Search PubMed⌕ Search

Biomedical subjects

J Morera

Publications and source records attributed to J Morera.

At least 91 records · Page 5Linked to original sources
PubMed1992

Effects of inhaled platelet activating factor on bronchial responsiveness in patients with symptomatic and asymptomatic pulmonary embolism.

To determine the possible role of platelet-activating factor (PAF) in pulmonary embolism (PE), the reactivity of the airways to inhaled PAF, using doses ranging from 6.25 to 400 micrograms, was examined in 24 patients with a past episode of PE. Twelve of these patients had experienced acute respiratory insufficiency during the episode (with or without additional symptoms). None of the remaining 12 patients had experienced any respiratory symptoms during the PE episode. Diagnosis was established by means of a ventilation-perfusion lung scan performed when admitted to the hospital because of deep venous thrombosis (DVT) in the lower limbs. Nonspecific bronchial reactivity as measured by the response to bronchoprovocation testing with methacholine showed no significant differences between both groups. PAF caused a dose-dependent bronchoconstriction defined by at least a 35 percent decrease in specific airway conductance (SGaw) in all patients. The average dose of PAF needed to decrease SGaw 35 percent was significantly lower in patients who had had a symptomatic PE than in those with asymptomatic PE (p = 0.011). This finding suggests that patients who suffered from symptomatic PE may present a greater airway reactivity to inhaled PAF. This different behavior might explain the existence of some of the respiratory symptoms of PE, which could be attributed to PAF-related effects. However, additional studies are needed to evaluate the role of PAF in PE.

Administration, Inhalation↗
PubMed1992

Sarcoidosis in Spain.

We review the Spanish literature on sarcoidosis, and describe the most important epidemiological and clinical findings. Recent epidemiological data show a cumulative annual incidence rate of 1.36 per 100,000 inhabitants. The most relevant clinical aspects are the high incidence of Löfgren syndrome (48% of the cases), and the low percentage of cases diagnosed by routine chest X-ray (9%). Findings of intrathoracic and extrathoracic sarcoidosis, biopsy procedures, Kveim test, lung function tests, as well as the activity markers are, in general, similar to those previously described in the literature. The overall prognosis of sarcoidosis in Spain is good.

Adolescent↗
PubMed1991

Hygroscopic condenser humidifier as a solution to nasal dryness due to nasal CPAP treatment for obstructive sleep apnea syndrome.

We report an apparent solution to nasal dryness for patients with obstructive sleep apnea syndrome treated with nasal continuous positive airway pressure (CPAP) when a hygroscopic condenser humidifier is introduced into the CPAP circuit. Six patients underwent a 5-h test period of nasal CPAP therapy with a mask containing a hygroscopic humidifier. The water vapor showed a statistically significant increase in both inspired and expired gases. The relative humidity of the inspired gases increased significantly. The levels of O2 and CO2 in the respired gases did not change. When patients were asked about nasal dryness at the end of the test, all of them reported marked improvement.

Air Conditioning↗
PubMed1991

Lung dust content in idiopathic pulmonary fibrosis: a study with scanning electron microscopy and energy dispersive x ray analysis.

Examination with an optical microscope and polarised light is not sensitive enough to detect low diameter asbestos fibres. This limitation implies that some cases of asbestosis can be erroneously diagnosed as idiopathic pulmonary fibrosis (IPF) if asbestos bodies are not found in the standard examination of abnormal tissue. To determine whether IPF is over-diagnosed, a study was carried out with scanning electron microscopy (SEM) and energy dispersive x ray analysis (EDXA) on 25 samples previously diagnosed as IPF at the standard examination. Scanning electron microscopy will show the presence of low diameter fibres in the lung without tissue destruction, and these fibres can be identified using EDXA. The quantitative and qualitative results for lung tissue from patients diagnosed as having IPF were compared with the results of the examination of 25 samples of normal lung. Most of the samples from patients diagnosed as having IPF showed only occasional inorganic particles (less than 10 particles/SEM field at 160 x), results equivalent to the results obtained in normal lung. Two cases of IPF, however, showed innumerable asbestos fibres (greater than 100 fibres/SEM field). One of these two patients had an antecedent of brief exposure to asbestos. No environmental antecedent was found in the second patient. Asbestosis was the final diagnosis for these two patients. The examination of inorganic particles in normal lungs showed mainly non-fibrous silicates (61.4%) and particles of heavy elements (34.9%). Only one asbestos fibre was found (0.9%). It is concluded that standard pathological techniques overdiagnose IPF in a few cases in which asbestos bodies are not found with the optical microscope.

Adult↗
PubMed1991

Radiographic appearance of nosocomial legionnaires' disease after erythromycin treatment.

Radiographic features of 71 patients (48 men, 23 women) with nosocomial Legionella pneumophila pneumonia were assessed and compared with those of other nosocomial series of L pneumophila pneumonia. Sixteen patients were assessed retrospectively and 55 prospectively. Chest radiographs were assessed at the onset of the illness, 10 days later, and at 3 months. Erythromycin was given to 67 patients at the time of the diagnosis and to the remaining four at a later stage. Forty eight patients were over the age of 60. On the initial chest radiograph 53 of the 71 patients had unilateral shadowing (23 of them in the right lung); 35 had unilobar shadowing and the remaining 36 had more than one affected lobe. Pleural effusion was present in 24 cases and cavitation in 2. One patient had evidence of a pericardial effusion. At 10 days 21 patients had evidence of radiographic progression (14 ipsilateral), but 28 had improved. At 3 months 36 patients had an abnormal radiograph, 30 showing residual scarring, 15 loss of volume, six pleural shadows and two cavitation. Our series shows a lesser incidence of unilateral shadowing and pleural effusion than other nosocomial series and a lesser tendency to progression, but more patients had radiographic abnormalities at long term follow up.

Adult↗
PubMed1991

The length of time healthy subjects and patients with chronic obstructive pulmonary disease are able to withstand maximal inspiratory pressure.

We measured the length of time that healthy subjects and patients with chronic obstructive pulmonary disease (COPD) were able to withstand an inspiratory pressure equal to or over 80% of the maximal static inspiratory pressure (PImax). For the purpose 10 patients with COPD, during a stable period of their illness, and 10 healthy subjects were studied. The mean values for PImax, maximal expiratory pressure (PEmax) and the length of time to withstand PImax (TPImax) were significantly lower in patients with COPD than in healthy individuals. In the group of patients with COPD, 50% exhibited a TPImax of less than 3 s and none were able to withstand PImax for more than 4.30 s. However, it should be pointed out that, even among healthy individuals, there were 4 subjects who were unable to withstand PImax for more than 3 s.

Forced Expiratory Volume↗
PubMed1991

Pulmonary mass and air meniscus sign in a 19-year-old man.

Sacrococcygeal teratoma is rarely diagnosed in adults. Pulmonary mass as the presenting clinical form of the malignant variety of this germ-cell tumor is exceptional. We report herein such a case with the noticeable peculiarity of showing the air meniscus sign on chest roentgenographic examination.

Adult↗
PubMed1991

Comparative study of Legionella pneumophila and other nosocomial-acquired pneumonias.

We studied, in a prospective way, the characteristics of definitively diagnosed nosocomially acquired pneumonias in our hospital over 36 months. Out of 55 cases, 27 were due to Legionella pneumophila and 28 to other, non-Legionella bacteria. The cases of legionellosis concentrated in July, August, and December. The only risk factors that showed significant differences (p less than 0.05) were general anesthesia and surgery and immunosuppressive disease, which were more frequent in the non-Legionella group, as were chronic liver disease and lowering of consciousness level. The absence of severe underlying disease, chronic or not, was uncommon in both groups, but more frequent in the Legionella group. We observed no differences in the clinical features of the two groups. Mean values of gamma-glutamyltranspeptidase and total bilirubin were higher (p less than 0.05) in the non-Legionella group. The only x-ray data that showed significant difference were pleural effusion, more frequent in the non-Legionella group (p less than 0.02). The mortality rate of legionellosis was 14.6 percent compared to 35.7 percent for the non-Legionella group (p less than 0.05). We conclude that a sure differential diagnosis based on clinical, roentgenographic and analytical features of both groups is not possible. The relatively low mortality rate of the Legionella group, when compared to other series of nosocomial legionellosis, could be due to the standard use of erythromycin in the therapeutic approach to nosocomial-acquired pneumonia in our hospital.

Adolescent↗
PubMed1991

Postural variation of the maximum inspiratory and expiratory pressures in obese patients.

Evaluating whether weight is a factor responsible for the decrease of muscle force in the supine position with respect to the upright and sitting positions, we measured maximum inspiratory and expiratory pressures (PImax and PEmax) in these postures in ten obese patients (age 38.7 +/- 9.1 years; height 168.7 +/- 8.9 cm; and weight 139.3 +/- 28.4 kg) and ten normal control subjects (age 38.4 +/- 8.2 years; height 169.3 +/- 7.9 cm and weight 66.9 +/- 11.9 kg.) In both study groups, PImax and PEmax values decreased in the supine posture with respect to upright and sitting positions. Differences between pressures in the various postures were similar for both groups with the exception of PEmax in obese females. The decrease in PEmax values from the sitting to supine positions was greater in obese than control females. Weight, sex and postural changes can influence the generation of maximal expiratory force.

Adult↗
PubMed1990

Tuberculosis of the breast: a rare modern disease.

A case of mammary tuberculosis is reported. A communication between the axillary glands and the breast emphasises Cooper's theory that the breast becomes secondarily involved by lymphatic extension. Involvement of other organs by acid-fast bacilli could not be demonstrated. A relapse occurred sixteen months after a 6-month course of treatment with rifampicin, isoniazid, ethambutol and pyrazinamide.

Antitubercular Agents↗
PubMed1990

Postural variation of the maximum inspiratory and expiratory pressures in normal subjects.

The maximum static inspiratory and expiratory pressures (MIP and MEP, respectively) were measured in 15 normal male subjects (average age, 27.14 years) in standing and sitting position. The MIP was determined at RV and FRC and MEP was determined at TLC and FRC. No significant differences were found for these parameters between the two postures. Our study proves that the posture adopted by the subject when these two maneuvers are performed does not influence the results obtained.

Adult↗
PubMed1990

Variation in maximum inspiratory and expiratory pressure after application of inspiratory loads in patients with COPD.

We studied eight men with chronic obstructive pulmonary disease (COPD) (age, 60.57 +/- 7.59 years; height, 162 +/- 10.43 cm; weight, 65 +/- 9.7 kg). Functional values of the sample were as follows: FEV1, 46 percent; FVC, 67 percent; PO2, 72.4 mm Hg; and pH, 7.41. We used a modification of the Nickerson and Keens method. Patients were required to perform 65 percent of maximal inspiratory pressure (MIP). We counted the time from the start of the test to exhaustion of the patient (TLIM). We measured basal MIP and maximal expiratory pressure (MEP) (TLC) at the TLIM and 10, 20, and 30 minutes and MIP was different from the basal value (MIP basal, 85.7 cm H2O; MIP 10 minutes, 79.1 cm H2O; MIP 20 minutes, 78.6 cm H2O; MIP 30 minutes, 79.6 cm H2O. The MEP was not different from the basal value. We concluded that in patients with COPD, MIP decreases significantly after inspiration through umbral inspiratory weight equal to 65 percent MIP and does not return to basal value for 30 minutes. The MEP does not change with respect to basal determination.

Airway Obstruction↗