Combined pulmonary fibrosis and emphysema with pulmonary arterial hypertension: A Rare Case Report.

Combined pulmonary fi brosis and emphysema (CPFE) is a recently recognized radiologically defi ned syndrome characterized by simultaneous coexistence of both upper lobe emphysema and lower lobe pulmonary fi brosis. We present a case of CPFE in a 57-year-old male smoker who presented with dry cough, progressive breathlessness, and swelling of feet. His chest X-ray revealed bilateral lower Zone reticulonodular opacities with hyperlucent upper Zones. Pulmonary function tests showed wellpreserved lung volumes and reduced diff using capacity of the lung for carbon monoxide. High-resolution computed tomogram showed bilateral lower lobe subpleural honeycombing along with fi brosis and traction bronchiectasis with bilateral upper lobe emphysema predominantly paraseptal type. His 2D echo was suggestive of moderate pulmonary arterial hypertension.

Inhaler use in adolescents and adults with self-reported physician-diagnosed asthma, bronchitis, or emphysema in the city of Pelotas, Brazil / Uso de inaladores na população de adolescentes e adultos com diagnóstico médico autorreferido de asma, bronquite ou enfisema em Pelotas, RS

OBJECTIVE: To evaluate the characteristics of users of inhalers and the prevalence of inhaler use among adolescents and adults with self-reported physician-diagnosed asthma, bronchitis, or emphysema. METHODS: A population-based study conducted in the city of Pelotas, Brazil, involving 3,670 subjects ≥ 10 years of age, evaluated with a questionnaire. RESULTS: Approximately 10% of the sample reported at least one of the respiratory diseases studied. Among those individuals, 59% reported respiratory symptoms in the last year, and, of those, only half reported using inhalers. The use of inhalers differed significantly by socioeconomic status (39% and 61% for the lowest and the highest, respectively, p = 0.01). The frequency of inhaler use did not differ by gender or age. Among the individuals reporting emphysema and inhaler use, the use of the bronchodilator-corticosteroid combination was more common than was that of a bronchodilator alone. Only among the individuals reporting physician-diagnosed asthma and current symptoms was the proportion of inhaler users higher than 50%. CONCLUSIONS: In our sample, inhalers were underutilized, and the type of medication used by the individuals who reported emphysema does not seem to be in accordance with the consensus recommendations. .

OBJETIVO: Avaliar as características dos usuários de dispositivos inalatórios e a prevalência de uso desses em adolescentes e adultos com diagnóstico médico autorreferido de asma, bronquite ou enfisema. MÉTODOS: Estudo de base populacional realizado em Pelotas, RS, incluindo 3.670 indivíduos com idade ≥ 10 anos, avaliados com um questionário. RESULTADOS: Aproximadamente 10% da amostra referiram pelo menos uma das doenças respiratórias investigadas. Entre esses, 59% apresentaram sintomas respiratórios no último ano, e, desses, apenas metade usou inaladores. O uso de inaladores diferiu significativamente de acordo com o nível socioeconômico (39% e 61% entre mais pobres e mais ricos, respectivamente; p = 0,01). Não houve diferença na frequência de uso de inaladores por sexo ou idade. Entre indivíduos com enfisema, o uso da combinação broncodilatador + corticoide inalatório foi mais frequente que o uso isolado de broncodilatador. Somente entre os indivíduos que referiram diagnóstico médico de asma e sintomas atuais, a proporção de uso de inaladores foi maior que 50%. CONCLUSÕES: Em nossa amostra, os inaladores foram subutilizados, e o tipo de medicamento usado por aqueles que referiram enfisema parece não estar de acordo com o preconizado em consensos sobre essa doença. .

Características y riesgo de las personas con diabetes y EPOC registrados en las empresas sociales del Estado de la red pública del departamento de Risaralda, durante el período comprendido entre el primero de julio 2002 al 30 de junio del 2005 / Characteristic and Risks of People with diabetes and Chronic Obstructive Pulmonary Disease Registered in the Public Network of Social Services of the Department of Risaralda from July 2002 to June 30, 2005

La Diabetes Mellitus y la Enfermedad Pulmonar Obstructiva Crónica, EPOC, hacen parte de las patologías que clásicamente se han definido como degenerativas y crónicas. La mortalidad en Risaralda reporta la EPOC sistemáticamente entre las tres primeras causas de defunción en la serie desde 1997. La tendencia es al descenso y aunque que la mortalidad por Diabetes Mellitus parece tener una tendencia al descenso, en el último año presenta alza en las tasas de mortalidad. A pesar que existe un sistema de información de morbilidad y mortalidad para la Secretaría Departamental de Salud de Risaralda, no son suficientes las políticas de promoción de la salud con la información reportada por los certificados de defunción, al punto que actualmente se desconocen las características de los factores de riesgo de las personas con diagnóstico de DIABETES y/o EPOC, registrados en las Empresas Sociales del Estado de la red pública del departamento Risaralda.

The Malaysian experience in the typing of genetic variants of alpha-1-antitrypsin.

It is known that alpha1-antitrypsin deficiency is associated with emphysema in adults and liver cirrhosis in neonates. The phenotypes PiZZ and PiSZ are considered to be high risk groups. alpha1-antitrypsin deficiency is one of the most common lethal congenital disorders in Europe and the USA, occurring in approximately 1 in 2,000 caucasians of North European descent. Studies in Malaysia have found that the phenotypes PiZ and PiS are present in our population. Out of 950 samples analyzed, it was found that 10 samples were shown to be apparently Z homozygous phenotype. The phenotype is determined by high resolution isoelectrofocusing on an ultra-thin polyacrylamide gel embedded with narrow range Pi phamarlyte. The isoelectrofocused bands are confirmed by immunofixation and the plasma alpha1-antitrypsin levels determined by electroimmunoassay. The abnormal phenotypes are further confirmed by polymerase chain reaction using allele specific oligonucleotides.