Endobronchial treatment of benign endobronchial neoplasms: Our 10 years of experience.

BACKGROUND: The aim of the study was to assess the safety, efficacy, complications, and long-term outcomes of endobronchial treatment for benign endobronchial tumors. METHODS: A total of 53 patients (39 males, 14 females; mean age: 53.7 years; range, 12 to 83 years) with the diagnosis of benign endobronchial neoplasms in our center between November 2010 and September 2019 were retrospectively analyzed. Data including demographic and clinical characteristics of the patients and treatment outcomes were examined. RESULTS: Tumors regressed in all patients with argon plasma coagulation, diode laser and electrocautery, which was combined with cryotherapy in some cases. Complications were observed in five (9%) patients. Major complications were atrial fibrillation in two patients and respiratory failure requiring mechanical ventilation in one patient. Minor complications were minimal bleeding in two patients. The response was very good in 39 (74%) patients and good in 12 (23%) patients. There was no significant difference in the residual tissue formation requiring cryotherapy among the endobronchial treatment modalities (p>0.05). The five-year survival rate was 94%. No endobronchial treatment-related mortality was observed in any of the patients. CONCLUSION: Endobronchial treatment modalities including diode laser, electrocautery, and argon plasma coagulation combined with or without cryotherapy are effective and safe in the treatment of benign endobronchial tumors.

Amplitud de distribución eritrocitaria en pacientes con enfermedad pulmonar obstructiva crónica y en sujetos sanos / Red blood cell distribution width in patients with chronic obstructive pulmonary disease and healthy subjects

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) incrementa el riesgo de enfermedad cardiovascular (ECV). La amplitud de distribución eritrocitaria (ADE) se considera un potente factor de predicción de la evolución de los pacientes con ECV. Objetivos. Analizar los valores de ADE de pacientes con EPOC y compararlos en relación al estado clínico, ecocardiográfico, nutricional y analítico de los pacientes. Por otra parte, nos propusimos analizar el efecto del consumo de tabaco sobre los valores de ADE de sujetos sanos. Métodos. En el estudio se incluyeron 175 pacientes con EPOC estabilizados y 210 sujetos sanos. Se registraron y se compararon las características demográficas, clínicas, nutricionales, ecocardiográficas y analíticas, y los valores de ADE. Resultados. Los valores de ADE fueron más altos en el grupo de pacientes con EPOC que en el grupo control (15 ± 2,3% vs. 13,8 ± 2,5%, p < 0,001). Los valores de ADE de los pacientes con EPOC mostraron una correlación positiva con las concentraciones de PCR (r = 0,27, p < 0,001), las concentraciones de albúmina (r = 0,23, p = 0,04) y la presencia de disfunción ventricular derecha (DVD) (r = 0,24, p = 0,001), hipertensión pulmonar (HAP) (r = 0,1, p = 0,02) y ECV (r = 0,24, p = 0,02). El análisis de regresión logística para variables múltiples sugirió una relación independiente de la presencia de ECV (4,3; IC 95%: 1,3-11; p = 0,01) y de DVD (3,1; IC 95%: 1,7-8,3; p = 0,02) con valores elevados de ADE en los pacientes con EPOC. En la población sana, el análisis solo mostró una correlación significativa entre la ADE y la duración del consumo de tabaco (r = 0,57, p < 0,001). Conclusión. En pacientes con EPOC, la ADE se asocia de manera independiente con la ECV y la DVD. En la población sana, la ADE también se asocia con el consumo de tabaco

Background. Chronic obstructive pulmonary disease (COPD) increases the risk of cardiovascular disease (CVD). Red blood cell distribution width (RDW) is accepted as a powerful predictor of outcomes in patients with CVD. Aims. To study RDW in patients with COPD, and to compare the value of this measurement with clinical, echocardiographic, nutritional and laboratory status. Secondly, we aimed to determine the effect of smoking on RDW values in healthy subjects. Methods. One hundred and seventy-five patients with stable COPD and 210 healthy controls were enrolled in the study. Demographic, clinical, nutritional status, echocardiographic, and laboratory characteristics, RDW values were recorded and compared. Results. RDW values were higher in the COPD group than in controls (15 ± 2.3% vs. 13.8 ± 2.5%, p < 0.001). In COPD patients, RDW levels positively correlated with CRP levels (r = 0.27, P < .001), albumin levels (r = 0.23, P = .04), right ventricular dysfunction (RVD) (r = 0.24, P = .001), pulmonary hypertension (PAH) (r = 0.1, P = .02), and presence of CVD (r = 0.24, P = .02). In multivariable logistic regression suggested that presence of CVD (4.3; 95% CI: 1.3 to 11; P = .01), and presence of RVD (3.1; 95% CI: 1.7 to 8.3; P = .02) were independently related to elevated RDW levels in COPD patients. In the healthy population, correlations analysis showed only a significant correlation between RDW and cigarette smoking years (r = 0.57, P < .001). Conclusion. RDW is independently associated with CVD and RVD in patients with COPD. In the healthy population, RDW is also associated with smoking status

Efecto de la hipoxia sobre el metabolismo de la glucosa en pacientes no diabéticos con síndrome de apnea obstructiva del sueño / Effect of Hypoxia on Glucose Methabolism in Nondiabetic Patients With Obstructive Sleep Apnea Syndrome

Objetivo: El síndrome de apnea obstructiva del sueño (SAOS) puede fomentar la hiperglucemia y la resistencia a la insulina. Nuestro objetivo es investigar el efecto del SAOS sobre la glucosa plasmática en ayunas, la hemoglobina glucosilada (HbA1c) y la proteína C reactiva (PCR) en pacientes no diabéticos. Material y métodos: Se determinaron los parámetros de analítica hemática de 90 pacientes no diabéticos consecutivos en los que se realizaron evaluaciones polisomnográficas en nuestro laboratorio del sueño. Un total de 61 de estos pacientes con una glucemia en ayunas normal fueron clasificados según el índice de apnea-hipopnea (IAH) como casos leves (n = 16, 26,2%), moderados (n = 18, 29,5%) o graves (n = 27, 44,2%) de SAOS. Se efectuaron determinaciones de la glucosa plasmática en ayunas, la HbA1c y la PCR. Resultados: La media de edad de los pacientes fue de 47,7 ± 11,2 años, y el 72% eran varones. Los niveles de HbA1c y de glucosa en ayunas presentan una correlación positiva con el IMC (r = 0,503, p = 0,00; r = 0,258, p = 0,045). No se detectó relación alguna de la HbA1c con el índice de apnea ni con el IAH, mientras que sí se observó una correlación positiva de la glucosa en ayunas con la PCR (r = 0,262, p = 0,042; r = 0,258, p = 0,045). Los niveles de HbA1c, glucosa en ayunas y PCR muestran una correlación negativa con los valores de SpO2 mínima (con valores de r = –0,302, p = 0,018; r = –0,368, p = 0,004; r = –0,365, p = 0,004, respectivamente). Los niveles de HbA1c, glucosa en ayunas y PCR muestran una correlación positiva con el índice de desaturación medio (tiempo durante el que la SpO2 es < 90% según la pulsioximetría) (r = 0,263, p = 0,041; r = 0,311, p = 0,015; r = 0,283, p = 0,027) (AU)

Conclusiones: Aunque no se detectó relación alguna entre el aumento de los niveles de HbA1c o de glucosa y la gravedad del SAOS en los pacientes con SAOS no diabéticos, sí se detectó una correlación con la hipoxia nocturna. Esto podría poner de manifiesto el efecto de la hipoxia nocturna sobre el metabolismo de la glucosa en los pacientes con SAOS (AU)

Aim: Obstructive sleep apnea syndrome (OSAS) may promote hyperglycemia and insulin resistance. Our aim is to investigate the effect of OSAS on the fasting plasma glucose, glycosylated hemoglobin (HbA1c), and C reactive protein (CRP) in nondiabetic patients. Materials and methods: Blood parameters of consecutive 90 non diabetic patients whom polysomnografic evaluations were done in our sleep laboratory was evaluated. Among these 61 patients with normal fasting blood glucose were classified due to their apne-hipopnea index (AHI) as mild (n=16, 26.2%), moderate (n=18, 29.5%) and severe (n=27, 44.2%) OSAS. The fasting plasma glucose, HbA1c and CRP were measured. Results: Mean age of the patients was 47.7±11.2 years, 72% male. HbA1c, fasting glucose levels show positive correlation with BMI (r=0.503, P=0.00; r=0.258, P=0.045). No relation of HbA1c to apnea index nor AHI was detected while positive correlation of fasting glucose and CRP was detected (r=0.262, P=0.042; r=0.258, P=0.045). HbA1c, fasting glucose and CRP levels show negative correlation with minimum SpO2 levels (by order of r=–0.302, P=0.018; r=–0.368, P=0.004; r=–0.365, P=0.004). HbA1c, fasting glucose levels and CRP levels show positive correlation with mean desaturation index (time duration in which SpO2<90% by pulse oxymeter) (r=0.263, P=0.041; r=0.311, P=0.015; r=0.283, P=0.027). Conclusions: Although no relation in between increased HbA1c or glucose levels and severity of OSAS was detected in nondiabetic OSAS patients, the correlation with the night hypoxia was detected. This could also show the effect of night time hypoxia on glucose metabolism in OSAS patients (AU)

Nutritional and prognostic significance of sick euthyroid syndrome in non-small cell lung cancer patients.

OBJECTIVES: Our study aimed to determine the frequency of sick euthyroid syndrome (SES) among patients diagnosed as non-small cell lung cancer (NSCLC) and its association with the stage of the disease, Karnofsky index (KI), and nutritional parameters. METHODS: We enrolled 80 consecutive patients with newly diagnosed NSCLC. Cases with NSCLC were staged by using the TNM system. The cases were examined for thyroid function tests, KI and nutritional evaluation before treatment. Moreover, cases were investigated for their overall survival ratio. RESULTS: Out of 80 patients, SES was identified in 28 (35%). SES was more frequent among stage III (26%) and stage IV (62%) cases. The body mass index (BMI), KI and serum albumin level were found to be significantly low in cases with SES when compared to cases without SES. SES was found to be negatively correlated with BMI, KI and serum albumin level, and it was positively correlated with disease stage and weight loss. Additionally, the presence of SES was found as a prognostic factor at survival analysis (p=0.0002). CONCLUSION: SES was frequently seen in cases with NSCLC. SES can be used as a predictor of poor prognosis in NSCLC patients.