Peritonsillar abscess (PTA) is relatively common but challenging to diagnose clinically. Several clinical signs may be used, with unknown performances. We evaluated and compared the diagnostic performance of individual and combined clinical signs (, , , , , and ) assessed by an otolaryngologist and of contrast-enhanced computed tomography (CT) to detect acute PTA. Prospective study in 133 consecutive adult patients (77 males, mean age = 33 years) with suspected clinical PTA and CT obtained in the emergency setting of a tertiary care hospital between November 2020 and October 2022. The standard of reference consisted of surgically proven pus within 24 h of CT or a favorable clinical evolution at 48 h without surgical intervention. PTA was present in 117/133 (88%) patients, with no difference between mean age or sex distribution between the groups with and without PTA. None of the evaluated clinical signs were associated with PTA (OR = 1.26-5.43, > 0.05), whereas the CT finding "abscess" was significantly associated with PTA (OR = 67.2, < 0.0001). The sensitivity of individual clinical signs varied between 19.7% and 73.5%, and the sensitivity of CT was significantly higher for all clinical signs (95.7%, < 0.0001) except for (97.4%, = 0.7266). The specificity of clinical signs varied between 12.5% and 93.8%, and the specificity of CT was significantly higher (75%, < 0.05) for and . All clinical signs together yielded an area under the curve (AUC) = 0.677. In adults, clinical assessment alone using independent clinical signs and overall clinical impression does not allow a reliable diagnosis of PTA, even when performed by an otolaryngologist. CT is reliable in diagnosing PTA and, whenever available, should be the examination method of choice for diagnosing PTA, especially by a non-specialist.
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Orv Hetil
January 2025
1 Semmelweis Egyetem, Általános Orvostudományi Kar, Belgyógyászati és Onkológiai Klinika Budapest, Korányi S. u. 2/A, 1083 Magyarország.
Calcif Tissue Int
January 2025
Endocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 262, Cuarto Piso, Santiago, Chile.
X-linked hypophosphatemia (XLH) is a rare metabolic disorder characterized by elevated FGF23 and chronic hypophosphatemia, leading to impaired skeletal mineralization and enthesopathies that are associated with pain, stiffness, and diminished quality of life. The natural history of enthesopathies in XLH remains poorly defined, partly due to absence of a sensitive quantitative tool for assessment and monitoring. This study investigates the utility of 18F-NaF PET/CT scans in characterizing enthesopathies in XLH subjects.
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January 2025
Department of Pediatric Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, China.
Objective: To review and compare robot-assisted ipsilateral ureteroureterostomy (RALUU) and laparoscopic ipsilateral uretero-ureterostomy (LUU) in terms of efficacy and outcomes.
Methods: Clinical data of 65 children with complete renal ureteral duplication deformity admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022 were collected. Among these, 42 patients underwent laparoscopic ureteroureterostomy (LUU), designated as the LUU group, while 23 patients received robot-assisted laparoscopic ureteroureterostomy (RALUU), designated as the RALUU group.
Kidney Int
January 2025
Laboratório de Fisiopatologia Renal (LIM 16), Nephrology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Universidade de São Paulo, São Paulo, Brazil. Electronic address:
In 2017, Kidney Disease: Improving Global Outcomes (KDIGO) published a Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Since then, new lines of evidence have been published related to evaluating disordered mineral metabolism and bone quality and turnover, identifying and inhibiting vascular calcification, targeting vitamin D levels, and regulating parathyroid hormone. For an in-depth consideration of the new insights, in October 2023, KDIGO held a Controversies Conference on CKD-MBD: Progress and Knowledge Gaps Toward Personalizing Care.
View Article and Find Full Text PDFPsychiatr Pol
October 2024
Śląskie Centrum Chorób Serca w Zabrzu; Katedra i Klinika Kardiochirurgii, Transplantologii, Chirurgii Naczyniowej i Endowaskularnej, Wydział Nauk Medycznych w Zabrzu, SUM w Katowicach.
During qualification for mechanical circulatory support, the comprehensive assessment of a patient's mental state is an integral element of the overall medical evaluation. It encompasses a range of psychosocial issues, and as such provides information helpful in the selection of a suitable candidate for the required treatment, and sometimes identifies contraindications to it. It allows ensuring that the patient meets expectations regarding both mental health stability and adherence to medical recommendations.
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