RESUMEN
OBJECTIVE: The objective of the present study was to compare the suitability of the B BACTEC™ Lytic/10 Anaerobic/F versus B BACTEC™ Plus Aerobic/F vials at the time of both Enterobacteriaceae recovery rate and detection time. METHODS: Prospective observational study from September 2018 to January 2019 in which 150 bacteremia. The samples were incubated in the automated BD BACTEC ™ FX system (Becton Dickison). RESULTS: A total of 180 Enterobacteriaceae were isolated: 93 B BACTEC™ Plus Aerobic/F and 87 from B BACTEC™ Lytic/10 Anaerobic/F belonging to 106 patients The urinary focus was the most frequent origin. The average detection time in both cases was not more than 15 hours. CONCLUSIONS: The combination of both bottles seems to be the best diagnostic strategy, thus reducing the detection time as well as increasing the recovery of Enterobacteriaceae. The combination of both vials could be implemented especially in selected situation of special urgency such as the sepsis code or critical patients.
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Bacteriemia , Sepsis , Bacteriemia/diagnóstico , Cultivo de Sangre , Medios de Cultivo , Enterobacteriaceae , HumanosRESUMEN
BACKGROUND AND OBJECTIVES: The homologous group of sweet grasses belongs to the Pooideae subfamily, but grass pollen species from other subfamilies can also cause allergy, such as Cynodon dactylon (Chloridoideae) and Phragmites communis (Arundinoideae). C dactylon and P communis have not been included in the sweet grasses homologous group because of their low cross-reactivity with other grasses. The aims of this study were to investigate the profile of sensitization to C dactylon and P communis in patients sensitized to grasses and to analyze cross-reactivity between these 2 species and temperate grasses. METHODS: Patients were skin prick tested with a grass mixture (GM). Specific IgE to GM, C dactylon, P communis, Cyn d 1, and Phl p 1 was measured by ImmunoCAP. A pool of sera was used for the immunoblot assays. Cross-reactivity was studied by ELISA and immunoblot inhibition. RESULTS: Thirty patients had sIgE to GM. Twenty-four (80%) had positive results for C dactylon, 27 (90%) for P communis, 22 (73.3%) for nCyn d 1, and 92.9% for rPhl p 1. Bands were detected in the 3 extracts by immunoblot. Inhibition of GM was not observed with C dactylon or P communis by immunoblot or ELISA inhibition. When C dactylon or P communis were used in the solid phase, GM produced almost complete inhibition. CONCLUSIONS: Eighty percent of patients sensitized to grasses were also sensitized to C dactylon and 90% were sensitized to P communis. Sensitization to these species seems to be induced by allergens different to those in sweet grasses.
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Alérgenos/inmunología , Antígenos de Plantas/inmunología , Reacciones Cruzadas/inmunología , Cynodon/inmunología , Poaceae/inmunología , Adulto , Femenino , Humanos , Hipersensibilidad/inmunología , Inmunoglobulina E/inmunología , Masculino , Persona de Mediana Edad , Proteínas de Plantas/inmunología , Polen/inmunología , Adulto JovenRESUMEN
UNLABELLED: Cystic fibrosis (CF)-related diabetes is an important complication of CF caused by a decrease in insulin secretion that is associated with weight loss, poor nutritional status and increased mortality. Leptin, a hormone secreted from white adipose tissue, has an important role in energy homoeostasis by inhibiting food intake and increasing energy expenditure. Leptin secretion can be increased by nutrient signals such as insulin. AIMS: Considering that leptin plays a role in energy homoeostasis and that CF is associated to poor weight gain and decreased insulin secretion, leptin levels in CF patients with different glucose tolerances were investigated and compared with those of healthy control subjects. METHODS: Two-hour oral glucose tolerance tests (OGTT) were performed in 82 patients with CF and various glucose tolerances as well as in 17 healthy control subjects during which blood was withdrawn every 30 min to measure glucose and insulin. Fasting leptin, fibrinogen and fat mass were also measured, and body mass index (kg/m(2)) calculated for all participants. Early and late insulin secretion was separated by calculating the area under the curve from time 0 to 30 min and 30 to 120 min of the OGTT (AUC(0-30) and AUC(30-120)). RESULTS: Leptin levels were comparable between CF patients and healthy control subjects. Interestingly, correlations were observed between leptin levels and insulin (AUC(0-120) and AUC(30-120)) after adjusting for gender and fat mass (P<0.05). CONCLUSION: This study suggests a potential role of insulin in regulating leptin levels in adults with stable CF.
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Glucemia/metabolismo , Fibrosis Quística/sangre , Diabetes Mellitus/sangre , Fibrinógeno/metabolismo , Insulina/sangre , Leptina/sangre , Adulto , Área Bajo la Curva , Índice de Masa Corporal , Canadá , Estudios de Cohortes , Fibrosis Quística/complicaciones , Fibrosis Quística/fisiopatología , Diabetes Mellitus/etiología , Diabetes Mellitus/fisiopatología , Ayuno , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/metabolismo , Resistencia a la Insulina , Secreción de Insulina , Masculino , Estudios ProspectivosRESUMEN
RATIONALE: Circulating adiponectin levels are negatively associated with glucose intolerance, inflammation and central adiposity. Since these conditions are common in cystic fibrosis (CF), we examined whether adiponectin values are altered in these patients. AIM: To determine if CF patients have altered adiponectin levels and if these levels correlate with glucose tolerance categories (normal, impaired glucose tolerance (IGT) and cystic fibrosis-related diabetes (CFRD)), insulin resistance or inflammatory markers such as fibrinogen and C-reactive protein (CRP). METHODS: Oral glucose tolerance tests (OGTTs) were performed and adiponectin levels were measured in 90 CF patients not known to be diabetic and 15 healthy controls matched for age, sex and body mass index (BMI). Inflammatory markers, serum albumin concentrations and the clinical status of CF patients (i.e. pulmonary function) were also examined. RESULTS: CF pathology was characterized by a high prevalence (43.5%) of glucose tolerance abnormalities: 26.5% of IGT and 17.0% of newly diagnosed CFRD. CF patients also presented systemic inflammation as revealed by a significant increase of fibrinogen (P=0.029) in all patients and higher CRP levels in CFRD patients compared to the controls (P<0.05). On the other hand, CF and control subjects had similar albumin serum concentration. While CF patients and controls had similar serum adiponectin values, women had significantly higher hormone levels than men (P<0.001). Adiponectin levels did not correlate with glucose tolerance, inflammatory markers or insulin resistance. On the other hand, they correlated positively with both total and HDL-cholesterol (P<0.001). CONCLUSION: CF patients did not show any alterations in adiponectin levels despite insulin resistance, glucose intolerance and sub clinical chronic inflammation. Thus, CF appears to be one of the rare conditions in which discordance between adiponectin values and insulin resistance or inflammation is evident.
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Adiponectina/sangre , Fibrosis Quística/sangre , Complicaciones de la Diabetes/sangre , Diabetes Mellitus/sangre , Intolerancia a la Glucosa/sangre , Adulto , Glucemia/metabolismo , Proteína C-Reactiva/metabolismo , Colesterol/sangre , Fibrosis Quística/complicaciones , Femenino , Fibrinógeno/metabolismo , Intolerancia a la Glucosa/complicaciones , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/sangre , Lipoproteínas HDL/sangre , Masculino , Valores de Referencia , Triglicéridos/sangreRESUMEN
BACKGROUND: Plane tree pollen allergy is a clinical disorder affecting human population in cities of Europe, North America, South Africa, and Australia. OBJECTIVE: To compare IgE-reactivity of the natural and recombinant forms of two major plane allergens, Pla a 1 and Pla a 2, with the reactivity of Platanus acerifolia pollen extract. METHODS: Forty-seven patients with P. acerifolia allergy, 15 of them monosensitized, and 24 control subjects were included in the study. Natural Pla a 1 and Pla a 2 were purified by standard chromatographic methods and recombinant proteins were expressed in Escherichia coli. Skin prick test and determination of specific IgE were performed with commercial P. acerifolia extract and natural and recombinant purified allergens. RESULTS: Pla a 1 and Pla a 2 were responsible for 79% of the IgE-binding capacity against P. acerifolia pollen extract. A high correlation has been found between the IgE response to nPla a 1 (R = 0.80; P < 0.001) or nPla a 2 (R = 0.79; P < 0.001) vs. P. acerifolia extract as well as between natural and recombinant Pla a 1 (R = 0.89; P < 0.001). Skin testing showed no significant differences between extract and nPla a 2, whereas a higher reactivity was found with nPla a 1. In contrast, rPla a 1 revealed markedly reduced sensitivity in comparison with extract by skin prick test and specific IgE. The sensitivity of the mix Pla a 1+Pla a 2 was 100% and 87.5% for monosensitized and polysensitized patients, respectively, with no false-positive reactions detected. Conclusion Pla a 1 and Pla 2 are sufficient for a reliable diagnosis of P. acerifolia in most patients and induce comparable skin test reactivity as a whole extract.
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Alérgenos , Pruebas Intradérmicas/métodos , Extractos Vegetales , Rinitis Alérgica Estacional/diagnóstico , Árboles , Adolescente , Adulto , Anciano , Alérgenos/aislamiento & purificación , Antígenos de Plantas , Reactores Biológicos , Estudios de Casos y Controles , Niño , Electroforesis en Gel de Poliacrilamida , Ensayo de Inmunoadsorción Enzimática , Escherichia coli , Femenino , Humanos , Immunoblotting , Inmunoglobulina E/sangre , Masculino , Persona de Mediana Edad , Polen , Prueba de Radioalergoadsorción , Proteínas Recombinantes/aislamiento & purificación , Sensibilidad y Especificidad , Estadísticas no ParamétricasRESUMEN
BACKGROUND: We reviewed radiologic features of gastrointestinal stromal tumors (GISTs) and correlated them with clinical and pathologic findings. METHODS: We investigated a series of 39 c-Kit-positive GISTs. Clinical and radiologic findings and management of these patients were recorded. RESULTS: Twenty women and 19 men (mean age 64 years) had histologically proved GIST. Tumor locations were the small bowel (n = 20), stomach (n = 14), rectum (n = 4), and omentum (n = l). Symptoms at presentation were most frequently gastrointestinal bleeding (n = 14) and abdominal pain (n = l1). Tumors were classified as very low risk (n = 2), low risk (n = 10), intermediate risk (n = 12), and high risk (n = 11). Ultrasonography, computed tomography, magnetic resonance, digital subtraction angiography, and barium series were used in the evaluation of these tumors. Most tumors were seen as well-delineated soft tissue masses with heterogeneous contrast enhancement. Necrosis, calcification, and ulceration were most commonly seen in large tumors that presented a more aggressive behavior. CONCLUSION: GISTs can arise anywhere in the gastrointestinal tract and present a great variety of clinical and radiologic features, depending mostly on size and location.
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Tumores del Estroma Gastrointestinal/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/uso terapéutico , Sulfato de Bario , Benzamidas , Medios de Contraste , Femenino , Tumores del Estroma Gastrointestinal/patología , Tumores del Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , UltrasonografíaAsunto(s)
Dermatitis Profesional/etiología , Frutas/efectos adversos , Dermatosis de la Mano/etiología , Adulto , Dermatitis Profesional/diagnóstico , Dermatitis Profesional/inmunología , Femenino , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/inmunología , Humanos , Inmunoglobulina E/sangre , Pruebas CutáneasRESUMEN
The present prospective, open, observational study assessed the effect of the use of standard environmental control measures together with the application of an acaricide-containing aerosol of esbiol/benzyl benzoate/piperonyl butoxide/2-phenylphenol (Frontac) on several clinical and environmental parameters in patients suffering from perennial allergic rhinoconjunctivitis related to house dust mites (HDM). Fifty-five patients were enrolled and studied for one year. Both symptoms and the patients' quality of life (evaluated by the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ)) were assessed at several clinic visits. The amount of HDM antigen was semi-quantitatively estimated using the guanine test. We found a significant decrease (p < 0.001) in most nasal symptoms scores: sneezing, runny nose, stuffy nose and itching. The overall quality of life (QoL) score also showed a significant improvement during the study period; the mean score decrease found was 0.86 (CI 95 %, 0.54-1.17) (p < 0.001). Five of the seven domains included in the questionnaire decreased significantly: non-hayfever symptoms; practical problems; nasal symptoms; eye symptoms, and emotions. These QoL score decreases were found during the first 3 months and later remained stable at lower levels than at baseline. The content of guanine in dust samples decreased significantly from 2.17 0.75 to 1.43 0.68 (p < 0.001). No toxic adverse events were recorded. In conclusion, these results show an improvement in the quality of life and a clinical benefit of the long-term use of the new chemical acaricide tested, together with environmental measures, in the home of patients suffering from allergic respiratory pathology.
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Acaricidas/farmacología , Exposición a Riesgos Ambientales/prevención & control , Hipersensibilidad Inmediata/prevención & control , Calidad de Vida , Rinitis Alérgica Perenne/prevención & control , Adulto , Animales , Conjuntivitis Alérgica/microbiología , Conjuntivitis Alérgica/prevención & control , Femenino , Humanos , Masculino , Pyroglyphidae/inmunología , Rinitis Alérgica Perenne/microbiología , Encuestas y CuestionariosRESUMEN
BACKGROUND: Plane trees, as Platanus acerifolia, are an important source of airborne allergens in cities of the United States and Western Europe. Little is known about the relevant allergens of this pollen. The aim of this study was to identify relevant allergens from P. acerifolia pollen and purify and characterize a major allergen of 18 kDa. METHODS: P. acerifolia pollen extract was fractionated using ion exchange, gel filtration, and reverse-phase chromatography. Analyzes were carried out by EAST, SDS-PAGE, isoelectric focusing, immunoblotting and amino-acid sequencing. RESULTS: An 18-kDa protein from the P. acerifolia pollen extract, which we named Pla a 1, was purified. This nonglycosylated protein had an isoelectric point value higher than 9.3 and was recognized by up to 92% of monosensitized Platanus allergic patients and 83% of polyzensitized patients. Sequencing of its N-terminal yielded an amino acid sequence which showed no homology to the known proteins in the databases. Other relevant allergens detected in monosensitized patients were proteins of 43 and 52 kDa, with immunoglobulin (Ig)E-binding prevalences of 83 and 42%, respectively. Profilin was an important allergen in polyzensitized patients. CONCLUSIONS: The most relevant allergens from the P. acerifolia pollen have been determined. A major allergen, specific of this pollen, and named Pla a 1, has been purified and characterized.
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Alérgenos/aislamiento & purificación , Polen/inmunología , Adolescente , Adulto , Alérgenos/química , Alérgenos/inmunología , Reacciones Cruzadas , Femenino , Humanos , Inmunoglobulina E/sangre , Focalización Isoeléctrica , Masculino , Persona de Mediana Edad , Peso MolecularRESUMEN
Idiopathic pylephlebitis and primary sclerosing peritonitis are two highly unusual entities. To our knowledge, the association of the two diseases has not been described previously. We report a 42-year-old patient with a protein S deficiency who presented with fever and chills, in whom idiopathic pylephlebitis was diagnosed. A year later, the patient was readmitted because of recurrent vomiting and weight loss. An exploratory laparotomy yielded diagnosis of sclerosing peritonitis, which resolved after surgery. The short time interval between the processes suggests that they were related to each other, and also to the protein S deficiency.
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Peritonitis/etiología , Flebitis/etiología , Vena Porta , Deficiencia de Proteína S/complicaciones , Adulto , Humanos , Masculino , Peritonitis/patología , EsclerosisAsunto(s)
Granulomatosis Linfomatoide/patología , Biopsia , Dolor en el Pecho/etiología , Diagnóstico Diferencial , Fiebre/etiología , Humanos , Pulmón/patología , Granulomatosis Linfomatoide/diagnóstico , Masculino , Persona de Mediana Edad , Polineuropatías/etiología , Pronóstico , Radiografía Torácica , Tomografía Computarizada por Rayos XAsunto(s)
Enfermedad de Whipple/diagnóstico , Dolor Abdominal/complicaciones , Artritis/complicaciones , Diagnóstico Diferencial , Diarrea/complicaciones , Fiebre/complicaciones , Bloqueo Cardíaco/complicaciones , Humanos , Enfermedades Linfáticas/complicaciones , Masculino , Persona de Mediana Edad , Derrame Pleural/complicaciones , Uveítis/complicaciones , Enfermedad de Whipple/complicaciones , Enfermedad de Whipple/patologíaAsunto(s)
Alérgenos , Anafilaxia/etiología , Glucocorticoides/efectos adversos , Parametasona/efectos adversos , Adulto , Anafilaxia/diagnóstico , Anafilaxia/terapia , Reacciones Cruzadas , Femenino , Glucocorticoides/administración & dosificación , Humanos , Inyecciones Intraarticulares , Parametasona/administración & dosificaciónRESUMEN
BACKGROUND: Sodium carboxymethylcellulose (SCMC) is the sodium salt of a polycarboxymethyl ether of cellulose. SCMC is widely used in pharmaceutical and food industries. We present the case of a 47-year-old man who suffered an anaphylactic shock after an intra-articular injection of Trigon depot. METHODS AND RESULTS: Prick and intradermal tests with Trigon depot and its components (triamcinolone acetonide, Tween 80, benzylalcohol, SCMC), mepivacaine 2% and latex were performed. Challenge test with mepivacaine 2% was also realized. RESULTS: Showed a positive intradermal test to Trigon depot and carboxymethylcellulose, with negative results to the rest (including challenge test to mepivcaine 2%). CONCLUSIONS: Our results support the diagnosis of anaphylactic shock after intra-articular injection of carboxymethylcellulose and we consider necessary to emphasize that excipients must be taken into account as a potential source of adverse reactions to drugs.
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Anafilaxia/etiología , Carboximetilcelulosa de Sodio/efectos adversos , Carboximetilcelulosa de Sodio/administración & dosificación , Excipientes/efectos adversos , Humanos , Inyecciones Intraarticulares , Masculino , Persona de Mediana Edad , Pruebas CutáneasAsunto(s)
Dermatitis Alérgica por Contacto/inmunología , Óvulo/inmunología , Hipersensibilidad Respiratoria/inmunología , Adulto , Alérgenos/análisis , Alérgenos/inmunología , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina E/análisis , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/inmunología , Prueba de Radioalergoadsorción , Pruebas CutáneasRESUMEN
This open labelled, group comparative, cross over study, was carried out to analyze the efficacy of two dosages of Nedocromil sodium (NS) in the prophylaxis of Exercise Induced Asthma (EIA). 13 athletes (6 males, 7 females), aged: 12-38 years, were studied measuring their EIA by forced spirometries prior and at 1, 3, 5, 10, 15 and 30 minutes post treadmill test. Four mg of NS were administered via inhalation chamber 30 minutes prior to the second test; prior to the third one;: NS at a dose of 4 mg every 8 hours during four weeks plus 4 mg of NS 30 minutes before it. In the baseline exercise test, a 33.6 +/- 10.5 percent decrease of FEV1 was observed; 12.6 +/- 11.4 in the second one, and 9.7 +/- 9.76 in the third test. A protection index higher than 30% was obtained in 9 cases of the second test (81.5 +/- 16.2%), and in 10 of the third one (77.2 +/- 15.3%). Nedocromil sodium (4 mg prior to exercise) is effective for EIA prophylaxis. Although no significant differences exist between both dosages, a greater protection index is reached after NS sustained administration.
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Antiasmáticos/uso terapéutico , Asma Inducida por Ejercicio/prevención & control , Nedocromil/uso terapéutico , Deportes , Adolescente , Adulto , Antiasmáticos/administración & dosificación , Antiasmáticos/farmacología , Niño , Estudios Cruzados , Prueba de Esfuerzo , Femenino , Volumen Espiratorio Forzado/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Nedocromil/administración & dosificación , Nedocromil/farmacología , Estaciones del AñoRESUMEN
The results of the use of the European Standard Series on 800 patients suffering from Contact Dermatitis, including occupational Dermatosis is reported. This work also attempts to provide insight into the interests and difficulties of carrying out an epidemiological study in an Allergy Centre and Immunology Clinic. All the patients underwent a Patch Test following the guidelines laid out by the International Contact Dermatitis Research Group. The results of the patch tests were positive in 462 patients (57.7%) and negative in 338 cases (42.3%). The agents responsible for the symptoms in our study were as follows: metals (33%), parafenilen-diamine (13.9%), cobalt (13.3%), perfumes (5.5%), benzocaine (5.4%) and potassium dichromate (5.4%). In this study 72 patients were verified to have Occupational Dermatosis, corresponding mainly to the following occupational sectors: metal industry workers, hairdressers and bakers and pastry makers.
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Dermatitis por Contacto/diagnóstico , Pruebas del Parche/métodos , Adolescente , Adulto , Anciano , Niño , Preescolar , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de ReferenciaRESUMEN
The aim of this study was to demonstrate the clinical effectiveness of treatment with specific immunotherapy using allergenic mite extracts modified with glutaraldehyde. The results showed an improvement both in clinical symptoms and a reduction in the complementary pharmacological therapy used. Several clinical "in vitro" and "in vivo" parameters were analysed during this study. The results obtained from the Nasal Challenge Test and the Skin Test (prick-test) were the most relevant. Patient tolerance to the diagnostic extract was increased in 45% of the patients, the result of which was registered in the Nasal Challenge Test. Evaluation of the results derived from the skin tests on conclusion of immunotherapy, showed a reduction in response in 55% of the patients. Progressive immunotherapeutic doses were applied at short intervals with no record of severe reactions.