Clinical and Epidemiological Features of Tuberculous Pleural Effusion in Alicante, Spain.

We aimed to (1) evaluate the incidence of tuberculous pleural effusion (TPE) over 25 years in our centre; (2) measure the yield of different diagnostic techniques; (3) compare TPE features between immigrant and native patients. Retrospective study of patients who underwent diagnostic thoracentesis and pleural biopsy in our hospital between 1995 and 2020. TPE was diagnosed in 71 patients (65% natives, 35% immigrants).

Management and referral of patients with severe and poorly controlled asthma in primary care.

Background: Over 50% of treated patients with asthma in Europe are not well controlled. Their management in primary health care (PHC) differs from that in specialized care, and there is no real coordination between the two.

Objectives: To identify barriers and solutions to improving the management of patients with severe and poorly controlled asthma and the communication between specialists and PHC, and to reach a consensus on the criteria for referral patients.

[Tuberculosis].

Tuberculosis (TB) continues to be an important public health problem. Currently, 2,100 million people--one third of the world population--are infected by Mycobacterium tuberculosis, with an estimated annual rate of 9.4 million new cases, and 440,000 cases of multidrug-resistant (MDR) TB in 2008; furthermore, cases of extensively-resistant (XDR) TB have been detected in 57 countries.

[Using newborn congenital hypothyroidism screening specimens to detect iodine deficiency in three regions of Spain].

Background: Neonatal hyperthyrotropinemia by measurements of thyrotropin (TSH) concentrations has been assessed in three different areas of Spain. The repercussions of a possible iodine deficiency in a congenital hypothyroidism screening program have also been analysed

Material And Methods: The study comprised 113,108 newborns, which were divided into two groups according to the time of blood sampling. In 78,646 newborns heel blood samples were obtained after 48h whereas in 34,462 newborns, samples were obtained at birth from the umbilical cord (early samples).

Nephrotic syndrome as paraneoplastic manifestation of a primary pulmonary lymphoepithelioma-like carcinoma.

We present a case of nephrotic syndrome secondary to a membranous glomerulonephritis (MG), in a nonsmoking female with a solitary pulmonary nodule, which did not show growth during 2 years of followup. A biopsy by videothoracoscopy showed a granulomatous non-neoplastic process with giant multinucleated cells. The appearance of a nephrotic syndrome and its interpretation as paraneoplastic revealed the existence of a primary pulmonary lymphoepithelioma-like carcinoma (LELC), a very rare pulmonary tumor.

[Description of a new procedure for fiberoptic bronchoscopy during noninvasive ventilation through a nasal mask in patients with acute respiratory failure].

A new method is described for performing oral fiberoptic bronchoscopy during noninvasive ventilation through the nose. The technique was successfully applied in 2 patients suffering from acute respiratory failure. The bronchoscope was inserted through a glove finger fitted into a mouth guard.

[Thoracic actinomycosis: an old disorder with new clinical manifestations].

Three cases of thoracic actinomycosis are described, two associated to bronchial obstruction (foreign body and bronchogenic carcinoma) and one in a patient with empyema. The clinical and radiological manifestations and diagnostic criteria are reviewed and all published cases in the Spanish literature are thoroughly analyzed.

Functional sequelae of tuberculous pleurisy in patients correctly treated.

Study Objectives: To assess the functional sequelae (FS) of patients with tuberculous pleurisy (TP), to analyze the influence of different factors in the occurrence of these FS, and, finally, to evaluate the relationship between the FS and roentgenographic sequelae.

Design: An observational, retrospective study.

Setting: A community teaching hospital in Alicante, Spain.

Obstructive sleep apnea syndrome as first manifestation of pharyngeal non-Hodgkin's lymphoma.

Obstructive sleep apnea syndrome (OSAS) is characterized by repetitive episodes of upper airway obstruction during sleep that provoke an abnormal number of apneas and hypopneas, leading to arousals and, as a result, to an altered sleep architecture. Here we present a patient with clinical symptoms characteristic of OSAS. During follow-up, pharyngeal non-Hodgkin's lymphoma was diagnosed and treated, with a nearly complete normalization of polysomnography.

Pulmonary dirofilariasis mimicking lung cancer.

We describe the case of a 30-year-old asymptomatic farmer who underwent a pulmonary segmentectomy due to the casual finding of a pulmonary nodule in preoperative chest radiography. As bronchoscopic samples rule out mycobacterium infection and malignancy, surgery could have been avoided with the use of serological tests and radiographic follow-up based on epidemiology of dirofilariasis in our country.

[Acute respiratory insufficiency as onset form of Lambert-Eaton's syndrome associated with pulmonary small cell carcinoma].

The Lambert-Eaton myasthenic syndrome is a rare disorder of neuromuscular transmission, usually presenting as a paraneoplastic process associated with a small cell lung cancer. Recently, respiratory muscular impairment has been described in these patients. Acute respiratory failure as a presenting symptom has been reported in few cases.

Acute psychosis after CPAP treatment in a schizophrenic patient with sleep apnoea-hypopnoea syndrome.

A 52-yr-old man with a residual phase of schizophrenia developed sleep apnoea-hypopnoea syndrome (SAHS). After five days of continuous positive airway pressure (CPAP) treatment, the patient developed an aggressive mood with incoherence, prominent hallucinations and agitation, and attempted to hit his relatives. He was finally admitted to the hospital with an acute psychotic episode.

[Validation of the Spanish version of the Epworth Sleepiness Scale in patients with a sleep apnea syndrome].

A Spanish version of the Epworth Sleepiness Scale (ESS-Sp) was developed by translation, back-translation, formal discussion, and a meeting of researchers with a group of patients with sleep apnea syndrome (SAS). The translated questionnaire was then tested in 345 patients, 275 with SAS at various levels of severity and 70 without SAS. Significant differences existed between the two groups as to age (53 +/- 11 years versus 47 +/- 13, p < 0.

Corynebacterium pseudodiphtheriticum pneumonia in an immunocompetent patient.

Corynebacterium pseudodiphtheriticum is a coryneform and diphtheromorphic bacteria rarely found as a cause of pneumonia in immunocompetent hosts. A case of an immunocompetent patient with C. pseudodiphtheriticum pneumonia is presented.

Nocturnal oximetry for the diagnosis of the sleep apnoea hypopnoea syndrome: a method to reduce the number of polysomnographies?

Background: Polysomnography (PSG) is currently the "gold standard" for the diagnosis of the sleep apnoea hypopnoea syndrome (SAHS). Nocturnal oximetry (NO) has been used with contradictory results. A prospective study was performed to determine the accuracy of NO as a diagnostic tool and to evaluate the reduction in the number of PSGs if the diagnosis of SAHS had been established by this method.

Bilateral lymphocytic alveolitis: a common reaction after unilateral thoracic irradiation.

The main aim of the present study was to assess the early diagnostic value of bronchoalveolar lavage (BAL) in radiation-induced lung injury in patients with breast carcinoma. Twenty-six females receiving postoperative radiotherapy for breast cancer were evaluated before and 0, 15, 30, 60, and 180 days after radiotherapy. History, physical examination, chest radiographs, and pulmonary function tests were obtained.

Perianal disease of tuberculous origin: report of a case and review of the literature.

Purpose: A case of anal tuberculosis in an otherwise asymptomatic patient with bleeding anal ulcers is presented. The clinical features of this entity and the problems in differential diagnosis between anal infectious vs. inflammatory diseases are discussed.