Browsing by Author "Caviedes, Ivan"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Intracardiac metastasis of lung adenocarcinoma diagnosed by convex-probe EBUS(2014) Rey, Diana; Labarca, Gonzalo; Caviedes, Ivan; Fernández-Bussy, SebastiánConvex-probe endobronchial ultrasound (CP-EBUS) identified a vascularised 30 mm lesion, along the right pulmonary vein extending into the LA (figure 2). Needle aspiration was performed to the described mass and to the subcarinal lymph node. Both biopsies results were positive for lung adenocarcinoma, immunohistochemistry showed positive thyroid transcription factor-1(TTF-1), molecular analysis demonstrated a negative epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK). The patient started chemotherapy, anticoagulation and localised radiotherapy in her right hip. Cardiac metastasis of lung cancer usually involves the pericardium or epicardium by direct invasion and/or lymphatic spread, however metastasis to the LA myocardium and endocardium are extremely rare.1 Lesions in the LA and proximal portions of great arteries can be visualised by CP-EBUS.Item Ultrasonografía bronquial con aspiración por aguja fina en el estudio lesiones adyacentes a la vía aérea central(Sociedad Medica de Santiago, 2016) Fernández-Bussy, Sebastián; Labarca, Gonzalo; Caviedes, Ivan; Folch, Erik; Majid, AdnanBackground: Endobronchial ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure with a high diagnostic yield for lesions adjacent to the central airway. Aim: To describe the diagnostic yield of EBUS-TBNA for lesions suspicious of Non-Small Cell Lung Cancer (NSCLC). Material and Methods: Prospective study of 128 patients aged 25 to 87 years (56% males) undergoing EBUS-TBNA. Radiological features of the lesions were recorded by chest CT scan such as morphology, margins of the lesion, lesion size and location based on the International Association for the Study of Lung Cancer (IASLC) map. Definitive pathological results were evaluated. Results: The average size of lesions was 18.5 millimeter and; 68 cases were of less than 20 millimeters. Sensitivity was 96.7%, specificity 100%, and negative predictive value 93.3%. The most common histological diagnosis was adenocarcinoma. Conclusions: EBUS-TBNA is a useful diagnostic tool for NSCLC suspicious lesions adjacent to the central airway.Item Ventilatory Inefficiency as a Limiting Factor for Exercise in Patients With COPD(American Association of Respiratory Care, 2012) Caviedes, Ivan; Delgado, Iris; Soto, RodrigoBACKGROUND: Ventilatory inefficiency increases ventilatory demand; corresponds to an abnormal increase in the ratio of minute ventilation (V̇E) to CO2 production (V̇CO2); represents increased dead space, deregulation of respiratory control, and early lactic threshold; and is associated with expiratory flow limitation that enhances dynamic hyperinflation and may limit exercise capacity. OBJECTIVE: To evaluate the influence of ventilatory inefficiency over exercise capacity in COPD patients. METHODS: Prospective study of 35 COPD subjects with different levels of severity, in whom cardiopulmonary stress test was performed. Ventilatory inefficiency was represented by the V̇E/V̇CO2 relation. Its influence over maximal oxygen consumption (V̇O2max), power (W), and ventilatory threshold was evaluated. Surrogate parameters of cardiac function, like oxygen pulse (V̇O2/heart rate) and circulatory power (%V̇O2max × peak systolic pressure), were also evaluated. RESULTS: Cardiopulmonary stress test was stopped due to dyspnea with elevated V̇E and marked reduction of breathing reserve. A severe increase in V̇E/V̇CO2 (mean ± SD 35.9 ± 5.6), a decrease of V̇O2max (mean ± SD 75.2 ± 20%), and a decrease of W (mean ± SD 68.6 ± 23.3%) were demonstrated. Twenty-eight patients presented dynamic hyperinflation. Linear regression showed a reduction of 2.04% on V̇O2max (P < .001), 2.6% on W (P < .001), 1% on V̇O2/heart rate (P = .049), and 322.7 units on circulatory power (P = .02) per each unit of increment in V̇E/V̇CO2, respectively. CONCLUSIONS: Ventilatory inefficiency correlates with a reduction in exercise capacity in COPD patients. Including this parameter in the evaluation of exercise limitation in this patient population may mean a contribution toward the understanding of its pathophysiology.