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C Disdier Vicente

Publications and source records attributed to C Disdier Vicente.

6 recordsLinked to original sources
PubMed2004

[Overall long-term survival in lung cancer analyzed in 610 unselected patients].

INTRODUCTION AND OBJECTIVES: Many studies of lung cancer survival are carried out in patients selected for certain features that usually influence prognosis favorably. The objective of this study was to assess the overall survival of unselected patients with a diagnosis of lung cancer in our practice. PATIENTS AND METHODS: We studied 610 patients for whom survival information was available, a population comprising 88% of the 694 with lung cancer diagnosed in our hospital from 1991 through 1998. The variables analyzed for their correlation with survival were age, sex, histology, tumor-node-metastasis (TNM) stage, treatment, and time of diagnosis (with patients grouped by 2-year periods). RESULTS: The cases of 596 men and 14 women with a mean age of approximately 67 years were studied. Small cell tumors were found in 141, non-small cell tumors in 447, and other tissue types in 22. Surgical excision was carried out on 118 (19.3%), and treatment was confined to control of symptoms for 6.4% of the patients with small cell tumors and 40.5% of those with non-small cell cancer. Symptomatic treatment alone was more common for patients older than 70 years (52.5%) and less common during the last 2 years of the study period (1997-1998: 19%). Overall 5-year survival was 7.9% (2.8% in small cell cancer and 9.4% in non-small cell cancer). Survival rates were lower in patients over 70 years of age. Significant differences in survival were seen for successive TNM stages, with the exception of IIIA and IIIB. The 1997-1998 period saw better survival rates, at 40.8% after 1 year and 11.2% after 5 years. CONCLUSIONS: The survival rates in lung cancer patients in our hospital practice are low because the rate of surgical resections is low owing to the high percentage of cases found in advanced stages. Our observations are similar to those reported from other European countries.

Adult↗
PubMed2003

[Sleepy drivers have a high frequency of traffic accidents related to respiratory effort-related arousals].

INTRODUCTION: Respiratory effort-related arousals (RERA) are secondary to subtle obstructions of the upper airway during sleep and can appear in the absence of a predominance of apneas and hypopneas, causing excessive daytime sleepiness. Analyzing the possible consequences of these new respiratory events is of increasing interest. Habitually sleepy drivers are at high risk of having traffic accidents related to sleep disorders (apneas, hypopneas and RERA). OBJECTIVE: The aim of this study was to determine whether excess RERA alone is an independent risk factor among sleepy drivers. METHOD: We studied 40 habitually sleepy drivers and 23 age- and sex-matched controls selected from a sample of 4,002 automobile drivers. We surveyed sleep habits, daytime sleepiness and traffic accidents. Sleep studies of esophageal pressure were performed. RESULTS: The sleepy drivers with apneas (apnea/hypopnea index > 10) had a higher 5-year accident rate (0.33 0.50) than did control drivers (0.004 0.21; p < 0.05). However, a high RERA index, but not sleep apnea, was an independent risk factor among the habitually sleepy drivers. The adjusted odds ratio (OR) for a RERA index > or = 10 was 7.6 (confidence interval [CI], 1.2 to 48); for a RERA index > or = 15, the OR was 17 (CI 1.5 to 91). CONCLUSIONS: The high risk of traffic accidents among sleepy drivers is mainly determined by the presence of RERA rather than the presence of apneas and hypopneas. These findings verify the importance of identifying RERA in routine sleep laboratory studies.

Accidents, Traffic↗
PubMed1996

[Diagnostic utility of carcinoembryonic antigen, neuron-specific enolase and squamous cell carcinoma antigen in malignant pleural effusion].

We evaluated the diagnostic utility of the carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC Ag.) in malignant pleural effusion (MPE). CEA, NSE and SCC Ag, blood and pleural levels were quantified by enzyme immunoassay (EIA) in 85 patients with pleural effusions: 35 non malignant pleural effusions, and 50 MPE; 42 with lung carcinoma (LC), and 8 with extrapulmonary carcinoma. The sensitivity and specificity was compared to cytological results of the pleural fluid. The sensitivities of CEA7 NSE and SCC Ag. (in pleural fluid) were 59.5%, 48.7% and 16.7% respectively in patients with LC (specificity higher than 90%). Using a combination with CEA and NSE, the sensitivity reached 80.9% (specificity, 91.4%). The cytology of pleural fluid was positive in 45.2%. The pleural/blood ratios did not improve the diagnostic performance. In patients with extrapulmonary carcinoma, the sensitivity of these tumor markers was lower. The combination of CEA and NSE pleural levels is useful in the diagnostic approach to the patient with pleural effusion. A high level of NSE is suggestive of small cell lung cancer (SCLC).

Antigens, Neoplasm↗
PubMed1995

Nasal intermittent positive pressure ventilation. Analysis of its withdrawal.

Nasal intermittent positive pressure ventilation (NIPPV) applied during sleep has been demonstrated to be useful in the treatment of restrictive thoracic diseases (RTD). The purpose of this study was to evaluate the repercussions of a withdrawal period from NIPPV of 15 days. This would be sufficient time for patients to go on trips without the respirator. It was hypothesized that once daytime improvement was achieved and was stable, it could be maintained for this period of time. Five volunteer patients with severe RTD who had been receiving treatment with nocturnal NIPPV for at least 2 months before and who had improved at least 5 mm Hg in daytime PO2 and PCO2 were included in the study. No significant differences were disclosed clinically or with arterial blood gas levels, spirometry results, lung volumes, airway resistances, or maximal muscle pressures 15 days following the withdrawal. However, in the sleep studies, a severe worsening of gas exchange was observed, mainly during rapid eye movement (REM) sleep, as well as a trend toward a more disturbed sleep pattern and more important alterations in cardiac rhythm. Consequently, withdrawing the treatment with nocturnal NIPPV cannot be recommended, at least for this particular removal period. Moreover, alterations in daytime gas exchange were found to originate in those produced during REM sleep through the blunting of the respiratory center to CO2. The NIPPV obstructs this mechanism, preventing the deterioration of gas exchange during sleep.

Adolescent↗
PubMed1994

[The usefulness of serum neuron-specific enolase in the clinical management of small-cell lung carcinoma].

The utility of neuron-specific enolase (NSE) for the diagnosis and management of small cell lung cancer (SCLC) is analyzed. Serum concentrations of NSE were measured in 69 healthy adults, 106 patients with non-neoplastic pneumopathy (NNP), 16 with pulmonary metastasis of extrapulmonary origin (PMEO), 126 with non-small cell lung cancer (NSCLC), and 77 with SCLC. Repeated analyses were carried out for patients in the last group during and after treatment, and survival time was recorded. NSE was high in 77.6% of patients with SCLC [50% in cases with limited disease (LD) and 93.6% in those with extensive disease (ED)]. NSE was high in 10.3% of those with NSCLC, in 11.5% of those with PMEO, and in 2.8% of those with NNP. NSE decreased 100% in SCLC patients achieving full remission after treatment and in 25% of those responding poorly. Later, this marker increased in 81.2% of those experiencing relapse, and in 6.2% of these the increased preceded symptoms. Initial NSE concentrations had prognostic value (p = 0.003) that was independent of disease stage (LD or ED). NSE is of great diagnostic and prognostic value in SCLC, accurately reflecting tumor size. Posttreatment changes closely parallel disease activity.

Adult↗