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Viqueira M, Alcaraz B, Cobos N, Jimeno A, del Amor M, Jiménez R, Ortín A, Giner J, Escribano P, Rojano R. Rendimiento de los hemocultivos en el diagnóstico microbiológico de la endocarditis infecciosa en el área sanitaria de cartagena. Cirugía Cardiovascular 2019. [DOI: 10.1016/j.circv.2019.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Jimeno A, Viqueira M, Alcaraz B, Ortín A, Giner J, Gutiérrez R, Rojano R, Jiménez R, Del Amor M, Cobos N. 9. Epidemiología de la endocarditis infecciosa con diagnóstico microbiológico confirmado en el Área II de Murcia-Cartagena. Cirugía Cardiovascular 2017. [DOI: 10.1016/j.circv.2016.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Marcos M, Soriano A, Inurrieta A, Martinez JA, Romero A, Cobos N, Hernandez C, Almela M, Marco F, Mensa J. Changing epidemiology of central venous catheter-related bloodstream infections: increasing prevalence of Gram-negative pathogens. J Antimicrob Chemother 2011; 66:2119-2125. [DOI: 10.1093/jac/dkr231] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Gartner S, Casals T, Marin J, Seculi J, Asensio O, Hernandez J, Prats R, Cobos N. Neonatal screening for cystic fibrosis in Cataluña, Spain: 10 years of experience. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pérez-Yarza EG, Badía X, Badiola C, Cobos N, Garde J, Ibero M, Villa JR. Development and validation of a questionnaire to assess asthma control in pediatrics. Pediatr Pulmonol 2009; 44:54-63. [PMID: 19061230 DOI: 10.1002/ppul.20929] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To develop and validate a questionnaire to assess asthma control in children (CAN). DESIGN Two versions of the CAN (for carers and children) were developed. Both versions were validated in an observational, prospective, multicenter study performed in 38 hospital outpatient clinics throughout Spain. Four hundred fifteen patients and their carers agreed to participate. Of these, 414 patients under 14 years old with frequent episodic or persistent (moderate to severe) asthma completed the questionnaire on 3 occasions (baseline, week 2, and week 12). For patients aged 2-8 the questionnaire was only completed by the carers, but for patients aged 9-14 the questionnaire was completed by the carers and the children. Clinician ratings of asthma control were used as a gold standard to assess the sensitivity, specificity, PPV and NPV of the new measure. RESULTS Evaluable responses were obtained from 215 carers for children aged 2-8 years and 199 children aged 9-14 years, and their parents. Using a questionnaire total score cut-off of 8 the patient version had a sensitivity of 76.3% and a specificity of 62.9%. For carer version these values were 73% and 69.7%, respectively. A cut point of 8 was selected to maximize the screening accuracy of the CAN questionnaire. Effect sizes in patients with clinician-rated improvements in asthma control were 0.33 and 0.57 for the carer and child versions, respectively. CONCLUSIONS The screening accuracy and validity of the CAN questionnaire make it suitable for use in research and clinical practice. The sensitivity and specificity were close to 70%, which is acceptable for the study objective: obtain a tool to measure the level of asthma control.
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Affiliation(s)
- E G Pérez-Yarza
- Department of Pediatrics, Division of Respiratory Medicine, Hospital Donostia, San Sebastián, Spain
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Perpiñá Tordera M, Luis Viejo J, Sanchis J, Badia X, Cobos N, Picado C, Sobradillo V, González del Río JM, Duce F, Muñoz Cabrera L. Satisfacción y preferencia del paciente asmático por los dispositivos de inhalación. Aplicación del FSI-10. Arch Bronconeumol 2008. [DOI: 10.1016/s0300-2896(08)70447-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Perpiñá Tordera M, Viejo JL, Sanchis J, Badia X, Cobos N, Picado C, Sobradillo V, Martínez González del Río J, Duce F, Muñoz Cabrera L. [Assessment of patient satisfaction and preferences with inhalers in asthma with the FSI-10 Questionnaire]. Arch Bronconeumol 2008; 44:346-352. [PMID: 18727886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Lack of adherence to inhaled corticosteroid therapy is common in patients with asthma, and it has been suggested that allowing patients to choose their own inhalers would resolve this problem. The FSI-10 (Feeling of Satisfaction with Inhaler) is a self-completed questionnaire to assess patient opinions regarding ease or difficulty of use, portability, and usability of devices for delivery of inhaled corticosteroids. The aim of this study was to define the measurement properties of the FSI-10 questionnaire and to use this inventory to compare satisfaction and preferences of patients with asthma regarding 3 different devices for delivery of inhaled corticosteroids: Turbuhaler, Accuhaler, and Novolizer. PATIENTS AND METHODS We performed a multicenter, prospective, observational study in 112 stable asthmatic patients (64 women; mean [SD] age, 37 [22] years) treated on a regular basis with inhaled corticosteroids. The use of the devices was explained to the patients and the order in which they should be used in each case was randomly assigned. The devices were used for 7-day periods and at the end of each the FSI-10 questionnaire was completed for the device used. Once the protocol was completed, patients stated their preference for the different devices used. RESULTS The FSI-10 was easily understood and rapidly completed, and it exhibited acceptable measurement properties. Factor analysis showed that the measure was unidimensional. Although acceptance of all 3 devices assessed was reasonable, the FSI-10 questionnaire detected significant differences between them: Turbuhaler and Novolizer scored higher than Accuhaler on a number of questions. This preference is partly explained by Turbuhaler having been the device that was commonly used by the patients prior to the study. However, the highest scoring and most often preferred inhaler in patients under 16 years of age was the Novolizer, even though the Turbuhaler had also usually been used by those patients prior to the study. CONCLUSIONS The FSI-10 is a useful instrument for assessing the degree of satisfaction of asthmatic patients regarding available inhalation devices. It is easy to understand and complete, and able to identify differences in patient satisfaction with the different inhalers.
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Perpiñá Tordera M, Viejo JL, Sanchis J, Badia X, Cobos N, Picado C, Sobradillo V, Martínez González del Río J, Duce F, Muñoz Cabrera L. Satisfacción y preferencia del paciente asmático por los dispositivos de inhalación. Aplicación del FSI-10. Arch Bronconeumol 2008. [DOI: 10.1157/13124581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Pérez-Yarza EG, Cobos N, de la Cruz JJ. [Variability in peak expiratory flow does not classify asthma according to severity]. Arch Bronconeumol 2008; 43:535-41. [PMID: 17939907 DOI: 10.1016/s1579-2129(07)60124-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether variability in peak expiratory flow (PEF) could be used to classify the level of severity of asthma in children. PATIENTS AND METHODS We studied 387 boys and girls diagnosed with asthma and classified severity according to clinical criteria (Spanish Society of Pediatric Pneumology). PEF variability was determined using a portable mini-Wright peak flow meter (Clement Clarke International, London, UK; range, 50 L/min-800 L/min) over a 14-day period, with no changes in normal treatment. The following indices were used to calculate PEF variability: 1) difference between morning PEF and nighttime PEF, expressed as a percentage of the mean value of the PEF measurements taken on that day; 2) minimum PEF rate during a week, expressed as a percentage of the highest value recorded during that week; 3) difference between the highest and the lowest PEF values, expressed as a percentage of the highest value; and 4) the 10th percentile of PEF values recorded during a week, expressed as a percentage of the highest value recorded during that week. We assessed agreement between clinical classification and PEF variability using the weighted kappa coefficient. We also analyzed the sensitivity and specificity of PEF variability indices for episodic and persistent asthma. RESULTS The analysis of levels of agreement between clinical classification of asthma and formulas 1, 2, 3, and 4 gave quadratic weighted kappa coefficients of 0.494, 0, 0.488, and 0.346, respectively. The results were similar when patients were grouped and analyzed by type of asthma (episodic or persistent asthma). CONCLUSIONS The monitoring of PEF variability, a recommendation common in national and international guidelines on the management of asthma in children, is not valid for classifying severity of asthma in children.
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Affiliation(s)
- Eduardo G Pérez-Yarza
- Unidad de Neumología, Servicio de Pediatría, Hospital Donostia, San Sebastián, Guipúzcoa, España.
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Tordera MP, Viejo JL, Sanchos J, Badia X, Cobos N, Picado C, Sobradillo V, del Río JMG, Duce F, Cabrera LM. Assessment of Patient Satisfaction and Preferences With Inhalers in Asthma With the FSI-10 Questionnaire. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1579-2129(08)60060-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pérez-Yarza EG, Cobos N, de la Cruz JJ. La variabilidad del flujo espiratorio máximo no clasifica el asma por niveles de gravedad. Arch Bronconeumol 2007. [DOI: 10.1157/13110878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ibero M, Badia X, Cobos N, Garde J, Pérez-Yarza E, Villa J, Badiola C. Development and Validation of 'Asthma Control in Paediatrics' Questionnaire (CAN). J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
BACKGROUND Since abnormalities in prostanoid metabolism occur in the lower airway of patients with cystic fibrosis (CF), it is likely that they could also be detected in the nose. METHODS The degree of mRNA and protein expression of cyclo-oxygenase (COX) enzymes 1 (COX-1) and 2 (COX-2) was examined using quantitative reverse competitive polymerase chain reaction (RT-PCR) and Western blot analysis in the nasal polyps from 10 patients with CF, nasal polyps from 10 non-CF patients and 11 nasal mucosa specimens. The results are presented as 10(6) cDNA molecules/mug total RNA and the densitometric ratio between protein and beta-actin. RESULTS COX-1 mRNA levels were significantly higher in CF nasal polyps (median 2.34, 25-75th percentiles 1.6-3.2) than in the nasal mucosa (0.78, 0.11-1.21), while there was no difference with non-CF nasal polyps (1.11, 0.80-3.15). COX-1 protein levels were significantly higher in CF nasal polyps (3.63, 2.71-4.27) than in nasal mucosa (1.55, 0.66-2.33) and non-CF nasal polyps (2.19, 1.72-3.68). COX-2 mRNA was significantly higher in CF nasal polyps (3.34, 2.42-7.05) than in nasal mucosa (1.69, 0.19-3.50). No differences were found in COX-2 mRNA expression between CF and non-CF polyps (1.38, 0.12-6.07). COX-2 protein levels were also significantly higher in CF nasal polyps (0.23, 0.04-0.34) than in non-CF nasal polyps (0.011, 0.009-0.016) or nasal mucosa (0.014, 0.014-0.016). CONCLUSIONS Upregulation in the expression of COX-1 and COX-2 could explain the high production of prostanoids reported in CF. These findings raise questions regarding the potential use of selective or non-selective COX-2 non-steroidal anti-inflammatory treatment in CF.
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Affiliation(s)
- J Roca-Ferrer
- Institut d'Investigaccions Biomèdiques, August Pi Syuner, IDIBAPS, Barcelona, Spain
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Gartner S, Martin C, Cobos N, Vizmanos G, Ferrer A, Moreno A, Alvarez A, De Gracia J, Liñan S. 97 Early treatment of first Pseudomonas aeruginosa isolation in Cystic Fibrosis patients. J Cyst Fibros 2006. [DOI: 10.1016/s1569-1993(06)80082-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cantón R, Cobos N, de Gracia J, Baquero F, Honorato J, Gartner S, Alvarez A, Salcedo A, Oliver A, García-Quetglas E. Antimicrobial therapy for pulmonary pathogenic colonisation and infection by Pseudomonas aeruginosa in cystic fibrosis patients. Clin Microbiol Infect 2005; 11:690-703. [PMID: 16104983 DOI: 10.1111/j.1469-0691.2005.01217.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Pseudomonas aeruginosa colonisation has a negative effect on pulmonary function in cystic fibrosis patients. The organism can only be eradicated in the early stage of colonisation, while reduction of bacterial density is desirable during chronic colonisation or exacerbations. Monthly, or at least 3-monthly, microbiological culture is advisable for patients without previous evidence of P. aeruginosa colonisation. Cultures should be performed at least every 2-3 months in patients with well-established colonisation, and always during exacerbations or hospitalisations. Treatment of patients following the first isolation of P. aeruginosa, but with no clinical signs of colonisation, should be with oral ciprofloxacin (15-20 mg/kg twice-daily for 3-4 weeks) plus inhaled tobramycin or colistin (intravenous treatment with or without inhaled treatment can be used as an alternative), while patients with acute infection should be treated for 14-21 days with high doses of two intravenous antimicrobial agents, with or without an inhaled treatment during or at the end of the intravenous treatment. Maintenance treatment after development of chronic P. aeruginosa infection/colonisation (pathogenic colonisation) in stable patients (aged>6 years) should be with inhaled tobramycin (300 mg twice-daily) in 28-day cycles (on-off) or, as an alternative, colistin (1-3 million units twice-daily). Colistin is also a possible choice for patients aged<6 years. Treatment can be completed with oral ciprofloxacin (3-4 weeks every 3-4 months) for patients with mild pulmonary symptoms, or intravenously (every 3-4 months) for those with severe symptoms or isolates with ciprofloxacin resistance. Moderate and serious exacerbations can be treated with intravenous ceftazidime (50-70 mg/kg three-times-daily) or cefepime (50 mg/kg three-times-daily) plus tobramycin (5-10 mg/kg every 24 h) or amikacin (20-30 mg/kg every 24 h) for 2-3 weeks. Oral ciprofloxacin is recommended for patients with mild pulmonary disease. If multiresistant P. aeruginosa is isolated, antimicrobial agents that retain activity are recommended and epidemiological control measures should be established.
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Affiliation(s)
- R Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain.
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Gartner S, Cobos N, Pérez-Yarza EG, Moreno A, De Frutos C, Liñan S, Mintegui J. [Comparative efficacy of oral deflazacort versus oral prednisolone in children with moderate acute asthma]. An Pediatr (Barc) 2005; 61:207-12. [PMID: 15469803 DOI: 10.1016/s1695-4033(04)78798-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To assess the efficacy and tolerability of oral deflazacort versus oral prednisolone in acute moderate asthma in children. PATIENTS AND METHODS We performed a prospective, randomized, parallel group trial of children aged 6 to 14 years old with a diagnosis of asthma who presented to the pediatric emergency department for moderate asthma exacerbation. All patients were administered short-acting beta2-adrenergic agonists. The intervention groups received either oral deflazacort (1.5 mg/kg) or prednisolone (1 mg/kg) for 7 days. The primary outcome measure was forced expiratory volume in 1 second (FEV1) and secondary outcome measures were pulmonary symptom score index, peak expiratory flow rate (PEFR), hospitalization rate and the use of rescue beta2-agonists. Patients were evaluated at the start of treatment (visit 1), on day 2 (visit 2) and on day 7 (visit 3). RESULTS Of the 54 children enrolled, two were hospitalized on visit 2 (one from each group). Baseline clinical data were similar in both groups: FEV1: 53 and 51 %; bronchodilator test: 119 and 121 %; PEFR: 169 and 165 L/min; symptom score: 6 and 6.5 for the deflazacort and prednisolone groups, respectively. On visit 2, all measures improved: FEV1: 122.2 and 126.5 % (p < 0.05); PEFR: 164 and 149 L/min (p < 0.05); symptom score: -4.4 and -3.8 (p < 0.05), without significant differences between groups. On visit 3 all variables continued to show improvement: FEV1: 133.2 and 132.5 % (p < 0.05); PEFR: 1115.7 and 187.6 L/min (p < 0.05); symptom score: -5.4 and -5.9 (p < 0.05), without significant differences between groups. No adverse effects were reported. CONCLUSIONS Deflazacort and prednisolone show similar efficacy in improving pulmonary function and in producing clinical improvement in the management of acute moderate asthma in children.
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Affiliation(s)
- S Gartner
- Unidad de Neumología y Fibrosis Quística, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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Moreno A, Maestre J, Balcells J, Marhuenda C, Cobos N, Roman A, Soler J, Montferrer N, Liñan S, Gartner S, Roqueta J, Majo J. Lung transplantation in young infants with interstitial pneumonia. Transplant Proc 2003; 35:1951-3. [PMID: 12962860 DOI: 10.1016/s0041-1345(03)00665-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We describe our experience with infants suffering from interstitial pneumonia referred for lung transplantation. METHODS From April 1998 to December 2000, three infants were admitted to our lung transplantation program: a 9-month-old girl (patient 1) suffering from surfactant protein C deficiency who had high oxygen requirements (fraction of inspired oxygen: 70% to 90%), and two boys, ages 2 (patient 2) and 9 months (patient 3), who were ventilator-dependent due to chronic pneumonitis of infancy. RESULTS Patients were transplanted at the age of 5 months (patient 2) and 13 months (patients 1 and 3) at 87 to 105 days after being accepted for lung transplantation. All cases underwent a sequential double lung transplant on cardiopulmonary bypass. The immunosuppressive regime included tacrolimus, prednisone, and azathioprine. Patients 2 and 3 also received basiliximab. Two cases suffered a mild rejection episode that responded to high-dose steroids. Patient 2 was ventilator-dependent for 8 months after transplant, owing to severe bronchomalacia and left main bronchus stenosis. Bronchial stenosis resolved after pneumatic dilatation and endobronchial stenting. This patient also presented with a pulmonary artery anastomosis stricture that required percutaneous balloon dilatation. All three patients are at home, carrying out normal activities for their age, with no respiratory symptoms after a period of 8 to 29 months of follow-up. CONCLUSIONS Interstitial pneumonia of infancy is a rare disease with a bad prognosis and no specific treatment; therefore, lung transplantation represents a good therapeutic option for these infants.
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Affiliation(s)
- A Moreno
- Department of Pediatric Pulmonology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Aulesa C, Mainar I, Prieto M, Cobos N, Galimany R. Use of the Advia 120 hematology analyzer in the differential cytologic analysis of biological fluids (cerebrospinal, peritoneal, pleural, pericardial, synovial, and others). Lab Hematol 2003; 9:214-24. [PMID: 14649464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The centralization of our laboratories and the demand for new parameters to measure have led to an increase in the number of biological fluid samples, which are generally sent for urgent analysis. Due to this they cannot be processed by manual methods. Meeting this increased demand for assistance is a challenge for the laboratory, and the challenge has been met by the automated hematology area. A study of the reliability of the Advia 120 hematology analyzer has been carried out through leukocyte and red blood cell counting of 179 biological fluids: cerebrospinal, peritoneal or ascitic, pleural, pericardial, synovial, and others. The automated leukocyte counts of cerebrospinal fluid samples containing up to 0.150 x 10(9) leukocytes/L are correlated with counts obtained with the manual reference method in a Neubauer counting chamber (r = 0.958; P = .0001). Applying Passing-Bablok regression analysis to these results indicates a slope p of 1.155 (95% confidence interval [CI], 0.915-1.347) and an ordinate intercept b of 0.0076 (95% CI, 0.012-0.034), showing the results to be perfectly interchangeable. In the comparison of the manual analysis of the leukocyte differential using the May-Grünwald-Giemsa staining method with the analysis using the automated method, the percentage of polymorphonuclear granulocytes of the Advia 120 basophil/lobularity method is significantly correlated (r = 0.844; P = .0001) with that obtained with the manual count. The results of Passing-Bablok regression analysis (p = 0.859 [95% CI, 0.58-1.190]; b = 8.8 [95% CI, -12.09-24.2]) indicate that these two counting methods are also perfectly interchangeable. Automated leukocyte and differential counts of peritoneal or ascitic fluids also show good correlations with the manual method, and the results are not statistically different. Pretreating synovial fluid samples with hyaluronidase enzyme allows their processing on the Advia 120; no significant differences were found between manual and automated methods with respect to leukocyte counts and differentials. Finally, results with pleural fluid samples indicated that leukocyte and differential counts obtained with the Advia 120 showed significant differences from results obtained with manual methods because of the high incidence of mesothelial, lymphoid, and other tumoral cells in this kind of fluid sample. This result shows that use of hematology analyzers is questionable for these kinds of samples, especially from oncology patients with tumors. A procedure is proposed for the processing of these pleural fluids.
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Affiliation(s)
- C Aulesa
- Unidad de Laboratorios, Ciudad Sanitaria Valle de Hebron, Barcelona, Spain.
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Abstract
BACKGROUND Our goal was to establish the clinical and genetic characteristics of patients diagnosed with adult-onset cystic fibrosis (CF). PATIENTS AND METHOD This was a retrospective observational descriptive comparative study of CF patients according to their age at the time of diagnosis. All adult patients (> 16 years old) attended in our CF Unit until November 2001 were included in the study. Those patients diagnosed of CF at their childhood (< 16 years old) were categorized as Group A patients, and those diagnosed in adulthood (>= 16 years old) were categorized as group B patients. Anthropometric parameters, respiratory and digestive clinical abnormalities, chest and abdominal radiological exams, sputum bacteriology, respiratory function and genetic tests were evaluated. Statistical analysis between groups was performed by comparing chi square test for qualitative values and the Student t test for quantitative values. RESULTS One hundred and eleven patients (60 women, mean age 28, range 16-69 years) out of a total sample of 245 (45.3%) patients attended at the CF unit were enrolled in the study. Group A included 61 patients (32 women; mean age 23) and group B included 50 patients (28 women; mean age 32). The comparative study between both groups showed that patients in group B were older, had a higher weight and less incidence of initial digestive abnormalities, pancreatic insufficiency, malnutrition, hepatic disease, chronic bronchial colonization by Pseudomonas aeruginosa, admissions, lung transplantation and deaths due to CF. On the contrary, these patients had a higher incidence of pancreatitis, allergic bronchopulmonary aspergillosis at diagnosis and better respiratory function test parameters. The sweat test was negative in 4 patients of group B and 1 of group A. The genetic study showed 31 different CF mutations, from which only 10 were observed in group B. CONCLUSIONS CF can also be diagnosed in adult age. Patients diagnosed in adulthood have less digestive abnormalities, better lung function and different genetic mutations. The sweat test can be negative or undetermined. These patients also display a better prognosis.
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Affiliation(s)
- Javier de Gracia
- Servei de Pneumologia. Unitat de Fibrosi Quística. Hospital Universitari Vall d'Hebron. Barcelona. Spain.
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Tal A, Simon G, Vermeulen JH, Petru V, Cobos N, Everard ML, de Boeck K. Budesonide/formoterol in a single inhaler versus inhaled corticosteroids alone in the treatment of asthma. Pediatr Pulmonol 2002; 34:342-50. [PMID: 12357478 DOI: 10.1002/ppul.10173] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this study was to evaluate the efficacy (expressed as effect on lung function) and tolerability of Symbicort (budesonide/formoterol in a single inhaler) in children with asthma. This was a double-blind, double-dummy, randomized, parallel-group, multicenter trial. After a 2-4-week run-in period, 286 asthmatic children (177 boys, 109 girls; mean age, 11 years; mean forced expiratory volume in 1 sec (FEV(1)), 75% predicted normal), previously treated with inhaled corticosteroids (average dose 548 microg/day), were randomized to 12 weeks' treatment with either budesonide/formoterol 80/4.5 microg, two inhalations twice daily (n = 148), or an equivalent dose of budesonide 100 microg, two inhalations twice daily (n = 138). Efficacy variables included morning and evening peak expiratory flow (PEF), spirometery, asthma symptoms, and use of rescue medication (beta(2)-agonists). Serial FEV(1) assessments were carried out on a subgroup of children (budesonide/formoterol, n = 41; budesonide, n = 40) at randomization and at week 12. Relative to baseline, morning PEF (primary variable) increased to a significantly greater extent with budesonide/formoterol than with budesonide alone (7.22% predicted normal vs 3.45% predicted normal; P < 0.001). Evening PEF also increased significantly with budesonide/formoterol (6.13% predicted normal vs. 2.73% predicted normal; P < 0.001), as did mean FEV(1) and serial FEV(1) measured over 12 hr (both P < 0.05). Similar improvements in asthma symptoms and rescue medication use were observed in both groups. The two treatment groups were similar in terms of their adverse-event profile and rates of discontinuation. Budesonide/formoterol in a single inhaler provided rapid improvements in PEF and FEV(1) compared to inhaled budesonide alone. These improvements were sustained throughout the study period. Budesonide/formoterol was well-tolerated in children with moderate persistent asthma.
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Affiliation(s)
- A Tal
- Department of Pediatrics, Soroka Medical Center, Ben-Gurion University, Beer-Sheva, Israel.
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22
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Abstract
UNLABELLED This was a study aimed to know the knowledge about asthma. SUBJECTS AND METHOD 933 teachers of 27 schools from 7 cities (children aged between 4 and 15 years) using a self-administered questionnaire Half of them knew asthma prevalence and its hereditary nature. Nearly all related asthma with allergy, 38% with exercise, 25%had students who suffered from asthma attacks in the school, and 91% admitted to have limited information and wish to improve it. CONCLUSION Our survey reveals that Spanish teachers have a limited information about asthma.
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Badia X, García-Hernández G, Cobos N, López-David C, Nocea G, Roset M. [Validity of the Spanish version of the Pediatric Quality of Life Questionnaire for evaluating quality of life in asthmatic children]. Med Clin (Barc) 2001; 116:565-72. [PMID: 11412631 DOI: 10.1016/s0025-7753(01)71907-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND To analyze the clinical utility of the quality of life questionnaire for asthmatic children (PAQLQ) and to validate it for use in clinical practice. PATIENTS AND METHOD 1,012 children between 6 and 14 years of age, with a diagnosis of mild to moderate asthma attending 48 Spanish hospitals were included in the study. The patients' socio-demographic and clinical characteristics were recorded and all patients were administered the PAQLQ and EQ-5D questionnaires on two occasions: at the baseline visit and at 2-3 months from baseline in patients with uncontrolled asthma(group A) and at baseline and 15 days from baseline in patients with controlled asthma (group B). The feasibility, validity, reliability and sensitivity to change of the PAQLQ were assessed. RESULTS The PAQLQ proved to be feasible for use in children over 7 years of age with mild or moderate asthma. The PAQLQ did not show a statistically significant relationship with socio-demographic variables, nor with the majority of clinical variables, with the exception of asthma severity, number of exacerbations, symptoms and use ofon- demand short-term beta2 agonist drugs. Correlations between PAQLQ and EQ-5D dimensions were strongest between dimensions measuring similar attributes. Cronbach's *coefficients for the PAQLQ ranged from 0.88 for the limitations in activities dimension to 0.96 for the overall score. The intraclass correlation coefficient for PAQLQscores in group B ranged from 0.71 (limitation of activities)to 0.83 (overall score). The effect size between both visits ranged from 0.49 to 0.69. CONCLUSIONS The Spanish version of the PAQLQ proved to be valid for use in children with mild to moderate asthma.
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Affiliation(s)
- X Badia
- Institut de Salut Pública de Catalunya. Universitat de Barcelona. L'Hospitalet de Llobregat. Barcelona.
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24
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Casals T, Pacheco P, Barreto C, Giménez J, Ramos MD, Pereira S, Pinheiro JA, Cobos N, Curvelo A, Vázquez C, Rocha H, Séculi JL, Pérez E, Dapena J, Carrilho E, Duarte A, Palacio AM, Nunes V, Lavinha J, Estivill X. Missense mutation R1066C in the second transmembrane domain of CFTR causes a severe cystic fibrosis phenotype: study of 19 heterozygous and 2 homozygous patients. Hum Mutat 2000; 10:387-92. [PMID: 9375855 DOI: 10.1002/(sici)1098-1004(1997)10:5<387::aid-humu9>3.0.co;2-c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report the clinical features of 21 unrelated cystic fibrosis (CF) patients from Portugal and Spain, who carry the mutation R1066C in the CFTR gene. The current age of the patients was higher in the R1066C/any mutation group (P < 0.01), as compared to the deltaF508/deltaF508 group. Poor values for lung radiological involvement (Chrispin-Norman) and general status (Shwachman-Kulcycki) were observed in the R1066C/any mutation group (P < 0.005 and P < 0.0004). A slightly, but not significantly worse lung function was found in the R1066C/any mutation group when compared with the deltaF508/deltaF508 patients. No significant differences were detected regarding the age at diagnosis, sweat Cl-values, or percentiles of height and weight between the two groups. Neither were significant differences observed regarding sex, meconium ileus (4.7% vs. 11.1%), dehydration (10.5% vs. 14.7%), or pancreatic insufficiency (PI) (100% vs. 97.8%). The proportion of patients with lung colonization by bacterial pathogens was slightly, but not significantly higher in the R1066C/any mutation group (70.0%), as compared with the deltaF508/deltaF508 group (57.5%). Other clinical complications were significantly more frequent in the R1066C/any mutation patients(P < 0.02) than in the deltaF508/deltaF508 group. The two homozygous R1066C/R1066C patients died at the ages of 3 months and 7 years. The data presented in this study clearly demonstrate that the R1066C mutation is responsible for a severe phenotype similar to that observed in homozygous deltaF508 patients. The poor clinical scores and complications of patients with the R1066C mutation are probably related to their slightly longer survival.
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Affiliation(s)
- T Casals
- Molecular Genetics Department (IRO), Hospital Duran i Reynals, Barcelona, Catalonia, Spain
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25
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Cobos N, Danés I, Gartner S, González M, Liñán S, Arnau JM. DNase use in the daily care of cystic fibrosis: who benefits from it and to what extent? Results of a cohort study of 199 patients in 13 centres. DNase National Study Group. Eur J Pediatr 2000; 159:176-81. [PMID: 10664231 DOI: 10.1007/s004310050046] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
UNLABELLED Short-term clinical trials with DNase have shown minor to moderate benefits in cystic fibrosis patients. This study was performed to analyse the effectiveness of DNase use in daily practice and to obtain information on its effects in the long term and at different disease stages. Patients being treated in 13 specialised units were included if they started DNase treatment before June 1996. Baseline data before DNase use and data during the DNase treatment period were recorded. Of the 199 patients included in the study 166 continued on DNase treatment while the data were being collected. The mean age (95% CI) was 14.5 (13.7; 15,2) years; 103 (51.8%) patients were female. The mean maximum change in forced expiratory volume in 1 s (FEV(1)) was observed during the first month of treatment [11.1% (6.1; 16.1)]. By the end of the first and the second year of treatment mean changes in FEV(1) were 3.3% (-1.1; 7. 6) and 5.1% (-0.7; 10.9) respectively; at the end of the same periods 34% of patients had improved their baseline FEV(1) by 10% or more but in around 50% of patients the level fell below the baseline. A large inter-individual variability in changes in pulmonary function after the start of DNase treatment was documented. In addition, the medium-term response to treatment was correlated with early response during the first 3 months. No consistent changes in exacerbation pattern were found during the first year of treatment. CONCLUSIONS The benefits of DNase use in daily practice are limited but apparently can be maintained in the medium term in some patients. A large inter-individual variability in response to DNase treatment has been documented and the benefits are doubtful in around 50% of patients. This observation points to the need to set up a withdrawal trial in these patients, using as an eligibility criterion the early response observed during the first 3 months of treatment.
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Affiliation(s)
- N Cobos
- Servei de Farmacologia Clínica, Fundació Institut Català de Farmacologia, Vall d'Hebron Hospitals, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
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26
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Maiz L, Antelo C, Baquero F, Cobos N, Morales P, Pérez-Frías J, Vázquez C. [Consensus on certain aspects of lung disease in cystic fibrosis patients]. Arch Bronconeumol 1999; 35:339-44. [PMID: 10439132 DOI: 10.1016/s0300-2896(15)30072-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- L Maiz
- Servicio de Neumología, Hospital Ramón y Cajal, Madrid.
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27
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Yeste D, Liñán S, Cobos N, Gussinyé M, del Río L, Carrascosa A. [Bone mass in patients with cystic fibrosis of the pancreas. Relationship with anthropometric parameters and genotype]. Med Clin (Barc) 1998; 111:485-8. [PMID: 9859064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Cross-sectional study of bone mineral density (BMD) in children and adolescents with cystic fibrosis of the pancreas. The relationship of BMD values with nutritional status, respiratory function and the cystic transmembrane regulator genotype was also evaluated. PATIENTS AND METHODS BMD expressed as grams of hydroxyapatite/cm2 was measured by dual-energy X-ray absorptiometry in the lumbar spine (L2-L4) in 41 patients (21 males and 20 women; age range: 4-21 years) with cystic fibrosis of the pancreas and compared with that of 471 normal controls (256 males and 215 women; age range: 1-20 years). Twenty patients were prepubertal, 9 pubertal and 12 young adults. RESULTS Clinical repercussion of the disease evaluated by clinical and anthropometric data (weight, height and body mass index) and respiratory function was considered moderate. Height z score (mean [MSE]) was -0.53 (0.28), weight -0.81 (0.21) and body mass index -0.82 (0.12) BMD z score values (mean [MSE]) were -1.14 (0.17) and differed significantly (p < 0.001) from those of normal age- and sex-matched controls. No significant differences were observed between males and women or among prepubertal, pubertal and young adult patients. BMD z score values less than-1 z score were found in 53% and under -2 z score in 8%. Cystic transmembrane regulator genotype was studied in 36 patients (17 were F508/-, 10 F508/F508, 5 G542X/- and 4 diverse) and did not predict bone mineral status. A statistically significant correlation was found between BMD z score values and height z score, weight z score, body mass index z score and clinical assessment according to Shwachman criteria. A negative and statistically significant correlation was observed between BMD z score and functional score. CONCLUSIONS The decrease in BMD values in CF patients begins early in life and appears to be related to the degree of clinical expression of the disease.
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Affiliation(s)
- D Yeste
- Departamento de Pediatría, Hospital Materno-Infantil Vall d'Hebron, Universidad Autónoma de Barcelona
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28
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Abstract
PURPOSE The clinical and imaging findings of children with Swyer-James-MacLeod syndrome (SJMS) were reviewed to determine the incidence and type of bronchiectasis and analyze whether the clinical course of patients with bronchiectasis differed from that of patients without bronchiectasis. METHOD Our study population consisted of 13 patients. All had inspiratory/ expiratory chest X-ray films, chest CT, and lung scans. Eight underwent pulmonary function test. The results of these studies at diagnosis and during follow-up were analyzed and compared with the clinical features. RESULTS Bronchiectasis was demonstrated in nine patients, being saccular in five and cylindrical in four. Expiratory slices were helpful for demonstrating bilateral lung involvement that had not been suspected on inspiratory CT scans or conventional radiographs. The clinical features of the five patients with saccular bronchiectasis resembled those of patients with classic postviral bronchiectasis who suffered recurrent pulmonary infections; three of them underwent lobectomy. The remaining patients presented mild respiratory symptoms, with a spontaneous tendency toward improvement. CONCLUSION SJMS should be considered as a spectrum disease. Bronchiectasis is not a universal finding. The presence and type of bronchiectasis will influence clinical manifestations and prognosis. Patients without bronchiectasis or with cylindrical bronchiectasis had a lower incidence of pneumonia episodes than those with saccular bronchiectasis.
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Affiliation(s)
- J Lucaya
- Department of Diagnostic Radiology, Hospital Universitari Materno-infantil Vall d'Hebron, Barcelona, Spain
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29
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Abstract
Antioxidant depletion and increased free radical production by inflammatory cells have been described in cystic fibrosis (CF) patients. To evaluate oxidative damage intensity, we measured plasma concentrations of malondialdehyde, hydroperoxides and protein carbon groups as markers of oxidative injury to lipids and proteins in a group of 101 CF patients free of acute exacerbation, and in 43-112 controls. Moreover, we estimated antioxidant function by measuring activities of erythrocyte superoxide dismutase, glutathione reductase and vitamin E concentrations. In CF patients, malondialdehyde and hydroperoxide plasma levels were significantly higher than in controls (p < 0.001). Increased lipid peroxidation was documented by these two markers. Parallel rises in protein carbonyls in plasma of CF patients were observed (p < 0.0001). These patients presented biochemical but not clinical vitamin E deficiency. Glutathione reductase and superoxide dismutase activities were significantly higher than in controls. These results show a serious imbalance of CF patients between oxidant-antioxidant status leading to oxidative stress.
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Affiliation(s)
- C Domínguez
- Centre d'Investigacions en Bioquímica i Biologia Molecular, Hospital Materno-Infantil Vall d'Hebron, Barcelona, Spain.
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30
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Casals T, Pacheco P, Barreto C, Giménez J, Ramos M, Pereira S, Pinheiro J, Cobos N, Curvelo A, Vázquez C, Rocha H, Séculi J, Pérez E, Dapena J, Carrilho E, Duarte A, Palacio A, Nunes V, Lavinha J, Estivill X. Missense mutation R1066C in the second transmembrane domain of CFTR causes a severe cystic fibrosis phenotype: Study of 19 heterozygous and 2 homozygous patients. Hum Mutat 1997. [DOI: 10.1002/(sici)1098-1004(1997)10:5<387::aid-humu9>3.3.co;2-v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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31
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Ericson N, Navarro S, Valderrama R, Adrián MJ, Lloberes P, Cobos N. [Changes in the pancreatic and respiratory functions in cystic fibrosis. The influence of the time of the evolution of the disease]. Med Clin (Barc) 1993; 101:650-2. [PMID: 8289509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Cystic fibrosis is the most frequent congenital disease in Caucasian and is transmitted by recessive autosomic inheritance. It is characterized by affection of different glands of exocrine secretion, particularly the pancreas and the lung. The aim of this study was to analyze the degree of alteration of pulmonary and pancreatic exocrine function in a group of patients with cystic fibrosis in relation to the time of disease evolution. METHODS Twenty-one patients between 9 and 31 years of age were studied; 11 with an evolution of lower than or equal to 158 months and 10 with an evolution of higher than 158 months (median of the total patients). To study pancreatic exocrine function the BT-PABA test immunoreactive serum trypsin test were used. To evaluate respiratory function FEV1, FVC, FEV1/FVC ratio and PaO2 were used. RESULTS The results obtained demonstrated that in the group with a lower time of evolution the diagnosis had been carried out at earlier ages (17 +/- 17 months versus 84 +/- 60 months; p = 0.002) and presented a significantly more altered pancreatic exocrine function (BT-PABA: 13 +/- 12% versus 35 +/- 23%; p = 0.013). However, respiratory function was altered in the group with longer time of evolution (FEV1: 68 +/- 20% versus 36 +/- 23%; p = 0.003; FVC: 74 +/- 9 versus 52 +/- 25%; p = 0.013; FEV1/FEV: 77 +/- 19 versus 50 +/- 9%; p < 0.001; PaO2: 84 +/- 16 versus 58 +/- 11%; p < 0.001). CONCLUSIONS Pancreatic exocrine function is most intensely affected in patients diagnosed with cystic fibrosis at earlier and with shorter times of evolution while patients who have the longest time of evolution and who were diagnosed later in life presented greater changes in respiratory function.
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Affiliation(s)
- N Ericson
- Servicio de Gastroenterología, Hospital Clínic i Provincial, Barcelona
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32
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Morral N, Nunes V, Casals T, Cobos N, Asensio O, Dapena J, Estivill X. Uniparental inheritance of microsatellite alleles of the cystic fibrosis gene (CFTR): identification of a 50 kilobase deletion. Hum Mol Genet 1993; 2:677-81. [PMID: 7689007 DOI: 10.1093/hmg/2.6.677] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
More than 250 mutations have been detected in the cystic fibrosis (CF) transmembrane regulator (CFTR) gene, most of which are single point mutations or small deletions or insertions of a few nucleotides. Here we report the first large deletion identified in the CFTR gene, which involves 50 kb in two stretches of DNA: one of 10 kb from exon 4 to exon 7, and another of 40 kb, spanning exons 11 to 18. The deletion has been detected via uniparental inheritance of CFTR microsatellite alleles (IVS17BTA and IVS17BCA) in 3 independent CF families. Clinical status of the 3 CF patients, of which two have the delta F508 mutation as the other CF allele, suggests that this mutation is responsible for a severe clinical phenotype, indistinguishable from homozygous delta F508 patients. The deletion detected here suggests that other large, but less complex molecular defects could also exist in the CFTR gene.
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Affiliation(s)
- N Morral
- Molecular Genetics Department, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Catalunya, Spain
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Ferrer A, Tórtola MT, Cobos N, González T, Fernández F. [Bacteriology of mucoviscidosis during a 5-year period]. Enferm Infecc Microbiol Clin 1992; 10:34-8. [PMID: 1498172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We have studied the bacteriology of mucoviscidosis cases from 1985 to 1989. MATERIAL A total of 336 samples from 50 patients (median age: 7 year, range: 1 day-18 years) with mucoviscidosis were studied. RESULTS The most frequently isolated microorganisms was Pseudomonas aeruginosa (59.2%), followed by Staphylococcus aureus (19%) and Haemophilus influenzae (18.4%). In patients younger than 1 year of age other different microorganisms were identified in 61.1% of cases, but S. aureus (11.1%) and Pseudomonas aeruginosa (5.5%) were also isolated. The incidence of Pseudomonas cepacia (0.6%) is low in our environment. We did not isolate any Legionella sp. strain.
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Affiliation(s)
- A Ferrer
- Servicio de Microbiología y Parasitología, Ciutat Sanitària de la Vall d'Hebron, Universidad Autónoma, Barcelona
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Regás JS, Ezzedine H, Martín N, Tresserra L, García-Vaquero JA, Cobos N, Liñan S, Boix-Ochoa J. [Our experience in the treatment of cervico-facial adenitis caused by non-tuberculous mycobacteria (atypical mycobacteria)]. Cir Pediatr 1990; 3:62-6. [PMID: 2252850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The authors believe that the greater part of chronic cervicofacial adenitis actually observed in our hospitals, are not caused by M. tuberculosis or M. bovis but by scrofulaceum mycobacterium, M. avium, M. fortuitum and M. Kansasii, and above all, by the first two of these. They present their experience with 16 cases of cervico-facial adenitis due to atypical mycobacterium (CAAM) treated in our centre during the last years, in which period no case of cervical tuberculosis (CT) was observed. It is important to establish an early differential diagnosis between both etiologies, seeing as treatment is different. Whilst tuberculostatics can solve the phymic infection, surgical extirpation is the only solution for CAAM. The diagnosis of these types of infection is achieved by means of a very characteristic clinical procedure and by cutaneous tests specific for each bacteria. Faced with the clinical suspicion, the total extirpation should be effected of the adenopathic block affected. The exact diagnosis can only be made by the culture of the operatory mass.
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Affiliation(s)
- J S Regás
- Departamento de Cirugía Pediátrica, Hospital Materno-Infantil Valle de Hebrón, Barcelona
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