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Biomedical subjects

A Pose Reino

Publications and source records attributed to A Pose Reino.

At least 19 recordsLinked to original sources
PubMed2006

Hospital at home for acute respiratory patients.

BACKGROUND: The issue of "hospital at home" (HAH) for acute respiratory patients is one that is still being debated, partly because economic, cultural and health service differences between locations imply that HAH schemes need to be tailored to local situations. The aim of the present study was to analyze the feasibility and effectiveness of HAH for patients with acute respiratory disease at our institution. METHODS: Of all the patients admitted to our institution via the emergency department during a 34-day subject enrollment period, 25 with diagnoses of respiratory infection, pneumonia, pulmonary insufficiency or exacerbated chronic obstructive pulmonary disease who were living within 25 km of our center and who were willing to receive HAH care were assigned to HAH. Fifty sex-matched controls with the same diagnoses were given conventional hospital care (CHC) as inpatients. The dependent variables evaluated included time to discharge, readmissions within 3 months and deaths within 3 months. RESULTS: There were no significant differences between the HAH and CHC groups with regard to age, diagnoses, physical and analytical findings, or co-morbidity, or with regard to deaths (HAH 16%, CHC 10%) or readmissions (HAH 17%, CHC 24%). Time to final discharge was significantly shorter for HAH patients (7 days) than for CHC patients (12 days). Some 95% of the HAH patients were satisfied and would choose HAH again. CONCLUSIONS: HAH seems feasible for appropriately selected acute respiratory disease patients presenting in our emergency department. It frees hospital beds for other patients, its readmission and mortality rates are no higher than for conventional hospitalization, and, in general, it is favorably evaluated by patients.

Journal Article↗
PubMed2006

[COPD, a public health problem].

The fundamental etiologic factor of COPD is tobacco. This has a 9% prevalence in Spain and although this rate is underestimated according to the last studies, COPD generates about 39,000 hospital admissions per year. It has a re-admission rate between 12% and 32%, infections being the fundamental cause. The average care cost per patient from its diagnostic to death is 27,500 euro and we should add a high percentage of employee absenteeism. Due to its chronic aspect, high health care cost and possible improvement of the quality of life of patient, the solution to the problem needs to have a more active involvement of the doctor who attends these patients.

Humans↗
PubMed1997

[Relation between left ventricular hypertrophy and retinal vascular changes in mild hypertension].

BACKGROUND: To evaluate the possible relation between left ventricular hypertrophy and vascular changes in retine, in patients with mild hypertension. PATIENTS AND METHODS: We established a group with 51 hypertensives (27 males and 24 females), with essential mild hypertension, which had never been treated. An ambulatory monitoring blood pressure, 24 hours electrocardiographic monitoring, echocardiography and funduscopy were realized to all of them. RESULTS: Fifty-five per cent of the hypertensives had retinopathy grades I-II. We established two subgroups with and without retinopathy. The age, systolic, diastolic and mean blood pressures, so as body mass index higher in the group with retinovascular damage. No significant differences were observed in the ecographic parameters between two subgroups except the interventricular septal thickness (10.5 +/- 2.1 min in the subgroup without vs 11.1 +/- 2.3 mm in the subgroup with retinovascular damage) (p < 0.05). As 24-hour maximum and mean systolic and diastolic blood pressure, daytime mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), daytime and night-time DBP load, as daytime SBP load were higher in the hypertensive patients with retinovascular changes. There was echocardiographic left ventricular hypertrophy in 51% of the hypertensive patients, without differences between both subgroups of hypertensive patients. Body mass index (g/m) correlated significantly (p < 0.01) with the retinovascular damage. In the multivariant analysis, male as well as female, the funduscopy correlated with left ventricular mass index (g/m2). We established a discriminant function to separate hypertensives with and without left ventricular hypertrophy and another to separate hypertensives with and without retinopathy. Both functions included body mass index and maximum SBP, so as daytime SBP load and nighttime mean DBP to the left ventricular hypertrophy function. CONCLUSIONS: Left ventricular hypertrophy and retinovascular damage appear early in the course of blood pressure elevation and both changes develop in parallel. Our results indicate that there exists a relation between both cardiac and vascular changes in the hypertension. Body mass index and maximum SBP, appear to be important determinants of structural adaptation in mild hypertension.

Body Mass Index↗
PubMed1997

Evolution of left ventricular hypertrophy and function during long-term treatment of systemic hypertension with enalapril.

Continued treatment of hypertensive patients with enalapril reduced left ventricular (LV) hypertrophy steadily over a period of 5 years (by which time gross structural parameters were normal) and produced no further reduction during the following 2 years. Temporary suspension of treatment after 5-year follow-up gave rise to an increase in blood pressure, and to deterioration of LV isovolumic relaxation time and deceleration of the ventricular filling E wave, both of which chiefly reflect the active relaxation of the ventricle.

Adult↗
PubMed1996

[Left ventricular structure and (systolic and diastolic) function in hypertensive patients without atherosclerotic coronaropathy].

INTRODUCTION AND OBJECTIVES: Electrocardiographic (ECG) ST-T segment abnormalities in hypertensive patients are traditionally associated with hypertrophy and/or ischaemia and a higher cardiovascular risk. Hypertensive patients with typical or non-typical chest discomfort and a normal coronarographic study underwent an echocardiographic and Doppler study in order to assess left ventricular structure and (systolic and diastolic) function. MATERIAL AND METHODS: Hypertensive patients with ST-T changes were classified as follows: Control group (CG) was made up of 12 hypertensive patients (6 women, 6 men, mean age 59.6 +/- 7.4 years) with normal ECG; Group A (GA), 10 patients (6 women, 4 men, mean age 63.1 +/- 6.8 years) with ECG image of strain; Group B (GB) (9 women and 8 men, mean age 61.3 +/- 10.1 years) with other ST-T alterations. We assessed by echocardiographic and transmitral flow Doppler study left ventricular structure and (systolic and diastolic) function. RESULTS: Interventricular septum thickness, left ventricular posterior wall thickness, left ventricular mass and mass index were significantly higher in the GA and GB than in the CG, without differences between GA and GB groups. No differences in left ventricular systolic function parameters were observed between the groups. In comparison with the CG, the GA and GB showed significant differences in E wave deceleration velocity and deceleration time, A wave deceleration time and isovolumetric relaxation time. Between GA and GB differences were observed in A wave deceleration time and isovolumetric relaxation time. CONCLUSIONS: In hypertensive patients without atherosclerotic coronaropathy, ST-T changes identify a group with greater left ventricular mass and worse left ventricular diastolic function. The patients with a ST-T strain pattern showed the impaired diastolic function.

Aged↗
PubMed1995

[Electrocardiographic patterns in hypertensive patients without atherosclerotic coronary disease. Influence of the left ventricular mass].

BACKGROUND: ECG ST-T segment abnormalities in hypertensive patients are traditionally associated with hypertrophy or ischaemia. Hypertensive patients with abnormalities in ST-T segment in DI, aVL and/or V5-V6 underwent an echocardiographic study in order to assess left ventricular structure. All of them, in addition to the electric changes, showed typical or non-typical thoracic discomfort, showing a normal coronariographic study. METHODS: Hypertensive patients with ST-T segment changes were classified as follows: group A, 12 patients (8 women, 4 men, mean age 63.6 +/- 7.2 years) with ECG image of left ventricular overload pattern; group B, 9 patients (3 men, 6 women, mean age 62.3 +/- 6.3 years) with flat ST segment depression; and group C, 10 patients (3 men, 7 women, mean age 62.4 +/- 9.7 years) without changes on the ST-T segment with flat or negative T wave. Control group is made up 12 hypertensive patients (7 women, 5 men, mean age 61.6 +/- 7.6 years) with normal ECG. We assess by echocardiography interventricular septal thickness (IVST) and left ventricular posterior wall thickness (PWT) in mm, left ventricular end-diastolic diameter (DTD) in mm, left ventricular mass (LVM) in grs, and the mass index (MI) in g/m2. RESULTS: IVST, PWT, LVM and MI were significantly (p < 0.05) higher in the groups A, B and C than in the control group. No statistically significant differences were observed between the A, B and C groups. Stepwise discriminant analysis showed that the only parameter with independent value for discriminating between control, group and group ABC (the union of groups A, B and C) was IVST. CONCLUSION: In hypertensive patients without coronariopathy, ST-T changes identify a group with greater left ventricular mass. The different electrocardiographic patterns considered were not associated with a significantly different left ventricular mass.

Aged↗
PubMed1995

Left ventricular systolic function after marked reduction of ventricular hypertrophy induced by 5 years' enalapril treatment.

OBJECTIVES: To determine the effects of long-term treatment of essential hypertension with an angiotensin-converting enzyme inhibitor as regards arterial pressure at rest and during exercise, left ventricular mass and functional sequelae. PATIENTS AND METHODS: Twenty-six patients with previously untreated essential hypertension took enalapril 20 mg twice daily for 5 years. Cardiovascular parameters were determined by two-dimensionally guided M-mode echocardiography in a pre-treatment placebo phase, 8 weeks and 1, 3 and 5 years after the start of therapy, and 8 weeks after drugs were discontinued. RESULTS: Therapy reduced resting arterial pressure from 156/105 to 128/84 mmHg (P < 0.001) and arterial pressure during exercise from 205/113 to 172/94 mmHg (P < 0.0011). After 1, 3 and 5 years' therapy, left ventricular mass index had decreased by 15, 28 and 39% respectively (P < 0.001 in each case). Eight weeks after treatment was halted, arterial pressure at rest and during exercise had returned to pre-treatment values, but decreased left ventricular mass was maintained. Left ventricular pump function had improved after 5 years' treatment, and this improvement was maintained during the 8 weeks without treatment. CONCLUSIONS: Significant reductions in arterial pressure at rest and during exercise were achieved by 8 weeks' treatment with enalapril and maintained during 5 years' further treatment, while a marked reduction in left ventricular mass took place progressively throughout the 5 year period. Reduction of myocardial hypertrophy by enalapril appeared to be beneficial rather than detrimental to cardiac pump performance.

Adult↗
PubMed1995

[The midterm inefficacy of 2 different dosages of chlorthalidone (50 and 25 mg/day) in the regression of left ventricular mass in arterial hypertension].

BACKGROUND: To evaluate the antihypertensive efficacy at rest and under exercise, and the modifications induced on the left ventricular mass in patients treated with two different doses of a diuretic. METHODS: Fifty hypertensive males, mean age 51 years, received during nine months 50 mg/day of chlortalidone and thirteen 25 mg/day for the next nine months. Baseline tension control and echocardiogram and each three months after starting therapy during the two phases of the study were performed. Thickness of the interventricular septum and posterior left ventricular wall in mm, left ventricular mass index in g/m2 were determined. RESULTS: The baseline septum was 15 +/- 3.3 mm, 14.6 +/- 3.1 mm at 9 months and 14.5 +/- 2.9 mm at 18 months, the posterior wall was 14.1 +/- 3.1 mm at baseline, 13.7 +/- 2.9 mm at 9 months and 13.6 +/- 2.9 mm at 18 months. The left ventricular mass index was 153 +/- 45 g/m2 at baseline, 146 +/- 36 g/m2 at 9 months and 144 +/- 39 g/m2 at 18 months. The antihypertensive efficacy at rest and under exertion was similar for the two doses of chlortalidone. CONCLUSIONS: After nine months of therapy the two doses of chlortalidone (50 and 25 mg/day) failed in reducing left ventricular mass. However, the design of the study and the small number of subjects enrolled introduce several important limitations to both the interpretation of our results and conclusions.

Aged↗
PubMed1993

[Comparative study of the lipid profiles in the health staff versus the non-health staff at a health center].

Levels of cholesterol (CT) and lipoproteins fractions (c-LDL and c-HDL), as well as the atherogenic index (CT/c-HDL), were assessed in 307 workers of a health center. The study population was classified into groups, based on age and sex and whether they were health (physicians, registered nurses, clinical assistants) or non-health staff. The lipidic profile of the health staff groups was similar to the profile of non-health staff groups of the same age and sex. The percentage of subjects with CT above 200 mg/dl. was significantly higher (79.6 vs 60.9%) (p < 0.05) among the male health staff versus the male non-health staff and lower among the female health staff versus the female non-health staff (34.5 vs 55.5%) (p < 0.05). The differences in the lipidic profile depending on age and sex were confirmed grouping the population on the basis of such criteria. We highlight that all groups, with the exception of the female health staff, had CT levels above those recommended by the WHO and we stress the need of making health professionals aware of the importance of a primary prevention plan for the control of the cholesterolemia.

Adult↗
PubMed1990

[Dyslipemia in physicians. The need for a plan of primary prevention of atherosclerosis in our country].

A comparative study of the total cholesterol (TC) and its fractions was carried out in 3 groups of males. The first group consisted of (C) 53 healthy males (18 between 30-39 years old, 17 between 40-49 and 18 between 50-65); the second group (M) was of 57 male doctors (19 between 30-39 years old, 21 between 40-49, and 17 between 50-65); third group (E) was of 94 males with myocardial infarction (22 between 30-39 years old, 32 between 40-49, and 40 between 50-65). TC was significantly lower (p less than 0.02 and p less than 0.001) in both the lower ages ranges in Group E compared to Groups C and M in all age ranges. Group M showed significantly lower (p less than 0.001) in Group E compared to Groups C and M in all age ranges. Group M showed significantly lower HDL-C (p less than 0.01) and to group M in the lowest age range (p less than 0.005). LDL-C was significantly higher (p less than 0.001) in Group M compared to C in the higher age range. VLDL-C was higher (p less than 0.05) in Group E compared to C in both the higher age ranges (p less than 0.05) as well as to the middle age range of Group M (p less than 0.05). The indexes TC/HDL-C and LDL-C/HDL-C were significantly higher in Group E compared to Groups C and M in all age ranges. These indexes were significantly higher (p less than 0.01 and p less than 0.05) in Group M compared to group C in all age ranges.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗