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Cutting the edge of idiopathic recurrent orbital myositis

100%
Ariatti A., Galassi G., Rovati R., Chiari A.
Open Medicine
|
2013
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vol. 8
|
issue 6
732-735
EN
The spectrum of orbital inflammatory diseases ranges broadly from specific diseases as connective tissue disorders, thyroid ophthalmopathy to non-specific inflammations, which may involve one or multiple structures of the orbit and/ or the surrounding sinus. Idiopathic orbital myositis (IOM) may be a localized process or it can be secondary to systemic diseases. We report 4 patients affected by IOM; in all relapsing diplopia was the main complaint, associated with orbital pain in 3 and with abnormal visual evoked responses in 2. Computed tomography (CT), magnetic resonance imaging (MRI) supported the diagnosis revealing enlargement, altered signal intensity of affected muscles. Repeated MRI scans and extensive laboratory examinations comprising of the search for a remote malignacy, lymproliferative, connective tissue diseases, thyroid ophthalmopathy were necessary to confirm the diagnosis. Oral or/and intravenous steroids were main treatments; relapses often occurred when steroid was tapered down. Intravenous immuneglobulins and azathioprine was used in one refractory case
2
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Tuberculous spondylitis in patients with end-stage renal disease undergoing chronic hemodialysis therapy - Report of two cases

88%
Kostov K., Yovchevski P., Petrov I.
Open Medicine
|
2010
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vol. 5
|
issue 4
475-477
EN
Tuberculous spondylitis is more common in patients with chronic renal failure who receive hemodialysis because of their abnormal T-cell-mediated immunity. It frequently poses both diagnostic and therapeutic challenges. We describe two cases of tuberculous spondylitis in patients undergoing chronic hemodialysis therapy. They are IFN-γ assay diagnosed (QuantiFERON-TB Gold) and conservatively treated. Our cases suggest that IFN-γ assays equip clinicians with more accurate tools for tuberculosis control. A combination of T-SPOT.TB testing and MRI assessment may be the accurate method to diagnose tuberculous spondylitis in patients with end-stage renal disease.
3
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Correlations between left ventricular mass index and cerebrovascular lesion

75%
Kang K., Lee S.-H., Kim B., Lim J.-S., Yoon B.-W.
Open Medicine
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2011
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vol. 6
|
issue 3
320-330
EN
Left ventricular (LV) mass and LV geometry are well-established measures of hypertension chronicity and severity, have a prognostic value on cardiovascular morbidity and mortality, and are related to asymptomatic cerebral small-artery disease (SAD) and largeartery disease (LAD). The aim of the present study was to clarify the different effects of LV mass and LV geometry on underlying SAD compared with its effects on underlying LAD in ischemic stroke patients. Four hundred three ischemic stroke patients underwent echocardiography to determine LV mass index and relative wall thickness. Brain magnetic resonance imaging, angiography, and carotid magnetic resonance angiography were preformed to detect LAD (≥50% stenosis) and SAD (leukoaraiosis, microbleeds, and old lacunar infarction) in the brain. Multivariate analyses showed that the LV mass index was highly associated with underlying SAD but not with underlying LAD. Among the various subtypes of SAD, only cerebral microbleeds were closely related to the LV mass index. Concentric LV hypertrophy was not related to the presence of either SAD or LAD. Subgroup analyses revealed that, among the various subtypes of SAD, only cerebral microbleeds were associated with concentric LV hypertrophy. In conclusion, cerebral microbleeds may imply more advanced target organ damage than underlying LAD and ischemic subtypes of SAD.
4
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Vancomycin-resistant Enterococcus faecium-associated encephalitis and concurrent cerebellitis

75%
Kang K., Yoon S.-S., Yoon B.-W.
Open Medicine
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2011
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vol. 6
|
issue 4
470-474
EN
Enterococci are uncommon etiologic agents of central nervous system infections. We describe a case of nosocomial encephalitis and concurrent cerebellitis associated with Enterococcus faecium in a man, with extranodal natural killer/T-cell lymphoma, nasal type, who underwent high-dose chemotherapy and autologous peripheral blood stem cell transplantation. Brain magnetic resonance images showed lesions in the bihemispheral cerebellar cortex with swelling and several small lesions in both cerebral hemispheres. The blood and cerebrospinal fluid cultures were positive for vancomycin-resistant E. faecium. Vancomycin-resistant E. faecium can cause encephalitis and concurrent cerebellitis in an immunocompromised patient who underwent autologous peripheral blood stem cell transplantation.
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