Premenstrual asthma and leukotriene variations in the menstrual cycle.

BACKGROUND: Several authors have reported an increase in leukotriene C4 in the premenstrual phase in women with severe premenstrual asthma, indicating that antileukotrienes could be used in treatment. OBJECTIVE: To analyse the role of leukotrienes in premenstrual asthma. METHODS: A questionnaire on respiratory symptoms and peak flow during one complete menstrual cycle was given to women of fertile age to define them as asthmatics who suffered from premenstrual asthma or not. Premenstrual asthma (PMA) was defined as a clinical or functional deterioration (≥20%) in the premenstrual phase compared with the preovulatory phase. Blood samples to measure leukotriene C4 were taken during the preovulatory and premenstrual phases. RESULTS: Blood samples were taken in 62 asthmatic women, 34 of whom (54.3%) presented PMA criteria, all with a premenstrual deterioration of between 20 and 40%. There was no difference in leukotriene C4 levels between the preovulatory and premenstrual phases in the women who suffered from PMA (1.50ng/mL vs. 1.31ng/mL; p=0.32) and those who did not (1.40ng/mL vs. 1.29ng/mL; p=0.62). Neither were there any differences in leukotriene levels between women with or without PMA. The results were similar for each category of asthma severity. CONCLUSIONS: Our data show that leukotriene C4 does not appear to be involved in the pathogenesis of premenstrual asthma, or support the use of anti-leukotrienes in the specific treatment of premenstrual asthma, at least in women with a moderate premenstrual deterioration. No differences appeared in any of the categories of asthma severity.

[Incidence of bronchopulmonary carcinoma in Extremadura in 1998]. / Incidencia de carcinoma broncopulmonar en Extremadura durante el año 1998.

OBJECTIVES: Our main objective was to determine the incidence of bronchopulmonary cancer in Extremadura (Spain). We also studied the presence of risk factors such as smoking and exposure to other carcinogens. MATERIAL AND METHODS: This prospective study used a protocol followed by all hospitals in Extremadura; enrolled were patients with a diagnosis of bronchopulmonary carcinoma in 1998 who lived habitually in the region. Cyto-histological confirmation of the diagnosis was sought or, when such confirmation was unavailable, diagnostic agreement among researchers was based on clinical, radiological and/or endoscopic data. RESULTS: The incidences adjusted to world population were 53.4, 2.16 and 25.3 per 100,000 inhabitants for men, women and the entire population sample, respectively. Patterns in the provinces of Cáceres and Badajoz were very similar. Of 433 cases recorded, 95% were men and 78% were aged 60 years or older. Cyto-histological confirmation of diagnosis was available for 92.2%. Most tumors were epidermoid (41.1%). The time between the start of smoking and diagnosis was significantly shorter in heavier smokers.

[Brief polysomnographic studies in the diagnosis of the obstructive sleep apnea syndrome]. / Estudios polisomnográficos cortos en el diagnóstico del síndrome de apnea obstructiva del sueño.

Firm diagnosis of obstructive sleep apnea syndrome (OSAS) is normally based on all-night-long polysomnograms, at considerable expenditure of time and money. Shorter studies have been proposed as an alternative. We have assessed the efficacy of polysomnograms recorded over the first three hours of nocturnal sleep (SN) for diagnosing OSAS and the results have been compared with those of polysomnograms recorded throughout the entire night (EN). Twenty-five male patients suspected of having OSAS were enrolled; 19 were diagnosed for OSAS by EN and 16 were diagnosed by SN, indicating 3 false negatives and a sensitivity of 84% for SS. No false positives were obtained by studying only the first three hours of sleep, indicating a specificity of 100%. Significant differences were found in minimum oxygen saturation (SatO2) and percent of total sleep time with intervals of SatO2 below 80%. We conclude that polysomnography during the first part of nocturnal sleep is a specific method for screening for OSAS and that, although this method's sensitivity is high, study should be continued throughout an entire night when results are negative. Desaturation levels may be underestimated in recordings lasting only the first half of the night.

[Usefulness of dehumidifiers in the reduction of acari concentrations]. / Utilidad de los dispositivos deshumidificadores en la reducción de la concentración de ácaros.

This study analyzes the role of dehumidifiers in asthma prophylaxis. The efficacy of dehumidifiers in the reduction of Dermatophagoides in the bedrooms of 9 patients with specific allergies was evaluated, along with success in reducing in high concentrations of mite allergens (D. pteronissinus I). Results were compared with those for a control group of 8 patients with the same allergy. In the group in whose homes a dehumidifier was installed, there was a significant reduction in relative humidity in the bedroom (54.84 +/- 4.33% and 45.23 +/- 4.92%; p < 0.05) as well as a significant decreased in concentrations of D. pteronissinus I (2.313 +/- 1.831 to 0.42 +/- 0.44 microgram/g; p < 0.05). This was not the case of patients in the control group (51.15 +/- 7.38% to 60.5 +/- 6.15%; p < 0.05 and 3.28 micrograms/g +/- 4.46 to 4.24 +/- 5.10; p = NS).

Validity of enlarged mediastinal nodes as markers of involvement by non-small cell lung cancer.

To assess the validity of enlarged mediastinal nodes as markers of involvement for staging in non-small cell lung cancer, we studied the records of 167 consecutive patients who underwent thoracotomy for this disease in the last 4 yr in our center. Careful search for both hilar (N1) and ipsilateral mediastinal nodes (N2) was done in every case. All nodes found at thoracotomy (regardless of their size) were either removed or sampled and then sent to the pathology department for examination. We found enlarged nodes (larger than 10 mm) in 131 of the 167 patients included in the study (72%). Of these patients, 58 had enlarged nodes at the hilar level (presumably N1 disease, 38%), and 73 were considered as presumably N2 at thoracotomy, before pathologic examination (62%). Only 12 of 58 patients with presumably N1 disease had true neoplastic involvement at this level (21%), whereas there was true N2 disease in only 18 of 73 patients with enlarged mediastinal nodes (25%). The positive predictive value for N2 in epidermoid carcinoma was 23%, and it was even lower with adenocarcinoma (18%). We conclude that open surgery with careful sampling is the method of choice for evaluation of mediastinal nodes in non-small cell lung cancer if evidence of malignant involvement cannot be proven histologically before thoracotomy.