Search

Smoking and depression are related. Bupropion, the first non-nicotinic drug that is an effective treatment in smoking cessation, is a tricyclic antidepressant that inhibits neuronal uptake of serotonin, dopamine and norepinephrine in the thalamic nuclei.To assess if certain personality factors (anxiety or depression) might predict the efficacy of bupropion for smoking cessation.The study was carried out in two smoking cessation clinics in Madrid and Barcelona. Fifty patients (21 men) declaring the desire to quit smoking were enrolled. Their mean age was 43.6 years (SD 8.75). The patients were treated with 300 mg of bupropion per day for one month and expired CO was monitored for 6 months. Personality factors were assessed on a hospital anxiety and depression scale (HADS). We evaluated whether there was a significant difference in HADS scores for patients who were still not smoking after 6 months and those who had not managed to quit.The 50 patients were smokers of a mean 39 packs per year (SD 17.82) and had mean scores of 7.4 (SD 4.15) for anxiety and 5.8 (SD 3.93) for depression. Four patients (8%) were unable to complete the study. After one month, 28% of the patients smoked, after 3 months 56% smoked and after 6 months 58% still smoked. The patients who smoked during the first month had higher depression scores than did the non-smokers (p = 0.03). After 3 and 6 months the patients who had managed to continue not smoking were those who had higher anxiety scores than did those who still smoked (p = 0.0052 at 3 months and p = 0.017 at 6 months).Patients who responded better to treatment with bupropion after 6 months of follow-up were those with higher anxiety scores on the HADS. Depression levels influenced outcome only during the first month.

Se presentan tres casos de proteinosis alveolar (PA), enfermedad pulmonar infrecuente cuya etiopatogenia permanece aun sin aclarar y que se caracteriza por el deposito en los espacios aereos pulmonares de una sustancia lipidoproteica semejante al surfactante pulmonar. Se senala que si bien la clinica y la radiologia no son caracteristicas, deben hacernos sospechar que se trate de esta entidad. La fibrobroncoscopia es una tecnica auxiliar importante mediante la cual podemos realizar lavados brocoalveolares y biopsia transbronquial, permitiendonos en algunos casos obviar la necesidad de llegar a la biopsia pulmonar abierta para establecer el diagnostico de certeza. El lavado broncopulmonar es en la actualidad el tratamiento de mayor validez para la PA; sin embargo, es una tecnica compleja no exenta de riesgos, lo que unido a que mas de la mitad de los casos de esta enfermedad no cursan con gravedad, hace que haya que valorar adecuadamente la indicacion del mismo para cada caso en particular.

Resumen Se estudiaron 31 enfermos con bronconeumopatia obstructiva cronica, separados tipologicamente segun sus caracteristicas clinicas, desde un punto de vista funcional en busca de los criterios con mayor capacidad diferencial. Los Grupos A («enfisema») y B («bronquitis cronica») mantuvieron un comportamiento funcional claramente distinto. Los indices estaticos de elasticidad utilizados (compliance estatica, resorte elastico e indice de retraccion) y en menor cuantia los gases arteriales, fueron los parametros mas utiles en esta diferenciacion. Los pacientes con caracteristicas clinicas mezcla de los anteriores (Grupo C ) no solo se diferenciaron de forma mas pobre sino que mostraron un comportamiento menos coherente que pudiera achacarse a los criterios empleados para su seleccion.

Resumen Se revisa la rentabilidad diagnostica de la broncoscopia y broncografia en una serie de 196 enfermos de Hidatidosis Pulmonar. Se clasificaron los enfermos en dos grupos: Hidatidosis Pulmonar integra, 125 casos, e Hidatidosis Pulmonar complicada, 71 casos. Las exploraciones broncologicas no fueron diagnosticas cuando el quiste hidatidico estaba integro. La broncoscopia fue diagnostica de Hidatidosis Pulmonar complicada en 14 de 44 enfermos, 32%. El broncoscopio flexible permitio la visualizacion