Selenium and oxidant injury in patients with cystic fibrosis.
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Adolescent↗
Biomedical subjects
B Aguilaniu
Publications and source records attributed to B Aguilaniu.
[Malnutrition and chronic obstructive bronchopathies].
A knowledge of the relationship between nutrition and the respiratory system applied in chronic airflow obstruction (BCO) enables a better understanding of the increased frequency (30 to 50%) of protein-energy malnutrition (MEP) in this population. The physiology of the wasting in chronic airflow obstruction seems to relate to hypermetabolism (HMB) which is not compensated by an increased alimentary intake. The HMB is linked to a rise in the work of the respiratory muscles whose efficiency is altered by intrathoracic hyperinfiltration and also the consequences of MEP on the mass and function of the respiratory muscles. In the animal MEP induced by alimentary restrictions leads to a model of pulmonary emphysema and to the diminution of the synthesis of surfactant. This emphysema seems to be principally due to an alteration of the process of protein synthesis and to a diminution of lysyl-oxydase activity. The nutrients (utilised notably by the venous route) have their own pharmacological role, and in addition they have an effect on the natural equilibrium of the energy and nitrogen balance. Lipids (rich in polyunsaturated fatty acids) intervene in the synthesis of prostaglandins, and exercise some effects on the inflammatory process and the activity in the bronchial and vascular smooth muscles. Based on this fact they have been used for their anti-inflammatory role at the pulmonary level in the treatment of mucoviscidosis. The administration of amino acids changes ventilation by acting on the central neuro-muscular command mechanism (VT/TI). The perfusion of amino acids enables a restoration of the chemo-sensitivity to oxygen and to CO2 abolished by the prolonged restricted diet. Finally the partial pressure of oxygen ought to be interpreted with respect to meal times because an oral dose of glucose can provoke an increase in the PaO2 of around 10 mmHg for healthy subjects and those with BCO. A preventive and therapeutic attitude vis a vis BCO should take account of the relationship between nutrition and the respiratory system in parallel with a correction of hypoxaemia in order to avoid the development of wasting.
Animals↗
[Comparative study of magnetic resonance imaging and tomodensitometry in the diagnosis of locoregional extension in 61 patients with bronchial cancers].
In order to assess the value of nuclear magnetic imagery NMR in the diagnosis of the extent of bronchial cancers, 61 patients with operable bronchial carcinoma had both a CT scan and an NMR scan pre-operatively. Fifty one mediastinoscopies were performed. Twelve times there were mediastinal glandular enlargement. Ten times the thoracotomy was performed straight away. After pathological studies of the biopsy, 24 patients were N2, 25 N1, 12 N0; the sensibility of NMR to foresee lymph node invasions was 83% (specificity 70%), for CT scanning 75% (specificity 81%). Thirteen patients presented with a direct mediastinal or parietal invasion. The sensibility of detecting these invasions was only 38% for NMR (specificity 94.5%) and for CT scanning 54% (specificity 94.5%). There is little difference in the results and no statistical difference. This leads us to conclude that at present, NMR does not give more information than TDM in the diagnosis of operability in bronchial cancers.
Bronchial Neoplasms↗
[Transparietal needle biopsy of pulmonary lesions with an image intensification system. Apropos of 82 biopsies].
We report the results of 82 needle biopsies of pulmonary nodules, using a fine screw needle. Owing to the very small diameter of the needle (0.8 mm), very few complications were observed (minor pneumothorax 13%, major pneumothorax 2.5%). The screw needle provided samples adequate for both cytological and histological examination. Forty-eight out of 53 cancers were diagnosed by this method (sensitivity 83%, specificity 100%).
Biopsy, Needle↗
[Primary alveolar hypoventilation. Clinical aspects and diagnostic problems. Apropos of a case].
Primary alveolar hypoventilation is a rare syndrome of unknown origin, characterized by a dysfunction of the automatic respiratory pattern in spite of normal lungs and in the absence of mechanical ventilatory defects. A reduction of the ventilatory response to CO2 is regularly found, and cardiac failure is common. The differential diagnosis mainly concerns the sleep apnoea syndrome. The usual treatments have little effectiveness.
Blood Gas Analysis↗
[Value of computed tomography in the diagnosis of the intrathoracic extension of bronchial cancer].
In 76 patients the diagnosis of the mediastinal extension of a bronchial cancer, assessed by computed tomography (CT), was compared to histological specimens obtained by mediastinoscopy and surgery (58/76). The extension to mediastinal nodes was present in 26 subjects (34.2%) and yet was not recognised 15 times on CT. There were 15 false negatives (FN) and 3 false positives (FP). Sensitivity 43%, specificity 94%, predictive value for positives (VPP) 70%, predictive value for negatives (VPN) 75%. Extension was present in 18 patients. These were recognised 14 times by CT. There were no false positives. (Sensitivity 70%, specificity 100%, VPP 100%, VPN 94%). We conclude That CT is useful for diagnosing direct mediastinal extension and allows the juxta-hilar extension of the cancer to be assessed. CT has no place in the diagnosis of mediastinal gland involvement. Mediastinoscopy (5.2% FN; no FP) is better than TDM for the diagnosis of extension to the mediastinal nodes both for peripheral and central cancers.
Carcinoma, Bronchogenic↗
[Rheumatic pelvispondylitis and non-tuberculous sclerotic lesions of the pulmonary apex].
Two new cases of rheumatic pelvispondylitis associated with bilateral fibrosis of the pulmonary apex are reported and published data are reviewed. The clinical, radiological, evolutive and diagnostic features of this probable pulmonary manifestation of rheumatic spondylitis are described, and the pathogenesis is discussed.
Humans↗
Muscle protein degradation in severely malnourished patients with chronic obstructive pulmonary disease subject to short-term total parenteral nutrition.
Patients with chronic obstructive pulmonary disease (COPD) often lose weight and muscle mass with progression of the disease. Muscle protein degradation in patients with COPD has never been examined before and during hypercaloric feeding. Eight severely malnourished patients with COPD were examined at home consuming their usual intake, in the hospital after 3 days of a meat-free regular oral diet (period B), and during a hypercaloric (55 kcal/kg) high-lipid (55%) parenteral formula (total parenteral nutrition [TPN]). During period B, 8 well-nourished patients and 10 malnourished cancer patients were used as control groups. Measurements included plasma assays, leg blood flow, leg exchange (of 3-methylhistidine [3MeH], glucose, lactate, and oxygen) and urinary measures of 3MeH, creatinine, and nitrogen. During period B, net release of 3MeH across the leg in patients with COPD was similar to that in well-nourished control subjects and cachectic cancer patients. In COPD patients, there was only a transient decrease in leg exchange values of 3MeH with administration of TPN. COPD patients demonstrated a reduction (p less than .01) in urinary 3MeH excretion and an increase in nitrogen balance (p less than .01) with TPN compared with period B. The decrease in muscle protein degradation with administration of TPN accounts for about 50% of the increase in nitrogen retention in patients with COPD. These data suggest that in severely malnourished patients with COPD the weight loss is not dependent on increased rates of skeletal muscle protein degradation; nevertheless, degradation rates attenuate with a positive nitrogen balance during nutrition repletion.
Aged↗