ABSTRACT
INTRODUCTION: Increased survival in lung transplant recipients, the need for immunosuppressive therapy, and many risk factors before and after transplantation enhance the development of malignancies. This study sought to analyze the incidence of noncutaneous tumors after lung transplantation in our hospital, the risk factors for malignancy, and its impact on prognosis. PATIENTS AND METHODS: A retrospective analysis of clinical records of patients after lung transplantation in our hospital from October 1993 to December 2014. RESULTS: The study population included 443 patients. In total, 35 neoplasia developed in 33 patients (9.6%). Twelve cases were posttransplant lymphoproliferative disorders (PTLDs), 7 localized in the native lung, 7 gynecologic neoplasia (2 in the breast, 4 in the vulva, and 1 in the cervix), 3 in the colon, 2 in the nervous system (one was an astrocytoma), 2 in the prostate, 1 in the kidney, and 1 in the esophagus. The average time between transplantation and malignancy detection was 52.7 ± 45.4 months, being earlier in patients with PTLDs than in non-PTLD. Eleven patients who developed malignancy (all patients with neoplasia in native lung and in cervix, 1 in the colon, 1 PTLD, and 1 in the nervous system) died as a result of it. The only factor associated with an increased risk of malignancy in our population was smoking history. CONCLUSIONS: Almost 10% of lung transplant recipients developed some type of noncutaneous neoplasia and the most frequently diagnosed were PTLDs. Lung neoplasia compromised most survival in these patients.
Subject(s)
Lung Transplantation/adverse effects , Neoplasms/epidemiology , Risk Assessment/methods , Transplant Recipients , Adult , Female , Humans , Incidence , Male , Neoplasms/etiology , Prognosis , Retrospective Studies , Risk Factors , Spain/epidemiology , Survival Rate/trendsABSTRACT
OBJETIVO: Determinar el efecto del ejercicio sobre la calidad de vida e impacto en actividades cotidianas de la vida de los pacientes con síndrome de apneas-hipopneas del sueño (SAHS) leve. PACIENTES Y MÉTODOS: Ensayo clínico controlado, aleatorizado y de grupos paralelos. Se incluyeron sujetos con un índice de apneas-hipopneas (IAH) < 20 y escasa actividad física. Los sujetos fueron aleatorizados a un grupo, que realizó un programa aeróbico de ejercicio físico, frente a un grupo que realizó las medidas habituales. Después de 24 semanas, se determinaron nuevamente la calidad de vida (cuestionario Euroqol-5D) y el impacto sobre las actividades de la vida cotidiana (cuestionario FOSQ). RESULTADOS: De los 27 pacientes con SAHS leve, no se analizaron 3 sujetos del grupo intervención (23%), ya que no cumplieron el programa de ejercicio, y 1 sujeto del grupo control (7%). Las características basales fueron similares en ambos grupos. Tras el seguimiento, en el grupo control (n = 13) no se encontraron diferencias respecto a los valores basales, mientras que en grupo intervención (n = 10) se observaron cambios significativos en la calidad de vida (movilidad, puntuación total de salud y autovaloración, p < 0,05) y en la puntuación del cuestionario FOSQ (cálculo total, dimensiones de productividad social, actividad, vigilancia e intimidad; p < 0,05), sin cambio significativo en el cuestionario de Epworth. CONCLUSIONES: En pacientes con SAHS leve, un programa de ejercicio aeróbico produce mejoría en la calidad de vida y en el impacto de la somnolencia diurna sobre su vida cotidiana
OBJECTIVE: To determine the effect of exercise in health-related quality of life and how it impacts on daily activities in mild obstructive sleep apnea (OSA) patients. Patients and METHODS: Controlled clinical trial, randomized and parallel groups. Patients with an apnea-hipopnea index (AHI) < 20 and with mild activity were included. Randomly, patients were undertaken to an aerobic program (intervention group) or to an usual therapeutic measures (control group). We analyzed health-related quality of life (Euroqol-5D questionnaire) and the impact on daily activities (FOSQ questionnaire) after 24 weeks. RESULTS: 27 patients were included. 3 patients in the intervention group (23%) with mild OSA were no analyzed because of lack of exercise adherence, while in the control group 1 patient (7%) was lost. Characteristics were similar in both groups. There were no differences in basal statements in the control group (n =13) after the following period. There were stadistical differences in quality of life (mobility, total score and visual anagogic scale score; p < 0.05) and in FOSQ questionnaire score (total score, social outcomes, activity level, vigilance and intimacy and sexual subscales; p < 0.05) in the interventional group (n = 10). No significant change in the Epworth questionnaire was observed. CONCLUSIONS: An aerobic exercise program in patients with mild OSA improves quality of life and produces a positive impact in daytime sleepiness on activities of daily living