Comparación de compuestos metabólicos en muestras de sudor entre pacientes con enfermedad pulmonar obstructiva crónica y cáncer de pulmón / Sweat sample metabolic compound comparison between patients with chronic obstructive pulmonary disease and lung cancer

Objetivo: Evaluar en pacientes con enfermedad pulmonar obstructiva crónica respecto a pacientes con cáncer epidermoide de pulmón en estadio inicial (CP I-II) si en el metaboloma del sudor existen diferencias en los compuestos. Metodología: Se incluyeron 11 pacientes con EPOC y 9 pacientes con CP I-II. El sudor se recogió siguiendo una técnica estandarizada y la muestra fue congelada a -80ºC hasta el análisis metabolómico, para lo que se utilizó un cromatógrafo de líquidos acoplado a un espectrómetro de masas de alta resolución (LC-QTOF) con ionización por electrospray. Se realizó un análisis de cambio (AC) para detectar las diferencias de concentración relativa de metabolitos entre grupos. Resultados. Las características basales de los sujetos incluidos en los dos grupos fueron similares. En la clínica destaca que un 67% de los enfermos con CP I-II (67%) no manifestaron síntomas atribuibles al tumor. El análisis metabolómico mostró que en el análisis de cambio una tetrahexosa presentó diferencias entre el grupo de enfermos con EPOC y con CP I-II (AC: - 4,021), igual tendencia se observó en un trisacárido fosfato (AC: -1,741) y en un lípido sulfónico (AC: -1,920). Conclusión: En muestras de sudor, el análisis de cambio muestra metabolitos con potencialidad para diferenciar entre pacientes EPOC y con CP I-II. Este resultado puede tener aplicabilidad en el cribado del cáncer de pulmón

Objective: To evaluate whether there are differences in sweat metabolite compounds in patients with chronic obstructive pulmonary disease compared to patients with early-stage squamous cell lung cancer (LC I-II). Methods: 11 patients with COPD and 9 patients with LC I-II were included. Sweat was collected using a standardized technique and the sample was frozen at -80ºC until the metabolic analysis was performed, which used a liquid chromatograph coupled with a high-resolution mass spectrometer (LC-QTOF) with electrospray ionization. A change analysis (CA) was done to detect the differences in the relative concentrations of metabolites between groups. Results: The baseline characteristics of subjects included in the two groups were similar. In the clinical presentation, it is worth noting that 67% of patients with LC I-II (67%) did not show symptoms that could be attributed to the tumor. The metabolic analysis showed that in the change analysis, a tetra-hexose showed differences between the COPD group and LC I-II group (CA: -4.021), the same pattern observed in a phosphate trisaccharide (CA: -1.741) and in a sulphonic lipid (AC: -1.920). Conclusion: In sweat samples, the change analysis shows metabolites with the potential to differ between patients with COPD and those with LC I-II. This result can be applied in lung cancer screening

Long-term Prognosis After Lung Transplantation: A Monocentric Study in 510 Patients.

INTRODUCTION: Lung transplantation is the final treatment option in patients with respiratory failure. Morbidity and mortality rates associated with the management of complications is high despite advances. Postoperative complications include acute transplant rejection, bronchiolitis obliterans, and infections. Because of that, the success of this treatment option depends on the correct choice of donor and candidates to receive a transplant. OBJECTIVE: This study aims to perform a survival analysis of transplanted patients in our center and determine predictive variables of mortality. PATIENTS AND METHODS: This study is a retrospective assessment of data collected from 510 patients at the Hospital University Reina Sofía from October 1993 to December 31, 2016. Patients who were retransplanted were excluded. We collected data regarding basal characteristics of the donors and candidates to receive a transplant. We analyzed the impact in terms of future survival of basal variables from donor and donor recipients. RESULTS: Five hundred ten patients were included (average age 44 ± 17 years, 69% male), with a maximum follow-up period of 21.6 years (average follow-up 4.52 years, interquartile ratio: 0.13 to 6.97 years). Two hundred twenty-seven patients died (54.3% of the total amount). The influence of donor's basal characteristics on mortality was analyzed; moreover, the relationship between basal variables and survival were analyzed using univariate analysis. Available variables were analyzed through multivariate analysis. CONCLUSION: Lung transplantation is a treatment option with an acceptable risk of morbidity and mortality. Increased awareness of features of evolution could help to reduce postoperative complications.

Relación entre las variables observadas en una prueba de marcha de 6 minutos y la desaturación nocturna en pacientes con EPOC / Relationship regarding the variables observed in a 6-minute walking test and desaturation at night in COPD

OBJETIVO: Determinar, en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) las variables que en la prueba de 6 minutos marcha (P6MM) aportan información sobre el grado de desaturación nocturna. METODOLOGÍA: Estudio prospectivo, transversal con muestreo consecutivo. Se incluyeron sujetos ambulatorios, en estabilidad clínica, con una saturación periférica de oxígeno (SapO2 ≥92%) y sin contraindicación para realizar una P6MM. A todos los sujetos se les realizaron dos determinaciones con el mismo pulsioxímetro (Pulsox-300i) durante la P6MM y sueño. Se realizó correlación entre las variables de la P6MM y el porcentaje del tiempo nocturno con SapO2 <90% (T90) y se construyó un modelo de regresión para evaluar la variabilidad del T90. RESULTADOS: Fueron incluidos 47 enfermos, 37 hombres (79%), edad = 61,6 ± 7,5 años, y un FEV1 post-BD = 50 ± 18,3 %. Respecto al T90 nocturno, las variables que mostraron correlación significativa en la P6MM fueron la SapO2 , basal, media y mínima, y el T90 y T88 (SapO2 <88%). El modelo de regresión lineal mostró una R2 ajustada de 0,644; (p <0,001) siendo las variables que se asociaron de forma independiente al T90 nocturno: el IMC (p = 0,049), SapO2 basal (p = 0,001), SapO2 media-P6MM (p = 0,006) y el T88-P6MM (p = 0,048). CONCLUSIONES: La P6MM aporta información relevante sobre el grado de desaturación nocturna. La SapO2 basal, y la SapO2 media y el valor del T88 fueron las variables que en la P6MM mostraron mayor influencia sobre la variabilidad del T90 nocturno

OBJECTIVE: Determine in patients with chronic obstructive pulmonary disease (COPD) those variables that provide information about degree of nocturnal desaturation in the 6-minute walk test (6MWT). METHODS: Prospective, transversal study with consecutive sampling. Outpatients were included in clinical stability, with peripheral oxygen saturation (SapO2 ≥92%) and without contraindication for a 6MWT. In all subjects were performed two determinations with the same pulse oximeter (Pulsox-300i) during the 6MWT and sleep. Was performed correlation between variables 6MWT and percentage nigh time with SapO2<90% (T90) and a regression model were constructed to evaluate the variability of the T90. RESULTS: We included 47 patients, 37 men (79%), age = 61.6 ± 7.5 years, and post-BD FEV1 = 50 ± 18.3%. Regard to T90 nocturnal, the variables that showed significant correlation in 6MWT were SapO2 basal, mean and minimum, and T90 and T88 (SapO2 <88%). The linear regression model showed an adjusted R2 of 0.644 (p< 0.001), and BMI (p = 0.049), baseline SapO2 6MWT (p = 0.001), mean SapO2 (p = 0.006) and T88-6MWT (p = 0.048) were the only variables independently associated to nocturnal T90. CONCLUSIONS: The 6MWT provides relevant information on the level of nocturnal desaturation. The basal SapO2 and mean and the value of T88 were the 6MWT variables that showed the greatest influence on variability nocturnal T90