[An infrequent cause of pulmonary thromboembolism]. / Una causa infrecuente de tromboembolismo pulmonar.

We present a case of pulmonary thromboembolism in a young patient triggered by a long haul travel, in which a homocygotic mutation in the gene of the metilentetrahidrofolate reductase was demonstrated. This mutation can cause hyperhomocysteinemia that is a recognized risk factor for venous thromboembolism (VTE). In the management of these patients, the levels of homocysteine should be lowered, as well as use of thromboprophylaxis before transitory risk situations. It is important to know when the screening should be performed, because they are behind an important number of cases of VTE.

[Young's syndrome in the adult age: home treatment with a mechanical device of intrapulmonary percusive ventilation]. / Síndrome de Young en la edad adulta: tratamiento domiciliario mediante un dispositivo mecánico de percusión intrapulmonar.

We studied a man with bronchiectasis, chronic sinopulmonary infections and obstructive azoospermia diagnosed of Young's syndrome in the adult age. The patient was treated at home by a mechanical system of respiratory care based in intrapulmonary percussive ventilation (Percussionaire) reaching a significant clinical and functional improvement. Our case enhanced the importance to make a proper history of fertility in patients with bronchiectasis in order to establish the diagnostic. We review different methods of respiratory mechanical assistance in patients with bronchiectasis.

[Humidifier fever: and unusual variant of hypersensitivity pneumonitis]. / Fiebre de los humidificadores: una rara variante de neumonitis por hipersensibilidad.

A case of a patient suffering three episodes consistent in fever, lung infiltrates, lymphocitosis in bronchoalveolar lavage and non-caseificant granulomata in transbronchial biopsy is reported.A relationship between exposition to the air conditioner in the office and the clinical picture was stablished, and the patient was finally diagnosed from humidifiers fever. We enfatize the manifestations of this uncommon disease, probably infradiagnosed, and the patogenic mechanisms are reviewed.

[Two new cases of chronic eosinophilic pneumonia. A revision of the literature]. / Dos nuevos casos de neumonía eosinófila crónica. Revisión de la literatura.

We present two cases of chronic eosinophilic pneumonia in two women of a seventy-seven and sixty-five years old. We revised the clinical and radiologic features, and their pathogenesis. It is necessary to recognize in a precocious time this entity and the utility of the bronchoalveolar lavage fluid in the diagnostic, for to begin a treatment with corticosteroids.

[Pneumothorax due to drug inhalation]. / Neumotórax por inhalación de drogas.

Two cases of spontaneous pneumothorax after repeated inhalation of cocaine and forced aspiration of marijuana smoke, respectively, are presented. The absence of pneumomediastinum and associated subcutaneous emphysema in both cases is stressed. Inspiratory manipulations against resistance are assessed as potential etiological factors, although the coexistence of other pneumothorax predisposing factors seems to be necessary.

[Acute lung injury as initial manifestation of diffuse alveolar hemorrhage]. / Daño pulmonar agudo como manifestación inicial de hemorragia alveolar difusa.

OBJECTIVE: To determine clinical features and outcome in hospitalized patients with acute lung injury secondary to diffuse pulmonary hemorrhage (DPH). PATIENTS AND METHOD: Eight adult patients suffering DPH and acute lung injury were undergone to diagnosis procedure and following. RESULTS: Two cases of idiopathic pulmonary hemosiderosis, two cases of systemic lupus erythematous, two cases of Goodpasture's syndrome, one case of idiopathic rapidly progressive glomerulonephritis and one of periarteritis nodosa were diagnosed. Treatment was methylprednisolone in all cases; besides, three cases required ventilatory support, and one immunosuppressive therapy, plasmapheresis and hemodialysis. One patient died and three of them suffered relapse with satisfactory outcome. CONCLUSION: We remark the presence of acute lung injury as an initial feature of DPH in our experience and the importance of a prompt diagnosis of the underlying disease.

[Legionellosis at intensive care units: study of 30 cases]. / Legionelosis en cuidados intensivos: estudio de 30 casos.

A prospective study during 44 months has been carried out in order to establish the incidence of pneumonia due to Legionella sp. in our hospital's intensive care unit (ICU). Thirty cases of legionellosis were diagnosed (22.2% of the studied pneumonias) two of them were acquired in the ICU and 76.6% were caused by L. pneumophila serotype. The most evident symptomatology was intense dyspnea, neurological disorders, acute respiratory and renal failure. The biochemical alterations, most commonly encountered were increased liver enzymes, hypoxemia, hypoalbuminemia, increased urea, creatinine and hematuria. As a consequence of this severe disease, the mortality rate was high (13 out of 30 cases).