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BACKGROUND: Since few years, the data describing the chronic obstructive pulmonary disease (COPD) have changed and new concepts have emerged. AIM: To study the clinical characteristics and outcome of patients with COPD in a Tunisian population. METHODS: It is a retrospective study including 150 patients with COPD admitted at the pulmonary department of Charles Nicolle Hospital in Tunis, during a period of ten years. RESULTS: Data from 150 patients hospitalized at the pulmonary department of Charles Nicolle Hospital in Tunis, were analyzed. They were 126 men and 24 women with a mean age of 67 years. Tobacco was the predominant risk factor. Eighty-two (55%) patients were classified GOLD stage IV at diagnosis. The number of exacerbation varied from 1 to 7 with an average higher in patients classified as stage IV (p = 0.007). CONCLUSION: The COPD is pathology of smoking men. Comorbidities and exacerbations prevalence increase according the disease severity. In fact, better knowledge of exacerbations etiologies allows considering better measurement of prevention.
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Hospitalización/estadística & datos numéricos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Estudios Retrospectivos , Túnez/epidemiologíaRESUMEN
INTRODUCTION: Undernutrition is a predictor of mortality in chronic obstructive pulmonary disease (COPD). The objectives of our study were to assess nutritional intake in COPD and to study its relationship with disease severity. METHODS: A cross-sectional study that included 66 patients followed for COPD. Patients included had a body composition study and a respiratory and nutritional assessment. RESULTS: The mean age of the population was 66±9 years. The lean body mass index (LMI) was reduced in 26.1% of patients. It was significantly associated with the GOLD group (P=0.04) and significantly correlated with the forced expiratory volume in the first second (FEV1) (P=0.02) and the distance covered during the six-minute walk test (TM6) (P=0.01). A significant difference was found between the caloric intakes and the different GOLD groups (P=0.04). Mean intakes of calories (P=0.002; r=0.07), protein (P=0.01; r=0.16), carbohydrates (P=0.02; r=0.2) and iron (P=0.01; r=0.13) were significantly correlated with the TM6 results. Caloric intake was significantly correlated with LMI (P=0.01; r=0.16), body mass index (P=0.04; r=0.12), FEV1 (P=0.04; r=-0.12) and GOLD stage (0.002). Similarly, protein intake was significantly correlated with LMI (P=0.001; r=0.11), body mass index (P=0.02; r=0.16), FEV1(%) (P=0.001; r=-0.16) and GOLD stage (P=0.002). CONCLUSION: Undernutrition in COPD is caused by decreased food intake and increased resting energy expenditure. Adequate intakes of glucose, protein, fibers, vitamins and zinc are associated with improved ventilatory function.
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Estado Nutricional , Enfermedad Pulmonar Obstructiva Crónica , Anciano , Estudios Transversales , Ingestión de Alimentos , Volumen Espiratorio Forzado , Humanos , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/epidemiologíaRESUMEN
Erythema elevatum diutinum is a rare condition of unknown etiology listed with cutaneous vasculitis or neutrophilic diseases. Medical records and histopathologic slides of 5 patients with erythema elevatum diutinum were studied to better understand the disease. Lesions were clinically characteristic. All biopsy specimens showed leucocytoclastic vasculitis. The most significant finding is the association of erythema elevatum diutinum whith seronegative rheumatoid arthritis.
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Eritema/patología , Vasculitis/patología , Adulto , Biopsia , Eritema/inmunología , Femenino , Humanos , Persona de Mediana Edad , Infiltración NeutrófilaRESUMEN
INTRODUCTION: Hydatid cysts may occur in any area of the body, but they usually localize to the liver and the lungs. Primary localization in bone is not common. PRESENTATION OF CASE: The authors report the case of multifocal hydatid disease appeared 3 years after the surgical treatment of a cyst of the hip. The patient presented with cough and chest pain of 2 months duration. Only the lung localization was symptomatic. The thoracic echography, the abdominal and chest scan allowed the diagnosis. DISCUSSION: Hydatid recurrence remain frequent, whatever is the nature of the treatment, surgical or chemical. CONCLUSION: The premature detection of recurrence is of great importance.
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The aim of this article is to give practicing physicians a practical approach to the treatment of latent and active tuberculosis. Most patients follow TB standard treatment recommended by WHO that depend on category of patient. It is a combination of four essential tuberculosis drugs of the first group: isoniazid, rifampicin, pyrazinamid and ethambutol; in some cases streptomycin can replace ethambutol. This initial phase of intensive treatment is followed by a consolidation phase. Drugs should be administered in the morning on an empty stomach one hour before meals. Treatment of latent tuberculosis (TB) infection is an important component of TB control programs. Preventive treatment can reduce the risk of developing active TB.
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Antituberculosos/uso terapéutico , Etambutol/uso terapéutico , Isoniazida/uso terapéutico , Pirazinamida/uso terapéutico , Rifampin/uso terapéutico , Tuberculosis/tratamiento farmacológico , Quimioterapia Combinada , Humanos , Tuberculosis Latente/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Resultado del Tratamiento , Tuberculosis Pulmonar/tratamiento farmacológico , Organización Mundial de la SaludRESUMEN
The authors report the case of a 20-year-old man in whom pulmonary and bone tuberculosis presented as bilateral pleural thickening without effusion.
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Tuberculosis Pleural/diagnóstico , Granuloma de Células Plasmáticas/complicaciones , Granuloma de Células Plasmáticas/diagnóstico , Humanos , Masculino , Radiografía Torácica , Tuberculosis Osteoarticular/complicaciones , Tuberculosis Osteoarticular/diagnóstico , Tuberculosis Pleural/complicaciones , Adulto JovenAsunto(s)
Quiste Broncogénico/diagnóstico , Neoplasias del Mediastino/diagnóstico , Neurilemoma/diagnóstico , Quiste Broncogénico/patología , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias del Mediastino/patología , Persona de Mediana Edad , Neurilemoma/patología , Radiografía Torácica , Fumar/efectos adversos , Tomografía Computarizada por Rayos XRESUMEN
UNLABELLED: Lung mycosis is rare. Diagnosis and treatment must be done the earliest possible. METHODS: It is about a retrospective study on clinical records including patients hospitalized for lung infection. RESULTS: From 2008 to 2011, 16 patients (13 men and three women, average age 42 years) developed a pulmonary infection. Twelve of our patients had respiratory or extrarespiratory histories. None of our patients had a neutropenia. The diagnoses were lung aspergilloma in four cases, invasive lung aspergillosis in three cases, allergic bronchopulmonary aspergillosis in three cases, mucormycosis in three cases, trichosporonosis in a case, actinomycosis in one case and penicilliosis in one case. An antifungal treatment consisting in amphotericin B or itraconazole was given to four patients and six patients, respectively. Surgery was chosen for six patients. The evolution was good for 12 patients, one presented renal failure, and three patients died.
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Enfermedades Pulmonares Fúngicas/epidemiología , Adulto , Anciano , Antifúngicos/uso terapéutico , Terapia Combinada , Comorbilidad , Susceptibilidad a Enfermedades , Femenino , Humanos , Huésped Inmunocomprometido , Pacientes Internos/estadística & datos numéricos , Recuento de Leucocitos , Enfermedades Pulmonares Fúngicas/diagnóstico por imagen , Enfermedades Pulmonares Fúngicas/tratamiento farmacológico , Enfermedades Pulmonares Fúngicas/inmunología , Enfermedades Pulmonares Fúngicas/cirugía , Masculino , Persona de Mediana Edad , Neutrófilos , Radiografía , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenAsunto(s)
Pulmón/irrigación sanguínea , Pulmón/diagnóstico por imagen , Venas Pulmonares/diagnóstico por imagen , Venas Pulmonares/patología , Várices/diagnóstico por imagen , Dilatación Patológica , Humanos , Pulmón/patología , Masculino , Persona de Mediana Edad , Radiografía Torácica , Tomografía Computarizada por Rayos X , Várices/patologíaRESUMEN
Bronchopulmonary sequestration is a rare malformation characterized by lung tissue fed by one or several aberrant systemic arteries. The authors present the case of a 35-year-old woman in whom extralobar sequestration was fortuitously detected at the time of persistent pleuropneumopathy. Computed tomography was used in the diagnosis of pulmonary sequestration. The most common and recommended treatment is the surgical removal of the pulmonary sequestration.