-
Revista Clínica Española 05/1999; 199(4):255. · 2.01 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The most frequent chest X-ray finding of descending thoracic aortic aneurysm is an enlargement of medial mediastinum. Haemoptysis caused by thoracic aortic aneurysm is rare and, normally, when it occurs, it is due to an aorto-bronchopulmonary fistula. We report the case of an 88 year-old male, heavy smoker with arterial hypertension, who had been operated on for abdominal aneurysm five years before, whose unique symptom was scant haemoptysis and radiologically presented a cavity mass in the upper left lobe. Autopsy revealed that the pulmonary cavity mass was due to a descending thoracic aortic aneurysm.
The Journal of cardiovascular surgery 05/1999; 40(2):281-3. · 1.56 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In patients with COPD, a relationship between breathlessness and respiratory effort, assessed in terms of mouth occlusion pressure (P0.1), has been described. To evaluate the short-term effects of inhaled terbutaline on breathlessness, breathing pattern, and P0.1 in patients with nonreversible COPD, we designed a randomized, double-blind, parallel, placebo-controlled study. Twenty-five patients with stable nonreversible COPD, mean age 64 +/- 11 years, were enrolled in the study. Patients received 500 micrograms inhaled terbutaline or placebo. Breathlessness, using the Borg scale, breathing pattern, and P0.1 were measured at baseline and 30 min after inhalation. Terbutaline resulted in a significant decrease in Borg scale, while no differences were observed after placebo. No significant changes in breathing pattern were found. Nevertheless, a decrease in P0.1 (0.31 +/- 0.07 vs 0.21 +/- 0.05 kPa; p < 0.001) after terbutaline inhalation was observed. Borg score was correlated with P0.1 in all patients. Moreover, changes in Borg score after medication were directly proportional to P0.1 changes (r = 0.85; p < 0.01). We conclude that terbutaline decreases central inspiratory drive and improves breathlessness in patients with nonreversible COPD.
Chest 10/1996; 110(3):637-41. · 5.25 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine if the perception of dyspnea during normal pregnancy may be related to an inappropriate ventilatory response to the increased metabolic rate, due to a higher chemosensitivity.
At weeks 12, 24, and 36 of gestation and 4 months after delivery, 11 healthy pregnant women with dyspnea and 12 asymptomatic pregnant women were studied. Progesterone plasma levels, lung volumes, diffusion capacity, maximal respiratory pressures, rest oxygen uptake, breathing pattern, and mouth occlusion pressure (P0.1) were measured. Progressive isocapnic hypoxic stimulation and progressive hyperoxic hypercapnic stimulation were performed.
Oxygen ventilation equivalent during pregnancy was significantly higher for the dyspneic group than for nondyspneic pregnant women. Dyspneic patients exhibited greater minute ventilation, tidal volume, and P0.1 than the nondyspneic group. The mean values of ventilatory and P0.1 slopes to hypoxia and CO2 during pregnancy were significantly greater in the patients with dyspnea than in asymptomatic subjects. These changes were not due to differences in progesterone plasma levels. A significant relation among the Borg score, inspiratory drive, and chemosensitivity was found.
In some pregnant women, a higher sensitivity to CO2 and hypoxia may induce excessive ventilation to metabolic demand, which would contribute to dyspnea.
Chest 09/1996; 110(2):446-53. · 5.25 Impact Factor
-
JNCI Journal of the National Cancer Institute 04/1996; 88(5):303. · 13.76 Impact Factor
-
Chest 01/1996; 110(3):637-641. · 5.25 Impact Factor
-
Revista Clínica Española 03/1995; 195(2):109-14. · 2.01 Impact Factor
-
Revista Clínica Española 01/1995; 194(12):1060-1. · 2.01 Impact Factor
-
Revista Clínica Española 10/1994; 194(9):731. · 2.01 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Bronchiolitis obliterans organizing pneumonia is the most serious disease of the bronchioli. An idiopathic form of the disease important for differential diagnosis in incipient forms of pulmonary fibrosis has been reported in the literature, along with other forms associated to drug use, infections, and collagen and localized diseases. We describe 3 patients with bronchiolitis obliterans organizing pneumonia, one associated with rheumatoid arthritis and consumption of gold salts, one with HIV infection and one localized form associated with pulmonary hydatidosis.
Archivos de Bronconeumología 06/1994; 30(5):263-5. · 2.17 Impact Factor
-
Medicina Clínica 05/1994; 102(14):556-7. · 1.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Tuberculosis (TB) is a disease caused by a mycobacterium, whose incidence has increased in the past years. This increase is related to the adquired immunodeficiency syndrome (AIDS). Due to its high prevalence, Spain is considered a developing country. The tuberculous infection depends on the degree of functionality of the alveolar macrophages that stimulate the lymphocytes and isolate the bacillus. The infection by mycobacterias can be quantified by means of the cutaneous reaction against tuberculin and mantoux, allowing us to select the subjects that must receive prophylaxis. For its correct interpretation, it is currently recommended to avoid BCG vaccination of children, except in countries with high prevalence of TB.
Anales de medicina interna (Madrid, Spain: 1984) 05/1993; 10(4):188-94.
-
Anales de medicina interna (Madrid, Spain: 1984) 03/1993; 10(2):86-90.
-
[show abstract]
[hide abstract]
ABSTRACT: Our goal was to assess the usefulness of spirometry to estimate the risk of pneumothorax in patients undergoing percutaneous needle biopsy with CT guidance for solitary pulmonary nodule (SPN).
We studied the results of 51 consecutive percutaneous needle biopsies with CT guidance for SPN obtained between 1988 and 1990. Forty-five men and six women, aged 65 +/- 11 (36-86) years, were included in the study. All biopsies were performed under CT guidance, with 90 mm 25G needles (0.5 mm thickness) fitted into luer-type syringes. The number of needle pass attempts never exceeded three. A spirometry before biopsy was performed in all patients.
Pneumothorax occurred in only 10 cases (19%). The patients with pneumothorax showed lower lesion size, forced vital capacity (FVC), forced expiratory volume (FEV1), and FEV1/FVC ratio. The contribution of these factors to pneumothorax was analyzed by a logistic regression model. The FEV1 was most strongly associated with the incidence of pneumothorax. We developed an equation for predicting the risk of this complication.
We conclude that decreasing FEV1 is associated with a higher pneumothorax rate.
Journal of Computer Assisted Tomography 20(1):20-3. · 1.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Lung cancer is the leading cause of death from cancer. Tobacco is related to the development of this type of tumor due to genetic alterations and to the secretion of certain biological markers. Bronchogenic carcinomas secrete a series of biological substances known as tumor markers. Some of these markers, such as carcinoembryonic antigen, neuron-specific enolase, tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and CYFRA 21.1, possess clear clinical value when analyzed in bronchoalveolar lavage (BAL) of patients with lung malignancies, particularly when they are analyzed in the two BAL fractions, bronchial (BF) and alveolar (AF), being more increased in the BF. For this reason, we intend to demonstrate that smokers with cancer secrete more biological substances in the BF and that the concentrations of these markers are higher in the BAL of smokers than in that of non-smokers.
The five aforementioned tumor markers were studied in the two BAL fractions of 52 lung cancer patients (46 smokers and 6 non-smokers). We performed BAL using 150 ml of 0.9% saline solution divided in three aliquots of 50 ml. The fluid obtained from the first 50 ml was the BF. The liquid from the other two aliquots was the AF. The five tumor marker concentrations were calculated in accord with the indications of the laboratory.
The TPA and TPS levels in the BAL of lung cancer patients were more increased in the BF than in the AF, even when the patients were divided into smokers and non-smokers. When we compared smokers with non-smokers, the smokers had higher levels of TPS in the BF and of TPA in the AF.
Thus, we believe that the cellular alterations produced by tobacco are responsible for the secretion of these tumor markers.
Tumori 85(6):454-7. · 0.86 Impact Factor
