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Biomedical subjects

S Díaz-Lobato

Publications and source records attributed to S Díaz-Lobato.

9 recordsLinked to original sources
PubMed2006

[Effective long-term noninvasive ventilation of a woman with kyphoscoliosis and sinus venosus atrial septal defect].

Atrial septal defects comprise one of the most common congenital cardiac malformations in adults and adolescents. However, such septal defects are rarely associated with chest wall diseases. When they are, respiratory failure soon develops and is severe. Cases in which the long-term course of disease is favorable with noninvasive ventilation have not been reported in the literature. We present the case of a 71-year-old woman with kyphoscoliosis, sinus venosus atrial septal defect, severe pulmonary hypertension, respiratory failure, and heart failure. We describe her response to treatment with noninvasive mechanical ventilation.

Aged↗
PubMed1998

Regulation of breathing in hyperthyroidism: relationship to hormonal and metabolic changes.

We sought to examine the breathing pattern, inspiratory drive and chemosensitivity of hyperthyroid patients and to explore the interactions between their thyroid hormones, basal metabolism and chemosensitivity. We studied 15 hyperthyroid patients and 15 sex- and age-matched controls. Thyroid hormone levels, arterial blood gas tensions, lung volumes, diffusing capacity for CO, maximal respiratory pressures and oxygen uptake measurements were performed. Breathing pattern and mouth occlusion pressure (P0.1), as well as ventilatory and P0.1 responses to hyperoxic progressive hypercapnia and isocapnic progressive hypoxia, were also evaluated. Compared with the control subjects, the hyperthyroid patients showed significantly lower resting arterial CO2 tension, tidal volume and significantly higher mean inspiratory flow and P0.1. Ventilatory and P0.1 responses to CO2 and hypoxia were also greater in the hyperthyroid patients than in the control group. All these changes returned to normal after treatment. In the patients, significant relationships between tri-iodothyronine and P0.1, P0.1 response to hypoxia, and P0.1 response to hypercapnia were found. In contrast, in hyperthyroidism there was no relationship between oxygen uptake and P0.1 response to hypoxia. We conclude that hyperthyroid patients exhibit a significant relationship between their thyroid hormone levels and their increased inspiratory drive and chemosensitivity.

Adult↗
PubMed1996

Short-term effects of inhaled beta-adrenergic agonist on breathlessness and central inspiratory drive in patients with nonreversible COPD.

In patients with COPD, a relationship between breathlessness and respiratory effort, assessed in terms of mouth occlusion pressure (P0.1), has been described. To evaluate the short-term effects of inhaled terbutaline on breathlessness, breathing pattern, and P0.1 in patients with nonreversible COPD, we designed a randomized, double-blind, parallel, placebo-controlled study. Twenty-five patients with stable nonreversible COPD, mean age 64 +/- 11 years, were enrolled in the study. Patients received 500 micrograms inhaled terbutaline or placebo. Breathlessness, using the Borg scale, breathing pattern, and P0.1 were measured at baseline and 30 min after inhalation. Terbutaline resulted in a significant decrease in Borg scale, while no differences were observed after placebo. No significant changes in breathing pattern were found. Nevertheless, a decrease in P0.1 (0.31 +/- 0.07 vs 0.21 +/- 0.05 kPa; p < 0.001) after terbutaline inhalation was observed. Borg score was correlated with P0.1 in all patients. Moreover, changes in Borg score after medication were directly proportional to P0.1 changes (r = 0.85; p < 0.01). We conclude that terbutaline decreases central inspiratory drive and improves breathlessness in patients with nonreversible COPD.

Administration, Inhalation↗
PubMed1996

[Home mechanical ventilation in neuromuscular diseases].

In most patients with neuromuscular disorders, respiratory insufficiency and problems arising from this are what determine whether or not they survive. Treatment for failure of the respiratory pump by mechanical ventilation in the patient's own home has become more common thanks to the advent of non-invasive methods of treatment such as the nasal mask. Home mechanical ventilation has improved both the survival rate and the quality of life of many of these patients. We review the different types of home ventilation, describing the advantages and disadvantages of each one, with the intention of making information regarding this kind of treatment more easily available.

Chronic Disease↗
PubMedDate not supplied

Use of spirometry to predict risk of pneumothorax in CT-guided needle biopsy of the lung.

OBJECTIVE: Our goal was to assess the usefulness of spirometry to estimate the risk of pneumothorax in patients undergoing percutaneous needle biopsy with CT guidance for solitary pulmonary nodule (SPN). MATERIALS AND METHODS: We studied the results of 51 consecutive percutaneous needle biopsies with CT guidance for SPN obtained between 1988 and 1990. Forty-five men and six women, aged 65 +/- 11 (36-86) years, were included in the study. All biopsies were performed under CT guidance, with 90 mm 25G needles (0.5 mm thickness) fitted into luer-type syringes. The number of needle pass attempts never exceeded three. A spirometry before biopsy was performed in all patients. RESULTS: Pneumothorax occurred in only 10 cases (19%). The patients with pneumothorax showed lower lesion size, forced vital capacity (FVC), forced expiratory volume (FEV1), and FEV1/FVC ratio. The contribution of these factors to pneumothorax was analyzed by a logistic regression model. The FEV1 was most strongly associated with the incidence of pneumothorax. We developed an equation for predicting the risk of this complication. CONCLUSION: We conclude that decreasing FEV1 is associated with a higher pneumothorax rate.

Adult↗
PubMedDate not supplied

[Mechanical ventilation in patients with amyotrophic lateral sclerosis].

INTRODUCTION AND DEVELOPMENT: In the final stage of amyotrophic lateral sclerosis, the majority of patients develop chronic respiratory failure. If these patients are not informed about the acute respiratory insufficiency, they run the risk of having to be intubated and stay in Intensive Care Unit over a long term; many of them die of respiratory failure without being informed about the available options. Prognosis and treatment options should be discussed with the patient and family. Their informed consent to prolonged mechanical ventilation of the lungs and stopped it under certain circumstances would be obtained before the condition progress to critical. The non invasive artificial home ventilation has led to advances in the management of patients with amyotrophic lateral sclerosis, as a longer period of survival with a higher level of quality of life. We also have analyzed ethical and social aspects and the results of long term mechanical ventilation in the literature.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

[Physiopathology of respiratory insufficiency of neuromuscular origin].

OBJECTIVE: To review the mechanisms involved in the appearance of respiratory failure in patients with neuromuscular disorders. DEVELOPMENT: The development of respiratory failure in patients with weakness of the respiratory muscles secondary to neuromuscular disease is not only due to the disease itself. There are also other mechanisms which contribute in varying degrees. These mechanisms are: 1. Alteration of the mechanical properties of the respiratory apparatus; 2. The appearance of muscle fatigue; 3. Alterations in the control of ventilation; 4. Alterations in gas exchange during the night leading to loss of sensitivity of central and peripheral chemoreceptors. 5. Dysfunction of the upper airway, which favors the appearance of obstructive apnea during sleep. The part played by each of these mechanisms in the development of respiratory failure is different in each individual patient, depending on the type and severity of his particular illness. Ventilatory assistance at night has been shown to be effective in correcting respiratory failure during the day in these patients, probably by acting to a greater or lesser extent on all the different mechanisms involved. CONCLUSIONS: The origin of the respiratory failure seen in patients with neuromuscular diseases is due to many factors. Nocturnal ventilatory assistance is effective since it acts on all the different mechanisms involved.

Airway Obstruction↗