Revista de Patologia Respiratoria最新文献

Introduction

The assessment of daily physical activity is important to prevent and treat many diseases more effectively.

Objectives

to evaluate daily physical activity using Tri-axial accelerometers in patients with pulmonary arterial hypertension and treated with endothelin receptor antagonists.

Material and methods

Six patients with pulmonary arterial hypertension diagnosed by right heart catheterization were included. World Health Organization functional class, 6-minute walking test, daily physical activity evaluated with the London Chest Activity of Daily Living Scale and with RT3 accelerometers devices were assessed in two opportunities, before and after three months of treatment with nonselective endothelin receptor antagonist drugs.

Results

Mean scores of the London Chest Activity of Daily Living Scale scale before and after three months treatment were 35.0 (26.8–43.5) [median and interquartilic range] and 22.0 (16.5–28.3), respectively (p=0.068). Daily physical activity measured by accelerometer was associated with the minimum oxygen saturation during the 6-minute walking test (r=0.825, p=0.043). The total period of low intensity physical activity registered was associated with pulmonary vascular resistances (r=0.989; p=0.001) and the total period of heavy intensity physical activity registered with the systemic vascular resistances (r=0.0890; p=0.043).

Conclusion

Daily physical activity of patients with pulmonary arterial hypertension could be evaluated with accelerometers. In this way, physical activity is associated with the exercise tolerance and with hemodynamic measures.

Airway endoluminal Metastasis of malignant melanoma are rare. We present a group of six cases of metastatic malignant melanoma in trachea and bronchial tube, four of them required endoscopic resection and laser therapy to treat secondary symptomatic severe airway obstruction.

Pulmonary hypertension (PH) is a disease characterized by a progressive increase of pulmonary vascular resistance, which gives rise to right ventricular failure and premature death. This may be idiopathic or be associated to different conditions, standing out among them collagen, toxic diseases and lung conditions such as interstitial lung diseases.

We present the case of a female patient diagnosed of PH with images suggestive of interstitial disease in the high resolution computed tomography and who was subsequently diagnosed of a non-specific interstitial pneumonia. It is important to stress the positive vasoreactivity test in cardiac catheterization that may indicate the presence of two independent conditions in the present case.

Cardiac tumors have low prevalence. They may be localized on any level and those found in the right atrium are generally malignant (sarcomas). The clinical manifestations are unspecific and depend on the localization. We present the case of an 80-year old man who was admitted to our unit with acute pulmonary edema secondary to an intracardiac mass and respiratory acidosis which required non-invasive mechanical ventilation.

Objective

To measure the correlation between perceived quality of life and two objective severity parameters: forced expiratory volume in one second (FEV₁) and body mass, airflow obstruction, dyspnea and exercise capacity (BODE) index.

Material and methods

Observational descriptive cross-sectional study involving 40 Chronic Obstruction Pulmonary Disease (COPD) patients. They were classified using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification system into moderate or severe. The Saint George Respiratory Questionnaire (SGRQ) was carried out by interview and the BODE value was analyzed after measurement of the parameters included in it. Anthropometry and demography data were also collected.

Results

A study including 40 patients, 38 of them men 38 (95%), with mean age 76.15 ± 5.82 was performed. The means obtained for the subjective variable of the SGRQ was 33.58 ± 18.14. Regarding the data obtained for the objective variables, the FEV₁ had a mean of 49.05 ± 15.731, and the BODE index showed 2.33 ± 1.8. The parameters making it up were: 6-minute exercise test 440 ± 87.9, mean MRC score: 1.4 ± 0.6, and body mass index (BMI) 28.16 ± 4.4. According to the values obtained, we observed the existence of a correlation between SGRO and the BODE index and between the activity, and subscale of the SGRO and BODE index.

Conclusions

The BODE index are weakly correlative with the results of the SGRO combined. High index BODE negatively affects the perceived quality of life of moderate/severe COPD patients.

Neurofibromas are neurogenic tumors originated from Schwann cells and the fibroblasts of the peripheral nerve sheaths.

From 40–60% of the posterior mediastinal tumors are neurofibromas and schawnomas. The schwannoma is the most frequent.

Its development is slow, which explains the large size observed at the time of diagnosis in some cases. This explains the compression symptoms.

We present the clinical case of a posterior mediastinal neurofibroma that began clinically with pleuritic pain and palpebral ptosis.