Buscando aliados en la Odontología / Seeking allies in odontology

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Diagnóstico precoz del cáncer de pulmón en la consulta de tabaquismo / Early diagnosis of lung cancer in the smoking habit consultation

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¿Por qué no se trata el tabaquismo del paciente hospitalizado? / No disponible

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Tabaquismo durante el embarazo: una realidad poco controlada / No disponible

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Atención al tabaquismo en las oficinas de farmacia / No disponible

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[Spontaneous pneumothorax and atmospheric pressure]. / Neumotórax espontáneo y presión atmosférica.

In order to assess factors associated with spontaneous pneumothorax (SP), mainly climatic changes, a prospective study was undertaken of 62 SP episodes among patients admitted to our hospital during a two-year period, from January 1994 to January 1996. Atmospheric pressure (AP) changes were analyzed, with daily recording of the number of unusual changes in AP (increases above 95th percentile and decreases below 5th percentile) and how many of these changes were followed by some episode of spontaneous pneumothorax during the following five days. To measure the degree of this association between the emergence of pneumothorax and exposure to unusual changes I AP, the relative risk (RR) was calculated. A total of 77 unusual AP changes were observed, 17 of which concurred with the emergence of 8 episodes of SP during the following five days, with a RR of 2.7 (1.6-4.4). Although the etiology of SP is unknown and probably of multifactorial origin, these data suggest that unusual changes in AP may play a relevant role in triggering this condition.

Neumotórax espontáneo y presión atmosférica / Spontaneous pneumothorax and atmospheric pressure

Con el fin de valorar los factores asociados al neumotórax espontáneo (NE), fundamentalmente climáticos, se realizó un estudio prospectivo de 62 episodios de NE ingresados en nuestro hospital durante un período de 2 años, desde enero de 1994 a enero de 1996. Para ello se analizaron las variaciones de la presión atmosférica (PA), determinándose diariamente el número de cambios no usuales de la PA (aumentos por encima del percentil 95 y caídas por debajo del percentil 5) y cuántos de estos cambios fueron seguidos de algún episodio de neumotórax en los 5 días siguientes. Para medir la fuerza de asociación entre la aparición del neumotórax y la exposición a cambios no usuales de la PA se calculó el riesgo relativo (RR). Se observaron 77 cambios no usuales de PA y 17 de ellos coincidieron con la aparición de 8 episodios de NE en los 5 días siguientes, obteniéndose un RR de 2,7 (1,6-4,4). Estos datos sugieren que aunque la etiología del NE es desconocida y, probablemente multifactorial, los cambios no usuales de la PA pueden desempeñar un papel importante en el desencadenamiento del mismo (AU)

[Miliary, ganglionar, pancreatic and costal tuberculosis. Clinical presentation and literature review]. / Tuberculosis miliar, ganglionar, pancreática y costal. Presentación clínica y revisión bibliográfica.

A 42-year-old man was admitted to the hospital with fever, abdominal pain and miliary radiological pattern. The amylase and lipase in serum, and the amylase in urine were increased. The tuberculin skin test was negative. The thoracic and abdominal CT scan showed costal affectation, multiple focal hepatic lesions and large necrosing peripancreatic lymphadenopathies. The transbronchial biopsy and the pancreatic punction demonstrated granulomatous necrotic lesions, and M. tuberculosis grew in the bronchial washing culture. The specific treatment normalized the pulmonary, costal and pancreatic lesions.

Tuberculosis miliar, ganglionar, pancreática y costal. Presentación clínica y revisión bibliográfica / Miliary, ganglionar, pancreatic and costal tuberculosis. clinical presentation and bibliographic review

Se presenta un paciente de 42 años que ingresa en nuestro hospital con fiebre, dolor abdominal y patrón radiológico miliar. Tenía un aumento de amilasemia y amilasuria y de la lipasa sérica. El mantoux era negativo. En el estudio de TAC había engrosamiento costal, lesiones hepáticas focales múltiples y adenopatías necrosadas en zona peripancreática.Las biopsias transbronquiales y la punción pancreática mostraron lesiones granulomatosas necrotizantes, cultivándose M. tuberculosis complex en el broncoaspirado. El tratamiento específico normalizó todas las alteraciones pulmonares, costales y pancreáticas (AU)

Spontaneous pneumothorax related with climatic characteristics in the Valencia area (Spain).

Spontaneous pneumothorax (SP) is a common respiratory condition that is easily recognized and treated, though the etiology remains largely unknown. Apart from individual factors, it has been suggested that changes in atmospheric pressure may trigger the onset of SP. Our aim was to examine the association between the onset of episodes of SP with atmospheric pressure changes in the general population of an area with a Mediterranean climate. A prospective survey was conducted to detect all episodes of SP in a region of Valencia (Spain) from January 1994 to January 1996. A total of 69 cases were identified; of these, 62 episodes of SP met the inclusion criteria for this survey. Climatic measurements during the two years studied were obtained from the Spanish National Meteorological Institute, including 6-hour readings of temperature, relative humidity, clear sunlight, atmospheric pressure, visibility, wind speed and rainfall. Associations were evaluated between the daily number of hospital admissions for SP and diurnal changes in atmospheric pressure involving rises and falls of as much as 7 and 10 mbar. In addition, the association of atmospheric pressure changes to time periods of 1 a.m., 7 a.m., 1 p.m. and 7 p.m. was assessed. Drops in atmospheric pressure below the fifth percentile and elevations above the ninety-fifth percentile were regarded as 'unusual'. There was no association between the development of SP and changes in atmospheric pressure, and no correlation was found with repeated exposure to unusual changes of atmospheric pressure. Further research is needed using similar methods to establish comparisons between countries with different climates.

[Smoking in health care workers. Identification of related factors]. / Tabaquismo en sanitarios. Identificación de factores asociados.

The objective of this study was to determine the epidemiology of smoking among health care givers in our setting and to describe their characteristics. We gave an anonymous questionnaire to 566 health care workers in the Valencian Community (248 physicians, 212 nurses and 106 aides). The results were as follows. Physicians: 46.4% were smokers, 25.4% were non smokers and 28.2% were ex-smokers. Most (69.3%) smoked 11 to 20 cigarettes/day. Low scores on Fagerström's test were recorded for 93%, and 57.3% have tried to quit smoking more than 5 times. The likelihood of being and ex-smoker increased with age (r = 0.158; p = 0.012) and with the number of attempts to quit (r = 0.170; p = 0.021). Nurses: 34.4% were smokers, 36.3% were non smokers and 29.2% were ex-smokers. The degree of nicotine addiction was low for 91.8% and 83% of the smokers and ex-smokers had tried at least once to quit smoking. Aides: 32% were smokers, 42.5% were non smokers and 25.5% were ex-smokers. The degree of addiction was low for 79.4% and 78.7% had tried to quit smoking at least once. The likelihood of being an ex-smoker increased with the number of attempts at quitting (r = 0.448; p = 0.000). In conclusion, we found that rate of smoking was higher than expected for persons who understand the related problems. The low level of physical addiction and the high number of times the subjects had tried to stop smoking suggest the need to create a program specifically to help health care workers in this respect.

[Bronchioloalveolar carcinoma in a young woman]. / Carcinoma bronquioloalveolar en mujer joven.

Bronchioloalveolar carcinoma is an infrequent malignant lung tumor, specially in patients younger than 50. Diagnosis is difficult and usually late, because its clinical and radiologic features are similar to other lung diseases and because its poor histopathologic differentiation from other primitive o metastatic adenocarcinoma. We report a case of multinodular, diffuse and bilateral bronchioloalveolar carcinoma in a young woman without previous lung disease which suspected diagnosis was by broncho-aspirated cytology and open lung biopsy was necessary for its confirmation.