[Extrinsic allergic alveolitis in male plaster worker].
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Biomedical subjects
Publications and source records attributed to P Cancelo Suárez.
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BACKGROUND: Metabolic alkalosis usually complicates the evolution of patients with hypercapnia under diuretic or steroid therapy. The objective of this study was to analyze the efficiency of therapy with acetazolamide, a reversible carbonic anhydrase inhibitor, in this condition. PATIENTS AND METHODS: Prospective study conducted at our hospital from June 1994 to March 1996, with 45 patients who had chronic respiratory acidosis and metabolic alkalosis. After a previous stabilization of the patient and eventually the discontinuation of diuretic or corticosteroid drugs fro 24-48 hours, 500 or 750 mg of acetazolamide were administered daily for 48 hours. Later, variations both in arterial gasometry and venous electrolytes were analyzed by comparing two means of paired data. RESULTS: After therapy with acetazolamide a clinical improvement was observed in patients, a decrease in PaCO2, pH and CO3H (p < 0.001) and an increase in PaO2 (p < 0.001). Hypochloremia (82.2%) and hypopotassemia (33.3%) were the most common electrolytic abnormalities before therapy. Both abnormalities improved significantly after the administration of acetazolamide. In five patients (11.1%) acetazolamide was discontinued when metabolic acidosis appeared, which only in three cases was associated with acidemia. No secondary effects were observed. CONCLUSIONS: Acetazolamide is an efficient alternative for treatment of patients with respiratory acidosis and metabolic alkalosis, particularly when other more common measures in this condition (discontinuation of diuretics and/or volemic replacement) have failed or are contraindicated. On the other hand, the emergence of relevant secondary effects is unlikely.
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A case of infected and suppurating pyourachal cyst is described. The rarity of urachal pathology in the adult prompted us to report the present case. The clinical features, diagnosis and treatment of this urachal complication are discussed.
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The aim of this study was to obtain pathologic diagnosis by aspiration punction (AP) by real time lineal echoendoscopy in different lesions suspected to be malignant. AP was performed in 6 cases with a Pentax-Hitachi FG 32UA lineal echoendoscopy. Four pancreatic neoplasms, one plastic linitis and one adenopathy of the celiac trunk were observed. Malignancy was confirmed by clinical evolution or surgery. The sensitivity of malignancy diagnosis was 67%, specificity 100% and diagnostic certainly 87%. No complications were observed. In the authors' preliminary experience, aspiration punction with real time lineal echoendoscopy allowed pathological diagnosis to be performed safely and effectively with relative simplicity.