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Biomedical subjects

J Villamor

Publications and source records attributed to J Villamor.

At least 37 records · Page 2Linked to original sources
PubMed1997

Nocturnal arterial oxygen desaturation secondary to a sphenoidal meningioma.

We report the case of a nonobese and nonsmoking 51-year-old man with nocturnal arterial oxygen desaturation that returned to normal after sphenoidal meningioma resection. He presented an important daytime hypersomnia and episodes of nocturnal apnea, without snoring. His arterial blood gases, mechanical properties of the respiratory system pulmonary diffusing capacity and chemosensitivity were normal. The most frequent causes of nocturnal hypoxemia are examined.

Blood Gas Analysis↗
PubMed1997

Comparison of helium dilution and plethysmographic lung volumes in pregnant women.

The multibreath helium equilibration method is the technique recommended for routine measurement of static lung volumes in normal subjects. However, pregnancy could be an exception to this general rule, due to airway closure during the second half of gestation. The aim of this study was to compare the measurements of lung volumes by plethysmography and helium dilution during pregnancy. Twenty three healthy women were studied at 12, 24 and 36 weeks of pregnancy, and 4 months postpartum. Total lung capacity (TLC), functional residual capacity (FRC) and residual volume (RV) were measured by multibreath helium equilibration (TLCHe, FRCHe and RVHe) and by plethysmography (TLCbox, FRCbox and RVbox). Only at 36 weeks were there differences between the two methods. RVbox was significantly larger than RVHe (1.01+/-0.18 vs 0.77+/-0.21 L; p<0.001). FRCbox was larger than FRCHe (1.95+/-0.32 vs 1.60+/-0.32 L; p<0.001) and TLCbox was larger than TLCHe (4.83+/-0.52 vs 4.45+/-0.51 L; p<0.05). The 95% limits of agreement for differences between lung volumes measured by the two techniques (helium dilution - plethysmography) at 36 weeks were: -0.42 to -0.06 L for RV; -0.54 to -0.17 L for FRC; and -0.66 to -0.11 L for TLC. We conclude that using the multibreath helium equilibration method to measure lung volumes in at-term pregnant women results in underestimation of functional residual capacity and total lung capacity.

Adult↗
PubMed1996

Regulation of breathing and perception of dyspnea in healthy pregnant women.

STUDY OBJECTIVE: To examine if the perception of dyspnea during normal pregnancy may be related to an inappropriate ventilatory response to the increased metabolic rate, due to a higher chemosensitivity. PATIENTS AND INTERVENTIONS: At weeks 12, 24, and 36 of gestation and 4 months after delivery, 11 healthy pregnant women with dyspnea and 12 asymptomatic pregnant women were studied. Progesterone plasma levels, lung volumes, diffusion capacity, maximal respiratory pressures, rest oxygen uptake, breathing pattern, and mouth occlusion pressure (P0.1) were measured. Progressive isocapnic hypoxic stimulation and progressive hyperoxic hypercapnic stimulation were performed. RESULTS: Oxygen ventilation equivalent during pregnancy was significantly higher for the dyspneic group than for nondyspneic pregnant women. Dyspneic patients exhibited greater minute ventilation, tidal volume, and P0.1 than the nondyspneic group. The mean values of ventilatory and P0.1 slopes to hypoxia and CO2 during pregnancy were significantly greater in the patients with dyspnea than in asymptomatic subjects. These changes were not due to differences in progesterone plasma levels. A significant relation among the Borg score, inspiratory drive, and chemosensitivity was found. CONCLUSIONS: In some pregnant women, a higher sensitivity to CO2 and hypoxia may induce excessive ventilation to metabolic demand, which would contribute to dyspnea.

Adult↗
PubMed1996

Short-term effects of inhaled beta-adrenergic agonist on breathlessness and central inspiratory drive in patients with nonreversible COPD.

In patients with COPD, a relationship between breathlessness and respiratory effort, assessed in terms of mouth occlusion pressure (P0.1), has been described. To evaluate the short-term effects of inhaled terbutaline on breathlessness, breathing pattern, and P0.1 in patients with nonreversible COPD, we designed a randomized, double-blind, parallel, placebo-controlled study. Twenty-five patients with stable nonreversible COPD, mean age 64 +/- 11 years, were enrolled in the study. Patients received 500 micrograms inhaled terbutaline or placebo. Breathlessness, using the Borg scale, breathing pattern, and P0.1 were measured at baseline and 30 min after inhalation. Terbutaline resulted in a significant decrease in Borg scale, while no differences were observed after placebo. No significant changes in breathing pattern were found. Nevertheless, a decrease in P0.1 (0.31 +/- 0.07 vs 0.21 +/- 0.05 kPa; p < 0.001) after terbutaline inhalation was observed. Borg score was correlated with P0.1 in all patients. Moreover, changes in Borg score after medication were directly proportional to P0.1 changes (r = 0.85; p < 0.01). We conclude that terbutaline decreases central inspiratory drive and improves breathlessness in patients with nonreversible COPD.

Administration, Inhalation↗
PubMed1996

[Ambulatory oxygen therapy via a transtracheal catheter].

Oxygen therapy by transtracheal catheter (TTC), as described by Heimlich in 1982, was originally conceived to conserve oxygen but later proved to be truly useful as a treatment for chronic respiratory insufficiency, although the technique is little used in Spain. We conducted a one-year long prospective study of 10 patients with chronic respiratory insufficiency in whom a TTC was placed for ambulatory oxygen therapy. Complications appearing were bloody expectoration (100%), granulomas at the site of incision (20%) and accidental extubation (10%). The index of acceptance among our patients was 9%. The oxygen savings achieved amounted to 46%. The number of hospitalized days before and after insertion of the catheter amounted to 28 and 3, respectively (p < 0.001). PCO2 levels were 62 +/- 14 at baseline, 51.9 +/- 8.8 (p < 0.1) after one week, and 52.9 +/- 10 (NS) after one year. The hematocrit was 45.6 +/- 10.22 before TTC placement and 43.4 +/- 3.02 (NS) after one year. Changes in PO2, FVC and FEV1 were not statistically significant. No problems derived from TTC or liquid oxygen management.

Aged↗
PubMed1995

Amyloid goitre and hypothyroidism secondary to cystic fibrosis.

Although cystic fibrosis (CF) is still the most frequently fatal childhood disease, many adults now survive into their third and fourth decades. Uncommon complications of chronic diseases, such as amyloidosis, while infrequent, may now appear during the course of CF in adulthood. We present a case of a patient with CF who was diagnosed with hypothyroidism due to amyloid deposits in the thyroid.

Adult↗
PubMed1995

Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome.

Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome.

Adult↗
PubMed1995

[Cytologic and biochemical component in 203 bronchoalveolar lavages. Reference values].

The bronchoalveolar lavage (BAL) is considered a basic technique as a diagnostic aid in Pneumology. However, one of the main problems faced by the clinician is the lack of standardization of the technique. This has been resolved through the drafting of international standards. The other problem is the lack of what might be called a "reference" BAL. In order to establish a reference BAL, we analyzed 203 BAL divided in two groups: a control group and a pathologic group, make up by extrinsic asthma, intrinsic asthma, pulmonary infections, diffuse interstitial pneumopathies, bronchopulmonary tumors and chronic bronchitis. We have studied both the cytologic and the biochemical component of the BAL. Among the biochemical markers, we have considered; carcinoembrionary antigen (CEA), tissular polypeptidic antigen (TPA), neuronal specific enolase (NSE), ferritin (FER), calcitonin (CT), ACTH, histamin (HIS) and prostaglandin (PGE2). In order to establish the reference values, we have used the modified Baye's theorema. The BAL that we obtained was the following: volume 20 ml, cells 35 x 10(5) cells/ml, macrophages 77%, lymphocytes 22%, neutrophils 4%, eosinophils 2%, CEA 14 ng/mg, TPA 84 U/g PT, NSE 5 ng/mg PT, FER 42 ng/mg PT, CT 15 pg/mg PT, ACTH 51 pg/mg PT, HIS 1.22 ng/mg PT, PGE2 35 pg/mg PT.

Adolescent↗
PubMed1995

Six cases of pulmonary alveolar proteinosis: presentation of unusual associations.

We report the cases of six patients with pulmonary alveolar proteinosis (PAP). Four of the patients were adults, two males and two females (mean age 39 +/- 19 yrs). The other two patients were children, both females, one aged 6 years and one 3 days old. The diagnosis was made by thoracotomy-lung biopsy in two subjects, autopsy in two, transbronchoscopic biopsy in one and bronchoalveolar lavage (BAL) in one. Some of our cases presented unusual associations that have not been described previously in the medical literature: renal tubular acidosis, Fanconi's disease, glioblastoma multiforme and atrioventricular septal defect. In two patients, treatment with acetylcysteine and ambroxol was unsuccessful. Therapeutic BAL improved the clinical, analytical, functional and radiological aspects of two cases. In one subject, three months after the diagnosis of PAP, pulmonary tuberculosis appeared. Both diseases disappeared with antituberculous treatment.

Acetylcysteine↗
PubMed1994

The clinical value of neuron-specific enolase as a tumor marker in bronchoalveolar lavage.

BACKGROUND: Neuron-specific enolase (NSE) is used in the staging and monitoring of responses to therapy and the detection of recurrences in lung cancer. The diagnostic value of NSE has been under discussion. This may be because NSE usually has been studied in the sera of patients with bronchogenic carcinoma and not in the bronchoalveolar lavage (BAL). METHODS: The NSE levels in the BAL of three groups--control subjects, patients with chronic bronchitis, and patients with tumors--were analyzed. The fluid obtained was centrifuged. The NSE was analyzed in the supernatant of the BAL (NSE, Pharmacia, Columbia, MD). Its concentrations were calculated in relation to milligrams of total protein. RESULTS: A significant difference was noted in the level of NSE in the BAL of the tumor group compared with those of the other two groups. No differences were observed between the other two groups or between healthy smokers and nonsmokers. No correlation was found with the histologic type of pulmonary carcinoma and NSE levels in BAL. The NSE levels were higher in the lavages of patients with primary pulmonary carcinomas than in those with metastases. CONCLUSIONS: Neuron-specific enolase could be of aid in the early diagnosis of solitary pulmonary nodules and lung cancer. More studies would be required to identify a correlation between NSE levels in BAL and those in serum, or between NSE levels in BAL and tumor size and location and disease stage of lung cancer.

Adenocarcinoma↗