Osteochondroplastic tracheobronchopathy: Four case reports. / Traqueobroncopatía osteocondroplástica: reporte de cuatro casos clínicos.

Introduction: Osteochondroplastic tracheobronchopathy is a rare benign chronic disease of unknown etiology. Bronchoscopy remains the gold standard for diagnosing osteochondroplastic tracheobronchopathy. Its typical findings are described as a cobblestone, rock garden, mountainscape, or stalactite cave appearance. The present work aims to show the main clinical features of this rare pathology. Clinical cases: The clinical data of four middle-aged patients, three men and one woman, were analyzed. The main clinical symptoms were chronic cough, dyspnea, and dysphonia. The patient's preliminary diagnosis was made by computed axial tomography of the chest, confirmed by bronchoscopy and histopathological examination. Treatment included medication for symptoms and, in one case, cryosurgery and argon plasma coagulation. Discussion: Diagnosing osteochondroplastic tracheobronchopathy was not easy, given its uncommon nature and non-specific symptoms often found in other pathologies. No case series articles on this pathology have been published in Peru. Therefore, we used the original articles published in other countries to reference our findings. Conclusion: Osteochondroplastic tracheopathy is a benign disease that typically affects adults. Men are more likely to be affected. Its clinical manifestations are non-specific and frequently of pharyngeal origin, and the cause is not yet defined. Chest computed axial tomography combined with bronchoscopy are the main diagnostic procedures. There is no standard treatment with consistent therapeutic effects.

Introducción: La traqueobroncopatía osteocondroplástica es una rara enfermedad crónica benigna de etiología desconocida. La broncoscopía sigue siendo el estándar de oro para el reconocimiento de traqueopatía osteocondroplástica. Sus hallazgos típicos se describen como un empedrado, un jardín de rocas, una apariencia de paisaje montañoso o de una cueva con estalactitas. El objetivo del presente trabajo es mostrar las principales características clínicas de una patología poco conocida. Casos clínicos: Se analizaron los datos clínicos de cuatro pacientes de mediana edad, tres fueron hombres y una mujer. Los principales síntomas clínicos fueron tos crónica, disnea, disfonía. Los pacientes tuvieron un diagnóstico preliminar mediante tomografía axial computarizada de tórax, confirmado por examen video broncoscópico e histopatológico. El tratamiento incluyó medicamentos para los síntomas y en un solo caso criocirugía y coagulación con argón plasma. Discusión: El diagnóstico de traqueobroncopatía osteocondroplástica no fue sencillo por ser una entidad rara, cuyos síntomas son inespecíficos y muy frecuentes en otras patologías. En Perú no se han publicado artículos de serie de casos sobre esta patología. Por lo tanto, tomamos como referencia artículos originales publicados en otros países para compararlos con nuestros hallazgos. Conclusión: La traqueopatía osteocondroplástica es una enfermedad benigna que predispone a los adultos, los hombres tienen más probabilidades de verse afectados. Sus manifestaciones clínicas son inespecíficas; frecuentemente de origen faríngeo y la causa no está aún definida. La tomografía axial computarizada de tórax combinada con video broncoscopía son los principales procedimientos para el diagnóstico. No existe un estándar de tratamiento con efectos terapéuticos consistentes.

Traqueobroncopatía osteocondroplástica: reporte de cuatro casos clínicos / Osteochondroplastic tracheobronchopathy: Four case reports

Introducción La traqueobroncopatía osteocondroplástica es una rara enfermedad crónica benigna de etiología desconocida. La broncoscopía sigue siendo el estándar de oro para el reconocimiento de traqueopatía osteocondroplástica. Sus hallazgos típicos se describen como un empedrado, un jardín de rocas, una apariencia de paisaje montañoso o de una cueva con estalactitas. El objetivo del presente trabajo es mostrar las principales características clínicas de una patología poco conocida. Casos clínicos Se analizaron los datos clínicos de cuatro pacientes de mediana edad, tres fueron hombres y una mujer. Los principales síntomas clínicos fueron tos crónica, disnea, disfonía. Los pacientes tuvieron un diagnóstico preliminar mediante tomografía axial computarizada de tórax, confirmado por examen video broncoscópico e histopatológico. El tratamiento incluyó medicamentos para los síntomas y en un solo caso criocirugía y coagulación con argón plasma. Discusión El diagnóstico de traqueobroncopatía osteocondroplástica no fue sencillo por ser una entidad rara, cuyos síntomas son inespecíficos y muy frecuentes en otras patologías. En Perú no se han publicado artículos de serie de casos sobre esta patología. Por lo tanto, tomamos como referencia artículos originales publicados en otros países para compararlos con nuestros hallazgos. Conclusión La traqueopatía osteocondroplástica es una enfermedad benigna que predispone a los adultos, los hombres tienen más probabilidades de verse afectados. Sus manifestaciones clínicas son inespecíficas; frecuentemente de origen faríngeo y la causa no está aún definida. La tomografía axial computarizada de tórax combinada con video broncoscopía son los principales procedimientos para el diagnóstico. No existe un estándar de tratamiento con efectos terapéuticos consistentes.

Introduction Osteochondroplastic tracheobronchopathy is a rare benign chronic disease of unknown etiology. Bronchoscopy remains the gold standard for diagnosing osteochondroplastic tracheobronchopathy. Its typical findings are described as a cobblestone, rock garden, mountainscape, or stalactite cave appearance. The present work aims to show the main clinical features of this rare pathology. Clinical cases The clinical data of four middle-aged patients, three men and one woman, were analyzed. The main clinical symptoms were chronic cough, dyspnea, and dysphonia. The patient's preliminary diagnosis was made by computed axial tomography of the chest, confirmed by bronchoscopy and histopathological examination. Treatment included medication for symptoms and, in one case, cryosurgery and argon plasma coagulation. Discussion Diagnosing osteochondroplastic tracheobronchopathy was not easy, given its uncommon nature and non-specific symptoms often found in other pathologies. No case series articles on this pathology have been published in Peru. Therefore, we used the original articles published in other countries to reference our findings. Conclusion Osteochondroplastic tracheopathy is a benign disease that typically affects adults. Men are more likely to be affected. Its clinical manifestations are non-specific and frequently of pharyngeal origin, and the cause is not yet defined. Chest computed axial tomography combined with bronchoscopy are the main diagnostic procedures. There is no standard treatment with consistent therapeutic effects.

Effect of hypobaric hypoxia on hematological parameters related to oxygen transport, blood volume and oxygen consumption in adolescent endurance-training athletes.

Objective: To analyze the effect of altitude on hematological and cardiorespiratory variables in adolescent athletes participating in aerobic disciplines. Methods: 21 females and 89 males participated in the study. All were adolescent elite athletes engaged in endurance sports (skating, running and cycling) belonging to two groups: permanent residents in either low altitude (LA, 966 m) or moderate altitude (MA, 2640 m). Hematocrit (Hct), hemoglobin concentration ([Hb]), total hemoglobin mass (Hbt), blood, plasma and erythrocyte volumes (BV, PV and EV), VO2peak and other cardiorespiratory parameters were evaluated. Results: Sex differences were evident both in LA and HA skating practitioners, the males having higher significant values than the females in oxygen transport-related hematological parameters and VO2peak. The effect of altitude residence was also observed in Hct, [Hb], Hbt and EV with increased (14%-18%) values in the hematological parameters and higher EV (5%-24%). These results matched the significantly higher values of VO2peak measured in MA residents. However, BV and PV did not show differences between LA and MA residents in any case. Sports discipline influenced neither the hematological variables nor most of the cardiorespiratory parameters. Conclusions: LA and MA adolescent skaters showed sex differences in hematological variables. Endurance-trained male adolescent residents at MA had an increased erythropoietic response and a higher VO2peak compared to their counterparts residing and training at LA. These responses are similar in the three aerobic sports studied, indicating that the variables described are highly sensitive to hypoxia irrespective of the sports discipline.

Effect of Chronic Altitude Hypoxia on Redox Balance in Preadolescents and Adolescents / Efectos de la hipoxia altitudinal crónica sobre el balance Redox de preadolescentes y adolescentes / Efeito da exposição crônica à hipóxia de altitude no equilíbrio oxidante/antioxidante de crianças e adolescentes

Living at high altitude increases oxidative stress. Likewise, growth and maturation during adolescence can increase levels of reactive oxygen species (ros). Changes in redox profiles have been evaluated in adults living at high altitudes; however, there are no studies on these changes in peripubertal populations living at moderate altitudes, we determine how living at moderate altitude affects the oxidative and inflammatory status of healthy preadolescents and adolescents. Materials and Methods: A cross-sectional study was conducted in healthy male Colombian preadolescents and adoles-cents (9­18 years old, Tanner scale classification) who lived at low altitude (n = 26) or moderate altitude (n = 26). Plasma oxidative and inflammatory status was assessed via spectrophotometry. Oxidative markers included malondialdehyde, 4-hydroxy-trans-2-nonenal, and carbonyl groups. Antioxidant markers included total antioxidant status, glutathione, catalase, superoxide dismutase, uric acid, and thiols. Inflammatory markers included interleukins-1, -6, and -10 and tumor necrosis factor. Results:Only uric acid levels were higher in adolescents (5.34 and 5.66 mg/dl) compared to preadolescents (3.85 and 4.07 mg/dl) in both moderate and low altitude groups, respectively. Participants who lived at mod-erate altitude presented significantly higher levels of malondialdehyde (4.82 and 3.73 nM/mg protein) and lower level of glutathione and thiols (1.21 and 1.26 µmol/mg protein) than in those at low altitude. Their inflammatory profiles did not differ. Conclusion: Oxidant profiles increased in peripubertal popu-lations residing at moderate altitude; this could be owing to antioxidant consumption by ros and active metabolism during puberty.

vivir en altura es un factor que se asocia con el estrés oxidativo. El crecimiento y la maduración pueden ser un estresor adicional. Es insuficiente la evidencia sobre alteraciones del perfil redox en peripúberes residentes a altitudes moderadas. El propósito fue establecer el efecto de vivir en una altitud moderada sobre el perfil redox e inflamatorio en preadolescentes y adolescentes sanos. Materiales y métodos: estudio transversal en varones preadolescentes y adolescentes sanos (9-18 años) que viven en altitud baja (n = 26) o altitud moderada (n = 26). El estado oxidativo plasmático se evaluó mediante espectrofotometría a través de marcadores de oxidación (malondialdehído e hidroxinonenal y grupos carbonilo) y antioxidantes (estado antioxidante total, glutatión, catalasa, superóxido dismutasa, ácido úrico y tioles). El perfil inflamatorio se midió con interleucinas 1, 6, 10 y factor de necrosis tumoral α. Resultados: solo el ácido úrico fue diferente entre adolescentes (5.34 y 5.66 mg/dl para moderada y baja altitud, respectivamente) y preadolescentes (3.85 y 4.07 mg/dl para moderada y baja altitud, res-pectivamente). El grupo de preadolescentes y adolescentes de moderada altitud presentó niveles más altos de malondialdehído (4.82 y 3.73 nM/mg de proteína, respectivamente) y menor glutatión y tioles (1.21 y 1.26 µmol/mg de proteína), en comparación con sus contrapartes de baja altitud. Conclusión: las poblaciones peripúberes que residen en una altitud moderada presentan un perfil oxidante más alto, lo que puede estar relacionado con la depleción de antioxidantes, por una mayor producción de especies reactivas de oxígeno relacionada con la hipoxia y el metabolismo activo de la pubertad.

viver em grandes altitudes é um fator de estresse associado ao estresse oxidativo. Durante a adolescência, os processos de crescimento e maturação podem aumentar as espécies reativas de oxi-gênio. Alterações no perfil redox foram estudadas em adultos expostos a grandes altitudes, mas não em populações peripubertais vivendo em altitudes moderadas. Nosso objetivo é estabelecer o efeito de viver em uma altitude moderada sobre o estado oxidativo e inflamatório em pré-adolescentes e adolescentes saudáveis. Materiais and métodos: foi realizado um estudo transversal em pré-adolescentes e adolescen-tes colombianos saudáveis (9-18 anos, na escala de classificação de Tanner) que viviam em baixa altitude (n = 26) ou altitude moderada (n = 26). O estado oxidativo e inflamatório do plasma foi avaliado por espectrofotometria: 1) Marcadores de oxidação: grupos Malondialdeído + 4-hidroxi-trans-2-nonenal e carbonila; 2) antioxidantes: estado antioxidante total, glutationa, catalase, superóxido dismutase, ácido úrico e tióis; 3) Marcadores de inflamação: interleucinas 1, 6, 10 e fator de necrose tumoral α. Resultados:apenas o ácido úrico foi maior em adolescentes (5,34 e 5,66 mg/dl) em comparação com pré-adolescentes (3,85 e 4,07 mg/dl) dos grupos de altitude moderada e baixa, respectivamente. A altitude moderada apre-sentou níveis significativamente maiores de Malondialdeído (4,82 e 3,73 nM/mg de proteína), e menores níveis de Glutationa e tióis (1,21 e 1,26 µmol/mg de proteína), em comparação com a baixa altitude. Nenhuma diferença foi detectada no perfil inflamatório. Conclusão: as populações peripubertais que residem em altitude moderada apresentam maior perfil oxidante, o que pode estar relacionado ao con-sumo de antioxidantes devido à maior produção de ros relacionada à hipóxia e ao metabolismo ativo por volta da puberdade.

Hemoglobin Mass, Blood Volume and VO2max of Trained and Untrained Children and Adolescents Living at Different Altitudes.

Introduction: To a considerable extent, the magnitude of blood volume (BV) and hemoglobin mass (Hbmass) contribute to the maximum O2-uptake (VO2max), especially in endurance-trained athletes. However, the development of Hbmass and BV and their relationships with VO2max during childhood are unknown. The aim of the present cross-sectional study was to investigate Hbmass and BV and their relationships with VO2max in children and adolescents. In addition, the possible influence of endurance training and chronic hypoxia was evaluated. Methods: A total of 475 differently trained children and adolescents (girls n = 217, boys n = 258; untrained n = 171, endurance trained n = 304) living at two different altitudes (∼1,000 m, n = 204, ∼2,600 m, n = 271) and 9-18 years old participated in the study. The stage of puberty was determined according to Tanner; Hbmass and BV were determined by CO rebreathing; and VO2max was determined by cycle ergometry and for runners on the treadmill. Results: Before puberty, there was no association between training status and Hbmass or BV. During and after puberty, we found 7-10% higher values in the trained groups. Living at a moderate altitude had a uniformly positive effect of ∼7% on Hbmass in all groups and no effect on BV. The VO2max before, during and after puberty was strongly associated with training (pre/early puberty: boys +27%, girls +26%; mid puberty: +42% and +45%; late puberty: +43% and +47%) but not with altitude. The associated effects of training in the pre/early pubertal groups were independent of Hbmass and BV, while in the mid- and late pubertal groups, 25% of the training effect could be attributed to the elevated Hbmass. Conclusions: The associated effects of training on Hbmass and BV, resulting in increased VO2max, can only be observed after the onset of puberty.

Tumor-to-Tumor Metastasis: Lung Adenocarcinoma as a Recipient of Metastasis from Renal Cell Carcinoma: A Case Report.

BACKGROUND The occurrence of metastasis from one neoplasm to another is known as tumor-to-tumor metastasis (TTM). It is a rare phenomenon in the natural history of any neoplasm, with approximately 100 cases reported in the literature to date. The lungs are the most frequent metastatic tumor donors and kidney cancer is the most common recipient. However, the opposite phenomenon (lung adenocarcinoma as a recipient of metastasis from renal carcinoma) has not been previously reported in the literature. CASE REPORT We present the case of a man with a history of multiple neoplasms. He had a diffuse large B-cell lymphoma in 2006, a left papillary renal cell carcinoma (RCC) type 2 in 2006, and an acinar adenocarcinoma of the prostate in 2011. A follow-up computed tomography scan in July 2019 showed a suspicious lung nodule on the left upper lobe and a retroperitoneal hypermetabolic mass on the positron emission tomography scan. The lung nodule and retroperitoneal mass biopsies were consistent with a primary lung adenocarcinoma with a lepidic pattern and a metastatic RCC, respectively. In January 2020, he underwent a thoracoscopic left upper lobectomy and a mediastinal lymph node dissection. Histopathological evaluation revealed a 2-cm nodule composed of a lung adenocarcinoma with an intratumoral metastasis from a papillary RCC. To date, the patient has stable renal neoplastic metastatic disease and no locoregional recurrences of the lung adenocarcinoma. CONCLUSIONS Metastasis from one primary tumor to another primary tumor is an extremely unusual event. We report one of the first cases of an RCC metastasis to a primary lung adenocarcinoma.

Quantification of testosterone-dependent erythropoiesis during male puberty.

NEW FINDINGS: What is the central question of this study? To what extent does testosterone influence haemoglobin formation during male puberty? What is the main finding and its importance? In boys, testosterone might be responsible for about 65% of the increase in haemoglobin mass during puberty. The underlying mechanisms are assumed to be twofold: (i) indirectly, mediated by the increase in lean body mass, and (ii) directly by immediate testosterone effects on erythropoiesis. Thereby, an increase in testosterone of 1 ng/ml is associated with an increase in haemoglobin mass of ∼65 g. These processes are likely to determine endurance performance in adulthood. ABSTRACT: The amount of haemoglobin during puberty is related to endurance performance in adulthood. During male puberty, testosterone stimulates erythropoiesis and could therefore be used as a marker for later endurance performance. This cross-sectional study aimed to determine the relationship between serum testosterone concentration and haemoglobin mass (Hbmass) in both male and female children and adolescents and to evaluate the possible influences of altitude and training. Three-hundred and thirteen differentially trained boys and girls aged from 9 to 18 years and living at altitudes of 1000 and 2600 m above sea level entered the study. The stage of sexual maturation was determined according to the classification of Tanner. Testosterone was measured by ELISA. Hbmass was determined by CO-rebreathing. Haemoglobin concentration did not change during maturation in girls and was 11% higher during puberty in boys, while Hbmass was elevated by 33% in Tanner stage V compared to stage II in girls (498 ± 77 vs. 373 ± 88 g) and by 95% in boys (832 ± 143 vs. 428 ± 95 g). This difference can most likely be attributed to indirect testosterone influences through an increase in lean body mass (LBM) and to direct testosterone effects on erythropoiesis, which increase the Hbmass by ∼65 g per 1 ng/ml. Altitude and training statuses were not associated with testosterone, but with an increase in Hbmass (altitude by 1.1 g/kg LBM, training by 0.8 g/kg LBM). Changes in Hbmass are closely related to testosterone levels during male puberty. Further studies will show whether testosterone and Hbmass during childhood and adolescence can be used as diagnostic tools for endurance talents.

Case report of recurring pneumonia due to unusual foreign body aspiration in the airway. / Reporte de caso de neumonía recurrente por aspiración de cuerpo extraño insólito en vía aérea.

Foreign body aspiration is a rare but life-threatening event. Most accidental aspiration events occur in children. In adults, it can represent up to 25% of cases. Bronchoscopy remains the gold standard for diagnosing and treating foreign body aspiration from the lower respiratory tract. A 63-year-old female smoker with a history of chronic alcoholism and exposure to pyrotechnic smoke presented a productive cough, with whitish expectoration, dyspnea and pleuritic chest pain on the right side. On chest X-ray, she presented opacity in 2/3 of the right hemithorax. Computed axial tomography revealed consolidation with an air bronchogram on the right hemithorax, cylindrical bronchiectasis, ground glass pattern and centrilobular nodules. Bronchoscopic examination revealed a foreign body covered with granulation tissue in the right segmental bronchus (B6). The granulation tissue was integrated into the foreign body. In a second attempt, the foreign body could be removed, which was of bone consistency, seemingly a bird bone, confirmed by pathological anatomy results. After further questioning, the patient reported that two years before, she had choked when eating chicken. She had a cough and an episode of hemoptysis, but she chose not to ask for medical advice.

La aspiración de cuerpo extraño es un evento poco frecuente en adultos, la mayoría de los eventos de aspiración accidental ocurren en niños, en los adultos puede representar hasta el 25% de los casos. La broncoscopía es el estándar de oro para el diagnóstico y el tratamiento de la aspiración de cuerpo extraño de las vías respiratorias bajas. Se reporta el caso de una mujer de 63 años fumadora, con antecedente de alcoholismo crónico y exposición frecuente a humo de pirotecnia. La paciente presentó tos productiva, con expectoración blanquecina, disnea y dolor torácico pleurítico en lado derecho. En la radiografía de tórax presentó opacidad en 2/3 del hemitórax derecho. La tomografía axial computarizada reveló consolidación con broncograma aéreo en la base del hemitórax derecho, bronquiectasias cilíndricas, patrón vidrio deslustrado y nódulos centrilobulillares. A través del examen broncoscópico se observó la presencia de un cuerpo extraño recubierto de tejido de granulación en el bronquio segmentario derecho (B6). El tejido de granulación estaba integrado al cuerpo extraño. En el segundo intento se pudo remover el cuerpo extraño, que resultó ser a simple vista de consistencia ósea, compatible con hueso de ave, lo que fue confirmado con resultados de anatomía patológica. En ampliación de historia clínica se obtuvo el dato que dos años antes tuvo atragantamiento al comer pollo; presentó tos y episodio de hemoptisis que la paciente prefirió no buscar atención médica.

Hemoptysis as a warning sign of thoracic aorta pseudoaneurysm: A case report. / Hemoptisis como signo de alarma de pseudoaneurisma de la aorta torácica: reporte de caso.

Pseudoaneurysm is defined as a reperfused pulsatile hematoma, encapsulated and communicated with the damaged vessel's lumen. It originates when there is a disruption of the arterial wall. Hemoptysis is a very rare sign/symptom of a thoracic aortic aneurysm or pseudoaneurysm. There is little information on hemoptysis associated with aortic aneurysm rupture, whose mechanisms are not explained by the presence of an aortopulmonary fistula. Among the hypotheses to explain this phenomenon, is the ability of the bronchial arteries to become hyperplasic and tortuous in the presence of a lesion that modifies the pulmonary architecture, being more susceptible to rupture. There are also descriptions of direct lung parenchymal injury from ruptured aneurysm. The present case illustrates that we must consider the hemoptysis as a warning sign in differential diagnosis of aortic aneurysms and pseudo aneurysms, among other causes, that it can be fatal in a short time due to massive hemorrhage.

El pseudoaneurisma se define como un hematoma pulsátil repermeabilizado, encapsulado y en comunicación con la luz de un vaso dañado. Se origina cuando hay una disrupción de la pared arterial. La hemoptisis es un signo/síntoma de presentación muy rara de aneurisma aórtico torácico y de pseudoaneurisma aórtico torácico. Hay poca información sobre la hemoptisis asociada con la ruptura del aneurisma aórtico cuyo mecanismo no se explica por la presencia de una fístula aortopulmonar. Entre las hipótesis para explicar este fenómeno, se encuentra la capacidad de las arterias bronquiales de volverse hiperplásicas y tortuosas en presencia de una lesión que modifica la arquitectura pulmonar, siendo más susceptibles a la ruptura. También hay descripciones de lesiones directas del parénquima pulmonar por aneurisma roto. El presente caso nos ilustra que debemos considerar a la hemoptisis como signo de alarma en el diagnóstico diferencial de los aneurismas y pseudoaneurismas aórticos entre otras causas que puede ser fatal en breve tiempo por una hemorragia masiva.

Hemoptisis como signo de alarma de pseudoaneurisma de la aorta torácica: reporte de caso / Hemoptysis as a warning sign of thoracic aorta pseudoaneurysm: a case report

El pseudoaneurisma se define como un hematoma pulsátil repermeabilizado, encapsulado y en comunicación con la luz de un vaso dañado. Se origina cuando hay una disrupción de la pared arterial. La hemoptisis es un signo/síntoma de presentación muy rara de aneurisma aórtico torácico y de pseudoaneurisma aórtico torácico. Hay poca información sobre la hemoptisis asociada con la ruptura del aneurisma aórtico cuyo mecanismo no se explica por la presencia de una fístula aortopulmonar. Entre las hipótesis para explicar este fenómeno, se encuentra la capacidad de las arterias bronquiales de volverse hiperplásicas y tortuosas en presencia de una lesión que modifica la arquitectura pulmonar, siendo más susceptibles a la ruptura. También hay descripciones de lesiones directas del parénquima pulmonar por aneurisma roto. El presente caso nos ilustra que debemos considerar a la hemoptisis como signo de alarma en el diagnóstico diferencial de los aneurismas y pseudoaneurismas aórticos entre otras causas que puede ser fatal en breve tiempo por una hemorragia masiva.

Pseudoaneurysm is defined as a reperfused pulsatile hematoma, encapsulated and communicated with the damaged vessel's lumen. It originates when there is a disruption of the arterial wall. Hemoptysis is a very rare sign/symptom of a thoracic aortic aneurysm or pseudoaneurysm. There is little information on hemoptysis associated with aortic aneurysm rupture, whose mechanisms are not explained by the presence of an aortopulmonary fistula. Among the hypotheses to explain this phenomenon, is the ability of the bronchial arteries to become hyperplasic and tortuous in the presence of a lesion that modifies the pulmonary architecture, being more susceptible to rupture. There are also descriptions of direct lung parenchymal injury from ruptured aneurysm. The present case illustrates that we must consider the hemoptysis as a warning sign in differential diagnosis of aortic aneurysms and pseudo aneurysms, among other causes, that it can be fatal in a short time due to massive hemorrhage.

La actividad física regula la ingesta de bebidas azucaradas y la velocidad al comer en adultos jóvenes de una institución de educación superior en Bogotá-Colombia / Physical activity regulates the intake of sugar added beverages and the eating speed in young adults from a higher education institution in Bogotá-Colombia

Introducción: El exceso de peso es un problema creciente a nivel mundial, como parte de los factores de riesgo identificados se encuentran dos conductas relacionadas con el con-sumo de alimentos: la ingesta de bebidas azucaradas y la velocidad al comer. Por su parte, la actividad física se ha propuesto como una estrategia útil para la prevención y tratamiento del exceso de peso y comorbilidades asociadas. Objetivo: Identificar la relación de la actividad física con la ingesta de bebidas azucaradas y la velocidad al comer en adultos jóvenes. Métodos: Se realizó un estudio transversal analítico con243 estudiantes de una Universidad de Bogotá, en edades comprendidas entre 18 a 29 años. Se utilizó el cuestionario International Physical Activity Questionnaire (IPAQ) para la actividad física, así como preguntas sobre la frecuencia de ingesta de bebidas azucaradas y la velocidad al comer. Resultados: Se encontró una correlación inversa leve entre la duración de la actividad física diaria y la frecuencia de consumo de bebidas azucaradas, especialmente en el sexo masculino; así mismo, la frecuencia semanal de actividad física vigorosa se relacionó con menor frecuencia de ingesta de bebidas azucaradas. Adicionalmente, se evidenció que la menor duración de la actividad física moderada o vigorosa se relacionó con menor velocidad al comer. Conclusiones: Esta investigación presenta evidencia del papel de la actividad física sobre conductas de riesgo relacionadas con el exceso de peso, se necesita más investigación en el área para fortalecer estos hallazgos. (AU)

Introduction: Excess weight is a growing problem worldwide, as part of the identified risk factors are two behaviors related to food consumption: the intake of sugar added beverages and eating speed. For its part, physical activity has been proposed as an useful strategy for the prevention and treatment of excess weight and associated comorbidities. Objective: To identify the relationship of physical activity with the intake of sugar added beverages and the eating speed in young adults. Methods: An analytical cross-sectional study with 243 students from an University of Bogota, aged between 18 to 29 years. The International Physical Activity Questionnaire (IPAQ) was used for the physical activity assessment, questions about the frequency of sugar added beverages intake and eating speed. Results: A slight inverse correlation was found between the duration of daily physical activity and the frequency of consumption of sugar added beverages, especially in males; Likewise, the weekly frequency of vigorous physical activity was related to a lower frequency of intake of sugar added beverages. Additionally, it was evidenced that the shorter duration of moderate or vigorous physical activity was related to lower speed when eating. Conclusions: This research presents evidence on the role of physical activity on risk behaviors related to excess weight, more research is needed in the area to strengthen these findings. (AU)

A case report of tuberculous chylothorax. / Reporte de un caso de quilotórax tuberculoso.

Tuberculous chylothorax is a rare infectious disease that occurs when the thoracic duct is obstructed. Treatment is directed to the tuberculosis infection. A 55-year-old male, driver, born in Trujillo (Peru) is admitted to the emergency department with increasing dyspnea and a 5-day dry cough. The physical examination revealed vocal fremitus, dullness to percussion, and a vesicular murmur that was decreased on the lower 2/3 of the left hemithorax. The X-ray and the thoracic ultrasound revealed significant left pleural effusion. The thoracocentesis drained fluid identified as chylothorax. Subsequently, a thoracic tube was placed, with a decrease in pleural fluid volume and later normalization of the cytochemical changes. Diagnostic video bronchoscopy was performed with a bronchoalveolar aspirate, revealing acid-fast bacilli. The patient received antituberculosis treatment with a favorable outcome. Tuberculous chylothorax is an important cause of chylothorax to be considered in endemic areas of tuberculosis. Proper treatment of the infection leads to resolution of the disease.

El quilotórax tuberculoso es una patología infecciosa infrecuente, que se produce como consecuencia del bloqueo del conducto torácico. Su tratamiento está dirigido a combatir la infección tuberculosa. Se presenta el caso de un varón de 55 años de edad, chofer, natural de Trujillo-Perú, que acudió a emergencia por disnea progresiva y tos seca de cinco días de evolución. El examen físico reveló frémito vocal, matidez y murmullo vesicular disminuido en 2/3 inferiores del hemitórax izquierdo. La radiografía y ecografía torácica evidenciaron derrame pleural significativo, y la toracocentesis reveló quilotórax. Posteriormente, se colocó un tubo de drenaje torácico, con disminución progresiva del volumen del líquido pleural y cambios citoquímicos. Se realizó videobroncoscopía diagnóstica con aspirado broncoalveolar, revelando bacilos ácido-alcohol resistentes. El paciente recibió tratamiento antituberculoso, con evolución favorable. El quilotórax tuberculoso constituye una causa importante de quilotórax a considerar en zonas endémicas de tuberculosis. El tratamiento adecuado de la infección, conlleva a resolución de la enfermedad.

Efectividad de un protocolo de entrenamiento nórdico sobre la fuerza explosiva en futbolistas del Club Deportivo La Equidad Seguros / Effectiveness of a Nordic training protocol on muscle power in soccer players of Club Deportivo la Equidad Seguros

Resumen Introducción . El entrenamiento nórdico ha sido estudiado para optimizar el gesto deportivo y prevenir lesiones en fútbol. Sin embargo, no se han reportado estudios que evidencien su efectividad sobre la fuerza explosiva del deporte. Objetivo. Determinar la efectividad de un protocolo de entrenamiento nórdico sobre la fuerza explosiva de miembros inferiores en futbolistas. Materiales y métodos. Se realizó un ensayo controlado y aleatorizado en el que 26 futbolistas masculinos fueron elegidos para hacer parte de un grupo intervención (n=12) y un grupo control (n=14). Al grupo intervención se le aplicó un protocolo de entrenamiento nórdico, mientras que el control realizó un programa de fortalecimiento convencional. Se evaluaron la fuerza explosiva de miembros inferiores, a través del Test de Bosco y Abalakov en una plataforma de salto, y el ángulo de mayor reclutamiento muscular del bíceps femoral durante la ejecución del ejercicio nórdico mediante de electromiografía de superficie. Resultados. Los dos grupos fueron homogéneos. Se evidenció una mejora en los componentes de la fuerza explosiva (p<0.05) para las variables de velocidad de despegue, de reclutamiento motor y de ángulo de registro del pico de reclutamiento motor en el grupo de intervención. Conclusión. La aplicación de un programa de entrenamiento en futbolistas demostró ser efectiva al influir de manera positiva en las variables involucradas en la fuerza explosiva.

Abstract Introduction: Nordic training has been designed to optimize the sporting movement and prevent injuries in soccer players. However, there are no reports on studies that demonstrate its effectiveness on the explosive power of such sport. Objective: To determine the effectiveness of a Nordic training protocol on the explosive force of lower limbs in soccer players. Materials and methods: A randomized controlled study was performed, in which 26 male players were chosen to be part of an intervention group (n=12) and a control group (n=14). The intervention group was applied a Nordic training protocol, while the control group followed a conventional strengthening program. The explosive force of lower limbs was evaluated through the Bosco and Abalakov tests on a jumping platform, as well as the angle of greater biceps femoris muscle recruitment while performing the Nordic exercise through surface electromyography. Results: Both groups were homogeneous. An improvement was evident in the components of the explosive force (p<0.05) for takeoff speed, the motor recruiting and the peak registration of angle recruitment variables in the intervention group. Conclusion: The implementation of a training program in soccer players proved to be effective by positively influencing the variables involved in the explosive force.

Efectos de un programa de promoción de actividad física sobre el fitness de mujeres adolescentes de dos colegios de Bogotá, D.C / Effects of a physical activity promotion program over adolescent women from two schools in Bogotá, D.C

Resumen Introducción. La inactividad física actualmente predomina en toda la población, en particular la adolescente, lo que genera consecuencias sobre la salud. A su vez, el ámbito escolar provee un ambiente propicio para intervenciones de promoción de hábitos de vida saludables. Este estudio propone implementar y evaluar el impacto de un modelo de promoción de actividad física, con el propósito de modificar comportamientos individuales y colectivos hacia la práctica regular de actividad física. Objetivo. Evaluar los efectos de un programa de promoción de actividad física sobre los componentes del fitness relacionado con la salud en mujeres adolescentes de dos colegios de Bogotá. Materiales y métodos. Este es un estudio longitudinal, descriptivo, exploratorio, con mediciones pre-post de los componentes del fitness relacionado con la salud. 49 mujeres sanas estudiantes de dos colegios de Bogotá (edad: 15.33±1.36 años) participaron en el programa de 12 semanas. El paquete estadístico SPSS 20 fue utilizado para el análisis. Resultados. Después de la intervención, se encontraron cambios significativos en la fuerza de abdominales y de miembros inferiores de las adolescentes participantes. Las demás variables medidas mostraron cambios positivos, pero no significativos. Conclusiones. El programa propuesto genera cambios positivos en la mayoría de componentes del fitness relacionado con la salud en mujeres adolescentes.

Abstract Introduction: Physical inactivity currently prevails throughout the population, particularly adolescents, generating health consequences. In turn, the school setting provides a conducive environment to promote healthy lifestyles. This study proposes the implementation and evaluation of the impact of a model for physical activity promotion, with the purpose of modifying individual and collective behaviors towards regular physical activity. Objective: To assess the effects of a physical activity promotion program on fitness components related to health in adolescent women from two schools in Bogotá. Materials and methods: This is a longitudinal, descriptive, exploratory study with pre-post fitness measurements related to health. 49 healthy female students from two schools in Bogota (aged15.33±1.36) participated in the program for 12 weeks. SPSS 20 was used for analysis. Results: After the intervention, significant changes were found in abdominal and lower limb strength. Other variables measured showed positive changes, but not significant. Conclusions: The proposed program generates positive changes in most fitness components regarding health in adolescent women.

Diseño y validación de un instrumento de evaluación de condiciones de salud y trabajo de los fisioterapeutas en Colombia / Design and validation of an instrument to assess health and work conditions of physical therapists in Colombia

Resumen Introducción. El estudio nacional de las condiciones de salud y trabajo de los fisioterapeutas no contaba con instrumentos diseñados y validados, coherentes con el marco analítico amplio de la relación entre salud y trabajo. Objetivo. Presentar los procesos de construcción y validación del instrumento denominado evaluación de condiciones de salud y trabajo de los fisioterapeutas en Colombia. Materiales y métodos. Se utilizó el coeficiente alfa de Cronbach para medir la relación entre las respuestas a cada variable con la magnitud de cada categoría, estableciendo mediciones fijas y consistentes con un elevado nivel de correlación. El proceso de validación se realizó en 1 711 fisioterapeutas de Colombia egresados desde el año 1980 hasta 2012. Resultados. La valoración de coherencia interna a través del alfa de Cronbach encontró cinco categorías del instrumento altamente coherentes, tres con valores mayores de 0.8: condiciones peligrosas del trabajo, organización de las tareas, satisfacción con el empleo, y dos con valoraciones superiores a 0.9: eventos en salud-enfermedad e identidad y autonomía. Discusión. El diseño y construcción del instrumento de valoración de las condiciones de salud y trabajo de los fisioterapeutas nacen de la necesidad del colectivo de fisioterapeutas para establecer líneas de base amplias sobre la relación entre el trabajo y la salud, y entender las condiciones de trabajo como elemento estructurante de la salud y enfermedad.

Abstract Introduction: The national survey on health and work conditions of physiotherapists did not have designed and validated instruments that considered the broad analytical framework of the relationship between health and work. Objective: To present construction and validation processes of the instrument known as health conditions and physical therapists work in Colombia. Materials and methods: Cronbach's alpha coefficient was used to measure the relationship between responses to each variable and the magnitude of each category, establishing fixed and consistent measurements with a high level of correlation. The validation process was carried out with 1 711 Colombian physiotherapists, graduated between 1980 and 2012. Results: The assessment of internal consistency through Cronbach's found five highly coherent categories, three values greater than 0.8 (hazardous working conditions, organization of work, job satisfaction), and two above 0.9 (events in health and disease and identity and autonomy). Discussion: The design and construction of the instrument for assessing health and work conditions of physiotherapists are generated based on the needs of physiotherapists to establish broad baselines regarding the relationship between work and health, and to understand working conditions as a structuring element of health and disease.

Factores relacionados con las prácticas alimentarias de estudiantes de tres universidades de Bogotá / Factors related to students' eating practices in three universities in Bogotá, Colombia

Objetivo Identificar y describir los hábitos alimentarios de los estudiantes de tres universidades de Bogotá y los factores que influyen en su adopción. Métodos Se realizaron tres grupos focales con participación promedio de 12 estudiantes de diferentes carreras de pregrado con edades entre 18 y 25 años. El contenido de los relatos fue analizado y categorizado de acuerdo a los factores que influyen en la selección de alimentos y los hábitos de alimentación. Resultados Los estudiantes señalan los factores sensoriales y de higiene, el costo de los alimentos, la disponibilidad de los mismos y el tiempo disponible para comer como principales factores que influyen en la selección. Se identifica además la influencia de los amigos y la familia, entre otros, en las elecciones en este aspecto. Los estudiantes participantes refirieron preferir la comida de su casa, consumir la mayor parte de sus comidas en el hogar y tener horarios de alimentación marcados por las actividades académicas. Conclusión Aunque los estudiantes tienen conocimientos acerca de lo que es bueno para ellos en términos de alimentación, en la vida universitaria la organización de las jornadas académicas, la disponibilidad de alimentos y de recursos económicos marcan de manera importante los hábitos y elecciones que realizan. Las estrategias de promoción de hábitos saludables en las universidades deberían entonces privilegiar el control de tales barreras.(AU)

Objective To identify and describe eating habits of students from three universities in Bogota and factors influencing their adoption. Methods: Three focus groups were formed with an average attendance of 12 students from different undergraduate programs, between the ages of 18 and 25. The content of the accounts was analyzed and categorized according to the factors influencing the selection of food and eating habits. Results Students identified sensory and hygiene factors, the cost of food, the availability of food and available time to eat as the main factors influencing food selection. We also identified the influence of friends and family, among others, in their choices. Students who participated reported to prefer food from home, eating most of their meals at home and having eating schedules influenced by academic activities. Conclusion Although students have knowledge about what is good for them in terms of food, in university life, the organization of academic schedule, food availability and economic resources show significant influence on their habits and choices. Strategies to promote healthy habits in universities should then prioritize the control of such barriers.(AU)

Efectos de la exposición a la altura sobre los indicadores de la eritropoyesis y el metabolismo del hierro / Effects of high altitude exposure on erythropoiesis and iron metabolism

Antecedentes. La investigación sobre los efectos de la exposición a la altura sobre la eritropoyesis y el metabolismo de hierro ha permitido conocer el comportamiento y las adaptaciones que se presentan en poblaciones residentes o expuestas a diversas alturas sobre el nivel del mar. Objetivo. El presente artículo de revisión tiene como objetivo analizar la información científica disponible y actualizar al lector respecto al efecto de la altura sobre los indicadores de la eritropoyesis y el metabolismo del hierro. Materiales y métodos. Se realizó una búsqueda de artículos de diferentes bases de datos como PubMed, MEDLINE, Scielo, EBSCO y OVID, la cual se hizo con base en los títulos médicos MeSH (Medical Subjects Headings) y DeCS Bireme (descriptores de la salud). Resultados. A nivel de la eritropoyesis se puede observar un incremento de la eritropoyetina y de los reticulocitos con el incremento en la altura. En el metabolismo del hierro se puede apreciar un descenso de las reservas del hierro (ferritina) y un incremento de la transferrina y del receptor soluble de transferrina con ascenso en la altitud. Conclusión. La magnitud de estos incrementos depende del tiempo de exposición a la hipoxia, el género y la población, ya que se han encontrado diferencias entre etnias que viven a la misma altura pero presentan diferencias en las adaptaciones. Las investigaciones existentes están referidas a grandes alturas, pero en alturas intermedias por debajo de los 2600 m s. n. m. todavía existen grandes interrogantes.

Background. Research on the effects of high altitude exposure on erythropoiesis and iron metabolism has revealed the behavior and adaptations that occur in populations that visit or live at different altitudes above sea level. Objective. To analyze the scientific information available and to give an update to the reader regarding the effects of high altitude exposure on erythropoiesis and iron metabolism. Materials and Methods. A research of articles in different databases such us PubMed, MEDLINE, Scielo, EBSCO and OVIDm was performed. This research was based on the MeSH (Medical Subject Headings) and DeCS Bireme (Health Descriptors) descriptors lists. Results. Regarding erythropoiesis, an increase of erythropoietin and reticulocytes have been observed when the altitude increases. Regarding iron metabolism a decline in reserves of iron (ferritin) and an increase of transferrin and soluble transferrin receptor can be noted when the altitude increases. Conclusion. The magnitude of these increases depends on the time of exposure to hypoxia, the individual's gender and the population, since differences between ethnic groups living at the same altitude have been found. Existing research is related to great altitudes, but at intermediate altitudes, below 2600m s. n. m., there is not enough research.

[Factors related to students' eating practices in three universities in Bogotá, Colombia]. / Factores relacionados con las prácticas alimentarias de estudiantes de tres universidades de Bogotá.

Objective To identify and describe eating habits of students from three universities in Bogota and factors influencing their adoption. METHODS: Three focus groups were formed with an average attendance of 12 students from different undergraduate programs, between the ages of 18 and 25. The content of the accounts was analyzed and categorized according to the factors influencing the selection of food and eating habits. Results Students identified sensory and hygiene factors, the cost of food, the availability of food and available time to eat as the main factors influencing food selection. We also identified the influence of friends and family, among others, in their choices. Students who participated reported to prefer food from home, eating most of their meals at home and having eating schedules influenced by academic activities. Conclusion Although students have knowledge about what is good for them in terms of food, in university life, the organization of academic schedule, food availability and economic resources show significant influence on their habits and choices. Strategies to promote healthy habits in universities should then prioritize the control of such barriers.

Effects of N-acetylcysteine on isolated mouse skeletal muscle: contractile properties, temperature dependence, and metabolism.

The effects of the general antioxidant N-acetylcysteine (NAC) on muscle function and metabolism were examined. Isolated paired mouse extensor digitorum longus muscles were studied in the absence or presence of 20 mM NAC. Muscles were electrically stimulated to perform 100 isometric tetanic contractions (300 ms duration) at frequencies resulting in ∼85% of maximal force (70-150 Hz at 25-40 °C). NAC did not significantly affect peak force in the unfatigued state at any temperature but significantly slowed tetanic force development in a temperature-dependent fashion (e.g., time to 50% of peak tension averaged 35 ± 2 ms [control] and 37 ± 1 ms [NAC] at 25 °C vs. 21 ± 1 ms [control] and 52 ± 6 ms [NAC, P < 0.01] at 40 °C). During repeated contractions, NAC maximally enhanced peak force by the fifth tetanus at all temperatures (by ∼30%). Thereafter, the effect of NAC disappeared rapidly at high temperatures (35-40 °C) and more slowly at the lower temperatures (25-30 °C). At all temperatures, the enhancing effect of NAC on peak force was associated with a slowing of relaxation. NAC did not significantly affect myosin light chain phosphorylation at rest or after five contractions (∼50% increase vs. rest). After five tetani, lactate and inorganic phosphate increased about 20-fold and 2-fold, respectively, both in control and NAC-treated muscles. Interestingly, after five tetani, the increase in glucose 6-P was ∼2-fold greater, whereas the increase in malate was inhibited by ∼75% with NAC vs. control, illustrating the metabolic effects of NAC. NAC slightly decreased the maximum shortening velocity in early fatigue (five to seven repeated tetani). These data demonstrate that the antioxidant NAC transiently enhances muscle force generation by a mechanism that is independent of changes in myosin light chain phosphorylation and inorganic phosphate. The slowing of relaxation suggests that NAC enhances isometric force by facilitating fusion (i.e., delaying force decline between pulses). The initial slowing of tension development and subsequent slowing of relaxation suggest that NAC would result in impaired performance during a high-intensity dynamic exercise.

Concordancia en la estimación del consumo máximo de oxígeno entre una prueba de esfuerzo y el Polar s810® / Agreement between a fitness test and Polar S810 for estimating maximum oxygen uptake

Objetivo Identificar la concordancia entre los datos de estimación del consumo máximo de oxígeno, obtenidos mediante una prueba de esfuerzo y el monitor de frecuencia cardiaca Polar S810® Métodos Se hizo un estudio observacional de concordancia entre dos métodos de estimación del VO2max, en forma simultánea e independiente. Se aplicaron dos protocolos, uno en reposo y otro en esfuerzo máximo, en 46 deportistas de la Universidad Nacional de Colombia, entrenados en deportes de resistencia aeróbica. Resultados El Coeficiente de correlación-concordancia (CCC) de Lin fue 0,31 (p < 0,003). Este coeficiente no se modificó sustancialmente al estratificar por género (masculino: CCC 0,29 IC 95 por ciento 0,04 - 0,54; femenino CCC 0,15 IC 95 por ciento -0,14 - 0,45), por tipo de deporte (grupal: CCC 0,38 IC 95 por ciento 0,04 - 0,54; individual: (CCC 0,16 IC 95 por ciento -0,20 - 0,52) y tan solo en los deportistas entre 24,1 y 28 años de edad mejoró su valor (CCC 0,65 IC 95 por ciento 0,35 - 0,93). Teniendo como referencia la prueba de esfuerzo, el Polar S810®, da valores superiores o inferiores, contando como punto de corte los 42 mL/Kg/min. Conclusiones La concordancia entre los dos métodos fue pobre en forma general y en los diferentes subgrupos de deportistas, lo cual no permite intercambiar los resultados de estimación del VO2max obtenidos entre la prueba de esfuerzo y el Polar S810®.

Objective Identifying agreement between data for estimating maximum oxygen uptake obtained by a fitness test and the Polar S810 heart rate monitor. Methods This was an observational agreement study comparing two methods for estimating VO2max (simultaneously and independently). Two protocols were applied to 46 athletes from the Universidad Nacional de Colombia who had been trained in endurance sports (one at rest and maximum effort i). Results Lin's concordance correlation coefficient CCC) was 0.31 (p<0.003). This coefficient did not change substantially when stratified by gender (male: CCC 0.29; 0.04-0.54 95 percentCI; female CCC 0.15; 0.14-0.45 95 percentCI), type of sport (group: CCC 0.38; 0.04-0.54 95 percentCI; individual: CCC 0.16; 0.20-0.52 95 percentCI) and its value only improved in athletes aged 24.1 to 28 (CCC 0.65; 0.35-0.93 95 percentCI). Regarding the maximum test, the Polar S810 gave higher or lower values, with 42 mL/kg/min cut-off. Conclusions Agreement between both methods was generally poor and in the different subgroups of athletes; this meant that the results obtained from estimating VO2max could not be exchanged between the fitness and Polar S810 tests.