[Lung adenocarcinoma feigning an interstitial lung disease in a 30-year-old man]. / Adenocarcinoma de pulmón simulando una enfermedad pulmonar intersticial en un varón de 30 años.

A case of a 30-year-old man is presented. He had a past medical history of asthma and presented with cough, shortness of breath, fever and chest pain. The chest X-ray showed cardiomegaly and a interstitial pattern. The echocardiogram revealed a severe pericardial effusion that required performing a pericardiocentesis. A CT scan showed mediastinal adenopathies and reticulonodular interstitial pattern. A bronchoscopy could not be completed because of non-tolerance. Finally a lung biopsy allowed us to reach a final diagnosis of lung adenocarcinoma. Following, some aspects of lung cancer in young people are commented, especially its incidence, histology, symptoms and a prognosis. A few aspects of the interstitial lung disease are also addressed and the differential diagnosis with lymphangitic carcinomatosis.

[Lung cancer in Avila province, Spain. Incidence rates, epidemiolgy of the year 2012 and trends in the last 20 years]. / Cáncer de pulmón en la provincia de Ávila. Tasas de incidencia, epidemiología del año 2012 y tendencias en los últimos 20 años.

BACKGROUND AND OBJECTIVES: To determine the extent of lung cancer in Alvila. Its incidence rates and significant epidemiological aspects of the year 2012 were recorded, and the results of each 5-year period (up to 20 years) were compared with those of known studies conducted using the same methodology. PATIENTS AND METHODS: A prospective study was conducted on all patients diagnosed with lung cancer in the Province of Avila throughout the year 2012. RESULTS: A total of 81 patients were diagnosed, of whom 70 were males and 11 females, with a mean age of 72.1 years (range: 44-91), and was higher than that found in previous studies. This gave gross, and adjusted to the standard world population, incidence rates in 2012 of 80.99 and 31.23 per 100,000, respectively, in males, and 12.97 and 5.68 per 100,000, respectively in females. These rates are lower in both sexes than those found in Alvila in 2002. In 2012, 80.25% had been smokers (90% of males and 18.18% of the women), although, on diagnosis, 68.75% had quit smoking. A clinical-radiological diagnosis was made in 9 (11.1%), with a histocytological diagnosis in 72 (88.9%). The histological types were: adenocarcinomas in 37.5%; squamous in 33.3%; microcytic in 13.8%; undifferentiated non-small cell in 11.1%; large cell in 2.77%, and carcinoid in 1.38%. The most frequent treatments were chemotherapy (50.6%), symptomatic (23.4%), and surgery (12.3%). CONCLUSIONS: The incidence of lung cancer in Avila has decreased in both sexes in the last 10 years. In 2012, the patients have been older, the majority with adenocarcinoma histology, and receiving chemotherapy.

[Effects of muscle training on breathing pattern in patients with severe chronic obstructive pulmonary disease]. / Efectos del entrenamiento muscular sobre el patrón ventilatorio en pacientes con enfermedad pulmonar obstuctiva crónica grave.

OBJECTIVE: During physical exertion, the ventilatory response of patients with severe chronic obstructive pulmonary disease (COPD) is more rapid and shallow than that of healthy subjects. There is evidence that exercise training can alter breathing pattern in COPD patients. The purpose of the present study was to observe the effects of physical training on patients with severe COPD and to determine whether or not any possible changes were maintained over time. MATERIAL AND METHODS: Patients with severe COPD without bronchial reversibility were enrolled in a randomized controlled trial of a peripheral muscle training program carried out in a hospital setting. All enrolled patients were clinically stable, without exacerbation, and were randomly assigned to a training program of high (group A) or low (group B) intensity. RESULTS: Thirty-five men with severe COPD in stable condition (mean [SD] forced expiratory volume in 1 second at 41%[7%]) were enrolled in the study. The mean age was 64(5) years. Group A underwent training at 70(22) W and group B at 35(10) W, such that the estimated total work was 8050(2882) kJ in group A and 4044(1205) kJ in group B. Breathing pattern changes were detected in exercise tests only for group A patients, but the changes were not maintained 12 months after the end of the program. CONCLUSIONS: Intense training produces changes in the breathing pattern of patients with severe COPD. The changes are not specific to the task performed, not dependent on lactate production, and not maintained over the long term.

[Pneumonia in the elderly. Patients living at closed institutions and risk classes]. / Neumonía en el anciano. Pacientes residentes en instituciones cerradas y clases de riesgo.

UNLABELLED: The residence and underlying diseases could be increase the severity and risk in the pneumonia in the elderly patient. BACKGROUND: To analyse demographics qualities and mortality in elderly inpatients with pneumonia, in relation with kind of residence, and to determine the risk classes distribution. METHOD: Were studied inpatients with 65 years old or more, with pneumonia in a period of 12 months, taking demographics values and underlying diseases, including each patient in a risk class (II to V). RESULTS: One hundred and three patients were studied (78.5 years mean age-SD 7.16), 67 males and 36 females, 80% includes in high risk classes, with 15.5% mortality. 17.5% were home nursing, older (82.7 years mean age-SD 5.72-) (p < 0.002), predominantly females and in high risk classes, and with lower length of hospital stay. CONCLUSIONS: The elderly patients with community-acquired pneumonia was high risk. Home nursing was older, more risk and lower length of hospital stay.

[Lupus vulgaris. Treatment with 3 drugs]. / Lupus vulgar. Tratamiento con tres drogas.

We report two cases of lupus vulgaris one of them on scar of scrofuloderma. We review the treatment of the skin tuberculosis (TBC) and we observed the favorable development to the total regression, using rifampin-isoniazid-pyrizinamide in the first two months and rifampin-isoniazid the four months left to complete six months of global therapy. We discard the monotherapy as treatment for this disease.

[Cardiovascular risk factors in a natural population. Study of Talavera de la Reina. Evaluation of smoking]. / Análisis de factores de riesgo cardiovascular en una población natural. Estudio de Talavera de la Reina. Evaluación del tabaquismo.

The Study of Talavera de la Reina analyzes the presence of several cardiovascular risk factors (CVRF) in this city, by means of a cross-sectional study of the population within 1989 and 1990. In this paper, the results on tobacco consumption, as well as the correlation between tobacco consumption and several anthropometric and biochemical parameters, some of which are independent CVRF theirselves, are presented. Seven hundred and two people were evaluated, 332 men and 370 women, with ages between 20 and 79 years, and were randomized according to the current population census. We have carried out a survey to assess smoking habits; physical examination to measure weight and height, systolic and diastolic arterial pressure, blood analysis including total cholesterol, C-HDL, triglycerides and glucose. C-LDL was obtained using the Friedewald-Fredickson formula. Smoking habits among the younger female population is almost equal to male population. Compared by age groups and similar sex, no significant differences were observed related to anthropometric and biochemical parameters between smokers and non-smokers. The lipidic profile of non-smokers against moderate/heavy smokers (smoking 10 or more gr/day) was compared. The presence of an atherogenic profile in 30 to 39-year-old men and in 40 to 49-year-old women was verified, as well as the lower C-HDL levels among younger smokers of both sexes. This provides tobacco with an added value, as it increases the impact of other CVRF in key ages for the pathogenicity of arteriosclerosis.

Cáncer de pulmón en la provincia de Ávila. Tasas de incidencia, epidemiología del año 2012 y tendencias en los últimos 20 años / Lung cancer in Avila province, Spain. Incidence rates, epidemiolgy of the year 2012 and trends in the last 20 years

Antecedentes y objetivos. Nos proponemos conocer la magnitud del cáncer de pulmón en Ávila: sus tasas de incidencia y aspectos epidemiológicos importantes en el año 2012, comparándolo con los resultados de estudios conocidos realizados con la misma metodología cada 5 años, desde hace ya 2 décadas. Pacientes y métodos. Inclusión prospectiva de todos los pacientes diagnosticados de cáncer de pulmón en la provincia de Ávila a lo largo del año 2012. Resultados. Se diagnosticaron 81 enfermos, 70 hombres y 11 mujeres, con edad media de 72,1 años (extremos: 44-91), superior a la encontrada en estudios anteriores. Dan lugar a unas tasas de incidencia en 2012, brutas y ajustadas a la población mundial estándar, de 80,99 y 31,23 por 100.000, respectivamente, en los hombres, y 12,97 y 5,68 por 100.000 en las mujeres. Estas tasas son menores, en ambos sexos, a las encontradas en Ávila en el año 2002. En 2012 habían sido fumadores el 80,25% (90% de los hombres y 18,18% de las mujeres), aunque al diagnóstico lo habían dejado el 68,75%. Realizamos diagnóstico clínico-radiológico en 9 (11,1%) y cito-histológico en 72 (88,9%). Tipos histológicos: adenocarcinomas 37,5%; escamosos 33,3%; microcíticos 13,8%; indiferenciados no microcíticos 11,1%; células grandes 2,77% y carcinoides 1,38%. Los tratamientos más frecuentes fueron quimioterapia (50,6%), sintomático (23,4%) y cirugía (12,3%). Conclusiones. En los últimos 10 años disminuye la incidencia del cáncer de pulmón en Ávila en ambos sexos. En 2012 los pacientes han sido más ancianos, predominando la histología adenocarcinoma y el tratamiento con quimioterapia (AU)

Background and objectives. To determine the extent of lung cancer in Alvila. Its incidence rates and significant epidemiological aspects of the year 2012 were recorded, and the results of each 5-year period (up to 20 years) were compared with those of known studies conducted using the same methodology. Patients and methods. A prospective study was conducted on all patients diagnosed with lung cancer in the Province of Avila throughout the year 2012. Results. A total of 81 patients were diagnosed, of whom 70 were males and 11 females, with a mean age of 72.1 years (range: 44-91), and was higher than that found in previous studies. This gave gross, and adjusted to the standard world population, incidence rates in 2012 of 80.99 and 31.23 per 100,000, respectively, in males, and 12.97 and 5.68 per 100,000, respectively in females. These rates are lower in both sexes than those found in Alvila in 2002. In 2012, 80.25% had been smokers (90% of males and 18.18% of the women), although, on diagnosis, 68.75% had quit smoking. A clinical-radiological diagnosis was made in 9 (11.1%), with a histocytological diagnosis in 72 (88.9%). The histological types were: adenocarcinomas in 37.5%; squamous in 33.3%; microcytic in 13.8%; undifferentiated non-small cell in 11.1%; large cell in 2.77%, and carcinoid in 1.38%. The most frequent treatments were chemotherapy (50.6%), symptomatic (23.4%), and surgery (12.3%). Conclusions. The incidence of lung cancer in Avila has decreased in both sexes in the last 10 years. In 2012, the patients have been older, the majority with adenocarcinoma histology, and receiving chemotherapy (AU)