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T Montemayor

Publications and source records attributed to T Montemayor.

13 recordsLinked to original sources
PubMed2000

[The use of cardiopulmonary exercise test in patients with mitochondrial myopathies].

BACKGROUND: Exercise tests has been used in the diagnosis of metabolic myopathies. If there is an abnormal response pattern in mild mitochondrial myopathy (MM) and her role in the initial suspect diagnostic is unknown. SUBJECTS AND METHODS: Prospective study of 26 patients with mitochondrial myopathy (15 men, 11 women) and a control group of 14 sedentary volunteers (9 men, 5 woman) with similar antropometric characteristics. We have made pulmonary function tests and treadmill exercise with serial venous sampling of blood lactate, piruvate, ketone bodies, free fatty acids and creatinkinase. RESULTS: Patients with MM showed exercise limitation with lower maximal power (MM = 143 [47] vatts, C = 187 [40] vatts, p = 0.006), maximal oxygen uptake (MM = 27 [8] ml/min/kg, C = 40 [7] ml/min/kg, p = 0.001) and maximal oxygen pulse (MM = 11 [3] ml/beat, C = 14 [3] ml/beat, p = 0.006). For the same oxygen uptake the heart rate was higher and the anaerobic threshold was earlier in MM patients (MM = 48% [14], C = 62% [12], p = 0.01). We found a considerable slower maximal oxygen uptake in patients with lipid increase in muscle biopsy (n = 15). Acetoacetate curves, beta-hydroxybutyrate, free fatty acids and creatinkinase were similar in both groups. The exercise test was pathologic in 17/26 of the patients. The sensitivity of the exercise test for maximal oxygen uptake was 0.65. CONCLUSIONS: The cardiopulmonary exercise test is a useful test in the suspect initial diagnostic of patients with mild mitochondrial myopathy because the majority of patients show a pathologic test.

Adolescent↗
PubMed1999

A shuttle walk test for assessment of functional capacity in chronic heart failure.

BACKGROUND: Peak oxygen uptake (peak VO(2)) is a reference parameter in the assessment of functional capacity of patients with chronic heart failure, but the procedure for cardiopulmonary exercise testing with expired gas analysis is complex and expensive, so more simple and available methods are desirable. METHODS: We compared the usefulness of a time-limited walk test, the 6-minute walk test (6-MT), with that of a symptom-limited walk test, the shuttle walk test (SWT), in the evaluation of patients with moderate to severe chronic heart failure. We prospectively studied 46 clinically stable patients in New York Heart Association class II to IV heart failure with left ventricular ejection fraction <40% (aged 53 +/- 10 years, ejection fraction 23% +/- 8%, New York Heart Association functional class 2.8 +/- 0.7). Each patient performed two 6-MT, two SWT and a cardiopulmonary exercise testing within 2 weeks. RESULTS: We found a close correlation between distance walked in SWT and peak VO(2 ) (r = 0.83, P <.001) and a moderate correlation between distance in 6-MT and peak VO(2) (r = 0.69, P <.001). Both walk tests showed to be reproducible after just one practice walk. All patients who walked > 450 m in SWT had a peak VO(2) >14 mL/kg/min. The overall discriminatory accuracy for SWT distance was greater than that for 6-MT distance for predicting a peak VO(2 ) <14 mL/kg/min (area under receiver operator characteristic curves 0.97 and 0.83 respectively, P =.02). Stepwise multivariate regression analysis, including clinical, exercise testing, echocardiographic, radionuclide-angiographic, and rest hemodynamic data, showed that distance walked in SWT was the only independent predictor of peak VO(2) (P <.001) and the strongest predictor of percent achieved of age- and sex-predicted peak VO(2) (%PVO(2)) (P <.001), with only age offering additional information (P =.02). CONCLUSIONS: The SWT shows to be a feasible and safe method to evaluate patients with chronic heart failure that strongly and independently predicts peak VO(2) and %PVO(2.) This symptom-limited walk test seems to be more useful than 6-MT in the assessment of functional capacity in these patients.

Adult↗
PubMed1999

[Peripheral muscle strength in stable COPD patients: correlation with respiratory function variables and quality of life].

The aim of this study was to assess peripheral muscle strength in patients with chronic obstructive pulmonary disease (COPD) using a simple test and to look for correlation with function variables, physiological strength variables and quality of life parameters. Twenty-three COPD patients with moderate to severe air-flow limitation (FEV1 = 39 +/- 12%) in stable phase but displaying inability to carry out daily tasks were enrolled. Peripheral muscle strength was assessed in all patients by measuring the maximum load in a single repetition of five simple upper and lower extremity exercises performed at a multi-gymnastics station. Results were compared to respiratory function variables (FVC, FEV1, FEV1/FVC and gasometry), to results of an exercise test on a cycle ergometer with monitoring of respiratory gases (VEmax, VO2max and Wmax), to endurance (minutes) to dyspnea (Mahler's scale) and to quality of life (Chronic Respiratory Disease Questionnaire-CRDQ). No relation between functional parameters and endurance in minutes was found. Minute ventilation (VE) proved to be significantly related to oxygen intake (VO) and maximum work in the stress test. Dyspnea on Mahler's scale was unrelated, but fatigue variables and emotional function variables on the CRDQ were related. We conclude that peripheral muscle strength is unrelated to level of flow limitation or exercise tolerance in COPD patients. Peripheral muscle strength is related, however, to maximum work load and some aspects of quality of life.

Aged↗
PubMed1998

[Efficacy of a program for tobacco use cessation with a combined substitution treatment of nicotine (patches plus chewing gum) at 6 months of follow-up].

Our aim was to assess the efficacy after 6 months of combined smoking cessation therapy using nicotine substitution with both chewing gum and patches. Sixty-six (25 women, 41 men) heavy smokers (38.04 packs/year and 8.42 mean score on Fagerström test) were followed between September 1995 and March 1997. Most patients were referred by respiratory, cardiology or ear-nose-and-throat outpatient clinics. The patients were prescribed 24-hour nicotine substitution therapy with 21 mg patches, plus chewing gum providing 2 mg of nicotine (3 to 10 per day) for a minimum of 8 weeks and a maximum of 12, with gradually decreasing doses. The patients were checked 1, 2, 4, 8, 12 and 24 weeks after enrollment. Expired air carbon monoxide was measured to confirm abstinence at each checkup and a simple questionnaire was filled in to assess abstinence syndrome and detect the presence of treatment side effects. Rate of abstinence achieved with this protocol after six months of follow-up was 37.9%. The failure rate was highest in the first week (33%) but gradually decreased until week 12. No patients had to abandon treatment due to side effects.

Administration, Cutaneous↗
PubMed1995

[Prediction of maximal ventilation during exercise in patients with chronic obstructive pulmonary disease].

To analyze the validity of baseline lung function parameters as predictors of maximal exercise ventilation (VEmax) in patients with chronic obstructive pulmonary disease (COPD), we studied 33 stable patients (FEV1 43.6 +/- 16.8%, FEV1/FVC% 48.4 +/- 9.2, FRC 156.8 +/- 32.7% and RV 212 +/- 53.9%). The sample was later divided into 3 groups based on severity of disease (severe, moderate or mild) in order to determine whether ability to predict VEmax increased with airways obstruction (FEV1 26.9 +/- 4.9%, 40.2 +/- 3.5% and 63.9 +/- 10%, respectively). The patients underwent lung function testing at rest and after a progressive stress test, with the maximal reading taken with the subject on a tread mill. We found greater correlation between VEmax and RV, FEV1 and FRC (r = -0.77, 0.75 and -0.74, respectively); the correlation was stronger in patients with severe COPD, in whom FEV1 was under 35% of the predicted value (r = -0.88, 0.753 and -0.83, respectively). Correlation decreased or disappeared with less functional impairment. Prediction of VEmax was more reliable with equations that employed FEV1 accompanied by data reflecting degree of insufflation, RV or FRC (VEmax = 45.2 +/- 8.98 x FEV1 - 5.07 x RV; r2 = 0.72) than with equations based on FEV1 alone (VEmax = 14.79 + 15.03 x FEV1; r2 = 0.56). We therefore conclude that ventilatory limitation during exercise in patients with COPD is better defined by considering parameters related to lung insufflation along with those reflecting degree of expiratory obstruction, given that the former affect the greater or lesser efficacy of muscles under stress.(ABSTRACT TRUNCATED AT 250 WORDS)

Exercise↗
PubMed1994

Role of cardiopulmonary exercise testing and the criteria used to determine disability in patients with severe chronic obstructive pulmonary disease.

The aim of this study was to evaluate the precision and variability with which resting pulmonary function tests (resting PFTs) can be used to predict the capacity in exercise, and the usefulness of the different measurements of pulmonary function in the evaluation of impairment/disability in patients with chronic obstructive pulmonary disease (COPD). We studied 78 patients with stabilized COPD (FEV1 45.1 +/- 17.1%). Of these, 39 suffered severe impairment according to the resting PFTs. Both the group with severe impairment (maximal oxygen consumption [VO2,max]: 16.22 +/- 5 ml/kg/min; maximal minute ventilation [VEmax]: 31.87 +/- 7.1 L/min; maximal heart rate [HRmax]: 133.8 +/- 10.9 beats/min) and the group with nonsevere impairment according to the resting PFTs (VO2max: 22.55 +/- 7.9 ml/kg/min; VEmax: 42.11 +/- 10.9 L/min; HRmax: 138 +/- 13.7 beats/min) showed ventilatory limitation during exercise. FEV1 was the most prevalent criterion for the determination of severe impairment (FEV1 < 40%), and was the variable best correlated to VO2max (r = 0.52 with VO2max as absolute value and r = 0.54 with VO2max expressed as a percentage of the reference value), but the resting PFTs were not predictive of exercise performance including patients with severe COPD. Evaluation of working capacity (based on VO2max) revealed a significant number of inaccurate predictions among the results of the resting PFTs. Sensitivity and specificity analysis were used to compare the different criteria used to evaluate the severity of disability. They reveal that the classification will be different according to the criteria used.(ABSTRACT TRUNCATED AT 250 WORDS)

Disability Evaluation↗
PubMed1991

[Inflammatory pseudotumor of the lung: presentation of 2 cases, one of them endobronchial].

Inflammatory pseudotumor (IP) is a rare pathological entity. Although, the pulmonary affection is the most frequent, any other organ can be involved. Its etiopathology is unknown. The disease is considered as a reactive process constituted by chronic inflammatory elements and a benign behavior. The lack of a specific clinical setting and the low profitability of the bloodless techniques makes mandatory the thoracostomy for a definitive diagnosis. We report two cases of pulmonary IP. One of them with an endobronchial localization which is a infrequent variety, scantily reported in the medical literature. We discuss the clinical and etiopathologic aspects of this rare pathological entity.

Adolescent↗
PubMedDate not supplied

Shuttle versus six-minute walk test in the prediction of outcome in chronic heart failure.

We prospectively analysed the potential usefulness of a symptom-limited walk test, the shuttle walk test (SWT), in the prediction of major cardiac events in 46 consecutive patients with chronic heart failure (NYHA class II-IV, ejection fraction <0.40) and compared it with that of a time-limited walk test, the six-minute walk test (6-MT). After a mean follow-up of 17 months (range, 8-28 months), 15 of 46 patients (33%) experienced a major cardiac event, defined as a cardiac death, urgent transplantation, or hospital admission for continuous inotropic or mechanical support. Distance walked in the SWT was shown to be a predictor of outcome at one year of follow-up (P=0.03), but distance ambulated in the 6-MT was not (P=0.07). In multivariate analysis, percentage of age-gender predicted peak oxygen uptake was the best predictor of major cardiac events. When patients were divided into tertiles according to performance in both walk tests, there was an overall difference in event-free survival at 12 months among SWT tertiles (P=0.004), but not among 6-MT tertiles (P=0.09). A low performance in the SWT (distance ambulated <450 m) allowed identification of a subgroup of patients with a high risk for major cardiac events at short-term. We conclude that, in patients with chronic heart failure, distance ambulated in the SWT predicts event-free survival at one year better than that in the 6-MT.

Exercise Test↗