48 results on '"Diagnostic Techniques, Respiratory System"'
Search Results
2. Future Diagnostic Techniques in Pulmonology. A Change in Mindset
- Author
-
Walther Ivan Girón-Matute, María Gallardo Bermejo, and Luis Puente-Maestu
- Subjects
Lung Diseases ,Medical education ,medicine.medical_specialty ,business.industry ,MEDLINE ,Diagnostic Techniques, Respiratory System ,Mindset ,General Medicine ,Pulmonology ,Internal medicine ,Medicine ,Humans ,business ,Forecasting - Published
- 2018
3. Diagnosing Sleep Apnea-Hypopnea Syndrome in Children: Past, Present, and Future
- Author
-
Pablo E, Brockmann, María Luz, Alonso-Álvarez, and David, Gozal
- Subjects
Sleep Apnea, Obstructive ,Adolescent ,Waiting Lists ,Polysomnography ,Diagnostic Techniques, Respiratory System ,Humans ,Oximetry ,Child ,Biomarkers ,Forecasting - Published
- 2017
4. Hypersensitivity Pneumonitis. Towards a Less Invasive Diagnostic Procedure
- Author
-
Ferran, Morell, Iñigo, Ojanguren, and María Jesús, Cruz
- Subjects
Diagnostic Techniques, Respiratory System ,Humans ,Alveolitis, Extrinsic Allergic - Published
- 2017
5. Spanish Guidelines for Management of Chronic Obstructive Pulmonary Disease (GesEPOC) 2017. Pharmacological Treatment of Stable Phase
- Author
-
Marc, Miravitlles, Juan José, Soler-Cataluña, Myriam, Calle, Jesús, Molina, Pere, Almagro, José Antonio, Quintano, Juan Antonio, Trigueros, Borja G, Cosío, Ciro, Casanova, Juan, Antonio Riesco, Pere, Simonet, David, Rigau, Joan B, Soriano, and Julio, Ancochea
- Subjects
Phosphodiesterase Inhibitors ,Oxygen Inhalation Therapy ,Diagnostic Techniques, Respiratory System ,Disease Management ,Risk Assessment ,Antioxidants ,Anti-Bacterial Agents ,Bronchodilator Agents ,Pulmonary Disease, Chronic Obstructive ,Phenotype ,Pulmonary Emphysema ,Adrenal Cortex Hormones ,Spain ,alpha 1-Antitrypsin ,Pulmonary Medicine ,Bronchitis ,Societies, Medical ,Expectorants - Abstract
The clinical presentation of chronic obstructive pulmonary disease (COPD) varies widely, so treatment must be tailored according to the level of risk and phenotype. In 2012, the Spanish COPD Guidelines (GesEPOC) first established pharmacological treatment regimens based on clinical phenotypes. These regimens were subsequently adopted by other national guidelines, and since then, have been backed up by new evidence. In this 2017 update, the original severity classification has been replaced by a much simpler risk classification (low or high risk), on the basis of lung function, dyspnea grade, and history of exacerbations, while determination of clinical phenotype is recommended only in high-risk patients. The same clinical phenotypes have been maintained: non-exacerbator, asthma-COPD overlap (ACO), exacerbator with emphysema, and exacerbator with bronchitis. Pharmacological treatment of COPD is based on bronchodilators, the only treatment recommended in low-risk patients. High-risk patients will receive different drugs in addition to bronchodilators, depending on their clinical phenotype. GesEPOC reflects a more individualized approach to COPD treatment, according to patient clinical characteristics and level of risk or complexity.
- Published
- 2017
6. [Management and Follow up of Respiratory Patients in the Post-COVID-19 Era: Are We Ready Yet?]
- Author
-
Alcázar-Navarrete B, Molina París J, and Martín Sánchez FJ
- Subjects
- COVID-19, Chronic Disease, Diagnostic Techniques, Respiratory System, Disease Management, Epithelium pathology, Epithelium virology, Exudates and Transudates, Fibrosis, Follow-Up Studies, Humans, Lung pathology, Lung virology, Mobile Applications, Respiration Disorders complications, Respiration Disorders therapy, SARS-CoV-2, Smartphone, Telemedicine methods, Telemedicine organization & administration, Aftercare organization & administration, Ambulatory Care organization & administration, Betacoronavirus isolation & purification, Coronavirus Infections complications, Coronavirus Infections diagnostic imaging, Coronavirus Infections pathology, Pandemics, Pneumonia, Viral complications, Pneumonia, Viral diagnostic imaging, Pneumonia, Viral pathology
- Published
- 2020
- Full Text
- View/download PDF
7. Recommendations of the Spanish Society of Pneumology and Thoracic Surgery on the diagnosis and treatment of non-small-cell lung cancer
- Author
-
Villar Alvarez, Felipe, Muguruza Trueba, Ignacio, Belda Sanchis, Jose, Molins Lopez-Rodo, Laureano, Rodriguez Suarez, Pedro Miguel, Cos Escuin, Julio Sanchez, Barreiro, Esther, Henar Borrego Pintado, M., Disdier Vicente, Carlos, Flandes Aldeyturriaga, Javier, Gamez Garcia, Pablo, Pilar Garrido López, Leon Atance, Pablo, Izquierdo Elena, Jose Miguel, Novoa Valentin, Nuria M., Rivas Andres, Juan Jose, Royo Crespo, Inigo, Salvatierra Velazquez, Angel, Seijo Maceiras, Luis M., Solano Reina, Segismundo, Aguiar Bujanda, David, Avila Martinez, Regulo J., Granda Orive, Jose Ignacio, Higes Martinez, Eva, Diaz-Hellin Gude, Vicente, Embun Flor, Raul, Freixinet Gilart, Jorge L., Garcia Jimenez, Maria Dolores, Hermoso Alarza, Fatima, Hernandez Sarmiento, Samuel, Honguero Martinez, Antonio Francisco, Jimenez Ruiz, Carlos A., Lopez Sanz, Iker, Mariscal Alba, Andrea, Martinez Vallina, Primitivo, Menal Munoz, Patricia, Mezquita Perez, Laura, Olmedo Garcia, Maria Eugenia, Rombola, Carlos A., Miguel Arregui, Inigo San, Somiedo Gutierrez, Maria Del Valle, Trivino Ramirez, Ana Isabel, Trujillo Reyes, Joan Caries, Vallejo, Carmen, Vaquero Lozano, Paz, Varela Simo, Gonzalo, and Zulueta, Javier J.
- Subjects
Lung Neoplasms ,Radiotherapy ,Diagnostic Techniques, Respiratory System ,Thoracic Surgery ,Comorbidity ,Combined Modality Therapy ,Cigarette Smoking ,Oxidative Stress ,Pulmonary Disease, Chronic Obstructive ,Risk Factors ,Spain ,Carcinoma, Non-Small-Cell Lung ,Antineoplastic Combined Chemotherapy Protocols ,Pulmonary Medicine ,Humans ,Mass Screening ,Smoking Cessation ,Pneumonectomy ,Societies, Medical ,Neoplasm Staging - Published
- 2016
8. Executive summary of the SEPAR recommendations for the diagnosis and treatment of non-small cell lung cancer
- Author
-
Eva de Higes Martinez, Ignacio Muguruza Trueba, Carlos A. Rombolá, Jorge Freixinet Gilart, Raúl Embún Flor, Juan José Rivas de Andrés, Pablo Gámez García, Pablo León Atance, Iñigo San Miguel Arregui, Fátima Hermoso Alarza, Andrea Mariscal de Alba, Gonzalo Varela Simó, Felipe Villar Álvarez, Laura Mezquita Pérez, Primitivo Martínez Vallina, Esther Barreiro, Segismundo Solano Reina, Carmen Vallejo, M. Henar Borrego Pintado, Maria Eugenia Olmedo Garcia, José Ignacio de Granda Orive, Régulo José Ávila Martínez, Pilar López, Carlos Disdier Vicente, Carlos A. Jiménez Ruiz, María Dolores García Jiménez, Pedro Rodríguez Suárez, David Aguiar Bujanda, José Miguel Izquierdo Elena, Laureano Molins López-Rodó, Patricia Menal Muñoz, Paz Vaquero Lozano, José Belda Sanchis, Luis Seijo Maceiras, Iker López Sanz, Íñigo Royo Crespo, Ángel Salvatierra Velázquez, Samuel Hernandez Sarmiento, Nuria María Novoa Valentín, Vicente Diaz-Hellín Gude, Antonio Francisco Honguero Martínez, María de Valle Somiedo Gutiérrez, Javier Flandes Aldeyturriaga, Javier J. Zulueta, Julio Sánchez de Cos Escuín, Joan Carles Trujillo Reyes, Ana Isabel Triviño Ramírez, [Villar Alvarez, Felipe] UAM, CIBERES, IIS Fdn Jimenez Diaz, Serv Neumol, Madrid, Spain, [Muguruza Trueba, Ignacio] Hosp Idcsalud, Dept Cirugia Torac, Madrid, Spain, [Belda Sanchis, Jose] Hosp Univ Mutua Terrassa, Serv Cirugia Torac, Barcelona, Spain, [Trujillo Reyes, Joan Caries] Hosp Univ Mutua Terrassa, Serv Cirugia Torac, Barcelona, Spain, [Molins Lopez-Rodo, Laureano] Hosp Clin Barcelona, Inst Clin Respiratori, Serv Cirugia Torac, Barcelona, Spain, [Rodriguez Suarez, Pedro Miguel] Hosp Univ Gran Canaria Dr Negrin, Serv Cirugia Torac, Las Palmas Gran Canaria, Las Palmas, Spain, [Freixinet Gilarte, Jorge L.] Hosp Univ Gran Canaria Dr Negrin, Serv Cirugia Torac, Las Palmas Gran Canaria, Las Palmas, Spain, [de Cos Escuin, Julio Sanchez] Hosp San Pedro Alcantara, Sec Neumol, Caceres, Spain, [Barreiro, Esther] Univ Pompeu Fabra, Hosp del Mar, Inst Salud Carlos III,Grp Invest Desgaste Muscula, Ctr Invest Red Enfermedades Resp CIBERES,Inst Inv, PRBB, Barcelona, Spain, [Borrego Pintado, M. Henar] Hosp Clin Univ, Serv Anat Patol, Valladolid, Spain, [Disdier Vicente, Carlos] Hosp Clin Univ, Serv Neumol, Valladolid, Spain, [Flandes Aldeyturriaga, Javier] UAM, ISS Fdn Jimenez Diaz, CIBERES, Serv Neumol,Unidad Broncoscopias & Neumol Interve, Madrid, Spain, [Somiedo Gutierrez, Maria de Valle] UAM, ISS Fdn Jimenez Diaz, CIBERES, Serv Neumol,Unidad Broncoscopias & Neumol Interve, Madrid, Spain, [Gamez Garcia, Pablo] Hosp Univ 12 Octubre, Serv Cirugia Torac, Madrid, Spain, [Avila Martinez, Regulo J.] Hosp Univ 12 Octubre, Serv Cirugia Torac, Madrid, Spain, [Diaz-Hellin Gude, Vicente] Hosp Univ 12 Octubre, Serv Cirugia Torac, Madrid, Spain, [Hermoso Alarza, Fatima] Hosp Univ 12 Octubre, Serv Cirugia Torac, Madrid, Spain, [Mariscal de Alba, Andrea] Hosp Univ 12 Octubre, Serv Cirugia Torac, Madrid, Spain, [Garrido Lopez, Pilar] Hosp Univ Ramon Y Cajal, Serv Oncol Med, Madrid, Spain, [Perez, Laura Mezquita] Hosp Univ Ramon Y Cajal, Serv Oncol Med, Madrid, Spain, [Garcia, Maria Eugenia Olmedo] Hosp Univ Ramon Y Cajal, Serv Oncol Med, Madrid, Spain, [Leon Atance, Pablo] Complejo Hosp Univ Albacete, Serv Cirugia Torac, Albacete, Spain, [Garcia Jimenez, Maria Dolores] Complejo Hosp Univ Albacete, Serv Cirugia Torac, Albacete, Spain, [Honguero Martinez, Antonio Francisco] Complejo Hosp Univ Albacete, Serv Cirugia Torac, Albacete, Spain, [Rombolda, Carlos A.] Complejo Hosp Univ Albacete, Serv Cirugia Torac, Albacete, Spain, [Trivino Ramirez, Ana Isabel] Complejo Hosp Univ Albacete, Serv Cirugia Torac, Albacete, Spain, [Izquierdo Elena, Jose Miguel] Hosp Univ Donostia, Serv Cirugia Torac, Donostia San Sebastian, Gipuzkoa, Spain, [Lopez Sanz, Iker] Hosp Univ Donostia, Serv Cirugia Torac, Donostia San Sebastian, Gipuzkoa, Spain, [Novoa Valentin, Nuria M.] Complejo Asistencial Univ Salamanca, Serv Cirugia Torac, Salamanca, Spain, [Varela Simo, Gonzalo] Complejo Asistencial Univ Salamanca, Serv Cirugia Torac, Salamanca, Spain, [Rivas de Andres, Juan Jose] Hosp Clin Univ Lozano Blesa & IIS Aragon, Hosp Univ Miguel Servet, Zaragoza, Spain, [Royo Crespo, Iriigo] Hosp Clin Univ Lozano Blesa & IIS Aragon, Hosp Univ Miguel Servet, Zaragoza, Spain, [Embun Flor, Raul] Hosp Clin Univ Lozano Blesa & IIS Aragon, Hosp Univ Miguel Servet, Zaragoza, Spain, [Martinez Vallina, Primitivo] Hosp Clin Univ Lozano Blesa & IIS Aragon, Hosp Univ Miguel Servet, Zaragoza, Spain, [Salvatierra Velazquez, Angel] Hosp Univ Reina Sofia, Unidad Cirugia Torac & Trasplante Pulmonar, Cordoba, Spain, [Seijo Maceiras, Luis M.] IIS Fdn Jimenez Diaz CIBERES, Serv Neumol, Madrid, Spain, [Solano Reina, Segismundo] HGU Gregorio Maranon, Serv Neumol, Unidad Tabaquismo, Madrid, Spain, [Vaquero Lozano, Paz] HGU Gregorio Maranon, Serv Neumol, Unidad Tabaquismo, Madrid, Spain, [Aguiar Bujanda, David] Hosp Univ Gran Canaria Dr Negrin, Serv Oncol Med, Las Palmas Gran Canaria, Las Palmas, Spain, [Hernandez Sarmiento, Samuel] Hosp Univ Gran Canaria Dr Negrin, Serv Oncol Med, Las Palmas Gran Canaria, Las Palmas, Spain, [de Granda Orive, Jose Ignacio] Hosp 12 Octubre, Serv Neumol, Madrid, Spain, [de Higes Martinez, Eva] Fdn Hosp Alcorcon, Serv Neumol, Madrid, Spain, [Jimenez Ruiz, Carlos A.] Comunidad Autonoma Madrid, Unidad Especializada Tabaquismo, Madrid, Spain, [Menal Munoz, Patricia] Hosp Clin Univ Lozano Blesa, Serv Radiol, Zaragoza, Spain, [Miguel Arregui, Iffigo San] Hosp Univ Gran Canaria Dr Negrin, Serv Oncol Radioterap, Las Palmas Gran Canaria, Las Palmas, Spain, [Vallejo, Carmen] Hosp Univ Ramon Y Cajal, Serv Oncol Radioterap, Madrid, Spain, and [Zulueta, Javier J.] Univ Navarra Clin, Serv Neumol, Pamplona, Spain
- Subjects
Lung Neoplasms ,Transbronchial needle aspiration ,medicine.medical_treatment ,Disease ,Recommendations ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Positron Emission Tomography Computed Tomography ,Diagnosis ,Pulmonary Medicine ,Medicine ,Respiratory function ,Stage (cooking) ,Pneumonectomy ,Early Detection of Cancer ,Societies, Medical ,Palliative Care ,Clinical-practice guidelines ,Staging project ,General Medicine ,Chemoradiotherapy ,Esmo consensus conference ,Pulmonology ,Cardiothoracic surgery ,Tnm classification ,030220 oncology & carcinogenesis ,Radiology ,Lung cancer ,International-association ,medicine.medical_specialty ,Ed american-college ,Diagnostic Techniques, Respiratory System ,Forthcoming 7th edition ,03 medical and health sciences ,Internal medicine ,Thoracic Oncology ,Bronchoscopy ,Biomarkers, Tumor ,Humans ,Intensive care medicine ,Neoplasm Staging ,Salvage Therapy ,Low-dose ct ,business.industry ,Induction chemoradiation ,medicine.disease ,Treatment ,Radiation therapy ,030228 respiratory system ,Spain ,Smoking Cessation ,business ,Tomography, X-Ray Computed - Abstract
The Thoracic Surgery and Thoracic Oncology groups of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) have backed the publication of a handbook on recommendations for the diagnosis and treatment of non-small cell lung cancer. Due to the high incidence and mortality of this disease, the best scientific evidence must be constantly updated and made available for consultation by healthcare professionals.To draw up these recommendations, we called on a wide-ranging group of experts from the different specialties, who have prepared a comprehensive review, divided into 4 main sections. The first addresses disease prevention and screening, including risk factors, the role of smoking cessation, and screening programs for early diagnosis. The second section analyzes clinical presentation, imaging studies, and surgical risk, including cardiological risk and the evaluation of respiratory function. The third section addresses cytohistological confirmation and staging studies, and scrutinizes the TNM and histological classifications, non-invasive and minimally invasive sampling methods, and surgical techniques for diagnosis and staging. The fourth and final section looks at different therapeutic aspects, such as the role of surgery, chemotherapy, radiation therapy, a multidisciplinary approach according to disease stage, and other specifically targeted treatments, concluding with recommendations on the follow-up of lung cancer patients and surgical and endoscopic palliative interventions in advanced stages. (C) 2016 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.
- Published
- 2015
9. Evolution, diagnosis and treatment of elderly subjects with thoracic sarcoidosis: Report of 6 cases
- Author
-
Lesly Ortega Molina, Nicolás Martínez Velilla, and Helena Gómez Herrero
- Subjects
Pediatrics ,medicine.medical_specialty ,Sarcoidosis ,Biopsy ,Diagnostic Techniques, Respiratory System ,Peptidyl-Dipeptidase A ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Sarcoidosis, Pulmonary ,Thoracic Diseases ,medicine ,Mediastinal Diseases ,Humans ,030212 general & internal medicine ,Age of Onset ,Aged ,Granuloma ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Surgery ,030228 respiratory system ,Thoracic diseases ,Differential diagnosis ,Age of onset ,business ,Biomarkers - Published
- 2015
10. Diagnosis and Treatment of Hemoptysis
- Author
-
Elena Bollo de Miguel, Rafael Jiménez Merchán, Rosa Cordovilla, Ana Núñez Ares, Inmaculada Herráez Ortega, and Francisco Javier Cosano Povedano
- Subjects
Lung Diseases ,medicine.medical_specialty ,Chronic bronchitis ,Hemoptysis ,Lung Neoplasms ,medicine.medical_treatment ,Diagnostic Techniques, Respiratory System ,Shock, Hemorrhagic ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Bronchoscopy ,medicine.artery ,Multidetector Computed Tomography ,medicine ,Pulmonary Medicine ,Humans ,Embolization ,Societies, Medical ,Bronchiectasis ,medicine.diagnostic_test ,business.industry ,Hemostatic Techniques ,Angiography ,Interventional radiology ,Hematemesis ,General Medicine ,medicine.disease ,Embolization, Therapeutic ,Antifibrinolytic Agents ,Surgery ,medicine.anatomical_structure ,030228 respiratory system ,Spain ,Practice Guidelines as Topic ,Sputum ,Radiology ,medicine.symptom ,business ,Bronchial artery ,Artery - Abstract
Hemoptysis is the expectoration of blood from the tracheobronchial tree. It is commonly caused by bronchiectasis, chronic bronchitis, and lung cancer. The expectorated blood usually originates from the bronchial arteries. When hemoptysis is suspected, it must be confirmed and classified according to severity, and the origin and cause of the bleeding determined. Lateral and AP chest X-ray is the first study, although a normal chest X-ray does not rule out the possibility of malignancy or other underlying pathology. Multidetector computed tomography (MDCT) must be performed in all patients with frank hemoptysis, hemoptoic sputum, suspicion of bronchiectasis or risk factors for lung cancer, and in those with signs of pathology on chest X-ray. MDCT angiography has replaced arteriography in identifying the arteries that are the source of bleeding. MDCT angiography is a non-invasive imaging technique that can pinpoint the presence, origin, number and course of the systemic thoracic (bronchial and non-bronchial) and pulmonary arterial sources of bleeding. Endovascular embolization is the safest and most effective method of managing bleeding in massive or recurrent hemoptysis. Embolization is indicated in all patients with life-threatening or recurrent hemoptysis in whom MDCT angiography shows artery disease. Flexible bronchoscopy plays a pivotal role in the diagnosis of hemoptysis in patients with hemoptoic sputum or frank hemoptysis. The procedure can be performed rapidly at the bedside (intensive care unit); it can be used for immediate control of bleeding, and is also effective in locating the source of the hemorrhage. Flexible bronchoscopy is the first-line procedure of choice in hemodynamically unstable patients with life-threatening hemoptysis, in whom control of bleeding is of vital importance. In these cases, surgery is associated with an extremely high mortality rate, and is currently only indicated when bleeding is secondary to surgery and its source can be accurately and reliably located.
- Published
- 2015
11. Farmer's Lung Disease. A Review
- Author
-
Adelaida Acuña, Teresa Hermida, María Guadalupe González, Esteban Cano-Jiménez, Irene Martín, Sonia Paredes, Pilar Sanjuán, Virginia Leiro, and María Isabel Botana
- Subjects
medicine.medical_specialty ,Antigens, Fungal ,Lymphocytosis ,Air Microbiology ,Diagnostic Techniques, Respiratory System ,Disease ,Air Pollutants, Occupational ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Respiratory system ,Respiratory Protective Devices ,Antigens, Bacterial ,medicine.diagnostic_test ,business.industry ,Anatomical pathology ,Humidity ,General Medicine ,medicine.disease ,Prognosis ,Animal Feed ,Bronchoalveolar lavage ,030228 respiratory system ,Food Storage ,Immunoglobulin G ,Immunology ,Farmer's Lung ,medicine.symptom ,business ,Hypersensitivity pneumonitis - Abstract
Farmer's lung disease (FLD) is a form of hypersensitivity pneumonitis (HP) caused by inhaling microorganisms from hay or grain stored in conditions of high humidity in the agricultural workplace. It is probably underdiagnosed, especially in northern Spain, where climatic conditions favor the development of this disease. According to previous studies, the most common antigens are usually thermophilic actinomycetes and fungi. The epidemiology of the disease is not well known, and is based on studies conducted by Central European and Asian groups. The clinical presentation may vary, differentiating the chronic (exposure to lower concentrations of the antigen over a longer period time) and the acute forms (after exposure to high concentrations of the antigen). In patients with respiratory symptoms and agricultural occupational exposure, radiological, lung function and/or anatomical pathology findings must be compatible with FLD, bronchoalveolar lavage must show lymphocytosis, and tests must find sensitivity to the antigen. The main treatment is avoidance of the antigen, so it is essential to educate patients on preventive measures. To date, no controlled studies have assessed the role of immunosuppressive therapy in this disease. Corticosteroid treatment has only been shown to accelerate resolution of the acute forms, but there is no evidence that it is effective in preventing disease progression in the long-term or reducing mortality.
- Published
- 2015
12. Complementary home mechanical ventilation techniques. SEPAR Year 2014
- Author
-
Eusebi, Chiner, José N, Sancho-Chust, Pedro, Landete, Cristina, Senent, and Elia, Gómez-Merino
- Subjects
Complementary Therapies ,Ventilators, Mechanical ,Patients ,Nutritional Support ,Diagnostic Techniques, Respiratory System ,Suction ,Home Care Services ,Respiration, Artificial ,Airway Obstruction ,Positive-Pressure Respiration ,Pulmonary Disease, Chronic Obstructive ,Sleep Disorders, Intrinsic ,Tracheostomy ,Cough ,Scoliosis ,Obesity Hypoventilation Syndrome ,Quality of Life ,Humans ,Kyphosis ,Forecasting - Abstract
This is a review of the different complementary techniques that are useful for optimizing home mechanical ventilation (HMV). Airway clearance is very important in patients with HMV and many patients, particularly those with reduced peak cough flow, require airway clearance (manual or assisted) or assisted cough techniques (manual or mechanical) and suctioning procedures, in addition to ventilation. In the case of invasive HMV, good tracheostomy cannula management is essential for success. HMV patients may have sleep disturbances that must be taken into account. Sleep studies including complete polysomnography or respiratory polygraphy are helpful for identifying patient-ventilator asynchrony. Other techniques, such as bronchoscopy or nutritional support, may be required in patients on HMV, particularly if percutaneous gastrostomy is required. Information on treatment efficacy can be obtained from HMV monitoring, using methods such as pulse oximetry, capnography or the internal programs of the ventilators themselves. Finally, the importance of the patient's subjective perception is reviewed, as this may potentially affect the success of the HMV.
- Published
- 2014
13. Guidelines for the diagnosis and monitoring of silicosis
- Author
-
Ramón Fernández Álvarez, Amador Prieto Fernández, Aida Quero Martínez, Cristina Martínez González, José Jesús Blanco Pérez, and Luis Carazo Fernández
- Subjects
medicine.medical_specialty ,Silicosis ,Diagnostic Techniques, Respiratory System ,Disease ,Asymptomatic ,Severity of Illness Index ,Disability Evaluation ,Clinical history ,Risk Factors ,medicine ,Pulmonary Medicine ,Effective treatment ,Humans ,Social Change ,Intensive care medicine ,Physician's Role ,Inhalation ,business.industry ,General Medicine ,medicine.disease ,Surgery ,Spain ,Radiological weapon ,Practice Guidelines as Topic ,medicine.symptom ,business ,Interstitial Disease - Abstract
a b s t r a c t Silicosis is one of the occupational respiratory diseases most commonly encountered in our setting. It is caused by inhalation of crystalline silica that triggers a fibrotic response in the lung parenchyma. It presents as diffuse interstitial disease and clinical expression ranges from asymptomatic forms to chronic respiratory failure. Diagnosis is based on clinical history and radiological findings. There is no effective treatment, and once diagnosed, the patient must avoid all sources of occupational exposure. In these guidelines, the clinical, radiological, and functional aspects of silicosis are reviewed, and strategies for diagnosis, monitoring, and classification of patients are proposed, along with recommendations regarding the occupational implications of this disease.
- Published
- 2014
14. Recommendations for fitness for work medical evaluations in chronic respiratory patients. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
- Author
-
Cristina, Martínez González, Francisco Javier, González Barcala, José, Belda Ramírez, Isabel, González Ros, Inmaculada, Alfageme Michavila, Cristina, Orejas Martínez, José Miguel, González Rodríguez-Moro, José Antonio, Rodríguez Portal, and Ramón, Fernández Álvarez
- Subjects
Research Report ,Respiratory Therapy ,Polysomnography ,Diagnostic Techniques, Respiratory System ,Work Capacity Evaluation ,Respiration Disorders ,Truth Disclosure ,Severity of Illness Index ,Medical Records ,Social Security ,Respiratory Function Tests ,Occupational Diseases ,Spain ,Accidents ,Chronic Disease ,Insurance, Disability ,Humans ,Workers' Compensation - Abstract
Chronic respiratory diseases often cause impairment in the functions and/or structure of the respiratory system, and impose limitations on different activities in the lives of persons who suffer them. In younger patients with an active working life, these limitations can cause problems in carrying out their normal work. Article 41 of the Spanish Constitution states that «the public authorities shall maintain a public Social Security system for all citizens guaranteeing adequate social assistance and benefits in situations of hardship». Within this framework is the assessment of fitness for work, as a dual-nature process (medico-legal) that aims to determine whether it is appropriate or not to recognise a person's right to receive benefits which replace the income that they no longer receive as they cannot carry out their work, due to loss of health. The role of the pulmonologist is essential in evaluating the diagnosis, treatment, prognosis and functional capacity of respiratory patients. These recommendations seek to bring the complex setting of fitness for work evaluation to pulmonologists and thoracic surgeons, providing action guidelines that allow them to advise their own patients about their incorporation into working life.
- Published
- 2013
15. Guidelines for the study of nonspecific bronchial hyperresponsiveness in asthma. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
- Author
-
Miguel, Perpiñá Tordera, Francisco, García Río, Francisco Javier, Álvarez Gutierrez, Carolina, Cisneros Serrano, Luis, Compte Torrero, Luis Manuel, Entrenas Costa, Carlos, Melero Moreno, María Jesús, Rodríguez Nieto, and Alfons, Torrego Fernández
- Subjects
Saline Solution, Hypertonic ,Dose-Response Relationship, Drug ,Contraindications ,Nebulizers and Vaporizers ,Diagnostic Techniques, Respiratory System ,Asthma ,Bronchial Provocation Tests ,Asthma, Exercise-Induced ,Bronchoconstrictor Agents ,Athletes ,Spirometry ,Exercise Test ,Humans ,Hyperventilation ,Bronchial Hyperreactivity - Published
- 2013
16. [Diagnostic and prognostic evaluation in patients with pulmonary hypertension]
- Author
-
Francisco Javier, Mazo Etxaniz and Luis Alberto, Ruiz Iturriaga
- Subjects
Lung Diseases ,Exercise Tolerance ,Hypertension, Pulmonary ,Ventricular Dysfunction, Right ,Diagnostic Techniques, Cardiovascular ,Disease Progression ,Hemodynamics ,Diagnostic Techniques, Respiratory System ,Humans ,Prognosis ,Algorithms - Abstract
Pulmonary hypertension (PH) is a hemodynamic disorder that occurs in a series of distinct diseases and is defined by the presence of a mean pulmonary artery pressure of ≥ 25 mm Hg. Clinically, this disorder is classified in five groups. Of these, group I, or pulmonary arterial hypertension (PAH), although infrequent, deserves special attention due to the specific therapeutic implications involved. Based on clinical suspicion and/or the results of echocardiogram, the diagnosis of this entity is established by following a strict protocol that should include right-sided cardiac catheterization. PH is a severe, progressive disease whose prognosis mainly depends on the degree of right ventricular involvement. Once the diagnosis has been confirmed, severity must be evaluated to initiate the most appropriate treatment for the patient's status. To do this, several clinical, biological, and echocardiographic-hemodynamic parameters and indicators of exercise capacity can be used.
- Published
- 2013
17. Guidelines for the management of respiratory complications in patients with neuromuscular disease. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
- Author
-
Eva, Farrero, Antonio, Antón, Carlos J, Egea, M José, Almaraz, J Fernando, Masa, Isabel, Utrabo, Miriam, Calle, Héctor, Verea, Emilio, Servera, Luis, Jara, Emilia, Barrot, and Vinyet, Casolivé
- Subjects
Patient Care Team ,Pulmonary Atelectasis ,Respiratory Therapy ,Terminal Care ,Palliative Care ,Diagnostic Techniques, Respiratory System ,Disease Management ,Neuromuscular Diseases ,Pneumonia, Aspiration ,Respiration Disorders ,Combined Modality Therapy ,Home Care Services ,Respiration, Artificial ,Respiratory Paralysis ,Respiratory Muscles ,Respiratory Function Tests ,Tracheostomy ,Cardiovascular Diseases ,Ambulatory Care ,Disease Progression ,Humans ,Advance Directives - Published
- 2012
18. Evaluating respiratory patient disability
- Author
-
Cristina Martínez González, Inmaculada Alfageme Michavila, Juan Ruiz Manzano, and Eusebi Chiner Vives
- Subjects
medicine.medical_specialty ,Activities of daily living ,Work Capacity Evaluation ,Respiratory Tract Diseases ,MEDLINE ,Diagnostic Techniques, Respiratory System ,Legislation ,World Health Organization ,Severity of Illness Index ,Social Security ,Disability Evaluation ,Physical medicine and rehabilitation ,Government Agencies ,Severity of illness ,Activities of Daily Living ,Medicine ,Humans ,Disabled Persons ,Intensive care medicine ,Societies, Medical ,Work disability ,business.industry ,Respiratory disease ,General Medicine ,medicine.disease ,Social security ,Occupational Diseases ,Spain ,Spirometry ,Practice Guidelines as Topic ,business - Abstract
The evaluation of the disabilities of patients with respiratory disease is regulated by the Spanish Ministry of Labor and Social Security, as are disabilities of any other type. We believe, however, that in respiratory pathologies this evaluation is especially complicated because, as they are chronic processes, they inter-relate with other systems. Furthermore, they tend to have occasional exacerbations; therefore, normal periods may alternate with other periods of important functional limitations. The present document arises from the desire of SEPAR to update this topic and to respond to the requests of respiratory disease patient associations who have asked us to do so. In this paper, we analyze the current situation of work disability legislation as well as the determination of degrees and percentages, including the current criteria for assigning disabilities due to respiratory tract deficiencies. Lastly, we propose work guidelines that would improve the existing scenario and outline this evaluation for specific pathologies.
- Published
- 2011
19. Evaluation of the use of a rapid diagnostic consultation of lung cancer. Delay time of diagnosis and therapy
- Author
-
Idoya Pascal Martínez, Isabel Andrade Vela, Javier Hueto Pérez de Heredia, Joan Boldú Mitjans, Pilar Cebollero Rivas, Víctor Manuel Eguía Astibia, and José Antonio Cascante Rodrigo
- Subjects
Lung Diseases ,Male ,Pediatrics ,medicine.medical_specialty ,Delayed Diagnosis ,Lung Neoplasms ,Time Factors ,Diagnostic Techniques, Respiratory System ,medicine ,Screening programs ,Ambulatory Care ,Humans ,Mass Screening ,In patient ,Stage (cooking) ,Lung cancer ,Referral and Consultation ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Cancer ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Standard system ,Hospitalization ,Socioeconomic Factors ,Spain ,Female ,business ,Lung cancer screening ,Delay time - Abstract
To analyze the results obtained in a lung cancer screening program since its inception five years ago regarding correct referrals, diagnostic and therapeutic delay times and days of hospitalization. To compare the diagnostic-therapeutic delays and hospital stays with those obtained in patients evaluated with the standard system.Included for study were all those patients evaluated in our Lung Cancer Screening Program (LCSP) in the last five years. For the cases with LC, we recorded the dates the patients were referred to a specialist, the first consultation, diagnostic tests, stage, start of treatment and days of hospitalization. We compared these same data with lung cancer patients who did not partake in the LCSP and were diagnosed between October 2008 and October 2010.We evaluated 179 patients remitted to the LCSP, which represented 26.7% of the consultations; 166 (92.7%) of the referrals were correct, out of which 44.5% were LC. In 75.6% of these, the entire study was completed in the outpatient setting, and more than 85% of the cases met the current recommendations related with diagnostic-therapeutic delays. When these results were compared with the non-LCSP group (n=151), differences were found in the data for hospitalizations: there was a lower percentage of hospitalizations (P.0001) and shorter hospital stays (P.0001) in the LCSP group. There were no differences between the two groups for diagnostic or therapeutic delays.In our setting, lung cancer screening programs allow for cancer studies to be carried out in the outpatient consultations in a large percentage of cases, and within the time periods recommended by current guidelines. In spite of this fact, we have detected that these programs are underused.
- Published
- 2011
20. [Inflammation and remodeling of the distal airways: studies in humans and experimental models]
- Author
-
David, Ramos-Barbón and Antonio, Parra-Arrondo
- Subjects
Inflammation ,Extracellular Matrix Proteins ,Diagnostic Techniques, Respiratory System ,Bronchi ,Asthma ,Matrix Metalloproteinases ,Airway Obstruction ,Pulmonary Alveoli ,Disease Models, Animal ,Species Specificity ,Airway Remodeling ,Animals ,Humans ,Anti-Asthmatic Agents ,Bronchial Hyperreactivity ,Pulmonary Eosinophilia ,Bronchioles - Abstract
Asthma is characterized by inflammation and remodeling of the airways, giving rise to airway obstruction and symptoms of wheezing, chest tightness, cough and dyspnea. Most of these observations arise from the study of samples obtained from the central airways by distinct methods. However, it is currently accepted that this inflammatory process occurs not only in the central airway but also in the small airway and even in the pulmonary parenchyma of all asthmatic patients, even those with mild asthma. CD4+ lymphocytes, activated eosinophils and IL-5 mRNA expression are present in a greater quantity in the small airways. Also present is remodeling, with an increase in submucosal thickness, the muscular layer and adventitia. This inflammatory process causes a disconnection between the pulmonary parenchyma and the airway, giving rise to obstruction of the small airway, which is currently considered to be predominant in asthmatic patients. Likewise, studies of experimental asthma in animals support the substantial role of the distal airway. Recognition that asthma affects the entire airway could be clinically important and lead to the distal lung being considered as a target in any effective therapeutic strategy. However, longitudinal studies are required to evaluate the impact of distal airway inflammation and its treatment in asthma.
- Published
- 2011
21. [Postgraduate training program in respiratory medicine]
- Author
-
Felipe, Rodríguez de Castro, José Luis, Alvarez-Sala, Fernando, Sánchez Gascón, and José, Villamor
- Subjects
Education, Medical ,Attitude of Health Personnel ,Research ,Diagnostic Techniques, Respiratory System ,Internship and Residency ,Education, Medical, Graduate ,Spain ,Pulmonary Medicine ,Humans ,Ethics, Medical ,Clinical Competence ,Curriculum ,Goals ,Specialization - Published
- 2008
22. [Diagnoses and diagnostic procedures in 500 consecutive patients with clinical suspicion of interstitial lung disease]
- Author
-
Ferran, Morell, Leonardo, Reyes, Gema, Doménech, Javier, De Gracia, Joaquim, Majó, and Jaume, Ferrer
- Subjects
Adult ,Aged, 80 and over ,Male ,Adolescent ,Diagnostic Techniques, Respiratory System ,Humans ,Female ,Middle Aged ,Child ,Lung Diseases, Interstitial ,Aged - Abstract
To determine the diagnostic yield achieved with the application of current recommendations for evaluating patients with suspected interstitial lung disease (ILD) and the procedures that must be applied to reach a definitive diagnosis.Over a 10-year period, 500 consecutive patients attending an ILD outpatient clinic who showed features of diffuse lung involvement were assessed with a single diagnostic protocol. Results were introduced in a dedicated database and diagnoses for idiopathic interstitial pneumonia were established according to a recent consensus classification.A definitive diagnosis was reached in 427 (85%) patients: in 125 without invasive procedures and in 302 with invasive procedures. In 73 (14.6%) cases a definitive diagnosis was not reached, and patients were placed in the group of unclassifiable interstitial pneumonia. Idiopathic interstitial pneumonia was the predominant group with 193 (39%) patients. The main specific entities included sarcoidosis with 93 (19%) patients, usual interstitial pneumonia with 84 (17%) patients, and hypersensitivity pneumonitis with 75 (15%) patients. Thirty (6%) patients were diagnosed with an illness other than ILD (false ILD). In 332 patients, we performed a total of 433 invasive procedures: transbronchial biopsy in 252 (direct diagnostic yield, 38%, or if used also to exclude other specific diagnosis, 50%), bronchoalveolar lavage in 260 (yield, 5%), and open lung biopsy in 141 (yield, 93%). Hence, following the current diagnostic approach, a definitive diagnosis was established for 85% of patients, for 25% solely on clinical grounds and imaging criteria and for 60% on the basis of invasive procedures. Diagnosis by open lung biopsy was still required for 141 (28%) patients.The diagnostic yield was high when the recommended study protocol was followed. A quarter of the diagnoses were reached with clinical criteria alone, but another quarter could only be made after open lung biopsy.
- Published
- 2008
23. [Changes in the acid-base equilibrium of pleural fluid during the first 2 hours after thoracentesis]
- Author
-
M. Lora-Díez, F. Sebastián-Quetglás, Manuel Haro-Estarriol, X. Baldó-Padró, M. Rubio-Garay, and M. Rubio-Goday
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Pleural effusion ,medicine.medical_treatment ,Diagnostic Techniques, Respiratory System ,Thoracentesis ,pCO2 ,medicine ,Humans ,Prospective Studies ,Aged ,Acid-Base Equilibrium ,business.industry ,General Medicine ,medicine.disease ,Transudate ,Surgery ,Body Fluids ,Pleural Effusion ,Effusion ,Anesthesia ,Pleural fluid ,Arterial blood ,Pleura ,Female ,Acid–base reaction ,business - Abstract
Objective The aim of this study was to assess changes in the acid-base equilibrium of pleural fluid during the first 2 hours after thoracentesis and to determine whether, as with arterial blood, it is important to keep the fluid on ice. Patients and methods A prospective, descriptive, comparative study was performed in 53 consecutive patients with pleural effusion. Thoracentesis was performed and pleural fluid was collected in 5 heparinized syringes to determine the pH, PO 2 , and PCO 2 at baseline and at 30, 60, 90, and 120 minutes. In the first 26 patients, pleural fluid was collected in a further 4 syringes that were kept on ice prior to performing the same measurements at 30, 60, 90, and 120 minutes. Results The patients had a mean (SD) age of 70 (14) years, 66% were smokers, 72% were men, 63% had right-sided pleural effusion, 85% had unilateral effusion, and 15% had massive effusion. In 10 patients the effusion was a transudate, in 35 it was lymphocytic, and in 8 it was neutrophilic. The etiology was benign in 34 cases and neoplastic in 19 cases. The baseline pH was 7.35 (0.1) and baseline values of PO 2 and PCO 2 were 57.8 (20) mm Hg and 53.7 (15) mm Hg, respectively. No significant changes were observed in the first 2 hours for either pH or PCO 2 , whereas PO 2 did undergo a significant change over this period. The difference between the baseline value and the value obtained at 120 minutes was 0.005 (0.02) for pH, 12.5 (19) mm Hg for PO 2 , and 0.8 (3) mm Hg for PCO 2 , with correlation coefficients of 0.97, 0.49, and 0.98, respectively. Comparison of values by simple regression analysis did not reveal a significant difference in the changes in pH, PO 2 , or PCO 2 associated with keeping samples on ice. Multivariate analysis revealed that neoplastic effusion and a higher red blood cell count in pleural fluid had a significant influence on pH changes. Conclusions The pH and PCO 2 of pleural fluid did not change significantly during the first 2 hours following thoracentesis, whereas PO 2 did undergo a significant change. Keeping samples on ice during this period is unnecessary. Only a higher red blood cell count in pleural fluid and neoplastic effusion had a limited effect on changes in the pH of samples from our patients during the first 2 hours following thoracentesis.
- Published
- 2005
24. [Methods for evaluating airway inflammation]
- Author
-
J B, Gáldiz Iturri
- Subjects
Diagnostic Techniques, Respiratory System ,Humans ,Bronchitis - Published
- 2005
25. Hypersensitivity Pneumonitis. Towards a Less Invasive Diagnostic Procedure.
- Author
-
Morell F, Ojanguren I, and Cruz MJ
- Subjects
- Diagnostic Techniques, Respiratory System, Humans, Alveolitis, Extrinsic Allergic diagnosis
- Published
- 2018
- Full Text
- View/download PDF
26. [Costs of chronic obstructive pulmonary disease in Spain. Estimation from a population-based study]
- Author
-
Marc Miravitlles, Carlos A. Jiménez-Ruiz, José Luis Viejo, Juan F. Masa, L. Fernández-Fau, V. Sobradillo, and Carlos Villasante
- Subjects
Spirometry ,Adult ,Male ,medicine.medical_specialty ,Population ,Respiratory System Agents ,Diagnostic Techniques, Respiratory System ,Disease ,Pharmacoeconomics ,Pulmonary Disease, Chronic Obstructive ,Cost of Illness ,Health care ,Epidemiology ,medicine ,Humans ,Medical diagnosis ,education ,Aged ,education.field_of_study ,COPD ,medicine.diagnostic_test ,business.industry ,General Medicine ,Health Care Costs ,Middle Aged ,medicine.disease ,Hospitalization ,Epidemiologic Studies ,Spain ,Emergency medicine ,Physical therapy ,Female ,business - Abstract
Objective In the studies carried out to date, the cost of chronic obstructive pulmonary disease (COPD) may have been overestimated due to the inclusion of previously diagnosed patients seeking medical attention for their symptoms. As a result, the severity of the cases included in these studies may have been greater than in an unselected sample of the general population. The aim of the present study was to estimate the direct cost of COPD on the basis of a representative sample of the overall Spanish population between 40 and 69 years of age (from the IBERPOC study). Method The cost was evaluated retrospectively by means of a questionnaire completed by the 363 patients with COPD from the IBERPOC study with questions referring to the previous year. Standardized spirometry was performed on all the patients by a pneumologist in each of the 7 geographical areas in which the study was carried out. Results Hospitalization accounted for the greatest expenditure (41% of total), followed by drug therapy (37%). The cost was €98.39 per patient, and €909.50 per previously diagnosed patient. The cost per person of severe COPD was more than 3 times that of moderate COPD and more than 7 times that of mild COPD. The estimated annual cost of COPD in Spain was €238.82 million (for 1997). Conclusion The present study, which was the first to estimate the cost of COPD in a representative sample of the general population, found the cost to be lower than in studies analyzing samples of patients with previous diagnoses of COPD. The cost distribution is not in line with recommended health care practices, underlining the need to optimize resources used to monitor and treat the disease, with an emphasis on early diagnosis.
- Published
- 2004
27. [Invasive diagnostic technics in pneumonia]
- Author
-
F J, Aspa, E, Prieto, and O, Rajas
- Subjects
Diagnostic Techniques, Respiratory System ,Humans ,Pneumonia - Published
- 1998
28. [Non-invasive technics in the diagnosis of pneumonia]
- Author
-
S, Bello, E, Chacón, and A, Hernández
- Subjects
Diagnostic Techniques, Respiratory System ,Humans ,Pneumonia - Published
- 1998
29. Evolution, diagnosis and treatment of elderly subjects with thoracic sarcoidosis: Report of 6 cases.
- Author
-
Gómez Herrero H, Martínez Velilla N, and Ortega Molina L
- Subjects
- Age of Onset, Aged, Biomarkers, Biopsy, Diagnosis, Differential, Diagnostic Techniques, Respiratory System, Granuloma diagnosis, Humans, Mediastinal Diseases diagnosis, Mediastinal Diseases epidemiology, Mediastinal Diseases therapy, Peptidyl-Dipeptidase A blood, Sarcoidosis epidemiology, Sarcoidosis therapy, Sarcoidosis, Pulmonary diagnosis, Sarcoidosis, Pulmonary epidemiology, Sarcoidosis, Pulmonary therapy, Thoracic Diseases epidemiology, Thoracic Diseases therapy, Sarcoidosis diagnosis, Thoracic Diseases diagnosis
- Published
- 2016
- Full Text
- View/download PDF
30. Is Chronic Obstructive Pulmonary Disease Caused by Wood Smoke a Different Phenotype or a Different Entity?
- Author
-
Torres-Duque CA, García-Rodriguez MC, and González-García M
- Subjects
- Age Factors, Biomass, Developing Countries, Diagnostic Techniques, Respiratory System, Female, Fossil Fuels adverse effects, Humans, Hypertension, Pulmonary etiology, Inhalation Exposure, Male, Meta-Analysis as Topic, Phenotype, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive etiology, Pulmonary Disease, Chronic Obstructive physiopathology, Pulmonary Emphysema etiology, Quality of Life, Sex Factors, Symptom Assessment, Tobacco Smoke Pollution adverse effects, Treatment Outcome, Pulmonary Disease, Chronic Obstructive classification, Smoke adverse effects, Nicotiana adverse effects, Wood
- Abstract
Around 40% of the world's population continue using solid fuel, including wood, for cooking or heating their homes. Chronic exposure to wood smoke is a risk factor for developing chronic obstructive pulmonary disease (COPD). In some regions of the world, this can be a more important cause of COPD than exposure to tobacco smoke from cigarettes. Significant differences between COPD associated with wood smoke (W-COPD) and that caused by smoking (S-COPD) have led some authors to suggest that W-COPD should be considered a new COPD phenotype. We present a review of the differences between W-COPD and S-COPD. On the premise that wood smoke and tobacco smoke are not the same and the physiopathological mechanisms they induce may differ, we have analyzed whether W-COPD can be considered as another COPD phenotype or a distinct nosological entity., (Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
31. Diagnosis and Treatment of Hemoptysis.
- Author
-
Cordovilla R, Bollo de Miguel E, Nuñez Ares A, Cosano Povedano FJ, Herráez Ortega I, and Jiménez Merchán R
- Subjects
- Angiography methods, Antifibrinolytic Agents therapeutic use, Bronchoscopy, Diagnosis, Differential, Embolization, Therapeutic, Hematemesis diagnosis, Hemoptysis etiology, Humans, Lung Diseases complications, Lung Neoplasms complications, Multidetector Computed Tomography, Practice Guidelines as Topic, Pulmonary Medicine organization & administration, Shock, Hemorrhagic prevention & control, Societies, Medical, Spain, Diagnostic Techniques, Respiratory System, Hemoptysis diagnosis, Hemoptysis therapy, Hemostatic Techniques
- Abstract
Hemoptysis is the expectoration of blood from the tracheobronchial tree. It is commonly caused by bronchiectasis, chronic bronchitis, and lung cancer. The expectorated blood usually originates from the bronchial arteries. When hemoptysis is suspected, it must be confirmed and classified according to severity, and the origin and cause of the bleeding determined. Lateral and AP chest X-ray is the first study, although a normal chest X-ray does not rule out the possibility of malignancy or other underlying pathology. Multidetector computed tomography (MDCT) must be performed in all patients with frank hemoptysis, hemoptoic sputum, suspicion of bronchiectasis or risk factors for lung cancer, and in those with signs of pathology on chest X-ray. MDCT angiography has replaced arteriography in identifying the arteries that are the source of bleeding. MDCT angiography is a non-invasive imaging technique that can pinpoint the presence, origin, number and course of the systemic thoracic (bronchial and non-bronchial) and pulmonary arterial sources of bleeding. Endovascular embolization is the safest and most effective method of managing bleeding in massive or recurrent hemoptysis. Embolization is indicated in all patients with life-threatening or recurrent hemoptysis in whom MDCT angiography shows artery disease. Flexible bronchoscopy plays a pivotal role in the diagnosis of hemoptysis in patients with hemoptoic sputum or frank hemoptysis. The procedure can be performed rapidly at the bedside (intensive care unit); it can be used for immediate control of bleeding, and is also effective in locating the source of the hemorrhage. Flexible bronchoscopy is the first-line procedure of choice in hemodynamically unstable patients with life-threatening hemoptysis, in whom control of bleeding is of vital importance. In these cases, surgery is associated with an extremely high mortality rate, and is currently only indicated when bleeding is secondary to surgery and its source can be accurately and reliably located., (Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
32. Farmer's Lung Disease. A Review.
- Author
-
Cano-Jiménez E, Acuña A, Botana MI, Hermida T, González MG, Leiro V, Martín I, Paredes S, and Sanjuán P
- Subjects
- Air Microbiology, Air Pollutants, Occupational adverse effects, Animal Feed microbiology, Antigens, Bacterial adverse effects, Antigens, Fungal adverse effects, Diagnosis, Differential, Diagnostic Techniques, Respiratory System, Food Storage methods, Humans, Humidity, Immunoglobulin G blood, Prognosis, Respiratory Protective Devices, Farmer's Lung diagnosis, Farmer's Lung epidemiology, Farmer's Lung etiology, Farmer's Lung prevention & control
- Abstract
Farmer's lung disease (FLD) is a form of hypersensitivity pneumonitis (HP) caused by inhaling microorganisms from hay or grain stored in conditions of high humidity in the agricultural workplace. It is probably underdiagnosed, especially in northern Spain, where climatic conditions favor the development of this disease. According to previous studies, the most common antigens are usually thermophilic actinomycetes and fungi. The epidemiology of the disease is not well known, and is based on studies conducted by Central European and Asian groups. The clinical presentation may vary, differentiating the chronic (exposure to lower concentrations of the antigen over a longer period time) and the acute forms (after exposure to high concentrations of the antigen). In patients with respiratory symptoms and agricultural occupational exposure, radiological, lung function and/or anatomical pathology findings must be compatible with FLD, bronchoalveolar lavage must show lymphocytosis, and tests must find sensitivity to the antigen. The main treatment is avoidance of the antigen, so it is essential to educate patients on preventive measures. To date, no controlled studies have assessed the role of immunosuppressive therapy in this disease. Corticosteroid treatment has only been shown to accelerate resolution of the acute forms, but there is no evidence that it is effective in preventing disease progression in the long-term or reducing mortality., (Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
33. Recommendations of the Spanish Society of Pneumology and Thoracic Surgery on the diagnosis and treatment of non-small-cell lung cancer.
- Author
-
Álvarez FV, Trueba IM, Sanchis JB, López-Rodó LM, Rodríguez Suárez PM, de Cos Escuín JS, Barreiro E, Henar Borrego Pintado M, Vicente CD, Aldeyturriaga JF, Gámez García P, Garrido López P, León Atance P, Izquierdo Elena JM, Novoa Valentín NM, Rivas de Andrés JJ, Crespo ÍR, Velázquez ÁS, Seijo Maceiras LM, Reina SS, Bujanda DA, Ávila Martínez RJ, de Granda Orive JI, Martínez Ede H, Gude VD, Flor RE, Freixinet Gilart JL, García Jiménez MD, Alarza FH, Sarmiento SH, Honguero Martínez AF, Jiménez Ruiz CA, Sanz IL, Mariscal de Alba A, Martínez Vallina P, Menal Muñoz P, Pérez LM, Olmedo García ME, Rombolá CA, Arregui ÍS, Somiedo Gutiérrez Mdel V, Triviño Ramírez AI, Trujillo Reyes JC, Vallejo C, Lozano PV, Simó GV, and Zulueta JJ
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Non-Small-Cell Lung epidemiology, Carcinoma, Non-Small-Cell Lung pathology, Cigarette Smoking adverse effects, Combined Modality Therapy, Comorbidity, Diagnostic Techniques, Respiratory System, Humans, Lung Neoplasms epidemiology, Lung Neoplasms pathology, Lung Neoplasms therapy, Mass Screening, Neoplasm Staging, Oxidative Stress, Pneumonectomy methods, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Medicine, Radiotherapy methods, Risk Factors, Smoking Cessation, Societies, Medical, Spain, Thoracic Surgery, Carcinoma, Non-Small-Cell Lung diagnosis, Carcinoma, Non-Small-Cell Lung therapy, Lung Neoplasms diagnosis
- Published
- 2016
- Full Text
- View/download PDF
34. Chronic Cough.
- Author
-
Pacheco A, de Diego A, Domingo C, Lamas A, Gutierrez R, Naberan K, Garrigues V, and López Vime R
- Subjects
- Anti-Allergic Agents therapeutic use, Anti-Infective Agents therapeutic use, Antitussive Agents therapeutic use, Chronic Disease, Diagnostic Techniques, Respiratory System, Disease Management, Gastroesophageal Reflux complications, Gastroesophageal Reflux drug therapy, Gastrointestinal Agents therapeutic use, Humans, Neural Pathways physiopathology, Psychophysiologic Disorders complications, Psychophysiologic Disorders drug therapy, Psychotropic Drugs therapeutic use, Respiratory Hypersensitivity complications, Respiratory Hypersensitivity drug therapy, Respiratory Tract Infections complications, Respiratory Tract Infections drug therapy, Sleep Apnea Syndromes complications, Therapies, Investigational, Cough diagnosis, Cough epidemiology, Cough etiology, Cough physiopathology, Cough therapy
- Abstract
Chronic cough (CC), or cough lasting more than 8 weeks, has attracted increased attention in recent years following advances that have changed opinions on the prevailing diagnostic and therapeutic triad in place since the 1970s. Suboptimal treatment results in two thirds of all cases, together with a new notion of CC as a peripheral and central hypersensitivity syndrome similar to chronic pain, have changed the approach to this common complaint in routine clinical practice. The peripheral receptors involved in CC are still a part of the diagnostic triad. However, both convergence of stimuli and central nervous system hypersensitivity are key factors in treatment success., (Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
35. Guidelines for the diagnosis and monitoring of silicosis.
- Author
-
Fernández Álvarez R, Martínez González C, Quero Martínez A, Blanco Pérez JJ, Carazo Fernández L, and Prieto Fernández A
- Subjects
- Diagnostic Techniques, Respiratory System, Disability Evaluation, Humans, Physician's Role, Pulmonary Medicine, Risk Factors, Severity of Illness Index, Silicosis epidemiology, Silicosis etiology, Silicosis prevention & control, Silicosis therapy, Social Change, Spain epidemiology, Practice Guidelines as Topic, Silicosis diagnosis
- Abstract
Silicosis is one of the occupational respiratory diseases most commonly encountered in our setting. It is caused by inhalation of crystalline silica that triggers a fibrotic response in the lung parenchyma. It presents as diffuse interstitial disease and clinical expression ranges from asymptomatic forms to chronic respiratory failure. Diagnosis is based on clinical history and radiological findings. There is no effective treatment, and once diagnosed, the patient must avoid all sources of occupational exposure. In these guidelines, the clinical, radiological and functional aspects of silicosis are reviewed, and strategies for diagnosis, monitoring and classification of patients are proposed, along with recommendations regarding the occupational implications of this disease., (Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
36. Guidelines for the management of respiratory complications in patients with neuromuscular disease. Sociedad Española de Neumología y Cirugía Torácica (SEPAR).
- Author
-
Farrero E, Antón A, Egea CJ, Almaraz MJ, Masa JF, Utrabo I, Calle M, Verea H, Servera E, Jara L, Barrot E, and Casolivé V
- Subjects
- Advance Directives, Ambulatory Care, Cardiovascular Diseases complications, Combined Modality Therapy, Diagnostic Techniques, Respiratory System, Disease Management, Disease Progression, Home Care Services, Humans, Neuromuscular Diseases physiopathology, Palliative Care, Patient Care Team, Pneumonia, Aspiration etiology, Pneumonia, Aspiration prevention & control, Pulmonary Atelectasis etiology, Pulmonary Atelectasis prevention & control, Respiration Disorders etiology, Respiration Disorders physiopathology, Respiration, Artificial ethics, Respiration, Artificial instrumentation, Respiration, Artificial standards, Respiratory Function Tests, Respiratory Muscles physiopathology, Respiratory Paralysis etiology, Respiratory Paralysis physiopathology, Respiratory Paralysis therapy, Respiratory Therapy standards, Terminal Care ethics, Terminal Care legislation & jurisprudence, Terminal Care methods, Tracheostomy, Neuromuscular Diseases complications, Respiration Disorders therapy
- Published
- 2013
- Full Text
- View/download PDF
37. Evaluating respiratory patient disability.
- Author
-
Ruiz Manzano J, Alfageme Michavila I, Chiner Vives E, and Martínez González C
- Subjects
- Activities of Daily Living, Diagnostic Techniques, Respiratory System, Government Agencies legislation & jurisprudence, Humans, Occupational Diseases diagnosis, Occupational Diseases physiopathology, Respiratory Tract Diseases physiopathology, Severity of Illness Index, Social Security legislation & jurisprudence, Societies, Medical, Spain, Spirometry, Work Capacity Evaluation, World Health Organization, Disability Evaluation, Disabled Persons legislation & jurisprudence, Practice Guidelines as Topic, Respiratory Tract Diseases diagnosis
- Abstract
The evaluation of the disabilities of patients with respiratory disease is regulated by the Spanish Ministry of Labor and Social Security, as are disabilities of any other type. We believe, however, that in respiratory pathologies this evaluation is especially complicated because, as they are chronic processes, they inter-relate with other systems. Furthermore, they tend to have occasional exacerbations; therefore, normal periods may alternate with other periods of important functional limitations. The present document arises from the desire of SEPAR to update this topic and to respond to the requests of respiratory disease patient associations who have asked us to do so. In this paper, we analyze the current situation of work disability legislation as well as the determination of degrees and percentages, including the current criteria for assigning disabilities due to respiratory tract deficiencies. Lastly, we propose work guidelines that would improve the existing scenario and outline this evaluation for specific pathologies., (Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
38. [Inflammation and remodeling of the distal airways: studies in humans and experimental models].
- Author
-
Ramos-Barbón D and Parra-Arrondo A
- Subjects
- Airway Obstruction etiology, Animals, Anti-Asthmatic Agents pharmacology, Anti-Asthmatic Agents therapeutic use, Asthma drug therapy, Asthma metabolism, Asthma pathology, Bronchial Hyperreactivity etiology, Bronchioles pathology, Diagnostic Techniques, Respiratory System, Extracellular Matrix Proteins metabolism, Humans, Inflammation, Matrix Metalloproteinases metabolism, Pulmonary Alveoli pathology, Pulmonary Eosinophilia etiology, Species Specificity, Airway Remodeling physiology, Asthma physiopathology, Bronchi pathology, Disease Models, Animal
- Abstract
Asthma is characterized by inflammation and remodeling of the airways, giving rise to airway obstruction and symptoms of wheezing, chest tightness, cough and dyspnea. Most of these observations arise from the study of samples obtained from the central airways by distinct methods. However, it is currently accepted that this inflammatory process occurs not only in the central airway but also in the small airway and even in the pulmonary parenchyma of all asthmatic patients, even those with mild asthma. CD4+ lymphocytes, activated eosinophils and IL-5 mRNA expression are present in a greater quantity in the small airways. Also present is remodeling, with an increase in submucosal thickness, the muscular layer and adventitia. This inflammatory process causes a disconnection between the pulmonary parenchyma and the airway, giving rise to obstruction of the small airway, which is currently considered to be predominant in asthmatic patients. Likewise, studies of experimental asthma in animals support the substantial role of the distal airway. Recognition that asthma affects the entire airway could be clinically important and lead to the distal lung being considered as a target in any effective therapeutic strategy. However, longitudinal studies are required to evaluate the impact of distal airway inflammation and its treatment in asthma., (Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
39. [Diagnostic and prognostic evaluation in patients with pulmonary hypertension].
- Author
-
Mazo Etxaniz FJ and Ruiz Iturriaga LA
- Subjects
- Algorithms, Diagnostic Techniques, Cardiovascular, Diagnostic Techniques, Respiratory System, Disease Progression, Exercise Tolerance, Hemodynamics, Humans, Hypertension, Pulmonary classification, Hypertension, Pulmonary etiology, Hypertension, Pulmonary physiopathology, Lung Diseases complications, Lung Diseases diagnosis, Lung Diseases physiopathology, Prognosis, Ventricular Dysfunction, Right complications, Ventricular Dysfunction, Right diagnosis, Ventricular Dysfunction, Right physiopathology, Hypertension, Pulmonary diagnosis
- Abstract
Pulmonary hypertension (PH) is a hemodynamic disorder that occurs in a series of distinct diseases and is defined by the presence of a mean pulmonary artery pressure of ≥ 25 mm Hg. Clinically, this disorder is classified in five groups. Of these, group I, or pulmonary arterial hypertension (PAH), although infrequent, deserves special attention due to the specific therapeutic implications involved. Based on clinical suspicion and/or the results of echocardiogram, the diagnosis of this entity is established by following a strict protocol that should include right-sided cardiac catheterization. PH is a severe, progressive disease whose prognosis mainly depends on the degree of right ventricular involvement. Once the diagnosis has been confirmed, severity must be evaluated to initiate the most appropriate treatment for the patient's status. To do this, several clinical, biological, and echocardiographic-hemodynamic parameters and indicators of exercise capacity can be used., (Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
40. [Postgraduate training program in respiratory medicine].
- Author
-
Rodríguez de Castro F, Alvarez-Sala JL, and Sánchez Gascón F
- Subjects
- Attitude of Health Personnel, Clinical Competence, Curriculum standards, Diagnostic Techniques, Respiratory System, Education, Medical, Ethics, Medical education, Goals, Humans, Research education, Spain, Specialization, Education, Medical, Graduate standards, Internship and Residency standards, Pulmonary Medicine education
- Published
- 2009
- Full Text
- View/download PDF
41. [A new case of idiopathic bronchiolocentric interstitial pneumonia].
- Author
-
Alama JM, Justribó MV, and Illa FB
- Subjects
- Animals, Animals, Domestic, Anti-Inflammatory Agents therapeutic use, Biopsy, Bird Fancier's Lung diagnosis, Birds, Diagnosis, Differential, Diagnostic Techniques, Respiratory System, Female, Humans, Hypercholesterolemia complications, Hypothyroidism complications, Idiopathic Interstitial Pneumonias complications, Idiopathic Interstitial Pneumonias diagnosis, Idiopathic Interstitial Pneumonias drug therapy, Lymphatic Diseases etiology, Middle Aged, Prednisone therapeutic use, Respiratory Insufficiency etiology, Smoking Cessation, Bronchioles pathology, Idiopathic Interstitial Pneumonias pathology
- Published
- 2009
- Full Text
- View/download PDF
42. [Diagnoses and diagnostic procedures in 500 consecutive patients with clinical suspicion of interstitial lung disease].
- Author
-
Morell F, Reyes L, Doménech G, De Gracia J, Majó J, and Ferrer J
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Diagnostic Techniques, Respiratory System, Female, Humans, Male, Middle Aged, Lung Diseases, Interstitial diagnosis
- Abstract
Objective: To determine the diagnostic yield achieved with the application of current recommendations for evaluating patients with suspected interstitial lung disease (ILD) and the procedures that must be applied to reach a definitive diagnosis., Patients and Methods: Over a 10-year period, 500 consecutive patients attending an ILD outpatient clinic who showed features of diffuse lung involvement were assessed with a single diagnostic protocol. Results were introduced in a dedicated database and diagnoses for idiopathic interstitial pneumonia were established according to a recent consensus classification., Results: A definitive diagnosis was reached in 427 (85%) patients: in 125 without invasive procedures and in 302 with invasive procedures. In 73 (14.6%) cases a definitive diagnosis was not reached, and patients were placed in the group of unclassifiable interstitial pneumonia. Idiopathic interstitial pneumonia was the predominant group with 193 (39%) patients. The main specific entities included sarcoidosis with 93 (19%) patients, usual interstitial pneumonia with 84 (17%) patients, and hypersensitivity pneumonitis with 75 (15%) patients. Thirty (6%) patients were diagnosed with an illness other than ILD (false ILD). In 332 patients, we performed a total of 433 invasive procedures: transbronchial biopsy in 252 (direct diagnostic yield, 38%, or if used also to exclude other specific diagnosis, 50%), bronchoalveolar lavage in 260 (yield, 5%), and open lung biopsy in 141 (yield, 93%). Hence, following the current diagnostic approach, a definitive diagnosis was established for 85% of patients, for 25% solely on clinical grounds and imaging criteria and for 60% on the basis of invasive procedures. Diagnosis by open lung biopsy was still required for 141 (28%) patients., Conclusions: The diagnostic yield was high when the recommended study protocol was followed. A quarter of the diagnoses were reached with clinical criteria alone, but another quarter could only be made after open lung biopsy.
- Published
- 2008
43. [Reliability of home respiratory polygraphy for the diagnosis of sleep apnea-hypopnea syndrome: analysis of costs].
- Author
-
Alonso Alvarez Mde L, Terán Santos J, Cordero Guevara J, González Martínez M, Rodríguez Pascual L, Viejo Bañuelos JL, and Marañón Cabello A
- Subjects
- Adolescent, Adult, Aged, Costs and Cost Analysis, Diagnostic Techniques, Respiratory System, Female, Humans, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Sleep Apnea Syndromes diagnosis, Sleep Apnea Syndromes economics
- Abstract
Objectives: To evaluate the reliability of home respiratory polygraphy for the diagnosis of sleep apnea-hypopnea syndrome (SAHS) and to compare the cost of this technique with that of nighttime polysomnography performed in a sleep laboratory., Patients and Methods: This was a prospective study of a random sample of patients with clinically suspected SAHS in which the participants who underwent both home respiratory polygraphy and nighttime polysomnography were blinded as to the results of their first test. Costs were calculated based on a theoretical population of 1000 individuals. A t test for paired samples, the Pearson correlation coefficient, and a receiver operator characteristic curve were used for the statistical analysis., Results: The study population was composed of 45 patients with a mean (SD) age of 52.3 (11) years of whom 21 (46.6%) were diagnosed with SAHS, defined by an apnea-hypopnea index greater than 10 in nighttime polysomnography. Comparison of the results obtained in both recordings revealed statistically significant correlations for all comparisons. The optimal cutoff in this population was a respiratory disturbance index of 13.7 or more, for which the area under the receiver operating characteristic curve was 87.5% (95% confidence interval, 74.2%-95.4%). The mean cost of home respiratory polygraphy in a patient with suspected SAHS was euro69, whereas that of polysomnography was euro179., Conclusions: Home respiratory polygraphy is a reliable technique for the diagnosis of SAHS. Using this technique routinely in patients suspected of SAHS will be more economical than using nighttime polysomnography. Uncertain results must be verified by nighttime polysomnography.
- Published
- 2008
44. [Changes in the acid-base equilibrium of pleural fluid during the first 2 hours after thoracentesis].
- Author
-
Haro-Estarriol M, Baldó-Padró X, Lora-Díez M, Rubio-Garay M, Rubio-Goday M, and Sebastián-Quetglás F
- Subjects
- Aged, Diagnostic Techniques, Respiratory System, Female, Humans, Male, Prospective Studies, Time Factors, Acid-Base Equilibrium, Body Fluids metabolism, Pleura metabolism, Pleural Effusion metabolism
- Abstract
Objective: The aim of this study was to assess changes in the acid-base equilibrium of pleural fluid during the first 2 hours after thoracentesis and to determine whether, as with arterial blood, it is important to keep the fluid on ice., Patients and Methods: A prospective, descriptive, comparative study was performed in 53 consecutive patients with pleural effusion. Thoracentesis was performed and pleural fluid was collected in 5 heparinized syringes to determine the pH, PO2, and PCO2 at baseline and at 30, 60, 90, and 120 minutes. In the first 26 patients, pleural fluid was collected in a further 4 syringes that were kept on ice prior to performing the same measurements at 30, 60, 90, and 120 minutes., Results: The patients had a mean (SD) age of 70 (14) years, 66% were smokers, 72% were men, 63% had right-sided pleural effusion, 85% had unilateral effusion, and 15% had massive effusion. In 10 patients the effusion was a transudate, in 35 it was lymphocytic, and in 8 it was neutrophilic. The etiology was benign in 34 cases and neoplastic in 19 cases. The baseline pH was 7.35 (0.1) and baseline values of PO2 and PCO2 were 57.8 (20) mm Hg and 53.7 (15) mm Hg, respectively. No significant changes were observed in the first 2 hours for either pH or PCO2, whereas PO2 did undergo a significant change over this period. The difference between the baseline value and the value obtained at 120 minutes was 0.005 (0.02) for pH, 12.5 (19) mm Hg for PO2, and 0.8 (3) mm Hg for PCO2, with correlation coefficients of 0.97, 0.49, and 0.98, respectively. Comparison of values by simple regression analysis did not reveal a significant difference in the changes in pH, PO2, or PCO2 associated with keeping samples on ice. Multivariate analysis revealed that neoplastic effusion and a higher red blood cell count in pleural fluid had a significant influence on pH changes., Conclusions: The pH and PCO2 of pleural fluid did not change significantly during the first 2 hours following thoracentesis, whereas PO2 did undergo a significant change. Keeping samples on ice during this period is unnecessary. Only a higher red blood cell count in pleural fluid and neoplastic effusion had a limited effect on changes in the pH of samples from our patients during the first 2 hours following thoracentesis.
- Published
- 2005
- Full Text
- View/download PDF
45. [Methods for evaluating airway inflammation].
- Author
-
Gáldiz Iturri JB
- Subjects
- Diagnostic Techniques, Respiratory System, Humans, Bronchitis diagnosis
- Published
- 2004
- Full Text
- View/download PDF
46. [Hypoxemia from multiple causes in a patient with acquired immunodeficiency syndrome].
- Author
-
Portillo K, Codina E, and Casan P
- Subjects
- Acquired Immunodeficiency Syndrome diagnosis, Acquired Immunodeficiency Syndrome therapy, Adult, Diagnostic Techniques, Respiratory System, Female, Humans, Hydrogen-Ion Concentration, Hypoxia diagnosis, Hypoxia therapy, Lung Diseases diagnosis, Lung Diseases therapy, Radiography, Thoracic, Acquired Immunodeficiency Syndrome complications, Hypoxia etiology, Lung Diseases complications
- Published
- 2004
- Full Text
- View/download PDF
47. [Invasive diagnostic technics in pneumonia].
- Author
-
Aspa FJ, Prieto E, and Rajas O
- Subjects
- Humans, Diagnostic Techniques, Respiratory System, Pneumonia diagnosis
- Published
- 1998
48. [Non-invasive technics in the diagnosis of pneumonia].
- Author
-
Bello S, Chacón E, and Hernández A
- Subjects
- Humans, Diagnostic Techniques, Respiratory System, Pneumonia diagnosis
- Published
- 1998
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.