No abstract

Blood collected from the bronchial veins of a heart-lung-bronchial preparation consists of two components: (a) fraction from the bronchial arteries, and (b) pulmonary to bronchial shunt It is estimated that the latter is more than half of total bronchial venous flow. The pulmonary to bronchial shunt is reduced by procedures which increase pulmonary arterial pressure. An intrinsic nervous reflex mechanism is suggested to explain such a response, particularly because the bronchial veins are more sensitive than the bronchial arteries to the vasoconstrictor action of epinephrine and norepinephirine, and to the vasodilator action of isoproterenol. acetylchohine, histamine, and DMPP. Alterations in bronchial venous flow induced by such chemical agents are independent of bronchoconstriction or bronchodilatation.

Hodgkin's disease (HD) is a curable tumoral disease. However, there are groups of patients who suffer relapse and the identification of prognostic factors and the adaptation of treatments to individual risk is one the lines of investigation in this disease. A study was performed on 526 patients diagnosed of HD in our hospital between January 1967 and September 2001. An analysis was made of the most important variables in terms of both disease-free and overall survival. Overall survival in this series of patients was 94% at 2 years, 86% at 5 years, 76% at 10 years and 72% at 15 years. Median survival was 249 months. Factors influencing poor prognosis in the overall survival were: male gender (P < 0.0001), lymphocyte depletion (P < 0.0001), stages III and IV (P < 0.0001), B symptoms (P < 0.0001), spleen involvement at diagnosis (P = 0.003), no complete remission after first line treatment (P < 0.0001), and more than 30 years-of-age (P < 0.0001). Disease free survival was 83% at 2 years and 68% at 5 years although without reaching the mean follow-up. The disease free survival study revealed the following risk factors: male gender (P = 0.02), lymphocyte depletion (P < 0.0001), stages III and IV (P < 0.001), B symptoms (P < 0.001), extranodal or splenic involvement (P < 0.05), and no complete remission after first line treatment (P < 0.0001). The result of treatment optimization is that some factors that were considered to indicate a poor prognosis have disappeared, and that others which are useful have appeared and allow us to establish groups with differing risks of relapse and who could be candidates for differentiated treatments.

El consumo global de fármacos en los ancianos en los países industrializados se caracteriza por dos hechos básicos; de un lado el marcado incremento, en cuanto a cantidad, evidenciado a lo largo de las ultimas décadas, situándose la media en 4,2-8 fármacos/persona/día (1-3), y de otro lado el tipo de fármacos, no todos están indicados para sus patologías, estimándose que el 97% de los ancianos que viven en residencia y el 61% de los que viven en domicilio (4) consumen un fármaco inapropiado o inadecuado. Teniendo en cuenta que el número total de fármacos que consume una persona es el principal factor asociado a la aparición de Efectos Adversos por Fármacos (EAF), estimar cuantos son innecesarios e inadecuados y los factores que se asocian al consumo de los mismos es el primer paso para conseguir una adecuada prescripción, y para disminuir los EAF que en la actualidad suponen entre un 7,2-14% (5,6) de ingresos de ancianos en los Servicios de Medicina Interna en España. El objetivo del presente estudio es establecer el porcentaje de ancianos que consumen este tipo de fármacos entre los que ingresan en un Servicio de Medicina Interna y la importancia