PubMed Health⌕ Search

Biomedical subjects

C Domingo Ribas

Publications and source records attributed to C Domingo Ribas.

8 recordsLinked to original sources
PubMed2001

[Effectiveness and efficiency of an outpatient clinic for corticosteroid-dependent asthmatics].

OBJECTIVE: To evaluate the efficacy and efficiency of a specialist outpatient clinic for corticosteroid-dependent asthmatics. The clinic was supervised by the respiratory medicine service of a reference hospital. MATERIAL AND METHODS: The first 20 consecutive patients (mean age 58.1+/- 9.5 years; 14 women, 6 men) treated at a specialist outpatient clinic for corticosteroid-dependent asthmatics were studied, with prospective follow-up of 12.33 +/- 4.6 months. The following variables were examined: a) forced spirometry (FS), b)corticosteroid doses, c) number and cost (NC) of visits to the outpatient clinic, d) NC of FS, e) NC of emergency room visits, f) NC of hospitalizations, g)cumulative cost of health care generated by these patients within the National Health Service of Catalonia (NHSC). The results were compared with those recorded in each patient's history. RESULTS: Findings were a) improved FEV1 (55.1 +/- 21.6% vs.60.1 +/- 21%, p = 0.02); b) decreased corticosteroid use (21.9 +/- 11.2 mg vs. 12.8 +/- 6.0 mg, p < 0.0001);c) statistically significant increase in NC to the outpatient clinic and NC of FS; d) statistically significant decrease in number of visits to emergency services and hospitalizations;e) reduced total cost of health care for these patients borne by the NHSC, which went from 4,400,070 Spanish pesetas to 1,171,157 Spanish pesetas. A hospital deficit of nearly 2,000,000 Spanish pesetas was canceled. CONCLUSIONS: Changing the system for delivering health care to these patients has led to improved care (effectiveness) and a noteworthy reduction in cost (efficiency). We conclude that medical specialists should play an important role in reorganizing the present health care system of the NHSC.

Adrenal Cortex Hormones↗
PubMed1999

[Efficiency of methotrexate in the treatment of cortico-dependent asthmatic patients].

OBJECTIVE: To evaluate the efficiency of low doses of methotrexate as corticosteroid sparing agent in asthmatic patients requiring long term corticosteroid therapy. METHODS: A prospective study was conducted with seven adult patients and one female pediatric patient suffering from corticosteroid-dependent bronchial asthma. The minimal stabilization time for each patient before initiating treatment with MTX was 3 months. The administered dose of methotrexate was 10 mg/week p.o. for adult patients and 15 mg/week for the pediatric patient. Dose tapering of methyl-prednisolone both during the stabilization and therapy periods was a 2 mg decrease every two weeks provided that no worsening in FEV1 higher than 5% occurred. RESULTS: For the group of adult patients, the stabilization time was 5.6 +/- 2.7 months. Methyl-prednisolone dose during the stabilization period could be decreased from 15.0 mg down to 25.4 +/- 12.0 mg (p = 0.013). The period of treatment of methotrexate was 7.3 +/- 3.4 months and the dose of methyl-prednisolone could be decreased from 25.4 +/- 12.0 mg down to 12.0 +/- 11.9 mg (p < 0.001). In the pediatric patient, the deflazacor dose was decreased from 60 down to 30 mg/day during treatment with methotrexate. In all patients a significant decrease could be obtained in the MP dose during treatment with methotrexate with no decrease in FEV1. No secondary effects were observed with the exception of a labial herpes in the pediatric patient. CONCLUSIONS: The administration of one single weekly dose of methotrexate 10 mg in adults and 15 in one pediatric patient allowed for a decrease of approximately 50% in the glucocorticosteroid dosage in this group of patients with corticosteroid-dependent bronchial asthma with no relevant adverse reactions during therapy.

Adolescent↗