ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718524

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryWe describe the trends over time in patient’s diagnoses, case-complexity, case-severity, length of stay and mortality rate during the last 15 years in an academic division of general internal medicine (GIM). Our study shows that GIM patients presented with a broad spectrum of diseases. Moreover important changes were observed in the patient characteristics, i.e. a progressive increase in urgent admissions, severe medical conditions and elderly population. This evolution was associated with a significant rise in case-severity and case-complexity which explains the observed increase in hospital mortality rate. These variables should be accounted for when analyzing processes and outcomes of inpatient medical care in internal medicine.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718525

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryThe authors report a case of unsuspected fetal storage disorder initially diagnosed by placental examination performed because of a transient ascites at 28 weeks of gestation. At birth mild dysmorphic features and gradual neurological deterioration were observed. Highly elevated alkaline phosphatase levels were repeatedly noticed. Deficiency ofβ-galactosidase was documented confirming GM1 gangliosidosis. Previous reports described the placental pathology after positive prenatal diagnoses of lysosomal diseases. In the present case, the postnatal diagnosis was made in view of the placental pathologic findings. Our observation indicates the need for thorough investigations in hydrops fetalis, in search for metabolic diseases.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718526

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryIn humans, rabies still is a fatally evolving encephalomyelitis caused by aRhabdovirusof the genusLyssavirus.In general, the disease is contracted through a contact with an infected mammal. Taxonomically, different rabies and closely related rabieslike viruses can be distinguished. New molecular identification techniques can be utilized as epidemiological tools to study the geographic distribution and presence in different reservoirs of the viruses. Antigenic diversity and new insights in the mechanisms of the immune response can have serious implication in vaccine strategies. Virus detection for diagnostic and epidemiological purposes can be done by immunofluorescency, by inoculating murine neuroblastoma cells and by using molecular techniques.Rabies is a zoonosis with a worldwide distribution. In Belgium, the epizootic is present in the Southern part of the country. Fox vaccination campaigns contributed significantly to the eradication of the virus from its natural reservoir. The importance of the prophylactic and therapeutic use of the vaccine, the control of wildlife animal reservoir and stringent public health measures to combat rabies is discussed. Due to stringent control measures, no endogenous case of human rabies have been reported since 1922 in Belgium.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718527

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryThe concept of spondyloarthropathy (SpA) gathers together a group of chronic diseases with common clinical, biological, genetic and therapeutic characteristics. The concept forms a distinct entity, different from other rheumatic diseases. The target organs are not only the joint, but also the axial skeleton, the enthesis, the eye, the gut, the urogenital tract, the skin and sometimes the heart. The prevalence of this entity in the general population is estimated 1%, equal to the prevalence of rheumatoid arthritis. Genetical predisposition (HLA-B27) is one of the clues to the pathogenesis of the disease. Since reactive arthritis is induced by specific urogenital or enterogenic bacteriae, and since the gut is implicated in different forms of spondyloarthropathies, especially in IBD, it was clear that the gut could play an important role by permitting exogenous factors to enter the body. This hypothesis was the rationale for investigating the gut in the spondyloarthropathies by performing ileocolonoscopies.In the first ileocolonoscopic studies of SpA patients, histological signs of gut inflammation were found in a relatively great number of patients, mostly without any clinical intestinal manifestations. These lesions were not seen in other inflammatory joint diseases.Further ileocolonoscopic studies confirmed the strong relationship between gut and joint inflammation. In patients in whom a second ileocolonoscopy was performed, remission of the joint inflammation was always connected with a disappearance of the gut inflammation, whereas persistence of locomotor inflammation was mostly associated to the persistence of gut inflammation.The hypothesis was proposed that some patients with a spondyloarthropathy had a form of subclinical Crohn’s disease in which the locomotor inflammation was the only clinical expression. This hypothesis was confirmed in prospective long-term studies in which the ileocolonoscoped patients were reviewed 2 to 9 years later: about 6% of SpA patients not presenting any sign of Crohn’s disease at first investigation but demonstrating gut inflammation on biopsy, developed full-blown Crohn’s disease.The discovery of subclinical gut inflammation in the SpA had therapeutic consequences. Sulphasalazine (SASP) has been proven to be an active drug in the treatment of IBD. Since the gut could play a crucial role in SpA, it was logic to use this drug in the treatment of this disease. Multiple open and doubleblind studies have proven the effectiveness of this drug in SpA; recent studies concluded that the beneficial effect of the drug in this disease entity is more prominent on the peripheral arthritis than on the axial disease.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718528

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718529

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryA 72-year-old man, presenting with hypernephroma and infraclinic adrenal adenoma, developed severe hypokalemia in the course of treatment for colonic perforation. Amikacin-induced hyperkaliuric hypokalaemia was suspected, and confirmed by withdrawal of the drug as well as observation of an unnoticed similar episode in the medical record of the patient.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718530

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

摘要:

SummaryWe report two patients with toxic hepatitis due to the solvent dimethylformamide (DMF). Other causes of hepatitis such as viral, drug induced or alcoholic hepatitis, could be excluded or were considered to be unlikely.Hepatotoxicity due to professional exposure to solvents e.g. dimethylformamide should be considered in any patient with unexplained hepatitis. The fast improvement of the clinical symptoms and die progressive normalisation of the liver function tests once the exposure to the product has been stopped, supports the diagnosis. Yet, non-drug induced toxic hepatitis remains an exclusion diagnosis. Therapy consists of avoiding every contact with the causative agent.Table 3 (Addendum) gives an overview of some industrial agents able to cause hepatitis.

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718531

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718532

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor

ISSN:1784-3286    

DOI:10.1080/22953337.1996.11718533

出版商:Taylor&Francis    

年代:1996

数据来源: Taylor