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Biomedical subjects

J Villamor

Publications and source records attributed to J Villamor.

At least 55 records · Page 3Linked to original sources
PubMed1994

[The predictive parameters in the response to almitrine treatment].

Almitrine bimesylate (AB) improves hypoxemia in an undetermined number of patients with respiratory failure. Our objective was to try to identify the patients likely to benefit from this treatment. We undertook a double blind study of AB (50-100 mg/day) vs placebo in 21 randomly chosen patients diagnosed as having chronic obstructive bronchitis who were receiving oxygen therapy in the home. The study lasted 3 months (T0 to T3). PaO2 rose from 51 +/- 5.3 to 58.5 +/- 10 mmHg (6.8 +/- 0.7 to 7.8 +/- 1.3 Kpa) in the 12 patients taking AB (p < 0.05). The remaining gasometric variables and results of functional respiratory exploration were unchanged. The 7 patients receiving AB who were defined as responding-whose PaO2 rose more than 5 mmHg (0.66 Kpa)-presented T0 values lower than those of the 7 non-responding patients in the same group, with respect to CO2 occlusion pressure, mean inspiratory flow and minute ventilation for both air and CO2. These variables can serve as predictors for gasometric response to AB.

Aged↗
PubMed1994

Breathing pattern and central ventilatory drive in mild and moderate generalised myasthenia gravis.

BACKGROUND: Myasthenia gravis is a specific autoimmune disease characterised by weakness and fatigue. Respiratory muscle weakness has been studied using the determination of maximal respiratory pressures, but the response of respiratory centres is not well characterised. This study was undertaken to determine the breathing pattern and the central ventilatory drive in patients with mild and moderate generalised myasthenia gravis. METHODS: Twenty four patients with myasthenia gravis were studied, divided into two groups. Group 1 included 13 subjects (eight women and five men aged 23-64) with mild generalised myasthenia gravis, and group 2 was composed of 15 patients (11 women and four men aged 23-69) with moderate generalised myasthenia gravis. A control group comprised 15 healthy persons with a similar age and sex distribution. Spirometric measurements and maximal respiratory pressures were performed under basal conditions in all subjects, and the rate and depth of breathing and the inspiratory occlusion pressure in the mouth in the first 0.1 second (P0.1) were measured. RESULTS: No difference was detected for parameters of breathing pattern between patients in group 1 and control subjects, although P0.1 was higher in those in group 1. Subjects in group 2 had a lower tidal ventilation, shorter inspiratory time, and a higher frequency with a higher P0.1 than control subjects. CONCLUSIONS: Mild myasthenia gravis causes increased neuromuscular drive with a normal breathing pattern. Moderate myasthenia gravis is characterised by a more rapid shallow breathing pattern.

Adult↗
PubMed1994

Nasal CPAP during wakefulness increases intraocular pressure in glaucoma.

Few important side-effects of nasal continuous positive airway pressure (nCPAP) have been reported. No increase of intraocular pressure (IOP) complicating this treatment has previously been described. The goal of our study was to analyse the influence of nCPAP on IOP. We evaluated 18 patients previously diagnosed as having glaucoma and 22 normal subjects. nCPAP was used during wakefulness, at +12 cmH2O for 15 min. The results showed that nCPAP significantly increases IOP in patients with glaucoma (before nCPAP 20.3 +/- 6.3 mmHg) (mean +/- SEM); after nCPAP 22.3 +/- 5.7 mmHg. We believe that nCPAP might be relatively contraindicated in difficult to manage glaucoma patients, if these results are corroborated.

Female↗
PubMed1994

[Variations of angiotensin converting enzyme in chronic obstructive pulmonary disease and chronic respiratory insufficiency].

UNLABELLED: Maintained hypoxia has been reported to induce inactivation of the Angiotensin Converting Enzyme (ACE). Variations have also been observed in patients with chronic obstructive pulmonary disease (COPD) who have chronic hypoxemia and loss of the vascular endothelium. OBJECTIVES: 1) to determine serum ACE activity in patients with COPD treated with and without continuous ambulatory oxygen therapy (CAOT); 2) to verify whether there is a correlation between ACE and any hematological, spirometric or gasometric parameter. METHODS: fifty-eight patients fulfilling clinical and spirometric parameters of COPD were studied. Patients were assigned to two groups of therapy: A) Group A, without Continuous Ambulatory Oxygen Therapy (CAOT): 31 males and 1 female (mean age: 64.8 +/- 6.52). B) Group B (with CAOT): 23 males and 3 females (mean age years: 63.76 +/- 8 years). The following procedures were performed: spirometry, gasometry, blood chemistry, and serum ACE measurements by means of a radioenzymatic assay. The Student "t" test with the Bonferroni correction and Pearson regression analysis were used for the statistical analysis. RESULTS: significant differences were observed for ACE values between Group A and Group B: 42.81 +/- 11.30 vs. 33.40 +/- 9.43 mumol/min/l, with a p value of 0.001, and also between Group B and reference values: 33.40 +/- 9.43 vs. 39.70 +/- 9.65 mumol/min/l, with a p value of 0.002. No differences were observed between Group A and reference values. No correlations wer found between ACE and any of the variables studied. CONCLUSIONS: ACE was not decreased in all patients with COPD. ACE was decreased only in patients with COPD and respiratory insufficiency requiring CAOT and with advanced disease. This results can be correlated with changes in vascular endothelium, pulmonary parenchyma and metabolism. It could be a marker of poor prognosis or advanced disease.

Aged↗
PubMed1994

Dissection of ascending aorta. A new cause of alveolar hemorrhage?

Alveolar hemorrhage is an entity caused by different etiologies. We report the case of a male who was admitted in our Service due to hemoptysis secondary to an alveolar hemorrhage diagnosed by chest X-ray and fiberoptic bronchoscopy. Thirty six hours after the admission the patient died and his necropsy showed dissection of ascending aorta and alveolar hemorrhage.

Aortic Dissection↗
PubMed1994

[CT-guided fine-needle thoracic aspiration puncture. Its cost effectiveness and complications].

OBJECTIVE: To study the profitability and complications of the puncture aspiration with thoracic thin-needle (PATTN). METHODOLOGY: The results of 160 PATTN, performed under TC control in 131 men and 29 women, average age 61.24 +/- 15.17 years were analyzed. The diagnosis obtained by PATTN was compared with the definitive diagnosis made with biopsy (bronchial, thoracotomy, or mediastinoscopy), the evolution or response to treatment, or at autopsy. Factor related to greater diagnostic reliability and risk of pneumothorax were analyzed. RESULTS: For the diagnosis of non-tumoral pathology, the technique achieved a sensitivity (S) of 90 percent, specificity (E) of 96.06 percent, and reliability (F) of 91.71 percent, while in malignant processes, S 72.4 percent, E 100 percent and F 88.52 percent, with a histological correlation of 72.72 percent in the first case and 68.80 percent in the second. The localization in superior lobes, radiological pattern of multiple or cavitied nodules, and size > 2 cm were identified as factors which significantly increased reliability. Pneumothorax was produced in 24 cases (15 percent) and was more common in patients diagnosed of COPD, with a lesion < 2.1 cm, and not attached to the pleura. CONCLUSIONS: The PATTN offers considerable profitability for the diagnosis of thoracic lesions of any localization and nature, at low costs and with few serious complications.

Adolescent↗
PubMed1994

Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy.

The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 +/- 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted.

Biopsy, Needle↗
PubMed1993

Interference of glycosylated human hemoglobin with endothelium-dependent responses.

BACKGROUND: Hypertension and other vascular diseases are more prevalent in diabetic patients than in the general population. In humans and in several animal models of diabetes, a disturbance of endothelium-dependent responses has been shown. Oxyhemoglobin is one of the most known modulators of these endothelium-dependent responses. We postulate that high levels of plasmatic glycosylated hemoglobin, a frequent profile in diabetic patients, may be the cause of the disturbance in endothelium-dependent relaxation and/or contraction. METHODS AND RESULTS: Endothelium-dependent responses to acetylcholine and several alpha-adrenergic agonists (norepinephrine, methoxamine, and clonidine) were tested in segments of rat aorta. Experiments were carried out in control segments and in those preincubated with several concentrations of nonglycosylated, low-glycosylated (7.3%), and high-glycosylated (14%) human hemoglobin. Low concentrations of high-glycosylated human hemoglobin (1 to 100 nmol/L) but not of low- or nonglycosylated hemoglobin, inhibited endothelium-dependent relaxation caused by acetylcholine in intact vessels. The same effect was observed on relaxations caused by nitric oxide in denuded ones. High-glycosylated human hemoglobin (10 nmol/L) induced an increase in norepinephrine-evoked contraction in intact vessels; this latter effect was also shown in vessels contracted with methoxamine but not with clonidine. De-endothelialization of the vascular segments blunted these effects of high-glycosylated human hemoglobin. CONCLUSIONS: High glycosylation of human hemoglobin impairs endothelium-mediated vasoactive responses and may play a pathophysiological role in producing hypertension and vascular diseases in diabetic patients.

Acetylcholine↗
PubMed1993

[Idiopathic pulmonary fibrosis: new diagnostic and therapeutic perspectives].

Idiopathic pulmonary fibrosis (IPF) is a disease of unknown etiology affecting alveolo-interstitial structures. It is clinically characterized by progressive dyspnea and dry cough. In the physical exploration, crakles at the pulmonary bases and acropachies are usually detected. Its diagnosis has been a major clinical problem. Currently, a definitive diagnosis can be established with high resolution computerized axial tomography, bronchoalveolar lavage and open pulmonary biopsy. The next clinical problem is the assessment of activity, since it allows to differentiate subsidiary patients for receiving treatment. The description of new therapeutical alternatives has brought new perspectives in the management of these patients. Corticotherapy associated to immunosuppressors has allowed to reduce side effects and to obtain dramatic improvements. Lung transplantation, currently under study, will be the therapy of the future.

Female↗
PubMed1993

[Elevated negative predictive value of angiotensin converting enzyme in the diagnosis of active sarcoidosis].

OBJECTIVE: To evaluate the usefulness of angiotensin converting enzyme (ACE) in the differential diagnosis of active sarcoidosis in action with other interstitial and granulomatous processes. METHODS: The study involved 30 patients with a histological diagnosis of sarcoidosis, 38 subjects with anatomopathologically and/or microbiologically confirmed pleuropulmonary tuberculosis, and 12 subjects with idiopathic pulmonary fibrosis confirmed by histological studies. Following the technique developed by Rohatgi and Ryan, a radioenzymatic system was used to determine the activity of serum ACE. In patients with sarcoidosis, levels of ACE were measured in active cases as well as those in remission. Our laboratory reference values for those over 20 years of age are 39.84 +/- 9.19 mumol/min/l. RESULTS: Levels of ACE were significantly higher (p < 0.001) in active sarcoidosis (67.71 +/- 17.73 mumol/min/l) than during inactivity (41.18 +/- 16.00 mumol/min/l), tuberculosis (46.99 +/- 13.65 mumol/min/l), or fibrosis (35.87 +/- 11.36 mumol/mol/l). A cut-off point of 59 mumol/min/l shows a significant association with the diagnosis of active sarcoidosis (p < 0.001) and reaches a negative predictive value of 90.90%. CONCLUSION: The usefulness of serum ACE in the differential diagnosis of sarcoidosis should be reconsidered.

Adult↗
PubMed1993

[Prevention of tuberculosis infection].

Tuberculosis (TB) is a disease caused by a mycobacterium, whose incidence has increased in the past years. This increase is related to the adquired immunodeficiency syndrome (AIDS). Due to its high prevalence, Spain is considered a developing country. The tuberculous infection depends on the degree of functionality of the alveolar macrophages that stimulate the lymphocytes and isolate the bacillus. The infection by mycobacterias can be quantified by means of the cutaneous reaction against tuberculin and mantoux, allowing us to select the subjects that must receive prophylaxis. For its correct interpretation, it is currently recommended to avoid BCG vaccination of children, except in countries with high prevalence of TB.

BCG Vaccine↗
PubMed1992

[New trends in medical education. Evaluation of placements in health centers].

Whether to use just hospitals or a wider range of health resources is one of the debating-points in the updating of undergraduate medical training programmes. The Faculty of Medicine in the Autonomous University of Madrid integrated obligatory Primary Care placements for students in the last year of their course, into its syllabus as from 1988/89. This programme and the students' own assessment of it was studied by means of a systematic, voluntary and anonymous survey, which covered various aspects of their assignments to Primary Care teams. 93% (473) replied. Every student took part in the clinical activities, both on demand and as programmed. 76% went on home visits along with their tutors. 88% considered that their placement was active. The overall evaluation of the placement by the students is 8 out of 10. Half believe that a month is too short a period and suggest that more time is offered as an optional placement. 98% consider that the Centre in which they were placed was sufficiently or very capable of teaching at the undergraduate level. Placing medical students in Primary Care teams is an essential part of today's medical teaching and is feasible within the present health system. The relationship between the University and the general physicians who act as tutors is seen as the main obstacle that needs to be overcome.

Community Health Centers↗
PubMed1992

Vasoconstrictive responses elicited by endothelin in bovine cerebral arteries.

1. Endothelin (ET-1) induced concentration-dependent contractions, which were slowly developed in segments of bovine cerebral arteries. Furthermore, this agent produced tachyphylaxis. 2. The contractions evoked by ET-1 were markedly reduced in Ca-free medium containing 1 mM EGTA and by the Ca channel antagonist, nifedipine (1 microM), but increased by the Ca channel agonist, BAY K 8644 (10 nM). 3. The contractions caused by ET-1 were significantly reduced by the protein kinase C (PKC) inhibitor, staurosporine (1 and 10 nM). 4. These results indicate that ET-1 induced potent vasoconstrictive responses, probably mediated by PKC activation, which were mainly dependent on extracellular Ca; this Ca enters the smooth muscle cells via dihydropyridine sensitive Ca channels.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗
PubMed1992

Receptors involved in the modulation of 5-hydroxytryptamine release in bovine cerebral arteries.

The uptake of [3H]5-hydroxytryptamine (5-HT) in bovine cerebral arteries was reduced by cocaine (1 microM), ouabain (100 microM), pretreatment with 6-hydroxydopamine (6-OHDA) (1.46 mM, 10 min) and metitepine (1 microM). Electrically-stimulated tritium release was decreased by tetrodotoxin (0.8 microM), Ca-free medium, denervation with 6-OHDA (1.46 mM, 10 min), 5-HT (10 microM), noradrenaline (1 microM) and the agonist of alpha 2-adrenoceptors B-HT 920 (0.1 and 1 microM), enhanced by metitepine (1 microM, antagonists of presynaptic 5-HT1 receptors) and rauwolscine (1 microM, antagonist at alpha 2-adrenoceptors, and also of 5-HT1D receptors) and not affected by ketanserin (1 microM, antagonist of 5-HT2 receptors), methysergide (0.1 microM, antagonist of 5-HT1 and 5-HT2 receptors) and phentolamine (1 and 3 microM antagonist of alpha-adrenoceptors and less potent of 5-HT1 receptors). The inhibitory action of 10 microM 5-HT was partially reversed by phentolamine (3 microM) and cocaine (1 microM) and completely reversed by both metitepine (1 microM) and rauwolscine (1 microM). Ketanserin (1 microM), methysergide (0.1 microM) or phentolamine (1 microM) had no effect. Rauwolscine (1 microM) antagonized the inhibition induced by both noradrenaline (1 microM) and B-HT 920 (0.1 and 1 microM). 5-HT induced tritium release which was inhibited by cocaine (an antagonist of 5-HT3 receptors) and denervation with 6-OHDA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Agonists↗