Clinical characteristics of COPD patients with early-onset desaturation in the 6-minute walk test.

BACKGROUND: Exercise-induced desaturation in chronic obstructive pulmonary disease (COPD) frequently has prognostic implications. Desaturation within the first minute of the walk 6-minute walk test will probably also occur in daily life activities and translate into hypoxaemic respiratory failure at rest in later years. This study aimed at comparing these patients with those who desaturate after the first minute and determine potential markers. METHODS: We conducted a cross-sectional, retrospective study collecting data on respiratory function tests, cardiovascular comorbidity, body mass index, pack-year index, 6-minute walk test outcomes, BODE index, and Charlson comorbidity index. Patients who desaturated during the first minute of the test were referred to as early desaturators compared to the non-early ones. RESULTS: We observed a higher mean body mass index in early desaturating patients, and an inverse relation as to the body mass index categories <25, 25-29, and ≥30. Early desaturators had a lower FEV1/FVC index. The mean distance walked in the test was shorter in early than in non-early desaturators, and they desaturated more deeply. CONCLUSION: Overweight and obesity, as determined by body mass index, seem to behave like markers for early desaturation. This simple anthropometric measure might indicate point to potential early desaturation in COPD patients.

Applicability of the COPD-LUCSS-DLCO score for patients with chronic obstructive pulmonary disease: Analysis in standard clinical practice conditions. / Aplicabilidad del score COPD-LUCSS-DLCO en pacientes con enfermedad pulmonar obstructiva crónica: análisis en condiciones de práctica clínica habitual.

INTRODUCTION: The COPD-LUCSS-DLCO score had been validated as a predictive tool capable of identifying patients with chronic obstructive pulmonary disease (COPD) and a high mortality risk associated with lung cancer (LC); however, studies have not been conducted yet on its use in standard clinical practice. The aim of this study was to estimate the COPD-LUCSS-DLCO scores for patients with COPD treated in Pulmonology consultations and to determine the incidence of LC in each of the subgroups. MATERIAL AND METHODS: A retrospective observational study was conducted with a cohort of 159 patients with COPD in Pulmonology outpatient follow-up consultations. We calculated the COPD-LUCSS-DLCO score (0-8) for each patient, with low risk considered at 0-3 points and high risk at ≥3.5 points. We calculated the incidence rate of LC in each of the subgroups. RESULTS: Sixty-two percent of the patients had a high-risk score. We estimated an overall LC rate of 30 per 1000 patients with COPD-year (95% CI: 16-53), 44 per 1000 patients with COPD-year (95% CI: 18-76) among those categorised as high risk and 17 per 1000 patients with COPD-year among those categorised as low risk (95% CI: 4-50). CONCLUSIONS: The use of the COPD-LUCSS-DLCO score in standard clinical practice could help detect patients with a greater risk of developing LC, which could help to better manage cases in an LC screening programme.

Comparison of computerized tomography parameters of the cervical spine in normal control subjects and spinal cord-injured patients.

The cross-sectional area and the sagittal and transverse diameters of the cervical spinal canal were measured, using high-resolution, thin-section computerized-tomography images, in 100 control subjects and forty-two patients who had a traumatic injury to the spinal cord. No significant differences were found between the control and the spinal cord-injured group with regard to the cross-sectional area of the spinal canal; however, the differences between the two groups were significant with regard to mean sagittal and transverse diameters of the spinal canal. The sagittal diameters of the spinal canal of the control group were significantly larger than those of the spinal cord-injured group. Conversely, the transverse diameters of the spinal canal of the spinal cord-injured group were significantly larger than those of the control group. These findings suggest that certain patients may be predisposed to spinal cord injury, given sufficient trauma. It is not the total volume of space in the spinal canal that is the critical factor; rather, it is the shape. An index of shape is the ratio of the sagittal to the transverse diameter. The difference between the two groups, based on the ratio of sagittal to transverse diameter, was highly significant. Because this measure is a ratio, there is no need to evaluate an individual on the basis of measurements of absolute values.

Neurochemical effects of danitracen (WA-355): mechanism of action.

Danitracen lowered serotonin levels in the cerebrum, cerebellum, medulla and the whole brain. The drug did not appear to affect the concentration of 5-HIAA except in the cerebellum where there was a considerable depletion. Danitracen pretreatment led to a lowering in the 5-HIAA levels in the whole brain and decreased NE levels in apomorphine and amphetamine treated rats. The findings indicate that the mechanism of action of danitracen also involves noradrenergic neurons along with a possible increase in the metabolism.

Effect of citalopram (Lu 10-171) on tranylcypromine and tryptophan-induced wet-dog shakes in rats.

It has been found that citalopram (Lu 10-171) has profound effects on serotonin (5-HT) metabolism by increasing the 5-HT levels in the cerebellum, medulla, and the whole brain with a corresponding decrease of the 5-HIAA levels in all parts of the brain except the brain stem. On the other hand, the drug does not appear to have any influence on the wet-dog shakes response induced by the combination of a monoamine oxidase inhibitor (MAOI) and L-tryptophan. It is suggested that by increasing the neuronal levels of 5-HT, citalopram decreases the turnover of 5-HT and firing rate of serotonin neurons. It has also been observed that citalopram could be an agonist of a certain type of 5-HT receptor which does not respond to the behavioral screening model proposed by Bedard and Pycock (1977).