[Tuberculosis in the year 2000].
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Biomedical subjects
Publications and source records attributed to R Martínez Cruz.
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Bronchoesophageal fistulas (BEF) in an adult, whether acquired or congenital, are uncommon but bronchoesophageal perforation secondary to broncholithiasis caused by calcified mediastinal adenopathy and leading to the formation of a fistulous tract is extremely rare. We present a case of acquired BEF in a 57-years-old women who presented cough with expectoration of broncholiths, hemoptysis and cough after swallowing liquid or solid hemoptysis and cough after swallowing liquid or solid foods. The chest film and computed tomographic scan showed calcified mediastinal adenopathy. Endoscopic examination of the esophagus revealed no mucosal abnormality. A bronchial esophageal fistula was identified at the level of the 1/3 midesophagus just below the carina in the esophagogram. The bronchoscopy showed a polypoid area located in the medial side of the right main bronchus. There was no evidence of neoplasm. The patient underwent excision of fistula and interposition of pleural bundle after completing a right posterolateral thoracotomy. The postoperative course was uneventful and the patient has been doing well on follow-up.
We describe a case of dirhythmic breathing in a 60-year-old man after neurosurgery. A large hemangioblastoma was removed from the cerebellum at the level of the fourth ventricle. The spirometric tracings showed two types of respiratory cycles: the rhythm. A was stable with a short inspiratory time; sometimes a second type of respiratory cycle, B, was present or erratically coupled with the A rhythm. It had very small tidal volume and mean inspiratory flow with phasic variations similar to those observed in Cheyne-Stokes breathing pattern.
Bilateral diaphragmatic paralysis is characterized by severe dyspnea in decubitus, with or without known respiratory or cardiac disorders. In both patients clinical diagnosis was confirmed by measuring the transdiaphragmatic pressure which was approximately zero. The first patient, previous to the clinical onset, had an episode of gastroenteritis and later developed a pneumonia; in the second patient, clinical manifestations started after neck surgery and both the clinical and functional disorders recovered within the following eight months.
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