Subject(s)
Pulmonary Embolism/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Tomography, X-Ray Computed , Ventilation-Perfusion Ratio , Adolescent , Femoral Vein/diagnostic imaging , Humans , Iliac Vein/diagnostic imaging , Lung/diagnostic imaging , Popliteal Vein/diagnostic imaging , Pulmonary Embolism/etiology , Ultrasonography , Venous Thromboembolism/complications , Venous Thromboembolism/diagnostic imagingABSTRACT
Objetivo: Valorar la eficacia de la radiografía simple de abdomen previa al enema opaco como sistema de evaluación de la limpieza intestinal.Material y métodos: Estudio observacional, transversal, unicéntrico, no controlado, abierto, fase IV, en 150 voluntarios a los que se les realizó una radiografía simple de abdomen y un enema opaco ambulatoriamente. En ambas exploraciones se valoró la limpieza intestinal como deseable o insuficiente (ausencia o presencia de restos fecales significativos que podrían dificultar la exclusión de lesiones polipoideas con diámetro 1 cm). Se determinó si la radiografía simple predijo correcta o incorrectamente la limpieza deseable y la insuficiente, utilizando como elemento de referencia la valoración en el enema opaco.Sobre la base de estos datos se calcularon la sensibilidad, la especificidad y los valores predictivos de la radiografía simple.Resultados: La radiografía simple de abdomen predijo el grado de limpieza intestinal con una sensibilidad de 96,22 por ciento, una especificidad de 20,45 por ciento, una tasa de falsos negativos de 3,77 por ciento, una tasa de falsos positivos de 79,54 por ciento, un valor predictivo negativo de 69,23 por ciento, un valor predictivo positivo de 74,45 por ciento, y un valor predictivo global (o exactitud predictiva) de 74 por ciento.Conclusiones: La radiografía simple de abdomen previa al enema opaco valora la limpieza intestinal de forma inexacta y poco efectiva (AU)
Subject(s)
Adult , Female , Male , Humans , Abdomen , Abdomen/pathology , Enema/classification , Enema/statistics & numerical data , Enema/methods , Polyps/complications , Polyps/diagnosis , Polyps , Sensitivity and Specificity , Clinical Protocols , Predictive Value of Tests , Cross-Sectional Studies , Homeopathic Clinical-Dynamic Prognosis , Signs and Symptoms , Radiation, Ionizing , Time FactorsABSTRACT
BACKGROUND: An assessment of the efficacy of the detection of volatile and non-volatile fatty acids that are produced by microorganisms aimed at the possible diagnosis of pleural empyema. METHODS: 106 pleural fluids were examined by gas-liquid chromatography in contrast to conventional aerobic and anaerobic cultures. The sample previously prepared (1 microliter) was injected in an Hewlett-Packard 5890 chromatograph, that was equipped with a fused silica capillary column and a flame ionization detector. RESULTS: Growth of aerobic or anaerobic microorganisms was obtained in 13 (12.3%) of the samples, and volatile or non-volatile fatty acids were detected in all of them (sensitivity = 1). No growth was obtained in the 93 samples, but volatile or non-volatile fatty acids were detected in 64 (68.8%) of them (specificity = 0.31). A positive predictive value of 0.17 and a negative predictive value of 1 were obtained. Growth of anaerobic microorganisms was obtained in 9 samples (8.5%) and volatile fatty acids were detected in all of them (sensitivity = 1). Anaerobic microorganisms did not grow in 97 samples, however volatile fatty acids were detected in 2 (2.1%) of them. A positive predictive value of 0.82 and a negative of 1 were obtained. CONCLUSIONS: Referring to pleural fluid samples, the detection of volatile and non-volatile fatty acids by gas-liquid chromatography is a highly sensitive method, that may be used to quickly reject negative samples in about 30 mins. Furthermore, when anaerobic microorganisms exist, the high specificity of gas-liquid chromatography will make it possible to confirm their presence in the sample, mainly if there is a clinical suspect of anaerobic infection. Thus, the utilization of this sensitive method may also change the therapeutic behaviour.
Subject(s)
Bacteria, Anaerobic/isolation & purification , Bacterial Infections/diagnosis , Chromatography, Gas , Empyema, Pleural/diagnosis , Fatty Acids, Volatile/analysis , Bacteria, Aerobic/isolation & purification , Bacteria, Anaerobic/chemistry , Bacterial Infections/microbiology , Empyema, Pleural/microbiology , Humans , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
A 19-years-old male was admitted for left bilobar pneumonia. All microbiologic studies in blood and in several samples obtained by bronchoscopy were negative. The patient worsened progressively despite antibiotherapy of a wide spectrum. A fine needle transparietal puncture was performed. The cultures of the sample were positive for Nocardia asteroides, a positive catalase germ. Immunologic studies initiated after this time showed negative tetrazolium nitroblue test, the results of which led to the diagnosis of chronic granulomatous disease. This disease is very infrequent and the polymorphonuclear leukocytes are genetically incapable of producing peroxides whose absence impedes lysis of the positive phagocytic catalase germs with which a histologic reaction is produced in the form of granulomas from which the name of the disease is derived.