ABSTRACT
Introduction: Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible and frequently fatal disease. Currently there are national and multinational registries in Europe, United States, Australia and China to better understand the magnitude of the problem and the characteristics of the IPF patients. However, there are no national or regional registries in Latin America, so the objective of this study was to carry out a Latin American registry that would allow the identification of IPF patients in our region. Methodology: A system consisting of 3 levels of control was designed, ensuring that patients met the diagnostic criteria for IPF according to international guidelines ATS/ERS/ALAT/JRS 2011. Demographic, clinical, serological, functional, tomographic, histological and treatment variables were recorded through a digital platform. Results: 761 IPF patients from 14 Latin American countries were included for analysis, 74.7% were male, with a mean age of 71.9+8.3 years. In general there was a long period of symptoms before definitive diagnosis (median 1 year). In functional tests, an average reduction of FVC (70.9%) and DLCO (53.7%) was detected. 72% received at least one antifibrotic drug (pirfenidone or nintedanib) and 11.2% of the patients had an acute exacerbation, of which 38 (45.2%) died from this cause. Conclusions: Like other registries, we found that there is difficulty in the recognition and excessive delay in the diagnosis of IPF in Latin America. Most of the patients in REFIPI received antifibrotics; these were well tolerated and associated with fewer adverse events than those reported in clinical trials. (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Idiopathic Pulmonary Fibrosis/diagnosis , Idiopathic Pulmonary Fibrosis/drug therapy , Idiopathic Pulmonary Fibrosis/epidemiology , Latin America , Pyridones , Treatment OutcomeABSTRACT
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible and frequently fatal disease. Currently there are national and multinational registries in Europe, United States, Australia and China to better understand the magnitude of the problem and the characteristics of the IPF patients. However, there are no national or regional registries in Latin America, so the objective of this study was to carry out a Latin American registry that would allow the identification of IPF patients in our region. METHODOLOGY: A system consisting of 3 levels of control was designed, ensuring that patients met the diagnostic criteria for IPF according to international guidelines ATS/ERS/ALAT/JRS 2011. Demographic, clinical, serological, functional, tomographic, histological and treatment variables were recorded through a digital platform. RESULTS: 761 IPF patients from 14 Latin American countries were included for analysis, 74.7% were male, with a mean age of 71.9+8.3 years. In general there was a long period of symptoms before definitive diagnosis (median 1 year). In functional tests, an average reduction of FVC (70.9%) and DLCO (53.7%) was detected. 72% received at least one antifibrotic drug (pirfenidone or nintedanib) and 11.2% of the patients had an acute exacerbation, of which 38 (45.2%) died from this cause. CONCLUSIONS: Like other registries, we found that there is difficulty in the recognition and excessive delay in the diagnosis of IPF in Latin America. Most of the patients in REFIPI received antifibrotics; these were well tolerated and associated with fewer adverse events than those reported in clinical trials.
Subject(s)
Idiopathic Pulmonary Fibrosis , Humans , Male , United States , Middle Aged , Aged , Aged, 80 and over , Female , Idiopathic Pulmonary Fibrosis/diagnosis , Idiopathic Pulmonary Fibrosis/drug therapy , Idiopathic Pulmonary Fibrosis/epidemiology , Latin America/epidemiology , Pyridones/therapeutic use , Registries , Europe , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
INTRODUCTION/OBJECTIVES: To define the performance of Minor Salivary Gland Biopsy (MSGB) and Dry Eye Tests (DET) to detect occult Sjögren Syndrome (SS) among Interstitial Pneumonia with Autoimmune Features (IPAF) patients. METHODS: Prospective study. Interstitial Lung Disease (ILD) patients without defined Connective Tissue Disease and one or more IPAF classification domains or xerophthalmia were included. MSGB, Schirmer's test (ST) and Ocular Staining Score (OSS) were performed in a blinded manner by experienced specialists. MSGB with ≥1 focus of lymphocytes and Dry Eye Test (DET) with OSS ≥ 5 and/or ST < 5 s were considered positive. SS was diagnosed according to the ACR 2016 criteria. RESULTS: 534 patients on the first consult were screened. 67 patients had at least one IPAF criteria, 53 (79.1%) female, mean age (SD) 64.2 years old (10.8). Positive ST in 36 (53.7%), positive OSS in 29 (43.3%) and positive MSGB in 36 (53.7%) were found. Finally, 27 (40.3%) met SS diagnostic criteria. 25 (37.3%) and 18 (26.8%) of them did not report dry eyes or dry mouth, respectively. 53 (79.1%) had negative anti SSA/Ro, 57 (85.1%) had negative anti LA/SSB, 30 (44.7%) had negative ANA, and 52 (77.6%) had negative RF, respectively. A significantly higher proportion of ANA (+), anti-SSA/Ro (+), anti-SSB/La (+), positive DET and positive MSGB were found in the SS population. CONCLUSIONS: A significant proportion of patients with occult SS were found in our study. MSGB and DET may be considered in the evaluation of IPAF patients.
Subject(s)
Lung Diseases, Interstitial/etiology , Sjogren's Syndrome/diagnosis , Aged , Autoimmunity , Biopsy , Diagnostic Techniques, Ophthalmological , Dry Eye Syndromes/diagnosis , Female , Humans , Lung Diseases, Interstitial/immunology , Male , Middle Aged , Prospective Studies , Salivary Glands/pathology , Sjogren's Syndrome/complications , Sjogren's Syndrome/pathologyABSTRACT
BACKGROUND: Endobronchial ultrasonography (EBUS) has been applied as a routine procedure for the diagnostic of hiliar and mediastinal nodes. The authors assessed the relationship between the echographic appearance of mediastinal nodes, based on endobronchial ultrasound images, and the likelihood of malignancy. METHODS: The images of twelve malignant and eleven benign nodes were evaluated. A previous processing method was applied to improve the quality of the images and to enhance the details. Texture and morphology parameters analyzed were: the image texture of the echographies and a fractal dimension that expressed the relationship between area and perimeter of the structures that appear in the image, and characterizes the convoluted inner structure of the hiliar and mediastinal nodes. RESULTS: Processed images showed that relationship between log perimeter and log area of hilar nodes was lineal (i.e. perimeter vs. area follow a power law). Fractal dimension was lower in the malignant nodes compared with non-malignant nodes (1.47(0.09), 1.53(0.10) mean(SD), Mann-Whitney U test p < 0.05)). CONCLUSION: Fractal dimension of ultrasonographic images of mediastinal nodes obtained through endobronchial ultrasound differ in malignant nodes from non-malignant. This parameter could differentiate malignat and non-malignat mediastinic and hiliar nodes.
Subject(s)
Bronchoscopy/methods , Lymph Nodes/diagnostic imaging , Diagnosis, Differential , Diagnostic Imaging , Fractals , Humans , Image Processing, Computer-Assisted , Lymph Nodes/anatomy & histology , Mathematical Concepts , Multimodal Imaging , UltrasonographyABSTRACT
Introducción: Actualmente en Argentina no hay información sobre la prevalencia de tabaquismo en pacientes internados por enfermedad respiratoria. El objetivo de este estudio es determinar la prevalencia de tabaquismo y evaluar las características de la adicción a la nicotina en pacientes internados por patología respiratoria. Materiales y métodos: Estudio de corte transversal en 9 Hospitales de Buenos Aires. Se encuestaron pacientes cuyo motivo de ingreso fueron enfermedades respiratorias. Las variables estudiadas fueron reporte de consumo de tabaco (fumador actual, ex fumador, nunca fumador), dependencia mediante test de Fagerstrõm (TF), abstinencia mediante Minessota Nicotine Withdrawal Scale (MNWS); y motivación para dejar defumar mediante test de Richmond. Se evaluó la implementación del consejo breve y del tratamiento farmacológico.Resultados: Se encuestaron 376 pacientes, la edad media fue de 53 ± 16 años; el 54.5% eran varones. La prevalencia de fumadores actuales fue 30.3 % (IC:25.8-35.3). Los pacientes fumadores actuales presentaron TF promedio de 4.59 ± 2.9 puntos (dependencia moderada) y MNWS promedio de 1.14 ± 0.85 puntos (abstinencia leve). El 79.7% presentaba motivación moderada a alta para dejar de fumar. El 77% (IC:64.5-86.8%) de los fumadores actuales recibió consejo breve, pero solo 10.2% (IC:3.8-20.8) recibió tratamiento farmacológico.Conclusiones: La prevalencia de tabaquismo es similar a la reportada en la población general de Argentina. Los pacientes fumadores actuales presentan dependencia a la nicotina moderada y síndrome de abstinencia leve; con motivación moderada a alta para dejar de fumar durante la internación. La mayoría recibió consejo breve pero notratamiento farmacológico.
Background: Nowadays Argentina has no data about the prevalence of tobacco smoking about patients hospitalized for respiratory diseases. The objectives of this study are to establish the prevalence of the tobacco smoking habit and to assess the features of nicotine addiction in these patients. Methods: We designed a cross-sectional study with the participation of 9 Buenos Aires Hospitals. We surveyed patients who were hospitalized for respiratory diseases. The survey included the tobacco smoking habit, nicotine dependence with Fagerstrõm test (FT), nicotine abstinence with Minessota Nicotine Withdrawal Scale (MNWS) andmotivation to quit with Richmond´s test. We also assessed the implementation of brief advice and pharmacological treatment for tobacco use cessation. Results: 376 patients were surveyed, the mean age was 53 ±16 years and 54.5% were male. Prevalence ofactive tobacco smokers was 30.3% (IC: 25.8-35.3). The mean FT was 4.59 ± 2.9 points (moderate dependence) and the MNWS mean was 1.14 ± 0.85 points (mild abstinence). The majority (79.7%) had moderate to high motivation to quit smoking. Despite77% (IC: 64.5-86.8%) of active tobacco smokers received a brief advice, only 10.2% (IC: 3.8-20.8) were prescribed pharmacological treatment for tobacco use cessation. Conclusion: The prevalence of tobacco smoking in patients who were hospitalized forrespiratory diseases is similar to the prevalence in the general population of Argentina. Active tobacco smokers who are hospitalized for respiratory diseases have moderate nicotine dependence, mild withdrawal symptoms and moderate to high motivation to quit the smoking habit. Most patients received a brief advice but no pharmacologicaltreatment for tobacco use cessation.
Subject(s)
Humans , Male , Adult , Female , Young Adult , Middle Aged , Aged, 80 and over , Respiratory Tract Diseases , Smoking Cessation , Tobacco Use Disorder/epidemiology , Argentina/epidemiology , Data Collection , Hospitalization , Hospitals, Private , Hospitals, Public , Multicenter Studies as Topic , PrevalenceABSTRACT
Introducción: Actualmente en Argentina no hay información sobre la prevalencia de tabaquismo en pacientes internados por enfermedad respiratoria. El objetivo de este estudio es determinar la prevalencia de tabaquismo y evaluar las características de la adicción a la nicotina en pacientes internados por patología respiratoria. Materiales y métodos: Estudio de corte transversal en 9 Hospitales de Buenos Aires. Se encuestaron pacientes cuyo motivo de ingreso fueron enfermedades respiratorias. Las variables estudiadas fueron reporte de consumo de tabaco (fumador actual, ex fumador, nunca fumador), dependencia mediante test de Fagerstr§m (TF), abstinencia mediante Minessota Nicotine Withdrawal Scale (MNWS); y motivación para dejar defumar mediante test de Richmond. Se evaluó la implementación del consejo breve y del tratamiento farmacológico.Resultados: Se encuestaron 376 pacientes, la edad media fue de 53 ± 16 años; el 54.5% eran varones. La prevalencia de fumadores actuales fue 30.3 % (IC:25.8-35.3). Los pacientes fumadores actuales presentaron TF promedio de 4.59 ± 2.9 puntos (dependencia moderada) y MNWS promedio de 1.14 ± 0.85 puntos (abstinencia leve). El 79.7% presentaba motivación moderada a alta para dejar de fumar. El 77% (IC:64.5-86.8%) de los fumadores actuales recibió consejo breve, pero solo 10.2% (IC:3.8-20.8) recibió tratamiento farmacológico.Conclusiones: La prevalencia de tabaquismo es similar a la reportada en la población general de Argentina. Los pacientes fumadores actuales presentan dependencia a la nicotina moderada y síndrome de abstinencia leve; con motivación moderada a alta para dejar de fumar durante la internación. La mayoría recibió consejo breve pero notratamiento farmacológico. (AU)
Background: Nowadays Argentina has no data about the prevalence of tobacco smoking about patients hospitalized for respiratory diseases. The objectives of this study are to establish the prevalence of the tobacco smoking habit and to assess the features of nicotine addiction in these patients. Methods: We designed a cross-sectional study with the participation of 9 Buenos Aires Hospitals. We surveyed patients who were hospitalized for respiratory diseases. The survey included the tobacco smoking habit, nicotine dependence with Fagerstr§m test (FT), nicotine abstinence with Minessota Nicotine Withdrawal Scale (MNWS) andmotivation to quit with Richmond´s test. We also assessed the implementation of brief advice and pharmacological treatment for tobacco use cessation. Results: 376 patients were surveyed, the mean age was 53 ±16 years and 54.5% were male. Prevalence ofactive tobacco smokers was 30.3% (IC: 25.8-35.3). The mean FT was 4.59 ± 2.9 points (moderate dependence) and the MNWS mean was 1.14 ± 0.85 points (mild abstinence). The majority (79.7%) had moderate to high motivation to quit smoking. Despite77% (IC: 64.5-86.8%) of active tobacco smokers received a brief advice, only 10.2% (IC: 3.8-20.8) were prescribed pharmacological treatment for tobacco use cessation. Conclusion: The prevalence of tobacco smoking in patients who were hospitalized forrespiratory diseases is similar to the prevalence in the general population of Argentina. Active tobacco smokers who are hospitalized for respiratory diseases have moderate nicotine dependence, mild withdrawal symptoms and moderate to high motivation to quit the smoking habit. Most patients received a brief advice but no pharmacologicaltreatment for tobacco use cessation. (AU)
