Resumen Objetivos A pesar de que las guías clínicas aún no recomiendan el uso de glucómetros en el lugar de asistencia al paciente (POCT) con fines diagnósticos, la prestación analítica de estos ...dispositivos ha mejorado significativamente. En este contexto, evaluamos la precisión analítica y la concordancia diagnóstica de los glucómetros POCT durante la prueba de tolerancia oral a la glucosa (PTOG), para el diagnóstico de prediabetes y diabetes en un estudio comparativo. Métodos En este estudio prospectivo observacional, fueron reclutados pacientes pediátricos con indicación de PTOG, derivados a la Unidad de Diabetes entre diciembre de 2020 y septiembre de 2021. Durante la prueba funcional, se midió la glucemia en sangre venosa con dos glucómetros POCT (uno con conectividad y otro sin conectividad) y en el laboratorio central. Resultados El estudio incluyó 98 pacientes. Observamos una elevada correlación entre los glucómetros y el laboratorio (coeficiente de Pearson=0,912 para el glucómetro sin conectividad y 0,950 para el glucómetro con conectividad). El tiempo de respuesta de la PTOG disminuyó significativamente (mediana glucómetro con conectividad: 2,02 horas rango intercuartílico: 2,00–2,07, laboratorio: 11,63 horas 6,09–25,80), con un coste global similar. La concordancia diagnóstica entre el glucómetro con conectividad y el laboratorio fue del 71,1 % (IC 95 % 61,5–79,2). La decisión clínica hubiera sido la misma en el 92,8 % de los casos, aunque no se habría indicado tratamiento en cuatro pacientes (4,1 %). Conclusiones Durante las PTOG, los glucómetros POCT muestran una elevada correlación y una concordancia diagnóstica aceptable con el laboratorio, ofreciendo además el glucómetro con conectividad una reducción significativa del tiempo de respuesta, sin incrementar los costes. No obstante, dado que en algún caso podría haber un impacto clínico grave, los glucómetros POCT aún no deben ser utilizados con fines diagnósticos.
ABSTRACT Introduction: Chronic recurrent multifocal osteomyelitis (CRMO), also called chronic non-bacterial osteomyelitis, is an autoinflammatory disease characterized by bone involvement, recurrent ...flare-ups, and the lack of microbiological isolation. It is a diagnosis of exclu sion, and the fundamental basis of treatment is non-steroidal anti-inflammatory drugs. The objective of the study is to describe our experience as a result of three girls diagnosed with CRMO, highlighting the clinical presentation, the findings in the complementary tests, the treatment, and the evolution of the disease. Patients and methods: Retrospective chart review of children with CRMO in the last 5 years, being followed-up in a pediatric rheumatology clinic in a tertiary center. Results: The cases are presented of 3 patients diagnosed with CRMO, all of them young girls, with a mean age of 11 years, who consulted due to pain and functional impotence. It was in single location in two cases, and the other with several sources of pain, at cervi cal and lumbar level, associated with weakness of the upper and lower limbs. Two of the cases received antibiotic treatment. One girl responded to treatment with anti-inflammatory drugs and another required combining corticosteroids. The remaining case, in addition to anti-inflammatory drugs and corticosteroids, required intravenous pamidronate. Conclusions: With this study, and despite the small sample size, the aim was to highlight the importance of this, in many cases unknown and underdiagnosed, pathology, and to stress the importance of establishing a diagnostic and therapeutic protocol for the correct approach to this disease.
La osteomielitis crónica multifocal recurrente (OCMR), también conocida como osteomielitis crónica no bacteriana, es una enfermedad autoinflamatoria caracterizada por afectación ósea, de curso en ...brotes y en ausencia de aislamiento microbiológico. El diagnóstico es de exclusión y el pilar fundamental del tratamiento son los antiinflamatorios no esteroideos (AINES). El objetivo del estudio es describir nuestra experiencia de tres niñas diagnosticadas de OCMR, destacando la presentación clínica, los hallazgos en las pruebas complementarias, el tratamiento y la evolución de la enfermedad.
Revisión retrospectiva de historias clínicas de niños diagnosticados de OCMR en los últimos cinco años, en seguimiento en consulta de reumatología pediátrica de un hospital terciario.
Presentamos tres pacientes diagnosticadas de OCMR, todas ellas mujeres adolescentes, con media de edad de 11 años. Consultaron por dolor e impotencia funcional, dos en una única localización y la otra por varios focos de dolor, a nivel cervical y lumbar, asociando debilidad de miembros superiores e inferiores. Con respecto al tratamiento, dos recibieron tratamiento antibiótico. Una niña respondió a antiinflamatorios; otra precisó asociar corticoides, y la restante, además de antiinflamatorios y corticoides, necesitó pamidronato intravenoso.
Con este estudio y a pesar del pequeño tamaño muestral, se pretende resaltar la importancia de esta patología, en muchos casos desconocida e infradiagnosticada, e insistir en la importancia de establecer un protocolo diagnóstico y terapéutico para su correcto abordaje.
Chronic recurrent multifocal osteomyelitis (CRMO), also called chronic non-bacterial osteomyelitis, is an autoinflammatory disease characterised by bone involvement, recurrent flare-ups, and the lack of microbiological isolation. It is a diagnosis of exclusion, and the fundamental basis of treatment is non-steroidal anti-inflammatory drugs. The objective of the study is to describe our experience as a result of three girls diagnosed with CRMO, highlighting the clinical presentation, the findings in the complementary tests, the treatment, and the evolution of the disease.
Retrospective chart review of children with CRMO in the last 5 years, being followed-up in a paediatric rheumatology clinic in a tertiary centre.
The cases are presented of 3 patients diagnosed with CRMO, all of them young girls, with a mean age of 11 years, who consulted due to pain and functional impotence. It was in single location in two cases, and the other with several sources of pain, at cervical and lumbar level, associated with weakness of the upper and lower limbs. Two of the cases received antibiotic treatment. One girl responded to treatment with anti-inflammatory drugs and another required combining corticosteroids. The remaining case, in addition to anti-inflammatory drugs and corticosteroids, required intravenous pamidronate.
With this study, and despite the small sample size, the aim was to highlight the importance of this, in many cases unknown and underdiagnosed, pathology, and to stress the importance of establishing a diagnostic and therapeutic protocol for the correct approach to this disease.
RESUMEN Introducción: Es necesario conocer con qué fuentes, con qué sustancias y en qué medida se contamina una región. Entre las causas principales de la contaminación del aire está la combustión. ...No es suficiente conocer las emisiones de un foco, es preciso determinar la inmisión. Objetivo: Determinar una alternativa tecnológica para reducir el impacto negativo del dióxido de azufre y el monóxido de nitrógeno en la textilera “Desembarco del Granma”. Materiales y Métodos: Se utilizó el equipo GASBOARD-3800P, para medir SO2, NO, CO, CO2 y O2. Se realizaron modelos de dispersión. Resultados y Discusión: Se determinó que el SO2 alcanza valores máximos de 200 μg/m3 y el NOx de 70 μg/m3 para una categoría de calidad del aire de mala. El SO2 es el de mayor incidencia debido al flujo de contaminantes emitido y al por ciento de azufre que tiene el fuel oíl. Conclusiones: Los valores medidos experimentalmente de las emisiones de NOx en el generador de vapor y en el calentador de aceite superan lo permitido para instalaciones existentes. Las inmisiones de SO2 y NOx sobrepasan los valores admitidos. Para reducir el impacto de los gases SO2 y NOx se propone agregar un sistema de control automático de relación aire/combustible al generador de vapor y al calentador de aceite y elevar la altura de la chimenea tres metros en este último. La inversión requerida para mejorar la calidad del aire de la textilera y sus alrededores es $ 7759,31.
Alterations in dopaminergic transmission are associated with neurological disorders, such as depression, autism, and Parkinson's disease. Exposure of rats to ambient fine (FP) or ultrafine (UFP) ...particles induces oxidative and inflammatory responses in the striatum, a neuronal nucleus with dense dopaminergic innervation and critically involved in the control of motor activity.
Objectives: We used an ex vivo system to evaluate the effect of in vivo inhalation exposure to FP and UFP on motor activity and dopaminergic transmission.
Materials and Methods: Male adult Wistar rats were exposed to FP, UFP, or filtered air for 8 weeks (subchronic exposure; 5 h/day, 5 days/week) in a particle concentrator. Motor activity was evaluated using the open-field test. Uptake and release of
3
H-dopamine were assessed in striatal synaptosomes, and dopamine D
2
receptor (D
2
R) affinity for dopamine was evaluated by the displacement of
3
H-spiperone binding to striatal membranes.
Results: Exposure to FP or UFP significantly reduced spontaneous motor activity (ambulatory distance: FP −25%, UFP −32%; ambulatory time: FP −24%, UFP −22%; ambulatory episodes: FP −22%, UFP −30%), decreased
3
H-dopamine uptake (FP −18%, UFP −24%), and increased, although not significantly,
3
H-dopamine release (113.3 ± 16.3 and 138.6 ± 17.3%). Neither FP nor UFP exposure affected D
2
R density or affinity for dopamine.
Conclusions: These results indicate that exposure to ambient particulate matter reduces locomotion in rats, which could be related to altered striatal dopaminergic transmission: UFP was more potent than FP. Our results contribute to the evidence linking environmental factors to changes in brain function that could turn into neurological and psychiatric disorders.
HIGHLIGHTS
Young adult rats were exposed to fine (FP) or ultrafine (UFP) particles for 40 days.
Exposure to FP or UFP reduced motor activity.
Exposure to FP or UFP reduced dopamine uptake by striatal synaptosomes.
Neither D
2
R density or affinity for dopamine was affected by FP or UFP.
UFP was more potent than FP to exert the effects reported.
Abstract
Objectives
Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can ...cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe.
Methods
We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000–2019) and extracted demographic, clinical and radiological information on each case, if available.
Results
Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases.
Conclusions
Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.
Identification of the causative pathogen is required to optimize the effective therapy in infective endocarditis (IE). The aim of this study was to assess a 16S rDNA PCR to identify bacteria from ...heart valve tissues and to evaluate its usefulness as a complement to blood and removed valves cultures. A total of 266 patients diagnosed with IE from January 2015 to December 2019 were evaluated. Results between 16S rDNA PCR from heart valve tissues were compared with microbiological cultures. Blood cultures were positive in 83.5% of patients diagnosed with IE, while 39.6% and 71.8% of the evaluated heart valve samples were positive by culture and 16S rDNA PCR, respectively. For 32 (12%) patients, 16S rDNA tissue PCR provided valuable information supporting the results of blood cultures in the case of bacteria characteristic from the skin microbiota. Additionally, a microorganism was identified by using 16S rDNA PCR in 36% of blood culture-negative cases. The present study reveals that molecular diagnosis using 16S rDNA tissue PCR provides complementary information for the diagnosis of IE, and it should be recommended in surgical endocarditis, especially when blood cultures are negative.
Abstract Objectives Despite clinical guidelines do not recommend the use of point-of-care testing (POCT) glucometers for diagnostic purposes yet, the analytical performance is continuously improving. ...Thus, we evaluate the technical accuracy and clinical concordance of POCT glucometers during an oral glucose tolerance test (OGTT) in children for prediabetes and diabetes diagnosis in a comparison study. Methods Pediatric patients with an OGTT indication who attended the Diabetes Unit between December 2020 and September 2021 were recruited for this prospective observational study. During the functional test, glycaemia was immediately measured in venous blood using two glucometers (unconnected and connected) and sent to the central laboratory. Results The study included 98 patients. There was a high correlation between the glucometers and the central laboratory (Pearson correlation coefficient=0.912 and 0.950, for unconnected and connected glucometer, respectively). The median OGTT turnaround time (TAT) was significantly decreased (connected glucometer: 2.02 h interquartile range, 2.00–2.07, central laboratory: 11.63 h 6.09–25.80), with similar overall cost. The diagnostic concordance between connected glucometer and the central laboratory was 71.1 % (95 % confidence interval (CI) 61.5–79.2). The clinical decision would have been the same in the 92.8 % of the cases, but treatment would have not been indicated in 4 patients (4.1 %). Conclusions POCT glucometers have demonstrated a high correlation and an acceptable diagnostic concordance with the central laboratory during an OGTT, as well the connected device offers a significant decrease in TAT, without increasing costs. However, as severe clinical impact could happen, POCT glucometers may not be used for diagnosis yet.
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