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Biomedical subjects

J M Borro

Publications and source records attributed to J M Borro.

32 records · Page 2Linked to original sources

Tuberous sclerosis and pregnancy; report of a case with renal and pulmonary involvement.

Tuberous sclerosis is a very infrequent hereditary disease, usually defined by the triad of epilepsy, mental retardation and adenoma sebaceum, although alterations in other organs can exist. Tuberous sclerosis in its association with pregnancy has seldom been described in the literature. One such case is reported here; that of a 24-yr-old woman whose pulmonary involvement constitutes its differentiating characteristic. We make special mention of the improvement of the respiratory function, without any modification of the renal function, in contrast with other previously published cases. She gave birth spontaneously by vaginal via. Finally, we underline the importance of prenatal diagnosis and genetic advice for these patients.

Adult↗

Gastroplasty with partial or total plication for gastroesophageal reflux: manometric and pH-metric postoperative studies.

From January, 1975, to December, 1980, 83 patients with sliding hiatal hernia, gastroesophageal reflux, or both were treated using a modified Collis gastroplasty associated with either partial or total gastric application. When partial plication was used, the five-year clinical results were considered satisfactory in 27 out of 35 patients (77%). When total plication was used, the results were satisfactory in 41 out of 46 patients (89%) after follow-up ranging from 12 to 60 months (average, 36 months), but no symptoms of gastroesophageal reflux reappeared in any patient. In patients undergoing partial plication, the mean preoperative high-pressure zone of 11.20 +/- 8.19 mm Hg increased after operation to 17.31 +/- 10.50 mm Hg, but in the second postoperative studies the value decreased to 13.69 +/- 7.24 mm Hg. When 360 degrees plication was used, the preoperative value of the high-pressure zone--9.36 +/- 4.80 mm Hg--increased after operation to 17.70 +/- 7.53 mm Hg but did not decrease significantly in the second postoperative studies: 16.46 +/- 7.99 mm Hg. When partial plication was used, the positivity of the abdominal compression test was 9 and 28% in the early and late postoperative studies, respectively. Using total plication, the percentage of positivity in the early and late postoperative periods was 0 and 2%, respectively. Concerning the acid reflux test, when partial plication was used, the test was positive in 3 out of 27 patients (11%) in the early postoperative studies and in 7 out of 30 (23%) one year later. For the total plication procedure, the percentage of positive tests was null in the first control and 3% in the second postoperative studies.

Deglutition Disorders↗

[Chronic obstructive pulmonary disease and lung transplants: results in Spain].

OBJECTIVE: To determine the outcome of lung transplantation in patients with chronic obstructive pulmonary disease (COPD) in Spain. METHODS: In all COPD patients transplanted at four Spanish hospitals over a period of seven years, we studied actuarial survival rates retrospectively using the Kaplan Meier test in relation to demographic characteristics, type of transplant, underlying disease, lung function evolution in terms of forced vital capacity (FVC), maximum expiratory flow in 1 second (FEV1) and gasometric evolution (PaO2 and PaCO2). RESULTS: Seventy-four transplants were performed in COPD patients over a five-year period. Mean age was 47 +/- 7 years (26-61) and 77% of the patients were men. A diagnosis of emphysema was made in 58%, alpha-1 antitrypsin deficiency emphysema in 14% and chronic bronchitis in 28%. The likelihood of survival was 75% for the first year, 63% for two years and 41% for the third year. Lung function and blood gases improved significantly by the third month after transplantation: FVC was 1677 +/- 637 ml before transplantation and 2631 +/- 670 ml afterwards; FEV1 was 585 +/- 189 ml before transplantation and 2118 +/- 673 ml afterwards (p < 0.001). Double lung transplants achieved significantly greater improvement in function variables than did single-lung transplants (FVC 2843 +/- 681 ml and FEV1 2543 +/- 620 ml by the third month in DLT patients versus FVC 2402 +/- 587 ml and FEV1 1659 +/- 350 ml for SLT), with no significant differences in blood gases after the two types of transplant. Half the sing-lung transplant patients developed hyperinflation of the native lung and reached maximum lung function values, which tended to be lower than those for patients who did not experience this complication (FEV1 1638 +/- 349 ml versus 1930 +/- 307 ml, p = 0.051). CONCLUSIONS: First-year mortality in patients with COPD undergoing lung transplantation in Spain is similar to that described in the International Transplant Registry. We found no differences between double- and single-lung transplant patients. Functional change is good for both types of transplantation, although this aspect of outcome is significantly better when two lungs are transplanted.

Adult↗