Endobronchial cryotherapy for a mycetoma.

Mycetoma is defined as a fungus ball that fills a preexisting lung cavity, most frequently being of tuberculous or sarcoid etiology. The most frequently isolated fungus is the species of Aspergillus, but other fungi such as Fusarium or Zygomycetes can also be present. Most patients lack symptoms. However, presentation may also be with hemoptysis, which can be massive and life-threatening. We describe the case of a 50-year-old man with a history of prior pulmonary tuberculosis, with recurrent episodes of cough and hemoptysis. He was diagnosed to have mycetoma in the left upper lobe cavity. The mycetoma was extracted through bronchoscopy under general anesthesia using a cryoprobe. Treatment was completed with amphotericin B instilled in the cavity and the patient was placed on oral itraconazole. This is the first case report to date in which cryotherapy was used to remove a mycetoma.

Use of an endoscopy face mask in patients with gastric distention undergoing noninvasive ventilation for acute respiratory failure: a comparative case study report.

We describe the use of an endoscopy face mask with a perforated membrane, which allows a nasogastric tube for continuous noninvasive ventilation in acute hypercapnic respiratory failure, in 2 patients who developed gastric distention. This interface was able to avoid most nonintentional leaks through the mask, as compared with a conventional approach, improving ventilation efficiency. To our knowledge, this is the first case report of an endoscopy face mask used in noninvasive ventilation for this specific side effect.

¿Dónde se debe tratar el tabaquismo en la EPOC? / No disponible

No disponible

Tabaquismo. Análisis de la producción científi ca en el Área de Tabaquismo de la SEPAR en el año 2009 / Smoking. Analysis of the Scientifi c Production in the SEPAR Smoking Area in 2009

El Área de Tabaquismo de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) se inició en elaño 1995. Sus principales objetivos fueron incrementar la sensibilización sobre el problema del tabaquismoentre los miembros de nuestra sociedad científi ca, mejorar sus conocimientos científi cos en esta afección,facilitar las intervenciones diagnósticas y terapéuticas en los fumadores y, por último, promover lasintervenciones para la prevención y el tratamiento del tabaquismo por parte de la administración políticosanitaria.Hoy día es una de las áreas más dinámicas de la SEPAR y cuenta con más de 400 miembros.Durante el año 2009, los profesionales sanitarios del Área de Tabaquismo de la SEPAR han desarrollado unaintensa labor de investigación que se ha traducido en una producción científi ca adecuada que ha abarcadodiferentes aspectos de la disciplina del tabaquismo. Entre los más impactantes merecen destacarse los estudiosrealizados para determinar el impacto que la Ley 28/2005 ha tenido en la prevalencia del tabaquismoen España, los estudios que valoran la productividad científi ca de los miembros del área y los numerososartículos que publican los resultados de las diferentes unidades de tabaquismo que lideran losneumólogos españoles(AU)

The SEPAR Smoking Area was started in the year 1995. Its main aims were to increase awareness of theproblem of smoking among the members of our scientifi c society, to improve their scientifi c knowledge onthis problem, to help in diagnostic and therapeutic interventions in smokers, and fi nally, to promoteinterventions for the prevention and treatment of smoking by the health and political administrations.Nowadays, it is the most dynamic areas of SEPAR and has more than 400 members.Throughout the year 2009, the health professionals of the SEPAR smoking area have carried out intenseresearch work that has led to a reasonable scientifi c production that has covered different aspects of thediscipline of smoking. The most impressive studies were those that tried to determine the impact that Law28/2005 has had in the prevalence of smoking in Spain, the studies that assessed the scientifi c productivityof the area members and the numerous articles that published the results from different smoking unitsthat are led by Spanish pneumologists(AU)

[Present and future of the SEPAR Smoking and Health Area]. / Presente y futuro del Area de Tabaquismo de la SEPAR.

Smoking is the primary avoidable cause of premature death and morbidity in our country. According to data from the WHO, tobacco costs more than 5 million lives per year, a figure that is assumed to continue increasing and will be 10 million by the year 2030. As health professionals we are obliged to be actively involved in this serious health problem, by correctly identifying, diagnosing and treating all smokers to help them in the process of giving up and help them achieve total abstinence. There is scientific evidence that smoking is the direct cause and reason for the worsening of many respiratory diseases, which due to their nature are basically the responsibility of the pneumologist, who officially, according to the Health Service Administration, is the specialist and expert in this area. The Smoking and Health Area of SEPAR was started in 1995. Its primary objectives were to increase the awareness of the smoking problem among the members of our Scientific Society, improve their scientific knowledge of this diseases, to help in diagnostic and treatment interventions in smokers, and lastly, to promote interventions for the prevention and treatment of smoking by the health and political Administrations. Nowadays it is one of the most dynamic areas of SEPAR and has more than 400 members. There are many unresolved challenges in our area, but the fundamental one which continues to occupy a particular place for the Administration, for our patients, for other health professionals of other specialties and scientific societies, and for all SEPAR professionals, is a key aspect of which there is no doubt: to defend the health and well-being of our population against the main cause of avoidable disease and death, tobacco.

El síndrome de apnea-hipopnea del sueño en 2009 / Sleep apnea-hypopnea syndrome 2009

El síndrome de apnea-hipopnea del sueño (SAHS) es una entidad con una elevada prevalencia en la poblacióngeneral que, debido a su repercusión sociosanitaria, se ha convertido en un problema de salud públicade primera magnitud. La defi nición del síndrome ha ido evolucionando, así como la defi nición de acontecimientorespiratorio. El papel de los mecanismos infl amatorios en el desarrollo de enfermedad cardiovascularse encuentra en plena investigación y es probable que en el futuro haya que añadir marcadores biológicostanto en la defi nición del síndrome como en la elección del tratamiento. Aunque la técnica de referenciaen el diagnóstico es la polisomnografía, la poligrafía respiratoria se ha convertido en una alternativa váliday complementaria al tratarse de un método simplifi cado, que puede realizarse en el domicilio, para descartaro confi rmar la enfermedad. Sistemas expertos como el monocanal quizá aporten nuevos datos en lasimplifi cación del diagnóstico. Actualmente el tratamiento con presión positiva continua de la vía aérea(CPAP) sigue siendo el método de referencia y su indicación principal en pacientes con SAHS moderado osevero en los cuales ha demostrado disminuir la mortalidad(AU)

Sleep apnea-hypopnea syndrome (SAHS) is a highly prevalent disease in the general population and, due toits social and health repercussions, has become a major public health problem. The defi nition of thissyndrome, as well as that of respiratory event, have been refi ned.The role of infl ammatory mechanisms in the development of cardiovascular disease is currently underinvestigation and biological markers will probably be added, both in the defi nition of SAHS and in thechoice of treatment. Although the gold standard in diagnosis is polysomnography, respiratory polygraphyhas become a valid and complementary alternative, since this technique is a simplifi ed method that can beperformed in the home to confi rm or exclude this disease. Expert systems such as single-channel devicesmay help to simplify diagnosis. Currently, the mainstay of treatment is still continuous positive airwaypressure (CPAP); this modality is mainly indicated in patients with moderate or severe SAHS and has beenshown to reduce mortality in this group(AU)

Presente y futuro del Área de Tabaquismo de la SEPAR / Present and Future of the SEPAR Smoking and Health Area

El tabaquismo es la primera causa evitable de mortalidad prematura y morbilidad en nuestro medio. Segúndatos de la Organización Mundial de la Salud, el tabaco se cobra más de 5 millones de vidas al año, cifraque presumiblemente irá en aumento y será de 10 millones para el año 2030.Los profesionales sanitarios estamos obligados a implicarnos activamente en este grave problema sanitarioidentificando, diagnosticando y tratando correctamente a todos los fumadores para ayudarles en el procesode abandono y facilitar el logro de la abstinencia definitiva.Existe evidencia científica que el tabaquismo es causa directa o motivo de empeoramiento de muchas enfermedadesrespiratorias, que por su naturaleza competen básicamente al neumólogo, que oficialmente, deacuerdo con la administración sanitaria, es el especialista y experto en la materia.El Área de Tabaquismo de la SEPAR se inició en el año 1995. Sus principales objetivos fueron incrementar lasensibilización sobre el problema del tabaquismo entre los miembros de nuestra sociedad científica, mejorarsus conocimientos científicos en esta afección, facilitar las intervenciones diagnósticas y terapéuticas enlos fumadores y, por último, promover las intervenciones para la prevención y el tratamiento del tabaquismopor parte de la administración político-sanitaria. Hoy día es una de las áreas más dinámicas de la SEPARy cuenta con más de 400 miembros.Muchos son los retos pendientes de nuestra área, pero el fundamental lo constituye seguir ocupando unlugar referente para la administración, para nuestros pacientes, para otros profesionales sanitarios de otrasespecialidades y sociedades científicas, y para todos los profesionales de la SEPAR en un aspecto clave queno merece dudas: defender el bienestar y la salud de nuestra población frente a la principal causa de enfermedady mortalidad evitable, el tabaco(AU)

Smoking is the primary avoidable cause of premature death and morbidity in our country. According todata from the WHO, tobacco costs more than 5 million lives per year, a figure that is assumed to continueincreasing and will be 10 million by the year 2030.As health professionals we are obliged to be actively involved in this serious health problem, by correctlyidentifying, diagnosing and treating all smokers to help them in the process of giving up and help themachieve total abstinence.There is scientific evidence that smoking is the direct cause and reason for the worsening of many respiratorydiseases, which due to their nature are basically the responsibility of the pneumologist, who officially,according to the Health Service Administration, is the specialist and expert in this area.The Smoking and Health Area of SEPAR was started in 1995. Its primary objectives were to increase theawareness of the smoking problem among the members of our Scientific Society, improve their scientificknowledge of this diseases, to help in diagnostic and treatment interventions in smokers, and lastly, topromote interventions for the prevention and treatment of smoking by the health and political Administrations.Nowadays it is one of the most dynamic areas of SEPAR and has more than 400 members.There are many unresolved challenges in our area, but the fundamental one which continues to occupy aparticular place for the Administration, for our patients, for other health professionals of other specialtiesand scientific societies, and for all SEPAR professionals, is a key aspect of which there is no doubt: to defendthe health and well-being of our population against the main cause of avoidable disease and death,tobacco(AU)