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Biomedical subjects

J Sanchís

Publications and source records attributed to J Sanchís.

16 recordsLinked to original sources
PubMed1998

[Clinical and biochemical characteristics of a new case of Tangier disease in Spain].

Tangier disease (TD) is a rare autosomal recessively inherited disorder characterized by the absence or severe deficiency of high density lipoproteins (HDL) in plasma. The affected subjects have no HDL subfraction alpha-Lp A-I, which is the most important subfraction in normal HDL, and can not transform prebeta-Lp A-I subfraction in alpha-Lp A-I. In this article we describe the second homozygous patient for TD in Spain, who presented the typical clinical and biological features (hypocholesterolemia with the absence of plasmatic HDL cholesterol, hepatosplenomegaly and orange yellow tonsils) and the alterations in HDL subfractions.

Cholesterol, HDL↗
PubMed1998

[Better at home: a continuous health care program for patients with advanced chronic respiratory disease].

The objective of this study was to analyze the effect of continuous health care on the frequency of readmissions of patients with advanced chronic respiratory disease. The study was prospective, enrolling 26 patients (16 with COPD, 7 with bronchiectasis and 3 with pachypleuritis) who had been admitted at least 3 times within the past year. The patients were assigned to 3 groups: group A was the ambulatory monitoring group, with 8 patients who were able to travel to the hospital for monthly outpatient checkups; group B was the ambulatory pulmonary rehabilitation group, with 10 patients who were able to travel to the hospital and who needed rebreathing training (one weekly group session); and group C was the home care group, with 8 patients who were unable to travel to the hospital and who received weekly or biweekly house calls. All patients had telephone contact with the program team. Mean lung function values for the whole population were FVC 40 (11)%, FEV1 23 (7)% of reference, PaO2 55 (7) and PaCO2 55 (10) mmHg. A significant decrease in number of admissions (79 versus 18, p < 0.0001) was observed in both the first and second halves of the year in all three treatment groups: A, 25 to 2; B, 28 to 8; and C, 26 to 8 (p < 0.001). The reduction in health care costs over the previous year's expenditure was calculated to be 22,751,402 pesetas. We conclude that specialized health care that is continuous and personalized reduces the number of hospital readmissions of patients with advanced chronic respiratory disease. Moreover, the overall cost of care, without the need to make house calls to all patients.

Aged↗
PubMed1997

[Factors related to diagnostic reliability of bronchial biopsy in primary bronchogenic carcinoma].

To analyze the diagnostic reliability of bronchial biopsy (BB) in bronchogenic carcinoma and the impact of several factors, among them patient symptoms and condition, tumor characteristics and the endoscopist's and pathologist's experience. One hundred eighty-four BB from 151 patients diagnosed of bronchogenic carcinoma in our hospital in the years 1993 and 1994 were reviewed. We first performed single variable analysis, and later logistical regression analysis taking BB positivity or negativity as the dependent variable. The independent variables were age, tumor stage, histological type, lesion necrosis, number of biopsy fragments collected, size of the largest fragment, the endoscopist who performed the BB and the pathologist who studied the specimen. The diagnosis sensitivity of BB was 69.6%. The variables that significantly influenced diagnostic accuracy, in both the single variable and multiple factorial analyses, were clinical status (p < 0.0004) and necrosis (p < 0.0057) with odds ratios of 4.6088 and 0.3766, respectively. The patient's clinical status and the presence or absence of necrosis are the factors that most influence diagnostic accuracy in BB for bronchogenic carcinoma. The likelihood of obtaining a diagnosis is 4.6 greater when clinical status is severe, and 2.7 times greater in the absence of necrosis. The experience of the bronchoscopist, after a learning period, and of the examining pathologist, do not appear to have a decisive effect on diagnostic reliability in this technique.

Adult↗
PubMed1996

[Persistence of the left superior vena cava associated with aortic insufficiency: diagnostic and therapeutic considerations].

In the course of the routine evaluation of a 26-years-old male for acquired aortic valve disease the persistence of a left superior vena cava draining into the coronary sinus was detected. This is a frequent congenital malformation of the systemic venous system that has no hemodynamic consequences in itself, though it may be associated to other congenital or acquired cardiac malformations that may require surgery. The preoperatory detection of the anomaly prevents unexpected problems when connecting the cardiopulmonary bypass. We emphasize the importance of procedures that suggest the diagnosis and characterize the anatomo-functional nature of the condition--including transthoracic and transesophageal echocardiography using echocardiographic contrast, and cardiac catheterization with cardiac and vascular angiography.

Adult↗
PubMed1995

[The clinical characteristics of pleural tuberculosis in patients with and without human immunodeficiency virus infection].

OBJECTIVE: To determine whether or not there are differences in the characteristics of pleural tuberculosis (PT) related to whether patients are or are not infected by human immunodeficiency virus (HIV). METHODS: We conducted a retrospective study of the medical histories of patients diagnosed of PT in our hospital between 1986 and 1993. RESULTS: We found no significant differences in the proportions of tuberculosis patients with or without HIV infection (8% versus 11%) who were diagnosed of PT. Of the 119 patients diagnosed of PT, 10% were also HIV positive. The HIV patients had more serious forms of PT, and among them there was a higher incidence of pleural discharge, more isolations of Mycobacterium tuberculosis in sputum and pleural fluid (42% and 45% versus 13% and 15%, p < 0.05), and more deaths before end of treatment (17% versus 1%, p < 0.05). The HIV patients had a lower rate of positive results in Mantoux's intradermal reaction test (17% versus 67%, p < 0.01), however, and fewer positive results for pleural biopsy (36% versus 84% positivity for granulomas, p < 0.01). CONCLUSIONS: The frequency of PT was similar for subjects with and without HIV infection in our study. In patients with both HIV and PT pleural fluid and sputum cultures are more useful diagnostic tools than pleural biopsy, and the former tests should therefore be stressed.

AIDS-Related Opportunistic Infections↗
PubMed1995

[The quality-of-life questionnaire with asthma patients: the Spanish version of the Asthma Quality of Life Questionnaire].

This paper describes the translation to Castilian and adaptation of a quality of life measurement instrument: the Asthma Quality of Life Questionnaire (AQLQ). The AQLQ, developed by Juniper et al, contains 32 items, 5 of which relate to habitual activities that the patient can choose from among a list of 26 possibilities. Answers are given on a scale of 7 points. To adapt this instrument for use in Spain, we subjected it to a process of translation/back translation by bilingual informants. The translated and original versions of each item, activity and answer option were evaluated as being totally equivalent (A), fairly equivalent but with some questionable wording (B), or of questionable equivalence (C). The naturalness and correctness of the Spanish version were also evaluated on a scale of 1 to 10. Three (9%) items and 1 (4%) activity were considered to be of questionable equivalence (C) and 12 (37%) items and 1 activity (4%) were considered to be of type B equivalence. The questionable aspects of types B and C equivalence were discussed in 2 meetings, along with expressions that were equivalent but unnatural or grammatically incorrect; the first meeting involved researchers and translators and the second was held with a group of 6 asthmatics. Consensus was finally obtained for each item and activity included in the second draft. That draft was then administered to another group of 7 patients in order to check comprehension and equivalence, after which a definitive version was produced by the researchers.(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗
PubMed1995

[Apical hypertrophic myocardiopathy and multiple fistulae between the coronary vessels and the left ventricle].

A male patient presented with symptoms of angor under effort. Echocardiography and angiocardiography revealed apical hypertrophic myocardiopathy, associated with multiple fistulas connecting the anterior descending coronary artery and right coronary artery with the cavity of the left ventricle, as demonstrated by coronariography. We comment on the hypothesis that support a causal relationship between the two anomalies, microfistulas being the possible cause of the reactive hypertrophy through the induction of a coronary steal phenomenon with local ischemia; alternatively, the myocardiopathy itself might be the cause of microfistulas formation by inducing an anomaly in the Thebesius venous system. A pathogenic relationship is suggested between the syndrome of angor and these two rare pathological entities.

Aged↗
PubMed1994

[The spectral analysis of heart rate variability. The methodological aspects].

OBJECTIVES: A study is made of the influence of methodology on the analysis of cardiac cycle variability in terms of frequency and time domains. METHODS: Twenty-five individuals were divided into three groups: 1) non-smokers (n = 10); 2) smokers (n = 8); and 3) non-smokers without guided respiratory frequency (n = 7). An analysis was made of RR variability during 5 min intervals in time domain (standard deviation, variation coefficient, and difference between maximum and minimum RR), and frequency domain (spectral analysis, Fast Fourier Transform algorithm using 5 types of data windows). RESULTS: On comparing the results obtained in the 25 individuals with the 5 data windows, significant differences were observed (ANOVA; p < 0.001) in maximum and total amplitudes of the spectrum (in absolute terms) in the low frequency band (0.04-0.15 Hz). No significant differences were found between the normalized values or between the low/high (0.15-0.40 Hz) frequency ratio: W1 = 1.63 +/- 0.30; W2 = 1.62 +/- 0.29; W3 = 1.65 +/- 0.31; W4 = 1.52 +/- 0.26, and W5 = 1.55 +/- 0.27 (X +/- SE). On averaging the RR intervals each 5 cycles, significant differences were encountered for great part of the parameters studied. No significant differences were encountered for great part of the parameters studied. No significant differences were noted between the non-smokers as regards the use or non-use of a metronome (low/high frequency ratio in group 1 = 1.85 +/- 0.39 vs group 3 = 1.78 +/- 0.43; NS). The linear regressions between the variability parameters in terms of time and frequency domains (absolute values), and age (group 1) were significant, with greater regression coefficients on using the linear transformation of an exponential model. On comparing groups 1 and 2, a non statistically significant trend towards smaller maximum and total amplitudes (absolute values) was noted in group 2 for both frequency bands. CONCLUSIONS: 1) The type of data window (Fourier analysis) introduces significant modifications of some parameters expressed in absolute values, but not between normalized values; 2) signal averaging greatly modifies the information obtained; 3) the decrease in variability parameters observed with age fits better to an exponential model; 4) no differences were detected on guiding or not respiratory frequency, and 5) smoking appears to induce a tendency towards reducing cardiac cycle variability.

Adult↗
PubMed1993

[Transcatheter ablation with high-frequency currents as a method for creating useful experimental models in the study of cardiac conduction and automatism].

PURPOSE: analyze the utility of transcatheter ablation with high-frequency currents to create different experimental models of altered cardiac automatism and conduction. METHOD: the results were obtained in six anesthetized dogs subjected to electrophysiological study after selectively applying transcatheter radiofrequency ablation to different zones of the specific cardiac conduction system. Ablation was carried out using conventional bipolar 7F catheter-electrodes. High-frequency currents (0.7 MHz) were emitted through the distal electrode, with variable intensity and duration according to the aim of the experiment. Anatomic (fluoroscopic) and electrophysiological criteria were used to position the electrode within the ablation zone. RESULTS: selective radiofrequency application to the atrioventricular junction zone affords complete A-V blocks with escape rhythms located in the A-V node or His-Purkinje system, together with different degrees of infra- and intra-hisian and intranodal blocks. The modification of intranodal refractoriness and conduction without interrupting atrial pulse transmission may manifest atypical patterns with truncated nodal conduction curves. The abolition of sinus function through ablation in the zone of the sulcus terminalis makes it possible to obtain supraventricular subsidiary rhythms. The obtaining of intranodal complete blocks with supra-Hisian escape rhythms demonstrates phenomena such as the modulation of subsidiary automatism by non-transmitted atrial pulses, analyzed by constructing phase-response curves. CONCLUSION: transcatheter ablation using high-frequency currents is useful in demonstrating phenomena related to intranodal and His-Purkinje conduction, subsidiary pacemaker automatism or the modulation of automatism and conduction via non-transmitted pulses.

Animals↗
PubMed1992

[Fetal cardiac arrhythmia characterized by Doppler echocardiography].

A fetal arrhythmia was detected in a pregnant woman. Fetal Doppler-echocardiography did not reveal cardiac structural alterations; the Doppler flow velocity recordings at the level of the left ventricular outflow tract revealed the continuous succession of three cardiac cycles: a prolonged cycle (456 +/- 6 ms, mean of five measurements), a medium duration cycle (428 +/- 4 ms) and a short cycle (296 +/- 4 ms) after which the prolonged cycle repeated. Identification of the late ventricle filling phase of the atrial systole in the Doppler flow velocity waveform during the long and medium duration cycles, the detection of the systolic movement of the atrial walls preceding contraction of the ventricle walls during the shortest cycle and the verification that summation of the shortest and longest cycles was inferior to twice the intervening cycle, supported the idea that the arrhythmia was produced by frequent atrial premature contractions (one every two sinus beats). The fetal arrhythmia progressively disappeared during pregnancy until delivery without complications, and the newborn's ECG only revealed sporadic premature atrial contractions.

Adult↗
PubMed1989

[Heart rate-ventricular extrasystole relations and their dependence on circadian rhythms].

The linear correlation of the circadian rhythms (CR) of heart rate (HR) with those of ventricular extrasystole (VE) is analyzed by electrocardiographic ambulatory monitoring in 32 patients: 22 with ischemic post-infarction cardiopathy (group A) and ten free of structural cardiopathy (group B). Variability expressed as the coefficient of ventricular extrasystole variation (100 x standard deviation/mean) presented an inverse correlation with the number of recording extrasystoles. Linear correlation between HR and VE was statistically significant in 72% of recordings in group A, and in 60% in group B. The percentage of cases with significant linear correlation was greater on analyzing the three-minute periods than with the longer periods. When the cases analyzed presented over 200 extrasystoles, the percentage with significant linear correlation between HR and extrasystole was greater in group A than in group B. The circadian rhythm of the ventricular extrasystoles using interpolation of a cosinor function was significant in 50% of group A cases, and in 60% of group B. The achrophases were diurnal in group B, but only in 45% of cases in group A, two correspondence models being found between the CR achrophases and the inverse linear correlation between HR and VE.

Adolescent↗