RESUMEN
Accumulation of viscous sputum enhances lung damage in patients with cystic fibrosis. High contents of DNA, released by leucocytes, are the major cause of the high viscosity of this sputum. Recombinant human DNase I (rhDNase) decreases viscoelastic properties of sputum in cystic fibrosis and improves lung function. We have investigated the effect of rhDNase over a period of 6 weeks, 2.5 mg once daily, on lung function and quality of life in 12 adult patients with cystic fibrosis. Significant improvements in FEV1, IVC and daily peak flow values were measured. Airway resistance and FVC did not improve significantly. The cause of the improvements found is probably due to recruitment of previously, due to mucus plugging, unventilated lung areas. In addition, the awareness of symptoms related to sputum retention improved, although subjective parameters on general well-being and physical condition remained unchanged.
Asunto(s)
Fibrosis Quística/tratamiento farmacológico , Desoxirribonucleasa I/uso terapéutico , Calidad de Vida , Trastornos Respiratorios/tratamiento farmacológico , Respiración/efectos de los fármacos , Adolescente , Adulto , Fibrosis Quística/complicaciones , Desoxirribonucleasa I/farmacología , Expectorantes/farmacología , Expectorantes/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/farmacología , Proteínas Recombinantes/uso terapéutico , Trastornos Respiratorios/etiología , Pruebas de Función RespiratoriaRESUMEN
We present the case of a patient with acute myeloid leukemia and secondary Pulmonary Alveolar Proteinosis (PAP), which is an underestimated cause of a persistent pulmonary infiltrate in patients with hematologic malignancies often accompanied by neutropenia due to therapy. Diagnosis is established by performing Periodic Acid-Schiff reaction (PAS) stains and transmission electron microscopy (EM) on bronchoalveolar lavage (BAL) fluid. We wish to stress the importance of the early recognition of PAP, which is potentially reversible, and routinely performing PAS staining on BAL fluid in patients with a hematologic disease especially myeloid disorders and a persistent lung infiltrate.
Asunto(s)
Leucemia Mieloide Aguda/complicaciones , Proteinosis Alveolar Pulmonar/diagnóstico , Líquido del Lavado Bronquioalveolar , Resultado Fatal , Femenino , Neoplasias Hematológicas/complicaciones , Humanos , Leucemia Mieloide Aguda/sangre , Persona de Mediana Edad , Reacción del Ácido Peryódico de Schiff , Proteinosis Alveolar Pulmonar/etiologíaRESUMEN
Previously healthy people without interfering conditions are rarely affected by anaerobic infections. We report a young patient with extended septic emboli in the lungs, after an episode of sore throat, due to anaerobic bacteremia with Fusobacterium necrophorum. The first description of oropharyngeal infection complicated by sepsis was given by Lemierre in 1936. Knowledge of Lemierre's syndrome should lead to early recognition and prompt action against this sporadic and possible fatal illness.