Biomedical subjects
J M González Ruiz
Publications and source records attributed to J M González Ruiz.
[Usefulness of CO measurement in expired air in the study of tobacco consumption by youths and adolescents].
The objective of our work was to know the relationship between carbon monoxide (CO) levels in expired air and smoking habits among school youths and the relationships that can be established between CO level and some peculiar attitudes regarding consume by youths, such as the number of cigarettes, inhaling technique and time elapsed since the last cigarette was smoked. The study, of cross-sectional design, was performed in two high school centres and a total of 777 students who answered a questionnaire and had an expired air CO sample in their own schoolroom tested were enrolled. CO determination in the schoolroom was a simple and attainable technique for the pupils, as only 32 cases (4.1%) had to be excluded due to poor collaboration or poor technique. The mean (mean and SD) CO level in the control group (n = 247), made up by non-smokers nor tobacco tasters was 4.75 (2.46) ppm, statistically lower than among smokers (p < 0.001), but with no differences compared with non smokers (n = 563), who had a CO level of 5.23 (3.4) ppm. This figure was also lower (p < 0.001) than that obtained in the smokers (12.6 [6.3] ppm), made up of 214 pupils, with a mean consume of 2.7 (1.69) cigarettes/day. Among smokers the mean abstinence time since the last cigarette was smoked was 26 (44) minutes and 54% of them admitted to have smoked in the last 10 minutes. CO in expired air correlated significantly with the number of smoked cigarettes (r = 0.58; p < 0.001). Likewise, it correlated significantly with abstinence minutes (r = -0.38; p < 0.001). The time required for CO level to decrease below 10 ppm was 140 minutes in four cases and 120 minutes in 33 cases.
[Carboxyhemoglobin levels in relation with home heating].
To study carboxyhemoglobin levels (HbCO) associated with use of different types of home heating and to evaluate the usefulness of measuring hemoglobin oxygen saturation. Nonsmoking patients with chronic respiratory insufficiency who were initially prescribed home oxygen therapy were enrolled in the study. One hundred four patients were studied in winter and summer (when heating was not used). The control group consisted of 92 hospitalized patients not exposed to carbon monoxide. Of the 104 patients 74.1% were men. Mean age was 72.33 (range 17 to 97 years) and 57.9% lived in rural areas. Mean HbCO in the control group was 1.53 +/- 0.96% (p = 0.01). Among the 39% who burned slack coal for heat, the mean HbCO was 4.63 +/- 2.87%. The 23.7% with central heating had HbCO levels of 2.15 +/- 0.87% (p < 0.0001). Pulse oximetry (SpO2) estimated higher hemoglobin oxygen than direct measurement (SaO2): 87.12 +/- 6% and 83.3 +/- 8%, respectively (p < 0.001). High HbCO concentrations are related to chronic exposure to slack coal fumes. Pulse oximetry, as opposed to SaO2, overestimates hemoglobin oxygen saturation in such cases.
[A mediastinal mass and chest pain].
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[Acute respiratory insufficiency and bilateral interstitial pattern].
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[Massive hemoptysis in a patient with an aortic pseudoaneurysm].
We present a case of non-fistulated, non-fissured arteriosclerotic pseudoaneurysm of the aorta in a patient with massive hemoptysis. The condition was resolved by resection, with the breach repaired with a Dacron patch. The diagnosis of thrombotic false aneurysm of the aorta was suspected after inspection of the digital angiograph and aortograph obtained by computed axial tomography. A review of the literature revealed 89 cases of non-surgically removable thoracic aortic aneurysm with hemoptysis; 72 of these cases involved aortobronchial fistulas. In only 1 case was the wall of the aneurysm intact, showing no fissures in spite of hemoptysis. The absence of fissuring or tearing in our patient may be accounted for by the delay of 10 days between the last bout of hemoptysis and surgical resection.
[The predictive parameters in the response to almitrine treatment].
Almitrine bimesylate (AB) improves hypoxemia in an undetermined number of patients with respiratory failure. Our objective was to try to identify the patients likely to benefit from this treatment. We undertook a double blind study of AB (50-100 mg/day) vs placebo in 21 randomly chosen patients diagnosed as having chronic obstructive bronchitis who were receiving oxygen therapy in the home. The study lasted 3 months (T0 to T3). PaO2 rose from 51 +/- 5.3 to 58.5 +/- 10 mmHg (6.8 +/- 0.7 to 7.8 +/- 1.3 Kpa) in the 12 patients taking AB (p < 0.05). The remaining gasometric variables and results of functional respiratory exploration were unchanged. The 7 patients receiving AB who were defined as responding-whose PaO2 rose more than 5 mmHg (0.66 Kpa)-presented T0 values lower than those of the 7 non-responding patients in the same group, with respect to CO2 occlusion pressure, mean inspiratory flow and minute ventilation for both air and CO2. These variables can serve as predictors for gasometric response to AB.
[Almitrine bismesylate treatment in chronic respiratory insufficiency].
This study was designed to evaluate the gasometric and functional respiratory responses in chronic bronchitic patients with chronic respiratory insufficiency (CRI) under ambulatory oxygen therapy (AOT) with almitrine bismesylate (AB). It was a double-blind, placebo-controlled, randomized, prospective study which lasted three months and with a dosage regime of 50-100 mg/day of AB. Fiftyfour patients completed the study (28 in AB and 24 in the placebo (P) groups, respectively). All patients were males, with a mean age or 65 +/- 6.1 years. In the study of pulmonary function only airway resistance (Raw) was changed, with a significant decrease at the third month in the AB group compared with the P group (0.83 +/- 0.31 vs. 1.07 +/- 0.46 kpa/L.S), with a p value of 0.05 (mean +/- SD) and PaO2 which improved from 8.15 +/- 0.88 to 8.81 +/- 2.3 kpa (61.17 +/- 6.6 to 66.10 +/- 10 mmHg), with a p value of 0.05. AB therapy was well tolerated.
[Pulmonary involvement in primary Sjogren syndrome].
We present 6 cases of patients diagnosed of Primary Sjögren's Syndrome (PSS) according to Fox's criteria (1986). Our goal was to document the pulmonary affection with bronchoalveolar lavage, transbronchial biopsy and respiratory functional assessment. We verified the double affection described for PSS: interstitial and airways. In all the cases, independently of the respiratory radiological or functional findings, we observed a variable lymphocytary alveolitis. We did not find any correlationship between this alveolitis and the histological findings. We conclude that bronchoalveolar lavage and transbronchial biopsy in the PSS are useful for the detection of early pulmonary pathology.
[Relationship between plasma insulin and C peptide and mild and severe obesity].
We performed this study in order to assess the degree of insulin secretion, both in moderate and severe obesity, and its relationship with body mass index (BMI). During fasting, we did not observe, in general, any modification in the hepatic clearance of insulin, both the moderate and severe obesity groups. After oral overload of glucose (OOG), there was an increase in the secretion of insulin and a decrease in its hepatic clearance in both groups of obesity, with no differences between them. The OOG produced a decrease in the hepatic clearance of insulin in the obese and control groups. Just a slight correlation was observed between insulin secretion and BMI in the control, group, and no correlation at all in both groups of obesity. Neither a correlation was observed between insulin secretion and age or sex.
[Plasma insulin changes in obesity with or without abnormal glucose tolerance].
The aim of this study was to know about the plasmatic variations of insulin and its potential origin in the obesity with or without abnormal tolerance to glucose. Obese patients with normal tolerance to glucose showed normal and hypersecretion of insulin during fasting and after oral overdose of glucose (OOG). Fasting hyperinsulinism in patients with normal secretion of insulin was due to a decrease in its hepatic clearance, whereas in patients with hypersecretion, it was due mainly to insulin hypersecretion. Most of the obese patients with glucose intolerance showed hypersecretion of insulin during fasting and after OOG, being their basal hyperinsulinism due to insulinic secretion. After the OOG, the hyperinsulinism due to insulin hypersecretion and/or a decrease in its hepatic clearance. In addition, we observed an inverse correlation between body mass index and obese patients with normal tolerance to glucose.
[Massive hemoptysis in a patient with arterial hypertension].
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[Sarcoidosis and Whipple's disease: an association or a relationship?].
Whipple's disease is a rare, systemic disorder characterized by arthritis, serositis, diarrhea, malabsorption, lymphadenopathies, weight loss, fever, cutaneous hyperpigmentation and central and peripheral nervous system disorders. There are approximately 60 published cases with pulmonary involvement, in general pleuritis, hilar adenopathies and interstitial affectation. In some occasions, sarcoidosis has been diagnosed prior to WD, postulating either a causal association between both entities, or a relationship between them, existing in WD and initial phase which mimics sarcoidosis. We present a patient diagnosed of sarcoidosis who during the evolution of the disease developed gastrointestinal symptoms compatible with WD.
[Multiple pulmonary nodules as presentation form of bronchopulmonary cancer].
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[Activity of the blood angiotensin converting enzyme in smokers].
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[Tuberculin test: usefulness of an old technique].
Tuberculin test was first used as a diagnostic test of tuberculous infection during the first decades of this century. From the up to date, no other method has proven to be more efficient for this task. In the present work we try to explain what the test consists of, what is its use, how it is interpreted, and which are the indications for the Mantoux intradermal reaction. We emphasize the importance of performing this technique correctly so as to not invalidate the results of this test which is essential both from a individual as from an epidemiological point of view.
[Current status of the antipneumococcal vaccine: a pending issue].
In spite of antibiotic treatment, mortality due to pneumonia caused by Streptococcus pneumoniae is still considerable and it is related to the presence of bacteremia. Prophylaxis with 23-polyvalent anti-pneumococcus vaccine would prevent severe processes in high risk populations. We present in this work the current status of our knowledge about this vaccine, regarding its efficacy in preventing bacteremia, economic cost, and secondary effects, we point out the indications of this vaccine according to IPAC (Immunization Practices Advisory Committee) and those special situations which modify prophylaxis (pregnancy, revaccination and massive immunizations) are discussed.