[Structure and metric properties of a questionnaire to measure disability in mobility activities in patients with chronic obstructive pulmonary disease (DIAMO-COPD questionnaire)]. / Estructura y propiedades métricas de un cuestionario para medir discapacidad en las actividades de movilidad en pacientes con enfermedad pulmonar obstructiva crónica (cuestionario DIAMO-EPOC).

OBJECTIVE: The aim of this study was to adapt a disability questionnaire in mobility activities (DIAMO-EPOC) incorporating scales based on the conceptual framework of the International Classification of Functioning, Disability and Health, and to examine its structure, reliability and validity in a cohort of patients with COPD. METHODS: A total of 137 patients with stable COPD were recruited. Two scales of 4 items each were designed and their structure was verified by exploratory factor analysis and multitrait scaling analysis. Additionally, reliability indices (internal consistency and test-retest) were calculated. Construct validity was analysed by known groups and convergence-divergence. RESULTS: The questionnaire had 2 scales, with 4 items each, corresponding to the domains of the International Classification of Functioning, Disability and Health "change and maintain the position of the body" and "walk and move". The reliability and internal consistency of the scales were acceptable and the test-retest was excellent with an ICC of 0.86 and 0.94, respectively. The scales showed a moderate association with dyspnoea, health status and muscle strength and a different score among participants with different physical performance in the Short Physical Performance Battery. CONCLUSIONS: The 2 scales of the DIAMO-EPOC questionnaire are one-dimensional and have a solid internal consistency, test-retest stability and validity, allowing the identification of specific areas of limited mobility in patients with COPD.

Estructura y propiedades métricas de un cuestionario para medir discapacidad en las actividades de movilidad en pacientes con enfermedad pulmonar obstructiva crónica (cuestionario DIAMO-EPOC) / Structure and metric properties of a questionnaire to measure disability in mobility activities in patients with chronic obstructive pulmonary disease (DIAMO-COPD questionnaire)

OBJETIVO: El objetivo del estudio fue adaptar un cuestionario de discapacidad en actividades de movilidad (DIAMO-EPOC) incorporando escalas basadas en el marco conceptual de la Clasificación Internacional del Funcionamiento, Discapacidad y Salud, y examinar su estructura, fiabilidad y validez en una cohorte de pacientes con EPOC. MÉTODOS: Un total de 137 pacientes con EPOC estable fueron reclutados. Se diseñaron dos escalas de cuatro ítems cada una y se verificó su estructura mediante análisis factorial y de multirrasgo. Adicionalmente, se calcularon los índices de fiabilidad (consistencia interna y test-retest). La validez de constructo se analizó mediante grupos conocidos y la convergencia-divergencia. RESULTADOS: El cuestionario resultó tener 2 escalas, con 4 ítems cada una, correspondientes a los dominios de la Clasificación Internacional del Funcionamiento, Discapacidad y Salud «cambiar y mantener la posición del cuerpo» y «andar y moverse». La fiabilidad y consistencia interna de las escalas resultaron aceptables y el test-retest excelente con CCI de 0,86 y 0,94, respectivamente. Las escalas mostraron una asociación moderada con la disnea, el estado de salud y la fuerza muscular de los pacientes y una diferente puntuación entre sujetos con distinto desempeño físico en la Short Physical Performance Battery. CONCLUSIONES: Las dos escalas del cuestionario DIAMO-EPOC son unidimensionales y tienen una sólida consistencia interna, estabilidad test-retest y validez, permitiendo identificar áreas específicas de movilidad limitada en pacientes con EPOC

OBJECTIVE: The aim of this study was to adapt a disability questionnaire in mobility activities (DIAMO-EPOC) incorporating scales based on the conceptual framework of the International Classification of Functioning, Disability and Health, and to examine its structure, reliability and validity in a cohort of patients with COPD. METHODS: A total of 137 patients with stable COPD were recruited. Two scales of 4 items each were designed and their structure was verified by exploratory factor analysis and multitrait scaling analysis. Additionally, reliability indices (internal consistency and test-retest) were calculated. Construct validity was analysed by known groups and convergence-divergence. RESULTS: The questionnaire had 2 scales, with 4 items each, corresponding to the domains of the International Classification of Functioning, Disability and Health "change and maintain the position of the body" and "walk and move". The reliability and internal consistency of the scales were acceptable and the test-retest was excellent with an ICC of 0.86 and 0.94, respectively. The scales showed a moderate association with dyspnoea, health status and muscle strength and a different score among participants with different physical performance in the Short Physical Performance Battery. CONCLUSIONS: The 2 scales of the DIAMO-EPOC questionnaire are one-dimensional and have a solid internal consistency, test-retest stability and validity, allowing the identification of specific areas of limited mobility in patients with COPD

[Quality of initial prescription of home oxygen therapy in a healthcare area of the Murcia Region (Spain)]. / Calidad de la prescripción inicial de la oxigenoterapia domiciliaria en un área sanitaria de la Región de Murcia.

OBJECTIVE: To analyse the quality of the prescription of home oxygen therapy (OT) in a health area of Murcia. METHODS: A prospective study of 125 patients in a respiratory therapy clinic, evaluated with a questionnaire and blood-gas analysis while breathing ambient air. Related respiratory therapy was also assessedin COPD and asthma patients. RESULTS: We studied 125 cases in the 3 months following the prescription of home oxygen therapy in 72 men (58%) and 53 women (42%) with a mean age of 77.2 ± 11.6. The most common type of home OT prescribed was for palliative cases in 45 patients (36%), followed by COPD in 42 (33.6%). In 88 (92%) of the 96 medical reports that we evaluated, insufficient data as to how to administer oxygen were available. Twenty-five percent of home OT prescriptions were given without blood-gas analyses, and in the 65 cases with a blood-gas analysis only 11 (17%) met oxygen value criteria for home OT as per regulations. Oxygen desaturation was not present in 31% of the palliative care home OT cases. The analysis of blood-gases during the clinic visit in non-palliative care cases demonstrated that 61% did not meet the blood-gas criteria to continue on home OT. Eighty percent of COPD and asthma patients on home OT did not receive the correct respiratory therapy. CONCLUSIONS: Quality problems in the prescription of home OT exist in our area. Palliative care is the principal reason for home OT prescriptions. In COPD and asthma patients who receive home OT, related respiratory therapy is not ideal.

Calidad de la prescripción inicial de la oxigenoterapia domiciliaria en un área sanitaria de la Región de Murcia / Quality of initial prescription of home oxygen therapy in a healthcare area of the Murcia Region (Spain)

Objetivo. Analizar la calidad de la prescripción de oxigenoterapia domiciliaria (OD) en un área sanitaria de Murcia. Métodos. Estudio prospectivo de 125 pacientes en consulta de terapias respiratorias, a los que se evaluó con un cuestionario y gasometría arterial respirando aire del ambiente. En EPOC y asma se valoró también el tratamiento inhalador asociado. Resultados. Estudiamos 125 casos en los 3 meses siguientes a la indicación de OD, 72 varones (58%) y 53 mujeres (42%), con una media de edad de 77,2±11,6 años. La indicación de OD más frecuente se consideró paliativa en 45 (36%), seguida de la EPOC, en 42 (33,6%). En 88 de los 96 informes médicos que se evaluaron (92%), no había datos suficientes de cómo administrar el oxígeno. Un 25% de las indicaciones de OD se realizaron sin gasometría arterial y, de 65 donde había gasometría, sólo en 11 (17%) los valores de oxígeno reunían criterios de OD según las normativas. En el 31% de las indicaciones paliativas de OD, no estaba la desaturación de oxígeno. El análisis de los gases arteriales en el momento de la consulta en los casos sin indicación paliativa, constató que el 61% no tenía criterios gasométricos de continuación de OD. El 80% de los pacientes con EPOC y asma con OD no recibía tratamiento inhalador correcto. Conclusiones. Se detectaron problemas de calidad en la prescripción de la OD en nuestra área. El tratamiento paliativo fue la principal causa de indicación de OD. En pacientes con EPOC y asma que recibían oxígeno domiciliario, el tratamiento inhalador asociado no resultó óptimo(AU)

Objective. To analyse the quality of the prescription of home oxygen therapy (OT) in a health area of Murcia. Methods. A prospective study of 125 patients in a respiratory therapy clinic, evaluated with a questionnaire and blood-gas analysis while breathing ambient air. Related respiratory therapy was also assessedin COPD and asthma patients. Results. We studied 125 cases in the 3 months following the prescription of home oxygen therapy in 72 men (58%) and 53 women (42%) with a mean age of 77.2±11.6. The most common type of home OT prescribed was for palliative cases in 45 patients (36%), followed by COPD in 42 (33.6%). In 88 (92%) of the 96 medical reports that we evaluated, insufficient data as to how to administer oxygen were available. Twenty-five percent of home OT prescriptions were given without blood-gas analyses, and in the 65 cases with a blood-gas analysis only 11 (17%) met oxygen value criteria for home OT as per regulations. Oxygen desaturation was not present in 31% of the palliative care home OT cases. The analysis of blood-gases during the clinic visit in non-palliative care cases demonstrated that 61% did not meet the blood-gas criteria to continue on home OT. Eighty percent of COPD and asthma patients on home OT did not receive the correct respiratory therapy. Conclusions. Quality problems in the prescription of home OT exist in our area. Palliative care is the principal reason for home OT prescriptions. In COPD and asthma patients who receive home OT, related respiratory therapy is not ideal(AU)

Descompensación asmática como forma de presentación de un hamartoma condroide endobronquial / Endobronchial chondroid hamartoma presenting as asthmatic attack

No disponible

Inmigración y tuberculosis / Imigration and tuberculosis

No disponible

[Pneumonia and acute renal failure as complications of varicella in adults]. / Neumonía e insuficiencia renal aguda como complicaciones de la varicela en el adulto.

Varicella is a disease in childhood. When it affects adults, serious complications can develop, the most frequent and most dangerous being pneumonia. Acute renal failure is an exceptional complication which infrequently is reported in relevant current literature. The association of pneumonia with acute renal failure in a patient with varicella is unusual. We report a varicella case in an adult patient who suffered from pneumonia with respiratory distress syndrome and acute renal failure, both of them had a favourable clinical course.

[Tuberculous liver abscess in an immigrant patient with pulmonary tuberculosis]. / Absceso hepático tuberculoso en paciente inmigrante con tuberculosis pulmonar.

Liver abscess due to Mycobacterium tuberculosis associated with pulmonary tuberculosis is a rare diagnosis, particularly in patients without AIDS. We report the case of a male immigrant with no HIV infection who developed a tuberculous liver abscess and pulmonary tuberculosis simultaneously. Ziehl-Neelsen stain, PCR and Löwenstein-Jensen culture of material sampled from the abscess established the microbiological diagnosis. The patient's course was good, with disappearance of symptoms and the abscess after tuberculostatic treatment and drainage of the abscess with monitoring by computed tomography.

Absceso hepático tuberculoso en paciente inmigrante con tuberculosis pulmonar / Tuberculous liver abscess in an immigrant patient with pulmonary tuberculosis

El absceso hepático por Mycobacterium tuberculosis asociado a una tuberculosis pulmonar es un diagnóstico poco frecuente, e incluso aún más raro es encontrarlo en pacientes sin el síndrome de la inmunodeficiencia adquirida (sida).Presentamos el caso de un paciente inmigrante con serología negativa para el virus de la inmunodeficiencia humana (VIH) que presentó simultáneamente un absceso hepático tuberculoso y una tuberculosis pulmonar. La tinción de Ziehl-Neelsen, la PCR y el cultivo en Löwenstein-Jensen del material extraído del absceso permitieron establecer el diagnóstico microbiológico del mismo. La evolución fue buena, con desaparición de los síntomas y del absceso, tras tratamiento tuberculostático y drenaje del absceso bajo control mediante tomografía computarizada (TC) (AU)

Neumonía e insuficiencia renal aguda como complicaciones de la varicela en el adulto / Pneumonia and acute renal failure complicating varicella in the adult

La varicela es una enfermedad propia de la infancia que puede afectar a adultos con serias complicaciones. La neumonía es la más frecuente y grave. La afectación renal está apenas descrita en la literatura. La presentación conjunta de ambas complicaciones es inusual. Presentamos un caso de varicela en el adulto que desarrolló simultáneamente neumonía con distrés respiratorio e insuficiencia renal aguda que evolucionaron favorablemente. (AU)

Neumonía intersticial linfoide asociada a enfermedad celíaca / Neumonía intersticial linfoide Asociada una Enfermedad celíaca

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[Acute lipoid pneumonia caused by accidental aspiration of vaseline used in nasogastric intubation]. / Neumonía lipoidea aguda debida a la aspiración accidental de vaselina utilizada en un sondaje nasogástrico.

Exogenous lipoid pneumonia is a rare disease which is often underdiagnosed. Exogenous lipoid pneumonia has traditionally been considered a chronic process secondary to continued aspiration or inhalation of fatty substances. In its acute form exogenous lipoid pneumonia sometimes coincides with accidental massive aspiration of lipidic material, as has been traditionally described for fire eaters. We review the literature and report a case of acute lipoid pneumonia secondary to accidental aspiration of vaseline used to place a nasogastric tube, which had been inserted for gastric lavage after a suicide attempt by flurazepam ingestion.

Neumonía lipoidea aguda debida a la aspiración accidental de vaselina utilizada en un sondaje nasogástrico / Acute lipoid pneumonia due to accidental aspiration of vaseline used during nasogastric intubation

La neumonía lipoidea exógena es una entidad poco frecuente y a menudo infradiagnosticada. Clásicamente, se ha considerado un proceso crónico secundario a la aspiración o inhalación continuada de sustancias grasas. En ocasiones, se puede observar una forma aguda coincidiendo con aspiraciones accidentales masivas de material lipídico descrita tradicionalmente en "comedores de fuego"1,2. Revisamos la bibliografía y presentamos un caso de neumonía lipoidea aguda secundaria a la aspiración accidental de vaselina utilizada en la colocación de una sonda nasogástrica para un lavado gástrico, tras intento de autólisis mediante la ingesta de flurazepam. (AU)