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F García Díaz

Publications and source records attributed to F García Díaz.

10 recordsLinked to original sources
PubMed2006

[Breaking bad news in medicine: strategies that turn necessity into a virtue].

Breaking bad news is one of physician's most difficult duties. In spite of this, communication skills are considered a minor professional ability. Bad news is defined as any news that drastically and negatively alters the patient's view of his/her future. Patients never forget where, when and what bad news they were told. The factors that make communicating bad new difficult may come from the sociocultural setting of the patient or the doctor. Randomized studies have shown that communication learning skills may cause a positive impact on the person giving and receiving the bad news. In order to facilitate this task, a practical and dynamic 6-step protocol, described by Baile and Buckman, that may be useful for this task, is described.

Attitude of Health Personnel↗
PubMed1999

[The treatment of myasthenia gravis by video thoracoscopic thymectomy. The technic and the initial results].

The primary role of thymectomy for the treatment of myasthenia gravis is currently undisputed. Traditionally, the approach of choice has been sternotomy, although a transcervical route has also been advocated because of its lower rate of associated morbidity. Our department performed thymectomy using a video-assisted thoracoscopic technique in 7 patients (2 men and 5 women) between March 1993 and October 1995. The patients' mean age was 43.4 years (range 20 to 66 years). Complications were few, consisting of 2 cases of pneumothorax due to contralateral opening of the pleura, resolved by pleural drainage. No deaths occurred. Clinical results over periods of observation ranging from 14 to 44 months were excellent in 2 cases of complete remission; good in 3 patients with considerable reduction in drug requirements; and fair in 2 patients who continued to need the same doses of medication throughout the 14 months after thymectomy. The technique we propose is less aggressive than mid-sternotomy, offering incontrovertible advantages and leading to faster. No patient required assisted ventilation for longer than 4 hours and the maximum time spent in the intensive care unit was 24 hours. We therefore suggest that thymectomy to treat myasthenia gravis be performed by thoracoscopy.

Adult↗
PubMed1998

[Prognostic evaluation of post-infarction patients using two-dimensional echocardiography, late ventricular potentials and baroreflex sensitivity].

BACKGROUND: Although many variables are useful predictors of post-infarction mortality, their predictive positive values are weak when applied individually. The aim of this study was to determine the prognostic value of the combination of left ventricular ejection fraction, ventricular late potentials and baroreflex sensitivity. PATIENTS AND METHODS: We studied 69 consecutive post-infarction patients. On the day of their discharge from the coronary unit, all patients underwent a two-dimensional echocardiography, to determine the ejection fraction as well as a high resolution electrocardiogram to detect late potentials. To a subset of 49 patients was carried out to learn their baroreflex sensitivity. The patients were followed for 14 +/- 7 months and the following cardiac end points were considered: sudden cardiac death, non sudden cardiac death and non-fatal episodes of sustained ventricular tachycardia or ventricular fibrillation. RESULTS: There were 8 end points: 3 sudden cardiac deaths, 3 non sudden cardiac deaths and 2 successfully resuscitated sustained ventricular tachycardia episodes. The rate of fibrinolysis was 55%. An ejection fraction < 45%, the presence of late potentials and a baroreflex sensitivity < 3.0 msec/mmHg were univariate predictors with predictive positive values of 33%, 24% and 16%, respectively. When ejection fraction < 45%, late potentials and baroreflex sensitivity < 3.0 were combined, we found a significant increase in the positive predictive value (50%). CONCLUSION: The combined determination of ejection fraction, ventricular late potentials and baroreflex sensitivity allows us to identify subset postinfarction patients with a high rate of cardiac complications.

Aged↗
PubMed1996

[Left splanchicectomy with videothoracoscopy for the control of pain in cancer of the esophagogastric union with invasion of the celiac plexus].

Blockade of the celiac plexus and the splanchnic nerves to combat abdominal pain can be achieved by percutaneous injection of local anesthetics or alcohol, or by thoracotomy. We describe the technique for performing splanchnicectomy with video-thoracoscopy in palliative surgery for cancer of the esophagogastric union, discussing the excellent results obtained immediately in 2 patients.

Aged↗
PubMed1996

[Disparity between cytohistopathological results of diagnostic specimens and the resected tumor piece in bronchopulmonary carcinoma].

In 88 patients diagnosed and intervened of lung carcinoma, we evaluate the security of the Diagnostic method--cytology: sputum, brushed bronchial, bronchial aspiration, puncture pulmonary aspiration and histology of the bronchial biopsy--when we correlate them with the histology of the dried up tumour. From the 88 patient, in 11 (12.5%) there was a disparity between some specimen and the piece tumour. If we analyze the specimen: the bronchial biopsy, was different in 3 cases, (4.8%); the brushed and the bronchial biopsy, aspiration in 2, (2.7% and 2.3% respectively); the puncture pulmonary aspiration in 6, (26%) and the cytology of sputum in 2 cases, (2.4%). In 8 patients (9%), the outputs of some specimen were not conclusive, if we remove these we find that: the bronchial biopsy was not conclusive in 2 cases, (3.2%), the brushed bronchial in 5, (6.8%); the bronchial aspiration in 9 (10.2%) and the cytology of sputum in 2 cases, (2.4%). With this data we could infer that sometimes the positive outputs of the specimen have no correlation with the histology of the tumour dried up. This disparity has not been observed in the oat-cells. Therefore when we send the specimens to the pathologist, it would always be advisable for him to inform us if there are any different cells belonging to the principal group of the tumor.

Adenocarcinoma↗
PubMedDate not supplied

[An assessment of the resectability of lung cancer by exploratory video thoracoscopy].

We describe our experience using exploratory video-assisted thoracoscopy (EVT) to definitively evaluate resectability in patients with lung cancer who are candidates for surgical resection. In a single procedure we performed full visual and surgical exploration of the pleural cavity, lung, mediastinum, as well as of the pericardial cavity when required. The technique was used in 151 patients. Resection was judged non viable in 18 (11.9%) and performance of exploratory thoracotomy was deemed unnecessary. In 3 cases thoracotomy proved necessary for exploration. Nineteen patients were treated by video-assisted surgery; standard thoracotomy was used to resect 111. Morbidity and mortality were null in the group undergoing EVT in whom resection was judged viable. We conclude that EVT should be used in all patients with lung cancer who are being considered for surgery before a thoracotomy is performed. EVT can be performed as part of the same surgical act, as it supposes a savings in exploratory thoracotomies (amounting to 11.9% in our series).

Adult↗
PubMedDate not supplied

[Treatment of spontaneous pneumothorax in patients over 70 years of age].

Forty-eight patients over the age of 70 with spontaneous pneumothorax (SP) are analyzed. The severity of the clinical picture is conditioned by the presence of earlier lung lesions, particularly related to emphysema, and by the degree of respiratory failure prior to SP. Treatment guidelines are listed. Pleural drainage/aspiration, applied in all cases, was of no avail in 69%. Tetracycline was injected into the pleural space of 23 patients, with failure recorded in 35%. Talc was applied by thoroscopy in 5 patients, to no avail. Video-assisted endoscopic surgery was carried out in 4 patients, with good results in 3. Surgery with access by lateral thoracotomy was carried out in 20 patients, with a single failure that was explained by the patient's condition.

Aged↗