RESUMEN
Solitary and early brain metastases from colon carcinoma are unusual. This possibility must be kept in mind, in patients with cerebral metastasis of unknown adenocarcinoma. These patients could benefit from colonoscopy and CEA studies with the aim of achieving more early diagnosis and surgical resection. The case of a 48-year-old woman with brain metastasis diagnosed 4 months before the primary tumor, a colon cancer, is reported.
Asunto(s)
Adenocarcinoma/secundario , Neoplasias Encefálicas/secundario , Neoplasias del Colon , Lóbulo Occipital , Lóbulo Parietal , Adenocarcinoma/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias del Colon/diagnóstico por imagen , Femenino , Humanos , Persona de Mediana Edad , Lóbulo Occipital/diagnóstico por imagen , Lóbulo Parietal/diagnóstico por imagen , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
Bronchial challenge test are useful in diagnosis of bronchial hyperresponsiveness (BH). To assess the sensitivity of histamine test (HT) and exercise test (ET), 45 asthmatic patients (31 men, 14 women, ages 9-34) with normal resting pulmonary function test were studied. HT and ET were performed in two different days. HT was positive in 40 (6 severe, 23 moderate and 11 mild) and ET was positive in 13 (88.8% vr 28.8%, p < 0.001). All patients with positive ET had positive HT. There is a relationship between the degree of BH severity and the response to ET (chi 2 = 5.995; p < 0.05). The HT has a high profitability the diagnosis of BH. The ET has a low sensitivity.
Asunto(s)
Asma/diagnóstico , Hiperreactividad Bronquial , Pruebas de Provocación Bronquial , Prueba de Esfuerzo , Histamina , Adolescente , Adulto , Asma/fisiopatología , Niño , Femenino , Humanos , Masculino , Pruebas de Función RespiratoriaRESUMEN
The aim of this study was to assess the effect of nasal continuous positive airway pressure (CPAP) breathing on patients with COPD when they are in respiratory failure during acute episodes of the disease. We studied 15 male patients with COPD who were in acute, unstable condition, without mechanical ventilatory support, before and during 4 h of nasal CPAP. The respiratory rate decreased (initial, 30 +/- 6; final, 25 +/- 6; p < 0.001), as did the subjective sensation of dyspnea (initial Borg index, 3 +/- 3; final, 2 +/- 2; p < 0.05). A significant decrease in the average PaCO2 (before, 73 +/- 10 mm Hg; after, 61 +/- 9 mm Hg; p < 0.001) and a significant increase in the PaO2 (before, 57 +/- 13 mm Hg; after 64 +/- 14 mm Hg; p < 0.05) were also observed. Nasal CPAP was generally well tolerated. According to these results, nasal CPAP should be considered as a possibility for treatment in patients with COPD who are in acute respiratory failure, in order to avoid mechanical ventilation.
Asunto(s)
Enfermedades Pulmonares Obstructivas/terapia , Respiración con Presión Positiva , Insuficiencia Respiratoria/fisiopatología , Enfermedad Aguda , Anciano , Dióxido de Carbono/sangre , Humanos , Enfermedades Pulmonares Obstructivas/sangre , Enfermedades Pulmonares Obstructivas/complicaciones , Enfermedades Pulmonares Obstructivas/fisiopatología , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Insuficiencia Respiratoria/etiología , Mecánica RespiratoriaRESUMEN
We reviewed the management of 167 patients with foreign body ingestion from 1980 to 1986. Two patients (1.1%) refused treatment. Nonoperative management was attempted in 14 (8.4%) patients. Endoscopy was performed on 117 patients with an overall success rate of 85.5% and a complication rate of 1.7%. Surgical treatment was required in 51 (30.0%) patients, 14 of whom had previous unsuccessful endoscopy.