[Unusual manifestations of tuberculosis].
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Biomedical subjects
Publications and source records attributed to J Vaara.
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A 59-year-old man, who suffered from achlorhydria and epigastric pains but was otherwise asymptomatic, was found to have a granulomatous lesion on the gastric mucosa suggesting sarcoidosis or a localized form of Crohn's disease. No sign of involvement of terminal ileum or rectum was detected. A liver biopsy specimen showed slight changes suggestive of granulomatous inflammation, but other signs of generalized sarcoid manifestations were absent. The patient was successfully treated with corticosteroids.
Twice-daily and four-times daily treatment with beclomethasone dipropionate aerosol were compared in a double dummy crossover study in patients with severe chronic bronchial asthma. The trial consisted of two two-month treatment periods preceded by a two-week baseline period. No significant difference was found in the morning or evening PEF, in symptom scores for wheeze, cough, sputum, sleep disturbance, limitation of daily activity, rhinitis, daily usage of bronchodilator aerosol or requirement for additional oral corticosteroids. The study has confirmed that in management of severe bronchial asthma, a twice-daily regimen of beclomethasone dipropionate aerosol is as effective as four-times daily treatment, if the total daily dose of beclomethasone dipropionate is kept unchanged.
We describe a 66-year-old woman with a "coin lesion" in the right upper lobe, diagnosed on a routine preoperative chest X-ray. At thoracotomy the lesion proved to be a solitary amyloid tumour of the lung. During the subsequent 6-year follow-up no recurrence has been detected.
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A case of multiple broncholithic casts is reported. The diagnosis was made on clinical and radiological findings without histological verification. Tuberculosis was regarded as the probable cause.
Case histories and previous chest X-ray films of 142 patients with bacteriologically confirmed active pulmonary tuberculosis from eastern Finland were re-examined. In 18% of the series the disease was a reactivation of previously diagnosed and treated tuberculosis. In 70% of the patients with first clinical attack of tuberculosis, previous RP-films revealed fibrotic lesions in the lungs. Only 23% of the whole series had no previous abnormality on chest X-ray examination or previous clinical tuberculosis. Fibrotic pulmonary lesions are therefore a significant risk factor in the epidemiology of pulmonary tuberculosis, which has been given too little attention.
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