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Biomedical subjects

I Padilla Navas

Publications and source records attributed to I Padilla Navas.

At least 19 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↗
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

[Tuberculosis outbreak at a public school].

BACKGROUND: At school there are special circumstances of living together and a particular susceptibility, which favour the emergence of tuberculosis microepidemics. We report here the microepidemic occurred at a school among 9-year old children. METHODS: After ruling out a possible familiar source in a child with pulmonary tuberculosis, we detected a case with high bacillar shedding in a female teacher and conducted a tuberculin search among children and teachers, initially outlining the theoretical groups at risk. Tuberculin positive children underwent chest-X-ray and when abnormalities were found, children were derived to the pediatrician for chemotherapy. All converters received secondary chemoprophylaxis and all non-respondents primary chemoprophylaxis. RESULTS: The classroom where the teacher spent most of het time had a higher rate of converters (70%) than other classroom, where the index teacher spent only a partial time (40%; RR: 1.75; CI: 1.06-2.88) or the collective of teachers (45.4%; RR: 1.45; CI: 0.94-2.23). Three additional cases of secondary disease were detected, all of them children. The initial compliance with chemoprophylaxis was greater among (for) children (97.0%) than among teachers (41.6%). Among children there was one case of tuberculin conversion compared with three cases among teachers. No additional cases were detected; also, an abnormal rate of reactors outside the initially studied groups was also not detected. CONCLUSIONS: Our results somehow agree with those reported from other school outbreaks. To note the anergy and lack of symptoms in the index case and the suggestion to delineate the degree of spending hours together to identify groups with a higher theoretical risk of being infected. Thus, an unnecessary expense of resources and a social alarm would be avoided.

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 effusion: criteria for distinguishing between transudates and exudates].

The first step in the diagnostic study of a pleural effusion is to classify as a transudate or exudate. Light's criteria (pleural fluid/serum proteines > 0.5; lactatedehydrogenase [LDH] > 2/3 of the upper normal limit in serum; pleural fluid/serum LDH > 0.6) usually used, incorrectly classify some cases, especially transudates. For this reason, different alternative criteria has been proposed: pleural fluid cholesterol, pleural fluid/serum cholesterol ratio, pleural fluid/serum bilirubin ratio, and serum/pleura albumin ratio. Althought the first results suggested better results that those obtained with the Light's criteria, after the analysis of the different studys we conclude that a method to diferentiate perfectly transudates and exudates is not yet available.

Cholesterol↗
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↗
PubMed1994

[A survey of the basic knowledge of chronic respiratory patients].

Sixty patients diagnosed as having chronic respiratory diseases were surveyed in order to establish how many knew the name of their disease, the medications they were taking, the name of the medical specialty dedicated to treating their condition and the nature of spirometry. Only 23 patients (38%) knew the name of their disease; among them were all those suffering asthma or silicosis, but only 24% of those with other diseases. Thirty-three (55%) were unable to name their medications. Only 22% knew what a pneumologist does or could define spirometry, although at least 45% of these patients had undergone the procedure. The majority, on the other hand, knew what a cardiologist (70%) does and what an electrocardiogram (80%) is. A large number of patients with chronic respiratory diseases know very little about basic aspects of their conditions. Use of correct terminology appears to be necessary if patient knowledge is to increase.

Aged↗
PubMed1994

[Tracheobronchial involvement in non-Hodgkin's lymphoma].

Tracheobronchial involvement in non-Hodgkin's lymphoma (NHL) has been little described. We present two patients with NHL and endobronchial involvement of different characteristics. In the first case diffuse involvement of the bronchial mucosa was observed in the context of a systemic NHL of 10 years' duration. In the second patient, endobronchial involvement consisted of a mass obstructing the trachea and the right main bronchus which was the first manifestation of lymphoma.

Aged↗
PubMed1993

[Primary microcytic carcinoma of the trachea].

Primary microcytic tumors of the trachea are very rare. Among them, primary microcytic carcinoma of the trachea has been described very few times. We present the case of a 44-year-old man with hemoptysis and asthenia, in which the thoracic radiography was normal. However, the bronchofibroscopy detected a microcytic carcinoma localized at the distal third of the trachea with adenopathies and hepatic metastasis. Complete remission was achieved with chemotherapy, remaining the patient free from the disease 10 months after the diagnosis.

Adult↗
PubMed1989

[Pleuropulmonary tumors. Presentation of 2 cases with peculiar clinicopathologic traits].

A pseudomesotheliomatous adenocarcinoma, which is a rare form of peripheral pulmonary tumor with diffuse thickening of the pleural cavity mimicking a mesothelioma, and a malignant mesothelioma with a carcinoma like disseminating pattern are presented. The biopsy obtained by thoracotomy in one case, and the necropsy studies enabled the diagnosis by the microscopic pattern, the presence of mucosubstances (PAS diastase) and the immune histochemical profiles with antibodies against several antigenic groups (CEA, EMA, CAM 5.2, and Vimentin. The value of these techniques to differentiate adenocarcinomas and mesotheliomas is discussed. The presence of CEA orients to an epithelial origin of a neoplasia.

Adenocarcinoma↗