Radiographic spectrum of adult pulmonary tuberculosis in a developed country

AbstractSetting. Bispebjerg Hospital, Department of Pulmonary Medicine P. The referral centre of adult tuberculosis in the municipality of Copenhagen, Denmark.Objective. To evaluate the radiographic spectrum of pulmonary tuberculosis (TB) in adults in a low-prevalence country and to correlate radiographic appearances with bacteriological results, clinical and demographic data.Design. Retrospective review of medical files on 548 cases with pulmonary TB according to the criteria of WHO.Results. Usual radiographic pattern of reactivating TB, with upper lobe involvement, was found in 92% (n=504). eight percent (n=44) showed unusual X-ray patterns for adults, such as isolated lower lobe infiltrations (n=19), hilar adenopathy (n=10), miliary TB (n=7), tuberculoma (n=2), pleural effusion (n=1) and normal chest X-ray (n=3). Eighty-nine percent of cases with cavitary lesions were positive by microscopy.Conclusion. The risk of missing a diagnosis of pulmonary TB may be high if patients present with an X-ray unusual for TB, but this is fortunately seen only in 8% of cases of pulmonary tuberculosis. Unusual X-ray is more commonly found in patients with concomitant disease, such as diabetes and cancer.If chest X-ray shows cavities, but the smear is negative for Mycobacterium, TB is unlikely and further diagnostic procedures should be performed without waiting for culture results

Decreased Heart Rate Variability in HIV Positive Patients Receiving Antiretroviral Therapy: Importance of Blood Glucose and Cholesterol

The presence of autonomic dysfunction in HIV patients is largely unknown. Early studies found autonomic dysfunction in patients with AIDS. Antiretroviral combination therapy (ART) has dramatically changed the course of the disease and improved prognosis and decreased morbidity

Decreasing Incidence of Alcohol-Related Liver Disease in Denmark: A 25-Year Nationwide Study.

PurposeAlcohol consumption has decreased in Denmark in recent years. We aimed to illustrate and investigate the developments in the incidence, hospital care, and mortality of alcohol-related liver disease (ALD) in Denmark during the last 25 years.Patients and methodsThrough nationwide healthcare registries, we identified all Danish patients with incident ALD in 1994-2018. We computed standardized incidence rates by sex, age, and geography, age-specific incidence rates by birth cohort, and standardized prevalence. We enumerated inpatient admissions, days of admission, outpatient visits, and emergency room visits. Lastly, we estimated relative risks of mortality, standardized mortality rates, and the proportion of deaths caused by ALD.ResultsThe standardized incidence rate decreased from its peak at 357 per 1,000,000 in 2009 to 240 per 1,000,000 in 2018, and the decrease was evident for both sexes and all age groups below 70 years. The standardized prevalence was stable around 0.22% from 2011 onwards. There was an almost fivefold geographic variation in standardized incidence by municipalities, and age-specific incidence rates decreased sequentially with each 5-year birth cohort after 1960. The number of inpatient admissions, days of admission, and emergency room visits decreased during the study period, while the number of outpatient visits was stable. For patients diagnosed in 2014-2018 compared to 1994-1998, the relative risk of 1-year mortality was 0.83 (95% confidence interval: 0.78-0.87), and the standardized mortality along with the proportion of deaths caused by ALD decreased during the study period.ConclusionThe incidence of ALD decreased from 357 to 240 per 1,000,000 over the last 10 years in Denmark. During the same period, the prevalence remained stable around 0.22% and mortality decreased. Additionally, the burden of ALD on hospital care decreased significantly between 1994 and 2018. We anticipate a further decrease in the incidence of ALD in the future

Estructura floral de la palma neotropical del género Chamaedorea (Arecoideae, Arecaceae)

Male and female floral structure has been studied in 28 species of Chamaedorea, the largest palm genus present in the Neotropics. The taxa investigated represent all subgenera according to the most recent taxonomic revision of the group. Morphological, histological and cytological features that are known to be of importance for interactions with visiting insects were studied and their putative role in protecting the flowering parts assessed. The taxonomic distribution of selected characters is in some cases congruent with relationships inferred by recently published molecular studies within the group.Se ha estudiado la estructura de las flores masculinas y femeninas en 28 especies de Chamaedorea, el género de palmas con mayor número de especies en la región neotropical. Los táxones investigados representan a todos los subgéneros contemplados en la más reciente revisión taxonómica del grupo. Se han estudiado los caracteres morfológicos, histológicos y citológicos de mayor importancia en cuanto a la visita de insectos y se ha examinado su rol dentro de la protección de los órganos florales. La distribución taxonómica de caracteres seleccionados ha demostrado, en algunos casos, ser congruente con las relaciones inferidas por los más recientes estudios moleculares que incluyen al grupo

Number of hospital contacts with alcohol problems predicts later risk of alcoholic liver cirrhosis.

AIMS: Alcoholic liver cirrhosis is usually preceded by years of heavy drinking. We investigated whether the risk of alcoholic liver cirrhosis increases as the number of hospital contacts with alcohol problems goes up. METHODS: This was a supplementary analysis on a nationwide register-based cohort study. All patients in Denmark with an initial hospital contact with alcohol problems (alcohol intoxication, harmful alcohol use or alcohol dependence) 1998-2002, free of liver disease, were followed for diagnosis of alcoholic liver cirrhosis. The number of subsequent hospital contacts with alcohol problems was estimated as a time-dependent variable for each patient. RESULTS: In all, 36,044 hospital patients with an initial hospital contact with alcohol problems were included. These patients had 301,525 subsequent hospital contacts with alcohol problems. Risk of alcoholic liver cirrhosis increased ( p < 0.0001) with number of alcohol hospital contacts in both men and women for up to nine contacts. CONCLUSIONS: The number of prior hospital contacts with alcohol problems might provide clinicians with a helpful metric in deciding whether to offer preventive interventions for alcoholic liver cirrhosis