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Langerhans cell histiocytosis revealed by painful hip: a case report.  Envoyer
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Langerhans cell histiocytosis revealed by painful hip: a case report.

Joint Bone Spine. 2009 Oct;76(5):565-6

Authors: Sabeur H, Chebil BM, Karim BA, Samir H, Leila G, Chiraz H, Slaheddine C, Néji GM

Langerhans cell histiocytosis is a rare disease in childhood. It has a very polymorphous clinical expression, ranging from a single bony disease to a multisystemic disease involving vital organs. Prognosis has been improved by use of chemotherapy. We report a 2-year-old girl with multifocal Langerhans cell histiocytosis of bone and skin, revealed by a pain of the left hip and a limp trailing from 2 months. The diagnosis has been established by histological exam. The patient received chemotherapy and steroids. Outcome was favourable over 6-month follow-up. Trailing limp should evoke diagnosis of Langerhans cell histiocytosis. Skin biopsy should be preferred to a bone biopsy because of its safety.

PMID: 19767229 [PubMed - indexed for MEDLINE]

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Case study: the challenges of self-management of exacerbation of pulmonary symptoms.  Envoyer
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Case study: the challenges of self-management of exacerbation of pulmonary symptoms.

Int J Nurs Terminol Classif. 2009 Oct-Dec;20(4):198-201

Authors: Barnes A

PURPOSE: This case study demonstrates the signs and symptoms of pulmonary exacerbation and the challenges of self-management for a female veteran. DATA SOURCES: Data were obtained through the author's clinical practice in primary care nursing and research literature sources. DATA SYNTHESIS: The appropriate nursing diagnosis, nursing interventions, and patient outcomes were identified through the use of NANDA-International, the Nursing Interventions Classification, and the Nursing Outcomes Classification. CONCLUSIONS: This case study illustrates the appropriate nursing diagnosis, interventions, and outcomes pertinent to an individual with pulmonary exacerbations. It provides a framework for nurses in primary care when caring for individuals with pulmonary exacerbations. IMPLICATIONS FOR NURSING PRACTICE: Employing the NANDA-International standardized nursing diagnoses, the Nursing Interventions Classification and the Nursing Outcomes Classification provided the needed constructs for improving care for a patient that had pulmonary issues in a primary care setting.

PMID: 19883457 [PubMed - indexed for MEDLINE]

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Images in clinical medicine. Radiation pneumonitis after radiotherapy for breast cancer.  Envoyer
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Images in clinical medicine. Radiation pneumonitis after radiotherapy for breast cancer.

N Engl J Med. 2009 Dec 31;361(27):e65

Authors: Bölke E, Matuschek C

PMID: 20042752 [PubMed - indexed for MEDLINE]

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A fatal case of spinal tuberculosis mistaken for metastatic lung cancer: recalling ancient Pott's disease.  Envoyer
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A fatal case of spinal tuberculosis mistaken for metastatic lung cancer: recalling ancient Pott's disease.

Ann Clin Microbiol Antimicrob. 2009;8:32

Authors: Ringshausen FC, Tannapfel A, Nicolas V, Weber A, Duchna HW, Schultze-Werninghaus G, Rohde G

BACKGROUND: Tuberculous spondylitis (Pott's disease) is an ancient human disease. Because it is rare in high-income, tuberculosis (TB) low incidence countries, misdiagnoses occur as sufficient clinical experience is lacking. CASE PRESENTATION: We describe a fatal case of a patient with spinal TB, who was mistakenly irradiated for suspected metastatic lung cancer of the spine in the presence of a solitary pulmonary nodule of the left upper lobe. Subsequently, the patient progressed to central nervous system TB, and finally, disseminated TB before the accurate diagnosis was established. Isolation and antimycobacterial chemotherapy were initiated after an in-hospital course of approximately three months including numerous health care related contacts and procedures. CONCLUSION: The rapid diagnosis of spinal TB demands a high index of suspicion and expertise regarding the appropriate diagnostic procedures. Due to the devastating consequences of a missed diagnosis, Mycobacterium tuberculosis should be considered early in every case of spondylitis, intraspinal or paravertebral abscess. The presence of certain alarm signals like a prolonged history of progressive back pain, constitutional symptoms or pulmonary nodules on a chest radiograph, particularly in the upper lobes, may guide the clinical suspicion.

PMID: 19930560 [PubMed - indexed for MEDLINE]

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