RESUMEN
Microbiological diagnosis of osteoarticular infections (OI) is crucial for a successful treatment. A prospective multicenter study including 262 synovial fluids with suspicion of acute OI was performed between July 2021 and October of 2022. BioFire Joint Infection Panel multiplex-PCR test was performed and results were compared with conventional cultures of synovial fluid specimens. In total, 136 microorganisms were detected, and fourteen samples were positive for more than one microorganism. In monomicrobial infections (n = 87) agreement with culture was 69%. In 26 samples, the multiplex PCR yield an additional positive result when culture result was negative. It helped in the detection of fastidious microorganisms as K. kingae and N. gonorrhoeae. This multiplex PCR has proven to be a useful technique that can be used for patients with high suspicion of acute OI in a rapid and automated manner.
Asunto(s)
Artritis Infecciosa , Humanos , Estudios Prospectivos , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/microbiología , Reacción en Cadena de la Polimerasa Multiplex/métodosRESUMEN
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a clinical entity with specific features that impacts significantly on patient quality of life (QoL). CRSwNP is often associated with asthma and is difficult to control and manage despite pharmacological and/or surgical treatment. Omalizumab, a monoclonal anti-IgE antibody, has emerged as a putative therapeutic option. OBJECTIVE: To evaluate the effects of omalizumab on nasal polyp (NP) size and QoL assessed by Sino-Nasal Outcome Test-22 (SNOT-22) in patients with recalcitrant CRSwNP and mild asthma. METHODS: A multicenter retrospective analysis of patient data from the Community of Valencia (Spain) was performed. Adult patients with recalcitrant CRSwNP and comorbid mild asthma receiving compassionate use of omalizumab were included. NP size measured by total nasal endoscopic polyp score (TPS) and QoL evaluated through the SNOT-22 questionnaire were assessed at baseline and monthly over 12 months. An ordinal regression model was built to analyze the results. RESULTS: A total of 23 CRSwNP patients with a mean age (± SD) of 54.78 ± 9.46 years were included. Nineteen suffered from aspirin-exacerbated respiratory disease (AERD). In all patients, a significant and sustained reduction in TPS was observed over time, accompanied by improvements in QoL reflected in lower SNOT-22 scores. In the ordinal regression model, time but not total IgE, age or tissue eosinophilia impacted on NP size and SNOT-22 outcomes. Additionally, improvements in QoL were not explained by reductions in the size of polyps. CONCLUSION: Omalizumab was effective for the treatment of patients with recalcitrant CRSwNP and mild asthma, even when AERD was present, by reducing NP size and improving QoL; treatment time was a key factor. SNOT-22 improvements were not explained by decreases in TPS, indicating that omalizumab may be effective in all patients, regardless of polyp size.
Asunto(s)
Asma , Pólipos Nasales , Rinitis , Adulto , Asma/complicaciones , Asma/tratamiento farmacológico , Asma/epidemiología , Enfermedad Crónica , Humanos , Pólipos Nasales/tratamiento farmacológico , Omalizumab/uso terapéutico , Calidad de Vida , Estudios Retrospectivos , Rinitis/tratamiento farmacológico , Resultado del TratamientoRESUMEN
OBJECTIVE: To relate symptoms of dysphagia to Forestier-Rotes Querol disease or diffuse idiopathic skeletal hyperostosis (DISH), a disorder due to ossification in the anterior longitudinal ligament and calcifications in other entheses. PATIENTS AND METHODS: Review of clinical and radiological findings in 455 outpatients attended at our Centre with dysphagia, for 5years, referred from dental, trauma, neurological or primary health care. A diagnosis of DISH was established using Resnick's criteria. RESULTS: We detected 51 cases with dysphagia consistent with DISH diagnostic criteria - 11.2% of subjects suffering this symptom- out of 32544 outpatients attended. An incidence of 7:100000 inhabitants per year was observed. Two cases showed significant improvement after removing the new bone in the spine. CONCLUSIONS: DISH is an ankylosing ossification between the joints, frequently systemic but showing no clinical symptoms. When symptoms manifest, neck movements and upper airways are involved, mainly dysphagia. A few cases need surgery to relieve the calcification processes.
Asunto(s)
Trastornos de Deglución/epidemiología , Hiperostosis Esquelética Difusa Idiopática/epidemiología , Anciano , Anciano de 80 o más Años , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/cirugía , Femenino , Humanos , Hiperostosis Esquelética Difusa Idiopática/diagnóstico por imagen , Hiperostosis Esquelética Difusa Idiopática/cirugía , Incidencia , Masculino , Persona de Mediana Edad , Radiografía , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , España/epidemiologíaRESUMEN
This case report describes a patient in their 40s with a history of bronchiectasis, azoospermia, and epididymal cysts who presented with bilateral nasal obstruction.
Asunto(s)
Senos Paranasales , Tomografía Computarizada por Rayos X , Cornetes Nasales , Humanos , Cornetes Nasales/anomalías , Cornetes Nasales/diagnóstico por imagen , Cornetes Nasales/patología , Senos Paranasales/anomalías , Senos Paranasales/diagnóstico por imagen , Masculino , FemeninoRESUMEN
OBJETIVO: Relacionar la clínica de disfagia con la enfermedad de Forestier-Rotes-Querol o hiperostosis esquelética difusa idiopática (HEDI), desorden por osificación del ligamento cervical anterior común y calcificaciones en otras articulaciones. PACIENTES Y MÉTODOS: Revisión del historial clínico-radiológico de 455 pacientes que en 5 años consultaron en nuestro centro por disfagia, remitidos desde Atención Primaria o diferentes especialidades. El diagnóstico de HEDI se estableció en función de los criterios descritos por Resnick. RESULTADOS: Sobre un volumen total de 32.544 pacientes atendidos, el 1,4% consultó por disfagia alta. En 51 casos con esta sintomatología -el 11,2% de los sujeto- pudieron verificarse datos congruentes con los hallazgos radiológicos diagnósticos de HEDI. La incidencia observada fue de 7:100.000 habitantes-año. Dos casos con disfagia severa mejoraron con la retirada del hueso cervical neoformado. CONCLUSIONES: La HEDI supone una osificación interarticular anquilosante habitualmente sistémica pero asintomática. Al manifestarse, distorsiona principalmente las funciones de cuello y vías altas, generando sobre todo disfagia. Unos pocos casos requieren cirugía liberadora de estas calcificaciones
OBJECTIVE: To relate symptoms of dysphagia to Forestier-Rotes Querol disease or diffuse idiopathic skeletal hyperostosis (DISH), a disorder due to ossification in the anterior longitudinal ligament and calcifications in other entheses. PATIENTS AND METHODS: Review of clinical and radiological findings in 455 outpatients attended at our Centre with dysphagia, for 5 years, referred from dental, trauma, neurological or primary health care. A diagnosis of DISH was established using Resnick's criteria. RESULTS: We detected 51 cases with dysphagia consistent with DISH diagnostic criteria - 11.2% of subjects suffering this symptom- out of 32544 outpatients attended. An incidence of 7:100000 inhabitants per year was observed. Two cases showed significant improvement after removing the new bone in the spine. CONCLUSIONS: DISH is an ankylosing ossification between the joints, frequently systemic but showing no clinical symptoms. When symptoms manifest, neck movements and upper airways are involved, mainly dysphagia. A few cases need surgery to relieve the calcification processes