Masa quística de mediastino como localización atípica de leishmaniasis visceral / Mediastinal cystic mass as atypical location of visceral leishmaniasis

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Variabilidad de los síntomas respiratorios en la EPOC grave / Variability of Respiratory Symptoms in Severe COPD

Introducción: Mientras se reconoce que los síntomas en el asma tienen un patrón muy variable, la creencia general es que los síntomas respiratorios en los pacientes con EPOC presentan habitualmente poca o ninguna variabilidad. Sin embargo, los pacientes con EPOC refieren tener «días malos». El objetivo del presente trabajo fue evaluar la variabilidad de los síntomas respiratorios y su impacto en las actividades de la vida diaria en una cohorte de pacientes españoles. Método: Se presentan los resultados de los pacientes españoles participantes en un estudio epidemiológico transversal realizado en 17 países europeos. Neumólogos y médicos de familia reclutaron pacientes con EPOC grave estable (FEV1<50%). La percepción de los pacientes sobre la variación de sus síntomas se recogió mediante entrevista telefónica. Resultados: Un total de 472 pacientes aportaron datos válidos para el análisis. La edad media fue de 68,6 años, el 93% fueron hombres y el FEV1(%) medio fue del 41%. El 84,1% de los pacientes experimentaron al menos un síntoma respiratorio en la semana previa y el 60,9% afirmaron que sus síntomas variaban a lo largo del día o de la semana. El momento del día donde los síntomas se percibían con mayor intensidad fue por la mañana. Conclusiones: Una proporción importante de pacientes con EPOC grave percibe variabilidad de sus síntomas respiratorios, con una mayor intensidad por la mañana. Esta observación puede tener implicaciones para el tratamiento de los pacientes con EPOC grave, ya que la variabilidad puede ser un signo inicial de descompensación de la enfermedad(AU)

Introduction: While it is known that asthma symptoms have a very variable pattern, the general belief is that the respiratory symptoms in COPD patients usually present little or no variability. Nevertheless, COPD patients report having "bad days". The objective of this present study was to evaluate the variability of the respiratory symptoms and their impact on the daily activities of a cohort of Spanish COPD patients. Method: We present the results of the Spanish patients who participated in a cross-sectional epidemiological study carried out in 17 European countries. Pulmonologists and Family Care physicians recruited patients with stable severe COPD (FEV1<50%). The perception of the patients on the variation in their symptoms was recorded by telephone interviews. Results: A total of 472 patients provided data that was valid for analysis. Mean age was 68.6; 93% were men; mean FEV1(%) was 41%. 84.1% of the patients experimented at least one respiratory symptom in the previous week and 60.9% affirmed that their symptoms varied over the course of the day or week. The moment of the day when the symptoms were perceived to be more intense was during the morning. Conclusions: An important proportion of severe COPD patients perceive variability in their respiratory symptoms, with a greater intensity in the morning. The observation can have implications in treating patients with severe COPD as variability can be an initial sign of decompensation of the disease(AU)

Variability of respiratory symptoms in severe COPD.

INTRODUCTION: While it is known that asthma symptoms have a very variable pattern, the general belief is that the respiratory symptoms in COPD patients usually present little or no variability. Nevertheless, COPD patients report having "bad days". The objective of this present study was to evaluate the variability of the respiratory symptoms and their impact on the daily activities of a cohort of Spanish COPD patients. METHOD: We present the results of the Spanish patients who participated in a cross-sectional epidemiological study carried out in 17 European countries. Pulmonologists and Family Care physicians recruited patients with stable severe COPD (FEV1<50%). The perception of the patients on the variation in their symptoms was recorded by telephone interviews. RESULTS: A total of 472 patients provided data that was valid for analysis. Mean age was 68.6; 93% were men; mean FEV1(%) was 41%. 84.1% of the patients experimented at least one respiratory symptom in the previous week and 60.9% affirmed that their symptoms varied over the course of the day or week. The moment of the day when the symptoms were perceived to be more intense was during the morning. CONCLUSIONS: An important proportion of severe COPD patients perceive variability in their respiratory symptoms, with a greater intensity in the morning. The observation can have implications in treating patients with severe COPD as variability can be an initial sign of decompensation of the disease.

Tracheal diverticulum: a review of the literature.

Tracheal diverticulum is a rarely encountered entity. It may be congenital or acquired, the difference residing mainly in the histologic features of the wall. Most cases are asymptomatic, but when symptoms are present they are usually nonspecific. Congenital diverticulum is not normally detected in infancy unless it is suggested by recurrent episodes of tracheobronchial infection or in associated with other malformations. Imaging techniques are useful for diagnosis because the point of communication with the trachea is difficult to detect with bronchoscopy. In the absence of symptoms, management should be conservative. We review the entity and report two new cases, one a casual finding in a 49-year-old man and the other in a 63-year-old woman who presented with occasional bloody sputum.