Síndrome de sarcoidosis-linfoma / Sarcoidosis-lymphoma syndrome

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Utilidad de la ultrasonografía endobronquial radial en el diagnóstico de lesiones pulmonares periféricas. Estudio controlado con fluoroscopia / Endobronchial Ultrasound for the Diagnosis of Peripheral Pulmonary Lesions. A Controlled Study With Fluoroscopy

Introducción: La broncoscopia guiada por fluoroscopia se utiliza para el diagnóstico de las lesiones pulmonares periféricas (LPP), pero su rendimiento es muy variable en función de los estudios. La ultrasonografía endobronquial (USEB) radial podría incrementar el rendimiento diagnóstico de la broncoscopia para estas lesiones. Objetivos: Comparar el rendimiento diagnóstico de la broncoscopia guiada por fluoroscopia y USEB radial con la broncoscopia guiada por fluoroscopia para el estudio de LPP. Métodos: Se incluyeron de forma prospectiva todos los pacientes que se sometieron a broncoscopia con fluoroscopia para el estudio de LPP desde enero de 2009 a diciembre de 2012. Los 145 pacientes se aleatorizaron en 2 grupos: fluoroscopia y USEB radial (50 pacientes, 71,3 ± 8,2 años) o fluoroscopia únicamente (95 pacientes, 68 ± 10,5 años). El diámetro medio de las lesiones fue de 41,97 ± 19,22 mm. Se tomaron muestras de cepillado bronquial citológico y biopsia transbronquial. Todas las exploraciones se realizaron bajo control fluoroscópico y con sedación intravenosa. Para la USEB se utilizó un procesador ecográfico equipado con una ultra-minisonda ecográfica de 20 MHz que se introducía por una guía. Broncoscopista, citólogo, protocolo de estudio, técnicas y utillaje fueron los mismos durante todo el estudio. Resultados: Ciento veintinueve (89%) pacientes presentaban patología maligna. Se obtuvo el diagnóstico por broncoscopia en 105 (72,4%) enfermos. En el grupo con fluoroscopia y USEB radial se diagnosticaron el 78% de los pacientes y en el grupo con solo fluoroscopia el 69,5% (n.s.). Sin embargo, para lesiones menores de 30 mm la fluoroscopia con USEB radial incrementaba significativamente el rendimiento diagnóstico comparado con la fluoroscopia únicamente (90 vs. 52%; p = 0,05). Conclusiones: La USEB radial asociada a fluoroscopia es una técnica especialmente útil para el diagnóstico de las LPP de un tamaño inferior a 30 mm

Introduction: Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions (PPL), but the diagnostic yield varies widely among studies. Endobronchial ultrasound (EBUS) can increase the diagnostic yield of bronchoscopic diagnosis of PPL. Objective: To compare the diagnostic yield of fluoroscopy-guided bronchoscopy and EBUS with fluoroscopy-guided bronchoscopy in the study of PPL. Methods: All patients who underwent bronchoscopy to study PPL from January 2009 to December 2012 were prospectively included. A total of 145 consecutive patients were randomly distributed in two groups: EBUS and fluoroscopy (50 patients, 71.3 ± 8.2 years) or fluoroscopy alone (95 patients, 68 ± 10.5 years). The mean diameter of the lesions was 41.97 ± 19.22 mm. Cytological brushing and transbronchial biopsies were obtained. All procedures were performed under fluoroscopic guidance with intravenous conscious sedation. EBUS was performed using an endoscopic ultrasound system equipped with a 20-MHz radial miniprobe introduced via a guide-sheath. Bronchoscopist, cytologist, study protocol, techniques and tools were the same throughout the whole study. Results: In all, 129 (89%) patients had malignant disease. A diagnosis with bronchoscopy was established in 105 (72.4%) patients. EBUS plus fluoroscopy obtained a diagnostic yield in 78% of patients and fluoroscopy alone in 69.5% (non-significant). In contrast, for lesions smaller than 30 mm, EBUS plus fluoroscopy guidance provided significantly greater diagnostic performance than fluoroscopy alone (90% vs 52%; P = 0.05). Conclusions: Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnosis of LPPs, especially those smaller than 30 mm in diameter

Endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions. A controlled study with fluoroscopy.

INTRODUCTION: Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions (PPL), but the diagnostic yield varies widely among studies. Endobronchial ultrasound (EBUS) can increase the diagnostic yield of bronchoscopic diagnosis of PPL. OBJECTIVE: To compare the diagnostic yield of fluoroscopy-guided bronchoscopy and EBUS with fluoroscopy-guided bronchoscopy in the study of PPL. METHODS: All patients who underwent bronchoscopy to study PPL from January 2009 to December 2012 were prospectively included. 145 consecutive patients were randomly distributed in two groups: EBUS and fluoroscopy (50 patients, 71.3 ± 8.2 years) or fluoroscopy alone (95 patients, 68 ± 10.5 years). The mean diameter of the lesions was 41.97 ± 19.22 mm. Cytological brushing and transbronchial biopsies were obtained. All procedures were performed under fluoroscopic guidance with intravenous conscious sedation. EBUS was performed using an endoscopic ultrasound system equipped with a 20-MHz radial miniprobe introduced via a guide-sheath. Bronchoscopist, cytologist, study protocol, techniques and tools were the same throughout the whole study. RESULTS: 129 (89%) patients had malignant disease. A diagnosis with bronchoscopy was established in 105 (72.4%) patients. EBUS plus fluoroscopy obtained a diagnostic yield in 78% of patients and fluoroscopy alone in 69.5% (non-significant). In contrast, for lesions smaller than 30 mm, EBUS plus fluoroscopy guidance provided significantly greater diagnostic performance than fluoroscopy alone (90 vs. 52%; P=.05). CONCLUSIONS: Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnostic of LPPs, especially those smaller than 30 mm in diameter.

Olive oil consumption, BMI, and risk of obesity in Spanish adults.

BACKGROUND: Olive oil is an energy-dense food frequently consumed in south European countries with increasingly high obesity prevalence. Evidence of the impact of olive oil consumption on BMI and the risk of obesity is limited. We analyzed this association taking into consideration the problem of energy underreporting. METHODS: Cross-sectional data on 6,352 Spanish adults were analyzed. Dietary intake was assessed using a validated food frequency questionnaire. Height and weight were measured. RESULTS: Higher olive oil consumption was not associated with energy compensation in the overall diet. Olive oil consumption was positively associated (p < 0.004) with BMI in non-energy-adjusted multivariate linear regression models. Statistical significance of this association disappeared after controlling for energy intake in plausible energy intake reporters. The obesity risk increased for olive oil consumption of more than 2 tablespoons/day in both plausible energy intake reporters (odds ratio 1.30 (95% CI 1.01-1.70)) and energy intake underreporters (odds ratio 3.06 (95% CI 2.15-4.35)). This association was not significant after additional adjustment for energy intake (odds ratio 1.19 (95% CI 0.91-1.56)) in plausible energy intake reporters. CONCLUSION: Olive oil intake did not affect BMI and the risk of obesity after adjustment for total energy intake in plausible energy intake reporters. The lack of energy intake compensation for olive oil consumption might explain the positive associations in models not adjusted for energy.