Cigarette smoke induces pulmonary arterial dysfunction through an imbalance in the redox status of the soluble guanylyl cyclase.

Chronic obstructive pulmonary disease (COPD), whose main risk factor is cigarette smoking (CS), is one of the most common diseases globally. Some COPD patients also develop pulmonary hypertension (PH), a severe complication that leads to premature death. Evidence suggests reactive oxygen species (ROS) involvement in COPD and PH, especially regarding pulmonary artery smooth muscle cells (PASMC) dysfunction. However, the effects of CS-driven oxidative stress on the pulmonary vasculature are not completely understood. Herein we provide evidence on the effects of CS extract (CSE) exposure on PASMC regarding ROS production, antioxidant response and its consequences on vascular tone dysregulation. Our results indicate that CSE exposure promotes mitochondrial fission, mitochondrial membrane depolarization and increased mitochondrial superoxide levels. However, this superoxide increase did not parallel a counterbalancing antioxidant response in human pulmonary artery (PA) cells. Interestingly, the mitochondrial superoxide scavenger mitoTEMPO reduced mitochondrial fission and membrane potential depolarization caused by CSE. As we have previously shown, CSE reduces PA vasoconstriction and vasodilation. In this respect, mitoTEMPO prevented the impaired nitric oxide-mediated vasodilation, while vasoconstriction remained reduced. Finally, we observed a CSE-driven downregulation of the Cyb5R3 enzyme, which prevents soluble guanylyl cyclase oxidation in PASMC. This might explain the CSE-mediated decrease in PA vasodilation. These results provide evidence that there might be a connection between mitochondrial ROS and altered vasodilation responses in PH secondary to COPD, and strongly support the potential of antioxidant strategies specifically targeting mitochondria as a new therapy for these diseases.

The Spanish flu and the fiction literature.

This review focuses on the fictional literature in which the Spanish flu is represented either as an anecdotal or as a historical aspect and the effect on the author or fictional character. We examine this sociocultural period in the press and mainly in Anglo-Saxon literary works and from other countries, including Spanish and Latin American literature that is not very represented in some international reviews on the subject. Also, we include books about the previous and subsequent influenza pandemics to the Spanish flu.

John Donne, Spanish Doctors and the epidemic typhus: fleas or lice?

We describe the infections that appeared in the life and work of John Donne (1572-1631), the English metaphysical poet, mainly the exanthematic typhus that suffered and gave arise to his work Devotions upon emergent occasions, and several steps in my sickness. We discuss the vector of transmission of this disease, in comparison of other infections in that period, that Donne´s scholars have related to the flea without mentioning the body louse, the true vector of the exanthematic typhus. Likewise, we mention the exanthematic typhus´s symptoms in his Devotions in comparison with the Luis de Toro´s or Alfonso López de Corella´s works, Spanish doctors in those times and the first doctors in write books about the disease, and the singular treatment of pigeon carcasses on the soles of the feet in English Doctors but not in Spanish Doctors.

Alteración nutricional del paciente con EPOC. Etiopatogenia. Consecuencias de la desnutrición en el paciente con EPOC / Nutritional alteration in copd. etiopathogenesis. consequences of malnutrition

Se analizan los parámetros de desnutrición y de composición corporal en los pacientes con EPOC (sarcopenia, IMC, porcentaje de masa libre de grasa) así como los mecanismos etiopatogénicos que conducen a esta situación y las características propias de la enfermedad que dificultan la adecuada ingesta de nutrientes y por tanto la cobertura de unas necesidades de aporte energético que están ya de por si aumentadas en el paciente con EPOC. Se resalta la importancia del conocimiento de la composición corporal como factor predictor de supervivencia y el interés que suscitan los distintos perfiles nutricionales para establecer fenotipos en función de su riesgo nutricional

The parameters of malnutrition and body composition are analyzed in patients with COPD (sarcopenia, BMI,% fat-free mass) as well as their etiopathogenic mechanisms. Also the characteristics of the disease that hinder adequate nutrient intake and therefore the coverage of energy needs that are already increased in the patient with COPD. The importance of knowledge of body composition as a predictor of survival and the interest of the different nutritional profiles raise to establish phenotypes based on their nutritional risk is highlighted

[An historical, sociocultural view and in the fiction literature of Bacillus anthracis cases by shaving brushes]. / Una visión histórica, socio-cultural y literaria de casos de Bacillus anthracis por brochas de afeitar.

In the period from 1915 to 1924 anthrax outbreaks were described by Bacillus anthracis due to the contamination of razor brushes that reached Europe and the United States from areas such as Japan, China or Russia. The brushes were made with badger hair, and then, to reduce the cost with horse hair and other animals. World War I supoosed that the traffics of these brushes, that passed through Europe, changed and the processes of sterilization of the same were deficient giving rise to these outbreaks, that in a percentage of 20% produced the death of the users. The impact of the fashion of wearing a beard, the presence of these cases in the press, in the society of that period, and literature are studied through the work of Agatha Christie who wrote, in 1936, the Hercules Poirot´s novel Cards on the table, and where she describes the murder of one of the characters with the shaving brush contaminated with Bacillus anthracis spores.

Desarrollo de embolismo pulmonar por cemento tras vertebroplastia / Pulmonary embolism after percutaneous vertebroplasty

En los últimos años se ha extendido el uso de la vertebroplastia percutánea con cemento de polimetilmetacrilato como técnica alternativa al tratamiento convencional de las fracturas vertebrales por osteoporosis. Presentamos el caso de una paciente sometida a vertebroplastia con polimetilmetacrilato que desarrolló embolismo pulmonar secundario a dicho material

In recent years the use of percutaneous vertebroplasty with polymethylmethacrylate cement as treatment of osteoporotic vertebral fractures has increased, gradually replacing the conventional treatment. A 51-year-old female’s case, who developed pulmonary embolism due to a precutaneous vertebroplasy, is presented in this article

EPOC y mujer / No disponible

No disponible

Absceso pulmonar por Pseudomonas aeruginosa en paciente / No disponible

En los pacientes inmunodeprimidos, entre las causa más frecuentes de absceso pulmonar se encuentra la Pseudomonas aeruginosa. Para el diagnóstico etiológico de absceso pulmonar necesitamos que la radiografía de tórax muestre un infiltrado con cavitación superior a 2 cm y que exista documentación microbiológica que determinará la elección del tratamiento antibiótico adecuado. En el caso de que el absceso sea por P. aeruginosa, resultará más complicado porque los antibióticos empíricamente indicados no suelen ir dirigidos específicamente a esta bacteria. Presentamos un caso de una paciente de 78 años con esclerosis sistémica y neumopatía intersticial no específica en tratamiento inmunosupresor que presentó un absceso pulmonar por P. aeruginosa de instauración brusca y de evolución tórpida

In the inmunocompromised patients, among the most common cause of lung abscess stand out Pseudomonas aeruginosa. For a etiologic diagnosis of lung abscess we need the thorax radiograph to show a pulmonary infiltrate with a cavitatiom with a depth of at least 2 cm and microbiological documentation, which will define which is the best antibiotic therapy. If the lung abscess is caused by the bacteria P. aeruginosa, its treatment will be more difficult because empirically recommended antibiotics barely target this bacteria. We present a 78-years-old female patient with systemic sclerosis and nonspecific interstitial pneumonia, who is receiveing an immunosuppressive treatment. She was diagnosed with a P. aeruginosa lung abscess which had a sudden onset and a bad evolution

Tobramycin inhalation powder (TOBI Podhaler) for the treatment of lung infection in patients with cystic fibrosis.

Cystic fibrosis (CF) is an autosomal recessive inherited disease secondary to a defect in the CF transmembrane conductance regulator gene (CFTR). Mortality in CF is associated with impairment of lung function in which bacterial infection plays a fundamental role. The microorganism Pseudomonas aeruginosa (P. aeruginosa) is a marker of poor prognosis. Tobramycin was the first parenteral antibiotic to be used as inhaled medication in CF. Owing to its beneficial effects; it was subsequently used in designed inhaled formulations. The first formulation was the inhalation solution, which improved lung function, lowered hospitalization rates, and reduced the courses of intravenous antibiotic. However, the high associated costs and time necessary to administer the medication negatively affected quality of life. The recent development of tobramycin inhalation powder has optimized treatment. The dry powder inhaler is a simple device that reduces administration time and improves adherence. As there is no risk of bacterial contamination, disinfection is unnecessary.

Comorbilidades en EPOC: Propuesta de una evaluación sistémica / No disponible

No disponible

Dermatofibrosarcoma protuberans metastásico: una causa poco frecuente de masa pulmonar / No disponible

El dermatofibrosarcoma protuberans (DFSP) es una neoplasia de partes blandas de malignidad intermedia localizada inicialmente en la piel, desde donde invade tejidos más profundos. Clínicamente se caracteriza por su presentación como un nódulo o placa indurada en tronco o extremidades. El tratamiento inicial es la extirpación quirúrgica local, siendo el factor de mal pronóstico más reconocido una extirpación quirúrgica inadecuada. Hay pocos casos de metástasis descritos en la literatura siendo la localización pulmonar la más frecuente. El estudio inmunohistoquímico se caracteriza por la expresión de vimentina y CD34, y el estudio genético-molecular por la presencia de translocación de cromosomas 17 y 22. El tratamiento de elección es la extirpación quirúrgica completa, seguida de radioterapia y quimioterapia en los casos avanzados. Por tanto, aunque las metástasis son extremadamente raras, la presencia de una masa pulmonar debe incluirse en el diagnóstico diferencial de un paciente con antecedentes de un DFSP

Dermatofibrosarcoma protuberans (DFSP) is a neoplasm of soft tissue of intermediate malignancy, initially localized in the skin developing in the deep layers of skin. Clinically it is characterized by its presentation as a nodule or indurated plaque on the trunk and proximal extremities.Initial treatment is local surgical excision, and an inadequate surgical removal is themayor risk for recurrence. There are few reports of metastases described in the literature; the lung is the most common site of metastasis. Immunohistochemical study is characterized by the expression of vimentin and CD34, and by a reciprocal chromosomal translocation, t(17;22). The treatment is a complete surgical excision, followed by radiotherapy and chemotherapy in advanced cases. Therefore, although metastases are extremely rare, the presence of a lung mass should be included in the differential diagnosis of a patient with a history of DFSP

Mujer con pulmón del cuidador de aves / Women with bird breeder's lung

La neumonitis por hipersensibilidad o alveolitis alérgica extrínseca (AAE) se origina por una reacción de hipersensibilidad a antígenos inhalados sobre un pulmón con una susceptibilidad individual. En el caso del pulmón del cuidador de aves, son partículas que suelen encontrarse en el epitelio, el polvo que cubre las plumas o las heces de las aves. En la exploración física destacan los crepitantes inspiratorios a la auscultación pulmonar y los hallazgos en la radiografía de tórax pueden ser muy variables. La TC nos muestra diferentes patrones en función de la fase de la enfermedad en que nos encontremos. Respecto a las pruebas de función respiratoria, la mayoría de los pacientes presenta un patrón restrictivo. Un diagnóstico precoz será crucial en la evolución de la enfermedad, ya que la progresión puede conducir a una fibrosis pulmonar o una enfermedad pulmonar obstructiva crónica. Lo principal es eliminar la exposición a los antígenos, con ello muchos pacientes se recuperan (AU)

Hypersensitivity pneumonitis or extrinsic allergic alveolitis (EAA) originates from a hypersensitivity reaction to inhaled antigens on a lung with individual susceptibility. In the case of bird breeder's lung, they are particles that are generally found on the epithelium, dust that covers the feathers or stools of the birds. In the physical examination, the inspiratory crackling rales heard on pulmonary auscultations stand out and the findings on the chest X-ray may vary greatly. The CT scan shows us different patterns based on the disease phase in question. Regarding the pulmonary function tests, most of the patients have a restrictive pattern. Early diagnosis is crucial in the disease course since progression may lead to pulmonary fibrosis or chronic obstructive pulmonary disease. The most important is to eliminate exposition to the antigens, with which many patients recover (AU)