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Biomedical subjects

E García Pachón

Publications and source records attributed to E García Pachón.

16 recordsLinked to original sources
PubMed2005

[Chronic idiopathic lithoptysis].

Broncholiths, which usually arise from calcified peribronchial lymph nodes, can be found by radiography or bronchoscopy. We describe the case of a 19-year-old man who had experienced lithoptysis of bronchial hydroxyapatite calculi for over 6 months and who reported having sandy expectoration since childhood. Exhaustive clinical, radiographic, and endoscopic diagnostic studies detected no calcified lesions in the thorax that could explain the origin of the broncholiths. Therefore, we propose that broncholiths may form by mechanisms similar to those involved in calculi formation in other locations.

Adult↗
PubMed2005

[Paradoxical costal shift throughout inspiration (Hoover's sign) in patients admitted because of dyspnea].

OBJECTIVE: To study the frequency and diagnostic usefulness of Hoover's sign (paradoxical costal shift throughout inspiration) in patients admitted because of dyspnea. PATIENTS AND METHODS: 268 patients admitted because of dyspnea in an Internal Medicine Department were included in the study. Physical examination was carried out on the first day of admission to establish the presence of Hoover's sign. RESULTS: Hoover's sign was present in 62 patients of 82 with a diagnosis of chronic obstructive pulmonary disease (COPD) (sensitivity: 76%), in 3 patients of 101 (3%) with a diagnosis of congestive heart failure, in 3 patients of 23 (13%) with a diagnosis asthma, and in 6 patients of 62 (10%) with other diagnoses. Specificity of Hoover's sign for EPOC diagnosis was 94%. CONCLUSIONS: Hoover's sign is a frequent finding in patients admitted because of EPOC and is found only rarely in patients without obstructive pulmonary disease. This sign contributes useful information for the evaluation of patients admitted because of dyspnea.

Adolescent↗
PubMed2005

[Apolipoprotein A1 and apolipoprotein B in pleural effusions].

OBJECTIVE: To determine the levels of apolipoprotein A1 and apolipoprotein B in pleural effusions and analyze their possible diagnostic value. PATIENTS AND METHODS: A total of 117 patients with pleural effusion (30 transudates and 87 exudates) were included. The apolipoproteins were measured by turbidimetry. RESULTS: The apolipoprotein B values in serum were slightly lower in transudates than in exudates, and both apolipoproteins had lower values in patients with benign exudates than in malignant ones. The apolipoprotein levels in pleural fluid were lower in transudates than in exudates. The pleural/serum fluid ratios of both apolipoproteins were significantly lower in malignant effusions compared with benign exudates. No cutoff value was found that would make it possible to differentiate between transudates and exudates or between benign and malignant exudates with sensitivity or specificity levels that had clinical interest. CONCLUSIONS: Apolipoprotein A1 and apolipoprotein B levels in pleural fluid are different in transudates and exudates, and the pleural/serum fluid ratios are also different between benign and malignant exudates. However, their measurement does not supply additional clinical information.

Apolipoproteins A↗
PubMed1998

[Pleural fluid to serum cholinesterase ratio to discriminate between transudates and exudates: reevaluation in 177 patients].

BACKGROUND AND OBJECTIVES: In a previous study we concluded that the pleural fluid/serum (PF/S) ratio of cholinesterase was the most useful parameter to discriminate between exudates and transudates. The objective of the present study was to confirm these findings in a prospective series of patients with pleural effusion. MATERIAL AND METHODS: A total of 177 patients, consecutively studied at two institutions, with the diagnosis of pleural effusion were included in this study. Thirty-six (20.3%) effusion were transudates and 141 (79.7%) exudates; of these, 73 and 68 were of malignant and benign origin, respectively. Both PF/S cholinesterase and Light's criteria were compared. RESULTS: The PF/S cholinesterase ratio incorrectly classified 12 pleural effusions (6.8%). These included 7 out the 36 transudates (19.4%) and 5 out of the 141 exudates (3.5%), the latter of malignant etiology. Following Light's criteria, four (2.2%) exudates were misclassified, all of them transudates. The higher accuracy of Light's criteria was statistically significant (p = 0.04). CONCLUSIONS: In this series of patients, Light's criteria were more accurate than PF/S cholinesterase ratio to discriminate between transudates and exudates. From these results, the use of the PE/S cholinesterase ratio parameters is no longer recommended.

Adult↗
PubMed1997

[The diagnostic usefulness of cholinesterase in pleural exudates].

BACKGROUND AND OBJECTIVES: The pleural fluid/serum cholinesterase ratio (PF/S) is the most efficient parameter to differentiate transudates from exudates. The objective of this study was to evaluate whether its determination might yield additional diagnostic information in pleural exudates. MATERIALS AND METHODS: A total of 167 patients with the diagnosis of pleural exudate were studied: 74 carcinomatous, 32 tuberculous, 31 parapneumonic, 30 other causes. Pleural fluids were divided on the basis of lymphocyte or polymorphonuclear predominance and were grouped according to diagnosis. The PF/S cholinesterase ratio was determined in all patient. RESULTS: In lymphocytic exudates, when PF/S ratio was < 0.42 pleural effusion was classified as malignant, with a sensitivity (S) of 56% (95% CI: 43%-66%) and a specificity (SP) of 90% (95% CI: 78%-95%). For the diagnosis of tuberculosis, in the total of pleural effusions, a ratio > or = 0.45 showed a S of 97% (95% CI: 82%-99%) and a SP of 51% (95% CI: 42%-59%). CONCLUSIONS: The PF/S cholinesterase ratio yielded an useful information on the diagnosis of pleural exudates. Thus, in our series of patients, a ratio < 0.42 in a lymphocytic effusion suggested a malignant origin, and a ratio < 0.45 practically ruled out tuberculosis, irrespective of the cellular predominance in the pleural fluid.

Adult↗
PubMed1996

[Pleural exudate as presentation of constrictive pericarditis].

An exudative pleural effusion is a very infrequent form of presentation of constrictive pericarditis, and it can induce diagnostic difficulties. We present a 71 year-old woman with a pleural effusion attributed to be due to congestive heart failure which does not respond to the treatment. The pleural fluid had biochemical characteristics of an exudate. The echocardiographic study showed severe constrictive pericarditis, and after the pericardectomy the pleural effusion completely resolved. The diagnostic suspicion of constrictive pericarditis in cases of exudative pleural effusion is of special interest because an specific and effective treatment is available.

Aged↗