Predictors of mediastinal staging and usefulness of pet in patients with stage IIIA (N2) or IIIB (N3) lung cancer.

OBJECTIVE: To analyze which factors predict mediastinal N2/N3 lymph node staging and diagnostic accuracy of PET and CT to determine it. PATIENTS AND METHODS: We analyzed data collected prospectively in a database that included patients with non-small cell lung cancer (NSCLC) who underwent EBUS-TBNA. Prior to EBUS-TBNA, CT and PET were used to define the radiographic N stage and lymph nodes with short axis ≥ 1 cm by CT or with ratio between maximum standardized uptake value (maxSUV), by PET, of lymph node and primary tumor greater than 0.56, were considered pathological. Definitive lymph node staging was established through EBUS-TBNA, mediastinoscopy or surgical lymph node dissection. RESULTS: One hundred and thirty four patients were included, in 88 of whom (65.6%), definitive lymph node staging was N2 or N3. Primary tumor of central location, lymph node size, maxSUV of lymph node and radiographic N stage by CT or PET were associated with N2/N3 in univariate analysis, but in logistic regression model it was only independently related with N stage by CT or PET. Negative predictive value and positive predictive value of CT were 0.81 and 0.74, respectively, and for PET 0.78 and 0.68. CONCLUSION: In NSCLC, in locoregional disease radiographic staging by CT or PET predict the existence of N2/N3 mediastinal disease, but negative and positive predictive values of both imaging techniques are not adequate, so EBUS-TBNA samples should be taken in all lymph nodes with a diameter greater than 5 mm, regardless of PET findings.

Obesidad y control del asma bronquial: un vínculo consistente / Asthma control and obesity: a solid link

Fundamento y objetivo: Parece existir una conexión epidemiológica entre asma bronquial y obesidad, pero su posible vínculo con el control de la enfermedad es controvertido. El objetivo del presente estudio es conocer si la obesidad se asocia con el control del asma. Pacientes y método: Se incluyeron pacientes ambulatorios, diagnosticados de asma bronquial, con buena adherencia terapéutica y técnica inhalatoria correcta. Se evaluó el control mediante el test de control del asma y se relacionó con: edad, sexo, volumen espiratorio forzado en el primer segundo, tabaquismo, índice de masa corporal (IMC), rinitis, trastornos ansioso-depresivos, bronquiectasias, reflujo gastroesofágico y atopia. Para el análisis estadístico se emplearon: ji al cuadrado, t de Student y regresión logística. Resultados: La muestra la constituyeron 110 pacientes, de los cuales 41 (37,3%) presentaban un IMC≥30kg/m2. El mal control se asoció en el análisis bivariado con: IMC, rinitis, trastornos ansioso-depresivos y sexo femenino. En el multivariado mantuvieron asociación: IMC (odds ratio [OR] 3,66, intervalo de confianza del 95% [IC 95%] 1,49-8,92), rinitis (OR 2,87, IC 95% 1,18-6,99) y trastorno ansioso-depresivo (OR 6,45, IC 95% 2,10-20). Conclusión: Hemos apreciado una asociación entre obesidad y control del asma, por lo que la reducción ponderal podría tener implicaciones clínicas (AU)

Background and objective: An epidemiological association between obesity and asthma has been confirmed, but its possible link to disease control is controversial. The aim of this study was to investigate if asthma control was related with obesity. Patients and methods: Asthmatics adult outpatients with good compliance on therapy and correct inhalation technique were included. An Asthma Control Test validated for Spanish population was used to measure asthma control and it was related with: age, sex, forced expiratory volume in one second, smoking, atopy, body mass index (BMI), rhinitis, anxiety and/or depression, bronchiectasis and gastroesophageal reflux. For statistical analysis chi square distribution, Student test and a logistic regression analysis were used. Results: One hundred and ten patients were included, of whom 41 (37.3%) had BMI 30 kg/m2. Poor asthma control was associated, in the bivariate analysis, with: BMI, rhinitis, anxiety-depressive disorders and female sex. In the multivariate analysis, it remained independently associated with: BMI (odds ratio[OR] 3.66, 95% confidence interval [95% CI] 1.49-8.92), rhinitis (OR 2.87, 95% CI 1.18-6.99 and anxiety depressive disorder (OR 6.45, 95% CI 2.10-20).Conclusions: We conclude that there is a link between obesity and poorly controlled asthma, hence weight loss may have major clinical implications (AU)

[Asthma control and obesity: a solid link]. / Obesidad y control del asma bronquial: un vínculo consistente.

BACKGROUND AND OBJECTIVE: An epidemiological association between obesity and asthma has been confirmed, but its possible link to disease control is controversial. The aim of this study was to investigate if asthma control was related with obesity. PATIENTS AND METHODS: Asthmatics adult outpatients with good compliance on therapy and correct inhalation technique were included. An Asthma Control Test validated for Spanish population was used to measure asthma control and it was related with: age, sex, forced expiratory volume in one second, smoking, atopy, body mass index (BMI), rhinitis, anxiety and/or depression, bronchiectasis and gastroesophageal reflux. For statistical analysis chi square distribution, Student test and a logistic regression analysis were used. RESULTS: One hundred and ten patients were included, of whom 41 (37.3%) had BMI ≥ 30 kg/m(2). Poor asthma control was associated, in the bivariate analysis, with: BMI, rhinitis, anxiety-depressive disorders and female sex. In the multivariate analysis, it remained independently associated with: BMI (odds ratio [OR] 3.66, 95% confidence interval [95% CI] 1.49-8.92), rhinitis (OR 2.87, 95% CI 1.18-6.99 and anxiety-depressive disorder (OR 6.45, 95% CI 2.10-20). CONCLUSIONS: We conclude that there is a link between obesity and poorly controlled asthma, hence weight loss may have major clinical implications.