Clasificación de la gravedad de la enfermedad pulmonar obstructiva crónica según la nueva guía Iniciativa Global para la Enfermedad Obstructiva Crónica 2011: COPD Assessment Test versus modified Medical Research Council / Classification of Chronic Obstructive Pulmonary Disease Severity According to the New Global Initiative for Chronic Obstructive Lung Disease 2011 Guidelines: COPD Assessment Test Versus Modified Medical Research Council Scale

Introducción: La revisión GOLD 2011 propone estratificar a los pacientes con EPOC midiendo la repercusión de la enfermedad mediante la escala mMRC o mediante el cuestionario CAT. Nuestro objetivo es conocer si la elección de un método u otro resulta equivalente. Pacientes y métodos: Estudio observacional sobre una cohorte de 283 pacientes diagnosticados de EPOC. Se analizaron resultados demográficos, funcionales respiratorios y de evaluación mediante CAT y mMRC, aplicados el mismo día y por el mismo entrevistador a cada paciente. Se distribuyeron en categorías GOLD 2011 según el resultado de la evaluación y se determinó el grado de concordancia y la correlación de Spearman. Se utilizó el test de ANOVA sobre las variables clínicas y funcionales de las 4 categorías GOLD 2011. Resultados: Al evaluar la clasificación de pacientes según el método empleado, se obtuvo una correlación global ρ = 0,613 y un grado de concordancia κ = 0,63 (moderado). Se obtuvo κ = 0,44 para los 152 pacientes de las categorías A y B (moderado-débil), y de 0,38 para los 131 pacientes de las categorías C y D (débil). Se apreciaron diferencias entre categorías en cuanto a parámetros funcionales. Conclusiones: La clasificación de los pacientes con EPOC según la evaluación propuesta por GOLD 2011 varía según se emplee CAT o mMRC; se reclasifica a más del 25% de pacientes en diferentes categorías, implicando diferencias en la estrategia terapéutica recomendada. Son necesarios estudios longitudinales que permitan valorar qué método clasifica mejor a los pacientes, atendiendo a su capacidad pronóstica

Introduction: The GOLD 2011 revision proposes to stratify patients with chronic obstructive pulmonary disease (COPD) by measuring the impact of the disease using the modified Medical Research Council (mMRC) scale or COPD assessment test (CAT). Our aim was to determine whether both methods are equivalent. Patients and methods: Observational study on a cohort of 283 patients diagnosed with COPD. We analyzed the demographic and lung function results. Patients were assessed by CAT and mMRC on the same day by the same interviewer, and divided into GOLD 2011 categories according to the result of the evaluation. The degree of concordance and Spearman correlation were determined. We used ANOVA on the clinical and functional variables of the four GOLD 2011 categories. Results: On assessing the classification of patients according to the method used, an overall correlation of ρ = 0.613 and a degree of concordance of κ = 0.63 (moderate) were obtained. κ = 0.44 was obtained for the 152 patients in categories A and B (moderate-low), and at 0.38 for the 131 patients in categories C and D (low). Differences were observed between the categories in terms of functional parameters. Conclusions: The classification of patients with COPD using the assessment proposed by GOLD 2011 varies according to the method used (CAT or mMRC); more than 25% of patients were reclassified into different categories, implying differences in the recommended therapeutic strategy. Longitudinal studies are needed to appraise which method does better classification of the patients, according to its prognostic ability

Classification of chronic obstructive pulmonary disease severity according to the new Global Initiative for Chronic Obstructive Lung Disease 2011 guidelines: COPD assessment test versus modified Medical Research Council scale.

INTRODUCTION: The GOLD2011 revision proposes to stratify patients with chronic obstructive pulmonary disease (COPD) by measuring the impact of the disease using the modified Medical Research Council (mMRC) scale or COPD assessment test (CAT). Our aim was to determine whether both methods are equivalent. PATIENTS AND METHODS: Observational study on a cohort of 283 patients diagnosed with COPD. We analyzed the demographic and lung function results. Patients were assessed by CAT and mMRC on the same day by the same interviewer, and divided into GOLD2011 categories according to the result of the evaluation. The degree of concordance and Spearman correlation were determined. We used ANOVA on the clinical and functional variables of the four GOLD2011 categories. RESULTS: Assessing the classification of patients according to the method used, an overall correlation ρ=0.613 and a degree of concordance κ=0.63 (moderate) were obtained. κ=0.44 was obtained for the 152 patients in categoriesA and B (moderate-low), and 0.38 for the 131 patients in categoriesC and D (low). Differences were observed between categories in terms of functional parameters. CONCLUSIONS: The classification of patients with COPD using the assessment proposed by GOLD2011 varies according to the method used (CAT or mMRC); more than 25% of patients were reclassified into different categories, implying differences in the recommended therapeutic strategy. Longitudinal studies are needed to appraise which method better classifies patients, according to its prognostic ability.

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Is a benign meningioma always an indolent tumor?

Meningiomas are considered to be slow-growing tumors that compress the brain without invading it. The development of metastases is uncommon, with a predilection for the lungs, liver, lymph nodes, and bone. We report the case of a 58-year-old man, diagnosed with a solitary pulmonary nodule in the left lower lobe that was resected through a thoracotomy. The pathology revealed lung metastases of an undiagnosed meningothelial meningioma. The evolution of the patient's case, the second case in the literature of this kind of benign tumor that has developed pleural metastases, was unsatisfactory.