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Biomedical subjects

F Carrión Valero

Publications and source records attributed to F Carrión Valero.

At least 19 recordsLinked to original sources
PubMed2003

[Individually tailored medical counseling for pregnant smokers].

OBJECTIVES: To identify the characteristics of smoking addiction in a group of pregnant women, to evaluate the efficacy of medical counseling tailored to the patient's stage in the cessation process and to examine factors that might affect the ability of a woman to quit smoking during pregnancy. PATIENTS AND METHODS: One hundred sixteen women (mean age 29.71 5.44 years; range 15-41) were referred by obstetricians to a respiratory medicine specialist if they continued smoking after being advised to quit. The information each woman received was appropriate to her stage in the cessation process and covered the risks that smoking posed for her child and the benefits that would come from quitting. Each woman was provided with guidelines for quitting and helped to choose the first day to start the cessation process. The women received follow-up counseling sessions after the first and third months. RESULTS: Twenty-seven women (23.3%) quit smoking, 18 (15.52%) advanced a stage in the cessation process and 30 (25.86%) smoked less. Overall, the program benefited 60 women (51.7%) who quit smoking, reduced the number of cigarettes they smoked or progressed to a new stage. CONCLUSIONS: The results reveal that most pregnant smokers need the intervention of specialists with knowledge of smoking addiction to facilitate the cessation process.

Adolescent↗
PubMed2002

[Influence of computed tomography of the abdomen for staging lung cancer].

OBJECTIVES: To analyze the influence of routine imaging of the upper abdomen by conventional computed tomography (CT) to stage bronchopulmonary carcinoma and to detect liver or adrenal metastasis. A second objective was to describe the characteristics of a large group of patients in our practice. MATERIAL AND METHODS: Retrospective study of 387 patients (367 men and 20 women; mean age [+/-SD] 62.3 +/- 10.4 years, range 34-90 years) who had received a diagnosis of lung cancer (203 epidermoid carcinoma, 75 adenocarcinoma, 15 non-small cell carcinoma, 68 small cell carcinoma and 25 mixed tumors). CT images were obtained of the chest and upper abdomen with intravenous contrast except in patients with a history of allergy or renal insufficiency. The characteristics associated with abdominal CT images aiding or confusing diagnosis were analyzed by Spearman coefficient. Differences related to sex or histology were studied using a Mann-Whitney U-test and Kruskal-Wallis test. RESULTS: The upper abdominal CT changed the staging of 27 patients (7%): non-small cell carcinoma 5% (16/319) and small-cell carcinoma 16.2% (11/68). Twelve patients (3.1%) showed evidence of unconfirmed adrenal or hepatic metastasis. Change of staging after CT was associated with a high creatinine concentration in blood (p = 0.032), whereas confusion of diagnosis after CT was more common for women (p = 0.002) and patients for whom the diagnosis was established by cytology of sputum or bronchial aspirate (p = 0.019). Differences between men and women were found for from pathology (p = 0.027), confusion after CT (p = 0.002), hemoglobin (p = 0.011), hematocrit (p = 0.019) and smoking (p = 0.000). CONCLUSION: Given the considerable limitations of CT imaging of the upper abdomen, new technologies should be developed to facilitate a more rational approach to the problem.

Adenocarcinoma↗
PubMed2002

[Lung toxicity due to thalidomide].

Although the side effects of thalidomide are well known, lung toxicity has not been reported. We describe the case of a 65-year-old man with multiple myeloma (IgG kappa) in stage IA who, on the thirty-seventh day of treatment with thalidomide, developed acute coughing, general malaise, dyspnea at rest and sudoresis. Blood pressure was 90/60 mm Hg and temperature was normal. An interstitial and alveolar pattern was visible on the right side of a chest film and arterial blood gases indicated partial respiratory insufficiency (pH 7.40, PaCO2 40 mmHg, PaO2 47 mmHg). Blood analysis showed alterations expected for multiple myeloma and microbiology was negative (sputum and blood cultures and urinary antigen detection for Streptococcus pneumoniae and Legionella pneumophila). After thalidomide was withdrawn and oxygen and intravenous corticoids were administered, outcome was good. A chest film 4 days later was normal and arterial blood gases showed that respiratory insufficiency had disappeared. We conclude that severe lung toxicity should be included among the potential adverse effects of thalidomide.

Aged↗
PubMed2002

[Mycobacterium kansasii lung infection and synchronous bronchopulmonary carcinoma].

The association of lung tuberculosis and carcinoma of the lung is very well-known, although it is exceptional the synchronous presentation of lung infection for nontuberculous mycobacteria and lung carcinoma. We present the case of a 41 year old male, smoker, with antecedents of lung tuberculosis in the adolescence and chronic liver disease for virus B and C that he presents fever, hoarseness and loss of 4 kg of weight of a month of evolution. The CT scan of the chest revealed a lung mass in left apex with pneumonitis, tumor invading chest wall and mediastinal lymph node enlargement. The biopsy of a supraclavicular node showed metastasis of squamous carcinoma, while in the sputum was isolated Mycobacterium kansasii sensitive to rifampin and ethambutol. HIV was negative. The possible mechanisms of this uncommon association are commented, next to a revision of the literature.

Adult↗
PubMed2002

[Lung hypoplasia in the adult: description, pathogenesis and review].

The lung hypoplasia is a very few frequent entity characterized by a detention in the lung development that leads to a poor development of this organ. Habitually this disease is diagnosed in the childhood and there are very few cases that pass unknown, being detected in the mature age (> 18 years). We present four cases of diagnoses adult patients of lung hypoplasia for diverse test (imaging or invasive) that consulted for not specific symptoms, mostly related with infections of the lung and their later evolution over the years. We also review the pathogenesis, etiology and malformations associated of this disease as well as a review of the published articles in this age group.

Adult↗
PubMed2001

[Chest wall destruction: unusual presentation form of pulmonary nocardiosis].

Nocardia spp infection is associated with immunosuppresion states, neoplasms and immunosuppresors and glucocorticoids prolonged treatments. Pulmonary involvement is the most typic feature and the dissemination to chest wall and subcutaneous cellular tissue is uncommon. We report one case of pulmonary nocardiosis by Nocardia asteroides, in a diabetic patient without others risk factors, manifested as a chest wall abscess with fifth rib destruction. The treatment with cotrimoxazol after lesion drainage was successful. We review the literature and remain the different diagnostic and therapeutics attitudes.

Abscess↗
PubMed2001

[Alveolar-arterial gradient of O2 in COPD with hypercapnia].

OBJECTIVE: This study was conducted to assess whether or not calculation of the alveolar-arterial oxygen tension difference (AaPO2) from arterial blood gas measurements, breathing air, is useful to discriminate patients with hypecapnia associated with obstructive lung disease. PATIENTS AND METHODS: The effect of different values for the respiratory exchange ratio (R) was also analyzed. We calculated the AaPO2 in 45 patients with chronic airway obstruction and hypercapnia (PaCO2 in 45 mmHg) and hemodynamic stability using the standard alveolar gas equation, PAO2 = PIO2 - PACO2 [FIO2 + (1-FIO2)/R], with R assumed to vary from 0.6 to 1.1 and the simplified alveolar gas equation, PAO2 = PIO2 - PACO2/R, with R assumed to be 0.8. It was considered that a patient was correctly classified when the calculated AaPO2 was greater than predicted AaPO2. RESULTS: When the simplified alveolar gas equation was used, 9 (20%) of 45 patients were misclassified, whereas using the standard equation with R assumed to be 0.8, 41 (91%) of 45 patients were correctly classified. Modification of the value of R only allowed improving the classification of two further patients. CONCLUSIONS: We conclude that calculation of the AaPO2 using the standard equation and R = 0.8 can be used to classify hypercapnic COPD patients. This laboratory parameter is of sufficient discriminant value to be used for clinical purposes.

Aged↗
PubMed2000

[Inhalation technique in patients with chronic respiratory diseases].

OBJECTIVE: To determine how inhalers are used by patients with chronic respiratory diseases in the Community of Valencia (Spain) and to identify the factors associated with correct use. MATERIAL AND METHODS: We carried out a prospective study of 554 patients (331 men, 223 women, mean age 50.5 +/- 21.5 years) who underwent spirometric testing (292 with bronchial asthma, 192 with COPD, 15 with bronchiectasis and 55 with other diagnoses). The patients were asked what type of inhaler they used. Pressurised canisters (PC) were used by 39.9%, inhalation chambers (IC) by 37.9% and dry powder inhalers (Turbuhalers) (DP) by 22.2%. They were also asked what instructions they had received; the inhalation techniques recommended by the Spanish Society of Pneumologists and Chest Surgeons (SEPAR) was reviewed step by step. RESULTS: a) Four hundred thirty-two patients (78%) reported having received instruction in how to use the inhaler; b) One hundred seventy-five (31.6%) used the correct technique: 25.3% using PC, 32.4% using IC and 41.5% using DP (p = 0.008); c) The most common errors were not holding the breath after inhaling in the case of PC users, not waiting 30 seconds between inhalation maneuvers and the lack of synchrony with inspiration among PC users; d) Use of correct inhalation technique was associated with prior instruction (rs = 0.249; p < 0.001) and younger age (rs = 0.92; p = 0.03). CONCLUSIONS: A high percentage of patients, particularly those using PC and those who received no instruction, use inhalers incorrectly in the Community of Valencia. We therefore recommend health education programs that target the main errors identified.

Administration, Inhalation↗
PubMed2000

[Minimal intervention in smoking in Spain].

OBJECTIVE: To determine the percentage of smokers who have been counseled by a physician to quit, among patients who visit a variety od specialist clinica; to identify the characteristics associated with a history of minimal intervention. PATIENTS AND METHODS: An anonymous survey of 501 patients over 14 years of age (230 men, 271 women; mean age of 51.4 yr) who were out patients in cardiology (61), neurology (68), digestive medicine (124), endocrinology (22), internal medicine (14), otorhinolaryngology (53) and dermatology (159) over a period of one week. The questionnaire asked if the patient smoked currently and if so, if a physician had ever recommended quitting. The association between a history or minimal intervention and other variables was evaluated using Spearman a correlation coefficient. RESULTS: 1) One hundred fifteen (22.9%) were smokers. 2) Only 49 (42.6%) of the smokers reported that a physician had advised quitting and 66 (57.4%) reported that none had done so. 3) We found an association between a history of minimal intervention and older age (rs = -0.246; p = 0.008) and male sex (rs = 0.244; p = 0.009). CONCLUSIONS: The infrequency with which physicians counsel patients to quit in our setting suggests an urgent need for the Spanish health authorities to develop programs aimed at minimal intervention.

Adolescent↗
PubMed2000

[Barometric pressure and respiratory quotient for estimating the alveolar-arterial oxygen gradient].

OBJECTIVE: To evaluate how they influence in the calculatión of the alveolar-arterial oxygen difference (AaPO2) the measurement of the barometric pressure (Pb) and respiratory quotient (R), in patients with chronic respiratory disease. METHOD: Prospective study of 39 patients with chronic respiratory disease in stable situation. We calculate: 1. AaPO2 (PAO2 - PaO2) through the equation of the alveolar air [PAO2 = PIO2 - PaCO2 [FiO2 + (1 - FiO2)/R)], assuming Pb = 760 mmHg and R = 0.8 and 2. Real AaPO2, with the figures measured of Pb and R. RESULTS: The values of AaPO2 and real AaPO2 were (mean +/- SD) 27.85 +/- 9.32 mmHg and 34.23 +/- 11.17 mmHg, respectively (p = 0.000). The figure of real AaPO2 is greater than AaPO2 in 34 patients, of those which in 21 cases (53.8%) is > or = 5 mm Hg and in 8 cases (20.5%) is > or = 10 mmHg. CONCLUSIONS: The traditional calculation of AaPO2 minimizes the severity of the pulmonary disease and it can contribute, in part, to the mistakes in the physiopathologic classification of the origin of the respiratory insufficiency (hipoxemia caused by alveolar hypoventilation and hipoxemia caused by alveolar hipoventilation complicated by other abnormalities of gas exchange).

Aged↗