ABSTRACT
Antecedentes: El cáncer de pulmón es la segunda causa de muerte después de las enfermedades cardiovasculares. El carcinoma broncogénico tiene una causa desencadenante fundamental, el tabaco. La fibrobroncoscopia es necesaria para el diagnóstico y la estadificación del cáncer pulmonar, lo que nos ayudará a estimar el pronóstico y decidir la actitud terapéutica a seguir. En este estudio analizamos la rentabilidad de las distintas técnicas de la broncoscopia en el diagnóstico del cáncer de pulmón. Métodos: En 181 pacientes a los que se realizó fibrobroncoscopia y que tuvieron un diagnóstico final de neoplasia, se analizó la comorbilidad previa, el hábito tabáquico, las diversas técnicas broncoscópicas a las que fueron sometidos y el estadio TNM en el que se hallaban en el momento del diagnóstico. También se valoró la rentabilidad de nuestras técnicas en relación con otros estudios de la bibliografía. Resultados: El 86,2% de los pacientes presentaba historia de tabaquismo; el 49,2%, diagnóstico de enfermedad pulmonar obstructiva crónica, y el 18,9%, otra neoplasia previa. La exploración endoscópica mostró lesión endobronquial en el 58% de los pacientes. El broncoaspirado fue positivo en el 53,6% de los procedimientos realizados; la biopsia bronquial, en el 81,9%; la biopsia transbronquial, en el 71,8% (en asociación con radioscopia positiva en el 81% y sin radioscopia, en el 61% de los casos), y la punción transbronquial, positiva en el 64,3% (con patólogo presente la rentabilidad diagnóstica ascendía al 72,7%). Conclusiones: La rentabilidad de las técnicas fibrobroncoscópicas que se utilizan en nuestro medio es similar a la de otros estudios importantes realizados hasta la fecha (AU)
Background: Lung cancer is the second leading cause of mortality after cardiovascular diseases. Bronchogenic carcinoma has a fundamental underlying cause, that is, tobacco. The bronchoscopy is required for lung cancer diagnosis and staging and will help us to estimate prognosis and determine the therapeutic approach to follow. In this study, the yield of the various techniques of bronchoscopy in the diagnosis of lung cancer has been analyzed. Methods: Previous comorbidity, smoking habit, the different bronchoscopic techniques the subject underwent and the patient's TNM stage at the time of diagnosis were analyzed in 181 patients who underwent bronchoscopy and whose final diagnosis was neoplasm. The performance of our techniques in relation to other studies in the literature was also evaluated. Results: A total of 86.2% of patients had a history of smoking, 49.2%, diagnosis of Chronic obstruction pulmonary disease and 18.9% had had another previous malignancy. The endoscopic examination showed endobronchial lesion in 58% of patients. BAS was positive in 53.6% of procedures performed, bronchial biopsy 81.9%, transbronchial biopsy in 71.8% (in association with positive fluoroscopy in 81% and without fluoroscopy in 61% of cases) and positive transbronchial needle aspiration in 64.3% (with pathologist present the diagnostic yield amounted to 72.7%). Conclusions: The yield of bronchoscopic techniques used in our environment is similar to that found in other major studies conducted to date (AU)
Subject(s)
Humans , Lung Neoplasms/diagnosis , Bronchoscopy , Carcinoma, Bronchogenic/diagnosis , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Presented here are the results of Legionella urinary antigen testing correlated with patient characteristics and severity of pneumonia (Fine score) in 295 patients diagnosed with Legionella pneumonia in connection with a large outbreak in Murcia, Spain. Overall, the sensitivity of the urinary antigen test was 47.7% (141/295). A statistically significant association was found between the clinical severity of pneumonia and test sensitivity; 85.7% for patients with severe pneumonia versus 37.9% for patients with mild pneumonia (risk ratio, 2.3). Variables significantly associated with test positivity in multivariate analysis were as follows: pre-existing pulmonary disease, body temperature >40 degrees C, leukocytosis and multilobar infiltrates. Patients with mild pneumonia may go undiagnosed if the urinary antigen test is used alone.
Subject(s)
Antigens, Bacterial/urine , Disease Outbreaks , Legionnaires' Disease/diagnosis , Legionnaires' Disease/physiopathology , Legionnaires' Disease/urine , Biomarkers/urine , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , Severity of Illness Index , Spain/epidemiologyABSTRACT
Se describe el proceso de gestión realizado en el Museo Anatómico Veterinario de la Universidad de Murcia, para conseguir una mejora en su estructuración. Se han aplicado técnicas museísticas adecuadas al contenido de la institución en consonancia con los medios materiales y humanos. Asimismo, la tarea realizada ha contribuido a un desarrollo de la función educativa, y a que el museo se muestre como instrumento de difusión cultural, ayudada por la incursión en el entorno web. Hay que señalar que todo el proceso está sostenido por las importantes colecciones que alberga el museo. (AU)
Subject(s)
Animals , History, Ancient , History, 19th Century , History, 20th Century , Museums , Organization and Administration , Anatomy, Veterinary/history , Anatomy, Veterinary/education , Information Systems , Planning , Organization and Administration/statistics & numerical data , Organization and Administration/standards , Education, Veterinary/history , Education, Veterinary/organization & administration , Surgery, Veterinary/education , Surgery, Veterinary/history , Veterinary Medicine/organization & administrationABSTRACT
BACKGROUND: Pneumonia by Rhodococcus equi is infrequent and is associated with patients with important immunosuppression. To date 66 cases of pneumonia by Rhodococcus equi in patients with HIV infection have been published. The diagnosis, problems in determining diagnosis and treatment are discussed. MATERIALS AND METHODS: Two new cases of pneumonia by Rhodococus equi in C3 stage patients with HIV infection are reported. Diagnosis was achieved by study of bronchoalveolar lavage samples with the Apy-Coryne method and gas chromatography. RESULTS: The two patients presented pneumonia, one of which was necrotizing pneumonia with localization in the upper left lung and in the lower right lung, respectively. The clinical manifestations were characterized by respiratory involvement of a subacute course with pleural involvement in both cases and hemoptisis in one. Prolonged, combined antibiotic treatment was administered with good response in both cases. One patient died at one year of diagnosis from consumptive syndrome while the other remains asymptomatic. CONCLUSIONS: Infection by Rhodococcus equi should be suspected in HIV patients with slow evolution pneumonia, especially in the pneumonia is necrotizing. Combined i.v. antibiotic treatment is recommended and followed from 3 to 5 months with an association including clarithromycin.
