Background : Exercise-induced bronchoconstriction (EIB) is a prevalent condition that is frequently underdiagnosed and affects athletic performance, even in subjects without a previous diagnosis of asthma. We hypothesized that the Cooper test could be useful for the routine detection of EIB in the school-age population. Methods : Observational study that included students aged 11-17 who attend a private school in Lavallol, Buenos Aires. The Cooper test was performed in an outdoor setting, and spirometry was performed in each subject before and 10-30 minutes after running. EIB was diagnosed if there was a fall in FEV 1 ≥ 10% from the pre-exercise level. Results : 176 subjects were able to perform a spirometric maneuver and completed the Cooper test, and were included in the analysis. Of these, 45 (25.5%) met EIB criteria. Significant differences were found between the two groups for the presence of a previous diagnosis of asthma (5 vs 3, P=0.014), with a prevalence of EIB in asthmatic patients of 62.5%. No significant differences were found for the remaining variables (Table 1). Conclusions : The Cooper test was able to detect EIB in a significant number of asymptomatic students. Most of the subjects did not have a known diagnosis of asthma. This test could be useful for the routine detection of EIB in schools.
Abstract A Patient with Autoimmune Hepatitis and Interstitial Lung Disease Autoimmune diseases can compromise the lung, for example the connective tissue di...
Background: The distance walked in a 6-minute walk test (6MWT) predicts mortality in severe Chronic Obstructive Pulmonary Disease (COPD). Little is known ab...
Pulmonary Alveolar Proteinosis: Up to Date Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by the accumulation of surfactant lipids and protein in the alveolar spaces, resulting in impairment in gas exchange. The clinical course can be variable, ranging from spontaneous resolution to respiratory failure and death. There are three forms of PAP: congenital, acquired and idiopathic, being the latter the most prevalent form in the adult population. Advances in the understanding of the pathophysiology of PAP demonstrate that the idiopathic form is due to antigranulocyte macrophage-colony stimulating factor (GM-CSF) antibodies. All the forms of PAP cause macrophage dysfunction leading to accumulation of the proteinaceous material. PAP is characterized by progressive exertional dyspnea and nonproductive cough with hypoxemia. Bilateral infiltrates are typically present on chest radiograph; high-resolution computed tomography reveals diffuse ground-glass opacities and airspace consolidation with interlobular septal thickening in a characteristic “crazy paving”
Background: Interstitial lung disease (ILD), is the main cause of mortality in Idiopathic inflammatory myopathy (IIM). Epidemiological, prognostic and treatment information are scarce. The goal was to characterize a cohort of IIM patients and compare response to immunosuppression (IS) among different types of IIM. Methods: Observational, multi-centric study in 30 centers from Argentina and Uruguay. Outcomes: Response to IS was defined as worsening: decline FVC >10%; improvement: increase FVC >10%; stability: changes FVC <10% at 6-12 months; Fisher test was used and OR was calculated by using contingency tables to assess the association of categorical variables. Results: We studied 56 patients with IIM; mean age 51 years; 77% women. 64% patients had anti-synthetase syndrome (ASS), and 36% had demarto/polymyositis. Mean FVC at baseline was 65 % and mean DLCO 55%. Tomographic patterns were nonspecific interstitial pneumonia (NSIP) in 46%, organizing pneumonia (OP) in 12%, overlap NSIP/OP in 17%. Only 55% had positive ANA. From ANA negative patients, 54% had at least one Anti-tRNA-synthetase antibody. Glucocorticoid (GC) were used in 95% of patients. 30% received GC pulses. Other IS drugs were cyclophosphamide, mycophenolate and azathioprine. For the overall cohort the outcomes were: stability 62%, improvement 32% and worsening 6% at 6-12 months. When analyzing response to IS, ASS had a better treatment response than other forms of IIM (OR 1.97 [95%CI 1.06-3.34]; p=0.03) for stability or improvement. Conclusions: ASS related ILD had a better treatment response than other forms of IIM in our cohort. ANA is often negative.
Introduction: In spite of its limited efficacy, cyclophosphamide (CYC) is frequently used to treat scleroderma-associated interstitial lung disease (SSc-IL...