The American journal of the medical sciences
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Review Case Reports
Brucella as a cause of severe sepsis: Case series and brief review.
Brucellosis is a serious public health problem worldwide and can affect any organ system. Due to brucellosis's variable clinical presentation, ranging from subclinical to fully symptomatic, and limited available information, it poses a diagnostic challenge. ⋯ These case presentations will be valuable in increasing the awareness of physicians. A prompt diagnosis is crucial, as detecting some clues of the infection in its early stages can help avoid misdiagnoses.
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Review Case Reports
Pressed for Understanding: Interstitial lung disease in Dry-Cleaning Workers.
Interstitial lung disease (ILD) represents a heterogeneous group of disorders characterized by inflammation and fibrosis of the pulmonary interstitium. Risk factors for ILD include various environmental exposures and identifying specific exposures offers a point of intervention for preventing disease. ⋯ While this report does not attempt to establish causality, we hypothesize that exposure to the industrial solvent tetrachloroethylene may serve as a contributing factor given its links to epithelial injury, inflammation, redox imbalance and apoptosis. We hope that this report serves to not only inform readers of this possible connection between dry cleaning and ILD but also lay the foundation for additional studies examining the effects of tetrachloroethylene on the lung.
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The relationship between diabetes and hepatitis B remains unclear. We have found that there is no general correlation between the incidence of diabetes and hepatitis B, except in certain populations. Patients with co-existing diabetes and hepatitis B tend to have poorer overall prognoses, primarily evidenced by an increased risk of hepatocellular carcinoma (HCC) and all-cause mortality within this population. ⋯ To improve long-term outcomes, we recommend specific anti-diabetic medications for this group. Additionally, it is advisable to administer the hepatitis B vaccine as soon as possible following a diagnosis of diabetes in order to enhance the patient's prognosis. Increased attention from health management authorities, revisions of relevant guidelines, and advancements in educational initiatives may also improve outcomes for this demographic.
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Asthma is a complex clinical syndrome characterized by airway inflammation that can cause variable, usually reversible airway obstruction and bronchial hyperreactivity. This illness has a spectrum from intermittent to persistent that has mild, medium or severe intensity. As our understanding of the underling inflammatory pathway grows, so too does our catalogue of advanced treatments (such as monoclonal antibodies), opening the path for treatment individually curated for patients. ⋯ However, a significant concern remains: the high financial costs for these advanced therapies continues to pose a significant burden both to patients and the healthcare system. Novel uses of long-acting bronchodilator-corticosteroids inhalers may reduce the use of highly priced biologics in many patients with comparatively less severe disease. Furthermore, the variability in patient response demands further research into to identify which patients will best respond to which specific therapy.
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Chronic Obstructive Pulmonary Disease (COPD) is a complex pulmonary condition characterized by chronic airflow limitation. Within the spectrum of COPD, distinct overlap conditions exist, including Asthma-COPD Overlap (ACO), COPD-Obstructive Sleep Apnea (COPD-OSA), Combined Pulmonary Fibrosis and Emphysema (CPFE), and Bronchiectasis-COPD Overlap (BCO). This review provides a comprehensive overview of the clinical and therapeutic implications of these conditions, highlighting the differences in complications compared with COPD alone in addition to the diagnostic challenges of identifying these conditions. ⋯ Optimal pharmacological management, disease-specific interventions, and comprehensive patient-centered care are crucial components of treatment strategies. This review provides insights for healthcare professionals by enhancing their understanding and management of these conditions. This emphasizes the importance of accurate diagnosis and individualized treatment plans, considering the specific complications associated with each COPD overlap condition.