可以深入了解俯卧位通气在ARDS中的作用。
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引用次数: 0
Long-term efficacy of different doses of steroidin hospitalized COVID-19 patients: A prospectivecohort study 不同剂量类固醇对 COVID-19 住院患者的长期疗效:前瞻性队列研究
IF 0.7 Q4 Medicine Pub Date : 2023-12-05 DOI: 10.18332/pne/174604
Gokhan Karakurt, H. Ucgun, Engin Aynaci, Mustafa Duger, Sukru E. Demir
prospective
未来的
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引用次数: 0
Change in smoking behavior and burnout syndrome among healthcare workers during the COVID-19 pandemic COVID-19 大流行期间医护人员吸烟行为的变化和职业倦怠综合征
IF 0.7 Q4 Medicine Pub Date : 2023-12-01 DOI: 10.18332/pne/174167
Eleni Papakala, S. Zarogiannis, C. Hatzoglou
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引用次数: 0
Achievement of high-quality home spirometry in patients with asthma: The NuvoAir platform 为哮喘患者提供高质量的家庭肺活量测量:NuvoAir 平台
IF 0.7 Q4 Medicine Pub Date : 2023-11-30 DOI: 10.18332/pne/174605
Dimitrios Potonos, K. Exarchos, A. Assioura, A. Sioutkou, K. Tatsis, C. Kyriakopoulos, A. Gogali, K. Kostikas
augments disease management by facilitating patients to record their level of asthma control electronically, supporting remote physician consultations. This study evaluated the quality of home-based spirometry in asthma using the NuvoAir platform (NuvoAir U.S inc, Boston, M.A., U.S.A.), which consists of a smartphone application, Bluetooth spirometer (AirNext), and physician portal.
NuvoAir 是一种基于家庭的哮喘患者肺活量测量系统,通过方便患者以电子方式记录自己的哮喘控制水平,支持医生远程会诊,从而加强疾病管理。这项研究评估了使用 NuvoAir 平台(NuvoAir U.S inc, Boston, M.A., U.S.A.)进行哮喘家庭肺活量测量的质量,该平台由智能手机应用程序、蓝牙肺活量计(AirNext)和医生门户网站组成。
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引用次数: 0
Symptomatic impact and anxiety generated by performing pulmonary function tests: Are there differences between patients with fibrotic interstitial lung disease and obstructive airway disease? 进行肺功能测试时产生的症状影响和焦虑:纤维化间质性肺病和阻塞性气道疾病患者之间是否存在差异?
IF 0.7 Q4 Medicine Pub Date : 2023-11-16 DOI: 10.18332/pne/172869
C. Costa, Diana Mendes, Joana Santos, Vera Afreixo, P.G. Ferreira
trend towards greater elevation of cardio-respiratory stress, specially through respiratory rate, was found after PFT in the group of patients with ILD. In contrast, a trend towards higher levels of anxiety immediately before PFT was observed in patients with obstructive disease (mostly COPD) compared to that seen in the group of patients with fibrotic ILD. The variables contributing the most to length of stay in the lung function laboratory were: undergoing a bronchodilation test; the number of attempts needed to reach a technically adequate flow-volume curve; the previous degree of dyspnea, heart rate and respiratory rate before the test; and male gender. A diagnosis of fibrotic ILD was also, by itself, a determining factor for a longer stay in the lab
在 ILD 患者组中,PFT 后心肺应激(特别是通过呼吸频率)呈上升趋势。相比之下,阻塞性疾病(主要是慢性阻塞性肺病)患者在进行肺功能检查前的焦虑程度要高于纤维化 ILD 患者。对肺功能实验室停留时间影响最大的变量是:接受支气管扩张试验;达到技术上足够的流量-容积曲线所需的尝试次数;试验前的呼吸困难程度、心率和呼吸频率;以及男性性别。纤维化 ILD 诊断本身也是实验室停留时间更长的一个决定因素
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引用次数: 0
Hemoptysis as an initial manifestation of antiphospholipid antibody syndrome 咯血是抗磷脂抗体综合征的最初表现
Q4 Medicine Pub Date : 2023-11-13 DOI: 10.18332/pne/172870
Mariana C. Tavares, Filipa Fernandes, Sara Dinis
1. Garcia D, Erkan D. Diagnosis and Management of the Antiphospholipid Syndrome. N Engl J Med. 2018;378(21):2010-2021. doi:10.1056/NEJMra1705454 CrossRef Pubmed Google Scholar
1. 贾建军,李建军。抗磷脂综合征的诊断和治疗。中华医学杂志,2018;37(6):391 - 391。doi:10.1056/NEJMra1705454 CrossRef Pubmed b谷歌Scholar
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引用次数: 0
Lipoid pneumonia presenting as lung mass following accidental diesel ingestion: An interesting case 意外摄入柴油后表现为肺肿块的脂质性肺炎:一个有趣的病例
Q4 Medicine Pub Date : 2023-11-10 DOI: 10.18332/pne/172871
Rahul Κ. Gupta, Amita Mason, Vinayak Agrawal, Smita Chandra, Rakhee Khanduri
1. Gonullu H, Karadas S, Oncü MR, Dulger AC, Keskin S. The analysis of the cases of aspired fuel oil and gasoline through siphonage method. J Pak Med Assoc. 2013;63(3):383-384. Pubmed Google Scholar
1. Gonullu H, Karadas S, Oncü MR, Dulger AC, Keskin S.虹吸法吸进燃料油和汽油的案例分析。中华临床医学杂志,2013;33(3):383-384。Pubmed b谷歌Scholar
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引用次数: 0
期刊
Pneumon
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