The American journal of the medical sciences
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Screening for and treatment of latent tuberculosis infection (LTBI) have been essential components of the TB elimination strategy. ⋯ The current rate of reactivation TB in Texas is much lower than rates reported in the United States in the 1950s. Certain patients are at increased risk for reactivation and should be monitored more closely during LTBI therapy.
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Utilization of tunneled indwelling pleural catheters (TIPCs) for persistent pleural effusions is increasingly more common; however, the presence of chylothorax is generally considered a contraindication for utilization of a TIPC due to concerns regarding potential nutritional, immunologic and hemodynamic complications. Therefore, in this study, a cohort of patients with persistent benign chylothorax managed with TIPCs is described. ⋯ Utilization of a TIPC for the management of persistent benign chylothorax should be considered early because pleurodesis may be frequently and safely achieved in this patient population.
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Comparative Study
Differences in outcomes between elderly and nonelderly breast cancer patients in Louisiana.
Elderly breast cancer patients are diagnosed with a higher stage of disease. They are also found to undergo less surgery, receive more frequently hormonal treatment and have decreased relative survival. The interest of this study was to examine the differences in treatment and survival between elderly versus young (>65 versus <65) patients in Louisiana. ⋯ Differences between young and elderly breast cancer patients were observed. Mortality is higher among elderly breast cancer patients in Louisiana compared with the national average. Further studies are needed to review these differences.
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Extraintestinal manifestatation such as prosthetic joint infection due to Clostridium difficile is a rare diagnosis. A 47-year-old female patient presented with chronic pain in left shoulder prosthetic joint. ⋯ The synovial fluid cultures and intraoperative deep joint cultures repeatedly grew Clostridium difficile. Patient was treated with antimicrobial therapy and surgical debridement with complete removal of hardware and revision arthroplasty.
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Review Case Reports
Hemoglobin SO-Arab and α-thalassemia diagnosed in an adult: A case-based review of the hemoglobinopathies.
Hemoglobin SO-Arab is a rare sickling disorder with a clinical course similar to that of hemoglobin SS. Hemoglobin C-Harlem is another rare condition that produces sickling disorders in affected individuals with a disease course and electrophoretic findings similar to that of hemoglobin SO-Arab. The authors report the case of a 38-year-old African American man with hemoglobin SO-Arab and the challenges that may arise in working up a rare hemoglobinopathy.