[Annual Review of COPD]. / Revista del año de la EPOC.

There have been significant advances in the knowledge in the thoracic and extrathoracic aspects of chronic obstructive pulmonary disease (COPD) in the past few years. COPD is associated with numerous comorbidities, the prevalences of which have recently been evaluated. Dyspnea has been shown to be associated with neuropsychiatric disturbances, such as anxiety. Muscular dysfunction has been associated with inflammation and oxidative stress, in which respiratory muscle satellite cells play an important role in repair. Respiratory rehabilitation and physiotherapy must form an important part of individualised patient treatment analogous to the pharmacological treatment. As regards acute exacerbations, infection is the cause of 75% of them, sputum characteristics and the suspicion of Pseudomonad being key factors in the antibiotic treatment. Questions, such as markers which can detect the origin of the infection, prognostic factors, or the role of short stay pneumology units, are of particular importance. The variability in COPD treatments and the lack of suitable international clinical guidelines, continue to be subjects of debate. To the poor use of the treatment schemes in the guidelines, can be added the irregular uses of inhaled medication, the insufficient use of medical advice or the low intervention in cigarette smoking in all age groups.

Revista del año de la EPOC / Annual Review of COPD

Durante los últimos años se han producido importantes avances en el conocimiento de la enfermedad pulmonarobstructiva crónica (EPOC), tanto en aspectos torácicos como extratorácicos. La EPOC se asocia anumerosas comorbilidades, incluidas el cáncer broncogénico, cuyas prevalencias se han evaluado. La disneaha demostrado estar relacionada con las alteraciones neuropsiquiátricas como la ansiedad. La disfunciónmuscular se ha relacionado con la inflamación y el estrés oxidativo, en cuya reparación tienen un papelrelevante las células satélite del músculo respiratorio. La rehabilitación respiratoria y la fisioterapiadeben formar parte de un tratamiento individualizado del paciente de manera análoga al tratamiento farmacológico.Sobre las agudizaciones, la infección es causa del 75% de éstas; las características del esputo yla sospecha de Pseudomonas son factores claves en la antibioterapia. Cuestiones como marcadores que detectensu origen infeccioso, factores pronósticos o el papel de las unidades de estancias cortas neumológicasson de especial relevancia. La variabilidad del tratamiento en la EPOC y su falta de adecuación a lasguías clínicas internacionales continúan siendo temas de debate. A la pobre utilización de las pautas detratamiento de las guías se añade el desigual uso de la medicación inhalada o el insuficiente uso del consejomédico o la intervención mínima en tabaquismo en todos los grupos de edad(AU)

There have been significant advances in the knowledge in the thoracic and extrathoracic aspects of chronicobstructive pulmonary disease (COPD) in the past few years. COPD is associated with numerous comorbidities,the prevalences of which have recently been evaluated. Dyspnea has been shown to be associatedwith neuropsychiatric disturbances, such as anxiety. Muscular dysfunction has been associated with inflammationand oxidative stress, in which respiratory muscle satellite cells play an important role in repair.Respiratory rehabilitation and physiotherapy must form an important part of individualised patient treatmentanalogous to the pharmacological treatment. As regards acute exacerbations, infection is the cause of75% of them, sputum characteristics and the suspicion of Pseudomonad being key factors in the antibiotictreatment. Questions, such as markers which can detect the origin of the infection, prognostic factors, orthe role of short stay pneumology units, are of particular importance. The variability in COPD treatmentsand the lack of suitable international clinical guidelines, continue to be subjects of debate. To the poor useof the treatment schemes in the guidelines, can be added the irregular uses of inhaled medication, the insufficientuse of medical advice or the low intervention in cigarette smoking in all age groups(AU)

[A study of 73 cases of bronchial tuberculosis]. / Tuberculosis bronquial. Estudio de 73 casos.

We reviewed 73 cases of bronchial tuberculosis (59 adults and 14 children) diagnosed between 1973 and 2000 using histologic and bacteriologic criteria. The most frequent symptom was cough. Radiographic studies showed an alveolar pattern in 35 cases and obstructive pneumonitis or atelectasis in 28 cases. Endoscopy results showed that granuloma was more common in children under 16 years of age (64%) than in adults (22%). Granulomatous or ulcerative bronchitis was significantly more frequent in adults (66%; P< .005). Bronchial tuberculosis is not an exceptional occurrence. Clinical and radiographic signs are nonspecific. Endoscopy images of granuloma and granulomatous or ulcerative bronchitis may be similar to those of bronchial neoplasia. Diagnosis therefore requires fiberoptic bronchoscopy combined with histology and microbiology studies.

Tuberculosis bronquial. Estudio de 73 casos / A study of 73 cases of bronchial tuberculosis

Hemos revisado 73 casos de tuberculosis bronquial (59 adultos y 14 niños) diagnosticados entre 1973 y 2000 según criterios histológicos y bacteriológicos. El síntoma más frecuente fue la tos. Desde el punto de vista radiológico, se observó patrón alveolar en 35 casos y neumonitis obstructiva o atelectasia en 28. En la endoscopia, el granuloma fue más frecuente en los menores de 16 años (64%) que en los adultos (22%). El conjunto de bronquitis granulosa y ulcerada predominó de forma significativa (p < 0,005) en los adultos (66%). La tuberculosis bronquial no es un hecho excepcional. La clínica y la radiografía son inespecíficas. Las imágenes endoscópicas de granuloma y de bronquitis granulosa o ulcerada pueden ser similares a las de una neoplasia bronquial, por lo que para su diagnóstico es imprescindible la práctica de una fibrobroncoscopia con estudio histológico y microbiológico

We reviewed 73 cases of bronchial tuberculosis (59 adults and 14 children) diagnosed between 1973 and 2000 using histologic and bacteriologic criteria. The most frequent symptom was cough. Radiographic studies showed an alveolar pattern in 35 cases and obstructive pneumonitis or atelectasis in 28 cases. Endoscopy results showed that granuloma was more common in children under 16 years of age (64%) than in adults (22%). Granulomatous or ulcerative bronchitis was significantly more frequent in adults (66%; P<.005). Bronchial tuberculosis is not an exceptional occurrence. Clinical and radiographic signs are nonspecific. Endoscopy images of granuloma and granulomatous or ulcerative bronchitis may be similar to those of bronchial neoplasia. Diagnosis therefore requires fiberoptic bronchoscopy combined with histology and microbiology studies

Quiste pleuropericárdico: un buen final para un mal inicio / Pericardial cyst: all’s well that ends well

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