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Biomedical subjects

J Morera

Publications and source records attributed to J Morera.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Syndrome of allopurinol hypersensitivity. Report of a new case and review of the Spanish literature].

Allopurinol is a drug of wide clinical use and good tolerance. Some patients develop severe hypersensitivity due to immunologic reaction to the drug. A new case which fulfills all the diagnostic criteria of the syndrome of allopurinol hypersensitivity with associated clinical manifestations of multiple mononeuritis and evidence of granulomas and vasculitis in liver biopsy as the most significant data is reported. The syndrome was favorably resolved following withdrawal of the drug without need for corticoid therapy. The characteristics of the cases described in the Spanish literature over the last few years are globally reviewed. The absence of mortality is of note. The inconvenience of prescribing allopurinol to patients with asymptomatic hyperuricemia is emphasized.

Aged↗
PubMed1994

[Oxygen therapy and other pneumological tools for home use in Barcelones Nord i Maresme. A descriptive study].

Against a background of differences in prevalence of chronic home oxygen therapy (CHO) and other pneumological tools (nasal continuous positive airway pressure, aerosol therapy, monitoring, assisted ventilation) found in studies of the various regions of Catalonia (Spain), we carried out a descriptive study to determine how these tools were being used in the northern Barcelona and coastal plain health region (population 657,376). Three hundred sixty-six (49.8%) patients used CHO, 39 (5.3%) used aerosol therapy, 52 (7.1%) used nasal continuous positive airway pressure, 3 (0.4%) were monitored at home and 1 (0.1%) was mechanically ventilated at home. Two hundred seventy-three patients about whom we had insufficient data did not keep their appointments with the doctor. Use of CHO was considered appropriate in 302 (82.5%) of the 366 patients reviewed; 6.5% of these were active smokers as indicated by measurement of CO in expired air. The number of patients resistant to treatment (273) is very high in the northern Barcelona and coastal plain region and should be followed up more carefully. Our finding allow us to estimate that CHO is appropriately prescribed in the northern Barcelona and coastal area for 87.5 patients per 100,000 inhabitants, a prevalence that is higher than that observed for other health regions in Catalonia.

Chronic Disease↗
PubMed1994

[Minimal intervention in smoking in the outpatient pneumonology consultation].

Brief intervention (BI) in smoking has been shown to be an effective way of stopping smoking in the general population. BI involves medical advice given to each smoking patient, with complementary information on the effects of smoking on the body and methods of giving up the habit. Patients who come to the clinic with respiratory disease may be especially receptive to BI since the strong link between their symptoms and smoking may increase their motivation for cessation. A BI protocol on smoking was applied in 285 smokers seen in an outpatient pneumological clinic. Two hundred eight smokers (group A) received medical advice and health care education with the offer of follow up. Seventy-seven smokers (group B) received the same BI protocol, with the offer of support treatment with nicotine gum (2 mg) and an explanation as to its use. One year after BI the patients were contacted by telephone to determine the number of non-smokers, with the result adjusted according to the truth index (71.4%) known for telephone response in this context. A total of 71 (24.9%) smokers were not located by telephone due to change of address, wrong number, exitus or lack of telephone. The estimated number of non-smokers in group A was 31.5/160 (19.7%) and 8.6/54 (15.9%) (non significant difference, chi square test). Group B's use of nicotine gum was therapeutically significant in 11.0% of the cases. We conclude that the efficacy of BI in the outpatient pneumological clinic is high.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Urological manifestations of herpes zoster.

Herpes zoster is an infection caused by the varicella virus. Inflammatory reaction can involve the spinal cord and anterior horn cells causing varied neurological disorders including urological alterations. We reviewed 57 patients who suffered herpes zoster between 1984 and 1991. 15 of them (26%) showed urological manifestations: 2 cases acute urinary retention, 3 patients urinary incontinence and 10 cases had a cystitis-like syndrome. The clinical findings and diagnostic procedures are studied. The possible etiological mechanisms are discussed. The literature is reviewed.

Adolescent↗
PubMed1993

Spirometry and maximal respiratory pressures in patients with facial paralysis.

The study included 17 patients with facial paralysis (FP) (10 male, 7 female) aged 47.6 +/- 21.0 years. Twelve of the 17 patients had Bell's palsy. The other causes of FP were as follows: one, polyradiculoneuritis; one, war injury; one, cerebrovascular accident; one, sarcoidosis; and one, dermatomyositis. Spirometry and maximal respiratory pressures (PImax and PEmax) were performed with three different techniques: without holding the lips, with patient holding lips, and with technician holding lips. We observed significant differences for PImax and PEmax among the three methods. There were no differences for spirometric values. In nine of the patients with Bell's palsy, PImax, PEmax, and spirometry tests were repeated two months after the first determination. With respect to the first determination, the values of Pmax-w/v holding lips increased, yet spirometric values were similar. In conclusion, PImax and PEmax can be an index of clinical FP evolution. Spirometric maneuvers can be performed with either patient or technician holding lips to ensure a perfect seal between lips and mouthpiece.

Adult↗
PubMed1993

Bronchial stump aspergillosis four years after lobectomy.

Bronchial stump aspergillosis (BSA) is an unusual entity. We report a case presenting hemoptysis four years after right upper lobe resection because of lung cancer. Simple removal of the silk suture is most likely the treatment of choice. No additional local or systemic antifungal therapy is needed.

Adult↗
PubMed1993

Acoustic analysis of vowel emission in obstructive sleep apnea.

UNLABELLED: We studied vocalization in 18 men with obstructive sleep apnea syndrome (OSAS) (age, 49 [7.5] years; body mass index [BMI] 33.6 [7.6]) and 10 normal men as a control group (age, 46.7 [6.2] years; BMI 24.6 [2.2]). Polysomnographic data for patients with OSAS were as follows: total sleep time (TST), 387.5 [27.9] min; awake, 17.6 (12.6% TST); stage 1, 19.8 (18.7 percent TST); stage 2, 54.8 (23.2 percent TST); stage 3 and 4, 1.5 (0.3 percent TST); and stage REM, 4.2 (1.7 percent TST). Apnea hypopnea index (AHI) was 43.0 (18.2) and lowest O2 saturation was 73.6 (11.4). We recorded the following sounds in all subjects: /a/ as in "father"; /e/ as in "get"; /i/ as in "see"; /o/ as in "go"; /u/ as in "too." Three maneuvers for each vowel sound were taken for analysis. Signals were digitized at 10,000 Hz. Fast Fourier transformation was applied to segments of 512 points of each utterance corresponding to the vowel sound. The following parameters were obtained: maximum frequency of harmonics, mean frequency of harmonics, and the number of harmonics. RESULTS: There were significant differences between both groups in the maximum frequency of harmonics of /i/ and /e/ vowels. (For /i/: 2,650 [672] Hz controls; 425 [71.2] Hz OSAS. For /e/: 2,605 [772.3] Hz controls; 1,250.0 [828.4] OSAS). The number of harmonics for /i/ vowel was 4.5 (1.2) for controls as compared with 2.7 (1) Hz for OSAS. CONCLUSIONS: Vocalization in patients with OSAS is different from normal subjects. Vowel /i/ can distinguish these patients from normal subjects.

Body Mass Index↗
PubMed1993

Maximum respiratory pressures in trumpet players.

We studied whether experienced trumpet players can develop higher pressures with their inspiratory and expiratory muscles than untrained subjects. Twelve male trumpet players (mean age, 22.4 +/- 3.3 years) participated in the study. All of them had played the trumpet for at least 4 years and were nonsmokers. Twelve healthy male subjects (mean age, 23.3 +/- 3.1 years) participated as a control group. There were no differences in spirometric parameters between both groups. Maximum respiratory pressures were higher in the trumpet player group (trumpet players: Pmax 151.3 +/- 19.8 cm H2O; Pemax, 234.6 +/- 53.9 cm H2O; control group: Pemax, 106.7 +/- 10.4 cm H2O; Pemax, 189.6 +/- 14.6 cm H2O). We concluded that in young trumpet players, maximum respiratory pressures are higher than in young people who do not play wind instruments. This is most probably a consequence of respiratory muscle training with a wind instrument.

Adult↗
PubMed1992

Transient global amnesia after cerebral angiography with iohexol.

We describe a patient without a previous history of migraine or epilepsy and with no known vascular risk factors, who suffered subarachnoid haemorrhage. During vertebral angiography using nonionic contrast medium (iohexol), spasm of the basilar artery was seen. The patient suffered transient global amnesia. Angiography 3 months later with the same contrast medium was normal and produced no further deficit. This case lends support to the supposed ischaemic aetiology of transient global amnesia; in patients without other evidence of cerebrovascular disease, arterial spasm may be responsible.

Amnesia, Retrograde↗
PubMed1992

Measurement of general health status of non-oxygen-dependent chronic obstructive pulmonary disease patients.

Chronic obstructive pulmonary disease is a prevalent condition causing a high level of disability, and it is one of the leading causes of death. To assess the general health status of moderate to severe Chronic obstructive pulmonary disease patients, we studied 76 male patients attending an outpatient hospital clinic who were not dependent on oxygen and who did not present bronchial obstruction reversibility. We assessed clinical status (dyspnea, six-minute walking distance) and functional respiratory impairment (spirometry, and blood gas analysis) of the patients and also asked them to respond to the Spanish version of the Nottingham Health Profile, a multi-dimensional generic health status measure. Patients scored especially higher than the general population (denoting more level of distress) in energy, physical mobility and sleep Nottingham Health Profile dimensions. The former two dimensions scores had a high correlation with dyspnea (respectively Spearman Rs = 0.60, and Rs = 0.64; P less than 0.01). High levels of sleep disturbances were found for patients reporting low or very low dyspnea level. Health status measurement (Nottingham Health Profile dimension scores) and functional respiratory impairment were not correlated. Results underscore the importance of measuring symptoms carefully when assessing these patients, whose health status is substantially affected by the Chronic obstructive pulmonary disease. They also suggest that it is relevant to assess sleep disturbances in these patients.

Activities of Daily Living↗
PubMed1992

Pulmonary capillary hemangiomatosis: report of a case and review of the literature.

We describe a case of pulmonary capillary hemangiomatosis in a 60-year-old woman with a 1-year history of progressive exertional dyspnea. Four years before admission a diagnosis of breast cancer was made, and she underwent mastectomy plus radiation therapy and treatment with oral antiestrogens. The chest X-ray showed bilateral interstitial infiltrates. Pulmonary function studies revealed a severe restrictive pattern. Abundant red blood cells were found in the bronchoalveolar lavage fluid. On the basis of open lung biopsy, interstitial fibrosis was diagnosed. Cardiac catheterization revealed pulmonary hypertension. Steroids were prescribed, but the patient's condition continued to deteriorate and she died approximately 3 years after presentation. The identification of proliferating and invasive capillaries, which are unique to pulmonary capillary hemangiomatosis, led to the correct diagnosis at autopsy.

Biopsy↗
PubMed1992

Effect of order on the performance of maximal inspiratory and expiratory pressures.

We studied the effect of order in the performance of maximal respiratory pressures (PImax and PEmax). For this purpose 20 healthy subjects (male/female: 1/1) were studied. PImax and PEmax were obtained on 2 different days at the same hours (9 and 12 a.m.). The test order was random. On the first day, the entire manoeuvre was performed twice, changing the order in the second determination. On the second day, we repeated the same exercises with reversed order. There were no differences between values for PImax and PEmax when we altered the order of manoeuvres on various days.

Adult↗
PubMed1992

Acute eosinophilic pneumonia due to toxocariasis with bronchoalveolar lavage findings.

A previously healthy young man presented with breathlessness, diffuse pulmonary infiltrates on the chest x-ray film, and a high degree of peripheral blood eosinophilia. Analysis of bronchoalveolar lavage (BAL) fluid showed 64 percent eosinophils. A diagnosis of toxocariasis was eventually reached on the basis of a positive enzyme-linked immunosorbent assay (ELISA) for Toxocara canis. The routine performance of the ELISA test for Toxocara in the diagnostic approach to pulmonary infiltration with eosinophilia could reveal an undetermined, sometimes unsuspected, number of cases of adult toxocariasis with pulmonary involvement. A high degree of eosinophilia in the differential cell count of BAL fluid may eventually prove to be a useful clue in favor of such a diagnosis.

Acute Disease↗