The 8-Odorant Barcelona Olfactory Test (BOT-8): Validation of a New Test in the Spanish Population During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVE: Most smell tests are difficult to implement in daily clinical practice owing to their long duration. The aim of the present study was to develop and validate a short, easy-to-perform, and reusable smell test to be implemented during the COVID-19 pandemic. METHODS: The study population comprised 120 healthy adults and 195 patients with self-reported olfactory dysfunction (OD). The 8-Odorant Barcelona Olfactory Test (BOT-8) was used for detection, memory/recognition, and forced-choice identification. In addition, a rose threshold test was performed, and a visual analog scale was applied. The Smell Diskettes Olfaction Test (SDOT) was used for correlation in healthy volunteers, and the University of Pennsylvania Smell Identification Test (UPSIT) was used for patients with OD to establish cut-offs for anosmia and hyposmia. In order to take account of the COVID-19 pandemic, disposable cotton swabs with odorants were compared with the original test. RESULTS: In healthy persons, the mean (SD) BOT-8 score was 100% for detection, 94.5% (1.07) for memory/recognition, and 89.6% (0.86) for identification. In patients with OD, the equivalent values were 86% (32.8), 73.2% (37.9), and 77.1% (34.2), respectively. BOT-8 demonstrated good test-retest reliability, with agreement of 96.7% and a quadratic k of 0.84 (P<.001). A strong correlation was observed between BOT-8 and SDOT (r=0.67, P<.001) and UPSIT (r=0.86, P<.001). Agreement was excellent for disposable cotton swabs, with a k of 0.79 compared with the original test. The cut-off point for anosmia was ≤3 (area under the curve, 0.83; sensitivity, 0.673; specificity, 0.993). CONCLUSION: BOT-8 offers an efficient and fast method for assessment of smell threshold, detection, memory, and identification in daily clinical practice. Disposable cotton swabs with odorants proved to be useful and safe during the COVID-19 pandemic.

The 8-Odorant Barcelona Olfactory Test(BOT-8): Validation of a New Test in the Spanish Population During the COVID-19 Pandemic

Background: Most smell tests are difficult to implement in daily clinical practice owing to their long duration. The aim of the present study was to develop and validate a short, easy-to-perform, and reusable smell test to be implemented during the COVID-19 pandemic. Methods: The study population comprised 120 healthy adults and 195 patients with self-reported olfactory dysfunction (OD). The 8-Odorant Barcelona Olfactory Test (BOT-8) was used for detection, memory/recognition, and forced-choice identification. In addition, a rose threshold test was performed, and a visual analog scale was applied. The Smell Diskettes Olfaction Test (SDOT) was used for correlation in healthy volunteers, and the University of Pennsylvania Smell Identification Test (UPSIT) was used for patients with OD to establish cut-offs for anosmia and hyposmia. In order to take account of the COVID-19 pandemic, disposable cotton swabs with odorants were compared with the original test. Results: In healthy persons, the mean (SD) BOT-8 score was 100% for detection, 94.5% (1.07) for memory/recognition, and 89.6% (0.86) for identification. In patients with OD, the equivalent values were 86% (32.8), 73.2% (37.9), and 77.1% (34.2), respectively. BOT-8 demonstrated good test-retest reliability, with agreement of 96.7% and a quadratic k of 0.84 (P<.001). A strong correlation was observed between BOT-8 and SDOT (r=0.67, P<.001) and UPSIT (r=0.86, P<.001). Agreement was excellent for disposable cotton swabs, with a k of 0.79 compared with the original test. The cut-off point for anosmia was ≤3 (area under the curve, 0.83; sensitivity, 0.673; specificity, 0.993). Conclusions: BOT-8 offers an efficient and fast method for assessment of smell threshold, detection, memory, and identification in daily clinical practice. Disposable cotton swabs with odorants proved to be useful and safe during the COVID-19 pandemic (AU)

Introducción: Las olfatometrías son difíciles de implementar en la práctica clínica diaria por su larga duración. El objetivo del presente estudio fue desarrollar y validar una prueba simple, fácil y reutilizable para ser utilizada durante la pandemia de COVID-19. Métodos: Se incluyeron 120 voluntarios sanos ≥18 años y 195 pacientes con disfunción olfatoria (DO) autoreportada. Se utilizó el Barcelona Olfactory Test (BOT-8) con 8 odorantes para la detección, memoria/reconocimiento e identificación. Además, se hizo una prueba de umbral de rosa (alcohol feniletílico) de 6 diluciones, escala visual analógica (EVA). Se compararon los resultados con una prueba validada Smell Diskettes Olfaction Test (SDOT), para definir puntos de corte de hiposmia y anosmia se comparó en pacientes con DO con UPSITTM. Considerando la pandemia de COVID-19, se compararon hisopos de algodón desechables con los odorantes respecto a la prueba original. Resultados: BOT-8 se tarda entre 3 y 7 minutos en realizar. En población sana, la media de detección fue del 100%, memoria 94,5% (DE=1,07) e identificación 89,6% (DE=0,86). En pacientes con DO fue de 86% (DE=32,8), 73,2% (DE=37,9) y 77,1% (DE=34,2), respectivamente. BOT-8 demostró buena fiabilidad test-retest con 96,7% de concordancia observada y una kappa cuadrática de 0,84 (p<0,001). Presentó una fuerte correlación con SDOT (r=0,673, p <0,001) en población sana y con UPSITTM en pacientes con DO (r=0,86, p<0,001). Los hisopos de algodón desechables mostraron una excelente concordancia (kappa de 0,79) en comparación con la prueba original. El punto de corte para anosmia fue ≤ 3 (AUC=0,83, Se= 0,673, Sp=0,993) y de hiposmia ≤ 6 (AUC=0,451, Se= 0,088, Sp= 0,814). Conclusiones: BOT-8 ofrece un método eficiente y rápido para ser utilizado en la práctica clínica diaria para evaluar el sentido del olfato mediante la detección, memoria, identificación y umbral (AU)

Achalasia--An Autoimmune Inflammatory Disease: A Cross-Sectional Study.

Idiopathic achalasia is a disease of unknown etiology. The loss of myenteric plexus associated with inflammatory infiltrates and autoantibodies support the hypothesis of an autoimmune mechanism. Thirty-two patients diagnosed by high-resolution manometry with achalasia were included. Twenty-six specimens from lower esophageal sphincter muscle were compared with 5 esophagectomy biopsies (control). Immunohistochemical (biopsies) and flow cytometry (peripheral blood) analyses were performed. Circulating anti-myenteric autoantibodies were evaluated by indirect immunofluorescence. Herpes simplex virus-1 (HSV-1) infection was determined by in situ hybridization, RT-PCR, and immunohistochemistry. Histopathological analysis showed capillaritis (51%), plexitis (23%), nerve hypertrophy (16%), venulitis (7%), and fibrosis (3%). Achalasia tissue exhibited an increase in the expression of proteins involved in extracellular matrix turnover, apoptosis, proinflammatory and profibrogenic cytokines, and Tregs and Bregs versus controls (P < 0.001). Circulating Th22/Th17/Th2/Th1 percentage showed a significant increase versus healthy donors (P < 0.01). Type III achalasia patients exhibited the highest inflammatory response versus types I and II. Prevalence of both anti-myenteric antibodies and HSV-1 infection in achalasia patients was 100% versus 0% in controls. Our results suggest that achalasia is a disease with an important local and systemic inflammatory autoimmune component, associated with the presence of specific anti-myenteric autoantibodies, as well as HSV-1 infection.

Linfangioma mediastínico / Lymphangioma of the mediastinum

Resumen. Contamos el caso de un paciente con una imagen quística mediastínica y un nódulo pulmonar, que fue diagnosticado en primera instancia de quiste broncogénico y la intervención se aprovechó para realizar el diagnóstico histológico del nódulo, que descartó malignidad. El quiste resultó ser un linfangioma mediastínico. Hacemos un repaso a esta rara entidad (AU)

Abstract. We speak about the case of a patient with a cystic mediastinic imagen and a pulmonary nodule, which was diagnosed in the first instance of bronchogenic cyst and the surgical intervention took advantage to realize the histological diagnosis of the nodule, which rejected malignance. The cyst turned out to be a lymphangioma of the mediastinum. We do a revision to this rare entity (AU)

Satisfacción con neumología en un hospital nuevo / Satisfaction with pneumology in a new hospital

Objetivos. Nos preguntamos si nuestros pacientes estaban satisfechos con el servicio de neumología como primer objetivo. Además, quisimos ver como objetivos secundarios la manera en que interactuaban las diferentes variables que pensamos incidían en la satisfacción, y si alguna característica del paciente, como la edad y el nivel educativo, influían en ello. Material y métodos. Recogimos 50 cuestionarios en los que pedíamos la evaluación de los pacientes. Analizamos los datos de forma descriptiva. Además hallamos las correlaciones entre variables, y calculamos si existían diferencias significativas entre los valores según la edad y nivel cultural. Resultados. Las valoraciones obtenidas fueron altas con una nota media de la satisfacción global de 8,7, concentrándose el 75% de resultados por encima del 8. Además, todas las variables correlacionaban entre sí. Lo que más correlacionaba con la satisfacción global era el trato médico (r = 0,78) y las habilidades comunicativas de enfermería (r = 0,78). Además, existía una diferencia estadísticamente significativa en las valoraciones según los tramos de edad. Según el nivel educativo la significación sólo se halló con el trato médico (p = 0,021) y las habilidades comunicativas de enfermería (p = 0,046). Conclusiones. Nuestros pacientes están satisfechos con el servicio de neumología. Dados los resultados, podemos intuir que todas las variables influyen entre sí, y pensamos que incluso la ubicación, el horario y otras variables externas, influyen en la satisfacción global y pueden ser importantes en la consideración que se tenga de los profesionales (AU)

Objective. We wonder if our patients were satisfied with the pneumology service as first goal. In addition, we wanted to see, as secondary objectives, how different variables, we think affect the satisfaction, interacted with each others, and whether any patient characteristics such as age and educational level influenced. Materials and methods. We collected 50 questionnaires in which we asked the patients evaluation. We analyzed data from a descriptive way. Also found correlations between variables, and calculate whether there were significant differences between the values depending on age and cultural level. Results. We obtained high ratings. All the evaluated variables correlated with each other. The obtained valuations were high with an average note of the global satisfaction of 8,7, centering the 75% of results over 8. All the evaluated variables correlated with each other. What is most correlated with global satisfaction was the medical treatment (r = 0.78) and communicative skills of nursing (r = 0.78). In addition there was a statistically significant difference in valuations according to age groups. According to the educational level the significance only was found with the medical treatment (p = 0.021) and the communicative skills of nursing (p = 0.046) Conclusions: Our patients are satisfied with the Pneumology Service. Given the results, we intuit that all variables influence one another, and we believe that even the location, hours and other external variables, influencing the overall satisfaction and can be important in the evaluation of the professionals (AU)