RESUMEN
Fifteen to fifty percent of patients with hereditary haemorrhagic telangiectasia have pulmonary arteriovenous malformations. The objective of this study was to measure the effect of the presence of pulmonary arteriovenous malformations and of their embolisation on respiratory-related quality of life (QoL). We prospectively recruited patients with a diagnosis of hereditary haemorrhagic telangiectasia based on the Curaçao criteria and/or the identification of a pathogenic mutation. Respiratory-related quality of life was measured using the Saint George's Respiratory Questionnaire (SGRQ). Patients who underwent embolisation of pulmonary arteriovenous malformations completed the questionnaire before and 6-12 mo after the procedure. The 56 participants were divided into three groups: no pulmonary arteriovenous malformation (group A, nâ=â10), small pulmonary arteriovenous malformations not accessible to embolotherapy (group B, nâ=â19), and large pulmonary arteriovenous malformations accessible to embolotherapy (group C, nâ=â27). The SGRQ score was significantly higher in group C compared to the other groups, indicating a worse respiratory-specific QoL. There was no significant difference between groups A and B. Among the 17 patients who underwent an embolisation, the SGRQ score decreased significantly after the procedure, to a value similar to that in patients without pulmonary arteriovenous malformation. Our results indicate that the presence of large but not small pulmonary arteriovenous malformations negatively affects the respiratory-related quality of life and that embolisation of pulmonary arteriovenous malformations normalizes the respiratory-related quality of life.
Asunto(s)
Fístula Arteriovenosa/psicología , Embolización Terapéutica , Arteria Pulmonar/anomalías , Venas Pulmonares/anomalías , Calidad de Vida , Telangiectasia Hemorrágica Hereditaria/psicología , Adulto , Fístula Arteriovenosa/complicaciones , Fístula Arteriovenosa/fisiopatología , Fístula Arteriovenosa/cirugía , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Arteria Pulmonar/fisiopatología , Arteria Pulmonar/cirugía , Venas Pulmonares/fisiopatología , Venas Pulmonares/cirugía , Respiración , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Telangiectasia Hemorrágica Hereditaria/complicaciones , Telangiectasia Hemorrágica Hereditaria/fisiopatología , Telangiectasia Hemorrágica Hereditaria/cirugíaRESUMEN
Chronic respiratory failure is a complex entity of varied etiology and physio-pathological mechanisms. It is mainly characterised by the respiratory system's difficulty in ensuring correct aeration at rest, resulting initially in insufficient oxygenation of arterial blood. Treatment is adapted to each etiology and aims to compensate for respiratory failure and to ensure the oxygenation of the organism.
Asunto(s)
Insuficiencia Respiratoria/diagnóstico , Insuficiencia Respiratoria/terapia , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Humanos , Insuficiencia Respiratoria/clasificación , Insuficiencia Respiratoria/etiologíaRESUMEN
INTRODUCTION: The proportion of elderly patients with lung cancer is increasing. The objectives of this study were to describe the initial symptoms in elderly patients (≥ 70 years) with lung cancer and to describe the diagnostic and treatment delays. PATIENTS AND METHODS: We reviewed all consecutive patients with lung cancer that were diagnosed between 2006 and 2008 in our department. The initial symptoms and delays in the diagnosis and treatment in elderly patients were compared with those of younger patients. RESULTS: One hundred ninety-three patients were included (26 small-cell cancers and 167 non-small-cell lung cancers [NSCLCs]). Ninety-two patients (47.7%) were ≥ 70 years old. No statistical differences were identified between the 2 groups concerning initial symptoms. In elderly patients, the delay between the initial symptoms and the first visit with a thoracic oncologist (median 1.6 months [IQR 23 days-3.3 months]), the delay between the first visit and the specific treatment (median 1.1 months [IQR 18 days-1.8 months]), and the delay between initial symptoms and the specific treatment (median 3 months [IQR 2-5.7 months]) were similar to those in the younger patients (P = .101, P = .084, and P = .671, respectively). Eighty-four percent of the elderly patients were actively treated vs. 98% of the younger patients (P = .001). CONCLUSION: We identified no differences regarding the initial symptoms in elderly patients with lung cancer compared with those in younger patients. The delays in diagnosis and treatment were similar between the 2 groups.