Archivos de bronconeumología
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Arch. Bronconeumol. · Jul 2010
Review[Permissive and non-permissive hypercapnia: mechanisms of action and consequences of high carbon dioxide levels].
Acute lung injury is a disease with high incidence of mortality and its treatment is still controversial. Increasing the levels of CO2 beyond the physiological range has been proposed as a potential protective strategy for patients on mechanical ventilation, as it could moderate the inflammatory response. In this article we review the published evidence on the role of CO2 during acute lung injury. We conclude that although there are reports suggesting benefits from hypercapnia, more recent evidence suggests that hypercapnia could be deleterious, contributing to worsening of the lung injury.
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Arch. Bronconeumol. · Jul 2010
Case Reports[Unilateral painful diaphragm paralysis as the only sign of amyotrophic neuralgia].
Amyotrophic neuralgia is an inflammatory and idiopathic neuropathy which is characterised by neuropathic pain. It was described for the first time in 1948 as condition that only affected the brachial plexus and was called Parsonage-Turner syndrome. Although this syndrome is more common in the brachial plexus, it can concomitantly, or in isolation affect the phrenic nerve, and in this case the diagnosis is very difficult if there is no high clinical suspicion. We present a case of a patient with amyotrophic neuralgia in which the only sign was left phrenic involvement, and we highlight the resistance of the pain to analgesics, as well as the persistence of the symptoms and diaphragm problems for over 6 months.
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Arch. Bronconeumol. · Jul 2010
Letter Case Reports[Non-specific interstitial pneumonia with unusual symptoms].
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Arch. Bronconeumol. · Jun 2010
Randomized Controlled Trial[A randomised study of midazolam for sedation in flexible bronchoscopy].
Flexible bronchoscopy (FB) is a procedure which is not usually tolerated well by the patient. This makes the examination more difficult, often needing repetition with the subsequent lowering of diagnostic performance. ⋯ Our results show that patients sedated with midazolam tolerate FB better, remember less of the procedure itself and have a better predisposition to repeat the procedure. The bronchoscopist has less difficulties during the procedure and shortens the time using the same techniques during the bronchoscopy. The lack of severe complications and these results suggest the use of sedation with midazolam as routine during FB.
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Arch. Bronconeumol. · Jun 2010
[Upper lobectomy for lung cancer with true tracheal bronchus: a unique presentation].
Tracheal bronchus is an aberrant bronchus usually originating from the right lateral wall of the trachea, with an incidence ranging from 0.1% to 5% and usually within 2.0cm above the carina. The incidence of lung cancer with bronchial anomaly is very rare. There are only nine cases of lung cancer developing from the tracheal bronchus reported in the literature. ⋯ This is the first documented case in the world of a squamous carcinoma arising from the true tracheal bronchus. Post-surgical histological stage was T2aN0M0 (stage IB). The patient is well 48 months after the operation and has no evidence of recurrence.