RESUMEN
A 61-year-old man with a history of progressive dysphagia in the last three years and current COVID-19 diagnosis, presented to our emergency department with sudden dyspnea and loss of consciousness. Initial examination revealed a respiratory rate of 30 bpm with an oxygen saturation of 94% with room air. A venous blood gas exam showed acute hypercapnic respiratory failure; therefore, he was intubated and admitted to the medical intensive care unit.
Asunto(s)
COVID-19 , Acalasia del Esófago , Insuficiencia Respiratoria , Masculino , Humanos , Persona de Mediana Edad , COVID-19/complicaciones , Prueba de COVID-19 , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/diagnóstico , HospitalizaciónRESUMEN
The major function of platelets is to contribute to hemostasis. If an impairment in their production and/or function occurs, abnormal bleeding can develop. An 18-year-old male presented to our hospital after four episodes of hematemesis. His medical history was relevant for Glanzmann thrombasthenia diagnosed during early childhood. On initial examination, he appeared pale and with normal blood pressure. His complete blood count included a hemoglobin concentration of 11.0 g/dL, additional laboratory tests were within the normal ranges. The initial approach consisted of a high dose of proton pump inhibitors. Hours later, esophagogastroduodenoscopy revealed diffuse oozing bleeding from gastric mucosa with no other visible lesions such as peptic ulcers or varices.
Asunto(s)
Úlcera Péptica , Trombastenia , Masculino , Humanos , Preescolar , Adolescente , Trombastenia/complicaciones , Trombastenia/diagnóstico , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/diagnóstico , Hematemesis/etiología , Enfermedad AgudaRESUMEN
Acute cholangitis is a life-threatening infection, and several features are associated with a worse prognosis if prompt treatment is not started. Eighty-six subjects with acute cholangitis were included in a retrospective analysis. Patients had a median age of 53 years (range: 34.5 to 70 years) and 55 (64.0 %) were female. Of the entire cohort, 16 patients had a history of diabetes mellitus. Regarding acute cholangitis severity, 17 (19.8 %) cases were classified as severe, 41 (47.7 %) as moderate, and 28 (32.6 %) as mild.
Asunto(s)
Infecciones Bacterianas , Colangitis , Diabetes Mellitus Tipo 2 , Infecciones Intraabdominales , Enfermedad Aguda , Adulto , Anciano , Bacterias , Infecciones Bacterianas/complicaciones , Colangitis/etiología , Diabetes Mellitus Tipo 2/complicaciones , Femenino , Humanos , Infecciones Intraabdominales/complicaciones , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
Myasthenia gravis (MG) is an autoimmune disease that affects the postsynaptic membrane at the neuromuscular junction. In MG, antibodies bind to acetylcholine receptors inducing muscle weakness. The weakness typically increases with exercise and repetitive muscle use. Improvement of muscular weakness after rest and/or administration of anticholinesterase drugs (edrophonium) are characteristic of MG. We report a patient with unexplained dysphagia, dysphonia, and dysarthria, whose diagnosis was suggested by high-resolution esophageal motility and edrophonium infusion. We highlight the importance of dysphagia as presenting or dominant symptom in MG and review the esophageal motility findings in this rare, but treatable disorder.
RESUMEN
No disponible
Asunto(s)
Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Cetoacidosis Diabética/diagnóstico , Cetoacidosis Diabética/terapia , Servicios Médicos de Urgencia , Estudios de Cohortes , Complicaciones de la Diabetes , Hiperglucemia/complicaciones , Cetosis , Hipoglucemia , Estudios Retrospectivos , Análisis de Varianza , Bicarbonatos/sangre , Choque Séptico/complicacionesAsunto(s)
Cetoacidosis Diabética/sangre , Cetoacidosis Diabética/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. OBJECTIVE: We investigated the association between MPV and disease activity in adult patients with SLE. METHODS: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. RESULTS: MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. CONCLUSIONS: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.
Asunto(s)
Plaquetas/citología , Lupus Eritematoso Sistémico/sangre , Volúmen Plaquetario Medio , Adulto , Humanos , Activación Plaquetaria , Estudios Prospectivos , Estudios RetrospectivosRESUMEN
ABSTRACT Background: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. Objective: We investigated the association between MPV and disease activity in adult patients with SLE. Methods: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. Results: MPV was significantly decreased with respect to those of inactive patients (7.16 ± 1.39 vs. 8.16 ± 1.50, p = 0.005). At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r = 0.407, p = 0.001), which in turn is inversely associated with disease activity. Conclusions: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.
RESUMO Antecedentes: Existem poucos biomarcadores disponíveis para avaliar a atividade da doença no lúpus eritematoso sistêmico (LES). O volume plaquetário médio (VPM) foi recentemente estudado como um biomarcador inflamatório. Atualmente não está claro se o VPM também pode desempenhar um papel como um biomarcador da atividade da doença em pacientes adultos com LES. Objetivo: Investigou-se a associação entre o VPM e a atividade da doença em pacientes adultos com LES. Métodos: Neste estudo retrospectivo, compararam-se dois grupos de pacientes adultos divididos de acordo com a atividade da doença (36 por grupo). Os indivíduos foram pareados por idade e gênero. Resultados: O VPM esteve significativamente diminuído nos pacientes com doença ativa em comparação com os níveis em pacientes com doença inativa (7,16 ± 1,39 versus 8,16 ± 1,50, p = 0,005). Em um nível de corte de 8,32 fL, o VPM tem uma sensibilidade de 86% e uma especificidade de 41% para a detecção da atividade da doença. Encontrou-se uma correlação positiva modesta entre o VPM e a albumina (r = 0,407, p = 0,001), que por sua vez está inversamente associada à atividade da doença. Conclusões: Em resumo, o VPM está diminuído em pacientes adultos com lúpus ativo e positivamente correlacionado com a albumina, outro biomarcador da atividade da doença. São necessários estudos prospectivos para avaliar o valor prognóstico desse biomarcador.
Asunto(s)
Humanos , Adulto , Plaquetas/citología , Volúmen Plaquetario Medio , Lupus Eritematoso Sistémico/sangre , Activación Plaquetaria , Estudios Prospectivos , Estudios RetrospectivosRESUMEN
BACKGROUND: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. OBJECTIVE: We investigated the association between MPV and disease activity in adult patients with SLE. METHODS: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. RESULTS: MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. CONCLUSIONS: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.