Browsing by Author "GUTIERREZ, M"

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    ANTICARDIOLIPIN ANTIBODIES IN ACUTE RHEUMATIC-FEVER
    (J RHEUMATOL PUBL CO, 1992) FIGUEROA, F; BERRIOS, X; GUTIERREZ, M; CARRION, F; GOYCOLEA, JP; RIEDEL, I; JACOBELLI, S
    Recent reports describe the association of antiphospholipid antibodies (aPL) with chorea or severe heart valve lesions in systemic lupus erythematosus, lupus-like disease, or the primary antiphospholipid antibody syndrome. We conducted a case series and a case-control investigation of patients with rheumatic fever with Sydenham chorea or other manifestations of rheumatic fever for anticardiolipin antibodies (aCL) during the acute attack and disease remission. Eighty percent of patients were positive for aCL during the rheumatic fever attack vs 40% when inactive (p = 0.035); IgG and IgM aCL increased significantly with disease activity. Individuals with or without Sydenham chorea were equally positive for aCL (76 and 83%, respectively). A significant association was found between IgM aCL and carditis: All patients with valvulitis had IgM aCL (100%) vs 37% of patients without valvular involvement (p = 0.02). aPL may play a role in the pathogenesis of some clinical manifestations of acute rheumatic fever.
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    WEEKLY CUIRASS VENTILATION IMPROVES BLOOD-GASES AND INSPIRATORY MUSCLE STRENGTH IN PATIENTS WITH CHRONIC AIR-FLOW LIMITATION AND HYPERCARBIA
    (1988) GUTIERREZ, M; BEROIZA, T; CONTRERAS, G; DIAZ, O; CRUZ, E; MORENO, R; LISBOA, C
    We studied the effects of an 8-h, once-a-week schedule of cuirass ventilation (CV) in 5 patients with advanced chronic air-flow limitation and chronic hypercarbia (PaCO2, 58.6 .+-. 10.1 mm Hg; mean .+-. SD). Repeated measurements of arterial blood gases, maximal inspiratory mouth pressure (Pimax), 12-min walking distance, and respiratory cycle were performed during a 1-mouth run-in period. Quality of life and transdiaphragmatic pressure were measured once. All patients completed the planned 4-month study. Four of them were ventilated for longer periods because CV could not be discontinued at the end of the study. PaCO2 showed a significant fall starting during the first month; PaO2 significantly increased from the second month, whereas Pimax significantly rose from the third month on. Maximal trnsdiaphragmatic pressure increased in the 2 patients with abnormal baseline values. The fall in PaCO2 was associated with an increase in tidal volume because of a longer inspiratory time. Significant improvements in quality of life and in the 12-min walking distance were observed. We conclude that weekly CV improves blood gases, inspiratory muscle strength, and clinical conditions of patients with chronic air-flow limitation and chronic hypercarbia, probably because of correction of chronic inspiratory muscle fatigue.