Archivos de bronconeumología
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Arch. Bronconeumol. · May 2009
Clinical Trial[Usefulness of radial endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of mediastinal lymph nodes].
Transbronchial needle aspiration (TBNA) is a bronchoscopic technique that has been shown to be useful for sampling enlarged mediastinal lymph nodes. The yield of this technique can be increased by using endobronchial ultrasound (EBUS) to guide needle placement. The aim of the present study was to compare the yield of radial EBUS-guided TBNA to that of conventional TBNA in the analysis of mediastinal lymph nodes. ⋯ Radial EBUS guidance increases the diagnostic yield of TBNA in paratracheal and hilar lymph node stations.
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Arch. Bronconeumol. · Apr 2009
[Causes of death and risk factors for mortality in patients with severe chronic obstructive pulmonary disease].
The objective of this study was to assess the causes of death and risk factors for mortality in a cohort of patients with severe chronic obstructive pulmonary disease (COPD). ⋯ Mortality in patients with severe COPD was high and exacerbation of the disease was one of the most frequent causes of death. Age, GOLD stage, cor pulmonale, prior admission to hospital, and need for admission to the ICU during follow-up were independent predictors of mortality.
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Arch. Bronconeumol. · Mar 2009
Multicenter Study[Noninvasive mechanical ventilation in Valencia, Spain: from theory to practice].
To obtain representative data on the frequency of use and availability of resources for noninvasive mechanical ventilation (NIV) in hospitals (acute respiratory failure) and at home (chronic respiratory failure). ⋯ We observed differences in the type of requirement used, and considerable deficiencies in the availability of human and material resources and support systems. Although NIV is mostly used in hospitals to treat patients with acute respiratory failure, home NIV is also very common and is characterized by greater variability in terms of the number and type of patients. We also observed deficiencies in terms of written protocols for patients with acute and chronic disease.
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Arch. Bronconeumol. · Mar 2009
Case Reports[Response to inhaled granulocyte-macrophage colony-stimulating factor in a patient with alveolar proteinosis].
Pulmonary alveolar proteinosis is a rare disease characterized by the accumulation of lipoproteinaceous material derived from alveolar surfactant in the alveoli, with a consequent deterioration in gas exchange. Pathogenesis is related to impaired phagocytic function of alveolar macrophages. In recent years, a new treatment for pulmonary alveolar proteinosis-consisting of subcutaneous administration of granulocyte-macrophage colony-stimulating factor (GM-CSF)-has become available. ⋯ Instead of subcutaneous administration, GM-CSF can also be inhaled as an aerosol. This route of administration of GM-CSF is safe and effective in the treatment of pulmonary alveolar proteinosis and represents an alternative to subcutaneous administration or whole lung lavage. We present a patient with pulmonary alveolar proteinosis who was treated with inhaled GM-CSF and describe her clinical and functional outcome after 1 year of treatment.
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Arch. Bronconeumol. · Feb 2009
[Residency training of European respiratory medicine specialists: The HERMES project].
Given the movement of medical specialists across borders in recent years, and the changes in legislation affecting the structure and operation of boards responsible for the various medical specialties, the task of harmonizing the training of respiratory medicine residents across the European Union has become crucial. The project for Harmonized Education in Respiratory Medicine for European Specialists (HERMES) is a collective response to this need. After 3 years of work toward building consensus, HERMES is entering its second phase. The Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has the aim of informing our resident trainees, their instructors, and others concerned with postgraduate education in respiratory medicine in Spain about this undeniably difficult task of harmonization.