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Biomedical subjects

A J Roncoroni

Publications and source records attributed to A J Roncoroni.

At least 55 records · Page 3Linked to original sources
PubMed1993

Bilateral carotid body paraganglioma and central alveolar hypoventilation.

A 62-year-old woman with a bilateral carotid body paraganglioma presented, 2 years after the removal of the right one, with signs of right-heart failure. Hypoxemia, hypercapnia, polycythemia and pulmonary hypertension with normal ventilatory capacity were found. Central alveolar hypoventilation was diagnosed on the basis of absence of ventilatory response and sensation to provoked hypercapnia, prolonged breath-holding time and correction of hypercapnia by voluntary hyperventilation.

Carotid Body Tumor↗
PubMed1993

[Standards established by consensus for the treatment of bronchial asthma and its exacerbations].

A group of pulmonologists from different sites of Argentina convened to establish consensus guidelines for treatment of acute and chronic bronchial asthma. General acceptance that in fatal asthma diagnosis and hospital admission are usually too late and treatment insufficient prompted the need for this meeting. The purpose of treatment was devised to keep the patient symptomless, decrease frequency of exacerbations and the risk of severe attacks. Peak expiratory flow rate (PEFR) measurement in all patients was decided. inhalation of anti-inflammatory drugs (corticosteroids, CE, and/or disodium cromoglycate, DSG, in those younger than 20 years) was established as first line of treatment. Inhaled CE (even in high doses such as 2 mg/day) do not provoke significant adverse systemic effects (immune depression, Cushing syndrome, hyperglycemia in diabetics or osteopenia). Secondary local adverse effects are however frequent: oral and pharyngeal candidiasis and dysphonia. It is advisable considering present evidence, that bronchodilators (Bd) be used preferentially on demand. On account of small bronchodilator effect and frequent secondary adverse effects, use of theophylline should be limited to patients not adequately responsive to anti-inflammatory drugs in high dosage. Immunotherapy is not useful in asthma. Four clinical levels were defined in chronic asthma considering severity of dyspnea, frequency of nocturnal bronchial obstruction, levels of PEFR and amount of required Bd. Guidelines of treatment were established for each clinical level considering increasing dosage of CGS, inhaled CE (up to 2 mg/day) and regular administration of Bd. Indications for systemic CE administration were also established. Three levels of acute asthma (sudden worsening of symptoms) were accepted based on clinical evidence and PEFR values. Treatment was quantitatively adjusted to severity. Criteria for hospital admission either in emergency or intensive care areas and treatment procedures were established.

Administration, Inhalation↗
PubMed1992

Plexogenic arteriopathy associated with pulmonary vasculitis in systemic lupus erythematosus.

Pulmonary arterial hypertension and compulmonale were found in a woman with inactive systemic lupus erythematosus (SLE). The patient died of right heart failure 5 years later. Postmortem study showed SLE reparative lesions, plexogenic arteriopathy and vasculitis in the lung vessels. Since no active SLE was found, the pulmonary vasculitis was attributed to plexogenic arteriopathy.

Adult↗
PubMed1992

Pulmonary hypertension in paroxysmal nocturnal hemoglobinuria.

Pulmonary arterial hypertension (PAH) and cor pulmonale were found in a patient with paroxysmal nocturnal hemoglobinuria (PNH). Autopsy revealed widespread thromboses in pulmonary microvasculature. Vascular thromboses attributed to hypercoagulability have been found in PNH in many organs, including the lungs. PAH has not been reported, however. This disease should then be considered a rare cause of PAH.

Chronic Disease↗
PubMed1991

Mycobacterium gastri arthritis: septic arthritis due to Mycobacterium gastri in a patient with a renal transplant.

We describe an 18-year-old man with a renal transplant who developed septic metacarpophalangeal arthritis due to Mycobacterium gastri. He had several episodes of crystal induced synovitis, and treatment with intraarticular steroids was complicated 3 months later by iatrogenic septic arthritis. Appropriate treatment based on in vitro drug susceptibility was successful. This seems to be the first case of articular infection and the third report of human infection caused by this atypical mycobacteria.

Adolescent↗
PubMed1990

[Diaphragmatic strength and ventilatory control in experimental hypothermia].

In ten lightly anaesthetized dogs breathing spontaneously, we studied diaphragmatic force generation (Pdi 10, 30, 100 Hz and single twitch) and ventilatory control (P 0, 1, Vt/Ti and respiratory frequency). We found CO2 retention proportional to hypothermia (Fig. 3). The TP was not changed while VMxA and VMxD decreased (Table 1). High frequency fatigue and low frequency potentiation were found (Fig. 1, 2). These changes do not explain CO2 retention which correlated with fall in central drive (P 0, 1, Vt/Ti, Fig. 3, 4) and respiratory timing (respiratory frequency, Fig. 4).

Animals↗
PubMed1990

[Diaphragmatic fatigue in hypovolemic shock].

A model of hemorrhagic shock (arterial mean pressure = 40 mmHg) terminated by death in all cases was developed in 21 dogs. The study was addressed to investigate the central respiratory response, development of diaphragmatic fatigue (FD) and the influence of the suppression of spontaneous rhythmic respiratory muscle activity by mechanical ventilation during shock. We measured diaphragmatic force: transdiaphragmatic pressure (Pdi), spontaneous and stimulated electrical activity of the diaphragm (integrated and rectified electromyogram: Edi) tracheal occlusion pressure (P 0, 1) cardiac output (Q) and survival, ventilatory variables were also measured. We constructed Pdi/Frequency and Pdi/Edi curves. The phrenic nerves were stimulated: 1) by bipolar electrodes at the 5th cervical roots or 2) by a bipolar electrode catheter introduced through the left jugular vein. The animals were divided in 3 groups: 1) during spontaneous breathing (light pentobarbital anesthesia and positive corneal reflex) Pdi/Frequency curves and Pdi response to single twitch were measured (n = 9); 2) evolution of Edi and Pdi/Edi curves during spontaneous breathing (n = 6); 3) Pdi/Frequency curves (n = 6) during mechanical ventilation (ARM). We found (groups 1, 2) initially compensated (increased P 0, 1 and hyperventilation: table 1) metabolic acidosis, followed by mixed acidosis after FD (fall in Pdi/Frequency: Fig. 1, and Pdi/Edi: Fig. 2, 3, table 3) and associated with falling respiratory frequency (Fr). During hyperventilation, central respiratory drive/minute: Edi.Ti.Fr (Ti = inspiratory time, sec) increased and fell later during FD, remaining however higher than basal.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Effect of aminophylline and verapamil upon diaphragmatic force generation in dogs.

The effects on the diaphragm of verapamil (VPM) and aminophylline (AMP) were studied in dogs during stimulation of phrenic nerves at the 5th cervical roots (5th-PS) or transvenously at the trunk (T-PS). Transdiaphragmatic pressure (Pdi)/frequency curves were constructed. Our findings were: 1) AMP increased Pdi at all stimulation frequencies (p less than 0.01) during 5th-PS but only at 10-30 Hz during T-PS; 2) in other dogs infusion of VPM (0.14 mg.kg-1.min-1) decreased Pdi at all frequencies (p less than 0.025) without change in diaphragmatic blood flow; 3) the effects of VPM were completely reverted by AMP; 4) after a large amount of AMP, infusion of VPM (0.21 mg.kg-1.min-1) decreased Pdi at all frequencies. Since these drugs have several mechanisms of action and do not show mutual blocking effect, different action sites are suggested.

Aminophylline↗
PubMed1989

Severe pulmonary hypertension with diffuse smooth muscle proliferation of the lungs. Pulmonary tuberous sclerosis?

A 49-year-old man with normal intelligence and no cutaneous lesions had symptoms and signs of cor pulmonale. The chest roentgenogram showed an interstitial pattern. Hemodynamic studies revealed increased pulmonary arterial and wedge pressures. The patient died in shock, and the postmortem findings were a diffuse smooth muscle proliferation in the lungs as the cause of the pulmonary hypertension. We presume that this is a form of pulmonary tuberous sclerosis of which few cases are reported with such severe pulmonary hypertension as shown by our measurements.

Humans↗