Carolina Salim Gonçalves Freitas

Pulmonary rehabilitation in lymphangioleiomyomatosis: a controlled clinical trial

Lymphangioleiomyomatosis (LAM) is a cystic lung disease frequently associated with reduced exercise capacity. The aim of this study was to assess safety and efficacy of pulmonary rehabilitation in LAM. This controlled clinical trial included 40 patients with LAM and a low physical activity level. The pulmonary rehabilitation programme comprised 24 aerobic and muscle strength training sessions and education. The primary outcome was exercise capacity (endurance time during a constant work rate exercise test). Secondary outcomes included health-related quality of life (St Georges Respiratory Questionnaire (SGRQ)), 6-min walking distance (6MWD), dyspnoea, peak oxygen consumption (V′O2), daily physical activity (pedometer), symptoms of anxiety and depression, lung function and peripheral muscle strength (one-repetition maximum). The baseline characteristics were well balanced between the groups. The pulmonary rehabilitation group exhibited improvements in the following outcomes versus controls: endurance time (median (interquartile range) 169 (2–303) s versus −33 (−129–39) s; p=0.001), SGRQ (median (interquartile range) −8 (−16–2) versus 2 (−4–5); p=0.002) and 6MWD (median (interquartile range) 59 (13–81) m versus 20 (−12–30) m; p=0.002). Dyspnoea, peak V′O2, daily physical activity and muscle strength also improved significantly. No serious adverse events were observed. Pulmonary rehabilitation is a safe intervention and improves exercise capacity, dyspnoea, daily physical activity, quality of life and muscle strength in LAM. Evaluation of a pulmonary rehabilitation programme in lymphangioleiomyomatosis demonstrates safety and efficacy http://ow.ly/Xmofp

Association of Pulmonary Cysts and Nodules in a Young Female Patient

A 27-year-old female patient was referred to our outpatient clinic with a 1-year history of shortness of breath when walking fast on level ground or when climbing stairs. Symptoms worsened after a second episode of spontaneous left pneumothorax, when a chest tube was placed in another hospital for complete lung expansion. During this hospitalization, an open lung biopsy was performed. There was no history of rhinorrhea, nasal congestion, cough, hemoptysis, wheezing, or expectoration.