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Biomedical subjects

A Arnau

Publications and source records attributed to A Arnau.

17 recordsLinked to original sources
PubMed1998

[Bronchial carcinoid tumors: a prospective study].

We report the results of a study performed in the thoracic surgery department of Hospital General Universitario of Valencia from October 1989 to December 1996. Of the 621 patients diagnosed of lung cancer during this period, 320 underwent the usual surgical excision, 18 were confirmed histologically as bronchial carcinoid tumors, indicating an incidence of 5.6% of all pulmonary neoplasms resected in our department. The symptoms most often reported were recurring infection (44.5%) and chest pain (33.3%). Only one patient presented carcinoid syndrome. The most common radiologic presentation was solitary pulmonary nodule (50%). The tumor was visible by fiberoptic bronchoscopy in 9 cases. Diagnosis was by bronchial biopsy in four cases. Confirmation was by immunohistochemical analysis of the specimen in all cases. Electron microscopy and immunohistochemical techniques using neuroendocrine panmarkers is considered fundamental for differentiating between neuroendocrine neoplasms and typical and atypical carcinoid tumors. Thirteen (72.2%) of the 18 patients studied were diagnosed of typical carcinoids and 5 (27.8%) of atypical carcinoids. Neuroendocrine marking showed neurospecific enolase in 15 patients and chromogranin positivity in 10.

Adolescent↗
PubMed1997

[Pneumoreduction in the treatment of emphysema: preliminary results].

The results of the first three pulmonary reduction operations performed at our hospital for the palliative treatment of pulmonary emphysema are described. The upper third of the upper right lobe and part of the middle lobe were resected in two patients. An upper right lobectomy was performed on the third. Goretex coated autosutures were used and pleurosis was performed with talcum on the upper third of the hemithorax. Drains with -5 cmH2O suction were inserted. We emphasize the advance stage of disease of the three patients and the good outcomes observed in terms of survival, hospital stay and improvement in lung function and symptoms. We discuss the functional improvement resulting from lung reduction in cancer patients if the resected area is emphysematous.

Aged↗
PubMed1997

Videothoracoscopy in the diagnosis and treatment of malignant pleural mesothelioma with associated pleural effusions.

Between 1985 and 1994 46 of 662 patients examined by thoracoscopy for secondary malignant pleural effusion were diagnosed to have diffuse malignant pleural mesothelioma. Mean patient age was 59 years, with a male: female ratio of 5:1. The right hemithorax was more frequently involved than the left (55% versus 45%). Pleural fluid cytology revealed malignancy in 61.5% of cases. All patients were treated thoracoscopically by talc pleurodesis. Mean patients survival was 9.4 months. Survival after one, two, and 5 years was 37.5%, 12.5%, and 5%, respectively. The characteristics of mesothelioma and pleural effusion evident in thoracoscopy and their diagnostic relevance are discussed. We suggest talc instillation as the sole therapeutic maneuver in evolutioned cases, since the literature and our own experience indicate that survival is not significantly prolonged by more aggressive surgical approaches.

Adult↗
PubMed1996

[The so-called malignant pleural effusion: a new review of direct data obtained with diagnostic pleuroscopy].

We analyze a series of 896 thoracoscopies for pleural effusion, of which 78% (662/896) were due to pleural carcinomatosis, primary or metastatic. Pleural malignancy was observed mainly, in the right hemithorax (65%), arising from tumors within the diaphragm. The likelihood of finding pleural metastasis in lung cancer was 77%. When the pleural effusion is slight (less than 500 ml) the likelihood falls to 22%. We therefore advise thoracoscopy in the former and thoracotomy in the latter. Blood-stained effusion continues to have the worst prognosis (84% stemming from metastasis) and signifies an advanced stage of pleural metastasis. The pleura parietal is involved in 69% of pleural carcinomatosis cases, and in 80% when the lower hemithorax or the area around breast or lung tumors are involved. The cytology yield was 45.9%, though always depending on extent of metastasis. When metastasis was slight, the likelihood of positive cytology was less (19%) and when metastasis was generalized throughout the entire pleura the likelihood increased to 73%. We found no reason to think that the cells in most pleural liquids are able to nest and form tumoral niches. The origin of such cell nests was rather found to be in shedding from the metastases themselves, from lung tumors or from carcinomatous lymphangitis by lymphatic obstruction. The diagnostic yield of thoracoscopy once again proved to be superior to that of pleural biopsy.

Adult↗
PubMed1994

The effect of hypo-, normo-, and hypercapnia induced by mechanical ventilation on intrapulmonary shunt.

The effects of hypo-, normo- and hypercapnia on the variations in arterial oxygenation and their indices in critical patients with acute respiratory failure (ARF) receiving mechanical ventilation are studied. It is a prospective and randomized study carried out in multidisciplinary ICU. Fifteen ARF patients, intubated and mechanically ventilated, were studied within the first 48 h of evolution. Three stages were delimited: I) 30 min after the beginning of anaesthesia; II) 30 min after adding 30 cm of dead space (VD); III) 30 min after replacing the previous VD with VD of 60 cm. Ventilation parameters and FiO2 were kept stable. Stage I was characterized by respiratory alkalosis and stage II by normal acid-base balance with an increase in PaO2 (p < 0.01) and a decrease in intrapulmonary shunt (Qsp/Qt) (p < 0.001); the indices alveolar to arterial oxygen tension gradient [P(A-a)O2], respiratory index (R.I.) and estimated shunt (Est Shunt) also decreased significantly, whereas arterial to alveolar oxygen tension ratio (PaO2/PAO2) and arterial oxygen tension to inspired oxygen fraction ration (PaO2/FiO2) increased significantly. In stage III there was pure hypercapnic acidosis, with decreases in PAO2 (p < 0.001), P(A-a)O2 (p < 0.01) and R.I. (p < 0.05), while PaO2, Qsp/Qt, Est Shunt, PaO2/PAO2 and PaO2/FiO2 remained stable with respect to the previous situation. The observed PaO2 differs (p < 0.05) from the expected PaO2 in stage III. It is suggested that local or regional modifications of pulmonary perfusion are responsible for the observed variations. The P(A-a)O2 and R.I. indices do not make it possible to differentiate the causes of arterial hypoxemia in the presence of hypercapnia.

Acute Disease↗
PubMed1994

[Pulmonary leiomyosarcoma].

We present the case of a young patient with leiomysarcoma of the lung that was at first diagnosed as a hydatid cyst. Pathological tissue analysis was needed for firm diagnosis. This rare tumor, of which fewer than 100 cases have been reported worldwide in the literature, needs to be considered as a differential diagnosis when lung cancer is suspected, given that leiomysarcoma has a better prognosis. Treatment is mainly surgical.

Adult↗
PubMed1993

Thoracoscopic pericardial fenestration: diagnostic and therapeutic aspects.

The cause of cardiac tamponade is only established in 50% of cases. This problem is most commonly treated by pericardiocentesis alone, pericardiotomy being reserved for cases of recurrence and pericardiectomy for those patients presenting with constrictive pericarditis. A series of 16 patients treated with pericardial fenestration via a thoracoscope is presented. Pericardial and pleural biopsies were performed, together with cytological and biochemical analysis of the pericardial and pleural fluid where present. This procedure established the aetiology of effusion in all cases. In malignant pericardial effusion bleomycin was used for pericardial sclerosis. This resulted in fewer recurrences than in those patients where sclerosis was not attempted (12.5% v 60%).

Adult↗
PubMed1989

Cell envelope proteins of environmental Vibrio cholerae non O1 isolates from Albufera Lake (Valencia, Spain) influence of some factors on OMP expression.

The cell envelope proteins of 89 environmental Vibrio cholerae non O1 strains isolated from lake and coastal waters near Valencia, Spain, and six Vibrio cholerae strains from culture collections were analyzed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Considerable heterogeneity was found in the major proteins of the environmental non-O1 strains, but bands between 25,000 and 48,000 daltons were observed in the majority of the strains. Estimated relative mobilities of the total protein profile ranged between 11 and more than 100 Kd. Cluster analysis revealed four groups of strains distinguishable by presence or absence of high and low molecular weight proteins. After treatment with Sarkosyl, the outer membrane proteins (OMPs) were characterized in all strains by densitometric methods. They ranged from 19 to 87 Kilodaltons, and corresponded to the major proteins observed in the total membrane preparations. The major OMP most frequently found had a molecular weight around 37 Kd, similar to that of porins in other Gram-negative bacteria. The OMP composition varied in response to culture medium and growth phase. Generally the OMP expression was affected only in a quantitative way by the growth phase while the growth medium had both a qualitative and a quantitative effect.

Bacterial Outer Membrane Proteins↗
PubMed1988

The annual cycle of zooplankton-associated Vibrio cholerae and related vibrios in Albufera lake and its coastal surrounding waters (Valencia, Spain).

Most probable numbers of zooplankton-associated Vibrio spp. and V. cholerae were determined in Albufera lake, Spain, and in its coastal receiving waters throughout a year. Highest counts of 10(5) bacterial cells/g of plankton were associated to high temperatures and were also related to the kind of water. All isolates were non-01 serovars, and most belonged to Heiberg groups I and II.

Animals↗
PubMed1985

Incidence of Vibrio cholerae and related vibrios in a coastal lagoon and seawater influenced by lake discharges along an annual cycle.

Most probable numbers of Vibrio cholerae and related vibrios were determined in Albufera Lake, Valencia, Spain, and in coastal waters under the influence of the lake discharges over the course of an annual cycle. The influence of temperature, kind of water, and characteristics of the different sampling sites on the numbers of vibrios recovered was evaluated. Maximum recovery of vibrios reached 10(3)/ml in both types of waters analyzed. V. cholerae numbers reached 10(3)/ml in the lake and 10(2) in one of the coastal sites. Frequently during the warm season, all vibrios isolated were identified as V. cholerae. Occasionally, no V. cholerae was recovered. The recovery of vibrios was significantly influenced by the temperature of the water and the type of water analyzed. Most of the V. cholerae isolates were included in Heiberg groups I and II, and nearly 50% of the strains used chitin as sole carbon source. Indole was not produced by 100% of the strains. All strains tested were non-O1 serovars.

Chitin↗
PubMed1983

Clinical use of the arterial/alveolar oxygen tension ratio.

A prospective study to verify the behavior of the arterial/alveolar oxygen tension ratio (PaO2/PAO2) at different fractions of inspired oxygen (FIO2), was performed in 15 adult hypoxemic patients. This index was useful not only for predicting the arterial oxygen tension but also for choosing the necessary oxygen supplementary levels. PaO2/PAO2 was a less reliable index in patients with mild intrapulmonary shunts, probably because of changes in the distribution of alveolar ventilation/perfusion ratios.

Adult↗
PubMedDate not supplied

[Iatrogenic bilateral hydrothorax following the placement of a central catheter].

We present a case of bilateral hydrothorax after internal jugular vein catheterization. 60 hours after placing the catheter, the patient showed an abrupt picture of jugular ingurgitation, abolished vesicular breath sounds, and displaced cardiac tones. It was necessary to immediately drain one hemithorax to guarantee ventilation of the patient. The present article examines iatrogenicity derived from the placement of central catheters, and special attention is given to the need for post-insertion x-ray control.

Adult↗