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J Villamor

Publications and source records attributed to J Villamor.

72 records · Page 4Linked to original sources
PubMed1992

[Bronchoalveolar lavage in respiratory pathology].

Bronchoalveolar lavage (BAL) offers great opportunities in the study of pulmonary diseases. It is safe and noninvasive technique, with similar possibilities than other invasive diagnostic methods and allo-wind repetitions. With the obtained sample, we can assess what happens at the bronchial level as well as the alveolar structures. The introduction of new study methods has increased its profitability in several respiratory pathologies: analysis of tumoral markers in lung cancer, monoclonal antibodies in histiocytosis X, and so on. The BAL can be considered a technique of diagnosis, follow-up, prognosis and evaluation in pulmonary diseases.

Adult↗
PubMed1992

[Preliminary results of a program of home oxygen therapy using transtracheal catheter].

We present our experience with oxygen-therapy with transtracheal catheter in the period between January 1990 and December 1991. This procedure was offered to 130 patients who met criteria of home oxygen-therapy being accepted only by twelve. Ten patients maintained oxygen-therapy with transtracheal catheter with excellent results and a notable improve in their quality of life. One patient died twenty-three days after beginning the procedure, due to evolution of main disease finding no role of the catheter in the disease. Another patient showed a vagal reaction after placement of the catheter, which forced to perform resuscitation with connection to mechanical ventilation taking the catheter off because familiar request. Patients who benefit this type of oxygen-therapy the trans-tracheal catheter has showed its usefulness. With few complications and showing no problems in its home handling. Oxygen savings with this technique have been of 55%. Trans-tracheal catheter was much more effective than face mask to correct desaturation after exercise (p less than 0.001).

Aged↗
PubMed1976

Giant esophageal leiomyoma with secondary megaesophagus.

A 25-year-old woman presented with a giant leiomyoma in the lower third of the esophagus. She had no digestive symptoms, although there was a severe esophageal dilation. Such a megaesophagus secondary to a leiomyoma has not been described previously. Esophagogastric resection was performed, followed by an uneventful recovery period. The literature on esophageal leiomyoma is reviewed.

Adult↗
PubMedDate not supplied

Use of spirometry to predict risk of pneumothorax in CT-guided needle biopsy of the lung.

OBJECTIVE: Our goal was to assess the usefulness of spirometry to estimate the risk of pneumothorax in patients undergoing percutaneous needle biopsy with CT guidance for solitary pulmonary nodule (SPN). MATERIALS AND METHODS: We studied the results of 51 consecutive percutaneous needle biopsies with CT guidance for SPN obtained between 1988 and 1990. Forty-five men and six women, aged 65 +/- 11 (36-86) years, were included in the study. All biopsies were performed under CT guidance, with 90 mm 25G needles (0.5 mm thickness) fitted into luer-type syringes. The number of needle pass attempts never exceeded three. A spirometry before biopsy was performed in all patients. RESULTS: Pneumothorax occurred in only 10 cases (19%). The patients with pneumothorax showed lower lesion size, forced vital capacity (FVC), forced expiratory volume (FEV1), and FEV1/FVC ratio. The contribution of these factors to pneumothorax was analyzed by a logistic regression model. The FEV1 was most strongly associated with the incidence of pneumothorax. We developed an equation for predicting the risk of this complication. CONCLUSION: We conclude that decreasing FEV1 is associated with a higher pneumothorax rate.

Adult↗
PubMedDate not supplied

The concentrations of five tumor markers in both BAL fractions in lung cancer patients in relation to cigarette smoking.

BACKGROUND: Lung cancer is the leading cause of death from cancer. Tobacco is related to the development of this type of tumor due to genetic alterations and to the secretion of certain biological markers. Bronchogenic carcinomas secrete a series of biological substances known as tumor markers. Some of these markers, such as carcinoembryonic antigen, neuron-specific enolase, tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and CYFRA 21.1, possess clear clinical value when analyzed in bronchoalveolar lavage (BAL) of patients with lung malignancies, particularly when they are analyzed in the two BAL fractions, bronchial (BF) and alveolar (AF), being more increased in the BF. For this reason, we intend to demonstrate that smokers with cancer secrete more biological substances in the BF and that the concentrations of these markers are higher in the BAL of smokers than in that of non-smokers. METHODS: The five aforementioned tumor markers were studied in the two BAL fractions of 52 lung cancer patients (46 smokers and 6 non-smokers). We performed BAL using 150 ml of 0.9% saline solution divided in three aliquots of 50 ml. The fluid obtained from the first 50 ml was the BF. The liquid from the other two aliquots was the AF. The five tumor marker concentrations were calculated in accord with the indications of the laboratory. RESULTS: The TPA and TPS levels in the BAL of lung cancer patients were more increased in the BF than in the AF, even when the patients were divided into smokers and non-smokers. When we compared smokers with non-smokers, the smokers had higher levels of TPS in the BF and of TPA in the AF. CONCLUSIONS: Thus, we believe that the cellular alterations produced by tobacco are responsible for the secretion of these tumor markers.

Aged↗
PubMedDate not supplied

How to express tumor markers in bronchoalveolar lavage.

INTRODUCTION: Bronchoalveolar lavage (BAL) is a fundamental technique in the diagnosis of different respiratory diseases including lung cancer. Tumor marker values can be determined in the BAL fluid, but controversy still exists about how to express the results. OBJECTIVE: The aim of this study was to determine the best method of expressing tumor markers in BAL, either referring to total proteins or volume of fluid recovered. PATIENTS AND METHODS: A prospective, randomized, non-blind study was carried out. Seventy-six patients (72 men and 4 women) diagnosed with lung cancer and 17 subjects without respiratory disease were included. BAL was performed in all patients and the fluid retrieved was divided into two fractions: a bronchiolar fraction (F0) and an alveolar fraction (F1). Five tumor markers: cytokeratin fragment 19 (CYFRA 21-1), squamous cell carcinoma antigen (SCC), tissue polypeptide antigen (TPA), tissue polypeptide-specific antigen (TPS) and neuron-specific enolase (NSE) as well as total protein were measured in both fractions. The concentrations were expressed in relation to the volume of BAL fluid recovered (ng or mU/mL) and in milligrams of total protein of lavage fluid (ng or mU/mg TP). The SPSS 11.01 software was used for statistical analysis. Mann-Whitney U test and ROC curves were developed when significant differences were found. RESULTS: We found significant differences in the CYFRA 21-1 values in the two BAL fractions and in both ways of expressing its concentration; in SCC in F1 expressed in ng/mg TP; in TPA in F0 expressed in mU/mg TP; in TPS in both fractions expressed in mU/mg TP, and in NSE in both fractions in ng/mg TP. The markers that best differentiated tumors from controls (ROC curves) were CYFRA 21-1 in F0 and NSE in both fractions in ng/mg TP. CONCLUSIONS: Our study demonstrates that the concentrations of tumor markers in BAL expressed in relation to total protein were more effective than if expressed in mL of BAL fluid collected.

Aged↗
PubMedDate not supplied

The use of mouth occlusion pressure to evaluate the effect of an initial inhalation of nebulized saline in methacholine challenge.

BACKGROUND: In spite of standardization of bronchial provocation tests, some methodological aspects yet are controversial. The role of saline solution inhalation is questionable. The measurement of mouth occlusion pressure 0.1 seconds after the onset of inspiration (P0.1) is a good means of detecting a response from bronchoprovocation tests. OBJECTIVE: We investigated the value of an initial challenge with nebulized saline in subjects undergoing methacholine challenge. METHODOLOGY: Eighty-four consecutive patients clinically suspected of bronchial asthma were studied. Bronchial methacholine challenge was performed by Chatham method. P0.1 before and three minutes after saline solution inhalation were determined by the method of Whitelaw. RESULTS: There was no significant P0.1 change following the inhalation of the initial dose of nebulized saline either in those subjects who went on to produce a 20% decrement in FEV1 following a standardised methacholine challenge test, or in those subjects who proved to be non-reactors. CONCLUSIONS: We shown that no modifications are present in respiratory center function when it is assessed by measurement of mouth occlusion pressure after saline solution inhalation in methacholine challenge. This may be another reason why saline solution challenge should be omitted from bronchoprovocation challenge.

Administration, Inhalation↗
PubMedDate not supplied

Value of the peak expiratory flow in bronchodynamic tests.

OBJECTIVE: To determine the accuracy of the peak expiratory flow (PEF) as an alternative parameter to the forced expiratory volume at first second (FEV1) in the bronchodynamic tests. METHODOLOGY: We studied 84 patients, 53 males and 31 females, with average age 46 +/- 13 years, as clinic suspects of bronchial asthma. PEF was determined with a "mini-Wright peak flow meter" and a spirometry was obtained. Based on the results, 44 subjects were classified under group 1 (FEV1/FVC < 70% and FEV1 < 80% of theoretic value) and subjected to a bronchodilator test. While in group 2 subjects (normal spirometry), a methacholine challenge was performed. During each procedure, PEF readings were obtained before FEV1 determination. The usefulness of the PEF for the diagnosis of reversibility or bronchial obstruction with respect to the FEV1 was assessed in both groups. RESULTS: In the bronchodilator tests, a cut-off point was found for the increase in the PEF > 18%, which showed a sensitivity of 85%, specificity of 79%, positive predictive value of 77% and negative predictive value of 86%, with respect to an increase in the FEV1 > 15%. In the methacholine challenge, a decrease in the PEF > 12% only achieved a sensitivity of 74% and specificity of 71%. CONCLUSION: Peak expiratory flow may be an useful parameter in bronchodilator tests. However, it should not be used in methacholine challenge.

Adolescent↗