ABSTRACT
The use of predictive variables of exacerbations of the COPD is not a practice generalized in our environment, for what we cannot characterize the exacerbating patient neither to design strategies for its integral handling. There was carried out a prospective descriptive study to correlate in patient with diagnosis of COPD from the Neumologic Hospital of Cuba, with the objective of determining the association between clinical, functional variables and imagenological and the exacerbations frequency a year. The population was constituted for patients with clinical diagnosis of COPD and the sample for those patients with confirmed diagnosis that they completed the inclusion approaches. The correlation among the variables was carried out by means of the Coefficient of Correlation of Pearson with an interval of Trust of 95% and the test t student with a significance level (p) smaller than 0.05. 81.82% of the very serious patients are exacerbating with emphysema. 75% of the patients with index of the lung artery / aorta have more than two exacerbations a year. 84.61% of the patient exacerbating presented degree four of the dyspnea. The half pressure of the lung artery next to the VEF1 constituted the best exacerbations predictors in the group of studied patients.
Subject(s)
Disease Progression , Dyspnea/physiopathology , Pulmonary Disease, Chronic Obstructive/physiopathology , Cuba , Female , Hospitalization , Humans , Male , Prospective Studies , Risk Factors , Severity of Illness IndexABSTRACT
Resumen Las mycobacterias no tuberculosas son poco reconocidas en la actualidad, pero su prevalencia se incrementa al sospechar su presencia en inmunodeprimidos o en enfermedades crónicas como la fibrosis quística. Se presenta el caso de una paciente con diagnóstico de síndrome de Lady Windermere con tos crónica. Se realizó tomografía computarizada donde se observaron bronquiectasias en el segmento lingular del pulmón izquierdo y en los lóbulos medio e inferior del derecho. En la broncoscopia se aisló complejo Mycobacterium avium-intracellulare. El no considerar en el diagnóstico de pacientes con tos crónica y sin factores predisponentes a las mycobacterias atrasa el diagnóstico y se acelera el deterioro clínico del paciente.
Abstract The nontuberculous mycobacteria are rarely recognized today in the world, being increased their prevalence about to departure of their suspicion in chronic illnesses such as inmunocompromised patients and cystic fibrosis. We present a case with diagnosis of syndrome of Lady Windermere about to departure of a square of chronic cough. Computed tomography was performed where bilateral bronchiectasis is observed in the left lingual segment and right upper lobe. In the Bronchoscopy was isolated complex Mycobacterium avium-intracellulare. The lack of suspicion of nontuberculous mycobacteria in patient without risk factors, with a square of chronic cough leads to the delay in the diagnosis and the patient's clinical deterioration.
ABSTRACT
El vólvulo gástrico es una entidad poco frecuente que puede presentarse de forma aguda o crónica. El vólvulo agudo puede presentarse con la triada de Borchardt, el crónico puede ser asintomático y su diagnóstico es usualmente incidental. Se presenta el caso de un piloto de avión que presenta falta de aire a los medianos esfuerzos con tos relacionada con episodios de acidez gástrica sobre todo después de comidas profusas. La confirmación diagnóstica se realizó mediante estudios radiológicos simples y contrastados. Se realizó intervención quirúrgica y los síntomas desaparecieron sin otras alteraciones en un período de seguimiento de un año...
The gastric volvulus is a not very frequent entity that can show up in acute form or chronic. The acute volvulus can show up with the triad of Borchardt, the chronic one can be asymptomatic and its diagnosis is usually incidental. We present shows a case of an airplane pilot that presents dyspnea to the medium efforts with cough related with episodes of gastric acidity mainly after profuse foods. The diagnostic confirmation was carried out by means of radiological simple and contrasted studies. A surgical intervention was performed and the symptoms disappeared without other alterations in a period of pursuit of one year...
Subject(s)
Humans , Male , Middle Aged , Dyspnea , Stomach VolvulusABSTRACT
Las micobacterias no tuberculosas son poco reconocidas hoy en el mundo, incrementándose su prevalencia a punto de partida de su sospecha en inmunodeprimidos o en enfermedades crónicas, como la fibrosis quística. Se presenta el caso de una paciente con diagnóstico de síndrome de Lady Windermere a punto de partida de un cuadro de tos crónica. Se realizó tomografía computarizada donde se evidenciaron bronquiectasias en el segmento lingular del pulmón izquierdo y en los lóbulos medio e inferior del derecho. Mediante la broncoscopia se aisló el complejo Mycobacterium avium-intracellulare. La falta de sospecha de micobacterias atípicas en pacientes sin factores predisponentes, con un cuadro de tos crónica, conduce al retraso en el diagnóstico y el deterioro clínico del paciente...
Nontuberculous mycobacteria are rarely recognized in the world today; their prevalence is increasing due to suspicion in immunocompromised patients or in those suffering from chronic illnesses such as cystic fibrosis. A case with of Lady Windermere Syndrome diagnosis that originally started with chronic cough is presented. Tomography showed bilateral bronchiectasis in the left lingual segment and in the middle and lower right lobe. Mycobacterium avium-intracellulare complex was isolated using bronchoscopy. The lack of suspicion of nontuberculous mycobacteria in patients without risk factors and chronic cough leads to diagnosis delay and clinical deterioration of the patient...
Subject(s)
Humans , Female , Middle Aged , Bronchiectasis/diagnosis , Mycobacterium avium Complex , Chronic Disease , Cough , Case ReportsABSTRACT
The gastric volvulus is a not very frequent entity that can show up in acute form or chronic. The acute volvulus can show up with the triad of Borchardt, the chronic one can be asymptomatic and its diagnosis is usually incidental. We present shows a case of an airplane pilot that presents dyspnea to the medium efforts with cough related with episodes of gastric acidity mainly after profuse foods. The diagnostic confirmation was carried out by means of radiological simple and contrasted studies. A surgical intervention was performed and the symptoms disappeared without other alterations in a period of pursuit of one year.
