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Biomedical subjects

E Farrero

Publications and source records attributed to E Farrero.

8 recordsLinked to original sources
PubMed1998

Proxy-perceived prior health status and hospital outcome among the critically ill: is there any relationship?

OBJECTIVES: To measure the health status of critically ill patients prior to hospital admission and to study the relationship between prior health status (PHS) and hospital mortality. DESIGN: 523 patients admitted to the intensive care department from October 1994 to June 1995 were included consecutively in the study. Health status 3 months prior to admission was assessed retrospectively by proxies using the EuroQol 5D (EQ-5D) and the Karnofsky Performance Status Scale (KF). Patients were classified into four admission categories: trauma injury, scheduled surgery, unscheduled surgery and other medical conditions. SETTING: Department of Intensive Medicine, University Hospital of Bellvitge, Barcelona, Spain. PATIENTS: 84 trauma injury patients, 239 scheduled surgery patients, 57 unscheduled surgery patients and 143 patients with other medical conditions. INTERVENTIONS: The descriptive system and visual analogue scale (VAS) of the EQ-5D and the K.F. MEASUREMENTS AND MAIN RESULTS: Using proxy responses we found that trauma injury patients had the best PHS and scheduled surgery patients the worst. There were statistically significant differences in mean VAS scores and all EQ-5D dimensions, except self-care, when trauma injury patients or scheduled surgery patients were compared with the other admission categories. No significant differences were found on these variables between unscheduled surgery patients and medical patients. We found no statistically significant differences in PHS health status between patients who died and those who survived, either within each admission category or in the sample as a whole. CONCLUSIONS: The PHS of critically ill patients varied according to admission category. Given the instruments used and population studied, there was no association between PHS and hospital outcome.

Adult↗
PubMed1998

[Usefulness of home visits in the control and evaluation of the appropriate use of home continuous oxygen therapy].

The aim of this study was to determine the usefulness of home visits to monitor and evaluate the appropriate use of domiciliary oxygen therapy (DOT). Appropriateness was based on the coincidence of circumstances needed to predict benefit from DOT: appropriate indications correct hypoxemia and patient compliance. All patients receiving DOT residing in the town of L'Hospitalet (Barcelona) in June 1994 were enrolled. During a home visit to each patient a questionnaire was administered and spirometric variables, CO in exhaled air and pulse oximetry were recorded. If DOT was not considered appropriate, the patient was referred to the hospital clinic for reevaluation of the prescription. One hundred twenty-eight patients (74% men) were visited. Mean age was 68 years. Use of DOT was seen to be appropriate in only 26% of patients. The prescription of DOT was considered strictly correct in 73 patients (49%); 13 of them were seen to have continued smoking. Of the 60 remaining patients, hypoxemia was correct with oxygen therapy in 46, and of these only 33 complied with DOT. The home visit combined with hospital monitoring allowed us to withdraw DOT from 20 patients, for whom the indications had been incorrect, and to introduce changes in oxygen supply sources for 16 patients who carried pumps. Fourteen started using a concentrator and 2 began using liquid oxygen. Periodic review is necessary for optimal treatment of DOT. The home visit is a good tool for improving DOT follow-up, as it allows the patient to be assessed in the setting where DOT is really applied. It is a monitoring method that is well accepted by the patient.

Aged↗
PubMed1998

Long-term mechanical ventilation in amyotrophic lateral sclerosis.

BACKGROUND: Acute respiratory insufficiency (ARI) with alveolar hypoventilation or incapacitating dyspnoea but without peripheral muscle involvement can be an early manifestation of respiratory involvement in amyotrophic lateral sclerosis (ALS). Some of these patients benefit from assisted ventilation. The object of this study was to analyse the results of long-term mechanical ventilation (LTMV) in ten patients with ALS. METHODS: A retrospective analysis of intensive care unit (ICU) or ambulant patients with ALS who underwent LTMV in a conventional hospital ward was performed. Erect and supine spirometry, blood gas analysis and pulse oximetry were performed before the start and during the course of ventilation. RESULTS: Ten patients on LTMV were included. Four from the ICU were ventilated via tracheostomy, and six ambulant patients had non-invasive (nasal) ventilation. In all cases, ventilation was performed in a conventional hospital ward. The ambulant patients improved symptomatically during ventilation, confirmed by measurement of gas exchange and of SaO2 by continuous pulse oximetry. Three of the ten patients survive in long-term care--two with nasal and one with tracheostomy ventilation. CONCLUSIONS: LTMV outside ICU was possible in ten patients, seven of whom returned home. Returning home is very difficult for patients dependent on a ventilator who lack family support.

Amyotrophic Lateral Sclerosis↗
PubMed1994

Tuberculous pleural effusion: experience with six months of treatment with isoniazid and rifampicin.

BACKGROUND: Tuberculous pleurisy is associated with small numbers of bacteria. Due to the low rate of primary resistance to antituberculous drugs a two-drug regimen was used to treat the condition. METHODS: Patients received isoniazid 5 mg/kg and rifampicin 10 mg/kg daily for six months. Clinical, radiological, and haematological assessments were performed during treatment and patients were followed up for a median period of 41 (range 6-96) months. RESULTS: One hundred and thirty patients were studied with a mean age of 27 (range 11-53) years. Seven were withdrawn due to parenchymal disease and eight were lost to follow up during the treatment period. Side effects during treatment were frequent (20.7%), but only three patients required a change in medication. No treatment failures were observed. One hundred and fifteen patients completed therapy and were followed up for 41 (range 6-96) months with no evidence of a relapse. CONCLUSIONS: Tuberculous pleurisy responds well to a two-drug regimen of antituberculous therapy given for six months.

Adolescent↗
PubMedDate not supplied

Inhaled steroids treatment and withdrawal in asthmatic children.

Twenty young mild asthmatics (age range 7-22 yrs) were studied in order to determine the time course of bronchial hyperresponsiveness during inhaled steroid treatment and after steroid withdrawal. Study has been divided in three periods: Baseline (two weeks), Treatment (eight weeks) and placebo (eight weeks). Inhaled budesonide was administered during treatment period at a doses of 0.4 or 0.6 mg/ml twice a day, depending on age. After withdrawal, placebo was administered in the same way. Bronchial responsiveness (BR) to exercise was estimated trough the Bronchial Lability Index (BLI) defined as the amplitude of change of peak expiratory flow rate in a percentage related to the basal during a free running test. A BLI higher than 20% defined Bronchial Hyperresponsiveness (BHR). All patients presented BHR during the baseline period. Forced spirometry and exercise tests were performed every two weeks throughout the study. No changes in spirometric parameters (FVC, FEV1) were observed either during treatment or during placebo periods. A highly significant decrease in BR to exercise was observed during active drug treatment (BLI = 32.4 +/- 3.1 to 8.2 +/- 0.7 from basal to the end of the two months treatment period, mean +/- sd). During the placebo period 10/17 patients increased BLI to near baseline values, and 7/17 patients remained at normal levels. This behaviour was related to the severity of asthma during infancy. Our results confirm the close association between inflammation and BHR.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗