Introduction. Malnutrition is underdiagnosed in chronic obstructive pulmonary disease. Objectives. This study aimed to evaluate the nutritional status of COPD patients and the link between dyspnea and nutritional status. Methods. This longitudinal observational study included patients hospitalized with exacerbated COPD. Nutritional status was assessed using Nutrition Risk Screening 2002, anthropometric, and biochemical assessments, in the first 48 hours of hospitalization. Results. Thirty patients were evaluated. According to the Nutrition Risk Screening 2002, half of the patients were at increased risk of malnutrition. 36.7% were classified as malnourished if we only considered the body mass index. From the evaluation of the tricipital skin fold, 69.0% were classified as malnourished, with 48.3% having severe malnutrition. According to the serum albumin level, 29.6% had malnutrition criteria. A significant association between dyspnea and increasing age (
p
=
0.037
) was found. There was a strong association between the fold classification and the degrees of severity of dyspnea (Fisher exact test: 13.60,
p
=
0.001
, V Cramer = 0.826). Most patients were malnourished and had higher grades of dyspnea. Tricipital skinfold reflects subcutaneous adipose tissue; this anthropometric measurement seems to be a good method to classify the nutritional status of COPD patients. It classified the biggest portion of patients as malnourished. Conclusion. The number of patients classified as malnourished changed with the method under analysis. The tricipital skin fold parameter was strongly associated with the dyspnea score. Most patients had adipose tissue and muscular mass depletion.
To the Editor, Interstitial lung abnormalities (ILAs) are a radiological entity characterized by incidental findings in chest computed tomography (CT) scans, with specific patterns of modifications in lung density in patients with no prior history of interstitial lung disease. These radiologic changes are present in more than 5% of nondependent lung parenchyma areas. And they include reticular abnormalities or groundglass attenuation, lung distortion, traction bronchiectasis/bronchiolectasis, honeycombing, and nonemphysematous cysts. 1,2 In some cases, ILA may represent an early form of pulmonary fibrosis. [1][2][3] ILA affects about 7% of the general population. The prevalence varies with age and with smoking habits, being more prevalent in older and smoker individuals. 1,3,4 These patients present more respiratory symptoms and changes in respiratory function tests, particularly with a decrease in forced vital capacity. [5][6][7] This entity seems related to raised proinflammatory molecules that lead to radiological changes. 4 This radiological concept has clinical implica-
The authors present the case of a 36-year-old woman with disseminated tuberculosis shown by pulmonary nodules and urogenital involvement. Positive cultures for Mycobacterium tuberculosis in urine and bronchial secretions made the diagnosis. After three months of multidrug treatment, there was a clinical and radiologic improvement. This case highlights an uncommon case of an immunocompetent patient with disseminated tuberculosis. A delay in the diagnosis of pulmonary tuberculosis can result in serious public health problems with disease spread.
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