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Hypersensitivity reactions can be complex and life-threatening to patients, especially when drugs such as β-lactam antibiotics are involved. To this day, there are diagnostic algorithms and mobile applications that improve the clinical approach, as well as laboratory tests and more specialized procedures, such as skin tests and controlled exposure tests; which are useful for identifying the drug involved and for selecting safe and effective therapeutic alternatives. For several years, the desensitization procedure has been positioned as a vital tool for clinical allergists and for their patients, and it is key to improving clinical outcomes such as survival and quality of life.
The impact of obesity on the severity of asthma continues to be a cause of controversy.
To compare the severity of asthma and asthma control in obese patients with non-obese patients.
A cross-sectional study which included 188 patients with asthma, of ≥ 18 years of age, who were selected consecutively. The patients were categorized and compared based on the presence or absence of obesity. In order to establish an association between variables, logistic regression analyses were performed.
In total, 111/188 of the patients had obesity; these patients were older than those without obesity (35.9 ± 15.3 years vs. 44.4 ± 13.8 years, p <0.001). No significant difference was observed in the groups regarding sex, total IgE serum concentration, peripheral blood eosinophil count, personal history of atopic diseases, frequency of allergic sensitization, hospitalization for asthma, and asthma control. Overall, obesity was significantly associated with moderate-severe asthma (OR = 1.82, p = 0.047), but not with asthma control (p = 0.094).
Our results suggest that patients with asthma and obesity are older and that their pulmonary function is worse, which is reflected in a greater level of severity of asthma.
Our results suggest that patients with asthma and obesity are older and that their pulmonary function is worse, which is reflected in a greater level of severity of asthma.
Information about the clinical and epidemiological characteristics of atopic dermatitis (AD) is essential to generate knowledge of the disease and its socioeconomic impact.
To describe the clinical characteristics of the patients of an atopic dermatitis clinic.
An observational, retrospective, and cross-sectional study. Demographic data, severity of the AD (according to the Eczema Area Severity Index), clinical phenotype, total serum IgE, the presence of allergic and non-allergic comorbidities, as well as of anxiety and depression, were recorded by means of targeted questionnaire and Hamilton Scale. Descriptive and inferential statistics were obtained, considering a statistical significance associated with a value of p <0.05.
187 patients were included; the median age was 12 years with a range of 1-87 years. Differences were found regarding sex and severity (p < 0.05). Mild forms of AD were presented in 57.8% of the patients, moderate forms in 20.9%, and severe forms in 21.4%. The severity was associated with allergic comorbidities such as asthma (p = 0.001) and allergic conjunctivitis (p <0.001). Severe AD was associated with a state of anxiety and depression (p <0.05), as well as with ocular affectation (p<0.001).
The pediatric population is the most affected by AD; however, in the adult population, the severe form associated with allergic comorbidities is observed.
The pediatric population is the most affected by AD; however, in the adult population, the severe form associated with allergic comorbidities is observed.
Pemphigus (Pm) is a chronic and recalcitrant autoimmune disease that affects the skin and mucous membranes. The first line of treatment are systemic corticosteroids; however, there are patients who are refractory to them, as well as to other immunosuppressants. Rituximab has been used as a successful alternative since 2000 with good results but without information on its behavior in the Mexican population.
To assess the clinical response to treatment with rituximab in Mexican patients with pemphigus.
This was a cross-sectional, retrospective study in a tertiary hospital, which included patients with moderate-severe pemphigus who had been treated with rituximab from 2007 to 2020.
Six medical records of patients diagnosed with pemphigus were obtained; four of them with Pm vulgaris, and two of them with pemphigus foliaceus; all patients had received systemic immunosuppressive therapy prior to rituximab. Debio 0123 supplier All six patients went into remission of the disease in an average of 12.5 weeks.
The use of rituximab for the treatment of patients with moderate-severe Pm who were refractory to immunosuppressive therapy proved to be very useful, and control of the disease was achieved in the medium term, without severe or idiosyncratic adverse effects in the analyzed Mexican population.
The use of rituximab for the treatment of patients with moderate-severe Pm who were refractory to immunosuppressive therapy proved to be very useful, and control of the disease was achieved in the medium term, without severe or idiosyncratic adverse effects in the analyzed Mexican population.
TempTest® is a new method based on the Peltier effect, which is validated for the diagnosis of patients with cold urticaria or heat urticaria, and it is able to measure the temperature variations and activity of these pathologies.
To analyze the results of provocation tests by using this new method in patients with UFr and UCal, who were followed in a center of reference and excellence for urticaria (GA2LEN UCARE) in Rio de Janeiro.
The medical records of 12 patients who had a history of UFr or UCal and were tested with TempTest® during December 2017 and February 2020 were analyzed. For temperature provocation tests, the patients were requested to place their forearm on the TempTest® thermal element for five minutes. A positive response was defined by the appearance of a 2-mm-papular lesion 10 minutes after the provocation test was started, as recommended.
10 of the patients were women and 2 of them were men, from 13 to 77 years of age (mean = 50.2 years). Among the twelve patients, three of them had heat urticaria and nine of them had cold urticaria. The patients who were diagnosed with heat urticaria tested positive for The patients with cold urticarial tested positive for temperatures of 27 °C or lower.
TempTest® is a reliable instrument to accurately diagnose and monitor diseases related to temperature variations, which is a factor that should be determined whenever possible since it can help patients prevent situations of exposure and danger.
TempTest® is a reliable instrument to accurately diagnose and monitor diseases related to temperature variations, which is a factor that should be determined whenever possible since it can help patients prevent situations of exposure and danger.A common clinical problem encountered by colorectal surgeons is the secondary tumors of the ovary (STO), particularly in young female patients. Most STO are from the digestive tract, and the known possible metastatic mechanisms include lymphatic, hematogenous, and intraperitoneal spreading. The molecular and histopathological characteristics of STO from different sites are diverse. It is particularly important to correctly identify the origin and feature of STO, which should be clarified by combining medical history, histopathology, immunohistochemistry, molecular biology, imaging and other means. The prognosis of patients with STO is poor in general. Comprehensive therapies based on surgical resection can benefit some patients. There is no specific treatment for STO at present, but not giving up easily on these patients is the right choice that every surgeon should understand.Anastomotic leak is one of the most severe complications following right hemicolectomy but rarely happens, which should be diagnosed based on clinical manifestations, laboratory and radiographic examinations. Influencing factors of anastomotic leak after right hemicolectomy include bowel preparation, emergency surgery, anastomotic procedure (side-to-side anastomosis vs. end-to-side anastomosis, instrument anastomosis vs. manual technigue and intracorporeal vs. extracorporeal anastomosis), surgical resection range and patient's characteristics. The occurrence of anastomotic leak might be avoided by standardized operations and indocyanine green fluorescence imaging. Active treatment is recommended once anastomotic leak is diagnosed. Most patients can be cured by non-surgical treatments such as adequate drainage and anti-infection therapy. When severe sepsis happens or non-surgical treatment fails, surgical treatment should be carried out in time.Objective Total mesorectal excision (TME) is the gold standard for surgical treatment of mid-low rectal cancer, but the postoperative incidence of urination and sexual dysfunction is relatively high. Preserving the Denonvilliers fascia (DF) during TME can reduce the postoperative incidence of urination and sexual dysfunction. In this study, high resolution magnetic resonance imaging (MRI) was used to observe the imaging performance and display of DF, so as to determine the value of this technique in preoperative evaluation of the preservation of DF. Methods A descriptive cohort study was carried out. Clinical data of patients with rectal cancer who underwent TME and received preoperative high-resolution MRI at department of Gastrointestinal Surgery, the Third Affiliated Hospital of Sun Yat-sen University from August 2015 to June 2017 were retrospectively analyzed. The characteristics of DF were examined, and the shortest distance (d) between the anterior edge of tumor and DF was measured on high-resolution MRI. The distance d was compared between patients with stage T1-T2 and those with stage T3. Receiver operating characteristic (ROC) analysis was used to determine the predictive value of d for stage T1-T2 disease. Results Thirty-two patients were enrolled in the study, including 27 males and 5 females with mean age of (62.9±8.9) years. DF was visualized in 96.9% (31/32) of cases on the T2WI sequence. The mean distance d in patients with stage T1-T2 disease (n=23) was (6.73±2.65) mm, and in those with stage T3 disease (n=9) was (1.30±1.15) mm (t=5.893, P3.05 mm, and Youden index was 0.957. Conclusions High-resolution MRI can show the DF and accurately evaluate the relationship of DF with tumor in rectal cancer patients. Analysis on d value can provide an objective basis for the safe preservation of DF.Objective To explore the efficacy and feasibility of transanal hand-sewn reinforcement of low stapled anastomosis in preventing anastomotic leak after transanal total mesorectal excision (taTME). Methods A descriptive cohort study was conducted. Clinical data of 51 patients with rectal cancer who underwent taTME with transanal hand-sewn reinforcement of low stapled anastomosis at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2020 were retrospectively collected. Inclusion criteria (1) age >18 years old; (2) rectal cancer confirmed by preoperative pathology; (3) distance from tumor to anal verge ≤ 8 cm according to pelvic MR; (4) the lesion was evaluated to be resectable before operation; (5) with or without neoadjuvant chemotherapy and radiotherapy; (6) taTME, end-to-end stapled anastomosis, and reinforcement in the anastomosis with absorbable thread intermittently were performed, and the distance between anastomosis and anal verge was ≤ 5 cm.
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