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Biomedical subjects

E Rodríguez Becerra

Publications and source records attributed to E Rodríguez Becerra.

At least 19 recordsLinked to original sources
PubMed2005

[Radiographic staging and bronchoalveolar lavage cell counts in sarcoidosis].

OBJECTIVE: Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown etiology that mainly affects the lungs and lymph nodes. Bronchoalveolar lavage (BAL) is known to be useful in diagnosis of the disease but its value as a prognostic marker is unclear. The aim of this study was to assess whether there is a characteristic pattern in BAL cell counts according to radiographic stage and determine whether BAL offers information on disease course. PATIENTS AND METHODS: The study included 34 patients with untreated sarcoidosis. Data were collected on the following variables: age, sex, smoking habit, treatment type, radiographic stage, respiratory function, serological parameters, and BAL cell counts. The patients were classified into 3 groups according to functional and radiographic change at 12-month follow-up. RESULTS: No differences in age, sex, or smoking habit were found according to either radiographic stage or disease course. Although the proportion of lymphocytes in BAL fluid was higher in radiographic stage I than in stages II and III, the differences were not statistically significant. The differences in BAL cell counts between groups based on disease course were not statistically significant. CONCLUSIONS: No differences were found in the characteristics of BAL fluid according to radiographic stage. The differential cell count in BAL fluid does not appear to predict the course of sarcoidosis in the first 12 months.

Adult↗
PubMed2003

[Evaluation of clinical diagnostic guidelines for idiopathic pulmonary fibrosis].

OBJECTIVES: To analyze the international consensus statement on diagnostic criteria for idiopathic pulmonary fibrosis. METHODS: All patients diagnosed of any interstitial lung disease by means of open lung biopsy since 1980 were included. The patients' clinical records were examined to determine whether they fulfilled the diagnostic criteria, and their biopsies were reviewed to find those with the usual interstitial pneumonia pattern. We calculated sensitivity, specificity, positive and negative predictive values and likelihood ratios for the diagnostic criteria in the consensus statement. Afterwards, we performed the analyses again using only one of the two conditions for fulfilling the function criterion. RESULTS: Of 39 patients enrolled in the study, 17 had idiopathic pulmonary fibrosis. Specificity and positive predictive value were both 100%, but sensitivity was 41.2% and negative predictive value was 68.7%. The likelihood ratio for a negative result was 0.59. In the second analysis, sensitivity was 64.7% and negative predictive value was 78.5%, while specificity and positive predictive value remained unchanged. The likelihood ratio for a negative result was 0.35. CONCLUSIONS: The criteria are sufficiently specific to allow us to diagnose confidently when the criteria are fulfilled. However, a slight change in the function criterion should be considered in order to increase diagnostic yield.

Adolescent↗
PubMed2003

[Metastatic pulmonary calcification: a rare cause of interstitial lung disease].

We report the case of a 58-year-old woman with metastatic pulmonary calcinosis who presented with bronchial hyperreactivity. She was receiving calcium and vitamin D supplementation following total bilateral thyroidectomy with parathyroidectomy and had a history of episodes of symptomatic hypercalcemia secondary to exogenous administration. Lung function testing showed slight obstruction that was reversed by bronchodilators. Images showed a bilateral micronodular pattern mainly in the upper fields (x-ray and high resolution computed tomography of the thorax) and abnormal calcium deposition in the lungs (bone scintigraphy). The diagnosis was established by transbronchial biopsy. The clinical course was favorable. Metastatic pulmonary calcinosis is rare and usually asymptomatic and evolution is good. This entity should be taken into account in the differential diagnosis of interstitial lung diseases involving micronodular infiltrates in patients at risk.

Calcinosis↗
PubMed2002

[Antisynthetase syndrome and interstitial lung involvement. Report of 6 cases].

The cases of 6 patients (4 men, 2 women) with antisynthetase syndrome are reported. The mean age was 60 years and the most frequent symptom was increasing dyspnea (4 patients). One of the remaining 2 patients had hemoptysis and the last was asymptomatic. Systemic symptoms included Raynaud's phenomenon (2 patients), arthritis in hands (3) and muscle impairment (4). Chest films showed linear interstitial infiltrates of varying severity in 5 patients; the patient without such infiltrates also suffered silicosis. Functional assessment showed restrictive impairment in 4 patients; of the remaining 2 patients, 1 had chronic obstructive pulmonary disease and 1 had normal function. The antisynthetase antibody (ASAB) detected was anti-Jo-1 in 4 cases, anti-PL-12 in 1 case, and unidentified in 1 case. The course of disease was satisfactory for 5 patients. ASAB analysis is useful for studying idiopathic interstitial lung disease.

Aged↗
PubMed1999

[A randomized comparative study of 3 days of azithromycin treatment and 10 days of cefuroxime treatment in exacerbations in patients with chronic obstructive pulmonary disease].

BACKGROUND: The aim of this study was to prospectively evaluate the clinical and gasometric evolution and the side effects of two treatment schedules in the exacerbations of patients with chronic obstructive pulmonary disease (COPD): 500 mg/24 h of azithromycin (AZM) for three days versus 500 mg/12 h of acetyl cefuroxime (ACF) for 10 days. PATIENTS AND METHODS: Patients were randomized included into each therapeutic schedule. The patients were seen three times (days 1 and 4, and at 15-21 days) to evaluate clinical symptoms scores. Forced spirometry and arterial gasometry were performed the first and the last time the patients were seen. The number of patients requiring admission during follow up and the secondary effects of each antibiotic were quantified. RESULTS: A total de 50 patients were treated with AZM and 51 with ACF. The evolution of the symptoms was similar although with a trend to greater improvement in those treated with AZM. This improvement was significant for the characteristics of expectoration (p < 0.05). Functional and gasometric evolution was similar in the two schedules. Three patients treated with AZM required hospital admission, as did 5 treated with ACF. A greater number of secondary effects were observed in patients treated with ACF (18%) than in those receiving AZM (10%), with gastrointestinal side effects being the most commonly observed. CONCLUSIONS: Treatment with short schedule of AZM may have the same activity as longer schedule of ACF, with fewer secondary effects thereby suggesting that AZM may be an effective alternative in the treatment of exacerbations in patients with COPD.

Administration, Oral↗
PubMed1999

[Evaluating the influence of hospital size on respiratory health care efficiency in Andalusia].

OBJECTIVE: To analyze the influence of hospital size on efficient delivery of health care to patients admitted with respiratory problems in Andalusia (Spain). METHOD: From the minimal data base of all public hospital releases from Andalusia for 1994 and 1995, we identified patients whose main diagnosis involved respiratory complaints as shown by diagnosis-related grouper AP-DRG-10.0, excluding patients aged under 15 years. A functional index for each hospital was calculated to estimate hospital efficiency; a case-mix index was used to express the complexity of cases attended. RESULTS: 1) The case-mix indexes of the hospitals studied were not significantly different. Functional indexes were positively related to hospital size. CONCLUSIONS: 1) In Andalusia, case complexity does not increase with the size of public hospital. 2) Larger hospital size led to decreased efficiency in caring for respiratory patients in the population and period under study.

Adult↗
PubMed1999

[Idiopathic pulmonary fibrosis in a 14-year-old girl].

Pulmonary fibrosis (PF) is a rare disease that develops as the final stage of scarring after a series of episodes of lung injury. PF is idiopathic in most cases (60%), though the exact rate varies from series to series. Childhood PF, which is even rarer than the adult form, is usually diagnosed when the patient is less than five years old. Some cases are familial. We report the case of a 14-year-old girl admitted with a three-year history of dry cough and increasing dyspnea that eventually appeared even with moderate effort. Pulmonary biopsy by mini-thoracotomy showed diffuse fibrosis of unknown cause. She died four years after diagnosis. The patient's age, the rapid course of disease, and the final outcome are all unusual features of this case.

Adolescent↗
PubMed1998

[Acute interstitial pneumonia (Hamman Rich syndrome)].

We report the case of a 65-year-old woman with no history of respiratory disease who suffered onset of dyspnea after an episode of pseudoinfluenza. Dyspnea progressed such that within 15 days it was triggered by minimal effort. The patient died 15 hours after admission to our hospital, with a clinical picture of adult respiratory distress. Autopsy allowed us to rule out several diseases and arrive at a diagnosis of acute interstitial pneumonia, consistent with clinical course, anatomical and pathological findings as described in the literature.

Acute Disease↗
PubMed1997

[Hospital admissions related to lung disease in Andalucia: 1993-1994].

To determine the pneumological causes for hospital admission in Andalucia (Spain) and thereby improve knowledge of respiratory morbidity. From the Combined Minimum Data Base on admissions to Andalusian hospitals for 1993 and 1994, adjusted to the CIE-9-MC coding system, we analyzed main diagnoses registered. Cases with respiratory involvement were obtained, excluding patients under 7 years of age. Admissions for pneumological causes accounted for 6.3% of all admissions, with a total of 314 diagnostic categories, although 98.5% of all admissions were related to only 139 diagnoses. The 53 most frequent diagnostic categories accounted for 93% of patients and 55.2% of admissions were related to only 10 causes and led to 54.16% of all stays for pneumological diseases. Categories 486 and 481 (pneumonias), along with 496, 491.2 and 491.21 (diseases involving chronic air flow obstruction) were the most often used. Respiratory problems account for 6.23% of all hospital admissions in Andalucia, with lung infections and conditions falling under the category of chronic obstructive pulmonary disease being by far the most frequent pneumologically related reasons for hospitalization. The precise interpretation of diagnostic categories needs to be better defined in the coding system.

Adolescent↗
PubMed1997

[Outpatient emergency care in pneumology. A method to alleviate pressure of hospital emergency services].

We analyze the result of using a pneumological rapid-attention facility for diagnosis and immediate treatment of patients with respiratory symptoms arriving at the emergency room of University Hospital Virgen del Rocío in Seville (Spain). In the first six months the outpatient service saw 321 patients (male/female ratio 2.6), most of whom were between 55 and 75 years of age and had never before seen a pneumologist (83.4%). Dyspnea was the most common respiratory symptom named (by 35% of patients), and acute exacerbation of chronic obstructive pulmonary disease was the most usual diagnosis (in 19.1%). Only 21 (7%) were admitted to the hospital. We that creating the outpatient unit effectively met a societal need for rapid diagnosis and treatment of patients with respiratory complaints in the area served by our hospital emergency service.

Adolescent↗
PubMed1993

[The effect of continuous positive pressure in the nasal airway on the right ventricular function in obstructive apnea sleep syndrome].

BACKGROUND: The aim of this study was to evaluate the right ventricular function in the obstructive apnea sleep syndrome (OSAS) and to determine the effect of the continuous use of a continuous positive pressure nasal device on the airway (CPSPn) produces on this aspect of the disease. METHODS: Forty patients were diagnosed of OSAS by study of spontaneous night sleep. A functional respiratory study was performed in all the patients as was a calculation of the index of body mass (IBM) and isotopic ventriculography for the calculation of the right and left ventricular ejection fractions (RVEF and LVEF). Twenty-six patients were followed after 8.4 +/- 3.3 months of home treatment with CPAPn in which these studies were repeated. RESULTS: Twenty-four of the 40 patients (60%) had RVEF lower than 0.45. These 24 patients had paO2 in vigil state (69.9 +/- 13.6 mmHg) than those with a normal RVEF (80.1 +/- 8.7 mmHg) (p < 0.05). After treatment with CPAPn an elevation was observed in the RVEF in the group which was followed. This increase was significant in the subgroup sharing low RVEF (n = 16) prior to starting treatment upon passing from 0.39 (+/- 0.02) to 0.45 (+/- 0.04) (p < 0.001). CONCLUSIONS: Right ventricular dysfunction in frequent in patients with the obstructive apnea sleep syndrome and is more frequent in patients maintaining hypoxemia in vigil. The continual use of continuous positive pressure in the nasal airway produces improvement in right ventricular function particularly in those in whom this was most disturbed.

Adult↗