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F Ruiz Laiglesia

Publications and source records attributed to F Ruiz Laiglesia.

9 recordsLinked to original sources

[Syncope: many studies and few diagnoses?].

INTRODUCTION: Syncope is a frequent disorder shows diagnostic difficulties, so that an important percentage of patients remain without diagnosis after the implementation of diagnostic tests that sometimes are unnecessary. METHOD: A retrospective analysis of the patients admitted during a period of two years because of syncope in an Internal Medicine Service was carried out. RESULTS: Of a total of 2,878 patients hospitalized during the years 1999 and 2000, 79 were admitted because of syncope (2.74%). Forty-five (57%) were men and 34 (43%) were women, with a median age of 68.8 years. Twenty-seven patients (34%) had history of syncope. After a median hospitalization of 9.5 days, the etiological diagnosis was established in 53 (67%) patients: in 25 patients (31.6%) the syncope was mediated by neurological mechanisms, in 16 (20.25%) it was of cardiology origin, in 4 (5.06%) it was of neurological origin and in 8 (10.1%) the syncope was secondary to other causes. In 54 patient (68.8%) at least one cardiology test was carried out (41 Holter, 32 echocardiograms, 6 tilt board tests, 3 maneuvers of massage of the carotid sinus, 3 ergometry studies, 3 electrophysiological studies, 2 coronary angiographies and 3 ventilation perfusion lung gammagraphies). In 51 patient (64%) at least one neurological test was carried out (31 EEG, 42 CT, 2 MNR, 1 Doppler cranial ultrasound and 3 electroneuromyogram). Only 4 of the Holter carried out were diagnostic, as well as 3 of the echocardiograms and only 2 of the CT carried out. No EEG was useful for the etiological diagnosis of the syncope. CONCLUSIONS: There is an excessive utilization of some diagnostic tests (EEG, Holter, cerebral CT), in spite of which in an important percentage of patients with syncope the etiological diagnosis is no done (33%). The use of diagnostic algorithms based on detailed clinical history, physical exploration and assessment of the ECG is proposed, that they would make it possible to issue a diagnostic hypothesis from which there could be begun the diagnostic study with a use as rational as possible of the complementary examinations.

Adolescent↗

[The length of stay in hospital emergency medical care].

The length of stay in emergency services has been considered as a quality control and evaluation index of emergency care. The impact of several factors on its magnitude is analyzed. The age of the patient, the time of admission, the performance of complementary explorations (simple radiology, analytic tests, abdominal echography), as well as the disease group including the diagnosis of the emergency service, significantly modify the length of stay. The age and performance of such tests seem to be the most relevant factors, although they may not be independent. The length of stay of the patients in the emergency service may be shortened by reducing the complementary explorations just to the ones mentioned above. The adequacy of the functional organization, the material and human resources, as well as the adequate staff skills and attitudes, may also reduce the length of stay of these patients in the hospital emergency care.

Chi-Square Distribution↗

[Febrile syndrome in hospitalized patients].

This study was designed to ascertain if certain characteristics of febrile patients could help to identify infectious or bacteremic conditions. Patients with axillary temperature higher than 37,4 degrees C visiting the emergency room and requiring hospitalization were included in the study. The sample included 345 patients. Infections made up 89% of the causes of fever. The most frequent site of infection was the respiratory system (39%). 13% of hemocultures were positive. Gram negative germs were the most frequent agents. Infectious FS was related with the presence of predisposing factors, duration of fever, erythrocyte sedimentation rate and hemoglobin. Bacteremia was associated to treatment prior hospitalization, average temperature, hemoglobin, AST and urinary sediment. We may conclude that infections are the most frequent cause of FS. We could not found any clinical or analytical parameters that, used together, could help us to identify infectious or bacteremic FS.

Adolescent↗

[Effect of age, nutritional status and tumor extension on various immunologic parameters in cancer patients].

We studied cellular immune (total lymphocytes, lymphocytary populations and delay hypersensitivity skin tests) and humoral (immunoglobulins and complement) response, as well as nutritional status (anthropometric and biochemical para meters), antitumoral treatment. The effect of tumoral extension, nutritional status and age on immunity was assessed. We have demonstrated a poor relationship between the cellular immunological response and the extension of neoplasia, a moderate effect of age and a significant impact of nutritional status.

Age Factors↗