Browsing by Author "Jorquera Arévalo, Jorge Antonio"

Now showing 1 - 6 of 6
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    CPAP in patients with obstructive sleep apnea and type 2 diabetes mellitus: Systematic review and meta-analysis
    (2018) Labarca, Gonzalo; Reyes, Tomas; Jorquera Arévalo, Jorge Antonio; Dreyse, Jorge; Drake, Lauren
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    Differences between manual and automatic analysis in determining the severity of obstructive sleep apnea using home sleep apnea testing
    (2018) Labarca, Gonzalo; Dreyse, Jorge; Salas, Constanza; Contreras, Andrea; Nazar, Gonzalo; Gaete, Maria I.; Jorquera Arévalo, Jorge Antonio
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    Extrapulmonary effects of continuous airway pressure on patients with obstructive sleep apnoea: protocol for an overview of systematic reviews
    (2017) Labarca, G.; Ortega, F.; Arenas, A; Reyes, T.; Rada G., Gabriel; Jorquera Arévalo, Jorge Antonio
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    Neumonía cavitada por Rhodococcus equi en paciente inmunocomprometido no infectado por virus de inmunodeficiencia humana: caso clínico y revisión
    (Sociedad Chilena de Infectología, 2005) Rabagliati Borie, Ricardo Miguel; Morales Soto, Arturo Javier; Baudrand Biggs, René; Jorquera Arévalo, Jorge Antonio; Oddo Benavides, David; García Cañete, Patricia; Carmona P., M. Cecilia; Cisternas Martínez, Marcela Carolina; Huete Garín, Alvaro
    Rhodococcus equi, es un bacilo grampositivo intracelular que causa infecciones mayoritariamente en pacientes inmunodeprimidos. Reportamos el caso de una mujer de 52 años, en tratamiento de lupus eritematoso sistémico, con historia progresiva de 10 meses de evolución caracterizada por tos, disnea progresiva, expectoración muco-purulenta, ocasionalmente hemoptoica, fiebre intermitente, y pérdida de peso del 10%. Tuvo respuesta parcial a diversos cursos de tratamiento antimicrobiano y el seguimiento radiológico evidenció la aparición de múltiples focos de consolidación bilaterales, algunos de ellos nodulares. El estudio microbiológico de un lavado broncoalveolar y de una biopsia pulmonar percutánea permitió la identificación de R. equi y la histología de la biopsia pulmonar fue compatible. Recibió tratamiento antimicrobiano bi-asociado prolongado con buena respuesta clínica y radiológica. Se debe considerar este agente en el estudio de pacientes inmunocomprometidos que cursan con neumonías de evolución prolongada.
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    Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD
    (EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2005) Diaz, O; Begin, P; Andresen, M; Prieto, ME; Castillo, C; Jorquera Arévalo, Jorge Antonio; Lisboa, C
    To assess the clinical impact of noninvasive mechanical ventilation (NIMV) on stable hypercapnic chronic obstructive pulmonary disease, changes in exercise capacity, dyspnoea and simple physiological parameters were evaluated. The time course of these effects during treatment and recovery was also assessed.
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    Successful treatment of severe hepatopulmonary syndrome with a sequential use of TIPS placement and liver transplantation
    (2009) Benitez, Carlos; Arrese, Marco; Jorquera Arévalo, Jorge Antonio; Godoy, Ivan; Contreras, Andrea; Loyola, Soledad; Pilar Dominguez, P.; Jarufe, Nicolas; Martinez, Jorge; Perez-Ayuso, Rosa Maria
    Hepatopulmonary syndrome (HPS) is a complication of portal hypertension (PH) defined by the presence of liver disease, abnormal pulmonary gas exchange and evidence of intrapulmonary vascular dilatations (IPVD) producing a right to left intrapulmonary shunt. Liver transplantation (LT) is the treatment of choice; however, severe hypoxemia may contraindicate LT. The use of transjugular intrahepatic portosystemic shunts (TIPS) could be effective in HPS, although available data is limited. Aim: To report a clinical case of severe HPS treated sequentially with TIPS and LT. Case report: A 46 year old female cirrhotic patient presented with rapidly progressive dyspnea, hypoxemia (PaO2 60 mmHg, SaO(2) 92%) and increased alveolar-arterial oxygen gradient (A-a) (46 mmHg). She also had orthodeoxia (SaO(2) 87% in sitting position, but 91% in a prone position). A CT scan and pulmonary angiography were normal. Spirometric assessment showed a mild restrictive pattern and a desaturation was observed in a six-minute walking test. Contrast-enhanced echocardiography (CEE) showed intrapulmonary shunting. A HPS was diagnosed and liver transplantation was disregarded due to severe hypoxemia. The patient underwent TIPS placement. After four weeks, a significant improvement of dyspnea and a complete remission of orthodeoxia were seen. One year later, the patient was successfully transplanted. Interestingly, six months after LT, and in the absence of dyspnea, a new CEE showed persistent passing of bubbles to the left cavities. Comments/Conclusion: Persistent right-to-left shunt after TIPS placement and liver transplantation in spite of the improvement of pulmonary function tests suggests long-term persistence of structural changes in the pulmonary vascular tree after liver transplantation. Because of lack of data, it is not possible to recommend the routine use of TIPS as a part of the conventional management of HPS. However, in patients with severe hypoxemia TIPS placement can reasonably be used as a bridge towards transplantation.