Candidal (yeast) and noncandidal (filamentous fungal) wound infections have become an increasingly important cause of burn-associated morbidity and mortality. However, these two diseases differ markedly in their epidemiology, onset, appearance, diagnosis, and treatment. In the last four years, we have had five cases of noncandidal sepsis (four mucoraceae and one aspergillus) that are illustrative of these differences. Early recognition and diagnosis are essential. Radical excision when the infection is confined to superficial invasion of only one anatomic area is key to decreasing mortality from this lethal disease.

Aspergillosis↗

PubMedDate not supplied

Huge response to letrozole in inoperable T4 breast cancer: a case report.

A 73 years-old woman presented with locally advanced breast cancer (cT4b cN1 M0, stage IIIB) and atrial flutter. Because of the arrhythmia, chemotherapy or tamoxifen, although malignancy was hormone-sensitive, were discarded. Letrozole was started. Two months later, the breast nodule and skin ulceration cleared up. Surgery was performed. Nowadays, 24 months later, patient does fine, continuing letrozole as adjuvant treatment.

Aged↗

PubMedDate not supplied

[The role of anti-endomysium and anti-transglutaminase antibodies in the diagnosis and follow-up of celiac disease].

Available, non invasive, serological tests such as the anti-endomysium antibodies (EmA) and anti-transglutaminase antibodies (Anti-tTg) has allowed better outlining of the clinical presentation as well as the pathogenesis of Coeliac Disease (CD). The aim of the study was to evaluate the reliability and concordance of EmA and anti-tTg at the diagnosis (T0) of CD and after 12 months (T12) of Gluten-Free Diet (GFD). Serum EmA and Anti-tTg were evaluated in 78 patients aged 6.3 +/- 4.7 SD yrs at diagnosis, in 56 of them at T0 and T12, as well as in a control group of 88 children aged 6.9 +/- 3.8 yrs. EmA were evaluated by indirect immunofluorescence and Anti-tTg by ELISA. All subjects had normal circulating IgA levels. In the control group, EmA and Anti-tTg resulted negative in all cases. At T0, 77/78 pts had both EmA and Anti-tTg positive, one pt (1.3%) had only EmA positive, demonstrating an overall positive concordance of 98.7%. At T12, 16 pts (28.6%) had both tests positive, 8 (14.3%) had only Anti-tTg positive (all of them were no fully compliant to GFD) and 32 (57.1%) had both tests negative. The overall concordance at T12 was 85.7%. The concordance between EmA and Anti-tTg at T0 is nearly absolute (98.7%). The higher prevalence of elevated anti-tTg than of positive EmA at T12 suggests a higher sensitivity of anti-tTg following intake of even small amounts of gluten.

Celiac Disease↗

PubMedDate not supplied

[Surgical therapy of diaphragmatic eventration in adults: indications, technique and choice of approach].

The Authors report their experience in the surgical treatment of eventration of the diaphragm in the adult. Symptoms and indications for surgery are evaluated and compared with data reported in the literature.

Adult↗

PubMedDate not supplied

Sleeve lobectomy in the treatment of bronchogenic carcinoma.

From 1980 to 1985, 44 sleeve lobectomies were carried out in patients with bronchial cancer. Sixteen patients received preoperative radiotherapy. Perioperative mortality was 6.8%. There were seven anastomotic complications (three fistulae and four stenoses) and two recurrences at the anastomosis. Overall actuarial survival was 45% at four years. These results seem to suggest that sleeve lobectomy should be considered an elective rather than a compromise procedure and a viable alternative to pneumonectomy. Preoperative radiotherapy neither increases complications nor has a negative effect on outcome. It contributes towards reducing local recurrences and maximizes tissue salvage. Long-term survival is related to stage or histology, factors generally governing the survival of lung cancer operated patients, although the TNM classification is ill-suited to identifying tumors which can be resected by a sleeve lobectomy.

Bronchi↗