Burnout, bipolar or borreliosis? : a diagnostic dilemma behind prolonged disability

Peer reviewe

Severe diarrhoea caused by highly ciprofloxacin-susceptible Campylobacter isolates

AbstractThe impact of fluoroquinolone resistance of Campylobacter jejuni and Campylobacter coli isolates on the outcome of the disease in sporadic Campylobacter infections of Finnish individuals was studied. Questionnaires were sent, during a 6-month study period, to patients who were stool culture-positive for Campylobacter spp. In total, 192 returned questionnaires were analysed and assessed, together with the susceptibility data of the respective bacterial isolates. Only one (2%) of the domestic, but half of the imported, Campylobacter isolates were resistant to ciprofloxacin. Ciprofloxacin resistance was not associated with particularly severe infection. Instead, ciprofloxacin-susceptible Campylobacter isolates, as compared to ciprofloxacin-resistant isolates, showed a tendency to cause more severe infections, characterized by bloody stools and hospitalization

Antibiootteja vai ei? - tapauksen ratkaisu

Anamneesin kertaus Nuoret vanhemmat toivat parivuotiaan poikansa yksityislääkärin vastaanotolle korkean kuumeen vuoksi. Terveyskeskuksesta heille oli vastattu, että siellä on pitkähkö jonotusaika, ja vanhemmat olivat huolissaan

Antibiootteja vai ei? - tapauksen ratkaisu

Anamneesin kertaus Nuoret vanhemmat toivat parivuotiaan poikansa yksityislääkärin vastaanotolle korkean kuumeen vuoksi. Terveyskeskuksesta heille oli vastattu, että siellä on pitkähkö jonotusaika, ja vanhemmat olivat huolissaan

Subclinical inflammation associated with prolonged TIMP-1 upregulation and arterial stiffness after gestational diabetes mellitus : a hospital-based cohort study

Background: Gestational diabetes mellitus (GDM) has significant implications for the future health of the mother. Some clinical studies have suggested subclinical inflammation and vascular dysfunction after GDM. We aimed to study whether concentrations of high-sensitivity C-reactive protein (hsCRP), tissue inhibitor of metalloproteinase-1 (TIMP-1), matrix metalloproteinase-8 (MMP-8) and -9, as well as values of arterial stiffness differ between women with and without a history of GDM a few years after delivery. We also investigated possible effects of obesity on the results. Methods: We studied two cohorts-120 women with a history of GDM and 120 controls-on average 3.7 years after delivery. Serum concentrations of hsCRP were determined by immunonephelometric and immunoturbidimetric methods, MMP-8 by immunofluorometric assay, and MMP-9 and TIMP-1 by enzyme-linked immunosorbent assays. Pulse wave velocity (PWV) was determined using the foot-to-foot velocity method from carotid and femoral waveforms by using a SphygmoCor device. Arterial compliance was measured non-invasively by an HDI/PulseWave T CR-2000 arterial tonometer. All 240 women were also included in subgroup analyses to study the effect of obesity on the results. Multiple linear regression analyses were performed with adjustment for confounding factors. Results: PWV after pregnancy complicated by GDM was significantly higher than after normal pregnancy, 6.44 +/- 0.83 (SD) vs. 6.17 +/- 0.74 m/s (p = 0.009). Previous GDM was also one of the significant determinants of PWV in multiple linear regression analyses. On the other hand, compliance indices of both large (p = 0.092) and small (p = 0.681) arteries did not differ between the study cohorts. Serum TIMP-1 levels were significantly increased after previous GDM (p = 0.020). However, no differences were found in the serum levels of MMP-8, MMP-9 or hsCRP. In subgroup analyses, there were significantly higher concentrations of hsCRP (p = 0.015) and higher PWV (p <0.001) among obese women compared with non-obese ones. Conclusions: PWV values were significantly higher after GDM compared with normoglycemic pregnancies and were associated with prolonged TIMP-1 upregulation. Cardiovascular risk factors were more common in participants with high BMI than in those with previous GDM.Peer reviewe

Urheilijapojan muljahteleva sydän - tapauksen ratkaisu

Anamneesin kertaus : 12-vuotias poika ohjattiin tutkimuksiin rytmihäiriötuntemuksen vuoksi. Sydämen muljahtelu on pakottanut keskeyttämään jalkapallon pelaamisen, mutta tuntemuksen mentyä ohi hän on palannut kentälle

Aristavat rauhaset kaulalla - tapauksen ratkaisu

Miten sinä hoitaisit.Heinäkuussa 2020 vanhemmat saattoivat 11-vuotiaan pojan lastenlääkärin vastaanotolle kaulalle ilmaantuneen lievästi aristavan patin vuoksi

Vielä iäkkäiden neuropaattisen kivun hoidosta

Vastaus kommenttii

Vältä pregabaliinia ja trisyklisiä masennuslääkkeitä iäkkään hoidossa

Amitriptyliini, nortriptyliini ja pregabaliini ovat yli 75-vuotiaiden hoidossa vältettäviä lääkeaineita. Ne saattavat lisätä kaatumisia ja murtumia sekä heikentää kognitiota ja aiheuttaa sekavuustiloja, muistuttaa Kela lääke-määräyspalautteessaan

Chlamydophila abortus Pelvic Inflammatory Disease

We report the first documented case of an extragestational infection with Chlamydophila abortus in humans. The pathogen was identified in a patient with severe pelvic inflammatory disease (PID) by sequence analysis of the ompA gene. Our findings raise the possibility that Chlamydiaceae other than Chlamydia trachomatis are involved in PID