Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Pressão Positiva Contínua nas Vias Aéreas/normas , Ventilação não Invasiva/normas , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Protocolos Clínicos , Infecção Hospitalar/prevenção & controle , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Pandemias/prevenção & controle , Ventilação não Invasiva/métodos , BetacoronavirusRESUMO
Adult pulmonary Langerhans cell histiocytosis (PLCH) is a rare disorder of unknown etiology that occurs predominantly in young smokers, with an incidence peak at 20-40 years of age. In adults, pulmonary involvement with Langerhans cell histiocytosis usually occurs as a single-organ disease and is characterized by focal Langerhans cell granulomas infiltrating and destroying distal bronchioles. We report a 23-year-old asymptomatic male smoker with a non specific interstitial infiltrate found in preventive chest X ray examination. A high resolution chest CT scan showed multiple cystic structures predominating in the upper lobes, with small centrilobular nodules. A transbronchial biopsy showed a lymphocytic lung infiltrate with Langerhans cells. A surgical biopsy confirmed the diagnosis of pulmonary Langerhans cell histiocytosis. After six months of follow up, the patient is in good conditions.
Assuntos
Humanos , Masculino , Adulto Jovem , Histiocitose de Células de Langerhans/diagnóstico , Biópsia , Pulmão/patologia , Pulmão , Fumar/efeitos adversosRESUMO
Exercise capacity can be evaluated in patients with chronic obstructive pulmonary disease (COPD), measuring the distance that patients are able to walk in 6 minutes (six-minute walk distance test; 6WDT). This test is simple to perform, inexpensive, reproducible and safe. It has been frequently employed for the assessment of COPD patients due to its high prognostic valué of mortality and its usefulness to evalúate long-term of therapeutic interventions. In severe stages of the disease, the declining results of the best are useful to detect worsening. This review describes the method, standardization and reference valúes for the 6WDY and the results obtained with different therapeutic interventions, based on data from the literature and from the authors experíence. We also review its predictive valué for mortality and its valué in the assessment of patients with more severe COPD.