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Biomedical subjects

J Sandoval

Publications and source records attributed to J Sandoval.

At least 37 records · Page 2Linked to original sources
PubMed1994

Survival in primary pulmonary hypertension. Validation of a prognostic equation.

BACKGROUND: The prognosis of patients with primary pulmonary hypertension (PPH) remains a major problem for the planning and assessment of therapeutic interventions. The objectives of this study were (1) to characterize mortality in a Mexican population of patients with PPH and to investigate factors associated with survival and (2) to test the applicability in this population of the prognostic equation proposed by the US National Institutes of Health study on PPH. METHODS AND RESULTS: A dynamic cohort of patients with PPH at our institution were enrolled between June 1977 and August 1991 and prospectively followed at regular intervals through September 1992. Measurements at diagnosis included hemodynamic and pulmonary function variables in addition to information on demographic data and medical history. The response to vasodilator treatment was also analyzed. The estimated median survival of the group was 4.04 years (95% confidence interval, 2.98 to 5.08 years). Variables associated with poor survival (univariate analysis) included an elevated mean right atrial pressure, a decreased cardiac index, and a decreased mixed venous PO2. A reduced forced vital capacity and the absence of vasodilator treatment were also associated with poor survival. A multivariate Cox proportional-hazards regression analysis was used to assess the adjusted hazard ratios, hence the relative contributions of the variables controlling for confounding. Reduced forced vital capacity and cardiac index and increased right atrial pressure were still significantly associated as risk factors for survival in patients with PPH. Survival as computed by the equation correlated with real survival of PPH patients with positive predictive values of 87%, 91%, and 89% at 1, 2, and 3 years, respectively. The equation, however, was relatively unable to predict deaths in our population, in part because of the strict limits of poor prognosis. CONCLUSIONS: Mortality in PPH is largely associated with hemodynamic variables that assess right ventricular function. The proposed prognostic equation had a high sensitivity and a relatively low specificity to predict survival in our PPH population. To improve this specificity it may be necessary to increase the limits of poor prognosis as defined by the equation.

Adult↗
PubMed1994

[Induction of fetal lung maturity with combined hormonal therapy in premature labor].

Thyrotropin Releasing Hormone (THR) induce fetal pulmonary maturation by direct stimulation, and increase of fetal T3 and T4 which produce biochemical and structural pulmonary maturation. To evaluate the effectivity of TRH associated to corticoides in the prevention of respiratory distress syndrome (RDS) in premature labor, we administered TRH plus Cidoten to patients with imminent premature labor and gestational age (GA) < or = 32 weeks. In a total of 12 patients, tolerance was good in 85% (n = 10), birthweight was 1.782 +/- 488 g (x +/- 2 SD). RDS incidence of only 15.3% and chronic lung disease (CLD) incidence = 0. Newborn of mothers treated with TRH plus corticoids form in evident premature labor in our unit, showed laser rates of RDS and CLD than the described in literature for newborn of similar weight and GA treated only with corticoids.

Drug Therapy, Combination↗
PubMed1994

[Efficacy of Chagas' disease vector control demonstrated through human infection].

The aim of this study was to assess the efficacy of Chagas disease vector control in Chile, using human disease as an index. After a twelve years control program using insecticides, dwelling infection in the IV region fell from 49 to 4%. In Combarbalá (a community of the IV region) the infection rate, detected by indirect hemagglutination, immunofluorescence and ELISA tests, decreased from 21.8% in 1986 to 8.2% in 1992 in primary school students (p < 0.001) and from 7.5 to 5% in high school students. Besides the vector control program, no other important epidemiological changes occurred in this period, excepting some ecological changes.

Adolescent↗
PubMed1993

Pulmonary arterial hypertension and cor pulmonale associated with chronic domestic woodsmoke inhalation.

We describe the clinical, radiologic, functional, and pulmonary hemodynamic characteristics of a group of 30 nonsmoking patients with a lung disease that may be related to intense, long-standing indoor wood-smoke exposure. The endoscopic and some of the pathologic findings are also presented. Intense and prolonged wood-smoke inhalation may produce a chronic pulmonary disease that is similar in many aspects to other forms of inorganic dust-exposure interstitial lung disease. It affects mostly country women in their 60s, and severe dyspnea and cough are the outstanding complaints. The chest roentgenograms show a diffuse, bilateral, reticulonodular pattern, combined with normalized or hyperinflated lungs, as well as indirect signs of pulmonary arterial hypertension (PAH). On the pulmonary function test the patients show a mixed restrictive-obstructive pattern with severe hypoxemia and variable degrees of hypercapnia. Endoscopic findings are those of acute and chronic bronchitis and intense anthracotic staining of the airways appears to be quite characteristic. Fibrous and inflammatory focal thickening of the alveolar septa as well as diffuse parenchymal anthracotic deposits are the most prominent pathologic findings, although inflammatory changes of the bronchial epithelium are also present. The patients had severe PAH in which, as in other chronic lung diseases, chronic alveolar hypoxia may play the main pathogenetic role. However, PAH in wood-smoke inhalation-associated lung disease (WSIALD) appears to be more severe than in other forms of interstitial lung disease and tobacco-related COPD. The patients we studied are a selected group and they may represent one end of the spectrum of the WSIALD.

Blood Pressure↗
PubMed1993

[Prevalence of fascioliasis in humans, horses, pigs, and wild rabbits in 3 Chilean provinces].

This study sought to estimate for the first time the prevalence of fascioliasis among the rural population in the Chilean provinces of Curico, Talca, and Linares, while also determining the disease's prevalence among horses and wild rabbits in Curico and Talca and among pigs in Talca. From January 1986 to December 1990 a randomly selected sample of 5,861 persons in the three provinces was given intradermal, complement-fixation, double-diffusion, and immunoelectrophoresis tests to detect antibody to Fasciola hepatica. In addition, the ELISA test was used in Talca and Linares. Fecal specimens from horses and pigs were inspected for eggs, and the liver and bile ducts of rabbits were examined histopathologically. The overall prevalence of infection among the human subjects was 0.70%, with rates of 0.6% in Curico, 0.75% in Talca, and 0.71% in Linares. The prevalences of infection in horses, rabbits, and pigs were 13.5%, 6.1%, and 20.6%, respectively. It is estimated that some 2,000 people are infected in the study area. It is recommended that rabbits be taken into account in all control programs for this zoonosis.

Adolescent↗
PubMed1992

Effect of hydralazine on vascular mechanics in a canine lobar preparation of pulmonary embolism.

We studied the effect of hydralazine (H) on pulmonary vascular mechanics in an isolated, in situ, canine lobe model of normal and increased pulmonary vascular resistance (Rp) produced by Gelfoam embolization (GE). Pulmonary pressure-flow (P-Q) curves from 24 lobes were obtained at baseline and after each intervention. Hemodynamic parameters for analysis included: the mean critical closing pressure (Ppai), vascular conductance (1/Rp), lobar flow (QL), and the pulmonary inflow pressure (Ppa) at different levels (50, 100, 200, 400, and 600 ml/min) of a fixed flow. After the preparation was stabilized, the 24 lobes were classified into 2 groups. For group 1 (n = 8) we studied the effect of H on the normal pulmonary vasculature. In group 2 (n = 16) we studied the effect of GE. Following GE, this group was further divided in half. For group 2A (n = 8) we followed the natural history of GE with measurements at 15 and 60 min. For group 2B (n = 8) measurements were done 15 min after GE and repeated again 15 min after the infusion of H. For group 1 lobes, H promoted a significant decrease (p less than 0.001) in Ppa at fixed flows of 200, 400, and 600 ml/min compared to baseline, with no change in Ppa for flows below 100 ml/min. QL and 1/Rp increased (p less than 0.01), and there was not any significant change in Ppai. In group 2A lobes, GE produced an increase in Ppa at all levels of flow (p less than 0.01), QL and 1/Rp decreased (p less than 0.05), and there was an increase in Ppai (p less than 0.05). These changes remained stable over the 60 min of observation. For group 2B lobes, GE produced the same hemodynamic changes as in group 2A, and the infusion of H caused a decrease in Ppa at flows between 100 and 300 ml/min. (p less than 0.01) with no change in Ppa at flows below 100 ml/min. QL and 1/Rp increased (p less than 0.01) and Ppai did not change compared to 15 min after GE. We conclude that in the normal canine pulmonary vasculature as well as in the model of GE, H decreased Rp and did not affect mean critical closing pressure, all of which may be explained by an increase in vascular conductance due to an increase in vascular distensibility.

Animals↗
PubMed1992

[Fascioliasis in populations of rural areas with high prevalence of animal infection].

Between January 1986 and December 1990 the prevalence of F. hepatica infection was studied in 5861 rural inhabitants of the provinces of Curico, Talca and Linares, VII Region, an hyperendemic zone of animal fascioliasis. Every one was screened by intradermal (IDR), complement fixation (CF), double diffusion (DD) counterelectrophoresis (CIEF), immunoelectrophoresis (IEP) and enzyme-linked immunoabsorbent assay (ELISA) tests. 366/1881 (9.3%) had positive IDR; 61 (1.04%) positive CF; 14 (0.24%) positive DD and 105/3838 (2.73%) positive ELISA and thus considered under suspicion to be infected. F. hepatica eggs were searched in stool in 241 of these persons. 37 cases were thus confirmed. Another 4 individuals with positive immunobiological tests and absence of the parasite eggs in stools were confirmed by duodenal intubation. 21 of the confirmed cases (51.2%) had less than 15 years of age. Women were more frequently infected than men (73.2% vs 26.8%). The 41 cases represent 0.7% of the surveyed population predicting 2000 cases among the total rural population of these provinces (300,000 persons). These results indicate that human fascioliasis is an important problem in the zone, perhaps much higher if family contacts of the index cases and symptomatic persons are included.

Adolescent↗
PubMed1991

Behavior of the pulmonary circulation at rest and during exercise in miliary tuberculosis.

We studied the hemodynamic behavior of the pulmonary circulation at rest and during exercise in six patients with MTB. As a group, in contrast to advanced fibrocaseous tuberculosis, these patients exhibited normal pulmonary hemodynamics at rest and during exercise. Only minor abnormalities in pulmonary vascular resistance at exercise (increased PAd-PWP gradient) were noted in two of the patients. The increase in Rp during exercise does not appear to be related to acute hypoxic vasoconstruction but rather to functional changes (compliance or recruitment or both) of the pulmonary microvasculature. In the genesis of these functional changes, chronic alveolar hypoxia and the inflammatory-fibrotic process might be interacting.

Adult↗
PubMed1990

Detection of antibodies against avian antigens in bronchoalveolar lavage from patients with pigeon breeder's disease: usefulness of enzyme-linked immunosorbent assay and enzyme immunotransfer blotting.

The study reported here evaluated the usefulness of the enzyme-linked immunosorbent assay (ELISA) in the detection of antibodies against pigeon antigens in the serum and bronchoalveolar lavage (BAL) of patients with clinical, radiological, and functional evidence of interstitial lung disease (ILD) with and without pigeon breeder's disease (PBD). The results were compared with those obtained by the simultaneous use of counterimmunoelectrophoresis (CIE) in the same patients. In PBD, ELISA detected antibodies against pigeon's sera in both serum and BAL in 100% of patients, while CIE failed to detect the antibodies in the serum of one patient and in most of the samples of BAL. In addition, we used enzyme immunotransfer blotting to determine the number of epitopes in pigeon serum recognized by antibodies present in serum and BAL. There was a heterogeneous response in both fluids, but the reaction pattern demonstrated that patient's sera recognize to-25 different pigeon epitopes. We conclude that ELISA is a highly sensitive and specific method for the detection of antibodies against pigeon antigens in the serum and BAL of patients with PBD and that the host response involves a great number of avian antigens.

Alveolitis, Extrinsic Allergic↗
PubMed1990

[Chagas cardiopathy in the first region of Chile. Clinical, epidemiologic, and parasitologic study].

705 inhabitants of rural towns in northern Chile were surveyed to study chagasic infection and cardiac involvement. Clinical evaluation, electrocardiogram, indirect hemagglutination test and xenodiagnosis for reactors were employed. Culture of positive xenodiagnosis was done to identify different zymodemes and schizodemes of T cruzi, T spinolai was not found in this area implying the absence of a wild cycle. Triotomines were not found over 3000 m high. Four cases of Z2b T cruzi strains were found. Simultaneous infection by Z1 and Z2b strains was found in the same bug obtained from houses. Overall human infection rate was 10%, and 69% of them showed altered electrocardiograms. Therefore, a lower infection rate but greater evidence of cardiac involvement is found in northern Chile compared to other areas in the country.

Adolescent↗
PubMed1988

PaO2 increases with coughing in patients with chronic lung disease.

We considered if the cyanosis frequently observed during a cough attack in patients with chronic lung disease was due to worsening hypoxemia. To investigate the effects of cough on PaO2, we measured arterial blood gases before and after a voluntary coughing period of 45 sec, in 11 patients with Interstitial Lung Disease (ILD) and 14 patients with Chronic Obstructive Lung Disease (COPD). All patients significantly increased (p less than 0.05) their PaO2 (COPD: from 49 +/- 2 to 60 +/- 2 mmHg; ILD from 44 +/- 2 to 51 +/- 3 mmHg, mean +/- SD) and decreased their PaCO2. We conclude that stable patients with COPD and ILD increase their PaO2 with coughing most likely due to hyperventilation. The cyanosis observed could be due to peripheral circulatory effects of coughing.

Adult↗
PubMed1988

Comparative scanning electron-microscopic study of the lingual papillae in two species of domestic mammals (Equus caballus and Bos taurus). II. Mechanical papillae.

The mechanical papillae of the horse and cow were studied by scanning electron microscopy in order to determine their morphostructural characteristics and the differences between the two species. The horse has only thin, small and interlaced filiform papillae, while the cow shows robust and more ordered filiform papillae. Furthermore, the cow tongue presents conical and lenticular papillae surrounded by a papillary groove. A characteristic distribution of stratified scales and channeled tracts is observed in conical and lenticular papillae but not in the filiform papillae. The morphostructural features of each papilla are analyzed and compared in each species and their possible significance is discussed.

Animals↗