Journal of bronchology & interventional pulmonology, Apr 1, 2009
Endobronchial tuberculosis is a rare occurrence in the developed countries. The diagnosis is ofte... more Endobronchial tuberculosis is a rare occurrence in the developed countries. The diagnosis is often delayed due to its nonspecific presentation and paucity of radiographic findings. The condition is often misdiagnosed as either bronchial asthma or lung cancer. The delay in the diagnosis often leads to airway stenosis and requires therapeutic bronchoscopy. Here we present 2 cases of endobronchial tuberculosis to illustrate our point.
To analyse the effectiveness and safety of the indwelling pleural catheter in the management of r... more To analyse the effectiveness and safety of the indwelling pleural catheter in the management of recurrent malignant pleural effusion. A prospective multicentre study was performed in 63 consecutive outpatients from four Spanish hospitals. A total of 43 men and 20 women were included, with a median age of 67 years. In seven of the cases treatment with pleurodesis had failed; in five other cases their lung was trapped; in another five cases after repeat therapeutic thoracocentesis, and the rest of them as a preference choice to pleurodesis. All patients had an indwelling pleural catheter inserted (PleurX), Denver Biomedical). Most of patients (94.5%) reported an improvement in their respiratory symptoms (cough and dyspnoea) and their ability to function independently. Average length of the catheterisation was 45 days (6-222). Average amount of drained pleural effusion was 75ml, with a frequency of drainage of between 3 and 4 times per week and once fortnightly. Spontaneous pleurodesis was achieved following 34.9% of procedures. No complications occurred during the insertion of the catheter. The post-catheterisation complications were empyema (3 cases), chest pain (2 cases), and tumour metastasis (3 cases). The use of an indwelling pleural catheter is an effective palliative treatment in the outpatient management for patients suffering malignant pleural effusion. It is also a simple treatment that can be easily applied, does not require hospitalisation and can be easily managed by the patient at home, with a low rate of complications.
In recent years, non-small cell lung cancer treatment has been revolutionized. EGFR tyrosine kina... more In recent years, non-small cell lung cancer treatment has been revolutionized. EGFR tyrosine kinase inhibitors and our improved understanding of its alterations have driven new diagnostic strategies. Liquid biopsies have emerged as a useful tool in these contexts, showing potential utility in early diagnosis combined with low-dose CT scans, as well as potential in monitoring treatment response and predicting the development of patients. We studied the circulating tumor DNA (ctDNA) of 38 EGFR-mutated non-small cell lung cancer patients at diagnosis in different moments of their disease by liquid biopsy techniques. Our results show that mean overall survival was significantly lower when a liquid biopsy was positive for the detection of EGFR mutations compared with wild-type patients in their liquid biopsy in both univariate (29 ± 4 vs. 104 ± 19 months; p = 0.004) and multivariate analysis (p = 0.008). Taking this into consideration, liquid biopsies could be key to improving the contro...
IntroductionAfter severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia, patient... more IntroductionAfter severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia, patients may show lung sequelae on radiology and functional impairment at the 1‐year follow‐up. We aimed to describe the persistence of symptoms, radiological alterations, or reduced diffusing capacity of the lung for carbon monoxide (DLCO) at 1‐year follow‐up in patients from the Spanish Registry RECOVID.MethodsRECOVID collected symptom and radiological and functional lung tests data on hospitalized patients with coronavirus disease 2019 during the acute phase and at the 6‐ and 12‐month follow‐up visits.ResultsOf the 2500 enrolled survivors (90% admitted to the ward), 1874 had follow‐up visits for up to a year. Of these, 42% continued to present with symptoms, 27% had radiological sequelae and 31% had reduced DLCO. Independently associated factors included female sex, asthma and the requirement for invasive or non‐invasive mechanical ventilation. Complete radiological resolution was 72.2% at 1...
Study objective: Malignant pleural effusion (MPE) is a common complication of some advanced malig... more Study objective: Malignant pleural effusion (MPE) is a common complication of some advanced malignancies with an important negative impact on symptoms and quality of life (QoL). Indwelling pleural catheter (IPC) is useful for controlling symptoms due to relapsed MPE. There are scarce data about its impact on QoL in patients with advanced malignancies. We aimed to assess the QoL along time in patients with diagnosis of recurrent MPE and IPC. Design and methods: A prospective multicentric observational study was performed in five university hospitals in Spain from September 2010 to September 2011. Patients included must have a histological-confirmed advanced malignancy and a diagnosis of MPE. QoL was assessed by the scale of the EORTC QLQ30. Three timing cut-off points were considered: previous insertion of pleural catheter (baseline), at 30 days and at 60 days after insertion. Results: 52 patients with MPE (median age 66 years; 30 male) were included. Most frequent symptoms at study ...
Since the publication of the National Emphysema Treatment Trial study, lung volume reduction (LVR... more Since the publication of the National Emphysema Treatment Trial study, lung volume reduction (LVR) has been considered a therapeutic alternative for patients with advanced obstructive lung disease. The high complication rate of surgical LVR has led to the development of bronchoscopic LVR (BLVR). Of the currently available BLVR alternatives, coils and unidirectional endobronchial valves lead the list. The choice of each device depends on emphysema characteristics and presence of collateral ventilation. Evaluation of these patients at centers with expertise in interventional pulmonology and management of BLVR is strongly recommended.
Journal of bronchology & interventional pulmonology, Apr 1, 2009
Endobronchial tuberculosis is a rare occurrence in the developed countries. The diagnosis is ofte... more Endobronchial tuberculosis is a rare occurrence in the developed countries. The diagnosis is often delayed due to its nonspecific presentation and paucity of radiographic findings. The condition is often misdiagnosed as either bronchial asthma or lung cancer. The delay in the diagnosis often leads to airway stenosis and requires therapeutic bronchoscopy. Here we present 2 cases of endobronchial tuberculosis to illustrate our point.
To analyse the effectiveness and safety of the indwelling pleural catheter in the management of r... more To analyse the effectiveness and safety of the indwelling pleural catheter in the management of recurrent malignant pleural effusion. A prospective multicentre study was performed in 63 consecutive outpatients from four Spanish hospitals. A total of 43 men and 20 women were included, with a median age of 67 years. In seven of the cases treatment with pleurodesis had failed; in five other cases their lung was trapped; in another five cases after repeat therapeutic thoracocentesis, and the rest of them as a preference choice to pleurodesis. All patients had an indwelling pleural catheter inserted (PleurX), Denver Biomedical). Most of patients (94.5%) reported an improvement in their respiratory symptoms (cough and dyspnoea) and their ability to function independently. Average length of the catheterisation was 45 days (6-222). Average amount of drained pleural effusion was 75ml, with a frequency of drainage of between 3 and 4 times per week and once fortnightly. Spontaneous pleurodesis was achieved following 34.9% of procedures. No complications occurred during the insertion of the catheter. The post-catheterisation complications were empyema (3 cases), chest pain (2 cases), and tumour metastasis (3 cases). The use of an indwelling pleural catheter is an effective palliative treatment in the outpatient management for patients suffering malignant pleural effusion. It is also a simple treatment that can be easily applied, does not require hospitalisation and can be easily managed by the patient at home, with a low rate of complications.
In recent years, non-small cell lung cancer treatment has been revolutionized. EGFR tyrosine kina... more In recent years, non-small cell lung cancer treatment has been revolutionized. EGFR tyrosine kinase inhibitors and our improved understanding of its alterations have driven new diagnostic strategies. Liquid biopsies have emerged as a useful tool in these contexts, showing potential utility in early diagnosis combined with low-dose CT scans, as well as potential in monitoring treatment response and predicting the development of patients. We studied the circulating tumor DNA (ctDNA) of 38 EGFR-mutated non-small cell lung cancer patients at diagnosis in different moments of their disease by liquid biopsy techniques. Our results show that mean overall survival was significantly lower when a liquid biopsy was positive for the detection of EGFR mutations compared with wild-type patients in their liquid biopsy in both univariate (29 ± 4 vs. 104 ± 19 months; p = 0.004) and multivariate analysis (p = 0.008). Taking this into consideration, liquid biopsies could be key to improving the contro...
IntroductionAfter severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia, patient... more IntroductionAfter severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pneumonia, patients may show lung sequelae on radiology and functional impairment at the 1‐year follow‐up. We aimed to describe the persistence of symptoms, radiological alterations, or reduced diffusing capacity of the lung for carbon monoxide (DLCO) at 1‐year follow‐up in patients from the Spanish Registry RECOVID.MethodsRECOVID collected symptom and radiological and functional lung tests data on hospitalized patients with coronavirus disease 2019 during the acute phase and at the 6‐ and 12‐month follow‐up visits.ResultsOf the 2500 enrolled survivors (90% admitted to the ward), 1874 had follow‐up visits for up to a year. Of these, 42% continued to present with symptoms, 27% had radiological sequelae and 31% had reduced DLCO. Independently associated factors included female sex, asthma and the requirement for invasive or non‐invasive mechanical ventilation. Complete radiological resolution was 72.2% at 1...
Study objective: Malignant pleural effusion (MPE) is a common complication of some advanced malig... more Study objective: Malignant pleural effusion (MPE) is a common complication of some advanced malignancies with an important negative impact on symptoms and quality of life (QoL). Indwelling pleural catheter (IPC) is useful for controlling symptoms due to relapsed MPE. There are scarce data about its impact on QoL in patients with advanced malignancies. We aimed to assess the QoL along time in patients with diagnosis of recurrent MPE and IPC. Design and methods: A prospective multicentric observational study was performed in five university hospitals in Spain from September 2010 to September 2011. Patients included must have a histological-confirmed advanced malignancy and a diagnosis of MPE. QoL was assessed by the scale of the EORTC QLQ30. Three timing cut-off points were considered: previous insertion of pleural catheter (baseline), at 30 days and at 60 days after insertion. Results: 52 patients with MPE (median age 66 years; 30 male) were included. Most frequent symptoms at study ...
Since the publication of the National Emphysema Treatment Trial study, lung volume reduction (LVR... more Since the publication of the National Emphysema Treatment Trial study, lung volume reduction (LVR) has been considered a therapeutic alternative for patients with advanced obstructive lung disease. The high complication rate of surgical LVR has led to the development of bronchoscopic LVR (BLVR). Of the currently available BLVR alternatives, coils and unidirectional endobronchial valves lead the list. The choice of each device depends on emphysema characteristics and presence of collateral ventilation. Evaluation of these patients at centers with expertise in interventional pulmonology and management of BLVR is strongly recommended.
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