Fibrosis pulmonar familiar en 2 hermanas mexicanas con síndrome de Hermansky-Pudlak

[The clinical view through the Archives: the clinical notes of 2009]

The Clinical Notes published in 2009 serve as a resource to reflect on clinical aspects relevant to different clinical entities. Through this review an attempt is likewise made to bring the reader closer to the clinical reality of our environment.

[Journal of the year 2009 in interventionist pneumology, interstitial diseases and transplant]

Endobronchial ultrasound bronchoscopy has been one of the most important contributions to the minimally invasive diagnosis and staging of mediastinal disease in the last few years. Two original works with linear and radial endobronchial ultrasound bronchoscopy published in the Archivos de Bronconeumología are analysed. In pleural pathology, we have selected a multicentre study one the usefulness of an outpatient tunnelised pleural drainage in 63 patients with malignant neoplastic effusions. This technique was indicated in 20% when pleurodesis failed or was not indicated, and an overall symptomatic improvement was achieved in 95% of cases. In interstitial diseases, we highlight the article on the usefulness of BAL in the initial diagnosis of these diseases in a series of 562 patients studied over 14 years. The authors highlight the minimal invasiveness of the technique and its value which, when added to the radiological and clinical findings, enables these diseases to be managed without surgical biopsy in around 90% of cases. Finally, we highlight the works on lung transplant which analysed the value of interleukin-8 by BAL in the donor lung to detect sub-clinical involvement that could lead to a primary dysfunction of the lung graft, the risk factors associated to mortality in 92 lung transplant receivers due to emphysema and, lastly, the experience of the transplant in 15 patients with pulmonary arterial hypertension in an advanced functional class, with a peri-operative survival at 5 years of 40%.