PubMed Health⌕ Search

Biomedical subjects

J Marín Pardo

Publications and source records attributed to J Marín Pardo.

At least 19 recordsLinked to original sources
PubMed2004

[Body mass, dyspnea, and quality of life as success predictors in emphysema surgery for reduction of pulmonary volume].

OBJECTIVES: Lung volume reduction surgery has recently been proposed as a palliative treatment for advanced emphysema. Some patients improve and others remains the same, being debated at this time the factors that predict improvement. The purpose of this work is to find predictive factors for positive response in patients operated with this surgery. MATERIAL AND METHODS: Patients with positive response (7 patients) and patients without positive response (5 patients) have been compared in our series of lung volume reduction surgery (12 patients). Positive response to surgery was defined as Delta FEV1 > or = 15%, dyspnea transitional index (Mahler scale) > or = 3, and improvement in the scoring surgery of quality of life for chronic respiratory disease questionnaire (Guyatt and Güell) > or = 1.5 3 months after the surgery. Basal values of FEV1, FEF50/FIF50%, hyperinsufflation degree, heterogeneity, PaO2, PaCO2, type of surgery, body mass index (BMI), dyspnea basal index (DBI) and quality of life questionnaire score (QLQS). RESULTS: Patients without and with positive response were different only because their baseline BMI, DBI and QLQS were lower. Other parameters studied (although the population was rather homogeneous) did not show significant differences between the two groups. CONCLUSIONS: Patients with higher subjective problems (dyspnea and quality of life) and more malnourished are those with less benefit from surgery for pulmonary volume reduction.

Body Mass Index↗
PubMed2004

[Four-year results after lung volume reduction surgery for emphysema].

OBJECTIVES: While the short-term results of lung volume reduction surgery are known, follow-up over several years has not often been described. The purpose of the present study was to describe results in terms of functional improvement, dyspnea, quality of life, and mortality over a 4-year period in patients with advanced emphysema. PATIENTS AND METHODS: Fourteen successive patients were enrolled between 1996 and 2000 and studied prospectively for 4 years. All patients served as their own controls and initially received pulmonary rehabilitation and medication. Preoperative data were used as baseline and were compared to postoperative data over 4 years. The data analyzed were: functional improvement (forced expiratory volume in 1 second [FEV1]), quality of life, dyspnea, and patient loss due to death or referral to a lung transplantation program. RESULTS: Patients with advanced emphysema (mean FEV1 [SD]: 22.8% [11%] of predicted) were studied. Postoperative mortality was 14%. Overall mortality (postoperative plus deaths due to respiratory insufficiency) was 28% at 1 year and 35% at 4 years. Two patients died of cancer and 5 were referred for transplantation. At 3 months, FEV1 had improved more than 15% in 9 patients (64%); the improvement was maintained in 43% of patients at 1 year and 7% at 4 years. Improvement in dyspnea paralleled improvement in FEV1. Overall, at 3 months mean FEV1 had improved 41.9% (68%), transitional dyspnea index 2.7 (3), and quality of life questionnaire score 1 (0.9). Thus, improvements were considerable, but there was great variation. Preoperative mean decrease in FEV1 was 50 (32) mL/y, and postoperative decrease 194 (70) mL/y. CONCLUSIONS: With the inclusion criteria used, there was considerable variation in the results. Significant overall functional improvement was maintained in 50% of the patients 1 year following surgery and in 7% 4 years after surgery. Given such results, together with a surgical mortality rate of 14% and overall mortality of 28% in the first year, we believe that the criteria for using lung reduction surgery should be revised.

Aged↗
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↗
PubMed2003

[High resolution computerized tomography in pulmonary tuberculosis with negative sputum bacilloscopy].

CONTEXT: Pulmonary tuberculosis with negative sputum bacilloscopy involves diagnostic difficulties when there are not available liquid culture media due to the slow growth of Mycobacterium tuberculosis in the traditional culture media, and also due to the need for carrying out invasive examinations. OBJECTIVE: Evaluate the high resolution computerized tomography findings (HRCT) in patients with pulmonary tuberculosis and negative bacilloscopy of sputum. METHOD: Prospectively 28 patients (12 with active tuberculosis and 16 with inactive tuberculosis) were evaluated through HRCT, assessing the following findings: centrolobular nodules, multiple branched linear structures, macronodules, cavitation, consolidation, enlargement of interlobular septums, ground-glass change, bronchiectases, emphysema, broncovascular distortion, fibrotic changes, calcified mediastinal adenopathies, parenchymous calcification, pleural enlargement, and pleural effusion. RESULTS: The findings that were associated significantly to the active disease were: consolidation (67%), macronodules (67%) and centrolobular nodules (67%). The presence of centrolobular nodules and/or consolidation had a sensitivity of 83% and a specificity of 87%. The findings significantly associated to inactive disease were bronchiectases (87%) and broncovascular distortion (62%). CONCLUSION: Our results support the value of HRCT in patients with pulmonary tuberculosis and negative sputum bacilloscopy, since the finding of centrolobular nodules and/or consolidation has good sensitivity and specificity for the diagnosis of active pulmonary disease.

False Negative Reactions↗
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 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

[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↗
PubMed1999

[Value of ventilation scintigraphy in the diagnosis of pulmonary thromboembolism].

OBJECTIVES: The objective of this work has been to know if to all patients with diagnostic suspected of acute pulmonary embolism and pathologic perfusion scanning, ventilation scintigraphy were performed in the assistance context, analyzing etiopathogenic, clinic and diagnostic factors related with the non prescription of the ventilation scintigraphic study. METHODS: In 1992 we have carried out a retrospective and random study of 50 patients with perfusion scintigraphy for diagnostic suspected of acute pulmonary embolism (APE). RESULTS: A diagnosis of acute pulmonary embolism and deep vein thrombosis was made respectively in 35 (70%) and 22 (44%) of a total of 50 patients. In twenty patients ventilation scintigraphic study were not performed, six of them with normal perfusion scanning and fourteen patients with pathologic scintigraphic perfusion and acute pulmonary embolism diagnosis (78.5% with high probability scintigraphic scans). In this work we find a total of 14 patients with perfusion scanning without ventilation study. The presence of high probability scintigraphic scans or the acute pulmonary embolism were significant statistically related with the non prescription of the ventilation study. CONCLUSIONS: In our opinion, none of these factors can explain the non realization of the ventilation scanning, considering this study indispensable before the presence of patient with scintigraphic perfusion defects and suspected of pulmonary embolus.

Acute Disease↗