Biomedical subjects

A Arnedillo

Publications and source records attributed to A Arnedillo.

6 recordsLinked to original sources

PubMed2006

Staff training influence on non-invasive ventilation outcome for acute hypercapnic respiratory failure.

BACKGROUND: Although non-invasive ventilation (NIV) efficacy in the treatment of acute hypercapnic respiratory failure (AHRF) have been previously demonstrated, not all the studies reveal this fact in the same degree, with some variability in the results. This study aimed to analyse variables related to NIV outcome for AHRF. METHODS: A group of consecutive patients requiring NIV due to AHRF were included in a prospective observational cohort study performed in conventional wards. Variables considered included those reported in the literature, as well as staff problems during the management of the ventilators. The study aimed to include all patients during one year, but after the initial results, it had to be suspended. RESULTS: Fifteen patients were included in the study: 10 males, mean age 68+/-12. APACHE-II score was 17.6+/-6.5. pH and pCO2 before NIV were 7.22+/-0.11 and 110+/-72 mmHg respectively. pH, corticosteroids use, APACHE score, and EPAP were found to influence outcome. Besides, an inadequate use of NIV due to lack of personnel training was detected in all patients with NIV failure (RR 3.5; 95% CI: 1.08-11.2; p = 0.007). In the light of these results, the study had to be suspended and patients were transferred to the respiratory ward. CONCLUSIONS: NIV is a life-saving respiratory treatment influenced by several factors, of which staff training is a key one. Centres attending acute respiratory patients should have an area in which this requirement is fulfilled.

APACHE↗

PubMed2006

Factors related to variability in long-term oxygen therapy prevalence.

OBJECTIVE: To analyse the variability of long term oxygen therapy (LTOT) prevalence according to several organisational and population factors. METHODS: Prospective multicentre survey in 29 public hospitals (population 6,796,964) recording data on the organisational structure of the participating centres and factors related to LTOT prevalence. Official figures were also obtained from local health authorities on the prevalence and cost of LTOT. RESULTS: The overall prevalence of LTOT was 184 per 100000 population (range 71-473). There was a specific unit or staff member for LTOT supervision in 17 (58.6%) centres, giving a lower prevalence (169 vs. 237/ 100000; P = 0.03). The altitude of the participating centres (median 92 m, mean 275 m; range 4-848 m) was found to influence LTOT prevalence (r = 0.73; P = 0.005). In the linear regression analysis, the coefficient of determination for altitude was 0.504. Other factors, such as percentage of population aged over 65 years, the attitude of prescribers towards patients with low adherence, current smokers or those with a PaO2 = 61 mmHg, were not related to LTOT prevalence. CONCLUSIONS: Altitude and the existence of a specific unit or staff member for LTOT supervision significantly influence LTOT prevalence.

Aged↗

PubMed2003

Long-term effects of a maintenance program after supervised or self-monitored training programs in patients with COPD.

The evaluation of a 13-month maintenance program (MP) for 39 severe COPD patients with FEV(1)%pred 44(7)% who, as result of two different 8-week leg exercise training (LET) programs, one supervised at the hospital (group S; n = 20) and the other self-monitored (SM; n = 19), had achieved different levels of exercise tolerance. After LET, patients in group S had a higher maximal oxygen uptake and endurance time than patients in the SM group [ O(2)max 1.43(0.30) l. min(-1)] vs l.25(0.27) l. min(-1) and endurance-time 16(4) min vs 12 (5) min, respectively). During the MP patients were advised to walk vigorously at least 4 km/day, 4 times/wk. After the MP, while endurance time remained higher than at baseline, it had decreased ( p < 0.01) immediately after LET in both groups and no differences were evident between groups (11(4) min and 10(4), respectively). In contrast, Chronic Respiratory Diseases Questionnaire scores, which had improved significantly after LET in both groups, remained high. Long-term effects of MP were independent of the training strategy or whether physiological improvements had been obtained with the initial LET. SM exercise programs do not seem capable of maintaining physiological improvements in exercise tolerance, though "quality of life" can be maintained.

Exercise Therapy↗

PubMed1997

[Congenital pulmonary arteriovenous fistulas].

Pulmonary arteriovenous fistulas are a very infrequent illness. The majority of these cases are associated with hereditary haemorrhagic telangiectasia, therefore their isolated presentation is exceptional. We present a patient that was diagnosed of two arteriovenous fistulas non associated with hereditary haemorrhagic telangiectasia. His main symptom was progressive dyspnea on exertion, with cyanosis and clubbing. His evolution after surgery was satisfactory. Theirs clinical, diagnosis and therapeutic peculiarities ware discussed.

Adult↗

PubMed1997

[Bronchial atresia and bronchogenic cyst in an adult].

We present the case of an asymptomatic patient, with a right paracardiac mass discovered in a preoperative radiologic study. The bronchoscopy showed the intermedius bronchus atresia, finished in bottom of sack, with absence of middle and lower right lobes. With the chest computed tomographic scan, two lobulated contour mediastinal masses were seen. The patient was submitted to surgery, being the pathological findings consistent with bronchogenic cysts with atresia of the intermediarius bronchus. The patient evolved favourably after surgery.

Adult↗

PubMed1994

[Comparative study of 2 diagnostic tests of aspecific bronchial hyperreactivity].

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.

Adolescent↗