TOLERANCE TO INHALED DUOVENT - A LONG-TERM STUDY

Fenoterol with ipratropium bromide (Duovent) is a recently used combination between an anticholinergic and a beta-adrenergic drug useful in obtaining a more effective bronchodilatation and/or reducing the single drug doses. It has been suggested that, as in the case of beta-agonists, its clinical efficacy may be limited by the development of tolerance. We studied the effects of inhaled Duovent in 15 asthmatic patients for 3 months, using a rigidly controlled protocol. Appropriate serial physiological measurements were made at regular intervals during the 90-day study. In all instances the day-one bronchodilator response was significant, prompt and sustained: at 1, 4, 8 and 12 weeks the response was statistically the same as on day 1. It is concluded that, when the important variables are properly controlled, no evidence of tolerance to long-term therapy with Duovent is demonstrable

Extraskeletal Ewing's Sarcoma: insight into a ten years follow-up.

Extraskeletal Ewing’s sarcoma is a rare malignant soft tissue tumor, classified within the Ewing’s Sarcoma Family Tumors. While the classical Ewing’s Sarcoma affects mainly the bone during youth, the Extraskeletal histotype differs for age incidence, primary location and prognosis. Peak incidence and typical location are during adolescence and in the extremities respectively. We report a 30 year old woman case with a positive outcome after ten years from first diagnosis of Extraskeletal Ewing’s sarcoma. Treatment was achieved through surgical resection plus adjuvant chemoradiotherapy derived from EW93 and IRS III trials

An inguinal bladder diverticulum Case report of a rare finding in a recurrent inguinal hernia.

We report a rare case of recurrent right inguinal hernia with bladder diverticulum incarcerated in a 63 years old male. Patient complained of painful swelling in inguinoscrotal region associated with urinary discomfort. Preoperatively diagnosis was made possible by ultrasound and urography imaging. Surgical treatment was achieved, by infra-umbilical incision, a reduction of the herniated and fixed diverticulum followed by a mesh repair of the wall defect. Patient was discharged five days after surgery and became free of symptomatology soon after surgical procedure. Bladder diverticulum involvement in a direct inguinal hernia is rare finding and define a potential pitfall for surgeon if not diagnosed preoperatively. There are no other cases of incarcerated bladder diverticulum incarcerated in a recurrent inguinal hernia described in Literature. KEY WORDS: Bladder diverticulum, Bladder hernia, Inguinal hernia

Alveolar cell population in HIV infected patients

Alveolar lymphocytosis, in the face of blood lymphopenia, is a common finding among patients with AIDS. We studied by bronchoalveolar lavage (BAL), the alveolar cell profile of 43 human immuno deficiency virus (HIV) seropositive patients divided into three groups involving the advanced stages of the disease: group A (n = 9; CDC III), ambulatory individuals without systemic or respiratory symptoms; group B (n = 15; CDC IV) patients admitted for evaluation of fever of unknown origin (FUO) without pulmonary involvement; group C (n = 19; CDC IV), patients admitted for evaluation of an acute pulmonary condition. Sex, age and risk factor were comparable among the groups. Alveolar lymphocytosis was found in no group A patients, in 2 out of 15 group B patients (both with P. carinii lung infection) and in all group C patients, where pulmonary involvement was due to opportunistic infection or to nonspecific interstitial pneumonitis. Our findings suggest that in patients with advanced HIV infection alveolar lymphocytosis may be an expression of a concomitant process within the lungs either clinically manifest or inapparent, or possibly related to HIV primary lung involvement