Case Series Study of Invasive Pulmonary Aspergillosis.

Diagnosis of invasive pulmonary aspergillosis (IPA) is challenging. The objective of the study was to assess the value of microbiological tests to the diagnosis of IPA in the absence of non-specific radiological data. A retrospective study of 23 patients with suspicion of IPA and positivity of some microbiological diagnostic tests was performed. These tests included conventional microbiological culture, detection of Aspergillus galactomannan (GM) antigen and in some patients (1 â†’ 3)-ß-D-glucan (BDG) and Aspergillus fumigatus DNA using the LightCycler® SeptiFast test. In 10 patients with hematological malignancy, 6 cases were considered 'probable' and 4 'non-classifiable.' In 8 patients with chronic lung disease, 7 cases were classified as 'probable' and 1 as 'proven,' and in 5 patients with prolonged ICU stay (>7 days), there were 2 'proven' cases, 2 'non-classifiable' and 1 putative case. Microbiological culture was positive in 17 cases and 18 Aspergillus spp. were isolated (one mixed culture). A. fumigatus was the most frequent (44.4%) followed by A. tubingensis. The Aspergillus galactomannan (GM) antigen assay was positive in 21 cases (91.3%). The GM antigen and the (1 â†’ 3)-ß-D-glucan (BDG) assays were both performed in 12 cases (52.2%), being positive in 9. The SeptiFast test was performed in 7 patients, being positive in 4. In patients with non-classifiable pulmonary aspergillosis and one or more positive microbiological tests, radiological criteria may not be considered a limiting factor for the diagnosis of IPA.

The influence of the age in the risk of the prothrombin G20210A mutation for spontaneous venous thrombosis.

BACKGROUND AND OBJECTIVE: Factor V Leiden mutation (FVL), and the prothrombin G20210A mutation (PT G20210A) are polymorphisms with a weak risk factor for venous thromboembolic disease. The probability of spontaneous venous thrombosis in carriers of thrombophilic mutations (FVL and PT G20210A) was analyzed. PATIENTS AND METHOD: We studied 735 individuals (407 were healthy controls and 328 patients with venous thrombosis) with respect to FVL and PT G20210A, determined by polimerase chain reaction in liquid phase, real time. chi2 test and logistic regression analysis were used to evaluate the results. The dates were analyzed with the statistical program SPSS v. 14.0. RESULTS: The carrier patients of PT G20210A mutation whose age was over 40 years had a risk factor for spontaneous venous thrombosis which was 9.28 (odds ratio [OR]) (95% confidence interval [CI], 3.01-28.60; p < 0.0005) times greater than carriers of the PT G20210A mutation who were 40 year-old or younger. In our patients, being male meant a weak risk factor for venous spontaneous thrombosis (p = 0.021; OR = 1.64; 95% CI, 1.08-2.51) . CONCLUSIONS: Our results demonstrate a potentiation of the thrombotic risk by an increase of age in the carriers of the PT G20210A mutation.

Edad y mutación de la protrombina G20210A en los pacientes con trombosis venosa espontánea / The influence of the age in the risk of the prothrombin G20210A mutation for spontaneous venous thrombosis

Fundamento y objetivo: El factor V Leiden (FVL) y la mutación de la protrombina G20210A (PT G20210A) son unos polimorfismos que suponen un débil factor de riesgo para presentar enfermedad tromboembólica venosa. Hemos analizado la probabilidad de tener una trombosis venosa espontánea en los portadores de las mutaciones trombofílicas (FVL y PT G20210A). Pacientes y método: Hemos estudiado a 735 personas (407 controles sanos y 328 pacientes con trombosis venosa) con relación al FVL y a la PT G20210A, determinados por reacción en cadena de la polimerasa en fase líquida, en tiempo real. Para evaluar los resultados utilizamos el test de la x2 y el análisis de regresión logística. Los datos se analizaron con el programa estadístico SPSS versión 14.0. Resultados: Los pacientes con la mutación PT G20210A que eran mayores de 40 años tuvieron un factor de riesgo para trombosis venosa espontánea con una odds ratio (OR) 9,28 (intervalo de confianza (IC) del 95%, 3,01-28,60; p < 0,0005) veces mayor que los portadores de la mutación PT G20210A que tenían 40 años o menos. En nuestra serie el sexo masculino representó un factor de riesgo débil para trombosis venosa espontánea (p = 0,021; OR = 1,64; IC del 95%, 1,08-2,51). Conclusiones: Nuestros resultados demuestran una potenciación del riesgo trombótico por el incremento de la edad en los individuos portadores de la mutación PT G20210A

Background and objective: Factor V Leiden mutation (FVL), and the prothrombin G20210A mutation (PT G20210A) are polymorphisms with a weak risk factor for venous thromboembolic disease. The probability of spontaneous venous thrombosis in carriers of thrombophilic mutations (FVL and PT G20210A) was analyzed. Patients and method: We studied 735 individuals (407 were healthy controls and 328 patients with venous thrombosis) with respect to FVL and PT G20210A, determined by polimerase chain reaction in liquid phase, real time. x2 test and logistic regression analysis were used to evaluate the results. The dates were analyzed with the statistical program SPSS v. 14.0. Results: The carrier patients of PT G20210A mutation whose age was over 40 years had a risk factor for spontaneous venous thrombosis which was 9.28 (odds ratio [OR]) (95% confidence interval [CI], 3.01-28.60; p < 0.0005) times greater than carriers of the PT G20210A mutation who were 40 year-old or younger. In our patients, being male meant a weak risk factor for venous spontaneous thrombosis (p = 0.021; OR = 1.64; 95% CI, 1.08-2.51) . Conclusions: Our results demonstrate a potentiation of the thrombotic risk by an increase of age in the carriers of the PT G20210A mutation