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A Baloira Villar

Publications and source records attributed to A Baloira Villar.

8 recordsLinked to original sources

[Bronchodilator efficacy of combined salmeterol and tiotropium in patients with chronic obstructive pulmonary disease].

OBJECTIVE: Bronchodilators are still the most effective drugs for controlling the symptoms of chronic obstructive pulmonary disease (COPD). Tiotropium bromide, a long-acting anticholinergic drug, has recently been added to the therapeutic arsenal for the disease. To date, there have been no studies combining 2 long-acting bronchodilators. The aim of the present trial was to determine whether the combination of salmeterol and tiotropium improved lung function in COPD patients more than either of them alone. PATIENTS AND METHODS: Twenty-two patients (20 men) diagnosed with COPD, with a mean age of 64 years, were enrolled in this cross-over trial. Active smokers were excluded. Mean (SD) forced expiratory volume in 1 second (FEV1) was 43% (14%) of predicted. All patients were experienced in the use of inhalers. The following 3 therapeutic combinations were randomly assigned to be administered for a 1-week period: a) fluticasone (500 microg/12 h), salmeterol (50 microg/12 h) and placebo; b) fluticasone, tiotropium (18 microg/24 h), and placebo; and c) fluticasone, salmeterol, and tiotropium. At the end of each period, forced spirometry was performed before inhalation of the therapeutic combination (between 8:30 am and 9:30 am) and 2 hours after inhalation. Throughout the week, morning peak flow rates measured immediately before inhalation were recorded, and there was a 48-hour wash-out period between each therapeutic combination. RESULTS: All the patients completed the protocol. There were no significant differences in preinhalation or postinhalation FEV1 with salmeterol compared to tiotropium (preinhalation FEV1, 1.17 [0.55] L compared to 1.19 [0.49] L; postinhalation FEV1, 1.32 [0.65] L compared to 1.29 [0.61] L). In all cases postinhalation FEV1 was significantly higher than preinhalation FEV1. The combination of fluticasone, salmeterol, and tiotropium proved superior to the other 2 combinations with respect to both preinhalation FEV1 and postinhalation FEV1 (preinhalation FEV1, 1.32 [0.56] L, [P<.03 in both comparisons]; postinhalation FEV1, 1.49 [0.68] L [P<.001 in both comparisons]). Peak flow rate was also significantly higher with the combination of the 2 bronchodilators (345 L/min compared to 291 L/min and 311 mL, respectively [P <.04 in both cases]). There were no notable side effects. CONCLUSIONS: In terms of improvement in lung function, the combination of salmeterol and tiotropium together with fluticasone is more effective in patients with moderate-to-severe COPD than either of the 2 bronchodilators administered alone.

Albuterol↗

[Multicenter, prospective study comparing enoxaparin with unfractionated heparin in the treatment of submassive pulmonary thromboembolism].

OBJECTIVE: To compare the safety and efficacy of enoxaparin and unfractionated heparin in the treatment of submassive pulmonary thromboembolism (PTE). MATERIAL AND METHODS: Fifty-six patients with PTE who did not need fibrinolytic treatment were enrolled prospectively. The patients were randomly assigned to 2 treatment groups: Group A received enoxaparin (1 mg/kg every 12 hours) and Group B received adjusted doses of unfractionated heparin. The oral anticoagulant therapy was started on confirmation of the diagnosis and continued for 6 months. Incidences of recurrence of thromboembolism and of severe bleeding were assessed at the end of this period. RESULTS: Six patients were withdrawn from the study. Twenty-nine of the 50 remaining patients were in Group A (enoxaparin) and 21 in Group B (unfractionated heparin). A recurrence of thromboembolism was diagnosed in 3 patients from Group A (10.7%) and 2 patients from Group B (9.5%). There were no significant differences. Two patients died, one death being attributed to bleeding secondary to the oral anticoagulant treatment (Group A) and the other to a process unrelated to PTE. CONCLUSIONS: Enoxaparin seems to be as effective and safe as unfractionated heparin in the initial treatment of PTE.

Aged↗

[Multiple aspergillomas in a patient with sarcoidosis].

Sarcoidosis is a disease which occasionally produces severe pulmonary fibrosis. Cystic cavitary lesions, which may or may not be colonized by mycetomas, are seen less often. We describe a patient with long-standing sarcoidosis who developed multiple cystic cavities mainly in the upper lobes. Five mycetomas were counted. We call for the use of high resolution computed tomography in such cases.

Aspergillosis↗

[Pleural effusion as the only manifestation of cryptococcosis in an AIDS patient].

Cryptococcosis is often seen in immunodeficient patients, including those with AIDS. It usually affects mainly the respiratory tract and central nervous system. We present a rare case of pleural involvement with no sign of disease at other sites. A review of the literature yields only three other similar cases. We discuss the diverse clinical manifestations of cryptococcosis, particularly those found in the respiratory tract.

AIDS-Related Opportunistic Infections↗

[Pulmonary mycetoma].

Ten cases of pulmonary mycetoma diagnosed in our service between 1985-1992 were retrospectively studied. Clinical methodology followed in the study is commented and the different therapeutic options are reviewed, so the literature concerning this process. The unspecificity of serum precipitins with Aspergillus is emphasised.

Adult↗