Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services.

BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.

¿Mienten los pacientes con EPOC sobre su hábito tabáquico? / Do COPD patients lie about their smoking habit?

OBJETIVO: Determinar la tasa de decepción o concordancia entre la respuesta de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) sobre su hábito tabáquico y la medición del mismo por cooximetría en una consulta monográfica EPOC. DISEÑO: Estudio observacional prospectivo para determinar la concordancia entre los valores de cooximetría y la respuesta a entrevista clínica sobre hábito tabáquico. EMPLAZAMIENTO: Consulta monográfica de EPOC, Neumología, Sevilla. PARTICIPANTES: Pacientes con diagnóstico confirmado de EPOC en cualquier grado. INTERVENCIONES: Entrevista clínica y medición de monóxido de carbono mediante cooximetría. MEDICIONES PRINCIPALES: Valores de cooximetría, respuestas sobre hábito tabáquico, variables sociodemográficas. RESULTADOS: Se incluyó un total de 169 pacientes (n: 169) de los cuales, 107 presentaron valores menores o iguales 6 ppm frente a 62 con valores mayores a 6 ppm, determinando una prevalencia de tabaquismo activo del 36,7%. La tasa de decepción fue del 19,5% del total de la muestra (24,3% de entre todos los que afirmaban no fumar), con una kappa de Cohen de 0,48 y p < 0,000. El 40% de los pacientes confesó no haber dicho la verdad. No se encontró ninguna relación de este dato con la edad, el consumo acumulado de tabaco ni el FEV1. Se halló una relación significativa con el sexo (tasa de decepción: 31,8% en las mujeres vs. 15,2% en los hombres, p 0,017). CONCLUSIONES: A pesar de nuestros intentos para que los pacientes dejen de fumar, la tasa de decepción en nuestra consulta fue considerable, mayor entre las mujeres, exfumadores recientes o en proceso de abandono, por lo que sería fundamental incorporar medidas objetivas como el cooxímetro en el abordaje de este tipo de pacientes

OBJECTIVE: To determine the deception rate or concordance between the interview on smoking and cooximetry in COPD patients from a monographic consultation. DESIGN: Prospective observational study to evaluate the concordance between the values of cooximetry and the response to a clinical interview on smoking. SETTING: COPD monographic consultation, Pneumology, Seville. PARTICIPANTS: Patients with a confirmed diagnosis of COPD in any degree. INTERVENTIONS: Clinical interview and measurement of carbon monoxide by cooximetry. MAIN MEASUREMENTS: Cooximetry values, responses on smoking, sociodemographic variables. RESULTS: n: 169. 107 patients presented values less than or equal to 6 ppm compared to 62 with values greater than 6 ppm, determining a prevalence of active smoking of 36.7%. The deception rate was 19.5% of the total sample (24.3% of all those who claimed not to smoke), with a Cohen kappa of 0.48 and p < 0.000. 40% of patients confessed not having told the truth. No relationship of this data was found with age, accumulated tobacco consumption or FEV1. A significant relationship with sex was found (deception rate: 31.8% in women vs. 15.2% in men, p 0.017). CONCLUSIONS: In spite of our attempts to make patients stop smoking, a considerable deception rate was found in our consultation; higher among women, recent ex-smokers or in the process of abandonment, so it would be essential to incorporate objective measures such as the cooximeter in the approach of this type of patient

[Do COPD patients lie about their smoking habit?] / ¿Mienten los pacientes con EPOC sobre su hábito tabáquico?

OBJECTIVE: To determine the deception rate or concordance between the interview on smoking and cooximetry in COPD patients from a monographic consultation. DESIGN: Prospective observational study to evaluate the concordance between the values of cooximetry and the response to a clinical interview on smoking. SETTING: COPD monographic consultation, Pneumology, Seville. PARTICIPANTS: Patients with a confirmed diagnosis of COPD in any degree. INTERVENTIONS: Clinical interview and measurement of carbon monoxide by cooximetry. MAIN MEASUREMENTS: Cooximetry values, responses on smoking, sociodemographic variables. RESULTS: n: 169. 107 patients presented values less than or equal to 6 ppm compared to 62 with values greater than 6 ppm, determining a prevalence of active smoking of 36.7%. The deception rate was 19.5% of the total sample (24.3% of all those who claimed not to smoke), with a Cohen kappa of 0.48 and p < 0.000. 40% of patients confessed not having told the truth. No relationship of this data was found with age, accumulated tobacco consumption or FEV1. A significant relationship with sex was found (deception rate: 31.8% in women vs. 15.2% in men, p 0.017). CONCLUSIONS: In spite of our attempts to make patients stop smoking, a considerable deception rate was found in our consultation; higher among women, recent ex-smokers or in the process of abandonment, so it would be essential to incorporate objective measures such as the cooximeter in the approach of this type of patient.

Sarcoma alveolar pulmonar primario. Un caso poco habitual / Primary pulmonary alveolar sarcoma. An unusual case

No disponible

Afectación pulmonar bilateral. Opciones no quirúrgicas del pseudotumor inflamatorio, a propósito de un caso / Bilateral Pulmonary Involvement. Non-Surgical Options for Inflammatory Pseudotumor - A Case Report

No disponible

Actinomicosis sobre cuerpo extraño inorgánico endobronquial / Endobronchial actinomycosis associated with an inorganic foreign body

No disponible

Técnicas endoscópicas de diagnóstico y estadificación. (Broncoscopia, EBUS, EUS) / No disponible

No disponible

Anxiety, depression and tobacco abstinence. / Ansiedad, depresión y deshabituación tabáquica.

There is evidence of the relationship between mental illness and smoking and increased risk of depressive episodes after quitting smoking, even with specific treatments for abstinence. OBJECTIVE: To assess the influence of a cessation program on the emotional state of patients by measuring levels of anxiety / depression and differences depending on the presence of psychiatric history. METHOD: A prospective observational study of patients taking part in a combined program (pharmacological and cognitive-behavioral) for giving up smoking. Anxiety (A) and depression (D) were measured using the HADS questionnaire at baseline, first and third month of abstinence. RESULTS: Anxiety and depression showed significant and progressive improvement during treatment (A: baseline 9.2 ± 4.5, 5.9 ± 3.6 1 month, 3 months 4.5 ± 3.1, p.

Existe evidencia de la relación entre patología mental y tabaquismo y del mayor riesgo de sufrir un episodio depresivo al dejar de fumar, incluso con tratamientos específicos para la abstinencia. Objetivo: valorar la influencia de un programa de abandono del tabaco en el estado emocional de los pacientes mediante la medición de los niveles de ansiedad/depresión y las posibles diferencias en función de la presencia de antecedentes psiquiátricos. Método: estudio de cohortes observacional y prospectivo de pacientes que acudieron a dejar de fumar mediante programa combinado (farmacológico y cognitivo-conductual). Se midió ansiedad (A) y depresión (D) utilizando el cuestionario HADS al inicio, primer y tercer mes de abstinencia. Resultados: la ansiedad y la depresión presentaron mejoría significativa y progresiva a lo largo del tratamiento (A: basal 9,2±4,6; 1 mes 5,9±3,6; 3 meses 4,5±3,1; p.

Ansiedad, depresión y deshabituación tabáquica / Anxiety, Depression and Tobacco Abstinence

Existe evidencia de la relación entre patología mental y tabaquismo y del mayor riesgo de sufrir un episodio depresivo al dejar de fumar, incluso con tratamientos específicos para la abstinencia. Objetivo: valorar la influencia de un programa de abandono del tabaco en el estado emocional de los pacientes mediante la medición de los niveles de ansiedad/depresión y las posibles diferencias en función de la presencia de antecedentes psiquiátricos. Método: estudio de cohortes observacional y prospectivo de pacientes que acudieron a dejar de fumar mediante programa combinado (farmacológico y cognitivo-conductual). Se midió ansiedad (A) y depresión (D) utilizando el cuestionario HADS al inicio, primer y tercer mes de abstinencia. Resultados: la ansiedad y la depresión presentaron mejoría significativa y progresiva a lo largo del tratamiento (A: basal 9,2±4,6; 1 mes 5,9±3,6; 3 meses 4,5±3,1; p<0,05 / D: basal 5,5±4,1; 1 mes 3±3; 3 meses 2,3±2,1; p<0,05), en la población psiquiátrica (A: basal 11,3±4,5; 1 mes 7,1±3,7; 3 meses 5,3±3,5; p<0,05 / D: basal 7,4±4,8; 1 mes 4,2±3,6; 3 meses 3±2,9; p<0,05), e independientemente del tratamiento. Tasa de abstinencia: 58,5%, no se vio afectada por los niveles basales de ansiedad y depresión. No se detectaron efectos secundarios neuropsiquiátricos relevantes. Conclusiones: los niveles de ansiedad y depresión evolucionan favorablemente durante el programa, alcanzándose buenos resultados, independientemente de la presencia de patología psiquiátrica

There is evidence of the relationship between mental illness and smoking and increased risk of depressive episodes after quitting smoking, even with specific treatments for abstinence. Objective: To assess the influence of a cessation program on the emotional state of patients by measuring levels of anxiety / depression and differences depending on the presence of psychiatric history. Method: A prospective observational study of patients taking part in a combined program (pharmacological and cognitive-behavioral) for giving up smoking. Anxiety (A) and depression (D) was measured using the HADS questionnaire at baseline, first and third month of abstinence. Results: Anxiety and depression showed significant and progressive improvement during treatment (A: baseline 9.2 ± 4.5, 5.9 ± 3.6 1 month, 3 months 4.5 ± 3.1, p <0 05 / D: baseline 5.5 ± 4.1; 1 month 3 ± 3; 3 months 2.3 ± 2.1, p <0.05), in psychiatry population (A: baseline 11.3 ± 4 , 5; 1 month 7.1 ± 3.7, 5.3 ± 3.5 3 months, p <0.05 / D: baseline 7.4 ± 4.8, 4.2 ± 3.6 one month; 3 months 3 ± 2.9, p <0.05), regardless of treatment. Abstinence rate: 58.5%, unaffected by baseline levels of anxiety and depression. No significant neuropsychiatric side effects were detected. Conclusions: Anxiety and depression levels evolved favourably during the program, achieving good results regardless of the presence of psychiatric pathology

Amiloidosis traqueobronquial difusa: uso de radioterapia local externa como modalidad de tratamiento / External Beam Radiation Therapy: A Treatment Modality in Diffuse Tracheobronchial Amyloidosis

No disponible

Síndrome de Pourfour du Petit en un paciente con adenocarcinoma mucinoso de pulmón / Pourfour du Petit syndrome in a patient with lung mucinous adenocarcinoma

No disponible

[Blood uric acid levels in patients with sleep-disordered breathing]. / Valores de ácido úrico en sangre en pacientes con trastornos respiratorios del sueño.

OBJECTIVE: Recurrent hypoxia associated with sleep apnea-hypopnea syndrome (SAHS) leads to an increase in the degradation of adenosine triphosphatase to xanthine and, secondarily, to an increase in uric acid concentrations. The aim of the present study was to determine whether there is a correlation between uric acid levels in peripheral blood and sleep-disordered breathing, independently of known confounding factors. PATIENTS AND METHODS: We carried out a retrospective cross-sectional study of 1135 patients evaluated for suspected SAHS. For all patients, a medical history was taken using a standardized protocol. In addition, biochemical analysis of venous blood and an overnight sleep study (with either conventional polysomnography or home monitoring) were carried out. RESULTS: The mean (SD) concentration of uric acid was 6.31 (1.5) mg/dL, and 36% of patients had concentrations above established normal values for their sex. We found a significant correlation between uric acid levels and some sleep study parameters (number of respiratory events, number of desaturations, or the cumulative percentage of time with oxygen saturation less than 90%). Those patients with more respiratory events (apnea-hypopnea index or respiratory event index >or= 30) had higher uric acid levels than those with mild or no SAHS. However, this difference was not apparent in the univariate analysis of variance, in which body mass index and cholesterol and triglyceride levels were considered confounding factors. CONCLUSIONS: Uric acid levels are positively correlated with the number of obstructive respiratory episodes and oxygen desaturations during sleep, but this correlation seems to be influenced by other factors, such as obesity.

Valores de ácido úrico en sangre en pacientes con trastornos respiratorios del sueño / Blood uric acid levels in patients with sleep-disordered breathing

Objetivo: La hipoxia recurrente del síndrome de apnea-hipopnea durante el sueño (SAHS) origina un aumento de la degradación de adenosintrifosfato a xantina y, secundariamente, de las concentraciones de ácido úrico. El propósito del presente estudio ha sido analizar si existe relación entre los valores de ácido úrico en sangre periférica y los trastornos respiratorios durante el sueño, independientemente de los factores de confusión conocidos. Pacientes y métodos: Se ha realizado un estudio transversal retrospectivo con 1.135 pacientes evaluados por sospecha de SAHS. A todos ellos se les realizaron una historia clínica protocolizada, un estudio bioquímico de sangre venosa y un estudio de sueño nocturno (polisomnografía convencional o poligrafía domiciliaria). Resultados: El valor medio (± desviación estándar) del ácido úrico fue de 6,31 ± 1,5 mg/dl, y el 36% de los pacientes presentaban unas concentraciones de uricemia superiores a las establecidas como normales según el sexo. Encontramos una correlación significativa entre los valores de ácido úrico y algunos parámetros de los estudios de sueño (número de eventos respiratorios, número de desaturaciones o el porcentaje de registro con saturación < 90%). Los pacientes con mayor número de eventos respiratorios (índice de apneas-hipopneas o índice de eventos respiratorios ≥ 30) tenían un valor más alto de ácido úrico que aquéllos sin SAHS o con SAHS leve, aunque esta diferencia desapareció al realizar un análisis de la variancia univariante en el que se consideraron factores de confusión el índice de masa corporal y los valores de colesterol y triglicéridos. Conclusiones: Los valores de uricemia aumentan a medida que lo hacen los episodios respiratorios obstructivos y las desaturaciones durante el sueño, pero este aumento parece condicionado por varios factores, como la obesidad

Objective: Recurrent hypoxia associated with sleep apnea-hypopnea syndrome (SAHS) leads to an increase in the degradation of adenosine triphosphatase to xanthine and, secondarily, to an increase in uric acid concentrations. The aim of the present study was to determine whether there is a correlation between uric acid levels in peripheral blood and sleep-disordered breathing, independently of known confounding factors. Patients and methods: We carried out a retrospective cross-sectional study of 1135 patients evaluated for suspected SAHS. For all patients, a medical history was taken using a standardized protocol. In addition, biochemical analysis of venous blood and an overnight sleep study (with either conventional polysomnography or home monitoring) were carried out. Results: The mean (SD) concentration of uric acid was 6.31 (1.5) mg/dL, and 36% of patients had concentrations above established normal values for their sex. We found a significant correlation between uric acid levels and some sleep study parameters (number of respiratory events, number of desaturations, or the cumulative percentage of time with oxygen saturation less than 90%). Those patients with more respiratory events (apnea-hypopnea index or respiratory event index ≥ 30) had higher uric acid levels than those with mild or no SAHS. However, this difference was not apparent in the univariate analysis of variance, in which body mass index and cholesterol and triglyceride levels were considered confounding factors. Conclusions: Uric acid levels are positively correlated with the number of obstructive respiratory episodes and oxygen desaturations during sleep, but this correlation seems to be influenced by other factors, such as obesity