[Saccharin test for the study of mucociliary clearance: reference values for a Spanish population]. / Test de la sacarina en el estudio del aclaramiento mucociliar. Valores de referencia en una población española.

OBJECTIVE: Mucociliary transport is an important defense mechanism for the airways. The aim of this study was to establish reference values for nasal mucociliary clearance time (MCT) by means of the saccharin test. SUBJECTS AND METHODS: A cross-sectional, descriptive, observational study was performed. The variables studied were nasal MCT, age, and sex. We included 249 healthy nonsmokers (134 male and 115 female subjects) aged over 10 years and stratified the sample by age. To establish reference values, percentiles were calculated and lower and upper limits of normal were established at percentiles 2.5 and 97.5, respectively. The association between nasal MCT and the main study variables was then investigated along with the reproducibility of the test. RESULTS: The following values for nasal MCT were obtained for the sample as a whole: mean (SD), 17.17 (8.43) minutes; median (interquartile range), 16 minutes (12-20 minutes), indicating that the central 50% of the sample fell within this 8-minute range; and maximum and minimum values of 4 to 54 minutes (range, 50 minutes). The upper and lower limits of normal were 6 and 36 minutes, respectively. In addition, it is noteworthy that only 6 subjects had a nasal MCT longer than 36 minutes. No significant differences between male and female subjects were found. Nasal MCT showed a positive correlation with age (rho=0.324; P=.0001). No significant differences were observed in the reproducibility test (P=.208). CONCLUSIONS: In addition to facilitating reliable data on mucociliary function, the saccharin test is easy to do, inexpensive, and reproducible. The data obtained from this study should allow the results of this test to be correctly interpreted for a given subject's age and so facilitate its use in clinical practice.

Test de la sacarina en el estudio del aclaramiento mucociliar. Valores de referencia en una población española / Saccharin test for the study of mucociliary clearance: reference values for a spanish population

OBJETIVO: El transporte mucociliar es un importante mecanismode defensa de las vías respiratorias. El objetivo deeste estudio ha sido obtener los valores de referencia deltiempo de transporte mucociliar nasal (TTMCN) medianteel test de la sacarina.SUJETOS Y MÉTODOS: Se ha realizado un estudio observacional,transversal y descriptivo. Las variables estudiadasfueron el TTMCN, la edad y el sexo. Se incluyó a 249 sujetos(134 varones y 115 mujeres) mayores de 10 años, sanos y nofumadores, que se asignaron a grupos según su edad. Parael análisis predictivo de los valores de normalidad se obtuvieronlos percentiles, estableciendo los límites de referenciapor los percentiles 2,5 y 97,5. Se analizó la asociación entreel TTMCN y las variables principales. Se estudió asimismola reproducibilidad del test.RESULTADOS: Del análisis global de la muestra destacanlos siguientes datos: mediana de 16 min; media ± desviaciónestándar de 17,17 ± 8,43 min; rango de 50 min (4-54); límitesde referencia de 6-36 min, y amplitud intercuartílica de 8min (un 50% central de la muestra entre 12 y 20 min). Esasimismo reseñable que sólo 6 sujetos tuvieron un TTMCNsuperior a 36 min. No se encontraron diferencias significativasentre varones y mujeres. El TTMCN mostró una correlaciónpositiva con la edad (rs = 0,324; p = 0,0001). No se observarondiferencias significativas (p = 0,208) en la pruebade reproducibilidad.CONCLUSIONES: El test de la sacarina es fácil de realizar,económico y reproducible, y facilita datos fiables de la funciónmucociliar. Los datos obtenidos en este trabajo permitenla correcta interpretación de los resultados de esta pruebasegún la edad del sujeto, lo que facilitará su uso

OBJECTIVE: Mucociliary transport is an important defensemechanism for the airways. The aim of this study was toestablish reference values for nasal mucociliary clearancetime (MCT) by means of the saccharin test.SUBJECTS AND METHODS: A cross-sectional, descriptive,observational study was performed. The variables studiedwere nasal MCT, age, and sex. We included 249 healthynonsmokers (134 male and 115 female subjects) aged over10 years and stratified the sample by age. To establishreference values, percentiles were calculated and lower andupper limits of normal were established at percentiles 2.5and 97.5, respectively. The association between nasal MCTand the main study variables was then investigated alongwith the reproducibility of the test.RESULTS: The following values for nasal MCT were obtainedfor the sample as a whole: mean (SD), 17.17 (8.43) minutes;median (interquartile range), 16 minutes (12-20 minutes),indicating that the central 50% of the sample fell within this8-minute range; and maximum and minimum values of 4 to54 minutes (range, 50 minutes). The upper and lower limits ofnormal were 6 and 36 minutes, respectively. In addition, it isnoteworthy that only 6 subjects had a nasal MCT longer than36 minutes. No significant differences between male and femalesubjects were found. Nasal MCT showed a positive correlationwith age ( =0.324; P=.0001). No significant differences wereobserved in the reproducibility test (P=.208).CONCLUSIONS: In addition to facilitating reliable data onmucociliary function, the saccharin test is easy to do,inexpensive, and reproducible. The data obtained from thisstudy should allow the results of this test to be correctlyinterpreted for a given subject’s age and so facilitate its usein clinical practice

[Hepatopulmonary syndrome in a patient with adenocarcinoma of the colon metastatic to the liver and no apparent chronic liver disease]. / Síndrome hepatopulmonar en paciente con adenocarcinoma de colon con metástasis hepáticas y sin hepatopatía crónica conocida.

Hepatopulmonary syndrome consists of a clinical triad: arterial blood deoxygenation, intrapulmonary vasodilation, and liver disease. Both acute and chronic cases of this syndrome have been reported, and the most common cause is cirrhosis. The principle disease mechanism is dilation of the pulmonary blood vessels causing alterations in gas exchange. Increased pulmonary production of nitric acid has been implicated as the primary pathogenic mechanism of vasodilation although it has also been associated with imbalance between vasodilators and vasoconstrictors. We describe the case of a patient with hepatopulmonary syndrome and adenocarcinoma of the colon with metastases to a previously healthy liver.

Síndrome hepatopulmonar en paciente con adenocarcinoma de colon con metástasis hepáticas y sin hepatopatía crónica conocida / Hepatopulmonary syndrome in a patient with adenocarcinoma of the colon metastatic to the liver and no apparent chronic liver disease

El síndrome hepatopulmonar comprende una tríada clínica caracterizada por desoxigenación arterial, dilataciones vasculares intrapulmonares y hepatopatía. Se han descrito tanto casos agudos como crónicos, y la causa más frecuente es la cirrosis. El mecanismo fisiopatológico principal es la dilatación de los vasos pulmonares, que produce una alteración del intercambio gaseoso. Se ha implicado la mayor producción pulmonar de óxido nítrico como mecanismo patogénico principal de la vasodilatación, aunque también se ha relacionado el desequilibrio entre sustancias vasodilatadoras y vasoconstrictoras. Describimos un caso en el que se produjo un síndrome hepatopulmonar en un paciente afectado de un adenocarcinoma de colon con metástasis hepáticas en un hígado previamente sano

Hepatopulmonary syndrome consists of a clinical triad: arterial blood deoxygenation, intrapulmonary vasodilation, and liver disease. Both acute and chronic cases of this syndrome have been reported, and the most common cause is cirrhosis. The principle disease mechanism is dilation of the pulmonary blood vessels causing alterations in gas exchange. Increased pulmonary production of nitric acid has been implicated as the primary pathogenic mechanism of vasodilation although it has also been associated with imbalance between vasodilators and vasoconstrictors. We describe the case of a patient with hepatopulmonary syndrome and adenocarcinoma of the colon with metastases to a previously healthy liver

Hemoptysis as an unusual manifestation of right atrial myxoma.

Atrial myxoma is the most frequent tumor of the heart, though right-side locations and initial clinical manifestation in the form of hemoptysis are infrequent. We describe the case of a young woman with right atrial myxoma diagnosed by transthoracic echocardiography and presenting hemoptysis as the most important manifestation. The symptomatology disappeared after surgical removal of the lesion.