Abstract:
BACKGROUND:The diagnosis of spinal tuberculosis (ST) is difficult and it commonly presents at an advanced stage. The management and follow up is complicated by a lack of guidance on the appropriate use and interpretation of spinal magnetic resonance studies (MR). AIMS:A retrospective study was performed at a UK centre to identify the demographic and presenting features of a spinal TB population, their response to treatment, and the value of follow up MR studies. PATIENTS AND RESULTS:Twenty one patients were identified with mean symptom duration of 11 (1.5-36) months having been assessed by a health practitioner on 3.2 (0-10) occasions before referral for investigation for ST. Twenty were born outside the UK. Their mean duration of residence in the UK was 6.67 (0.75-20) years, and six (32%) were resident for more than 10 years. Most (85.7%) did not have a medical history and one was HIV positive. Back pain, neurological, and constitutional symptoms were found in 100%, 29%, and 38% respectively. Musculoskeletal and neurological signs were found in 29% and 19% respectively. Spinal MR performed between 6 and 12 months suggests that six months of chemotherapy (for a fully sensitive organism) may not be sufficient to achieve disease resolution. CONCLUSIONS:Awareness of the demographic, clinical, and laboratory features of an ST population may facilitate earlier diagnosis. Guidance is required on the appropriate use and interpretation of MRI in the follow up of these patients.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Cormican L,Hammal R,Messenger J,Milburn HJdoi
10.1136/pgmj.2005.032862subject
Has Abstractpub_date
2006-01-01 00:00:00pages
46-51issue
963eissn
0032-5473issn
1469-0756pii
82/963/46journal_volume
82pub_type
杂志文章abstract::Tuberculosis of the appendix is rare. It is usually secondary to tuberculosis elsewhere in the abdomen. Tuberculosis of the appendix is not associated with any specific clinical features and diagnosis is revealed only after histopathological examination. Appendicectomy should be performed in all patients with abdomina...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.744.855
更新日期:1987-10-01 00:00:00
abstract::Purtscher's retinopathy presents to the clinician as loss of vision in a patient with a history of a possible precipitating event such as recent major trauma, pancreatitis, childbirth or renal failure. The ophthalmological picture is one of ischaemia at the posterior pole with white patches of oedema and haemorrhages ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.72.849.409
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abstract::The anti-hypertensive effect of 250 mg tienilic acid was comparable to that of 50 mg hydrochlorothiazide. Unlike hydrochlorothiazide, tienilic acid caused a statistically significant decrease in the serum uric acid values. Clinically non-significant rises in blood urea nitrogen and serum creatinine occurred with both ...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-01-01 00:00:00
abstract::The relative prevalence of abnormalities of coronary flow reserve and oesophageal function was ascertained in 32 syndrome X patients with typical angina chest pain, a positive exercise test, and normal coronary arteries. Coronary flow reserve in response to a hyperaemic dose of papaverine was measured using an intraco...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.844.99
更新日期:1996-02-01 00:00:00
abstract::Thirty patients who had undergone major abdominal surgery were randomly assigned to a continuous infusion of either 0.45 mg meptazinol/kg/hr or 0.3 mg pethidine/kg/hr. Analgesia was assessed by rating scale, ranging from 0 (no pain) to 10 (unbearable pain), and by questionnaire. Respiration rate was closely monitored ...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-01-01 00:00:00
abstract::The treatment of renal anaemia by recombinant human erythropoietin (EPO) is now well established. Several studies have examined the pharmacokinetics and efficacy of the drug given intravenously, intraperitoneally and subcutaneously and there is increasing evidence that the subcutaneous route has several advantages inc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.67.783.9
更新日期:1991-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 历史文章,杂志文章
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更新日期:2003-03-01 00:00:00
abstract::We report on 8 patients with giant lymph node hyperplasia (GLNH), diagnosed over a 10-year period. The age of the patients at diagnosis, the clinical presentation and the histological subtype varied, indicating that GNLH is a heterogeneous condition. One case was associated with liver cirrhosis, and in another patient...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.67.786.366
更新日期:1991-04-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.766.515
更新日期:1989-08-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.822.302
更新日期:1994-04-01 00:00:00
abstract::In the changing National Health Service, there is an increasing awareness of stress related problems in the medical workforce. Mentorship has been shown to help with both stress reduction and adaptation to change. There are recognised difficulties with providing mentorship for doctors but there are ways in which these...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2006.054155
更新日期:2007-05-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.652.80
更新日期:1980-02-01 00:00:00
abstract::Five cases of primary peritonitis are presented, with a sixth related case of pneumococcal peritonitis secondary to a ruptured ovarian cyst. The patients comprised 4 young girls who recovered, and 2 elderly females who died. Pneumococci were isolated in 3 patients; no organism was found in the other 3. One case of pri...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.687.21
更新日期:1983-01-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2018-135828
更新日期:2018-08-01 00:00:00
abstract::We analysed data from 64 patients with Wegener's granulomatosis to determine predictor variables of outcome. The mean period of observation after the diagnosis had been established was 3.2 (range 0.1-11.2) years. At the time of diagnosis, 15 (23%) patients had only local symptoms. The disease was generalized to multip...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.817.856
更新日期:1993-11-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.41.474.186
更新日期:1965-04-01 00:00:00
abstract::We describe two patients with diabetes mellitus and associated neuropathy, who presented with painless foot swelling and no history of trauma. X-Rays revealed recent underlying fractures-in one of a metatarsus, and the other of a proximal phalanx. These were assumed to be 'stress' fractures unassociated with pain beca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.858.241
更新日期:1997-04-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2012-303958rep
更新日期:2014-03-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.874.468
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVES:Although risk assessment is an integral part of management, there are currently no risk calculators of long-term mortality after acute coronary syndrome (ACS). The aim was to provide risk equations for 10-year and 20-year mortality following ACS. METHODS:Patients hospitalised with ACS from December 1990 to ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2016-134129
更新日期:2017-05-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.702.272
更新日期:1984-04-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.781.949
更新日期:1990-11-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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更新日期:2010-08-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.755.681
更新日期:1988-09-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:1984-07-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.620.324
更新日期:1977-06-01 00:00:00
abstract::We present a 78-year-old woman with clinical acute hypopituitarism in whom pathologic findings showed lymphocytic hypophysitis and retroperitoneal fibrosis. Lymphocytic hypophysitis should be included in the differential diagnosis of hypopituitarism at any age. The association with idiopathic retroperitoneal fibrosis ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.865.732
更新日期:1997-11-01 00:00:00
abstract::A patient is described who developed acute pericarditis during a severe first attack of Crohn's disease. The opportunity was taken to measure levels of circulating immune complexes, both during the acute phase of the illness and during convalescence; no significant change in these levels from normal values was found. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.708.682
更新日期:1984-10-01 00:00:00
abstract::Intraoperative transluminal endoscopic illumination is of benefit to locate angiodysplasias of the small bowel at laparotomy in the quiescent non-bleeding phase. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.745.995
更新日期:1987-11-01 00:00:00
abstract::A case of cervical osteoid osteoma is reported, with a brief account of the diagnosis and treatment of these lesions. Cervical osteoid osteoma is rare but its pattern of presentation varies little and it should therefore be possible to suspect it on clinical grounds alone. Bone scanning is now regarded as more efficie...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.660.724
更新日期:1980-10-01 00:00:00