Algoritmo de retirada de corticoides inhalados en la EPOC / No disponible

No disponible

[Exogenous lipoid pneumonia. Presentation of a new case]. / Neumonía lipoidea exógena. Presentación de un nuevo caso.

Exogenous lipoid pneumonia is a rare disease, secondary to continued aspiration of exogenous lipoid. Usually is a chronic disease, but also an acute form can be produced by massive accidental aspirations of lipidic material. We present a case of chronic lipoid pneumonia secondary to the continued aspiration of "nasal drops ".

Neumonía lipoidea exógena. Presentación de un nuevo caso / Exogenous lipoid pneumonia. Presentation of a new case

La neumonía lipoidea exógena es una entidad poco frecuente, secundariaa la aspiración continuada de lípidos exógenos. Su forma de presentación crónica es la más habitual, pero también se puede observar de forma aguda en casos de aspiraciones masivas accidentales de material lipídico. Presentamos un caso clínico de neumonía lipoidea crónica secundaria a la aspiración continuada de “gotas nasales”

Exogenous lipoid pneumonia is a rare disease, secondary to continued aspiration of exogenous lipoid. Usually is a chronic disease, but also an acute form can be produced by massive accidental aspirations of lipidic material. We present a case of chronic lipoid pneumonia secondary to the continued aspiration of “nasal drops”

Valor clínico de la excreción urinaria de N-acetil-betaglucosaminidasa en la retinopatía diabética / Clinical trascendence of urinary excretion of N-acetyl-beta-glucosaminidase in diabetic retinopathy

Objetivo: Estudiar la excreción urinaria del enzima N-acetil-beta-glucosaminidasa (NAG), marcador bioquímico de daño renal precoz, en diabéticos tipo 2 con diferentes grados de retinopatía, estableciendo su relación con el grado de afección retiniana. Método: Realizamos un estudio prospectivo de 144 pacientes diabéticos tipo 2 y 94 controles sanos. Se les realizó una exploración oftalmológica (incluida angiografía fluoresceínica) y un estudio bioquímico que incluía la determinación de NAG en orina. Los pacientes fueron clasificados en varios grupos, dependiendo de su afección retiniana: 76 no presentaban retinopatía diabética (40 hombres y 36 mujeres), 30 tenían retinopatía no proliferativa precoz (13 hombres y 17 mujeres), 22 retinopatía no proliferativa avanzada (5 hombres y 17 mujeres) y 21 pacientes presentaban retinopatía diabética proliferativa (10 hombres y 11 mujeres). Los resultados se sometieron a un análisis estadístico mediante comparación de medias con el test de la t de Student. Resultados: Nuestros resultados mostraron que existe un aumento en la excreción urinaria de NAG conforme avanza el grado de retinopatía diabética. Asimismo, también destacamos la mayor excreción urinaria de NAG en los pacientes diabéticos que no presentaban retinopatía respecto a los controles sanos. Conclusión: Existe un paralelismo entre las lesiones renales y retinianas en la diabetes tipo 2, tal y como otros autores habían demostrado previamente para la diabetes tipo 1 (AU)

[Clinical value of urinary excretion of N-acetyl-beta-glucosaminidase in diabetic retinopathy]. / Valor clínico de la excreción urinaria de N-acetil-betaglucosaminidasa en la retinopatía diabética.

PURPOSE: To test N-acetyl-beta-glucosaminidase (NAG) urinary excretion, early renal damage biochemical marker, in patients with non-insulin-dependent diabetes mellitus grouped according to the degree of retinopathy, establishing its relationships to retinal involvement. METHODS: We make a prospective study of 144 type 2 diabetic patients and 94 healthy subjects. We realized an ocular exploration that included fluorescein angiography and a biochemical study that included the determination of NAG urinary excretion in all of them. The patients were grouped depending on their retinal disease. 76 subjects without retinal abnormalities (40 men and 36 women), 30 with early nonproliferative diabetic retinopathy (13 men and 17 women) and 21 subjects with proliferative diabetic retinopathy (10 men and 11 women). Results were analyzed by using statistical analyses. RESULTS: Our results showed that there exist an increase in the urinary excretion of NAG according to the degree of diabetic retinopathy advance. We also highlight the biggest urinary excretion of NAG in the diabetic patients without retinal involvement regarding healthy subjects. CONCLUSION: There is a parallelism between renal and retinal complications in type 2 diabetes mellitus as other authors had demonstrated previously for the type 1 diabetes mellitus.

[Bronchiolitis obliterans with organized pneumonia associated with measles virus]. / Bronquiolitis obliterante con neumonía organizada relacionada con virus del sarampión.

Bronchiolitis obliterans with organizing pneumonia (BOOP) is a nonspecific form of pulmonary injury related to different etiologic agents. The disorder is not only limited to the alveoli but also affects to the alveolar ducts and distal bronchioles. This fact may differentiate this disorder of others with chronic inflammatory diffuse alveolar lesion as chronic eosinophilic pneumonia (CEP), extrinsic allergic alveolitis (EAA) or diffuse alveolar damage (DAD). It has been described an idiopathic form and other associated with connective tissue diseases, infections, organ's transplantation, drug or chemical induced reactions, irradiation pneumonitis and aspiration pneumonitis, among others. Their extremely variable clinical presentation and course, etiology, and histologic appearance and, in some way, the considerable confusion as a result to the different terminologies applied, has made difficult a clear understanding of this disease. We present two cases of BOOP related to infection by measles virus, whose diagnostic was obtained through pulmonary thoracoscopic biopsy and serological study respectively. Patients were treated with steroids (6 months) with a favorable outcome in terms of clinical symptoms, radiological findings, and a normalization of the pulmonary function tests. We suggest that in each patient with clinic and radiological study suspicious of BOOP, it seem to be useful to include measles virus in serologic study. This investigation may contribute to reduce the number of cases classified as idiopathic BOOP.