Giant primary mediastinal liposarcoma: A rare cause of atrial flutter.

We report the case of a 68-year-old man who presented with atrial flutter and was observed radiologically to have a large mass in the posterior mediastinum. During surgical removal, spontaneous recovery of sinus rhythm occurred. There was no late recurrence of arrhythmia. The diagnosis was mediastinal liposarcoma of mixed type (extremely rare). Supraventricular arrhythmia associated with mediastinal tumors is exceptional. Surgery appears to be the only potentially curative treatment for these tumors. In cases like ours presenting with arrhythmia, surgery is considered essential for control of the arrhythmia.

Clasificación de la gravedad de la enfermedad pulmonar obstructiva crónica según la nueva guía Iniciativa Global para la Enfermedad Obstructiva Crónica 2011: COPD Assessment Test versus modified Medical Research Council / Classification of Chronic Obstructive Pulmonary Disease Severity According to the New Global Initiative for Chronic Obstructive Lung Disease 2011 Guidelines: COPD Assessment Test Versus Modified Medical Research Council Scale

Introducción: La revisión GOLD 2011 propone estratificar a los pacientes con EPOC midiendo la repercusión de la enfermedad mediante la escala mMRC o mediante el cuestionario CAT. Nuestro objetivo es conocer si la elección de un método u otro resulta equivalente. Pacientes y métodos: Estudio observacional sobre una cohorte de 283 pacientes diagnosticados de EPOC. Se analizaron resultados demográficos, funcionales respiratorios y de evaluación mediante CAT y mMRC, aplicados el mismo día y por el mismo entrevistador a cada paciente. Se distribuyeron en categorías GOLD 2011 según el resultado de la evaluación y se determinó el grado de concordancia y la correlación de Spearman. Se utilizó el test de ANOVA sobre las variables clínicas y funcionales de las 4 categorías GOLD 2011. Resultados: Al evaluar la clasificación de pacientes según el método empleado, se obtuvo una correlación global ρ = 0,613 y un grado de concordancia κ = 0,63 (moderado). Se obtuvo κ = 0,44 para los 152 pacientes de las categorías A y B (moderado-débil), y de 0,38 para los 131 pacientes de las categorías C y D (débil). Se apreciaron diferencias entre categorías en cuanto a parámetros funcionales. Conclusiones: La clasificación de los pacientes con EPOC según la evaluación propuesta por GOLD 2011 varía según se emplee CAT o mMRC; se reclasifica a más del 25% de pacientes en diferentes categorías, implicando diferencias en la estrategia terapéutica recomendada. Son necesarios estudios longitudinales que permitan valorar qué método clasifica mejor a los pacientes, atendiendo a su capacidad pronóstica

Introduction: The GOLD 2011 revision proposes to stratify patients with chronic obstructive pulmonary disease (COPD) by measuring the impact of the disease using the modified Medical Research Council (mMRC) scale or COPD assessment test (CAT). Our aim was to determine whether both methods are equivalent. Patients and methods: Observational study on a cohort of 283 patients diagnosed with COPD. We analyzed the demographic and lung function results. Patients were assessed by CAT and mMRC on the same day by the same interviewer, and divided into GOLD 2011 categories according to the result of the evaluation. The degree of concordance and Spearman correlation were determined. We used ANOVA on the clinical and functional variables of the four GOLD 2011 categories. Results: On assessing the classification of patients according to the method used, an overall correlation of ρ = 0.613 and a degree of concordance of κ = 0.63 (moderate) were obtained. κ = 0.44 was obtained for the 152 patients in categories A and B (moderate-low), and at 0.38 for the 131 patients in categories C and D (low). Differences were observed between the categories in terms of functional parameters. Conclusions: The classification of patients with COPD using the assessment proposed by GOLD 2011 varies according to the method used (CAT or mMRC); more than 25% of patients were reclassified into different categories, implying differences in the recommended therapeutic strategy. Longitudinal studies are needed to appraise which method does better classification of the patients, according to its prognostic ability

Classification of chronic obstructive pulmonary disease severity according to the new Global Initiative for Chronic Obstructive Lung Disease 2011 guidelines: COPD assessment test versus modified Medical Research Council scale.

INTRODUCTION: The GOLD2011 revision proposes to stratify patients with chronic obstructive pulmonary disease (COPD) by measuring the impact of the disease using the modified Medical Research Council (mMRC) scale or COPD assessment test (CAT). Our aim was to determine whether both methods are equivalent. PATIENTS AND METHODS: Observational study on a cohort of 283 patients diagnosed with COPD. We analyzed the demographic and lung function results. Patients were assessed by CAT and mMRC on the same day by the same interviewer, and divided into GOLD2011 categories according to the result of the evaluation. The degree of concordance and Spearman correlation were determined. We used ANOVA on the clinical and functional variables of the four GOLD2011 categories. RESULTS: Assessing the classification of patients according to the method used, an overall correlation ρ=0.613 and a degree of concordance κ=0.63 (moderate) were obtained. κ=0.44 was obtained for the 152 patients in categoriesA and B (moderate-low), and 0.38 for the 131 patients in categoriesC and D (low). Differences were observed between categories in terms of functional parameters. CONCLUSIONS: The classification of patients with COPD using the assessment proposed by GOLD2011 varies according to the method used (CAT or mMRC); more than 25% of patients were reclassified into different categories, implying differences in the recommended therapeutic strategy. Longitudinal studies are needed to appraise which method better classifies patients, according to its prognostic ability.

¿Tiene tratamiento la ereutofobia? / Is there a treatment for ereuthophobia?

No disponible

Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática / Effect of flavonoids in the prevention of lung cancer: systematic review

Desde hace años, el cáncer de pulmón es el tumor que origina un mayor número de muertes en los países industrializados y emergentes. Un cuidado meticuloso de los aspectos nutricionales, insistiendo en altos niveles de consumo de frutas y verduras, puede suponer un importante elemento de prevención primaria. Investigando el efecto de sustancias con poder antioxidante, numerosos estudios epidemiológicos han centrado su atención en los flavonoides. El objetivo de esta revisión es analizar la evidencia científica disponible en la literatura médica respecto al papel de los flavonoides en el cáncer de pulmón. Tras una revisión bibliográfica sistemática, se identificaron un metaanálisis, una revisión sistemática, 11 estudios prospectivos de cohortes y 5 estudios de casos y controles.Tras analizar la evidencia científica establecida por estos trabajos, se observó un pequeño efecto protector del consumo de flavonoides (especialmente a altas dosis) frente al desarrollo de cáncer de pulmón, aunque no todos los estudios lo confirman. En este sentido, parecen no existir diferencias entre la ingesta selectiva de distintos tipos de flavonoides y el consumo de flavonoides totales, pero sí se observan diferencias entre las distintas poblaciones estudiadas (AU)

For years, lung cancer has been the tumor causing more deaths in industrialized and emerging countries. A meticulous care of the nutritional aspects, with emphasis on high consumption of fruits and vegetables, can be an important element of primary prevention.Taking into account research on the effect of substances with antioxidant power, many epidemiological studies have focused on flavonoids. The objective of this review is to analyze the available scientific evidence in the literature regarding the role of flavonoids in lung cancer.After a systematic literature review, we identified a meta-analysis, a systematic review, 11 prospective cohort studies and 5 case-control studies. After reviewing the scientific evidence provided by these works, there was a small protective effect of flavonoid consumption (especially at high doses) against the development of lung cancer, although not all studies confirmed it. There seems to be no differences between selective intake of different types of flavonoids and consumption of total flavonoids, but there are differences between the different populations studied (AU)

Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática / Effect of flavonoids in the prevention of lung cancer: systematic review

Desde hace años, el cáncer de pulmón es el tumor que origina un mayor número de muertes en los países industrializados y emergentes. Un cuidado meticuloso de los aspectos nutricionales, insistiendo en altos niveles de consumo de frutas y verduras, puede suponer un importante elemento de prevención primaria. Investigando el efecto de sustancias con poder antioxidante, numerosos estudios epidemiológicos han centrado su atención en los flavonoides. El objetivo de esta revisión es analizar la evidencia científica disponible en la literatura médica respecto al papel de los flavonoides en el cáncer de pulmón. Tras una revisión bibliográfica sistemática, se identificaron un metaanálisis, una revisión sistemática, 11 estudios prospectivos de cohortes y 5 estudios de casos y controles. Tras analizar la evidencia científica establecida por estos trabajos, se observó un pequeño efecto protector del consumo de flavonoides (especialmente a altas dosis) frente al desarrollo de cáncer de pulmón, aunque no todos los estudios lo confirman. En este sentido, parecen no existir diferencias entre la ingesta selectiva de distintos tipos de flavonoides y el consumo de flavonoides totales, pero sí se observan diferencias entre las distintas poblaciones estudiadas (AU)

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[Effect of flavonoids in the prevention of lung cancer: systematic review]. / Efecto de los flavonoides en la prevención del cáncer de pulmón: revisión sistemática.

For years, lung cancer has been the tumor causing more deaths in industrialized and emerging countries. A meticulous care of the nutritional aspects, with emphasis on high consumption of fruits and vegetables, can be an important element of primary prevention. Taking into account research on the effect of substances with antioxidant power, many epidemiological studies have focused on flavonoids. The objective of this review is to analyze the available scientific evidence in the literature regarding the role of flavonoids in lung cancer. After a systematic literature review, we identified a meta-analysis, a systematic review, 11 prospective cohort studies and 5 case-control studies. After reviewing the scientific evidence provided by these works, there was a small protective effect of flavonoid consumption (especially at high doses) against the development of lung cancer, although not all studies confirmed it. There seems to be no differences between selective intake of different types of flavonoids and consumption of total flavonoids, but there are differences between the different populations studied.

Técnica de cierre de la toracotomía y su relación con el dolor postoracotomía: revisión sistemática / Suture Techniques of the Intercostal Space in Thoracotomy and Their Relationship with Post-Thoracotomy Pain: A Systematic Review

El dolor postoracotomía es un síntoma de alta incidencia entre los pacientes sometidos a toracotomía, que actúa como factor de riesgo importante en la patogénesis de diversas complicaciones posquirúrgicas. Su cronificación postoracotomía alcanza una alta prevalencia. Desde los primeros estudios se observó su relación con la lesión de los nervios intercostales y la conveniencia de evitar su lesión durante la toracotomía. Esta revisión pretende establecer el procedimiento quirúrgico más adecuado para el cierre de la toracotomía, mediante una revisión sistemática de la literatura médica y el análisis de los niveles de evidencia que proporcionan los estudios hallados.Tras una búsqueda bibliográfica exhaustiva en MEDLINE, EMBASE, IME, IBECS y Biblioteca Cochrane Plus, se hallaron escasos estudios. Cada uno de ellos se orienta a distintos aspectos de técnica quirúrgica en toracotomía, con el denominador común del enfoque hacia la preservación de los nervios intercostales, y conclusiones con distintos niveles de evidencia(AU)

Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found.After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence(AU)

Suture techniques of the intercostal space in thoracotomy and their relationship with post-thoracotomy pain: a systematic review.

Post-thoracotomy pain is a symptom of high incidence among patients who have undergone thoracotomy and is a major risk factor in the pathogenesis of several postoperative complications. Chronic pain after thoracotomy reaches a high prevalence. Since the earliest studies, this pain has been seen to be related with intercostal nerve injury, thus the need to avoid these lesions during thoracotomy has been recommended. This review aims to establish the appropriate surgical procedure for closure of the thoracotomy through a systematic review of the literature and analysis of levels of evidence provided by the studies found. After an exhaustive search in MEDLINE, EMBASE, IME, IBECS and Cochrane Library, few studies were found. Each focuses on different aspects of thoracotomy surgical techniques, with a common denominator focused on the preservation of the intercostal nerves, and conclusions with different levels of evidence.