Respiratory failure due to muscle weakness in inflammatory myopathies: maintenance therapy with home mechanical ventilation.

Polymyositis and dermatomyositis are idiopathic inflammatory myopathies. Respiratory complications are a common feature, but ventilatory insufficiency is rare in these patients. We describe here three patients diagnosed with inflammatory myopathy (polymyositis) with respiratory failure due to muscle weakness who did not respond to immunosuppressive therapy. Mechanical ventilation at home with nasal or tracheal intermittent positive pressure resulted in improved chronic hypoventilation. This treatment improves the quality of life of patients with inflammatory myopathies and can be lifesaving in some cases.

[Prevalence of respiratory diseases in a rural population in the north of Catalonia: La Cerdanya]. / Prevalencia de enfermedades respiratorias en una población rural del norte de Cataluña: La Cerdanya.

BACKGROUND: There are few epidemiological studies on health respiration in the population of Catalonia (Spain). This is a cross-sectional study of prevalence about respiratory diseases in a rural population in La Cerdanya (Catalonia). METHODS: The sample was obtained by a simple random method among the Cerdanya population older than 6 years. The questionnaire used was from the American Thoracic Society for the Division of Lung Disease with an annex attached for extrinsec allergic alveolitis which was worked out. RESULTS: The smoking prevalence was 24.2%, among the farmers (17.1%) was lower than the general population, and it was higher in the men (36.0%). The bronchitis chronic symptoms prevalence was 9.2%, higher in the men (11.3%). The bronchial asthma symptoms prevalence was 4.8% and the farmer's lung symptoms was 0.2% in the general population and 1.0% among the farmers. CONCLUSIONS: The smoking frequency La Cerdanya is lower than in the rest of Catalonia, probably because the farmers have a lower prevalence of smoking. The smoking habit and chronic bronchitis is higher in males. The chronic bronchitis prevalence in farmers with moderated or severe contact with organic dust is higher than in the farmers with lighter contact.

[Chronic eosinophilic pneumonia: report of eight cases (author's transl)]. / Neumonía eosinófila crónica. Estudio de ocho casos.

Eight cases of chronic eosinophilic pneumonia (CEP) diagnosed between January 1977 and December 1979 are described. Clinical manifestations included toxic syndrome, cough and fever, lasting from 1 to 15 months. Chest x-ray revealed peripheric bilateral infiltrates, with the exception of one case. In two patients there was no peripheral eosinophilia and five received antituberculous drugs at some point during the illness. In all cases tests for fungi and parasites were negative. In only two patients was an increase in IgE found. Hystological study confirmed CEP in 7 patients through either trans-bronchial biopsy or minimal thoracotomy. Treatment with corticosteroids was dramatically effective in all patients; both clinically and radiologically. In two cases which were asymptomatic, decreased carbon monoxide diffusing capacity persisted six months later. One hundred fifteen cases of CEP published since Carrington et al. first described CEP as a separate entity of the pulmonary infiltrates with eosinophilia syndrome are reviewed.

[Pleural sarcoidosis: report of five cases (author's transl)]. / Sarcoidosis pleural: descripción de cinco casos.

From a series of 110 patients with sarcoidosis seen at our hospital from October 1971 to September 1979, five cases were found with histologically proven pleural sarcoidosis, an incidence of 4.6%. Pleural involvement was not described in the surgical or autopsy protocols. Infiltration by sarcoid granulomas was found in the visceral and/or parietal layers in five cases of seven in whom pleural tissue was available for examination. The layer affected depended directly on the available sample. Only one patient had pleural effusion, which was an exudate with a high lymphocyte count; the case corresponded to a stage II sarcoidosis. The number of histologically proven cases of pleural sarcoidosis reported in the medical literature is very small, only 52 cass, including our own. In conclusion, it appears that the frequency of pleural sarcoidosis is falsely low, and that the availability of pleural tissue in patients with sarcoidosis undergoing thoracotomy might rise the figures heretofore encountered.