PubMed Health⌕ Search

Biomedical subjects

R Blanquer Olivas

Publications and source records attributed to R Blanquer Olivas.

12 recordsLinked to original sources

[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↗

[Spontaneous pneumothorax and atmospheric pressure].

In order to assess factors associated with spontaneous pneumothorax (SP), mainly climatic changes, a prospective study was undertaken of 62 SP episodes among patients admitted to our hospital during a two-year period, from January 1994 to January 1996. Atmospheric pressure (AP) changes were analyzed, with daily recording of the number of unusual changes in AP (increases above 95th percentile and decreases below 5th percentile) and how many of these changes were followed by some episode of spontaneous pneumothorax during the following five days. To measure the degree of this association between the emergence of pneumothorax and exposure to unusual changes I AP, the relative risk (RR) was calculated. A total of 77 unusual AP changes were observed, 17 of which concurred with the emergence of 8 episodes of SP during the following five days, with a RR of 2.7 (1.6-4.4). Although the etiology of SP is unknown and probably of multifactorial origin, these data suggest that unusual changes in AP may play a relevant role in triggering this condition.

Adolescent↗

[Relationship between dyspnea and quality of life with body mass index and pulmonary function in patients with chronic obstructive airways disease and emphysema].

BACKGROUND: We aimed to evaluate the differences in pulmonary function, quality of life (CVRS) and dyspnea in patients with chronic obstructive pulmonary disese (COPD) and emphysema according to the body mass index (BMI). Moreover, we analyzed the relation between BMI, pulmonary function, CVRS and dyspnea. PATIENTS AND METHOD: This was a prospective, 12-months study including 20 patients with COPD and emphysema. They were classified in group A (BMI < 21 kg/m(2) group B (BMI >= 21 kg/m(2)). We performed pulmonary function tests and determined the levels of dyspnea and CVRS according to a scale of dyspnea and a CVRS questionnaire. RESULTS: Seven patients had a BMI < 21 kg/m(2) and it was >=21 kg/m(2) in 13 patients. DLCO in group A patients was lower than in group B. After a multiple regression analysis, the FVC accounted for 52% of dyspnea variability. Both PEM and dyspnea were the parameters that better predicted the CVRS. CONCLUSIONS: Patients with COPD and emphysema with a VMI < 21 kg/m(2) have a lower DLCO than patients with a BMI >= 21 kg/m(2). In our patients, dyspnea sensation depended on the FVC. In addition,the CVRS depended on dyspnea sensation and PEM.

Aged↗

[Miliary, ganglionar, pancreatic and costal tuberculosis. Clinical presentation and literature review].

A 42-year-old man was admitted to the hospital with fever, abdominal pain and miliary radiological pattern. The amylase and lipase in serum, and the amylase in urine were increased. The tuberculin skin test was negative. The thoracic and abdominal CT scan showed costal affectation, multiple focal hepatic lesions and large necrosing peripancreatic lymphadenopathies. The transbronchial biopsy and the pancreatic punction demonstrated granulomatous necrotic lesions, and M. tuberculosis grew in the bronchial washing culture. The specific treatment normalized the pulmonary, costal and pancreatic lesions.

Adult↗

[A pulmonary cellular immunity study in HIV patients].

BACKGROUND: Cellular immunity disorder, showed by a decreased blood level of lymphocytes T CD4, is the main indicator of progression in HIV infection. The diminished level of these lymphocytes and CD4/CD8 ratio in pulmonary samples obtained by bronchoalveolar lavage (BAL) is known, so as the enhanced level of lymphocytes T CD8, while the pulmonary diseases high incidence in these patients could be due to a local immunity disorder or systemic one remains unknown. The aim of this study is to compare systemic immunity disorders, studied in blood samples, with local immunity replay, showed by BAL samples, in patients with HIV infection. METHODS: 74 HIV patients were studied, all of them hospitalized due to acute respiratory disease, and undergone to fiberoptic bronchoscopy for diagnosing. Cellular and lymphocytic populations are compared and measured by flow cytometry in blood and BAL samples. RESULTS: Percentage of total lymphocytes and CD4+ population were decreased in BAL samples, above all in patients with CD4 level minor than 25%. CONCLUSIONS: Cellular immunity disorder of patients with HIV infection is bigger in lung than in blood. It's possible to foresee the lymphocytes T CD4+ pulmonary depletion from their blood levels.

Adolescent↗

[Acute lung injury as initial manifestation of diffuse alveolar hemorrhage].

OBJECTIVE: To determine clinical features and outcome in hospitalized patients with acute lung injury secondary to diffuse pulmonary hemorrhage (DPH). PATIENTS AND METHOD: Eight adult patients suffering DPH and acute lung injury were undergone to diagnosis procedure and following. RESULTS: Two cases of idiopathic pulmonary hemosiderosis, two cases of systemic lupus erythematous, two cases of Goodpasture's syndrome, one case of idiopathic rapidly progressive glomerulonephritis and one of periarteritis nodosa were diagnosed. Treatment was methylprednisolone in all cases; besides, three cases required ventilatory support, and one immunosuppressive therapy, plasmapheresis and hemodialysis. One patient died and three of them suffered relapse with satisfactory outcome. CONCLUSION: We remark the presence of acute lung injury as an initial feature of DPH in our experience and the importance of a prompt diagnosis of the underlying disease.

Acute Disease↗

Severe pulmonary hypertension: a feature of Swyer-James syndrome?

Swyer-James syndrome, unilateral hyperlucent lung with air entrapment, generally occurs after severe infections during childhood. It is usually diagnosed by its characteristic chest radiographic image film or computed tomography, in patients who are almost asymptomatic. We report a case of Swyer-James syndrome, diagnosed from the study of severe pulmonary hypertension and with a fatal outcome.

Adult↗

[Bronchioloalveolar carcinoma in a young woman].

Bronchioloalveolar carcinoma is an infrequent malignant lung tumor, specially in patients younger than 50. Diagnosis is difficult and usually late, because its clinical and radiologic features are similar to other lung diseases and because its poor histopathologic differentiation from other primitive o metastatic adenocarcinoma. We report a case of multinodular, diffuse and bilateral bronchioloalveolar carcinoma in a young woman without previous lung disease which suspected diagnosis was by broncho-aspirated cytology and open lung biopsy was necessary for its confirmation.

Adenocarcinoma, Bronchiolo-Alveolar↗

[Can we improve the prevention of tuberculosis? Analysis of the application of chemoprophylaxis].

To analyze the situations that make chemoprophylaxis for tuberculosis difficult. One hundred twenty-eight patients consecutive (106 HIV negative and 22 HIV positive) diagnosed of tuberculosis (TB) were studied. The patients were interviewed and a questionnaire was filled out in order to identify risk groups and determine what steps had been taken to prevent TB. In the HIV negative group, 63 (57.8%) had at least one risk factor. The most common were contact with persons with active TB (31.1%), former TB (15.1%), rapid weight loss or chronic malnutrition (13.2%) and residence in closed institutions (5.6%). Of the 51 (48.1%) for whom evaluation of chemoprophylaxis was indicated, 43 (84.3%) had been examined by a physician within the past five years; only 10 (23.3%) of them, however, had been checked for TB and isoniazide had been prescribed for only 4 (9.3%). In the HIV positive group, 13 (72.2%) of those for whom evaluation of chemoprophylaxis was indicated had been seen by a physician; 12 (97.7%) of them were given tuberculin tests checked for TB and isoniazide was prescribed for 4 (30.7%). None of the patients in either group who were prescribed a full course of prophylaxis actually took the drug enough. Most HIV negative patients for whom evaluation of chemoprophylaxis was indicated had been examined by a physician in the five years before disease was detected; less than a quarter of them were checked for TB, however. This situation is probably a consequence of the structure of health care in Spain as it affects TB control. Nearly all the HIV positive patients were checked for the disease, as they benefited from protocolized health care.

Adult↗