Biomedical subjects
Publications and source records attributed to J Gea.
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In forty-one patients (mean [+/- SD] age 51 +/- 19 years; range, 11 to 88 years; seven female and 34 male) with clinical signs and symptoms of pneumonia, we performed a nonfluoroscopic percutaneous lung needle (22 gauges) aspiration (PLNA) to investigate the diagnostic yield of this technique. All the patients were receiving antibiotics at the time of the study, and PLNA was performed either because of a lack of response to empiric antibiotic treatment or because of the severity of the pneumonia or the underlying condition of the patient. Eight patients were mechanically ventilated (MV) due to acute respiratory failure. The PLNA was performed at bedside and without fluoroscopic guidance. Twenty-two microorganisms were identified by means of stains and/or cultures of PLNA samples. Sensitivity of PLNA was 43 percent (18/41). We detected three false-positive cultures probably due to contamination from the skin area punctured. In the eight MV patients studied, the sensitivity of PLNA was 37.5 percent, and the microbiologic findings turned out to be crucial for the outcome of the patients. Pneumothorax developed in three patients (7 percent) after PLNA. None of these three patients developed a pleural infection but two of them required thoracostomy drainage. None of the MV patients presented complications. Our results showed that nonfluoroscopic PLNA is a technique with moderately good sensitivity and with a low rate of false-positive cultures (8 percent) to diagnose pulmonary infections in patients with unresponsiveness to empiric antibiotic treatment or with severe pneumonia. Further evaluation of its diagnostic value and complications in MV patients is needed, although our preliminary results suggest that PLNA can be an alternative technique to other methods for diagnosing pulmonary infections in patients receiving artificial ventilatory support.
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Eleven out of thirteen patients hospitalized because of severe pneumonia caused by Legionella Pneumophila were evaluated over a period of 53 months. During the acute phase, all but one patient manifested severe hypoxaemia, needing either supplementary oxygen or, in the case of three, mechanical ventilation and one died. Following recovery, two patients complained of mild shortness of breath alone. However, most of the individuals showed subclinical mild to moderate ventilatory and/or gas exchange abnormalities a few months after discharge (less than 6 months). Despite the fact that some of these functional findings in part persisted at long-term (6-33 months), a significant overall improvement in lung function was noticed. The main pulmonary functional sequelae following Legionnaires' Disease might include a restrictive ventilatory defect, a low transfer factor and hypoxaemia.
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Sorption of toxics by algae may be important and occurs very early. Thus, a decrease of the experimental toxic concentrations in the medium results in understating toxicity when tests are conducted under static conditions. In this work, two different methods of exposure of algae (Chlorella vulgaris) are studied, the static test and the pseudodynamic test. Acute effects (biological and analytical effects) of inorganic compounds (Cu2+, Cd2+, Pb2+, Cr6+) have been evaluated for 96 hr of exposure; in each case, IC50 is much lower in the dynamic condition than in the static one. The percentage of reduction varies from 55 to 75% after 96 hr. Accumulation of metal by chlorellae is greater when testing by the pseudodynamic way, with Cu2+ and Pb2+. But in the case of Cd2+ and Cr6+, the concentration factors are similar in the two kinds of exposure. These results point out the advantage of the pseudodynamic test, of which the methodology is very easy, for a more realistic assessment of acute ecotoxicity in these organisms.
There is increasing evidence that exercise overload induces changes in skeletal muscle structure and function. Recent studies suggest that muscle mitochondria could be involved either as the result or the origin of these changes. This study describes a case of a patient with marked air flow obstruction related to chronic obstructive pulmonary disease, in which large aggregates of mitochondria were found in diaphragm muscle fibers. Many of the mitochondria contained paracrystalline rectangular inclusions. Latissimus dorsi and intercostal muscles were also available for ultrastructural examination that showed, respectively, normal and moderately increased number of mitochondria with normal mitochondrial structure. This is the first known report of paracrystalline rectangular inclusions in respiratory skeletal muscle from a patient with chronic obstructive pulmonary disease.