Silicosis is a diffuse interstitial fibronodular lung disease, caused by the inhalation of crystalline silica. We undertook a brief review of the topic, focusing on the most important aspects and performed a retrospective analysis of 84 patients admitted to the Pulmonology Ward of the Coimbra University Hospital over a 10-year period whose main or secondary diagnosis was silicosis. We also present the most relevant clinical features and the conclusions drawn from this review. The authors assess patients' occupational history, changes in respiratory function study, the imaging findings and the associated complications.
We found that patients receiving antiretroviral therapy had higher cortisol levels than those untreated, with the highest levels corresponding to those taking efavirenz. Multivariate analysis revealed that only the presence of antiretroviral therapy, treatment with efavirenz and a prior diagnosis of AIDS were significantly predictive of cortisol levels.
A esperança de vida dos doentes com fibrose quística (FQ) tem vindo a aumentar, sendo mais frequente a identificação de osteoporose. A patogénese de uma baixa densidade mineral óssea (DMO) na FQ parece ser multifactorial e o objectivo deste trabalho foi avaliar a prevalência de baixa DMO num grupo de doentes com FQ e a sua correlação com outros parâmetros avaliados. O estudo incluiu 22 doentes com FQ com idades compreendidas entre os 14 e os 45 anos (média 26,3), dois dos quais transplantados pulmonares. A DMO foi avaliada por densitometria óssea ao nível da coluna lombar e do colo do fémur. Estes dados foram correlacionados com os valores séricos de 25-hydroxivitamina D, o IMC e o volume expiratório máximo forçado no primeiro segundo (VEM).
A case of a 12-year-old boy who developed catatonia is presented. He had no previous psychiatric history but has a family history of affective disorder. An extensive medical workup was negative. Despite a negative lorazepam challenge test, lorazepam was titrated up to 24 mg/day, with resolution of most catatonic symptoms. The case highlights an important point in the management of catatonia that may be a source of confusion, i.e., a positive lorazepam challenge test corroborates the diagnosis of catatonia; however, a negative lorazepam challenge test does not negate the diagnosis of catatonia, and subsequent focused benzodiazepine treatment may still be effective.
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