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J Belda

Publications and source records attributed to J Belda.

At least 19 recordsLinked to original sources
PubMed2006

Field study of the efficacy of halofuginone and decoquinate in the treatment of cryptosporidiosis in veal calves.

Ninety, seven- to 10-day-old calves were allocated to three groups of 30 and treated daily for seven days with either 100 microg/kg halofuginone hydrobromide or 2.5 mg/kg decoquinate orally or left untreated as controls. The levels of diarrhoea and dehydration were monitored daily for 28 days from the first day of treatment (day 0) and samples of faeces were collected on days 0, 7, 14, 21 and 28, to quantify the excretion of Cryptosporidium parvum oocysts. The calves were weighed on days 3 and 28. The treatments had no effect on the levels of diarrhoea or dehydration, the proportions of diarrhoeic calves or the proportions of calves shedding oocysts. However, unlike decoquinate, halofuginone significantly reduced the excretion of oocysts on day 7 (P<0.0001), and decoquinate increased the average daily weight gain of the calves (P=0.049).

Animals↗
PubMed2006

[Markers of airway remodeling in induced sputum from healthy smokers].

OBJECTIVE: Airway remodeling in chronic obstructive pulmonary disease (COPD) has been linked to the equilibrium between matrix metalloproteinase (MMP) 9 and its inhibitor, tissue inhibitor of metalloproteinase (TIMP) 1. However, that equilibrium has not been analyzed in healthy smokers. The aim of this study was to assess the equilibrium between MMP-9 and TIMP-1 in induced sputum from healthy smokers, healthy nonsmokers (controls), and patients with COPD. PATIENTS AND METHODS: Samples of induced sputum were obtained from 35 individuals: 12 healthy smokers, 12 controls, and 11 patients with COPD. In each sample, a differential cell count was performed and enzyme-linked immunosorbent assays were used to analyze the concentrations of MMP-9 (total and active fraction) and TIMP-1. RESULTS: Compared with controls, healthy smokers were found to have a higher mean (SD) concentration of total MMP-9 (273 [277] ng/mL vs 128 [146] ng/mL) and a higher ratio of total MMP-9 to TIMP-1 (0.16 [0.14] vs 0.08 [0.06]). However, the ratio of active MMP-9 to TIMP-1 was similar in the 2 groups. Samples from patients with COPD had the highest concentrations of total MMP-9 (477 [262] ng/mL) and active MMP-9 (178 [126] ng/mL) and the lowest concentrations of TIMP-1 (1.044 [1.036] microg/mL). When all groups were considered together, there was an inverse relationship between the MMP-9/TIMP-1 ratio and the forced expiratory volume in the first second (FEV1). The relationship between the active MMP-9/TIMP-1 ratio and FEV1 was even stronger, and the relation of both ratios with FEV1 became stronger still when smoking was considered. CONCLUSIONS: Healthy smokers had a higher concentration of total MMP-9 and that concentration was correlated with their exposure to tobacco smoke. Maintenance of the active MMP-9/TIMP-1 ratio in healthy smokers may explain the absence of progressive airway obstruction. Measurement of active MMP-9 concentration could be useful for assessment of airway remodeling.

Adult↗
PubMed2005

[Bronchial exudate of serum proteins during asthma attack].

OBJECTIVE: Although altered vascular permeability and edema of the bronchial mucosa are associated with asthma attack, their influence on its severity remains unknown. We address this issue by comparing relative indices for the concentration of albumin (RIAlb) and alpha2-macroglobulin (RIalpha2M) in induced sputum and peripheral blood from patients with exacerbated asthma, patients with stable asthma, and control subjects. PATIENTS AND METHODS: Forty-six volunteers participated in the study: 14 with exacerbated asthma (forced expiratory volume in the first second [FEV1] 74.3% [SD, 20.8%] of reference), 23 with stable asthma (FEV1 93.6% [7.5%]), and 9 controls (FEV1 101.1% [9.9%]). The concentrations of albumin and alpha2-macroglobulin were quantified by immunoturbidimetry and immunonephelometry, respectively. The relative index was then calculated by dividing the concentration in sputum supernatant by the concentration in peripheral blood. RESULTS: The mean RIAlb was 1.2 (1.1) in the control group, 2.9 (3.1) in the stable asthma group, and 6.0 (6.7) in the exacerbated asthma group. The RIalpha2M values were 11.7 (10.9), 11.9 (14.7), and 3.2 (3.8) for the control group and stable and exacerbated asthma groups, respectively. The increases in the RIAlb values between all groups, and the decrease in the RIalpha2M value between the exacerbated asthma and control groups were statistically significant (P<.05). The percentage of neutrophils, but not of eosinophils, in sputum was correlated with the RIAlb (r=0.39; P=.008) but not the RIalpha2M (r=-0.035; P=.82). FEV1 displayed an inverse relationship with the RIAlb (r=-0.43; P=.009) but not with the RIalpha2M (r=-0.206; P=.24). No correlation was found between oxyhemoglobin saturation and either the RIAlb (r=-0.33; P=.19) or the RIalpha2M (r=-0.12; P=.84). CONCLUSIONS: Vascular permeability is altered during asthma exacerbations and appears to be correlated with the presence of neutrophils and the degree of bronchial obstruction.

Acute Disease↗
PubMed2005

[Expansion of primary bronchial epithelial cell cultures].

OBJECTIVE: Cell cultures provide a good model for studying lung diseases but they are difficult to reproduce and the number of cells obtained is limited. The aim of this study was to develop a way to increase the production of human bronchial epithelial cells (BEC) in primary cultures. MATERIAL AND METHODS: A total of 12 samples (9 from surgical specimens and 3 from endoscopic biopsies) were processed on plates coated with type I collagen with growth medium supplemented for BEC. When cell proliferation started, the explants were removed for successive subculturing. The remaining cells were left to proliferate and were trypsinized after 50% confluence. We recorded the number of cells obtained, cell viability, and the percentage positive for cytokeratin 7. RESULTS: The total number of cells obtained by this method was 3-fold the number of human BEC obtained with simple primary cultures. The maximum number of subcultures was 5, mean (SD) cell viability was 91.9% (11.7%), and the percentage of cells positive for cytokeratin 7 was 30.71% (10.68%). CONCLUSIONS: The described method for expanding primary BEC cultures increases cell production.

Aged↗
PubMed2005

Incomplete esophageal myotomy and early recurrence of an epiphrenic diverticulum.

The established management of epiphrenic diverticula combines diverticulectomy with myotomy of the distal esophagus including the lower esophageal sphincter. We report a patient with prompt recurrence of an epiphrenic diverticulum after laparoscopic transhiatal diverticulectomy associated with esophagomyotomy and partial posterior fundoplication due to an incomplete myotomy.

Digestive System Surgical Procedures↗
PubMed2004

[Video-assisted thoracoscopic sympathectomy for the treatment of facial flushing: ultrasonic scalpel versus diathermy].

OBJECTIVE: To evaluate the advantages of the ultrasonic scalpel compared to electrocoagulation in patients undergoing video-assisted thoracoscopic sympatholysis or sympathectomy for uncontrolled facial blushing. METHODS: Two hundred bilateral video-assisted thoracoscopic procedures to interrupt transmission in the thoracic sympathetic nerve were performed in 100 patients with incapacitating facial blushing. In 2 cases, the video-assisted approach was chosen because of pleural symphysis. The mean age of patients was 34 years (range: 15 to 67). The sympathetic chain was interrupted from the lower portion of the first thoracic ganglion through the third. RESULTS: All patients were discharged within 24 hours with the exception of one on whom an emergency thoracotomy had been performed. No complications were reported in the group in which a harmonic scalpel was used. One case of temporary Horner syndrome (4 months) and 3 cases of persistent chest pain (more than 2 weeks) were reported in the diathermy group. There were 9 cases of partial and asymptomatic pneumothorax that resolved without treatment or prolonged hospital stays. CONCLUSION: Dissection of the sympathetic nerve is accomplished more reliably and with better visualization with the ultrasonic scalpel. Peripheral lesions in lung parenchyma and adjacent tissues (intercostal vessels and nerves) are avoided, as is Horner syndrome, which can be caused by dispersion of heat. Use of the ultrasonic scalpel would also lead to a lower incidence of postoperative neuralgia.

Adolescent↗
PubMed2004

[Lung function in cardiac dysfunction].

OBJECTIVE: The alterations in lung function caused by heart failure were first described some decades ago. The advent of new tools for the diagnosis and investigation of heart disease, such as echocardiography, has subsequently made it possible to classify cardiac dysfunction with greater precision. The objective of this study was to analyze and compare a series of lung function and gas exchange variables in patients who had been classified into 4 groups according to type of heart disease as diagnosed by echocardiography. MATERIALS AND METHOD: Emergency room patients whose main symptom was acute dyspnea caused by cardiac or respiratory disease were included in the study. The final sample comprised 71 patients whose echocardiogram revealed cardiac dysfunction. Spirometry was carried out and resting arterial blood gases measured in this group. RESULTS: Of the 71 patients with cardiopathy, 31 had systolic dysfunction, 27 diastolic dysfunction, 7 cor pulmonale, and 6 primary valve disease. Spirometry revealed a generally obstructive pattern, more marked in the group with cor pulmonale. Analysis of arterial blood gases revealed slight hypoxemia with normocapnia in all groups, but this was more accentuated in the patients with cor pulmonale and diastolic dysfunction. An analysis of the correlations (Pearson's r) between cardiac and pulmonary variables revealed the statistically significant associations between cardiac mass and other variables to be as follows: forced vital capacity r=0.34 (P=.02), forced expiratory volume in one second r=0.526 (P=.0001), forced expiratory volume in one second as a percentage of predicted r=0.3 (P=.037), and forced midexpiratory flow rate r=0.31 (P=.03). The correlation between left ventricular ejection fraction and PaO2 was r=-0.312 (P=.01); the correlation between left ventricular end-diastolic diameter and PaO2 was r=0.369 (p=.006). CONCLUSIONS: In patients with cardiac dysfunction, spirometry reveals a generally obstructive pattern, which is more accentuated in patients with right ventricular dysfunction owing to the existence of prior lung disease. The associations found between the cardiac and lung function variables do not help the physician to determine the predominant diagnosis for a patient more precisely or to establish a prognosis.

Adult↗
PubMed2004

[Patient preference in the choice of dry powder inhalers].

OBJECTIVE: To investigate a group of patients' preferences among 3 dry powder inhalers--Accuhaler, Easyhaler, and Turbuhaler--and to analyze the features that were most important for motivating choices. MATERIAL AND METHOD: The study enrolled 30 patients with stable asthma with a mean (SD) age of 40 (13) and who habitually used inhaled corticosteroids. The patients were shown in detail how to use each of the devices and were randomized to begin using them in different orders. After using each inhaler for a week, the patients assessed 9 different features on a scale of 0 to 10 with an independent observer. The patients were asked to put the inhalers in order of preference, and finally to demonstrate they could use them correctly. RESULTS: All patients correctly performed the inhalation maneuver at the beginning and the end of the study. The mean final scores out of 90 of the 9 features evaluated were 75 (13) for the Easyhaler, 67 (12) for the Accuhaler, and 65 (14) for the Turbuhaler. Differences were statistically significant between the first and the second device (P=0.02) and the first and the third (P=.001) but not between the Accuhaler and the Turbuhaler (P=.376). Mean rating scores were 8.6 (1.4) for the Easyhaler, 7.3 (1.9) for the Turbuhaler, and 7.1 (1.6) for the Accuhaler. The Easyhaler was the first choice for 53% of patients, the Turbuhaler for 27%, and the Accuhaler for 20%. CONCLUSIONS: The Easyhaler was rated the highest by the patients in the study. The scores were a long way from the maximum score, so research into developing an ideal inhaler must continue.

Adult↗
PubMed2004

[Bronchial carcinoid tumor: a retrospective analysis of 62 surgically treated cases].

OBJECTIVE: To evaluate the results of surgical treatment for lung carcinoid tumor. PATIENTS AND METHOD: The medical records of 62 patients who underwent surgical intervention for lung carcinoid tumor between May 1985 and October 2000 were reviewed. RESULTS: Fifty-two patients had typical carcinoid tumors and 10 had atypical carcinoid tumors. Hilar or mediastinal lymph node metastases were present in 9 patients. Distant metastasis occurred in 5 patients and was significantly more frequent in those with the atypical carcinoid histological subtype. The overall survival rate at 15 years was 70%, with a mean survival rate of 138 (SD 11) months, calculated with the Kaplan-Meier method. We found no statistically significant correlation between smoking and the development of carcinoid tumors. CONCLUSIONS: Although carcinoid tumors behave like low-grade malignant tumors, they should be treated in the same way as other malignant lung tumors. Curative surgical resection is the technique of choice whenever possible.

Adolescent↗
PubMed2003

[Video-assisted lobectomy through the auscultatory triangle for the surgical treatment of bronchopulmonary carcinoma. Preliminary experience].

OBJECTIVE: To describe a technique for video-assisted lobectomy through the auscultatory triangle (VALAT) and to assess early and medium-term outcome of the procedure in patients with non-small cell bronchopulmonary carcinoma in stage I. PATIENTS AND METHOD: Between April 1999 and May 2002 we performed 25 VALAT procedures (24 lobectomies and 1 bilobectomy) in 25 patients with a mean age of 63.6 years (range 39-80). RESULTS: No deaths occurred during or after surgery. Conversion to conventional thoracotomy was necessary in two cases. One patient was re-operated to resolve hemothorax and one developed a bronchopleural fistula that was treated by pleural drainage. The mean hospital stay was 6.3 days. Twenty-three patients have been disease-free throughout a mean follow-up period of 11.5 months (range 1-36). The two-year actuarial survival rate (Kaplan-Meier) was 93% 7%. CONCLUSIONS: VALAT is a safe procedure that nevertheless requires specific training. The rate of complications was low in our patient series and mortality was nil. The outcome for patients with stage I bronchogenic carcinoma over a two-year follow-up period has been comparable to results obtained with conventional thoracotomy.

Adult↗
PubMed2003

[Post-pneumonectomy edema].

A 64-year-old man complained of irritable cough of 3 months' duration and 1 episode of hemoptysis and dyspnea related to effort. The radiograph revealed a mass in the upper right lobe. Adenocarcinoma of the lung was diagnosed by mediastinoscopy. After removal of the right lung, the patient was admitted to the recovery unit for 36 hours and transferred out without complications. The clinical course in 48 hours on the ward included increasing dyspnea, tachypnea and greater respiratory effort with hypoxemia in spite of increased FiO2. A radiograph showed pulmonary edema and the patient was readmitted to the recovery unit. We describe this case of postpneumonectomy edema and discuss the possible origins of the clinical picture, differential diagnosis, preventive measures and possible treatments.

Humans↗
PubMed2001

[Prevalence of chronic hidden infections in a cohort of patients in substitutive treatment with methadone].

BACKGROUND: To analyse prevalence of hidden hepatitis B infection (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and tuberculosis infection in drug users (DU) in a maintenance programme with methadone (MPM). PATIENTS AND METHOD: 189 DU were tested for HBV, HCV, HIV and tuberculin test. Drug addition history and route of administration were evaluated. RESULTS: Prevalence of HIV, HCV, and tuberculous infection was 29.2%, 75.9% and 59.3% respectively. Intravenous route, early use of heroin and delay to enter in MPM were significatively associated with HIV and HCV infections. CONCLUSIONS: There is a high prevalence of tuberculous and HCV infections in DU. Early access to MPM could decrease prevalence of those infections.

Adult↗
PubMed2001

Repeatability and validity of cell and fluid-phase measurements in nasal fluid: a comparison of two methods of nasal lavage.

BACKGROUND: There is little information on the repeatability of cell counts and fluid-phase measurements in nasal fluid obtained by different methods of nasal lavage. OBJECTIVE: To compare the repeatability and validity of total and differential cell counts and eosinophil cationic protein (ECP) in nasal secretions obtained by two methods of nasal lavage. PATIENTS AND METHODS: Twelve healthy subjects and twelve subjects with clinically stable allergic rhinitis were randomly assigned to two nasal lavages (separated by 48 h), by one of two methods in the first week and by the second method in the following week. One method was a modification of the method described by Greiff et al. and Grunberg and coworkers and the other was that described by Naclerio and coworkers. RESULTS: Both methods of nasal lavage gave poorly repeatable eosinophil counts and ECP in normal subjects but better repeatability in subjects with rhinitis. The modified Greiff/Grunberg method gave higher and more repeatable total cell count and, in subjects with rhinitis, more reproducible ECP levels compared with the Naclerio METHOD: Both methods were able to discriminate between healthy and rhinitic subjects: mean +/- SD eosinophil percentage count and eosinophil cationic protein differences were 4.5 +/- 4% (P < 0.05) and 24.5 +/- 46.9 microg/L (P < 0.05), respectively, with the modified method and 7.0 +/- 4% (P < 0.05) and 26.9 +/- 68 microg/L (P < 0.05), respectively, with the Naclerio method. CONCLUSION: Both methods are valid and discriminate between normal and rhinitic subjects. In subjects with rhinitis, although the repeatability of eosinophil counts is similar by both methods, the modified Greiff/Grunberg method gives more reproducible ECP measurements, compared with the Naclerio method.

Adult↗
PubMed2001

Sputum induction: effect of nebulizer output and inhalation time on cell counts and fluid-phase measures.

BACKGROUND: A knowledge of the factors that can affect induced sputum results is essential in order to standardize the procedure. OBJECTIVE: We investigated the influence of nebulizer output on sputum cell counts and fluid phase measurements at increasing times of sputum induction. METHODS: Eighteen adults with stable asthma inhaled an aerosol of 3% hypertonic saline to induce sputum after 7, 14 and 21 min on 2 days separated by 48 h. On one day, in random order, the ultrasonic nebulizer used had a relatively low output of 0.87 mL/min (particle size 5.58 microm mass median aerodynamic diameter, MMAD) and, on the other, a higher output of 1.90 mL/min (particle size 4.14 microm MMAD). The sputum was selected from each expectorate and examined blind to the induction procedures. RESULTS: With both nebulizers, the 14- and 21-min samples were lower in weight, neutrophils, eosinophils, eosinophil cationic protein (ECP) and interleukin (IL)-8 and higher in macrophages. The higher output nebulizer induced sputum with higher cell viability and lower ECP and IL-8. CONCLUSION: The results identify that the volume of hypertonic saline inhaled in sputum induction influences the fluid-phase measurements. The duration of induction does alter the cell counts and suggests that the later expectorated sputum samples originate from more peripheral airways. The results draw attention to the need to standardize the volume and time of nebulization to accurately interpret and compare results.

Administration, Inhalation↗
PubMed2001

Mild exacerbations and eosinophilic inflammation in patients with stable, well-controlled asthma after 1 year of follow-up.

OBJECTIVES: To determine the time to exacerbation and probability of a mild exacerbation of asthma, and the impact of eosinophilic inflammation on these parameters in patients with stable, well-controlled asthma. PATIENTS AND METHODS: A cohort of 31 patients with stable, well-controlled asthma receiving inhaled steroid treatment regularly were followed up for 1 year or until a mild exacerbation occurred. Mild exacerbation was defined as symptoms of asthma lasting > 48 h with a fall in peak expiratory flow > 20%. FEV(1), provocative concentration of methacholine causing a 20% fall in FEV(1), eosinophil count, and eosinophilic cationic protein (ECP) levels in blood and in sputum were measured at the first visit and every 2 months. RESULTS: At baseline, the mean (SD) eosinophil count was 0.39 x 10(9)/L (0.21 x 10(9)/L) in blood and 13% (14%) in sputum; ECP was 30 microg/L (28 microg/L) in blood and 75 microg/L (85 microg/L) in sputum. Thirteen subjects experienced a mild exacerbation during the 1-year follow-up period. The mean time to mild exacerbation was 293 days (95% confidence interval [CI], 248 to 337 days), and the cumulative probability of not experiencing a mild exacerbation in 1 year was 49% (95% CI, 39 to 59%). An increased risk of mild exacerbation was associated with blood eosinophil count > 0.4 x 10(9)/L (relative risk 4.5; 95% CI of relative risk, 1.8 to 38.0), blood ECP > 20 microg/L (relative risk, 2.1; 95% CI of relative risk, 1.0 to 9.2), and sputum ECP > 40 microg/L (relative risk, 2.5; 95% CI of relative risk, 1.2 to 11.2), but was unassociated with other variables. CONCLUSIONS: Patient with stable, well-controlled asthma are at risk of mild exacerbation during 1 year of follow-up despite regular inhaled steroid treatment. Eosinophilic inflammation expressed as eosinophil count and ECP is associated with higher risk of mild exacerbation.

Administration, Inhalation↗