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Biomedical subjects

T Perez

Publications and source records attributed to T Perez.

70 records · Page 4Linked to original sources
PubMed1991

[Study of high-resolution thoracic computerized tomography and bronchoalveolar lavage in 36 patients presenting with systemic disease and a normal thoracic radiography].

Systemic diseases such as scleroderma (ScI), rheumatoid polyarthritis (PR), Gougerot-Sjögren Syndrome (GS) have a well known propensity for the lungs. Previous studies have shown evidence of disturbed alveolar cell repair as evidence of a sub-clinical alveolitis. The significance of such cases of latent alveolitis remains to be specified. To determine if latent alveolitis was associated with interstitial chest disease which was undetectable by chest X-ray, 36 consecutive patients had an BAL and a high resolution computered tomographic examination (HRTC) (Scl: n = 21; PR: n = 9; GS: n = 6). The patients had normal respiratory function and chest X-ray was normal. Our results showed 17 out of 36 (47%) with a latent alveolitis (the percentage of lymphocytes and of alveolar polymorpho-nuclear neutrophils was superior or equal to 18 and 4% respectively) (Scl: 12/21; PR: 1/9; GS: 4/6). In the cases of scleroderma a neutrophil alveolitis was predominant (9/12) and was associated in 2 cases with a honeycomb lung and evidence of fibrotic lesions using TDM-HR. Those examinations using HRTC which were normal were equally associated with a latent alveolitis (Scl: 6/12; PR: 1/6; GR: 4/5). These results suggest that the alveolitis can preceed the anatomical damages. These results need to be confirmed in a larger series and the value of early treatment should be evaluated.

Adolescent↗
PubMed1991

[Pleuro-pulmonary manifestations of rheumatoid polyarthritis].

Sensitive investigations such as pulmonary function tests, broncho-alveolar lavage or computered tomography at high resolution enable pleuro-pulmonary disease to be detected in nearly 50% of those patients studied who had rheumatoid arthritis (PR). The prevalence of these manifestations is most usually elevated in male PR sufferers, those who are sero-positive or have associated extra-articular signs such as sub cutaneous nodules. More recently there has been evidence of genetic risk factors linked to HLA grouping or Pi phenotype. Amongst the usual manifestations, the pleurisies and above all necrobiotic nodules, which are most often asymptomatic, sometimes pose difficult problems in differential diagnosis, particularly when they precede the articular disease. The diffuse interstitial fibrosis remains the most worrying specific complication due to the fact of its potential seriousness. The pathophysiology of this form of fibrosis is better understood since the introduction of LBA. In the absence of any specific controlled studies its treatment remains impirical and is similar to that given for diffuse or idiopathic interstitial fibrosis. Pulmonary vascularity, the bronchiolitis obliterans with organising pneumonia and apical fibrosis, very similar to Hamilton's syndrome, are much rarer manifestations. On the other hand non specific respiratory infections are the cause of death in 10-20% of cases. Bronchiolitis obliterans induced by D Penicillamine is the most severe iatrogenic manifestation, since corticosteroid therapy associated with immunosuppressive drugs enables at best a stabilisation of the alveo bronchiolar lesions. More recently there have been twenty observations of hypersensitivity pneumonia to low dose methotrexate. The prevalence of these pulmonary disorders during the treatment of PR is around 5%. However the respiratory contraindications of these drugs which are being used more and more and the methods of pulmonary surveillance under treatment are not yet defined.

Arthritis, Rheumatoid↗
PubMed1990

Subclinical alveolitis in immunological systemic disorders. Transition between health and disease?

A subclinical inflammatory alveolitis as assessed by BAL cell analysis may be present in a high proportion of symptomless patients with immunological systemic disorders and with normal chest roentgenogram. Subclinical alveolitis can be characterized by the relative proportions of the different cell populations comprising the alveolitis and by the activated state of the cells. Thus, subclinical alveolitis can be classified into two major groups: lymphocyte and neutrophil alveolitis. Lymphocyte alveolitis is frequently found in patients with extrathoracic granulomatosis (Crohn's disease, primary biliary cirrhosis, extrathoracic sarcoidosis) or with some collagen vascular diseases (Sjögren's syndrome, rheumatoid arthritis, systemic lupus erythematosus). Neutrophil alveolitis is a main finding in collagen vascular diseases, especially progressive systemic sclerosis, dermatopolymyositis and mixed connective tissue disease. In addition, alveolar macrophages may be spontaneously activated and release various mediators that could be relevant to the pathogenesis of interstitial lung disease. On the other hand, some other alveolar macrophage functions (antibacterial activity may be severely impaired in some diseases, for example systemic lupus erythematosus). Alveolar inflammation is associated with an increase in the permeability of the alveolar membrane responsible for an increased influx of blood proteins in the alveolar spaces. Although subclinical inflammation may also be detected by high resolution computed tomography (HRCT) scan and/or lung permeability scintigraphic studies, the significance and prognostic value remains unclear and clearly differs according to both the disease and the pattern of alveolitis.

Humans↗
PubMed1989

Cholestasis and pneumonitis induced by gold therapy.

The authors describe the association of gold salt-induced cholestasis and lymphocytic alveolitis proved by liver biopsy and broncho-alveolar lavage. To our knowledge this is the third case report on the combination of liver disease and pulmonary infiltration induced by gold compounds.

Aged↗
PubMed1989

Gender and adjustment to chronic disease. A study of couples with colon cancer.

The adjustment of 39 couples in which one partner has cancer of the colon was assessed. The main findings were that the adjustment of male patients was superior to that of female patients. In the spouses' group the opposite was found, namely the adjustment of husbands was far worse than that of wives of cancer patients.

Adaptation, Psychological↗
PubMed1989

Subclinical alveolar inflammation in rheumatoid arthritis: superoxide anion, neutrophil chemotactic activity and fibronectin generation by alveolar macrophages.

Interstitial lung disease (ILD) can be detected by pulmonary function testing (PFT) in 30-40% of rheumatoid arthritis (RA) patients. We assessed by bronchoalveolar lavage (BAL) the patterns of alveolitis in 21 RA patients: group 1 comprised 12 patients without evidence of ILD, and group 29 patients with clinical ILD defined by abnormal pulmonary function tests and/or chest X-ray. Cellular characteristics of BAL were studied in both groups. In addition, alveolar macrophages (AM) from patients in group 1 were isolated, and three parameters of cellular activation were studied: superoxide anion, fibronectin and neutrophil chemotactic activity generation. Total cell counts were not increased in group 1 but significantly increased in group 2 compared to controls. In group 1, 5/12 patients had elevated lymphocyte percentage (greater than 18%) suggesting subclinical lymphocyte alveolitis. In contrast, neutrophil alveolitis (greater than 4%) was found in 7/9 patients in group 2, mean percentage 12.9 +/- 4.2, compared with 1.2 +/- 6.4% in controls and 1.9 +/- 0.5% in group 1. These changes were not correlated with disease duration nor rheumatoid factor titres. Marked elevation of lymphocyte percentage was observed in patients with abnormal serum beta-2-microglobulin. Alveolar macrophages from group 1 patients released increased amounts of superoxide anion (7260 +/- 2700 vs controls 850 +/- 120 URL/5.10(5) cells), neutrophil chemotactic activity (21 +/- 4.8 vs controls 8.1 +/- 0.7 cells/HPF), and fibronectin (6.1 +/- 1.6 vs controls 1.3 +/- 0.2 ng.10(6) cells/hour). Whether or not lymphocyte alveolitis and/or AM dysfunction are pathogenic mechanisms of subsequent interstitial lung disease in patients who are still free of symptoms remains to be determined.

Adult↗
PubMed1988

[Transluminal angioplasty of the coronary vessels in patients with pluritruncular unstable angina].

Between October, 1979 and August, 1987, 489 patients with multivessel coronary disease and unstable angina underwent transluminal angioplasty of coronary arteries with the following results: primary success in 90 p. 100 of the patients, emergency bypass surgery of occlusive dissection in 1.8 p. 100, myocardial infarction in 2.9 p. 100, death in 1.4 p. 100. These results were similar to those obtained in 369 patients with stable angina whose coronary vessels were dilated by the same group during the same period. The death rate was significantly higher in elderly people and in women. 398/489 patients were followed up for 2 to 45 months: 1.8 p. 100 died, 2 p. 100 developed myocardial infarction and 2.3 p. 100 underwent coronary bypass. 46 patients had repeat angioplasty for restenosis. After single or repeat angioplasty, 68 p. 100 of the primary success patients followed up were asymptomatic, and 73 p. 100 had lasting clinical improvement. Among 221 patients studied with different numbers of vessels treated, the degree of revascularization did not make any significant difference in the percentage of symptom-free patients. Data from the literature concerning the medical treatment of unstable angina indicate a high incidence of complications and a mediocre long-term functional benefit, while data concerning surgical treatment show a better long-term functional result. Compared with these two types of treatment, transluminal coronary angioplasty appears as a satisfactory method to treat unstable angina in patients with multivessel coronary disease.

Adult↗
PubMed1987

[Demonstration of reversible myocardial ischemia in necrotic akinetic areas using endocoronary ECG during angioplasty].

The presence of ischaemic myocardial tissues in necrotic territories and the usefulness of revascularizing these territories are controversial matters. We have determined the existence of this phenomenon by the per-angioplastic intracoronary ECG method, and we have compared the sensitivities of intracoronary ECG and surface ECG. Intracoronary EVG is achieved by using the mobile teflon-coated guide wire of coronary angioplasty as a unipolar epicardial electrode. Being epicardial and localized, the electrode explores a limited area of the myocardium, distal to the artery being dilated and momentarily occluded by the balloon during inflations. The study involved 12 patients (mean age 53.7 years) who presented with the following criteria of admission: transmural myocardial infarction, presence of a Q wave on two leads, akinetic segment at ventriculography and coronary stenosis or occlusion amenable to angioplasty. Patients with collateral circulation between the larger epicardial vessels were excluded. Intracoronary ECG recordings were taken before, during and after inflations. In 9 out of 12 patients the ST segments was elevated by 1.3 mV on average between inflations (S.D. 3.14 mV) and by 4.8 mV (S.D. 3.99 mV) during inflations. These high standard deviations were due to major inter- and intra-individual variations of ST. The difference was significant (p less than 0.05) at variance analysis. No variation of ST was observed in 3 patients. Only one of the 12 patients had elevated ST on both surface ECG and intracoronary ECG tracings. Thus, intracoronary ECG is a sensitive method to evaluate myocardial ischaemia during coronary angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Anaphylactic manifestations during protected sexual intercourse disclosing allergy to latex].

Reports of allergy to latex have been increasingly frequent during the last few years. The culprit is the natural Hevea Brasiliensis latex which is present in numerous latex-containing materials for daily use. Clinical manifestations are usually benign. Systemic manifestations have been reported mainly in general anaesthesia. We report a case of severe anaphylactic manifestations that occurred during a condom-protected sexual intercourse. The responsibility of latex for this accident was demonstrated by skin and biological tests.

Adult↗