Archivos de bronconeumología
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Arch. Bronconeumol. · Apr 2011
Review[Imaging techniques in the examination of the distal airways: asthma and COPD].
Imaging techniques are highly useful diagnostic tools to study small airway diseases. Despite their differences, from a clinical pathological perspective, these diseases show similar radiological manifestations. High-resolution computed tomography (CT) is the technique of choice to study diffuse diseases and those of the small airways; the slices obtained in expiratory high-resolution CT scan should form part of the study protocol of small airway diseases. ⋯ In asthmatic patients, multi-detector CT (MDTC) allows clinical symptoms, thickening of the airway wall and the degree of airflow obstruction to be directly correlated. MDTC is also useful for quantitative evaluation of the degree of air trapping in patients with emphysema. Magnetic resonance imaging after inhalation of distinct gases, such as (3)He and xenon-129 and dual-energy CT are also useful imaging techniques in the direct or indirect evaluation of the degree of airflow obstruction (air trapping).
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Arch. Bronconeumol. · Mar 2011
Nuclear translocation of the glucocorticoid receptor in fibroblasts of asthmatic patients with nasal polyposis insensitive to glucocorticoid treatment.
Nasal polyposis (NP) is treated with topical glucocorticoids (GC). Some patients require endoscopic nasal surgery because GC treatment is ineffective. To exert its function, the GC needs to bind with the GC receptor (GR) and the GC-GR complex moves to the cell nucleus. Our aim was to establish whether the poor response to GC is due to an alteration in the translocation of the GR to the nucleus. ⋯ The insensitivity to GC treatment does not appear to be due to an alteration in GR translocation to the nucleus. Neither does the severity of asthma or intolerance to NSAIDs appear to alter GR translocation. The association between atopy and the alteration in GR function deserves further investigation.
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To describe our experience in airway complications following lung transplant and to suggest a management algorithm, using different tools from the Interventional Pulmonology armamentarium. ⋯ Airway complications after lung transplant are frequent. Balloon dilation was effective only in a few patients with bronchial stenosis, although the majority ultimately needed a stent. Airway repermeabilization after stent placement improved FEV(1). Based on our experience, we propose a management algorithm for airway complications after lung transplant.