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Biomedical subjects

J Morera

Publications and source records attributed to J Morera.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Sarcoidosis in Catalonia: analysis of 425 cases].

In a retrospective cooperative study carried out in three Barcelona hospitals, 425 patients in whom a diagnosis of sarcoidosis had been made during a 15-year period were evaluated. Several parameters were evaluated and compared with those from the longest series in the literature. Remarkable epidemiological and clinical features included the female predominance, explained by the high frequency of clinical presentations with erythema nodosum; the high incidence of other skin lesions, and, by contrast, the low frequency of eye involvement. It was also remarkable that in a few cases the diagnosis was made in a routine chest radiogram. In diagnostic procedures there was a good diagnostic yield from mediastinoscopy and muscle and pre-scalene fat biopsies The results of Kveim's test, functional respiratory testing and such current activity markers as 67-gallium pulmonary scintigraphy, serum levels of angiotensin converting enzyme and bronchoalveolar lavage were analyzed, and no differences with other series from the literature were found. The presence of the B8 allele and the A1 B8 haplotype was highly significant in subacute sarcoidosis. It is concluded that sarcoidosis is not an uncommonly found condition in this country if the suspicion index is high and an appropriate diagnostic workup is carried out. Its features are not different, as a rule, from those in other European series.

Adolescent↗
PubMed1989

[Early detection of tuberculosis by the evaluation of contacts].

We have evaluated the close contacts of 191 patients diagnosed of tuberculosis in our center between 1984 and 1987. The overall number of evaluated contacts was 666, and the mean number of contacts for each index case was 3.7. In 55% of the evaluated population PPD reaction was positive, and their mean age was 33.3 years. In 132 cases chemoprophylaxis was given during one year (22%). Forty-one new cases of tuberculosis were detected, with a mean age of 25.6 years. In ten new cases the source of infection was familial. When the contacts were distributed according to the bacteriologic status of the index case (direct investigation of tubercle bacilli positive in 103 cases and negative in 167), the rate of disease and infection was significantly higher among those related to positive patients. In the group related to negative patients we discovered 7 new cases of active tuberculosis. Our results confirm the usefulness of the systematic evaluation of the contacts of tuberculous patients in our area, as it permits the identification of an important number of new patients which should be adequately treated. This practice contributes to interrupt the epidemiologic transmission chain of the disease and to facilitate its eradication.

Adolescent↗
PubMed1989

Estimation of the ratio of pulmonary to systemic pressures by pulsed-wave Doppler echocardiography for assessment of pulmonary arterial pressures.

This study describes a method for estimation of the ratio of pulmonary to systemic pressures by pulsed-wave Doppler echocardiography. Sixty-eight patients ages 1 day to 68 years who underwent cardiac catheterization had Doppler studies of the right and left ventricular outflows. Preejection period (PEP), ejection time (ET) and mean acceleration to peak velocity (ACCm) were measured on each waveform. The expression: F = (PEP x ACCm)/ET was calculated for right and left ventricular outflows as an index of the effects that the interaction between ventricular contraction and afterload has on the shape of the Doppler waveforms generated in each outflow. The quotient of (F for the right outflow)/(F for the left outflow), or waveform contour ratio, was used to express the degree of pressure-dependent variability between each subject's right and left ventricular outflow tracings. The waveform contour ratio was strikingly similar to the ratio of systolic pulmonary to systemic pressures and also closely correlated to the ratio of mean pressures. The product of waveform contour ratio and arm systolic pressure gave a consistently accurate estimate of systolic pulmonary pressures. It is concluded that the present method can be used successfully for the noninvasive assessment of pulmonary arterial pressures.

Adolescent↗
PubMed1989

[Lumbosacral plexopathy caused by aneurysms of the abdominal aorta].

We report three patients who presented pain in the sciatic-crural region as presenting feature of an aneurysm of the abdominal aorta. The first patient developed a fullblown plexopathy with bad condition due to a large aneurysm of common iliac artery. The remaining two patients had abdominal aneurysms each that manifested as femoral neuropathy in one case and as L5-S1 radiculopathy in the other patient. The mechanism of neural involvement is discussed and those clinical and radiologic findings which may prompt us to think of such etiology in front of painful clinical pictures in this region are emphasized.

Aneurysm↗
PubMed1989

Recurrent pulmonary embolism. A prospective study.

We have prospectively studied a series of 121 consecutive patients with venous thromboembolism (38 with pulmonary embolism, 83 with venous thrombosis of the lower extremities) searching for recurrences of pulmonary embolism despite adequate heparin therapy. A baseline ventilation-perfusion lung scan was obtained initially in every patient, whether the original diagnosis was pulmonary embolism or venous thrombosis. Repeat chest roentgenograms and lung scans were obtained routinely at eight days of heparin treatment. The primary trial endpoints were a finding of a clinically apparent recurrent pulmonary embolism, or laboratory evidence of subclinical pulmonary embolism. Eight items of clinical and laboratory information were recorded at admission and then correlated with the lung scan results. Recurrences were seen in seven of 38 patients with an original diagnosis of pulmonary embolism, and in five of 83 patients admitted because of venous thrombosis (p = 0.034). Recurrences were also more frequent in patients with a free-floating thrombus on venography (p = 0.014). The risk of new defects in patients with venous thrombosis and without free-floating thrombus was 3.05 percent, venous thrombosis with free-floating thrombus, 13.33 percent; patients with pulmonary embolism without free-floating thrombus, 11.42 percent; and with free-floating thrombus, 38.67 percent. Venography seems thus mandatory in patients with pulmonary embolism, as it recognizes a subgroup of patients at a high risk of recurrences.

Adult↗
PubMed1989

[Respiratory distress in an addict on parenteral drugs with tricuspid endocarditis due to Staphylococcus aureus and with Pneumocystis carinii pneumonia].

A case of a female, intravenous (I.V.) drug user with respiratory distress syndrome as first manifestation 24 hours after admission, is presented. The clinical suspicion of tricuspid valve endocarditis associated to Pneumocystis carinii pneumonia arose because this patient was a member of a high-risk AIDS group. An empiric treatment was applied and the diagnosis was made posterior to this. We comment on the unusual coincidence of both pathologic states, highlighting the early diagnosis and treatment.

Adolescent↗
PubMed1989

[Neurophysiologic study in patients with human immunodeficiency virus infection].

Peripheral nervous system (PNS) involvement in the form of different neuropathies in human immunodeficiency virus (HIV) infection is increasingly more common. We present a series of 20 HIV + patients subjected to neurophysiological study. The most commonly observed neurological disorder was a slight axonal-type sensitivo-distal polyneuropathy that predominantly affected the lower limbs during the early stages of infection. As HIV infection evolves, the polyneuropathy worsens and becomes a sensitivo-motor polyneuropathy with a more important axonal component. Secondary demyelinization is observed, with additional involvement of the upper limbs in the final stages of infection. The most frequent neurophysiological finding was a decrease in somatosensory evoked potential (SEP) and conduction velocity (CV) of the sural nerve.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Spinal cord involvement by the human immunodeficiency virus. Vacuolar myelopathy].

Vacuolar myelopathy is the most frequent spinal syndrome in patients infected with the human immunodeficiency virus, presently considered to be related to a direct action of the virus. The authors review the historical, clinical, pathological and etiopathogenetic aspects of this new entity, stressing the difficulties posed by its differential diagnosis and its scarce therapeutic possibilities.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Amiodarone toxicity: recurrence of interstitial pneumonitis after withdrawal of the drug.

Amiodarone hydrochloride, an iodinated benzofuran derivative, is effective for treatment of supraventricular and ventricular arrhythmias. Pulmonary fibrosis has been reported after treatment with this drug. We present a patient with amiodarone pulmonary toxicity, who initially responded to corticosteroid therapy, but who developed a clinical relapse two months after withdrawal of the drug.

Amiodarone↗
PubMed1987

A randomized study comparing platinum, doxorubicin, and VP-16 with platinum, 4'-epidoxorubicin, and VP-16 in patients with non-small-cell lung cancer.

Forty-four previously untreated patients with advanced non-small-cell lung cancer were treated in a randomized trial comparing platinum (60 mg/m2), doxorubicin (40 mg/m2), and VP-16 (150 mg/m2) (PAV) with platinum (60 mg/m2), 4'-epidoxorubicin (50 mg/m2), and VP-16 (150 mg/m2) (PEV). The overall response rate was 10%. Major response rates were quite similar for the 21 patients treated with PAV (5%) and the 23 patients treated with PEV (18%) (p = 0.2). Of the 23 patients with assigned to PEV, two (9%) achieved complete responses for a median duration of 20 weeks and 44+ weeks. There was no significant difference (p = 0.75) in the median survival among patients treated with PAV (24 weeks) and those treated with PEV (20 weeks). Toxicity was generally mild and tolerable. The lack of response found in both arms of treatment caused the study to be terminated early. Some benefit could be appreciated in patients with limited disease and good Karnofsky performance status.

Adenocarcinoma↗
PubMed1986

Captopril and bronchial reactivity.

In order to assess the effect of captopril on bronchial reactivity, 16 consecutive patients with asthma and hypertension were randomized in a double-blind crossover study, with increasing doses of placebo or captopril for 4 week periods. Forced expiratory flow (FEV1) and a dose-response curve with methacholine (PD20) were measured before and after treatment . Effective control of hypertension was achieved in all patients on captopril (P less than 0.05), while no changes in FEV1 and PD20 were observed. We conclude that captopril can be used as a first step in the treatment of asthmatic patients with hypertension.

Asthma↗
PubMed1984

Treatment of exacerbations of chronic bronchitis. A comparative double-blind study with cotrimoxazole and cefadroxil.

A double-blind, randomized study was carried out in 40 chronic bronchitic patients, to evaluate the effectiveness of cefadroxil as compared with cotrimoxazole in the treatment of the exacerbation stage. The patients were in hospital while the study lasted and received cotrimoxazole at doses of 160 mg of trimethoprim and 800 mg of sulfamethoxazole twice a day, or cefadroxil 500 mg twice a day, for seven days. To evaluate the response the following parameters were used: clinical improvement, reduction in volume of sputum, reduction in purulence of the sputum and eradication of germs from the sputum. All the parameters improved in both groups of patients without any significant difference between the two types of treatment.

Adult↗