RESUMEN
OBJECTIVE: Obstructive Sleep Apnea (OSA) has been associated with both subclinical and accelerated atherosclerosis; however, it still remains unknown whether this association is unique or is mediated by the higher burden of co-existing cardio-metabolic disorders frequently seen in patients with OSA. PATIENTS AND METHODS: A total of 40 subjects without clinically diagnosed cardiovascular disease (CVD) referred for polysomnography test were included in the study. Subjects with apnea/hypopnea index (AHI > 15/h) were classified as moderate/severe OSA. Subclinical changes in carotid atherosclerosis were assessed using mean carotid intima-media thickness (cIMT) and presence of atheromatic plaques on both carotid arteries. The measurement was performed using B-mode ultrasonogram. Framingham risk score was used in the approximation of cardiovascular risk. RESULTS: The mean age of our cohort was 56.8 years, 70% (n = 28) of whom were males. Moderate/severe OSA was diagnosed in 21 subjects. Both groups were well matched in terms of clinical and demographic characteristics, and cardiovascular risk profile, as shown in their respective Framingham risk scores (10.4 ± 6.6 vs. 11.8 ± 8.8, p = NS). Patients with moderate/severe OSA had a higher mean AHI, 3% oxygen desaturation index, and lower minimum nocturnal oxygen saturation than controls. No significant differences were detected in terms of C-reactive protein levels. The two groups had similar cIMT (0.66 ± 0.17 vs. 0.75 ± 0.20 p = 0.33) and presence of atheromatic plaque (50% vs. 45%, p = 1.00). CONCLUSIONS: Our study suggests that among patients with similar cardiovascular risk profile and free of overt CVD, the severity of newly diagnosed OSA was not correlated with increased inflammation or subclinical carotid atherosclerosis.
Asunto(s)
Enfermedades Cardiovasculares , Enfermedades de las Arterias Carótidas , Apnea Obstructiva del Sueño , Grosor Intima-Media Carotídeo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Factores de Riesgo , Apnea Obstructiva del Sueño/diagnósticoRESUMEN
OBJECTIVE: Obstructive Sleep Apnoea Syndrome (OSAS) is a respiratory disorder characterized by recurrent airflow obstruction caused by total or partial collapse of the upper airway. OSAS is an established independent factor of cardiovascular risk together with other risk factors such as smoking and increased lipids. The aim of our study was to measure serum levels of aldosterone and renin in OSAS patients that did not suffer from arterial hypertension and compare them to matched healthy subjects in order to reveal the impact of chronic intermittent hypoxia on the renin-angiotensin-aldosterone system. PATIENTS AND METHODS: The patients that enrolled in this study were 19 OSAS patients who had undergone overnight polysomnography and had an Apnoea Hypopnoea Index (AHI) greater than 10 events/hour. They were compared to 20 healthy non-OSAS closely matched controls. Serum aldosterone and direct renin concentration were measured by radioimmunoassay. RESULTS: Aldosterone concentration follows a diurnal variation; therefore, all blood samples were obtained at the same time (6 AM). There were no significant differences in serum aldosterone levels between the two studied groups of OSAS patients and the healthy subjects group (140.6 pg/ml ± 25.2 vs. 133.2 pg/ml ± 18.5 with p = 0.223). Similar were the results for the renin levels (25.0 ± 6.9 vs. 24.9 ± 4.4 with p = 0.360). CONCLUSIONS: Our study suggests that patients with OSAS, but without existing hypertension have aldosterone and renin levels similar to healthy subjects. According to our findings a direct connection between OSAS and the development of arterial hypertension may not be established via sympathetic system activation.
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Aldosterona/sangre , Renina/sangre , Apnea Obstructiva del Sueño/sangre , Apnea Obstructiva del Sueño/diagnóstico , Adulto , Biomarcadores/sangre , Ritmo Circadiano/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía/métodos , Sistema Renina-Angiotensina/fisiología , Factores de Riesgo , Apnea Obstructiva del Sueño/fisiopatologíaRESUMEN
We present the case of a 33-year-old male patient suffering from lymphocytic pleural effusion, as a result of pleural mesothelioma. Mesothelioma is a malignant tumor of the pleura that is mainly caused by chronic exposure to asbestos fibers and more than 40 years of exposure are needed to develop the disease. Early studies on the relationship of asbestos and mesothelioma were issued in the 1960s. Fibers migrate from the parenchyma of the lung to the visceral pleura. It is widely known that asbestos is an oncogenic factor which can cause damage to DNA. A chest x-ray may reveal pleural effusion with or without pleural thickening, whereas a chest CT may also reveal pleural thickening, uniform and/or lobular. Specific tests, such as immunohistochemical staining, are used in order to help differential diagnosis. Extrapleural pneumonectomy is used as a therapeutic option which involves removal of the lung as well as both the visceral and parietal pleura, the affected part of the pericardium and diaphragm. Surgery should be followed up by radiotherapy and chemotherapy. The surgery may lead to a mean survival rate of approximately 9-21 months. The case presented underlines that in the event of pleural effusion with a lymphocyte type physicians should consider the possibility of a pleural mesothelioma during differential diagnosis, even in relatively young patients.
Asunto(s)
Asbestosis/complicaciones , Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Neoplasias Pleurales/diagnóstico , Tomografía Computarizada por Rayos X , Adulto , Broncoscopía , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/cirugía , Masculino , Mesotelioma/etiología , Mesotelioma/cirugía , Mesotelioma Maligno , Neoplasias Pleurales/etiología , Neoplasias Pleurales/cirugía , NeumonectomíaRESUMEN
OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) is a common disorder defined by repeated episodes of airflow cessation (apneas)leading to arterial hypoxemia and sleep disruption. OSAS has been associated with increased morbidity, mortality and diminished quality of life so far. This cross-sectional study aimed to assess the impact of OSAS on patients' Quality of Life, as measured by the Medical Outcomes Study Short Form-36 (SF-36). PATIENTS AND METHODS: Two hundred and forty five subjects referred to the sleep laboratory and underwent full polysomnography overnight. Prior to sleep study onset, we registered height and weight, medical history, smoking habit, drug consumption. Afterwards, each patient completed the SF-36. Eighty subjects not diagnosed with sleep apnea [apnea hypopnea index (AHI < 5)] were excluded. Therefore, 165 subjects (121 male and 44 female) remained. RESULTS AND CONCLUSIONS: Statistical analysis revealed that in patients with respiratory disturbance index (RDI) ≥ 15, (n = 115), RDI was independently associated with lower performance in role limitations due to physical problems (p = 0.005). Additionally, RDI was the only factor associated with decreased vitality (p = 0.014) and mental health scores (p = 0.047). In the same patient subgroup, body mass index (BMI) and age were associated with poorer scores in physical functioning (p < 0.001 and p = 0.003, respectively). BMI was an independent clinical predictor of worse scores in bodily pain (p = 0.006) general health (p = 0.006), social functioning (p = 0.025) and role limitations due to emotional problems (p = 0.004).
Asunto(s)
Salud Mental , Actividad Motora/fisiología , Calidad de Vida , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/fisiopatología , Encuestas y Cuestionarios , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/psicologíaRESUMEN
Beta-arrestins are small cytosolic proteins that have been known so far as negative feedback regulators of G-protein coupled receptors (GPCRs). This receptor superfamily, characterized by a heptahelical transmembrane motif, mediates the signals of a multitude of extracellular ligands including chemokines, cytokines, hormones and growth factors. Beta-arrestins "arrest" the GPCR signaling capability through its desensitization and internalization. However, novel roles for these molecules have emerged and research demonstrates that beta-arrestins can mediate intracellular signaling independently of their effects on G-protein stimulation. Acting as scaffolding proteins, they can lead to the assembly of intracellular signalsomes that can activate or inhibit the function of various signaling cascades, such as the MAP kinase, JNK and NF-kappaB cascades, ultimately affecting gene expression. Finally, they can even regulate gene transcription by modulating histone acetylation and chromatin assembly. This pleiotropic activity of beta-arrestins can regulate both physiologic and pathophysiologic responses and will be reviewed in the context of lung inflammatory diseases and lung cancer.
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Arrestinas/fisiología , Enfermedades Pulmonares/fisiopatología , Neoplasias/etiología , Animales , Proteínas de Unión al GTP/fisiología , Humanos , Invasividad Neoplásica , Metástasis de la Neoplasia , Receptores Adrenérgicos beta 2/fisiología , Transducción de Señal/fisiología , beta-ArrestinasRESUMEN
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by the presence of a low-grade systemic inflammation that is implicated in the pathogenesis of numerous extrapulmonary manifestations, such as hypogonadism. Endothelin-1 (ET-1) is a molecule that demonstrates pro-inflammatory properties and can augment the airway and systemic inflammation. Single nucleotide polymorphisms (SNPs) of the ET-1 gene that increase ET-1 serum levels are an important area of investigation. We examined the alterations in inflammatory markers [C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)] and in the levels of testosterone, free testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) in a group of male COPD smokers when compared to their age-matched controls and how these alterations relate to the presence of a functional ET-1 SNP, the adenine insertion SNP +138 insA/delA. MATERIALS AND METHODS: In this case control study, 80 male control smokers and 82 male COPD smokers were recruited for comparison. Among the male COPD smokers, 37 were carriers of the +138 insA/delA SNP. Two COPD subgroups according to genotype were formed: (1) A group of 45 males homozygous for the wild type allele (3A/3A) and (2) a group of 37 males heterozygous for the mutant allele (3A/4A). RESULTS: Levels of testosterone and free testosterone were lower in the COPD group and even lower in the 3A/4A COPD group. CRP and ESR levels were higher in both COPD groups, but their elevation was statistically significant only for the 3A/4A COPD group. Testosterone and free testosterone levels correlated positively with PaO2 for both COPD groups. An inverse correlation between testosterone and CRP was demonstrated for the 3A/4A COPD subgroup. CONCLUSIONS: Levels of testosterone correlated to FEV1, hypoxemia and weakly to CRP. The synchronous presence of the +138 insA/delA SNP resulted in even greater sex hormone level decline probably due to the presence of a more intense systemic inflammation.
Asunto(s)
Endotelina-1/genética , Hormonas Esteroides Gonadales/sangre , Inflamación/etiología , Polimorfismo de Nucleótido Simple , Enfermedad Pulmonar Obstructiva Crónica/genética , Fumar/sangre , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Endotelina-1/sangre , Hormona Folículo Estimulante/sangre , Volumen Espiratorio Forzado , Genotipo , Humanos , Hormona Luteinizante/sangre , Masculino , Enfermedad Pulmonar Obstructiva Crónica/sangreRESUMEN
We present a case of an idiopathic pulmonary artery aneurysm in an asymptomatic patient who was treated for an irrelevant medical condition. Pulmonary artery aneurysms (PAA) are quite rare and can either be congenital or acquired. Congenital aneurysms are usually associated with cardiac malformations leading to pulmonary hypertension. Acquired aneurysms can be idiopathic or associated with infections (tuberculosis, syphilis), trauma, pulmonary valvular stenosis, or collagen diseases. Pulmonary artery aneurysms are not common and an idiopathic pulmonary artery aneurysm is a rare finding that could be diagnosed incidentally.
Asunto(s)
Aneurisma/diagnóstico por imagen , Arteria Pulmonar , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Anciano , Aneurisma/complicaciones , Diagnóstico Diferencial , Humanos , Hallazgos Incidentales , Masculino , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND AND AIM: The phenotypic expression of COPD consists of pulmonary emphysema and chronic bronchitis. An imprecise phenotypic definition may result in inconsistencies among genetic studies regarding COPD pathogenesis. Endothelin-1 gene polymorphisms have been linked to increased susceptibility of COPD development. The present study examined the involvement of +138 insA/delA and G198T ET-1 polymorphisms with emphysematous and bronchitic COPD phenotypes. METHODS: In order to narrow down the phenotypic choices to either COPD-associated pulmonary emphysema or chronic bronchitis, a DLCO < 60% predicted threshold was chosen as an indicator of severe emphysema. 116 COPD smokers and 74 non-related, non-COPD smokers were evaluated. RESULTS: Statistical analysis showed that the 4A allele of the +138insA/delA SNP and the 4A:T haplotype were associated predominantly with a chronic bronchitis phenotype, whereas the TT genotype of the G198T SNP was found to be protective from emphysema development. CONCLUSIONS: The presence of both the 4A and T allele seems to modify the final expression of COPD towards a chronic bronchitis phenotype, since the G:3A haplotype was associated with a predominantly emphysematous phenotype in our study.
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Endotelina-1/genética , Polimorfismo de Nucleótido Simple , Enfermedad Pulmonar Obstructiva Crónica/genética , Población Blanca/genética , Volumen Espiratorio Forzado , Genética de Población , Genotipo , Haplotipos , Humanos , FenotipoRESUMEN
Pulmonary infection by Nocardia spp. has been recognized the last decades. Nocardia is an opportunistic pathogen in immunocompromised individuals; nevertheless, it has been recognized as an uncommon pathogen in immunocompetent patients. We report a case of pulmonary infection by Nocardia asteroides in an immunocompetent host who had a history of sulfate acid aspiration, followed by gastric tube interposition, reconstruction of the hypopharynx and gastric-hypopharyngial anastomosis.
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Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/microbiología , Nocardiosis/diagnóstico , Nocardia asteroides , Adulto , Anastomosis Quirúrgica , Biopsia con Aguja Fina , Hemoptisis/etiología , Humanos , Hipofaringe/cirugía , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Nocardiosis/diagnóstico por imagen , Recurrencia , Estómago/trasplante , Tomografía Computarizada por Rayos XRESUMEN
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide that may lead to impaired exercise tolerance. In this study we exhibit the relationship between two endothelin-1 (+134 3A/4A and G198T) SNPs involved in COPD and their association to impaired exercise tolerance. MATERIALS AND METHODS: The study population consisted of 22 COPD smokers and 32 smoking controls which underwent pulmonary function tests to assess forced expiratory volume for 1 second (FEV1), forced vital capacity (FVC), as well as cardiopulmonary exercise testing. Single nucleotide polymorphism were isolated using Real-Time PCR. RESULTS: The distribution of both genotypes (3A3A, 3A4A, 4A4A for the +134 3A/4A and GG, GT, TT for the G198T) did not different among patients and non-COPD smoking controls. Multivariate analysis showed that the 3A4A and GG genotypes in the COPD group were independently associated with better V'O2max values (Odd's Ratio (OR) = 12.5, 95% CI = -0.85-25.1, p = 0.049, and OR = 6.1, 95% CI = 0.83-11.4, p = 0.026, respectively). On the contrary analogous analysis in the non-COPD control group, showed that the 3A3A genotype was independently associated with increased V'O2/pulse (OR = 51.5, 95% CI = 17.2-85.7, p = 0.005) and the 3A4A genotype with increased DVE/DVCO2 value (OR = 3.8, 95% CI = -0.27-7.9, p = 0.054). DISCUSSION: Our results show that endothelin-1 gene is implicated in exercise performance in COPD patients and might play a role in adaptation of the cardiopulmonary system to exercise.
Asunto(s)
Endotelina-1/genética , Prueba de Esfuerzo , Polimorfismo de Nucleótido Simple , Enfermedad Pulmonar Obstructiva Crónica/genética , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Adulto , Anciano , Femenino , Genotipo , Humanos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Proyectos PilotoRESUMEN
Gastroesophageal reflux disease (GERD) has been associated with a variety of pulmonary manifestations, but it is unclear if gastroesophageal reflux causes any abnormality in pulmonary function. Cardiopulmonary exercise test (CPET) is a specialized method that is used to evaluate respiratory function during exercise. The aim of this study was to reveal any abnormality of pulmonary function in patients with GERD and respiratory symptoms. We evaluated 34 patients with GERD (24 men and 10 women, aged 21-63) and extraesophageal respiratory symptoms (wheezing and/or cough) before therapy and after a 12-week treatment with double dose of omeprazole. No patient presented abnormal spirometry. CPET was performed in all the patients at baseline and after completion of the 12-week treatment. CPET parameters including VO(2) rest, VO(2) max, VCO(2) rest, VCO(2) max, O(2)-puls rest, O(2)-puls max, HR (heart rate) rest, HRmax, PETCO(2) rest, PETCO(2) max, and VE/VCO(2) slope were recorded pretreatment and posttreatment. Twenty-four patients (70.6%) had esophagitis (grade A-D), 16 patients had hiatal hernia (47.1%), and 13 patients (38.2%) tested positive for Helicobacter pylori. All of the patients completed the CPET. No one presented shortness of breath or respiratory symptoms. CPET parameters were within normal limits in all of the patients. Twenty-eight patients were reevaluated. No improvement in any CPET parameter posttreatment was observed despite remission of esophageal and extraesophageal respiratory symptoms in all patients. No statistically significant difference was observed pretreatment and posttreatment between the patients older and younger than 40 years, smokers and nonsmokers, Hp(+) and Hp(-) patients, and those with and without hiatal hernia and esophagitis. The patients with GERD and respiratory manifestations and normal spirometry present no pulmonary dysfunction during CPET. No alterations in CPET values posttreatment or differences in CPET values according to age, smoking, Hp status, presence of esophagitis, or hiatal hernia were observed.
Asunto(s)
Tos , Prueba de Esfuerzo , Reflujo Gastroesofágico/fisiopatología , Ruidos Respiratorios , Adulto , Antiulcerosos/uso terapéutico , Femenino , Reflujo Gastroesofágico/tratamiento farmacológico , Gastroscopía , Frecuencia Cardíaca , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Omeprazol/uso terapéutico , Oxígeno/metabolismo , EspirometríaRESUMEN
BACKGROUND: Endothelin-1 (ET-1) is a potent vasoconstrictor and bronchoconstrictor but it has been shown to have also proinflammatory properties. Its ability to attract inflammatory cells in its site of production, upregulates the synthesis of adhesion molecules and stimulates the release of cytokines. The fact that cytokines have the ability to induce its synthesis and release, creates a dynamic loop for self-preservation and augmentation of the airway inflammation in Chronic Obstructive Pulmonary Disease (COPD), even after the ceasing of the noxious stimulus, i.e., cigarette smoke. Therefore, functional polymorphisms that may lead to increased levels of ET-1 may also cause an increased susceptibility to COPD development. MATERIALS AND METHODS: We analyzed the longitudinal effect on lung function of two ET-1 gene polymorphisms in a population of 190 smokers (95 non-COPD and 95 COPD smokers). The two polymorphisms involved an insertion polymorphism (+138 adenine insertion 3A/4A, 138bp downstream from the transcription start site, exon 1) and a single nucleotide transversion polymorphism on exon 5 (G/T, Lys198Asn). A total of 190 subjects were enrolled in the study for each polymorphism and were followed for 3 years by annual spirometry sessions. RESULTS: The adjusted annual decline of forced expiratory volume in 1 second (dFEV1) was greater for those having at least one copy of the mutated gene ins/delA compared to those with the wild type allele both in the non-COPD smokers group (mean difference in dFEV, of 19.4 ml/year, p = 0.004) and COPD smokers (mean difference in dFEV1 of 11.15 ml/year, p = 0.003). On the contrary, those heterozygous for the Lys198Asn polymorphism were found to have a slower decline in FEV1 compared to those homozygous for the wild type allele. The non-COPD smokers group had a gain-in-loss of 11,24 ml/year (p < 0.001) while the COPD-smokers group had a slower decline of 11.42 ml/year (p = 0.002). Those homozygous for the polymorphisms examined show an even greater deviation from those with the wild type allele but due to the small number comprising their group, the results don't have enough statistical power. Though, they still show the trend of the effect the polymorphisms have on annual FEV1 decline. CONCLUSIONS: The present data shows that ET-1 and its functional polymorphisms may be implicated in COPD phenotype and severity.
Asunto(s)
Endotelina-1/genética , Polimorfismo Genético , Enfermedad Pulmonar Obstructiva Crónica/genética , Fumar/efectos adversos , Adulto , Anciano , Alelos , Exones , Femenino , Estudios de Seguimiento , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Fenotipo , Proyectos Piloto , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Índice de Severidad de la Enfermedad , EspirometríaRESUMEN
Obstructive Sleep Apnea Syndrome (OSAS) is a recognized risk factor for cardiovascular disorders and in some cases is complicated with Pulmonary Arterial Hypertension (PAH), as the endothelium is affected. Recent studies provide strong evidence for endothelial dysfunction in obstructive sleep apnea. The resultant vasoconstriction, abnormal cell proliferation and hyper-coagulability may lead to the initiation or progression of atherosclerotic cardiovascular and cerebrovascular disorders, which are frequently encountered in OSA patients. While the currently available therapies for OSAS, such as Continuous Positive Airway Pressure therapy (CPAP therapy), improve endothelial dysfunction, they are not well-tolerated by patients. CPAP therapy can reduce nocturnal hypoxemias and decrease noradrenaline circulating levels, but does not affect ET-1 plasma levels. Potent and selective Endothelin-1 receptor antagonists have been developed and have shown promising results in the treatment of cardiovascular diseases such as pulmonary arterial hypertension, acute and chronic heart failure, hypertension, renal failure, and atherosclerosis. However, results are often contrasting and complicated because of the tissue-specific vasoconstrictor actions of Endothelin-B receptors and the fact that endothelin is an autocrine and paracrine factor whose activity is difficult to measure in vivo.
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Endotelina-1/antagonistas & inhibidores , Hipertensión Pulmonar/etiología , Apnea Obstructiva del Sueño/etiología , Presión de las Vías Aéreas Positiva Contínua , Endotelina-1/fisiología , Humanos , Hipertensión Pulmonar/metabolismo , Hipertensión Pulmonar/terapia , Receptores de Endotelina/química , Receptores de Endotelina/metabolismo , Apnea Obstructiva del Sueño/metabolismo , Apnea Obstructiva del Sueño/terapiaRESUMEN
Inhalation of metal dusts and fumes can induce a wide range of respiratory disorders, including granulomatosis, chemical pneumonitis and pulmonary interstitial disease. Laryngeal cancer is the most common cancer of the upper aerodigestive tract. We present a patient with occupational lung disease whose chest CT showed miliary nodular pattern, with concurrent laryngeal cancer who had been engaged in type printing for 22 years. Histology of the laryngeal lession showed squamous cell laryngeal cancer. Histology of the nodules showed a foreign body granulomatous response with several foreign body cells, most probably due to exposure to numerous inorganic (lanthanides, elements such us La, Ce, Nd, Sm, EU, Tb, Lu) and organic particles (such us acrylates, epoxy- and urethane-acrylates).
Asunto(s)
Neoplasias Laríngeas/patología , Enfermedades Pulmonares/patología , Enfermedades Profesionales/patología , Humanos , Neoplasias Laríngeas/complicaciones , Neoplasias Laríngeas/diagnóstico por imagen , Laringe/patología , Pulmón/química , Pulmón/patología , Enfermedades Pulmonares/complicaciones , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Metales/efectos adversos , Metales/análisis , Persona de Mediana Edad , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/diagnóstico por imagen , Compuestos Organometálicos/efectos adversos , Compuestos Organometálicos/análisis , Tomografía Computarizada por Rayos XRESUMEN
Baker's asthma, like other forms of occupational asthma is probably the most serious manifestation of occupational allergy among bakery workers. It is caused by immunologic sensitization and subsequent allergic reactions in the airways to occupational specific airborne allergens. Skin Prick Tests (SPTs) play an important role in the diagnosis of baker's asthma and epidemiological field studies on frequencies of sensitization to flour. This paper presents a review of the available literature on prevalence of flours sensitization in bakery workers. Atopy and level of exposure appears to be a very strong determinant for sensitization to flour allergens. Prevention strategies and standard setting are discussed.
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Alérgenos , Asma/epidemiología , Grano Comestible/inmunología , Harina , Enfermedades Profesionales/epidemiología , Asma/inmunología , Asma/prevención & control , Grano Comestible/efectos adversos , Harina/efectos adversos , Manipulación de Alimentos , Humanos , Enfermedades Profesionales/inmunología , Enfermedades Profesionales/prevención & control , Prevalencia , Pruebas Cutáneas , alfa-Amilasas/inmunologíaRESUMEN
BACKGROUND: Exercise is known to be a powerful stimulus for the endocrine system. The hormonal response to exercise is dependent on several factors including the intensity, duration, mode of exercise (endurance versus resistance), and training status of the subject. The aim of the present study was to determine the steroid hormonal response (immediately after a race and 1 week later) to endurance exercise under the real conditions of the classic Athens marathon in a group of well-trained, middle-aged, non-elite athletes. METHODS: Blood samples were drawn 1 week before the race, directly after completion of the race, and 1 week later. RESULTS: Serum cortisol and prolactin showed distinct rises 1 h after the race and returned to baseline 1 week later. Androstenedione and dehydroepiandrosterone sulphate did not show any changes. Total testosterone as well as free testosterone dropped significantly 1 h after the race but returned to baseline 1 week later. CONCLUSION: In this particular group of non-elite, middle-aged marathon runners, the race resulted in an acute increase in serum cortisol and prolactin levels and in a concomitant decline in testosterone level. The aforementioned changes returned to baseline 1 week later.
Asunto(s)
Hidrocortisona/sangre , Resistencia Física , Prolactina/sangre , Carrera , Testosterona/sangre , Adyuvantes Inmunológicos/sangre , Anciano , Androstenodiona/sangre , Biomarcadores/sangre , Deshidroepiandrosterona/sangre , Humanos , Hormona Luteinizante/sangre , Masculino , Persona de Mediana Edad , Deportes , Factores de TiempoRESUMEN
We report the case of a 23-year-old female patient, who was admitted to our hospital because of aggravating pain in the right shoulder, right chest and ear accompanied by cough and dyspnea. Imaging revealed a soft tissue mass in the mediastinum in close relation with an additional large mass extending in the right upper thorax, right axilla and neck. The tissue obtained during surgery showed the former mass to be a cystic thymoma, being in contact with an extensive vascular dysplasia. The characteristic clinical presentation, the contribution of imaging, the results of operation, and the follow-up are rather unique. The review of the literature did not reveal similar cases.
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Quiste Mediastínico/complicaciones , Quiste Mediastínico/patología , Timoma/complicaciones , Timoma/patología , Neoplasias del Timo/complicaciones , Neoplasias del Timo/patología , Enfermedades Vasculares/complicaciones , Enfermedades Vasculares/patología , Biopsia , Femenino , Humanos , Quiste Mediastínico/cirugía , Toracotomía , Timoma/cirugía , Neoplasias del Timo/cirugía , Tomografía Computarizada por Rayos X , Enfermedades Vasculares/cirugía , Adulto JovenRESUMEN
Clear decrements in lung function have been reported in patients with diabetes over the past two decades, and many reports have suggested plausible pathophysiological mechanisms. However, there are no reports of functional limitations of activities of daily living ascribable to pulmonary disease in patients with diabetes. This review attempts to summarize the available information from the present literature, to describe the nature of the lung dysfunction in diabetes and the emerging clinical implications of such dysfunction.
Asunto(s)
Complicaciones de la Diabetes/fisiopatología , Enfermedades Pulmonares/fisiopatología , Pulmón/fisiopatología , Animales , Volumen Espiratorio Forzado , Humanos , Estrés Oxidativo/fisiología , Alveolos Pulmonares/fisiopatología , Intercambio Gaseoso Pulmonar , Respiración , Espirometría , Capacidad VitalRESUMEN
Tuberculosis (TB) caused by the human pathogen Mycobacterium tuberculosis, is the leading cause of morbidity and mortality caused by infectious agents worldwide. Recently, there has been an ongoing concern about the clarification of the role of specific human genes and their polymorphisms involved in TB infection. In the vast majority of individuals, innate immune pathways and T-helper 1 (Th1) cell mediated immunity are activated resulting in the lysis of the bacterium. Firstly, PTPN22 R620W polymorphism is involved in the response to cases of infection. The Arg753Gln polymorphism in TLR-2 leads to a weaker response against the M. tuberculosis. The gene of the vitamin D receptor (VDR) has a few polymorphisms (BsmI, ApaI, Taq1, FokI) whose mixed genotypes alter the immune response. Solute carrier family 11 member (SLC11A1) is a proton/divalent cation antiporter that is more familiar by its former name NRAMP1 (natural resistance associated macrophage protein 1) and can affect M. tuberculosis growth. Polymorphisms of cytokines such as IL-10, IL-6, IFN-g, TNF-a, TGF-b1 can affect the immune response in various ways. Finally, a major role is played by M. tuberculosis antigens and the Ras-associated small GTP-ase 33A. As far as we know this is the first review that collates all these polymorphisms in order to give a comprehensive image of the field, which is currently evolving.
Asunto(s)
Tuberculosis/genética , Tuberculosis/inmunología , Predisposición Genética a la Enfermedad , Humanos , Tuberculosis/terapiaRESUMEN
Tonsillitis is a common disease especially of children and young adults. The diagnosis of tonsillitis generally requires the consideration of Group A beta-hemolytic streptococci infection. Pneumonia is an inflammation of the alveoli and terminal airspaces in response to invasion by an infectious agent that is introduced into the lungs through hematogenous spread or inhalation. We present a case of a concurrent acute tonsillitis and pneumonia due to S. pyogenes. To our knowledge, a similar case has not been previously described in the literature.