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Biomedical subjects

R Escamilla

Publications and source records attributed to R Escamilla.

33 records · Page 2Linked to original sources
PubMed1991

Amiodarone-induced pulmonary toxicity. Immunoallergologic tests and bronchoalveolar lavage phospholipid content.

Amiodarone (A) is a widely-used antiarrhythmic drug. Pulmonary toxicity is the most serious adverse effect with an estimated mortality of 1 to 33 percent. In order to determine an element helpful for diagnosis, we examined four patients with amiodarone-induced pulmonary toxicity, three patients treated with A, without evidence of pulmonary toxicity but with a main underlying pulmonary disease, and four healthy volunteers. Daily and cumulative doses or duration of treatment were similar in the first two groups. Pulmonary function tests (spirometry, CO-diffusing capacity, arterial blood gases), roentgenographic examinations, pulmonary biopsies or immunoallergologic tests (skin reaction, lymphoblastic transformation test and human basophile degranulation test) did not provide any discriminatory element. In APT+, we observed an increased cellularity of the bronchoalveolar lavage. Neither the differential cell count nor the presence of foamy macrophages were distinguishable between APT+ and APT-. The phospholipid composition of BAL fluid showed a decreased total phospholipid and phospholipid/protein ratio in all patients compared to normal subjects. These changes reflect more the severity of pulmonary disease than the specificity of the causative agent. However, we observed that the unique PL which decreases in APT- and remains normal in APT+ is phosphatidyl-serine + phosphatidylinositol (PS + PI). This has to be confirmed and should be evaluated at different stages of the disease to determine an eventual specific element. We conclude that there are no data currently available to establish the diagnosis of APT except perhaps for the analysis of BAL PL content.

Aged↗
PubMed1990

Pulsed Doppler echocardiography in the diagnosis of pulmonary hypertension in COPD.

We used pulsed Doppler echocardiography to examine the systolic ejection flow from the right ventricle in 66 patients with chronic obstructive pulmonary disease. Adequate recordings were obtained in 60 patients, in conjunction with right heart catheterization. Patients without pulmonary artery hypertension at rest (mean pulmonary artery pressure less than 20 mm Hg) underwent an exercise test which identified a group with PAH during exercise (MPAP greater than 30 mm Hg). The patients were divided into four groups: group 1, or control group: 17 healthy nonsmokers without normal respiratory function data; group 2: COPD without PAH (n = 12); group 3: PAH during exercise (n = 26); group 4: PAH at rest (n = 22). Analysis of Doppler data included time to peak velocity, right ventricular pre-ejection period, and ejection period. Pulsed Doppler echocardiography was a simple and reliable method of detecting PAH. Latent PAH, revealed by the exercise test, was accompanied by significant changes in Doppler findings, confirming the sensitivity of the method.

Cardiac Catheterization↗
PubMed1989

[Bronchial hyperreactivity in non-asthmatic patients harboring a uterine fibroma].

One of the etiological factors of female late onset asthma lies in endocrine disorders and it often occurs during a period of hormonal instability (menopause or premenopause). Moreover various studies have shown increased allergic manifestations in women with gynecological problems (dysmenorrhea, premenstrual syndrome). Gynecological pathology is found in 30% of 67 women who suffer from late onset asthma. Prospective studies were carried out in 28 women with surgical uterine fibroma, to investigate bronchial hyperreactivity (BHR). The study included atopic research through questioning and allergy skin tests; spirographic respiratory function study, airway resistance, carbachol BHR with determination of the threshold dose (FEV1 20% decrease). Carbachol BHR was found in 8/28 persons (28%), but with no clinical manifestations. None of the patients smoke and only one suffers from mite-allergic rhinitis-conjunctivitis without asthma. BHR is often found in asymptomatic women with uterine fibroma. Is this BHR due to an autonomic dysregulation or to a hormonal malfunction? This hypothesis would require further studies to elucidate, since premenstrual asthma worsening is a well known phenomenon, which can be improved by progesterone. This may suggest a possible link between hormonal malfunction and BHR in women. A long term survey will facilitate detection of late onset asthma.

Adult↗
PubMed1987

[Cardiac tolerance of a beta 2-sympathomimetic spray in 37 asthmatic adults monitored by Holter recording].

Thirty-seven asthmatic adults (27 women, 10 men), aged 28 to 70 yrs (mean 50. yrs), in a stable condition, were studied to assess the cardiac tolerance of B2SM sprays. These patients had no cardiac arrhythmia (checked by echocardiography), no hypertension and no hyperthyroidism. Two thirds had severe asthma, and 16 suffered from chronic asthma. After their condition was stabilized, they continued their previous treatment, consisting of theophylline (34 cases), moderate corticotherapy (19 cases), atropine spray (14 cases). Holter monitoring was performed before and 3 days after the institution of treatment by Fenoterol spray at 1,600 micrograms per day in 4 doses at fixed times. Gasometry was tested immediately before and during the protocol. Before B2SM treatment, 26 patients had a normal Holter, 11 had an abnormal first recording (4 important atrial ectopic beats (EBs), 5 ventricular EBs, 1 associating the two), 1 patient had an episode of ventricular tachycardia (VT). With Fenoterol, we observed (with no clinical manifestation) the aggravation of 1 pre-existing atrial EBs and 2 ventricular EBs. Two patients had a short episode of tachycardia but the role of Fenoterol was uncertain: one case was an elderly hypoxaemic patient and in the second a high theophylline level (20 mg/l) was found. The arrhythmogenic property peculiar to B2SM in spray form seems low at the dose we used. However in this study and in certain circumstances, such as hypoxemia, metabolic acidosis, or theophylline overload, the use B2SM may have contributed, together with other factors, to induce disquieting infraclinical cardiac dysrhythmia. We stress that this short-term study involved stable asthmatic patients under surveillance in hospital conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Influenza vaccination and asthma].

A double investigation was carried out on the respiratory tolerance of IV in the asthmatic patient: 1. Retrospective based on case history in 87 mature adults (mean age 61 years) previously vaccinated once or several times. This showed poor respiratory tolerance in 21 patients (24%), as shown by difficulty in breathing (8 cases), paroxystic dyspnea (5 cases), an acute episode of asthma (8 cases), occurring soon after vaccination. 2. Clinical and respiratory functional prospective study of bronchial reactivity to carbachol (CBL) and flow-volume curves before and after administration of inactivated polyvalent vaccine, compared in 8 control subjects, 12 asthmatic patients, 19 cases of non-spactic chronic obstructive airway disease, 7 patients with sequelae of pulmonary tuberculosis or operated bronchial cancer, investigated immediately before (day 0), 2, 6, 8 or in some cases 20 or 30 days after IV (D2, D6, D8, D20, D30): 2 of 8 controls showed a decrease in CBL sensitivity threshold at D2 or D6; 6 of 12 asthmatics reacted to the vaccine: 2 showed increased CBL reactivity, 1 lowered sensitivity threshold, 2 a decrease in the 50% and 25% flows at D2 and D6, 1 decreased MMFR and distal flows at D2; 4 of 19 cases of COPD, 1 of 7 cases of tuberculous sequelae showed various reactions at D2, D6, D8.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Pulmonary lipogranulomatosis due to excessive consumption of apples.

A 55-year-old man was admitted for treatment of unstable angina. Chest x-ray films showed a micronodular pattern, but there were no respiratory symptoms. Autopsy, carried out following sudden death, revealed pulmonary granulomas surrounding lipid crystals. The same crystals were found elsewhere: lymph nodes, spleen, liver, adrenal glands, and were composed of aliphatic hydrocarbons of vegetal origin, mainly C29H60. Investigation of the case history revealed excessive consumption of apples, to which the hydrocarbon deposition could be attributed, since C29H60 is a natural constituent of the cuticular wax in apple peel. This is a unique example of pulmonary granulomatosis due to storage of vegetal hydrocarbons of dietary origin.

Dietary Fats↗
PubMed1985

[Cardiac tolerance of a beta-2-sympathomimetic spray: fenoterol. Apropos of 37 patients followed using a Holter monitor during a brief treatment protocol].

37 subjects with stable asthma and a mean age of 50.3 undertook a protocol to study the cardiac tolerance to a spray B2SM. A Holter monitor was performed before and 48 hours after the institution of a Fenoterol spray in 4 daily doses of 600 micrograms at fixed times. Before starting treatment with a beta 2 sympathomimetic spray (B2SM) 11 subjects had abnormal traces with significant auricular extra-systoles in 4, ventricular extra-systoles in 5 and both in one subject: one patient had a run of ventricular tachycardia without symptoms. On Fenoterol, a worsening of pre-existing extra systoles was noted thrice, one was auricular the other two ventricular. Two patients had brief runs of ventricular tachycardia but the role of Fenoterol was uncertain; one of the patients was very elderly and hypoxaemic. In the second and elevated theophylline level of 20 micrograms/l was noted. The arrythmogenic power of a B2SM seems weak, but in certain situations such as hypoxaemia, metabolic acidosis and overdosage of theophylline, over consumption of B2SM in association with the above factors could contribute to serious arrhythmias. Also in this study in which there was a protocol limited in time, no premature conclusion should be made on the crucial problem of the cardiovascular risks of B2SM in the basic treatment of asthma but raises the problem of the arrythmogenic potential of the drug association of Theophylline + B2SM.

Adult↗
PubMed1985

[Thromboembolic disease in pneumology. Value of mercury-gauge plethysmography with venous occlusion].

Mercury gauge plethysmography with venous occlusion (PJC) is an atraumatic procedure for the diagnosis of deep venous thrombosis (TVP) of the lower limbs: 103 patients were studied both by plethysmography and phlebography (the reference examination). 54 were hospitalised for a suspicion of pulmonary emboli (EP), 21 for clinical phlebitis and finally 28 subjects had the studies as part of a systematic work-up. 60 cases of TVP of the lower limbs were discovered: 47 were recent, 34 were proximal and 13 sural. The clinical examination failed to reveal these in 36% of cases; the phlebographic and PJC results were concordant for 75% of cases: PJC seemed particularly to be the technique of high sensibility for the early diagnosis of proximal TVP but of a lesser interest for the early diagnosis of peripheral TVP (sensibility 69%). This examination makes an important contribution: for the early diagnosis of hidden proximal TVP; for the diagnosis of EP in its deceptive forms where the presence of a peripheral embolic focus constitutes one weighing factor towards the diagnosis of peripheral thrombo-embolic disease (MIE); for the control of anti-coagulant therapy in the clinic where the local inflammatory process and the biology controlling the consumption of heparin are jointly observed and the study of venous drainage allows an appropriate decision to be made as to the cessation of anticoagulant therapy and minimises the risk of recurrence or avoiding postphlebitis disease by a prolonged treatment.

Anticoagulants↗
PubMed1984

[Castleman's tumor with thoracic localization. Apropos of a case].

Castleman tumor usually presents as a mediastinal tumor which is never accurately diagnosed before surgery. Pathological findings and postoperative course establish the benign nature of this tumor. However, plasmocytic forms with prominent hematologic manifestations may be difficult to distinguish from a malignant lymphoma or thymoma. Differential diagnosis is all the more important that no complementary postoperative treatment is indicated in benign lymphoid tumors.

Adult↗
PubMed1984

[Hepatitis B virus markers and lymphocyte populations in the asymptomatic multiple-drug addict].

The authors have studied in particular hepatitis B virus markers and the ratio of OKT4+/OKT8+ cells in two subgroups of 52 deprived asymptomatic drug addicts. In the group 1 (deprived for 19 days on an average), 52% of the subjects showed a ratio of OKT4+/OKT8+ less than 1, whereas in the group 2 (deprived for 30 months on an average), this percentage is only of 25%. HBV markers were present in 90% of the subjects in each group. We would like to point out the high frequency of the anti-HBc positivity without other markers in these two groups, respectively 20% in the group 1 and 32% in the group 2. These results emphasize the interest in screening systematically this marker in all blood donors.

Adolescent↗
PubMedDate not supplied

[The role of needle-biopsy and cyto-diagnosis in the diagnosis of malignant pleurisy (author's transl)].

The reliability of cyto-diagnosis and needle-biopsy in the diagnosis of malignant pleural effusions is examined on the basis of a personal series of 237 malignant pleurisies and a review of the literature. The results of the two methods, taken separately and together (respectively 42%, 46% and 56% in this study), are below the average figures obtained by compiling 18 large series in the literature (50, 60 and 70%). The reasons for this divergence in the statistics are studied, as well as the uneven reliability of cyto-histology, depending on the site of the original cancer. The authors recalled the simplicity, the reliability and, at the present time, the unrivalled usefulness of these routine methods of cyto-histology in the study of pleural carcinoma. Nevertheless, the authors also point out these routine methods and the equivocal significance of the negative result. The false security of these negative results, in the context of radical surgery for cancer, is stressed as the use in such cases of other more direct methods of exploring the pleura.

Biopsy, Needle↗