ABSTRACT
Introducción La fibrosis quística (FQ) es una enfermedad causada por mutaciones en el gen localizado en el cromosoma 7 que codifica la proteína reguladora de la conductancia transmembrana de la FQ. Varios ensayos han demostrado la eficacia y seguridad de la combinación ELE/TEZ/IVA en los pacientes que tienen al menos una mutación F508del. El objetivo principal del estudio fue evaluar la seguridad a los 3 y 6 meses del tratamiento con ELE/TEZ/IVA en pacientes adultos con FQ. Métodos Se trata de un estudio transversal, prospectivo y unicéntrico de vida real en el que se incluyeron pacientes adultos de la unidad multidisciplinar de FQ del Hospital Universitario Ramón y Cajal que cumplían criterios para recibir tratamiento con ELE/TEZ/IVA. Se registraron las características demográficas y clínicas de todos los pacientes. Durante el tiempo del estudio, se llevaron a cabo 3 visitas (basal, a los 3 y a los 6 meses). Se registraron los efectos secundarios y la evolución de la función hepática durante el tiempo de seguimiento. Resultados A los 3 meses del inicio del tratamiento se observó una mejoría estadísticamente significativa de la función pulmonar, el IMC, las exacerbaciones pulmonares y el nivel de energía, así como en todas las categorías del cuestionario CFQ-R excepto en el dominio digestivo. Esta mejoría se mantuvo, pero no se incrementó, a los 6 meses en todas las variables, excepto en el IMC, donde sí se observaron diferencias entre los 3 y 6 meses de tratamiento. Conclusiones En la cohorte estudiada, el tratamiento con ELE/TEZ/IVA tiene un buen perfil de seguridad y produce un mejoría precoz en la función pulmonar, el IMC, la calidad de vida y el «nivel de energía» de los pacientes adultos con FQ, que se mantiene a los 6 meses de tratamiento (AU)
Introduction Cystic fibrosis (CF) is a disease caused by mutations in the gene located on chromosome 7 that encodes the CF transmembrane conductance regulator protein. Several trials have demonstrated the efficacy and safety of the ELE/TEZ/IVA combination in patients who have at least one F508del mutation. The main objective of the study was to evaluate the safety at 3 and 6 months of treatment with ELE/TEZ/IVA in adult patients with CF. Methods This is a real-life, prospective, single-center, cross-sectional study that included adult patients from the CF multidisciplinary unit. The demographic and clinical characteristics of all patients were recorded. During the time of the study, 3 visits were carried out (baseline, at 3 and at 6 months). Side effects were recorded during the follow-up time. Results 3 months after the start of treatment, a statistically significant improvement was observed. of lung function, BMI, pulmonary exacerbations and energy level, as well as in all the categories of the CFQ-R questionnaire except in the digestive domain. This improvement was maintained, but not increased at 6 months in all variables, except BMI, where differences were observed between 3 and 6 months of treatment. Conclusions In the cohort studied, treatment with ELE/TEZ/IVA has a good safety profile. and produces an early improvement in lung function, BMI, quality of life and the energy level of adult patients with CF, which is maintained at 6 months of treatment (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Cystic Fibrosis/drug therapy , Chloride Channel Agonists/administration & dosage , Treatment Outcome , Cross-Sectional Studies , Prospective Studies , Drug Therapy, CombinationABSTRACT
Introduction: To compare the efficacy and safety of indwelling pleural catheters (IPC) in relation with the timing of systemic cancer therapy (SCT) (i.e., before, during, or after SCT) in patients with malignant pleural effusion (MPE). Methods: Systematic review of randomized controlled trials (RCT), quasi-controlled trials, prospective and retrospective cohorts, and case series of over 20 patients, in which the timing of IPC insertion in relation to that of SCT was provided. Medline (via PubMed), Embase, and Cochrane Library were systematically searched from inception to January 2023. The risk of bias was assessed using the Cochrane Risk of Bias (ROB) tool for RCTs and the ROB in non-randomized studies of interventions (ROBINS-I) for non-randomized designs. Results: Ten studies (n=2907 patients; 3066 IPCs) were included. Using SCT while the IPC was in situ decreased overall mortality, increased survival time, and improved quality-adjusted survival. Timing of SCT had no effect on the risk of IPC-related infections (2.85% overall), even in immunocompromised patients with moderate or severe neutropenia (relative risk 0.98 [95%CI: 0.931.03] for patients treated with the combination of IPC and SCT). The inconsistency of the results or the lack of analysis of all outcome measures in relation to the SCT/IPC timing precluded drawing solid conclusions about time to IPC removal or need of re-interventions. Conclusions: Based on observational evidence, the efficacy and safety of IPC for MPE does not seem to vary depending on the IPC insertion timing (before, during, or after SCT). The data most likely support early IPC insertion. (AU)
Subject(s)
Humans , Catheter-Related Infections/etiology , Pleural Effusion, Malignant/therapy , Catheters, Indwelling/adverse effects , Pleurodesis/methods , Retrospective StudiesABSTRACT
INTRODUCTION: To compare the efficacy and safety of indwelling pleural catheters (IPC) in relation with the timing of systemic cancer therapy (SCT) (i.e., before, during, or after SCT) in patients with malignant pleural effusion (MPE). METHODS: Systematic review of randomized controlled trials (RCT), quasi-controlled trials, prospective and retrospective cohorts, and case series of over 20 patients, in which the timing of IPC insertion in relation to that of SCT was provided. Medline (via PubMed), Embase, and Cochrane Library were systematically searched from inception to January 2023. The risk of bias was assessed using the Cochrane Risk of Bias (ROB) tool for RCTs and the ROB in non-randomized studies of interventions (ROBINS-I) for non-randomized designs. RESULTS: Ten studies (n=2907 patients; 3066 IPCs) were included. Using SCT while the IPC was in situ decreased overall mortality, increased survival time, and improved quality-adjusted survival. Timing of SCT had no effect on the risk of IPC-related infections (2.85% overall), even in immunocompromised patients with moderate or severe neutropenia (relative risk 0.98 [95%CI: 0.93-1.03] for patients treated with the combination of IPC and SCT). The inconsistency of the results or the lack of analysis of all outcome measures in relation to the SCT/IPC timing precluded drawing solid conclusions about time to IPC removal or need of re-interventions. CONCLUSIONS: Based on observational evidence, the efficacy and safety of IPC for MPE does not seem to vary depending on the IPC insertion timing (before, during, or after SCT). The data most likely support early IPC insertion.
Subject(s)
Catheter-Related Infections , Pleural Effusion, Malignant , Humans , Pleural Effusion, Malignant/therapy , Catheters, Indwelling/adverse effects , Retrospective Studies , Pleurodesis/methods , Catheter-Related Infections/etiologyABSTRACT
INTRODUCTION: Cystic fibrosis (CF) is a disease caused by mutations in the gene located on chromosome 7 that encodes the CF transmembrane conductance regulator protein. Several trials have demonstrated the efficacy and safety of the ELE/TEZ/IVA combination in patients who have at least one F508del mutation. The main objective of the study was to evaluate the safety at 3 and 6 months of treatment with ELE/TEZ/IVA in adult patients with CF. METHODS: This is a real-life, prospective, single-center, cross-sectional study that included adult patients from the CF multidisciplinary unit. The demographic and clinical characteristics of all patients were recorded. During the time of the study, 3 visits were carried out (baseline, at 3 and at 6 months). Side effects were recorded during the follow-up time. RESULTS: 3 months after the start of treatment, a statistically significant improvement was observed. of lung function, BMI, pulmonary exacerbations and energy level, as well as in all the categories of the CFQ-R questionnaire except in the digestive domain. This improvement was maintained, but not increased at 6 months in all variables, except BMI, where differences were observed between 3 and 6 months of treatment. CONCLUSIONS: In the cohort studied, treatment with ELE/TEZ/IVA has a good safety profile. and produces an early improvement in lung function, BMI, quality of life and the "energy level" of adult patients with CF, which is maintained at 6 months of treatment.
Subject(s)
Cystic Fibrosis , Humans , Adult , Cystic Fibrosis/drug therapy , Cystic Fibrosis/genetics , Cross-Sectional Studies , Prospective Studies , Quality of Life , MutationABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Adolescent , Aged , Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Betacoronavirus , Pandemics , Tomography, X-Ray Computed , Image-Guided Biopsy/methodsSubject(s)
Adenocarcinoma/diagnostic imaging , Betacoronavirus , Bone Neoplasms/diagnostic imaging , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Image-Guided Biopsy/methods , Lung Neoplasms/diagnostic imaging , Lung/diagnostic imaging , Pandemics , Pneumonia, Viral/diagnosis , Sarcoma, Ewing/diagnostic imaging , Adenocarcinoma/complications , Adenocarcinoma/pathology , Aged , Betacoronavirus/genetics , Betacoronavirus/isolation & purification , Bone Neoplasms/complications , Bone Neoplasms/pathology , COVID-19 , COVID-19 Testing , Coronavirus Infections/complications , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/epidemiology , Disease Management , Female , Humans , Incidental Findings , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Lung Neoplasms/complications , Lung Neoplasms/pathology , Male , Neoplasm Invasiveness , Personal Protective Equipment , Pleural Neoplasms/diagnostic imaging , Pleural Neoplasms/secondary , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/epidemiology , RNA, Viral/blood , Real-Time Polymerase Chain Reaction , Rib Cage/diagnostic imaging , SARS-CoV-2 , Sarcoma, Ewing/complications , Sarcoma, Ewing/pathology , Spinal Canal/diagnostic imaging , Spinal Canal/pathology , Telecommunications , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Polychondritis, Relapsing/diagnosis , Chronic Disease , Cough/etiology , Ear Cartilage , Polychondritis, Relapsing/complicationsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged, 80 and over , Bone Cements , Postoperative Complications/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Vertebroplasty , Asymptomatic Diseases , Pulmonary Embolism/pathology , Vertebroplasty/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Vocal Cord Paralysis/diagnostic imaging , Carcinoma, Bronchogenic/complications , Vocal Cords/diagnostic imaging , Vocal Cords/injuries , Carcinoma, Bronchogenic/diagnostic imaging , Positron-Emission Tomography/methods , Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging , Bronchoscopy/methodsABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Bronchiolitis/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Tomography, X-Ray Computed/methods , Leukemia, Myeloid, AcuteSubject(s)
Lung Neoplasms/complications , Positron Emission Tomography Computed Tomography , Recurrent Laryngeal Nerve , Vocal Cord Paralysis/diagnostic imaging , Vocal Cords/diagnostic imaging , Diagnosis, Differential , Humans , Male , Middle Aged , Vocal Cord Paralysis/metabolism , Vocal Cords/metabolismSubject(s)
Bronchiolitis Obliterans/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Postoperative Complications/etiology , Adult , Algorithms , Bronchiolitis Obliterans/diagnostic imaging , Exhalation , Female , Humans , Postoperative Complications/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
PURPOSE: Congenital cystic adenomatoid malformation (CCAM) of the lung in adults is very rare. We aimed to evaluate the clinicoradiological features of adult patients with CCAM. METHODS: Adult patients diagnosed with CCAM were evaluated for clinicoradiological presentation and management. METHODS: Nine patients were diagnosed with CCAM (four were incidentally diagnosed on chest imaging). Most cases appeared on computed tomography as thin-walled multiseptated cystic lesions. Two patients had another concurrent pulmonary developmental anomaly. Five patients were surgically treated and three conservatively. CONCLUSIONS: CCAMs might be incidentally diagnosed on routine chest imaging in adults and can be safely treated with minimally invasive techniques.
Subject(s)
Cystic Adenomatoid Malformation of Lung, Congenital/diagnostic imaging , Lung/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Cystic Adenomatoid Malformation of Lung, Congenital/diagnosis , Cystic Adenomatoid Malformation of Lung, Congenital/therapy , Female , Follow-Up Studies , Humans , Incidental Findings , Male , Middle Aged , Retrospective Studies , Treatment OutcomeSubject(s)
Arterio-Arterial Fistula/congenital , Brachial Artery/abnormalities , Carcinoma, Squamous Cell/complications , Lung Neoplasms/complications , Pulmonary Artery/abnormalities , Aged , Angiography , Arterio-Arterial Fistula/complications , Arterio-Arterial Fistula/diagnosis , Biopsy , Brachial Artery/diagnostic imaging , Carcinoma, Squamous Cell/diagnosis , Humans , Lung Neoplasms/diagnosis , Male , Pulmonary Artery/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
La neumonía lipoidea exógena (NLE) es una patología inusual (incidencia del 1-2,5%), frecuentemente infradiagnosticada, causada por la aspiración y la acumulación de lípidos de origen exógeno dentro de los alvéolos pulmonares. Se han descrito casos por inhalación de lubricantes en fosas nasales y orofaringe, aspiración de aceites minerales contenidos en laxantes en pacientes con trastornos alimentarios, aplicación de brillo de labios, exposición profesional a parafina líquida o aceites minerales («comedores de fuego», uso industrial en lavado de maquinaria, talleres de automóviles, pinturas plásticas, etc.) y aplicación de vaselina en la inserción de sondas nasogástricas y en el cuidado de traqueotomías en pacientes traqueotomizados. Radiológicamente la NLE suele presentarse como consolidaciones peribronquiales de baja atenuación y opacidades en vidrio deslustrado con una distribución preferentemente bibasal. Presentamos 5 casos de pacientes laringectomizados de larga evolución con diagnóstico de NLE que admitían el uso de vaselina en el cuidado del estoma traqueal
Exogenous lipoid pneumonia (ELP) is a rare (incidence 1.0%-2.5%), often under-diagnosed disease, caused by the aspiration and accumulation of exogenous lipids within the pulmonary alveoli. Various cases have beendescribeddue to inhalationoflubricants via thenasalpassages andoropharynx, aspirationofmineral oils in laxatives in patients with eating disorders, application of lip gloss, occupational exposure to liquid paraffin or mineral oils ('fire-eaters', industrial use in washing of machinery, automobile workshops, plastic paints, etc.) and application of Vaseline during the insertion of nasogastric tubes and in the care of tracheotomy patients. ELP usually presents radiologically as areas of low-attenuation peribronchial consolidation and ground glass opacities, with a predominantly bibasal distribution. We present 5 cases of long-standing laryngectomy patients diagnosed with ELP who admitted using Vaseline in their tracheal stoma care
Subject(s)
Aged, 80 and over , Aged , Female , Humans , Male , Middle Aged , Pneumonia, Lipid , Laryngeal Neoplasms/surgery , Laryngectomy , Tomography, X-Ray Computed , Magnetic Resonance Spectroscopy , Petrolatum/adverse effectsABSTRACT
Exogenous lipoid pneumonia (ELP) is a rare (incidence 1.0%-2.5%), often under-diagnosed disease, caused by the aspiration and accumulation of exogenous lipids within the pulmonary alveoli. Various cases have been described due to inhalation of lubricants via the nasal passages and oropharynx, aspiration of mineral oils in laxatives in patients with eating disorders, application of lip gloss, occupational exposure to liquid paraffin or mineral oils ("fire-eaters", industrial use in washing of machinery, automobile workshops, plastic paints, etc.) and application of Vaseline during the insertion of nasogastric tubes and in the care of tracheotomy patients. ELP usually presents radiologically as areas of low-attenuation peribronchial consolidation and ground glass opacities, with a predominantly bibasal distribution. We present 5 cases of long-standing laryngectomy patients diagnosed with ELP who admitted using Vaseline in their tracheal stoma care.
Subject(s)
Intubation/methods , Laryngectomy , Lubricants/adverse effects , Multimodal Imaging , Petrolatum/adverse effects , Pneumonia, Aspiration/diagnostic imaging , Positron-Emission Tomography , Postoperative Complications/diagnostic imaging , Surgical Stomas , Tomography, X-Ray Computed , Tracheostomy , Aged, 80 and over , Asymptomatic Diseases , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/secondary , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , Female , Humans , Laryngeal Neoplasms/drug therapy , Laryngeal Neoplasms/radiotherapy , Laryngeal Neoplasms/surgery , Lipids/analysis , Lung Neoplasms/secondary , Macrophages/chemistry , Macrophages/ultrastructure , Magnetic Resonance Imaging , Male , Middle Aged , Pneumonia, Aspiration/chemically induced , Postoperative Complications/chemically induced , Radiotherapy, Adjuvant , ThyroidectomyABSTRACT
El Síndrome de apnea hipopnea del sueño (SAHS) se contempla como una enfermedad crónica. Sin embargo, algunos pacientes con SAHS pueden presentar episodios agudos, en relación con alteraciones en la repolarización ventricular, como arritmias potencialmente mortales, parada cardiorrespiratoria e incluso muerte súbita. La repolarización ventricular se ha evaluado mediante mediciones de la onda T y el intervalo QT. El incremento de mortalidad en pacientes con SAHS, especialmente durante la noche, obliga a identificar parámetros predictores de trastornos de la repolarización miocárdica, así como evaluar un tratamiento eficaz en este tipo de pacientes donde la parada cardiorrespiratoria, puede ser el primer síntoma de esta enfermedad (AU)
Obstructive sleep apnea syndrome (OSAS) is a common chronic respiratory sleep disorder; however, patients with OSAS may occasionally present with severe cardiac arrhythmias and sudden cardiac death caused by electrical disturbances during ventricular repolarization. The assessment of ventricular repolarization has been evaluated by using T wave and QT interval measurements. Increased mortality in patients with OSAS, particularly at night, emphasizes the importance of identifying possible parameters by which OSAS could affect myocardial electrical stability and requires the study of an effective treatment in this kind of patients where the cardiac arrest, could be the first symptom of this disease (AU)
