Excessive dynamic airway collapse in a small cohort of chronic obstructive pulmonary disease patients.

INTRODUCTION: The prevalence of EDAC (Excessive Dynamic Airway Collapse) has not been studied specifically in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: The aim of this study was to investigate the prevalence of EDAC in COPD and to determine whether there are clinical factors or functional variables that could influence the degree of expiratory collapse of central airways. METHODS: Prospective observational study of a group of patients with COPD. The degree of tracheobronchial collapse was evaluated by low-dose dynamic airway computed tomography (CT). We recorded clinical and pulmonary function tests data, quality of life and BODE index. RESULTS: This study included 53 patients with COPD, 46 (87%) males, mean age 65 (SD, 9) years. CONCLUSIONS: The prevalence of EDAC observed in a sample of patients with different levels of COPD severity is low. The degree of dynamic central airway collapse was not related to the patient's epidemiological or clinical features, and did not affect lung function, symptoms, capacity for effort, or quality of life.

[Descriptive study of a pneumonia episode due to Legionella]. / Estudio descriptivo de un brote de neumonía por Legionella.

BACKGROUND: Legionella is a gram negative aerobic bacillus. A total of 42 species with 64 serogroups have been described, Legionella pneumophila serogroup 1 being the one that causes the disease most frequently. OBJECTIVE: Describe an outbreak of legionellosis with some characteristics different from those communicated previously. MATERIAL AND METHODS: Descriptive study of the epidemiological and clinical characteristics of the patients affected by an outbreak of pneumonia due to Legionella pneumophila serogroup 1, that occurred in Vigo in September and October, 2000, seen in the Hospital Xeral-Cies. RESULTS: A total of 33 patients, with a mean age of 61 years, were diagnosed. Fifty-nine percent had underlying diseases. The most frequent symptoms were fever, cough, dyspnea, diarrhea and awareness level alterations. Elevation of creatinphosphokinase in 79% and hyponatremia in 12%. The X-ray pattern observed most frequently was unilateral alveolar with predominant involvement of inferior lobes. A total of 77% received treatment with beta lactamics and macrolides, 13% beta lactamics and quinolones and 7% quinolones. Clinical and gasometric improvement were observed at a mean of 5 and 7 days, respectively. X-ray abnormalities improved in 62% in the first week. Eighteen percent had multiorgan failure and four patients died. In the analysis of the variables considered to have poor prognosis, only multiorgan failure demonstrated a significant association with mortality. DISCUSSION: The characteristics of the patients affected by an episode of legionellosis in our health care area were similar to those described in other outbreaks, except for the rapid resolution of the pulmonary infiltrates and low presence of hyponatremia. Multiorgan failure was the only factor associated with poor prognosis.

Estudio descriptivo de un brote de neumonía por Legionella / Descriptive study of a pneumonia episode due to Legionella

Introducción. La Legionella es un bacilo aerobio gramnegativo. Se han descrito 42 especies con 64 serogrupos, siendo Legionella pneumophila serogrupo 1 la que causa enfermedad con mayor frecuencia. Objetivo. Describir un brote de legionelosis con algunas peculiaridades distintas a las comunicadas con anterioridad. Material y método. Estudio descriptivo de las características epidemiológicas y clínicas de los pacientes afectados por un brote de neumonía por Legionella pneumophila serogrupo 1 ocurrido en Vigo durante septiembre y octubre del año 2000 atendidos en el Hospital Xeral-Cíes. Resultados. Se diagnosticaron 33 pacientes, con una edad media de 61 años. El 59% tenía enfermedades subyacentes. Los síntomas más frecuentes fueron fiebre, tos, disnea, diarrea y alteraciones del nivel de conciencia. Se detectó elevación de la creatinfosfoquinasa en el 79% e hiponatremia en el 12%. El patrón radiológico observado con mayor frecuencia fue alveolar unilateral con afectación predominante de lóbulos inferiores. El 77% recibió tratamiento con betalactámicos y macrólidos, el 13% betalactámicos y quinolonas y el 7% quinolonas. Se observó mejoría clínica y gasométrica a los 5 y 7 días de media, respectivamente. En el 62% las alteraciones radiológicas mejoraron en la primera semana. El 18% presentaron fallo multiorgánico y cuatro pacientes fallecieron. En el análisis de las variables consideradas de mal pronóstico, sólo el fracaso multiorgánico demostró una asociación significativa con la mortalidad. Discusión. Las características de los pacientes afectados por un brote de legionelosis en nuestra área sanitaria fueron similares a las descritas en otros brotes, a excepción de la rápida resolución de los infiltrados pulmonares y la baja presencia de hiponatremia. El fracaso multiorgánico fue el único factor que se asoció con mal pronóstico

Background. Legionella is a gram negative aerobic bacillus. A total of 42 species with 64 serogroups have been described, Legionella pneumophila serogroup 1 being the one that causes the disease most frequently. Objective. Describe an outbreak of legionellosis with some characteristics different from those communicated previously. Material and methods. Descriptive study of the epidemiological and clinical characteristics of the patients affected by an outbreak of pneumonia due to Legionella pneumophila serogroup 1, that ocurred in Vigo in September and October, 2000, seen in the Hospital Xeral-Cies. Results. A total of 33 patients, with a mean age of 61 years, were diagnosed. Fifty-nine percent had underlying diseases. The most frequent symptoms were fever, cough, dyspnea, diarrhea and awareness level alterations. Elevation of creatinphosphokuinase in 79% and hyponatremia in 12%. The X-ray pattern observed most frequently was unilateral alveolar with predominant involvement of inferior lobes. A total of 77% received treatment with beta lactamics and macrolides, 13% beta lactamics and quinolones and 7% quinolones. Clinical and gasometric improvement were observed at a mean of 5 and 7 days, respectively. X-ray abnormalities improved in 62% in the first week. Eighteen percent had multiorgan failure and four patients died. In the analysis of the variables considered to have poor prognosis, only multiorgan failure demonstrated a significant association with mortality. Discussion. The characteristics of the patients affected by an episode of legionellosis in our health care area were similar to those described in other outbreaks, except for the rapid resolution of the pulmonary infiltrates and low presence of hyponatremia. Multiorgan failure was the only factor associated with poor prognosis