ABSTRACT
El SARS-CoV-2 es un virus emergente que se extendió por todo el mundo desde China a finales de 2019, generando en el individuo una respuesta inflamatoria sistémica con afectación severa de los principales órganos (pulmón, corazón, sistema nervioso central, etc.). A la enfermedad causada por el mismo, la denominamos COVID-19. Una de las complicaciones descritas en la literatura, más frecuentemente asociadas a la infección, es la enfermedad tromboembólica venosa (embolismo pulmonar y trombosis venosa profunda). Se cree que la causa es debida a la inflamación excesiva y un estado de hipercoagulabilidad, con activación plaquetaria, disfunción endotelial y estasis sanguínea, que favorece la adhesión plaquetaria y formación de trombos. Presentamos dos casos clínicos diagnosticados en nuestro centro durante el periodo de pandemia en los que se observó esta complicación (AU)
SARS-CoV-2 is an emerging virus spread over the world from China in late 2019, generating in the patient a systemic inflammatory response with severe involvement of the main organs (lung, heart, central nervous system, etc.). The disease produced by this virus is called COVID-19. Previous studies show that one of the most commonly associated complications with COVID-19 is venous thromboembolic disease (pulmonary embolism and deep vein thrombosis). The cause is thought to be due to excessive inflammation and hypercoagulability, with platelet activation, endothelial dysfunction and blood theses, which promotes platelet adhesion and thrombus formation. We present two clinical cases reported during the pandemic period in which this complication was reported (AU)
Subject(s)
Humans , Male , Middle Aged , /complications , /diagnosis , Pulmonary Embolism/diagnosis , Pulmonary Embolism/virology , Tomography, X-Ray ComputedABSTRACT
La presentación clínica del cáncer renal y de su enfermedad metastásica es muy variable. El carcinoma renal metastatiza, por orden de frecuencia, a pulmón, hueso, hígado, suprarrenales y cerebro. Las metástasis son la causa más frecuente de lesiones extrapulmonares. Su diagnóstico se realiza mediante radiografía de tórax, como prueba de imagen inicial, seguido de la TAC, la cual permite determinar con más precisión la localización, origen y extensión de la lesión (para establecer el estadio de estos tumores), y porque además, junto con la ecografía, se utiliza como método guía para la realización de procedimientos intervencionistas
The clinical presentation of renal cancer and its metastatic disease is very variable. Renal carcinoma can metastasize, in order of frequency, to lung, bone, liver, adrenal and brain. Metastases are the most frequent cause of extrapulmonary lesions. The diagnosis is made by chest radiography, as an initial imaging test, followed by CT, which allows to determine more precisely the location, origin and extent of the lesion (to establish the stage of these tumors), and because in addition, with the ultrasound, it is used as a guiding method for performing interventional procedures
Subject(s)
Humans , Male , Aged , Kidney Neoplasms/pathology , Carcinoma, Renal Cell/pathology , Lung Neoplasms/complications , Lung Neoplasms/secondary , Pleural Effusion/diagnostic imaging , Pleural Effusion/etiology , Tomography, X-Ray ComputedABSTRACT
Los pacientes con fibrosis pulmonar idiopática (FPI) presentan un mayor riesgo de desarrollar complicaciones pulmonares agudas, incluyendo entre ellas el neumotórax y el neumomediastino. Describimos los hallazgos en la radiografía y el TAC de tórax en un paciente con diagnóstico de FPI. El examen radiológico realizado por dos radiólogos especialistas de tórax reveló hallazgos de aire extra alveolar. La disnea, disfagia, afonía y dolor torácico fueron los síntomas más llamativos que presentó el paciente. En la Rx de tórax se apreció neumotórax bilateral y neumomediastino. El paciente falleció a los 22 días de iniciado el deterioro clínico por insuficiencia respiratoria
Patients with idiopathic pulmonary fibrosis (IPF) have a higher risk of developing acute pulmonary complications, including pneumothorax and spontaneus pneumomediastinum. We describe the findings in the xray and CT scan of the thorax in a patient diagnosed with IPF. The radiography examination by two thoracic specialist radiologists revealed evidenced extravascular air in the thorax. Disnea, disphagia, aphonia, thoracic pain were the most concerning symptom presented in the patient. The thoracic radiology display air in the pleural cavity along bilateral pneumothorax and pneumomediastinum. The patient died 22 days after the start of clinical deterioration due to respiratory failure
Subject(s)
Humans , Male , Middle Aged , Mediastinal Emphysema/diagnosis , Pneumothorax/diagnostic imaging , Pulmonary Fibrosis/complications , Pulmonary Fibrosis/diagnostic imaging , Radiography, Thoracic , Blood Gas AnalysisABSTRACT
Lung cancer (LC) is the leading cause of cancer death in men and the second leading cause in women worldwide. The use of low-dose computed tomography in early diagnosis was shown to reduce mortality by 20% with a median follow-up time of 6.5 years. In order to increase profitability and reduce radiation risks and costs, exhaled biomarkers could serve to help establish narrower inclusion criteria. The aim of this study was to identify new, well-founded volatile organic compounds in exhaled breath which distinguish LC patients from chronic obstructive pulmonary disease (COPD) patients and healthy subjects. There were 210 subjects enrolled and divided into three groups: control group (n = 89), COPD group (n = 40 stable COPD patients) and LC group (n = 81 with histological confirmation). Exhaled breath samples were collected using BioVOC® breath sampler devices. The analytical technique used was thermal desorption-gas chromatography-mass spectrometry. The compounds studied were hexanal, heptanal, octanal, nonanal, propanoic and nonanoic acids. Nonanoic acid showed statistically significant differences between the LC group and the other groups. It is 2.5 times and almost 9 times more likely to be found in the LC group than in the control group or COPD group, respectively. It is independent of histology but depends on tumour stage.
Subject(s)
Aldehydes/analysis , Breath Tests/methods , Exhalation , Fatty Acids/analysis , Lung Neoplasms/diagnosis , Lung Neoplasms/metabolism , Adult , Aged , Biomarkers/analysis , Case-Control Studies , Demography , Female , Gas Chromatography-Mass Spectrometry , Humans , Limit of Detection , Male , Middle Aged , Neoplasm Staging , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/metabolism , ROC Curve , Sensitivity and Specificity , Volatile Organic Compounds/analysisABSTRACT
Objetivo: Fue conocer la producción, repercusión y la colaboración sobre reducción del consumo de tabaco (RCT) a través del Science Citation Index-Expanded (SCI-E) en el período 2002 a 2007. Métodos: Se realizó una búsqueda bibliográfica de los artículos relacionados con RCT, en el SCI-E el 18 de enero de 2008 para el período 2002-2007, con descriptores ya definidos previamente. Posteriormente los artículos fueron revisados manualmente para evitar registros no pertinentes. El análisis estadístico fue descriptivo (IC 95%). Resultados: Tras el descarte de los registros no pertinentes se obtuvieron 100 documentos, con un total de 272 autores (contando un anónimo) y un total de firmas de 372, sobre un total de 119 instituciones de 14 países. El tipo de documento más frecuentemente publicado fue el original (66%), con índice de firmas por trabajo (IFT) de 3,72 y las revistas más productivas fueron Nicotine & Tobacco Research con 19 artículos, y Addiction y Tobacco Control con 9 y 6 artículos respectivamente. Fueron 67 el número de documentos que recibieron citas, con un número total de citas de 534, siendo la media de citas por trabajo de 5,34. Hemos encontrado unos grupos de trabajo bien consolidados pero todavía con una escasa colaboración entre ellos. Conclusiones: Podemos afirmar que RCT es una subárea pujante y emergente dentro del tabaquismo, que presenta unos grupos de trabajo consolidados pero todavía sin una cohesión clara entre ellos. La repercusión de RCT es mayor que la media encontrada para el conjunto del tabaquismo (AU)
Objective: To determine the production, impact and collaboration of smoking reduction (SR) articles published from 2002 to 2007 using the Science Citation Index-Expanded (SCI-E). Methods: We performed a bibliographic search of the articles related with SR in the SCI-E on January 18, 2008, for the years 2002-2007, using previously-defined descriptors. Later, the articles were manually reviewed in order to avoid the inclusion of non-pertinent registers. The statistical analysis was descriptive (95% CI). Results: After discarding the non-pertinent registers, 100 documents remained, with a total of 272 authors (including one anonymous) and 372 signatures from a total of 119 institutions in 14 different countries. The type of document most frequently published was original research (66%), with a mean number of signatures per article (SPA) of 3.72. The most productive journals were Nicotine & Tobacco Research with 19 articles and Addiction and Tobacco Control with 9 and 6 articles, respectively. The number of documents that were cited was 67, with a total of 534 citations and a mean of 5.34 citations per study. We have found that there are some well-consolidated workgroups, although there still has not been much collaboration amongst them. Conclusions: We can affirm that SR is a thriving, emerging subarea of smoking research that presents consolidated workgroups, although there is no clear cohesion among these. The impact of SR research is greater than the mean found for total smoking research (AU)
Subject(s)
Humans , Tobacco Use Disorder/epidemiology , Smoking/epidemiology , Smoking Cessation/statistics & numerical data , Biomedical Research/trends , Tobacco Smoke Pollution/prevention & control , Tobacco Use Cessation/statistics & numerical data , Journal Impact Factor , 50088ABSTRACT
El concepto de asma de control difícil engloba a todos aquellos pacientes con asma insuficientemente o mal controlada, a pesar de seguir una estrategia terap¨¦utica apropiada, una vez se ha comprobado el cumplimiento de esta, se han descartado otras enfermedades y controlados los factores agravantes de la enfermedad. Los factores que contribuyen a que el asma sea refractaria al tratamiento no son bien conocidos. Algunos estudios establecen asociaciones d¨¦biles entre determinadas alteraciones gen¨¦ticas y varios factores ambientales. Se ha descrito que mutaciones del gen IL-4 y su receptor parecen tener relaci¨®n con la p¨¦rdida de funci¨®n pulmonar y con episodios de asma de riesgo vital. Tambi¨¦n se han relacionado con la gravedad del asma factores implicados en el remodelado de la v¨ªa a¨¦rea as¨ª como mutaciones de los receptores para los glucocorticoides y los ¦Â2-adren¨¦rgicos. Por otra parte se han asociado con la gravedad del asma diversos factores ambientales como la exposici¨®n continua a al¨¦rgenos, tabaquismo, intolerancia a antiinflamatorios no esteroideos (AINE) e infecciones. Estudios multic¨¦ntricos como el estudio ENFUMOSA y el estudio TENOR nos han ayudado a comprender en parte esta enfermedad (AU)
The concept of difficult-to-control asthma covers all those patients with insufficiently or poorly controlled asthma who, in spite of having followed an appropriate therapeutic strategy, and after having verified its compliance, other diseases have been ruled out and aggravating factors of the disease controlled. The factors that contribute to making asthma refractory to treatment are not well known. Some studies establish weak associations between certain genetic alterations and several environmental factors. It has been described that mutations of the IL-4 gene and its receptor seem to have a relationship with loss of pulmonary function and with life-threatening asthma episodes. They have also been related with the severity of the asthma factors involved in airway remodeling and mutations of glucocorticoids and beta 2-adrenergic receptors. On the other hand, different environmental factors such as continuing exposure to allergens, tobacco smoke, intolerance to NSAIDs and infections have been associated with the severity of asthma. Multicenter study such as the ENFUMOSA study and the TENOR study have partially helped us to understand this disease (AU)
Subject(s)
Humans , Asthma/complications , Drug Resistance , Risk Factors , Severity of Illness Index , Adrenal Cortex Hormones/therapeutic use , Receptors, Glucocorticoid/genetics , Airway Remodeling/physiologyABSTRACT
El síndrome de Mouniere-Kuhn se caracteriza por bronquiectasias (BQ) congénitas asociadas a traqueobroncomegalia. Es una enfermedad poco prevalente en la población general (1-4,5%), siendo infrecuente el diagnóstico en la edad adulta. Las infecciones respiratorias constituyen una complicación frecuente en su evolución y entre ellas, la infección y colonización por Pseudomona aeruginosa. La terapia antibiótica inhalada con colistina, tobramicina, etc. ha demostrado su eficacia en pacientes con BQ asociadas a fibrosis quística. La instauración de este tratamiento en nuestro caso se asoció con una mejoría en la sintomatología clínica y reducción de las exacerbaciones (AU)
Mounier-Kuhn syndrome is characterized by congenital bronchiectasis (BC) associated to tracheobronchomegaly. It is a disease of little prevalence in the general population (1-4.5%), its diagnosis being uncommon in the adult age. Respiratory infections are a frequent complication in its course and, among them, infection and Pseudomona aeruginosa colonization. Inhaled antibiotic therapy with colistin, tobramycin, etc. has demonstrated its efficacy in patients with cystic fibrosis bronchiectasis. The establishment of this treatment in our case was associated with an improvement in the clinical symptoms and reduction of the deteriorations (AU)
Subject(s)
Humans , Male , Aged , Hypertrophy/etiology , Bronchiectasis/congenital , Tracheal Diseases/congenital , Respiratory Tract Infections/epidemiology , Pseudomonas aeruginosa/pathogenicity , Pseudomonas Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Administration, InhalationABSTRACT
Reumen. Se ha comprobado la utilidad de la gammagrafía con depreótida (un péptido que interacciona con receptores de somatostatina) en el diagnóstico de nódulos pulmonares malignos, pero se desconoce su rendimiento en el derrame pleural (DP) de posible origen neoplásico, donde la citología y biopsia pleural cerrada son de bajo rendimiento. Presentamos nuestra experiencia en tomogammagrafía SPECT (single photon emission computed tomography) de receptores de somatostatina con 99mTc-depreótida en 12 pacientes con NPS (nódulo pulmonar solitario) sospechosos de malignidad y en los que se detectó la presencia de derrame pleural, bien en fase inicial o en el transcurso del seguimiento del NPS. Pacientes y método. Estudio retrospectivo (julio de 2004 a abril de 2006) de los pacientes con DP y sospecha de neoplasia intratorácica a los que se había realizado tomogammagrafía SPECT de tórax con depreótida marcada con Tc 99m como parte del trabajo diagnóstico. Resultados. Se registraron los datos de 12 pacientes. Se observó hipercaptación significativa (grado 2 o 3) del radiotrazador en 5 de 7 DP asociados a neoplasia del pulmón o pleural (categoría A), y en 3 DP asociados a cáncer extrapulmonar diseminado (categoría B). En otros dos pacientes se observó hipercaptación pleural y no se confirmó neoplasia intra o extratorácica (categoría C). Conclusiones. La tomogammagrafía con depreótida marcada (NeoSpect) podría ser de utilidad en el estudio de DP de origen tumoral. La existencia de resultados positivos con esta técnica en derrames no malignos hace necesarios estudios más amplios para determinar su valor diagnóstico (AU)
Summary. We know the use of depreotide scintigraphy (a peptide with affinity for the somatostatin receptor) in the diagnose of malignant pulmonary nodules, but we do not know the efficiency in neoplastic pleural effusions, where the cytology and percutaneous pleural biopsy are of poor efficiency. We show our experience in Technetium 99m-Tc depreotide single photon emission computed tomography (SPECT) in 12 patients with suspicious malignant solitary pulmonary nodule, who moreover had pleural effusion on start or during the follow up of solitary pulmonary nodule. Patients and method. Retrospective study (from July 2004 to April 2006) of patients with pleural effusion and suspicion of intrathoracic malignacy to whom we carried out thoracic 99m-Tc depreotide SPECT besides of other diagnostic procedures. Results. We registered the data of 12 patients and took notice of significant (degree 2 or 3) uptake in 5 out of 7 pleural effusions associated to pleural or lung neoplasm (group A) and in 3 pleural effusions associated to spread extrapulmonary primary tumor (group B). In 2 other patients we take notice of pleural uptake without confirmation of intrathoracic or extrathoracic malignancy (group C). Conclusions. The tomographical imaging got with somatostatin receptor scintigraphy with 99m-Tc depreotide (NeoSpect) can be used in the study of neoplastic pleural effusions. The positive findings in non-malignant pleural effusions make necessary extra studies to determine its diagnostic meaning (AU)
Subject(s)
Humans , Positron-Emission Tomography/methods , Pleural Effusion , Technetium , Spectrometry, Gamma/methods , Lung Neoplasms , Pleural Neoplasms , Patient SelectionABSTRACT
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Humans , Male , Adult , Athletic Injuries/diagnosis , Thoracic Injuries/diagnosis , Soccer/injuries , Rib Fractures/diagnosis , Hematoma/diagnosisABSTRACT
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Subject(s)
Humans , Asthma/physiopathology , Asthma/diagnosis , Asthma/drug therapyABSTRACT
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Subject(s)
Humans , Pulmonary Fibrosis/complications , Lung Diseases, Interstitial/classification , Recurrence , Acute Disease/epidemiology , Disease Progression , Steroids/therapeutic use , Oxygen Inhalation TherapyABSTRACT
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Humans , Male , Aged, 80 and over , Hematoma , Thoracic Wall/injuries , Pleural Diseases , Radiography, Thoracic/methods , Incidental FindingsABSTRACT
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Subject(s)
Humans , Male , Aged , Pulmonary Atelectasis/etiology , Lung Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Bronchoscopy , Tomography, X-Ray ComputedABSTRACT
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Subject(s)
Humans , Female , Aged , Teratoma/diagnosis , Mediastinal Neoplasms/diagnosis , Diagnosis, Differential , Aneurysm/diagnosis , Echocardiography , Tomography, X-Ray ComputedABSTRACT
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Subject(s)
Humans , Lung Neoplasms/epidemiology , Lung Neoplasms/diagnosis , Lung Neoplasms/prevention & control , Mass Screening , Early Diagnosis , Cost-Benefit AnalysisABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Pleural Effusion/etiology , Mesothelioma/pathology , /pathology , Tobacco Use Cessation , ThoracoscopyABSTRACT
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