Cost-effectiveness and safety of mediastinal transbronchial cryobiopsy guided by endobronchial ultrasonography (CRYO-EBUS) in 110 cases. / Rentabilidad y seguridad de la criobiopsia transbronquial mediastínica guiada por ultrasonografía endobronquial (CRYO-EBUS) en 110 casos.

INTRODUCTION: Transbronchial needle aspiration guided by endobronchial ultrasonography (EBUSTBNA) has the disadvantage of sometimes offering samples of an unsuitable size for an accurate histo-molecular diagnosis. Transbronchial mediastinal cryobiopsy (CRYOEBUS) is a very novel and additional technique to EBUS-TBNA that allows us to obtain larger and quality samples, improving diagnostic performance. MATERIAL AND METHODS: Descriptive study of 110 patients with lesions and/or mediastinal lymphadenopathy who underwent EBUS-TBNA and CRYO-EBUS in a single procedure. Our objective was to analyze the diagnostic profitability and safety of the technique. RESULTS: CRYO-EBUS obtained samples of 0.42cm on average compared to 0.14cm obtained by EBUS-TBNA. The overall diagnostic performance of the techniques was 60% for EBUS-TBNA and 94.5% for CRYO-EBUS. Furthermore, the latter was more sensitive for the diagnosis of both malignant and benign diseases. With a very high security profile. CONCLUSIONS: The CRYO-EBUS technique is cost-effective and safe, and is superior to EBUS-TBNA. Future studies may confirm our findings.

Citopatología y bioquímica del líquido pleural reumatoideo. A propósito de un caso / Cytopathology and biochemistry of the rheumatoid pleural fluid. Presentation of a case

Entre las distintas complicaciones pleuropulmonares de la artritis reumatoide, la pleuresía reumatoidea es la más comúnmente observada, sucediendo hasta en el 5% de los pacientes afectos de artritis reumatoide. La mayoría de estos, corresponden a un subtipo compuesto fundamentalmente por varones de edad media con altos títulos de factor reumatoide, nódulos reumatoideos y HLA-B8 y Dw3. Si bien el derrame pleural reumatoideo se presenta generalmente como un exudado inespecífico, se han descrito características de laboratorio, que aunque infrecuentes, nos pueden ser de gran utilidad, en el diagnóstico del mismo

Among the various pleuropulmonary complications of rheumatoid arthritis, rheumatoid pleurisy is the most commonly observed1, occurring in up to 5% of patients with rheumatoid arthritis. The majority of these correspond to a subtype composed mainly of middle-aged men with high rheumatoid factor titres, rheumatoid nodules, and presence of HLA-B8 and Dw3. Although rheumatoid pleural effusion generally presents as a non-specific exudate, laboratory characteristics have been described that, although infrequent, can be very useful in its diagnosis

Markers for the validation of reported dietary intake in adults with cystic fibrosis.

OBJECTIVE: To identify different markers in order to validate the assessment of dietary intake in adults with cystic fibrosis (CF). DESIGN: Cross-sectional survey. SETTING: Tertiary care. SUBJECTS: We assessed 37 adults with CF whose nutritional and respiratory condition was stable and 37 healthy adults, matched for age, sex, and nutritional status. INTERVENTIONS: A consecutive, 7-day, prospective dietary survey was given to all the participants. Anthropometric variables were measured and a fasting blood sample was drawn to measure the composition of the serum phospholipid fatty acids by gas chromatography. We also measured fecal fat and nitrogen at 72 hours and 24-hour urine nitrogen. RESULTS: The ratio of energy intake to basal metabolic rate expenditure was significantly greater in the patients (2.1+/-0.4) than the controls (1.79+/-0.4) and the percentage of patients with the ratio of energy intake to basal metabolic rate lower than 1.55 was 24% in the controls (n=9) vs 8% in the patients (n=3). Fecal nitrogen correlated significantly with total energy and the intake of carbohydrates, lipids, and proteins. In the patients, total dietary energy and fat and protein intake correlated positively with fecal fat. The protein and fat intake and fecal nitrogen and fat correlated significantly with urine nitrogen. In the controls, significant correlations were seen between different parameters of intake and the percentage of certain serum phospholipid fatty acids. These correlations in the patients were either absent or less marked. CONCLUSIONS: Use in persons with CF of the energy intake to basal metabolic rate ratio, measurement of fecal fat and nitrogen at 72 hours and of urine nitrogen may be useful to validate dietary surveys. The serum phospholipid fatty acid profile, however, may be less useful for this purpose in these patients.