ABSTRACT
Antecedentes y objetivos. Nos proponemos conocer la magnitud del cáncer de pulmón en Ávila: sus tasas de incidencia y aspectos epidemiológicos importantes en el año 2012, comparándolo con los resultados de estudios conocidos realizados con la misma metodología cada 5 años, desde hace ya 2 décadas. Pacientes y métodos. Inclusión prospectiva de todos los pacientes diagnosticados de cáncer de pulmón en la provincia de Ávila a lo largo del año 2012. Resultados. Se diagnosticaron 81 enfermos, 70 hombres y 11 mujeres, con edad media de 72,1 años (extremos: 44-91), superior a la encontrada en estudios anteriores. Dan lugar a unas tasas de incidencia en 2012, brutas y ajustadas a la población mundial estándar, de 80,99 y 31,23 por 100.000, respectivamente, en los hombres, y 12,97 y 5,68 por 100.000 en las mujeres. Estas tasas son menores, en ambos sexos, a las encontradas en Ávila en el año 2002. En 2012 habían sido fumadores el 80,25% (90% de los hombres y 18,18% de las mujeres), aunque al diagnóstico lo habían dejado el 68,75%. Realizamos diagnóstico clínico-radiológico en 9 (11,1%) y cito-histológico en 72 (88,9%). Tipos histológicos: adenocarcinomas 37,5%; escamosos 33,3%; microcíticos 13,8%; indiferenciados no microcíticos 11,1%; células grandes 2,77% y carcinoides 1,38%. Los tratamientos más frecuentes fueron quimioterapia (50,6%), sintomático (23,4%) y cirugía (12,3%). Conclusiones. En los últimos 10 años disminuye la incidencia del cáncer de pulmón en Ávila en ambos sexos. En 2012 los pacientes han sido más ancianos, predominando la histología adenocarcinoma y el tratamiento con quimioterapia (AU)
Background and objectives. To determine the extent of lung cancer in Alvila. Its incidence rates and significant epidemiological aspects of the year 2012 were recorded, and the results of each 5-year period (up to 20 years) were compared with those of known studies conducted using the same methodology. Patients and methods. A prospective study was conducted on all patients diagnosed with lung cancer in the Province of Avila throughout the year 2012. Results. A total of 81 patients were diagnosed, of whom 70 were males and 11 females, with a mean age of 72.1 years (range: 44-91), and was higher than that found in previous studies. This gave gross, and adjusted to the standard world population, incidence rates in 2012 of 80.99 and 31.23 per 100,000, respectively, in males, and 12.97 and 5.68 per 100,000, respectively in females. These rates are lower in both sexes than those found in Alvila in 2002. In 2012, 80.25% had been smokers (90% of males and 18.18% of the women), although, on diagnosis, 68.75% had quit smoking. A clinical-radiological diagnosis was made in 9 (11.1%), with a histocytological diagnosis in 72 (88.9%). The histological types were: adenocarcinomas in 37.5%; squamous in 33.3%; microcytic in 13.8%; undifferentiated non-small cell in 11.1%; large cell in 2.77%, and carcinoid in 1.38%. The most frequent treatments were chemotherapy (50.6%), symptomatic (23.4%), and surgery (12.3%). Conclusions. The incidence of lung cancer in Avila has decreased in both sexes in the last 10 years. In 2012, the patients have been older, the majority with adenocarcinoma histology, and receiving chemotherapy (AU)
Subject(s)
Adult , Aged, 80 and over , Aged , Female , Humans , Male , Middle Aged , Lung Neoplasms/epidemiology , Lung Neoplasms/prevention & control , Adenocarcinoma/drug therapy , Prospective Studies , Confidence Intervals , Lung Neoplasms/diagnosis , Lung Neoplasms/drug therapy , Lung Neoplasms/physiopathologyABSTRACT
BACKGROUND AND OBJECTIVES: To determine the extent of lung cancer in Alvila. Its incidence rates and significant epidemiological aspects of the year 2012 were recorded, and the results of each 5-year period (up to 20 years) were compared with those of known studies conducted using the same methodology. PATIENTS AND METHODS: A prospective study was conducted on all patients diagnosed with lung cancer in the Province of Avila throughout the year 2012. RESULTS: A total of 81 patients were diagnosed, of whom 70 were males and 11 females, with a mean age of 72.1 years (range: 44-91), and was higher than that found in previous studies. This gave gross, and adjusted to the standard world population, incidence rates in 2012 of 80.99 and 31.23 per 100,000, respectively, in males, and 12.97 and 5.68 per 100,000, respectively in females. These rates are lower in both sexes than those found in Alvila in 2002. In 2012, 80.25% had been smokers (90% of males and 18.18% of the women), although, on diagnosis, 68.75% had quit smoking. A clinical-radiological diagnosis was made in 9 (11.1%), with a histocytological diagnosis in 72 (88.9%). The histological types were: adenocarcinomas in 37.5%; squamous in 33.3%; microcytic in 13.8%; undifferentiated non-small cell in 11.1%; large cell in 2.77%, and carcinoid in 1.38%. The most frequent treatments were chemotherapy (50.6%), symptomatic (23.4%), and surgery (12.3%). CONCLUSIONS: The incidence of lung cancer in Avila has decreased in both sexes in the last 10 years. In 2012, the patients have been older, the majority with adenocarcinoma histology, and receiving chemotherapy.
Subject(s)
Adenocarcinoma/epidemiology , Lung Neoplasms/epidemiology , Smoking/epidemiology , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Female , Humans , Incidence , Lung Neoplasms/pathology , Lung Neoplasms/therapy , Male , Middle Aged , Prospective Studies , Sex Distribution , Spain/epidemiologyABSTRACT
A case of a 30-year-old man is presented. He had a past medical history of asthma and presented with cough, shortness of breath, fever and chest pain. The chest X-ray showed cardiomegaly and a interstitial pattern. The echocardiogram revealed a severe pericardial effusion that required performing a pericardiocentesis. A CT scan showed mediastinal adenopathies and reticulonodular interstitial pattern. A bronchoscopy could not be completed because of non-tolerance. Finally a lung biopsy allowed us to reach a final diagnosis of lung adenocarcinoma. Following, some aspects of lung cancer in young people are commented, especially its incidence, histology, symptoms and a prognosis. A few aspects of the interstitial lung disease are also addressed and the differential diagnosis with lymphangitic carcinomatosis.
Subject(s)
Adenocarcinoma, Papillary/diagnosis , Lung Diseases, Interstitial/diagnosis , Lung Neoplasms/diagnosis , Adenocarcinoma, Papillary/complications , Adenocarcinoma, Papillary/diagnostic imaging , Adenocarcinoma, Papillary/drug therapy , Adenocarcinoma, Papillary/secondary , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Cardiomegaly/etiology , Cisplatin/administration & dosage , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Dyspnea/etiology , Fibrosis , Humans , Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Lymphatic Metastasis , Male , Radiography , GemcitabineABSTRACT
Presentamos el caso de un varón de 30 años de edad, con antecedentes de asma bronquial, que presentó un cuadro de tos, disnea, fiebre y dolor torácico. En la radiografía de tórax se observó cardiomegalia y un patrón intersticial bilateral. En el ecocardiograma, se apreció un derrame pericárdico severo, que obligó a la realización de una pericardiocentésis. En una TAC torácica se observaron adenopatías mediastínicas y un patrón intersticial retículo nodular bilateral. No se pudo completar la broncoscopia por mala tolerancia. Finalmente una biopsia pulmonar permitió el diagnóstico de adenocarcinoma de pulmón. Posteriormente se comentan algunos aspectos del cáncer de pulmón en pacientes jóvenes (menores de 40 años), destacando datos sobre su incidencia, anatomía patológica, clínica y pronóstico. Referimos algunos aspectos de la enfermedad intersticial pulmonar y su diagnóstico diferencial con el carcinoma de pulmón con linfangitis carcinomatosa
history of asthma and presented with cough, shortness of breath, fever and chest pain. The chest X-ray showed cardiomegaly and a interstitial pattern. The echocardiogram revealed a severe pericardial effusion that required performing a pericardiocentesis. A CT scan showed mediastinal adenopathies and reticulonodular intertitial pattern. A bronchoscopy could not be completed because of non-tolerance. Finally a lung biopsy allowed us to reach a final diagnosis of lung adenocarcinoma. Following, some aspects of lung cancer in young people are commented, especially its incidence, histology, symptoms and a prognosis. A few aspects of the interstitial lung disease are also addressed and the differential diagnosis with lymphangitic carcinomatosis
Subject(s)
Male , Adult , Humans , Adenocarcinoma/diagnosis , Lymphangitis/diagnosis , Lung Neoplasms/diagnosis , Lung Diseases, Interstitial/diagnosis , Adenocarcinoma/pathology , Diagnosis, Differential , Radiography, Thoracic , Pericardiocentesis/methods , Biopsy/methods , Lung Neoplasms/pathology , Lung Diseases, InterstitialABSTRACT
No disponible
Subject(s)
Humans , Guideline Adherence , Internal Medicine , Pneumonia , Community-Acquired Infections , Pulmonary Medicine , Hospital UnitsABSTRACT
No disponible
Subject(s)
Humans , Tuberculin Test , Comorbidity , Antitubercular Agents , Prevalence , Pneumonia , Hospitalization , Community-Acquired Infections , Age Factors , Tuberculosis, PulmonaryABSTRACT
OBJECTIVE: During physical exertion, the ventilatory response of patients with severe chronic obstructive pulmonary disease (COPD) is more rapid and shallow than that of healthy subjects. There is evidence that exercise training can alter breathing pattern in COPD patients. The purpose of the present study was to observe the effects of physical training on patients with severe COPD and to determine whether or not any possible changes were maintained over time. MATERIAL AND METHODS: Patients with severe COPD without bronchial reversibility were enrolled in a randomized controlled trial of a peripheral muscle training program carried out in a hospital setting. All enrolled patients were clinically stable, without exacerbation, and were randomly assigned to a training program of high (group A) or low (group B) intensity. RESULTS: Thirty-five men with severe COPD in stable condition (mean [SD] forced expiratory volume in 1 second at 41%[7%]) were enrolled in the study. The mean age was 64(5) years. Group A underwent training at 70(22) W and group B at 35(10) W, such that the estimated total work was 8050(2882) kJ in group A and 4044(1205) kJ in group B. Breathing pattern changes were detected in exercise tests only for group A patients, but the changes were not maintained 12 months after the end of the program. CONCLUSIONS: Intense training produces changes in the breathing pattern of patients with severe COPD. The changes are not specific to the task performed, not dependent on lactate production, and not maintained over the long term.
Subject(s)
Breathing Exercises , Exercise Therapy/methods , Pulmonary Disease, Chronic Obstructive/rehabilitation , Respiratory Muscles/physiopathology , Aged , Humans , Male , Middle Aged , Physical Education and Training , Physical Endurance , Pulmonary Disease, Chronic Obstructive/physiopathology , Respiration , Respiratory Function Tests , Treatment OutcomeABSTRACT
OBJETIVO: Durante el esfuerzo físico la respuesta ventilatoria de los enfermos con enfermedad pulmonar obstructiva crónica (EPOC) grave es más rápida y superficial que la de los sujetos sanos, y existen indicios de que el entrenamiento físico podría cambiar el patrón ventilatorio de estos pacientes. El propósito del presente estudio fue comprobar los efectos que el entrenamiento físico de los pacientes con EPOC grave tiene sobre el patrón ventilatorio, así como determinar o no el mantenimiento de los posibles cambios producidos en el tiempo. MATERIAL Y MÉTODO: Se realizó un estudio aleatorio y controlado con pacientes con EPOC grave sin reversibilidad bronquial. En estos pacientes se efectuó una intervención mediante entrenamiento físico. Los pacientes fueron remitidos al hospital para entrenamiento muscular periférico, todos ellos en situación clínica estable, sin exacerbación, y fueron asignados a dos programas diferentes de entrenamiento físico. RESULTADOS: Se estudiaron 35 pacientes varones con EPOC grave, estables (volumen espiratorio forzado en el primer segundo del 41 ñ 7 por ciento), con una edad media de 64 ñ 5 años, divididos en dos grupos con diferente potencia media estimada de entrenamiento (grupo A: 70 ñ 22 W; grupo B: 35 ñ 10 W) y trabajo total desarrollado (grupo A: 8.050 ñ 2.882 kJ; grupo B: 4.044 ñ 1.205 kJ). Sólo se objetivaron cambios en el patrón ventilatorio durante el ejercicio realizado durante la prueba de esfuerzo en el grupo A, que no se mantuvieron a los 12 meses de finalizado el programa. CONCLUSIONES: El entrenamiento intenso produce cambios en el patrón ventilatorio de los pacientes con EPOC grave que son inespecíficos de la tarea e independientes de la producción de lactato, y que no se mantienen a largo plazo (AU)
Subject(s)
Middle Aged , Aged , Male , Humans , Breathing Exercises , Treatment Outcome , Physical Education and Training , Physical Endurance , Respiratory Muscles , Respiration , Pulmonary Disease, Chronic Obstructive , Exercise Therapy , Respiratory Function TestsSubject(s)
AIDS-Related Opportunistic Infections/microbiology , Bacteroidaceae Infections/complications , HIV-1 , Lung Abscess/microbiology , Prevotella/isolation & purification , AIDS-Related Opportunistic Infections/drug therapy , Adult , Anti-Bacterial Agents/therapeutic use , Bacteroidaceae Infections/drug therapy , Bacteroidaceae Infections/microbiology , Clindamycin/therapeutic use , Humans , Lung Abscess/diagnostic imaging , Lung Abscess/drug therapy , Male , Radiography, Thoracic , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Adult , Male , Humans , HIV-1 , Radiography, Thoracic , Bacteroidaceae Infections , Prevotella , Treatment Outcome , AIDS-Related Opportunistic Infections , Anti-Bacterial Agents , Clindamycin , Lung AbscessABSTRACT
BACKGROUND: It is necessary to determine what patients with community acquired pneumonia (CAP) are at highest risk of death and which characteristics allow such determination. OBJECTIVE: To analyze the risk classes in the CAP. To verify what was the associated comorbidity and whether age, sex or residence area of inpatients with CAP increased the proportion of deceased patients. METHODS: A total of 113 patients were studied (68 males and 45 females) and 15 died (13.3%). The mean age of the deceased patients was 82.5 years (standard error [SE]: 6.63 years) significantly higher than that in survivors (70.5 years, SE: 17.3 years). There were no significant differences concerning age or sex between the deceased patients and survivors belonging to the most severe class. Most patients had comorbidities (82 patients, 72.6%). Seventeen (15%) of the inpatients came from a nursing home, more frequently among the deceased (5 patients, 33%) than among survivors (12 patients, 12%), a statistically significant difference (p < 0.05). CONCLUSIONS: No differences were observed between patients regarding age or sex, once patients were stratified by risk classes. There was a high proportion of concomitant diseases, and the mortality rate was higher among patients with some associated disease. In our series, patients from a nursing home had a higher mortality rate.
Subject(s)
Pneumonia, Bacterial/epidemiology , Aged , Aged, 80 and over , Community-Acquired Infections/epidemiology , Comorbidity , Female , Humans , Male , Retrospective Studies , Risk FactorsABSTRACT
Es necesario determinar qué pacientes con neumonía adquirida en la comunidad (NAC) presentan más riesgo de muerte y las características que nos permitan tal determinación. Objetivos. Analizar las clases de riesgo de la NAC. Comprobar cuál era la comorbilidad asociada y si la edad, el sexo o el lugar de residencia de los pacientes con NAC ingresados incrementan la proporción de fallecidos. Método. Estudio retrospectivo con 113 pacientes diagnosticados de NAC e ingresados en una Unidad de Hospitalización de Neumología. Resultados. Se estudiaron 113 pacientes (68 hombres y 45 mujeres), de los cuales fallecen 15 (13,3 por ciento). La edad media de los fallecidos era de 82,5 años (desviación estándar [DE]: 6,63), significativamente mayor que los supervivientes (70,5 años, DE: 17,3). No existían diferencias significativas de edad o sexo entre los fallecidos y los supervivientes pertenecientes a la clase de mayor riesgo. La mayoría tenían comorbilidad (82 pacientes, 72,6 por ciento). Procedían de una residencia asistida 17 de los pacientes ingresados (15 por ciento), más frecuente en los fallecidos (5 pacientes, 33 por ciento) que entre los supervivientes (12 pacientes, 12 por ciento), diferencia estadísticamente significativa (p < 0,05).Conclusiones. No encontramos diferencias de mortalidad entre los pacientes en función de la edad o el sexo una vez estratificados por clases de riesgo. Existe una alta proporción de enfermedades coexistentes, falleciendo en mayor proporción aquellos que asocian alguna de ellas. En nuestra serie los pacientes procedentes de una residencia asistida presentan una mayor mortalidad (AU)
Subject(s)
Aged, 80 and over , Aged , Male , Female , Humans , Risk Factors , Comorbidity , Community-Acquired Infections , Pneumonia, Bacterial , Retrospective StudiesABSTRACT
UNLABELLED: The residence and underlying diseases could be increase the severity and risk in the pneumonia in the elderly patient. BACKGROUND: To analyse demographics qualities and mortality in elderly inpatients with pneumonia, in relation with kind of residence, and to determine the risk classes distribution. METHOD: Were studied inpatients with 65 years old or more, with pneumonia in a period of 12 months, taking demographics values and underlying diseases, including each patient in a risk class (II to V). RESULTS: One hundred and three patients were studied (78.5 years mean age-SD 7.16), 67 males and 36 females, 80% includes in high risk classes, with 15.5% mortality. 17.5% were home nursing, older (82.7 years mean age-SD 5.72-) (p < 0.002), predominantly females and in high risk classes, and with lower length of hospital stay. CONCLUSIONS: The elderly patients with community-acquired pneumonia was high risk. Home nursing was older, more risk and lower length of hospital stay.
Subject(s)
Institutionalization , Pneumonia/epidemiology , Aged , Aged, 80 and over , Female , Humans , Male , Risk FactorsABSTRACT
La residencia del paciente y enfermedades subyacentes pueden incrementar la gravedad y el riesgo de la neumonía en el paciente anciano. Objetivos: Analizar las características demográficas y la mortalidad de los pacientes ancianos ingresados con neumonía, según su procedencia y determinar la distribución por clases de riesgo. Método: Se estudiaron los pacientes de al menos 65 años, ingresados con neumonía durante 12 meses, recogiendo datos demográficos, clínicos y de las enfermedades coexistentes, asignando cada paciente a una clase de riesgo (de II a V). Resultados: Se estudiaron 103 pacientes (edad media de 78,5 años-DE 7,16-), 67 hombres y 36 mujeres, el 80% pertenecientes a clases de riesgo alto, con una mortalidad del 15,5%. El 17,5% procedían de una Residencia asistida, con una edad superior al resto (edad media de 82,7 años-DE 5,72-) (p<0,002), mayor proporción de mujeres y de pacientes de clases de riesgo alto, y una menor estancia hospitalaria. Conclusiones: Los pacientes ancianos con neumonía tienen riesgo alto. Los procedentes de residencia son de mayor edad, mayor riesgo, mayoritariamente mujeres, y tenían menos estancia hospitalaria (AU)
The residence and underlying diseases could be increase the severity and risk in the pneumonia in the elderly patient. Background: To analyse demographics qualities and mortality in elderly inpatients with pneumonia, in relation with kind of residence, and to determine the risk classes distribution. Method: Were studied inpatients with 65 years old or more, with pneumonia in a period of 12 months, taking demographics values and underlying diseases, including each patient in a risk class (II to V). Results: One hundred and three patients were studied (78,5 years mean age- SD 7,16), 67 males and 36 females, 80% includes in high risk classes, with 15,5% mortality. 17,5% were home nursing, older (82,7 years mean age-SD 5,72-) (p<0,002), predominantly females and in high risk classes, and with lower length of hospital stay. Conclusions: The elderly patients with community-acquired pneumonia was high risk. Home nursing was older, more risk and lower length of hospital stay (AU)
Subject(s)
Aged , Aged, 80 and over , Male , Female , Humans , Institutionalization , Risk Factors , PneumoniaABSTRACT
No disponible
