Anales de medicina interna (Madrid, Spain : 1984)
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Review Case Reports
[Tuberculous chylothorax: case report and review of the literature].
Chylothorax is an unusual manifestation of tuberculous disease. Anecdotal cases of chylothorax due to Mycobacterium tuberculosis have been reported in the literature. ⋯ None of these cases was diagnosed by the application of polymerase chain reaction in pleural effusion. This test applied to different specimens has shown high specificity and sensitivity; for this reason, the routine use of this test, on pleural effusion, could be very useful, quick, and few aggressive in the diagnosis of tuberculous chylothorax, especially when chest X-ray is normal.
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At last year the great scientific advances in genetics and molecular biology have led to a bigger knowledge about we nowadays call "Autoinflammatory syndromes", characterized by recurrent inflammatory episodes genetically determined and not mediated by autoimmunity. In this group, they are included the hereditary periodic fever syndromes: familial mediterranean fever (FMF), hyper Ig-D syndrome (HIDS), TNF-receptor-associated periodic syndrome (TRAPS), Muckle-Wells syndrome (MWS), familial cold autoinflammatory syndrome (FCAS), CINCA syndrome. The past 6 year have witnessed the identification of genes causing these diseases. ⋯ The purpose of this article, is to carry out review of the genetic, clinical, molecular and rheumatologic aspect of these syndromes, in part unknown. Although they are not common, they are not absent in our diary clinical practise. Their study and research we will be able to obtain new knowledge that lead us to solve the complex inflammatory process.
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For better or for worse, bioethics is a discipline that, on occasion, presents more doubts and questions than solutions or answers for the variety of issues it implies. Sedation-as it concerns the terminally ill patient-is a clear example of one such issue. Sedation, used to diminish the intense suffering of those terminally ill patients who do not respond to conventional treatment, is a standard method by which the practice of palliative care presents often significant bioethical conflicts. I reconsider these ethical dilemmas that occur as a result of this decision.
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Letter Review Case Reports
[Mycoplasma pneumoniae pneumonia: and uncommon cause of adult respiratory distress syndrome].
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Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition and most epidemiological studies have found that COPD prevalence, morbidity and mortality have increased over the last few years. Recent trials suggest that treatments are improving. Several studies have demonstrated the usefulness of the long-acting inhaled beta-2-agonists. ⋯ Likewise, these drugs may offer benefits in combination with long-acting inhaled beta-agonists. Finally, a better understanding of the molecular and cellular mechanisms involved in COPD pathogenesis should lead to effective treatments that slow or halt the course of the disease. New classes of agents such as the phosphodiesterase inhibitors are now in development.