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J Díaz López

Publications and source records attributed to J Díaz López.

5 recordsLinked to original sources
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↗
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

[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↗