Introduction The MEGA (MEchanism underlying the Genesis and evolution of Asthma) project is a multicenter cohort study carried out in eight Spanish hospitals, gathering clinical, physiological, and molecular data from patients with asthma and multimorbidities in order to gain insight into the different physiopathological mechanisms involved in this disorder. Material and Methods We report the baseline clinical and physiological characteristics and biomarker measures of adult participants in the project with the aim of better understanding the natural history and underlying mechanisms of asthma as well as the associated multimorbidities across different levels of severity. We carried out a detailed clinical examination, pulmonary function testing, measurement of fractional exhaled nitric oxide (FeNO), blood counts, induced sputum, skin prick tests, chest computed tomography scan, asthma questionnaires, and multimorbidity assessment in 512 asthmatic patients. Results When compared to patients with milder disease, severe asthmatic patients showed greater presence of symptoms, more exacerbations, lower asthma control, increased airflow obstruction, and higher frequency of chronic rhinosinusitis with nasal polyps, severe rhinitis, anxiety and depression, gastroesophageal reflux, and bronchiectasis. Conclusion The MEGA project succeeded in recruiting a high number of asthma patients, especially those with severe disease, who showed lower control and higher frequency of multimorbidities.
ResumenObjetivo: Analizar una larga serie de esta rara entidad para entenderla mejor y valorar el riesgo de malignización y comprender esta enfermedad infrecuente para el correcto diagnóstico y tratamiento. Material y métodos: Diecisiete casos de encondromatosis múltiple tratados desde el año 1976 hasta el año 2006. Las variables estudiadas son: edad al diagnóstico y malignización, localización de la lesión, asociación familiar con otros tumores, hallazgos radiológicos, tratamientos aplicados, evolución en el tiempo, metástasis y supervivencia. Resultados: Se incluyen 16 casos de Ollier y un caso de síndrome de Maffucci. La gammagrafía fue el método de imagen que nos llevó al diagnóstico. La mediana de edad al diagnóstico de las malignizaciones es de 45 años, mientras que la mediana de edad al diagnóstico de los que no sufrieron malignización fue de 11 años. Fracturas patológicas, dismetrías y deformidades conducen al diagnóstico en la gente joven. Las lesiones benignas fueron tratadas mediante cirugía menor. Hubo 5 malignizaciones en 4 pacientes (23,5%). El fémur distal y la pelvis son los lugares de mayor frecuencia de malignización, todos ellos hacia condrosarcoma de grado I. La cirugía es el único tratamiento en todos ellos. Conclusiones: La enfermedad de Ollier es una enfermedad benigna con alto riesgo de malignización a partir de los 40 años. La gammagrafía ósea es la mejor prueba diagnostica para detectar el crecimiento del tumor y la posible malinización de las múltiples lesiones. La cirugía amplia es la única herramienta para lograr la supervivencia en estos pacientes; por eso el diagnóstico precoz es esencial. © 2010 Asociación Española de Pediatría. Publicado por Elsevier España, S.L. Todos los derechos reservados. KEYWORDSOllier disease; Enchondromatosis; Maffucci syndrome; Chondrosarcoma Ollier disease: benign tumours with risk of malignant transformation. A review of 17 cases Abstract Aim: To review Ollier disease, an uncommon disease, in order to understand the clinical symptoms, diagnosis, correct treatment, and risk factors in order to prevent malignant transformation. * Autor para correspondencia. Correo electrónico: bvazquez@unav.es (B. Vázquez-García).
Summary. A total of 90 cases of suspected dermatophytoses was observed over a period of 9 months in the city of Cusco (Peru) and in its environs. The age groups most commonly infected were 1–10 and 11–20 year old. The most common tineae diagnosed were tinea capitis (13.3%) and tinea unguium (11.1%). Only four species of dermatophytes were isolated: Microsporum canis (52.4%), Trichophyton mentagrophytes (35.7%), Tr. rubrum (9.5%) and Epidermophyton floccosum (2.4%). Dry weather, low temperature and high altitude do not seem to affect proliferation and infections by dermatophytes. Zusammenfassung. In Cusco (Peru) und seiner Umgebung wurden insgesamt 90 Patienten mit Verdacht auf Dermatophytose über 9 Monate hin‐weg beobachtet. Die am stärksten infizierten Al‐tersgruppen waren die 1–10‐ und 11–20jährigen. Als häufigste Lokalisationen wurden Tinea capitis (13,3 %) und Tinea unguium (11,1%) beobachtet. Es wurden nur 4 Dermatophytenarten isoliert: Mi‐crosporum canis (52,4 %), Trichophyton mentagro‐phytes (35,7 %), Tr. rubrum (9,5 %) and Epider‐mophyton floccosum (2,4%). Trockenes Klima, niedrige Temperatur und große Höhe scheinen das Auftreten und Wachstum von Dermatophyten nicht zu beeinflussen.
Background. Chronic rhinosinusitis with nasal polyps (CRSwNP), characterized by partial (hyposmia) or total (anosmia) loss of smell, is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), worsens disease severity and quality of life. The objective of this study was to determine whether, in real-life conditions, biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare smell improvement in N-ERD and non-N-ERD subgroups. Methods. A multicenter, non-interventional, retrospective, observational study was performed, including 206 patients with severe asthma undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab) with CRSwNP. Results. Improved olfaction was found after treatment with all monoclonal antibodies: omalizumab (35.8%), mepolizumab (35.4%), reslizumab (35.7%), and benralizumab (39.1%), with no differences between groups. Patients with atopy, greater use of short course systemic corticosteroids, and larger polyp size were more likely to experience improvement in smell. The proportion of patients experiencing smell improvement was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. Conclusions. This is the first study to compare real-life improvement in sense of smell among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in sense of smell (with non-significant differences between biologic drugs). No differences were found in smell improvement between the N-ERD and non-N-ERD group.
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