La escala de Tal como test diagnóstico y el diagnóstico clínico como gold standard en el síndrome bronquial obstructivo del lactante / No disponible

Objetivo: evaluar la utilidad diagnóstica del índice de Tal aplicado por profesional sanitario no médico en el ámbito extrahospitalario como test diagnóstico y la “impresión clínica” como gold standard en el diagnóstico del síndrome bronquial obstructivo del lactante. Material y métodos: estudio observacional de test diagnóstico de casos consecutivos. Resultados: la escala de Tal presenta una sensibilidad del 77%, (IC 95%, 70-82%), una especificidad del 88,4% (IC 95%, 84-92%), un valor predictivo positivo del 87% (IC 95%, 81- 91%) y un valor predictivo negativo del 80% (IC 95% 74-85%). Conclusiones: en esta muestra el índice de Tal efectuado por profesionales sanitarios no médicos demuestra tener una buena correlación en el diagnóstico del lactante con obstrucción bronquial

Objective: to evaluate the Tal score like diagnostic test applied by non-medical professionals and “clinical impression” (clinical diagnosis) like Gold Standard in the diagnosis of infants with acute wheezing bronchitis. Material and methods: a diagnostic test study. Results: the sensitivity of Tal score was 77% (confidence interval 95% [CI] 70-82%) and the specificity 88.4% (CI 95% 84-92%). The positive predictive value was 87% (CI 95% 81- 91%) and the negative predictive value 80% (IC 95% 74-85%). Conclusions: in this study the Tal score as diagnostic test applied by non-medical professionals compared with “clinical impression” (clinical diagnosis) like Gold Standard show a good correlation in the diagnosis of infants with acute wheezing bronchitis

[Acute cholangitis caused by choledocholithiasis: traditional surgery or endoscopic biliary drainage]. / Colangitis aguda debida a coledocolitiasis: cirugía tradicional o drenaje biliar endoscópico?

BACKGROUND: Endoscopic drainage of the biliary tree for acute cholangitis is a therapeutic modality with a lower mortality and complication rates. AIM: To compare endoscopic drainage with surgical treatment in the emergency management of acute cholangitis. PATIENTS AND METHODS: Between 1995 and 1998, sixty five patients with acute cholangitis were subjected to an endoscopic drainage of the biliary tree. In the same period, 40 patients were treated with traditional surgical procedures. The evolution of both groups of patients were compared. RESULTS: Sixty two patients (95.4%) subjected to endoscopic treatment had a satisfactory evolution, compared with 23 (58%) of those operated (p < 0.001). Five operated patients and no individual subjected to endoscopic drainage died (p < 0.01). Mean postoperative hospital stay of operated patients was 15.5 +/- 19.6 days compared to 5.8 +/- 4.2 days in those subjected to endoscopic drainage (p < 0.001). Definitive resolution of biliary obstruction was achieved in 83% of patients subjected to endoscopic drainage or traditional surgery. CONCLUSIONS: Endoscopic drainage has a lower rate of complications and mortality than traditional surgery, in the treatment of acute cholangitis.