Tracheobronchial Aspergillosis in a Lung Transplant Recipient / Aspergilosis traqueobronquial en un receptor de trasplante de pulmón

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Extrapulmonary Nontuberculous Mycobacteriosis in a Lung Transplant Recipient / Micobacteriosis no tuberculosa extrapulmonar en un receptor de transplante de pulmón

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Not Cancer After All: Two Rare Cases of IgG4-Related Lung Disease / Al final, no era cáncer: dos casos infrecuentes de enfermedad pulmonar relacionada con IgG4

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Kaposi Sarcoma and Lung Transplant: Two Case Reports / Sarcoma de Kaposi y trasplante pulmonar: dos casos clínicos

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Una causa inusual de hemoptisis / An unusual cause for hemoptysis

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Lung and renal transplantation.

UNLABELLED: Renal transplantation is the most common type of solid organ transplantation and kidney transplant recipients are susceptible to pulmonary complications of immunosuppressive therapy, which are a diagnostic and therapeutic challenge. AIM: To evaluate patients admitted to the Renal Transplant Unit (RTU) of Hospital de S. João with respiratory disease. SUBJECT AND METHODS: We performed a retrospective study of all patients admitted to RTU with respiratory disease during a period of 12 months. RESULTS: Thirty-six patients were included. Mean age 55.2 (+/-13.4) years; 61.1% male. Immunosuppressive agents most frequently used were prednisolone and mycophenolate mofetil associated with ciclosporin (38.9%) or tacrolimus (22.2%) or rapamycin (13.9%). Thirty-one patients (86.1%) presented infectious respiratory disease. In this group the main diagnoses were 23 (74.2%) pneumonias, 5 (16.1%) opportunistic infections, 2 (6.5%) tracheobronchitis, and 1 case (3.2%) of lung abscesses. Microbiological agent was identified in 7 cases (22.6%). Five patients (13.9%) presented rapamycin-induced lung disease. Fibreoptic bronchoscopy was performed in 15 patients (41.7%), diagnostic in 10 cases (66.7%). Mean hospital stay was 17.1 (+/-18.5) days and no related death was observed. CONCLUSION: Respiratory infections were the main complications in these patients. Drug-induced lung disease implies recognition of its features and a rigorous monitoring of drug serum levels. A more invasive diagnostic approach was determinant in the choice of an early and more specific therapy.

Acute exacerbation of idiopathic pulmonary fibrosis.

Some patients with Idiopathic Pulmonary Fibrosis (IPF) have disease accelerated deterioration without identifiable cause referred as "acute exacerbation" or "accelerated stage". It is characterized by severe worsening of dyspnea, hypoxemia and new or progressive opacities on imaging studies. The typical histological findings are diffuse alveolar damage in addition to the features of usual interstitial pneumonia pattern. Mortality in this clinical entity is very high and no efficacious therapeutic have been described. The authors describe the clinical, functional and radiological features, treatment and evolution of five patients with IPF acute exacerbation. A discussion will be carry out concerning the IPF acute exacerbation usual features comparing with the alterations noticed in those patients.

Streptococcus pneumoniae - caused CAP in hospitalised patients: mortality predictors.

Probably the most important decision in the management of Community-Acquired Pneumonia (CAP) is patient site of care. Patients with Streptococcus pneumoniae-caused CAP admitted to our hospital between 1st January and 31st December 2006 were retrospectively analysed. Samples of blood, sputum, bronchial and bronchoalveolar lavage and urine were collected for microbiological testing using standard culture techniques and urine antigen detection. Pneumonia Severity Index (PSI) and British Thoracic Society (BTS) CURB-65 scoring tools were evaluated. The statistical treatment was performed using the SPSS 14.0 program. We included 104 patients, 67.3% male, median age 63 years old, mortality 13.4%. There was a significant association between the PSI and CURB-65 score and mortality. Despite advances, CAP is still an important health problem with a high attendant morbi-mortality. This study confirms the value of PSI and CURB-65 in the prediction of severe pneumonia.

Smoking habits and awareness of smoking risks depending on academic background in university students.

OBJECTIVE: To evaluate smoking habits among a group of medical students and engineering students in order to assess whether, depending on their specific academic background, differences in smoking habits and attitudes towards smoking were present. METHODS: Medical and engineering students from the Oporto University were surveyed using a questionnaire, in which they were asked to mention their smoking habits, their perception about cigarette dependence and to point out, from a list of 12 tobacco-related diseases, which were associated with tobacco use.