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1.
Rev. esp. quimioter ; 37(2): 1-4, abr. 2024. tab
Artigo em Inglês | IBECS | ID: ibc-ADZ-261

RESUMO

Objectives. Our observational, retrospective study aimed to determine the correlation between bacteria isolated from bronchial aspirates of pediatric ICU patients (PICU) with respiratory infections and those obtained from conjunctival swabs of the same patients exhibiting clinical conjunctivitis. Material and methods. Throughout the period from 2015 to 2022, we reviewed all clinically significant bronchial aspirates (≥105 CFU/mL) and positive conjunctival swabs obtained from PICU patients. These records were retrieved from the microbiology database, cross-referencing the data to identify patients who tested positive for both during the same clinical episode. Results. The median age of the patients was 5 months (interquartile range: 1-7). Among the cohort, twenty-one patients exhibited positivity in both bronchial aspirate and conjunctival swab samples, showcasing a microbial match in 85.71% of cases (18 out of 21). The most frequently isolated microorganisms were Haemophilus influenzae (55.6%), followed by Pseudomonas aeruginosa (14.3%), Klebsiella aerogenes (9.5%), and Escherichia coli, Stenotrophomonas maltophilia, and Enterobacter cloacae, each accounting for 4.8% of the isolates. Conclusions. Our study demonstrates a strong concordance between the isolated microorganisms from both samples in patients presenting clear symptoms of clinical conjunctivitis. These findings provide a basis for future prospective studies that may leverage conjunctival swabs as a predictive tool for identifying microorganisms involved in respiratory infections. (AU)


Objetivos. Nuestro estudio observacional y retrospectivo tuvo como objetivo determinar la correlación entre las bacterias aisladas de aspirados bronquiales de pacientes de UCI pediátrica (UCIP) con infecciones respiratorias y las obtenidas de hisopos conjuntivales de los mismos pacientes que presentaban conjuntivitis clínica. Material y métodos. A lo largo del periodo comprendido entre 2015 y 2022, se revisaron todos los aspirados bronquiales clínicamente significativos (≥105 UFC/mL) y los hisopos conjuntivalespositivos obtenidos de pacientes de UCIP. Estos registros se recuperaron de la base de datos de microbiología, cruzando los datos para identificar a los pacientes que dieron positivo en ambos durante el mismo episodio clínico. Resultados. La mediana de edad de los pacientes fue de 5 meses (rango intercuartílico: 1-7). Entre la cohorte, veintiún pacientes presentaron positividad tanto en las muestras de aspirado bronquial como en las de hisopo conjuntival, mostrando una coincidencia microbiana en el 85,71% de los casos (18 de 21). Los microorganismos más frecuentemente aislados fueron Haemophilus influenzae (55,6%), seguido de Pseudomonas aeruginosa (14,3%), Klebsiella aerogenes (9,5%) y Escherichia coli, Stenotrophomonas maltophiliay Enterobacter cloacae, cada uno de los cuales representó el 4,8% de los aislamientos. Conclusiones. Nuestro estudio demuestra una fuerte concordancia entre los microorganismos aislados de ambas muestras en pacientes que presentan síntomas claros de conjuntivitis clínica. Estos hallazgos proporcionan una base para futuros estudios prospectivos que podrían aprovechar los hisopos conjuntivales como herramienta predictiva para identificar microorganismos implicados en infecciones respiratorias. (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Olho , Brônquios , Unidades de Terapia Intensiva Pediátrica , Infecções Respiratórias , Conjuntivite , Microbiologia , Estudos Retrospectivos
4.
Arch. bronconeumol. (Ed. impr.) ; 59(8): 502-509, ago. 2023. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-224084

RESUMO

Background: Blood eosinophil count (BEC) is currently used as a surrogate marker of T2 inflammation in severe asthma but its relationship with tissue T2-related changes is elusive. Bronchial biopsy could add reliable information but lacks standardization. Objectives: To validate a systematic assessment of the bronchial biopsy for the evaluation of severe uncontrolled asthma (SUA) by standardizing a pathological score. Methods: A systematic assessment of submucosal inflammation, tissue eosinophilic count/field (TEC), goblet cells hyperplasia, epithelial changes, basement membrane thickening, prominent airway smooth muscle and submucosal mucous glands was initially agreed and validated in representative bronchial biopsies of 12 patients with SUA by 8 independent pathologists. In a second phase, 62 patients with SUA who were divided according to BEC≥300cells/mm3 or less underwent bronchoscopy with bronchial biopsies and the correlations between the pathological findings and the clinical characteristics were investigated. Results: The score yielded good agreement among pathologists regarding submucosal eosinophilia, TEC, goblet cells hyperplasia and mucosal glands (ICC=0.85, 0.81, 0.85 and 0.87 respectively). There was a statistically significant correlation between BEC and TEC (r=0.393, p=0.005) that disappeared after correction by oral corticosteroids (OCS) use (r=0.170, p=0.307). However, there was statistically significant correlation between FeNO and TEC (r=0.481, p=0.006) that was maintained after correction to OCS use (r=0.419, p=0.021). 82.4% of low-BEC had submucosal eosinophilia, 50% of them moderate to severe. Conclusion: A standardized assessment of endobronchial biopsy is feasible and could be useful for a better phenotyping of SUA especially in those receiving OCS. (AU)


Assuntos
Humanos , Asma/diagnóstico , Asma/tratamento farmacológico , Asma/patologia , Eosinofilia , Eosinófilos , Hiperplasia/patologia , Brônquios , Inflamação
5.
Arch. bronconeumol. (Ed. impr.) ; 59(7): 435-438, jul. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-223089

RESUMO

Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is commonly used for the study of intrathoracic lymphadenopathy and centrally tumours but no report has discussed the contribution of routine cytological and microbiological BA during the procedure. The aim of the study was to analyse the diagnostic yield of BA during EBUS, and to determine the potential cost reduction. Methods: A prospective study of cytological and microbiological BA collected during EBUS-TBNA was conducted between January 2021 and June 2022. Demographic data, indication, previous BA bronchoscopy or EBUS diagnosis were recorded. The main variable tested was the number of patients in which the result of the BA obtained through EBUS-TBNA determined a change in the diagnosis. Results: A total of 450 (70.9% male) patients were included. BA cytology showed abnormal cells in 33 (7.3%) of patients, and only 1 case (0.2%) provided a previously unknown diagnosis. All these cases were patients with suspected malignancy. BA microbiological samples found germens in 30 (6.7%) patients but only in 5 cases (1.1%) found microbiological specimens not detected in previous bronchoscopy. None of them received antibiotics and evolved correctly. The potential total cost reduction during the study period at our centre if routine BA was deleted would be 21,937.50€ for routinely combined study. Conclusions: The low diagnostic yield of cytological and microbiological bronchial aspirate in EBUS-TBNA supports the idea of not performing routine BA. Although the potential for cost savings in caring for an individual patient is modest, many centres routinely perform BA, so the potential savings could be significant. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Linfadenopatia/patologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Brônquios/diagnóstico por imagem , Broncoscopia/métodos , Linfonodos/diagnóstico por imagem , Estudos Retrospectivos , Estudos Prospectivos
7.
Cir. Esp. (Ed. impr.) ; 101(1): 51-54, en. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-EMG-427

RESUMO

Las resecciones sublobares anatómicas mínimamente invasivas han ganado relevancia durante los últimos años gracias al avance de las técnicas de imagen, los programas de cribado y el aumento de segundas neoplasias. La identificación precisa del bronquio segmentario o subsegmentario objeto de resección es vital para obtener resultados óptimos en segmentectomías y subsegmentectomías. Dada la complejidad y la posibilidad de variaciones anatómicas, varios autores han publicado distintos métodos para identificar el bronquio objetivo de la resección. Sin embargo, estos métodos tienen ciertas limitaciones. El presente artículo describe una nueva técnica rápida, efectiva, con bajo riesgo de complicaciones y sin coste adicional para la identificación de los bronquios segmentarios en segmentectomías mínimamente invasivas. (AU)


Minimally invasive anatomical sublobar resections have gained relevance in recent years mainly due to advances in imaging techniques, screening programs and the increase in second neoplasms. Accurate identification of the segmental or subsegmental bronchus is vital to guarantee optimal results in segmentectomies and subsegmentectomies. Given the complexity and the possibility of anatomical variations, several authors have published different methods to identify the target bronchus. However, these methods have certain limitations. This article describes a new rapid and effective technique, with a low risk of complications and without additional cost, for the identification of segmental bronchi in minimally invasive segmentectomies. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Fluorescência , Brônquios , Neoplasias Pulmonares , Raios Infravermelhos , Adenocarcinoma , Robótica
8.
Med. clín (Ed. impr.) ; 160(1): 23-26, enero 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-213904

RESUMO

Introducción: El suero salino hipertónico (SSH) nebulizado mejora la calidad de vida y reduce las exacerbaciones en pacientes con fibrosis quística. Se desconoce si ofrecería los mismos beneficios en otras patologías hipersecretoras.MétodosEstudio observacional retrospectivo. Se incluyeron pacientes que superaron la prueba de tolerancia e iniciaron SSH al 5,8% con un año de seguimiento. Se cuantificaron parámetros clínicos y asistenciales en los años previo y posterior al inicio del tratamiento.ResultadosUn total de 101 pacientes, 60,4% mujeres, media de edad 65años (IC95%: 62,4-67,9): 82 (81,2%) bronquiectasias, 6 (5,9%) EPOC, 2 (2%) asma, 1 (1%) EPID y 10 (9,9%) otros. Se evidenció una reducción de la broncorrea (91,1% vs 75,2%), de las infecciones de repetición (57,4% vs 22,8%) y de los ciclos de antibioterapia (1,54 vs 0,55), así como un aumento del FEV1 (1.881ml vs 1.942ml) y una disminución de las asistencias a atención primaria (2,94 vs 1,1), de urgencias (0,36 vs 0,17) y de hospitalizaciones (0,17 vs 0,06). Setenta y tres pacientes (72,3%) presentaron una adecuada tolerancia.ConclusiónLa nebulización de SSH al 5,8% en pacientes con hipersecreción bronquial es segura y tiene un destacable impacto clínico y asistencial. (AU)


Introduction: Nebulized hypertonic saline (HS) improves quality of life and reduces exacerbations in patients with cystic fibrosis. It is unknown if it would offer the same benefits in other hypersecretory pathologies.MethodsRetrospective observational study. Patients who passed the tolerance test and started HS 5.8% with one year of follow-up were included. Clinical and healthcare parameters were quantified in the year before and after the start of treatment.Results101 patients, 60.4% women, 65years (95%CI: 62.4-67.9): 82 (81.2%) bronchiectasis, 6 (5.9%) COPD, 2 (2%) asthma, 1 (1%) ILD, and 10 (9.9%) other causes. There was a reduction in bronchorrhea (91.1% vs 75.2%), recurrent infections (57.4% vs 22.8%) and cycles of antibiotic therapy (1.54 vs 0.55), as well as an increase in FEV1 (1881ml vs. 1942ml) and a decrease in visits to primary care (2.94 vs. 1.1), emergencies (0.36 vs. 0.17) and hospitalizations (0.17 vs. 0.17). 06). 73 patients (72.3%) presented an adequate tolerance.ConclusionNebulization of HS 5.8% in patients with bronchial hypersecretion is safe and has a remarkable clinical and healthcare impact. (AU)


Assuntos
Humanos , Organização e Administração , Brônquios , Fibrose Cística , Solução Salina Hipertônica/efeitos adversos , Solução Salina Hipertônica/uso terapêutico , Nebulizadores e Vaporizadores , Qualidade de Vida
9.
Cir. Esp. (Ed. impr.) ; 101(1): 51-54, en. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-226687

RESUMO

Las resecciones sublobares anatómicas mínimamente invasivas han ganado relevancia durante los últimos años gracias al avance de las técnicas de imagen, los programas de cribado y el aumento de segundas neoplasias. La identificación precisa del bronquio segmentario o subsegmentario objeto de resección es vital para obtener resultados óptimos en segmentectomías y subsegmentectomías. Dada la complejidad y la posibilidad de variaciones anatómicas, varios autores han publicado distintos métodos para identificar el bronquio objetivo de la resección. Sin embargo, estos métodos tienen ciertas limitaciones. El presente artículo describe una nueva técnica rápida, efectiva, con bajo riesgo de complicaciones y sin coste adicional para la identificación de los bronquios segmentarios en segmentectomías mínimamente invasivas. (AU)


Minimally invasive anatomical sublobar resections have gained relevance in recent years mainly due to advances in imaging techniques, screening programs and the increase in second neoplasms. Accurate identification of the segmental or subsegmental bronchus is vital to guarantee optimal results in segmentectomies and subsegmentectomies. Given the complexity and the possibility of anatomical variations, several authors have published different methods to identify the target bronchus. However, these methods have certain limitations. This article describes a new rapid and effective technique, with a low risk of complications and without additional cost, for the identification of segmental bronchi in minimally invasive segmentectomies. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Fluorescência , Brônquios , Neoplasias Pulmonares , Raios Infravermelhos , Adenocarcinoma , Robótica
12.
Rev. patol. respir ; 24(4): 143-144, oct. - dic. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-228432

RESUMO

El bronquio traqueal o bronquio porcino es una rara anomalía congénita que se define como la salida del bronquio del lóbulo superior derecho directamente a la tráquea, próximo a la carina principal. En principio se considera una variante anatómica de la normalidad, pero hay que tener especial cuidado en ciertas situaciones como la intubación orotraqueal (AU)


The tracheal bronchus or porcine bronchus is a rare congenital anomaly that is defined as the exit of the bronchus from the right upper lobe directly to the trachea, close to the main carina. In principle, it is considered an anatomical variant of normality, but special care must be taken in certain situations such as orotracheal intubation (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Anormalidades do Sistema Respiratório/diagnóstico por imagem , Brônquios/anormalidades , Brônquios/diagnóstico por imagem
13.
Rev. patol. respir ; 24(4): 145-147, oct. - dic. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-228433

RESUMO

Una correcta sistemática en el estudio fibrobroncoscópico de masas tumorales periféricas es necesaria para describir todo el árbol bronquial, tales como la presencia de cuerpos extraños como en nuestro paciente. Nuestro caso condujo al diagnóstico de infección por Aspergillus spp, patología en la que dependiendo de su gravedad varía el tratamiento que se administra (AU)


A correct systematic in the fibrobronchoscopic study of peripheral tumor masses is necessary to describe the entire bronchial tree, such as the presence of foreign bodies as in our case. Our case led to the diagnosis of infection by Aspergillus spp, a pathology that, depending on its severity, varies the treatment administered (AU)


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Corpos Estranhos/diagnóstico por imagem , Broncoscopia/métodos , Aspergilose/diagnóstico , Brônquios
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