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Biomedical subjects

G Rodrigo

Publications and source records attributed to G Rodrigo.

At least 37 records · Page 2Linked to original sources
PubMed1995

High-dose MDI salbutamol treatment of asthma in the ED.

Beta-adrenergics have long been under special scrutiny because of their potential for cardiotoxicity. To assess the safety of high doses of salbutamol delivered by metered dose inhaler (MDI) with spacer in the emergency department (ED) setting, 11 patients (mean age 33 +/- 12.2 years) with severe acute asthma were studied. All patients were treated with 400 micrograms of salbutamol at 10-minute intervals for 3 hours (1,200 micrograms each 30 minutes or 7,200 micrograms at 180 minutes. There were dose-related significant increases in forced expiratory volume in the first second (FEV1) and peak expiratory flow (PEF) (P < .01), with a net mean increase of 90.4% and 80.1%, respectively. A significant (P < .01) reduction of heart rate was observed with treatment. At the end of protocol, reductions ranged from 7 beats/min to 35 beats/min (mean decrease 10.6 +/- 10.5 beats/min). There was no prolongation in the QTc interval. Mean baseline serum potassium was 4.23 +/- 0.53 mmol/L and decreased nonsignificantly after treatment to 3.99 +/- 0.62 mmol/L. Only 4 patients showed net decreases. There were no significant changes in oxygen saturation and plasma glucose. The mean end-treatment salbutamol level was 10.0 +/- 1.67 ng/mL. These data support the notion that treatment of acute asthma patients in the ED with 2.4 mg salbutamol per hour delivered by MDI and spacer produce satisfactory bronchodilation, low serum concentration, and minimal extrapulmonary effects.

Acute Disease↗
PubMed1994

Early administration of hydrocortisone in the emergency room treatment of acute asthma: a controlled clinical trial.

STUDY OBJECTIVE: To determine whether early administration of a single dose of intravenous hydrocortisone (500 mg) modified the need for hospitalization and duration of treatment, and improve pulmonary function assessed by subjective and objective criteria of acute asthma patients. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: The emergency room (ER) of a large, urban hospital with primary and referral care responsibilities. PATIENTS: Ninety-eight patients from 18 to 50 years of age with acute bronchial asthma, with a PEFR and FEV1 in the first second below 50% of predicted value (FEV1 mean % of predicted = 27.8 +/- 10.0) and without history of chronic cough or other medical disease. INTERVENTIONS: The corticosteroid group received 500 mg of intravenous hydrocortisone whereas the control group received intravenous normal saline immediately after arrival to the ER. Additional treatment included salbutamol delivered with metered-dose inhaler into a spacer device (Volumatic), in four puffs actuated in rapid succession (100 micrograms per actuation), at 10-min intervals. The final mean dose was 5.7 mg for the steroid group and 5.6 mg for the control one (P = 0.86). Hospitalization was mandatory if total treatment time was greater than 6 h. MEASUREMENTS AND RESULTS: Age, sex, PEFR, FEV1, FVC, symptom index, and corticosteroids use were similar in both groups. FEV1 expressed as mean % of predicted was 54.6 +/- 17.3% in the control group and 54.6 +/- 17.4% in the steroid group (P = 0.75). Duration of ER treatment was 2.22 +/- 1.75 h in the corticosteroid group and 2.24 +/- 1.70 h in the control group (P = 0.81). The hospital admission rate was 10.2% for the corticosteroid group and 8.16% for the control group. There were no differences between the groups when patients admitted or discharged were examined separately. CONCLUSIONS: Early administration of corticosteroids does not modify outcome of ER treatment of asthma, and does not improve pulmonary function in the first 6 h of treatment. In accord with this, administration of corticosteroids to these patients could be delayed by several hours without modifying clinical outcome. When an aggressive beta-agonist bronchodilator regimen is used, it obviates the need for steroids in this early stage of treatment.

Acute Disease↗
PubMed1994

Production of a plasmid mediated AmpC-like beta-lactamase by a Klebsiella pneumoniae septicaemia isolate.

A septicaemia Klebsiella pneumoniae isolate from Greece (Ath1) was shown to be resistant to third generation cephalosporins, aztreonam and cefoxitin and this resistance was not decreased in the presence of clavulanic acid. The gene coding for the resistance phenotype, associated with a beta-lactamase showing cephalosporinase activity and a pI of 8.6, could be transferred into Escherichia coli K-12 by conjugation and transformation. DNA-hybridisation showed that this gene was located on two different plasmids, 7.8 and 80 kb respectively. The larger, conjugative plasmid also carried genes coding for another beta-lactamase (pI 6.6) and resistance to aminoglycosides, tetracycline, chloramphenicol and trimethoprim. Under highly stringent conditions the gene coding for the pI 8.6 beta-lactamase hybridised with chromosomal DNA from Citrobacter freundii OS60 but not from E. coli or Enterobacter cloacae. Furthermore, the restriction map of this beta-lactamase gene corresponded to that of ampC from C. freundii OS60. The regulatory ampR gene could not be detected in the plasmid DNA from the Ath1 K. pneumoniae by DNA hybridisation. The relationship between a plasmid-mediated extended spectrum beta-lactamase in a K. pneumoniae septicaemia isolate and chromosomal AmpC beta-lactamase from C. freundii was demonstrated.

Citrobacter freundii↗
PubMed1994

Treatment of acute asthma. Lack of therapeutic benefit and increase of the toxicity from aminophylline given in addition to high doses of salbutamol delivered by metered-dose inhaler with a spacer.

We conducted a randomized, double-blind, placebo-controlled study to determine if intravenous aminophylline adds any benefit to high doses of inhaled salbutamol in patients who presented for treatment of acute asthma. We studied 94 patients (mean age, 35.6 +/- 11.2 years) with moderate to severe acute asthma. All patients received therapy with salbutamol delivered with metered-dose inhaler (MDI) into a spacer device (Volumatic) in four puffs (400 micrograms) at 10-min interval, and intravenous hydrocortisone (500 mg). Patients were randomly assigned to receive either a loading dose of intravenous aminophylline followed by a routine infusion (n = 45) or an equal volume of placebo as a loading dose and infusion (n = 49). The two groups showed no differences in measurements of peak expiratory flow, FEV1, and FVC at baseline and at the end of treatment. However, the patients treated with aminophylline had significantly more adverse effects (p < 0.05). There were no differences in the final mean dose of salbutamol (6.3 +/- 44.5 mg for the placebo group and 5.8 +/- 4.2 mg for the aminophylline group), hospital admission rate (10.2 percent for the placebo group and 9.0 percent for the aminophylline group), and mean duration of Emergency Department treatment (2.5 +/- 1.83 h for the placebo group and 2.37 +/- 1.75 h for the aminophylline group). The results were similar when the patients were divided in accord with the degree of respiratory obstruction (baseline FEV1 < 30 percent of predicted) and theophylline level at 30 min of treatment (placebo group patients with theophylline level < 10 mg/L vs aminophylline group patients with theophylline level > or = 10 mg/L). We conclude that intravenous aminophylline adds to the toxicity but not the efficacy of inhaled salbutamol in the treatment of acute exacerbations of asthma.

Acute Disease↗
PubMed1993

Assessment of the patient with acute asthma in the emergency department. A factor analytic study.

Acute asthma is a very common medical emergency. Thus, a variety of measures are currently used to assess severity; most are logical and seem reasonably effective but have never been scientifically tested in a comprehensive manner. Additionally, simple brief measures are needed for greater specificity in describing variables and in assessing different aspects of asthma. The purpose of this study was to examine the most common clinical and objective measures utilized in the assessment of acute asthma in the emergency department for determining whether these variables comprise separate or distinct dimensions. To carry out the above purpose, we used the multivariate statistical technique of factor analysis. Measures of age, duration of attack, heart rate, respiratory rate, peak expiratory flow (PEF), FVC, FEV1 percent of predicted, accessory-muscle use, dyspnea, wheezing, steroid use, and early response to treatment in 194 patients with acute asthma (mean age = 32.8 +/- 11.9 years) were factor analyzed through the method of principal components. Factors extracted with this method were then rotated orthogonally through the Varimax procedure. The first factor contained the three measures of lung function (PEF, FVC, and FEV1 percent of predicted) and early response of treatment. The second factor extracted contained respiratory rate, accessory-muscle use, and dyspnea. Factor 3 contained heart rate and wheezing, and factor 4 contained age, duration of attack, and steroid use. Exploratory analysis of subgroups (by randomization, by severity of airflow obstruction, and by use of steroids) confirmed the results of the primary analysis. The coefficients of congruence obtained were above 0.90. Early response of treatment measured by the percent variation of FEV1 at 30 min over baseline value significantly correlated with a broad variety of asthma characteristics (PEF, FVC, FEV1 percent of predicted, accessory-muscle use, and duration of attack), resulting in a rather general measure, and suggesting that its measure can be a reliable assessment of acute adult asthma. Finally, early response to treatment was the most important predictor of the patient outcome (r = 0.48, p < 0.00). In summary, the results of this study support the hypothesis that most of the subjective and objective measures utilized in the assessment of patients with acute adult asthma represent separate and nonoverlapping dimensions and provided a useful summary of acute asthma. Early response to treatment in combination with measures of the four identified factors could be included in other acute adult asthma research protocols promoting greater comparable among studies.

Acute Disease↗
PubMed1992

Diagnosis of mycobacterial infections by PCR and restriction enzyme digestion.

A method for the diagnosis of mycobacterial infections by PCR amplification followed by selective restriction enzyme digestion of the PCR product was developed. The amplified DNA sequence used in this study occurs within the gene encoding for the mycobacterial 65 kDa heat shock protein (Hance et al. 1989), which is found in all mycobacteria. However, there are minute differences in the amplified sequence from the Mycobacterium tuberculosis complex compared with the corresponding sequence from the Mycobacterium avium complex. These differences made it possible to rapidly identify to which mycobacterial complex a particular sample belonged by restriction enzyme digestion of the PCR product. A total of 66 samples were tested and all of them were correctly identified. This and similar methods should provide a sensitive, specific and rapid (within 12 h) way of diagnosing mycobacterial infections to the species level.

Animals↗
PubMed1992

Season of birth of schizophrenics in Mississippi, USA.

Prior reviews indicate that schizophrenics tend to be born in the winter, relative to non-psychiatric controls. This conclusion has been criticized, however, as the association between birth seasonality and schizophrenia may be the result of a statistical artifact, the age-incidence effect. To examine this possibility, we studied the birth seasonality of 2892 schizophrenics, controlling for the age-incidence effect. Both before and after instituting these controls, we found excesses for the months of December and March. We conclude that the age-incidence hypothesis does not provide any general explanation of the season-of-birth effect in schizophrenia.

Adolescent↗
PubMed1992

Factor structure of a Spanish version of the Toronto Alexithymia Scale.

A Spanish adaptation of the Toronto Alexithymia Scale (TAS) was factor-analyzed and its factor solution compared with the Canadian version of this test. A principal factor analysis was performed, revealing four factors of alexithymia. These factors are quite similar to those found through factor analysis of the TAS for the Canadian sample. A discussion of the factor structure is presented.

Adolescent↗
PubMed1992

[Typing of human papillomavirus (HPV) in the male and female genitalia].

Diagnosis and typing of HPV was started in November 1990 at the Virology department of the National Health Institute, Lisbon. Eighty one samples from 70 patients were studied, 57 from women observed at the cervico-vulvar out patient unit of the Gynecology department of Sta Maria Hospital, Lisbon, and 13 from male contacts of some of these women. Forty nine women (86%) had colposcopic, histological or cytological evidence of HPV infection. Eleven men (85%) have clinical signs of infection and 2 (15%) had had sexual intercourse with infected partners with clinical evidence of infection. HPV DNA was detected in 43 patients (61%). Forty two were infected with HPV 6/11 (98%) and one with HPV 16 (2%). These preliminary results suggest that genital infection by HPV must also be considered a public health problem in the field of sexually transmitted diseases in Portugal.

Adolescent↗
PubMed1991

Differences between schizophrenics born in winter and summer.

A total of 1814 patients were studied from the Mississippi State Hospital with a DSM-III diagnosis of schizophrenia and aged 15-39 years at the time of admission. The 634 schizophrenics with a birth date between 1 December and 31 March were compared with the 1180 born between 1 April and 30 November for age of admission, race, sex, marital status, duration of initial admission and clinical subtype. The only significant difference between the variables was the duration of the first admission: winter-born patients had a shorter psychiatric hospitalization than summer-born schizophrenics. These findings are discussed in accord with similar studies.

Adolescent↗
PubMed1989

Alexithymia: reliability and validity of the Spanish version of the Toronto Alexithymia Scale.

This study was conducted to explore reliability and validity from the Spanish version of the Toronto Alexithymia Scale (TAS). An alpha coefficient of 0.78, and a test-retest reliability of 0.83 over a 3-week period were obtained. In a sample of 111 college students, TAS correlated strongly and positively with the hypochondriasis subscale of the MMPI and with a somatization disorder questionnaire, but negatively with measures of sociability and psychological mindedness. In addition, factor analysis showed the TAS to have a stable, replicable factor structure. These findings suggest that this Spanish adaptation of the TAS is a psychometrically sound measure of the alexithymia construct.

Adolescent↗
PubMed1988

Effects on memory following a single oral dose of diazepam.

The effects of diazepam on learning and memory were investigated in a double-blind study of 28 Uruguayan university women who were randomly assigned to four treatments, seven subjects each: placebo, 0.1, 0.2, and 0.3 mg/kg diazepam orally. Subjects were presented with five uncategorized and categorized word lists, a 12-digit number list, and a tonal discrimination test, before and up to 200 min after treatment. Immediate and delayed recall were tested. Performance of the 0.1 mg/kg diazepam group did not show significant differences from placebo in any of the tests. For the 0.2 dose group, marginal impairments were noted at 60 min followed by full recovery at 190 min. On the contrary, 0.3 mg/kg diazepam produced significant impairments on immediate and delayed recall, with marginal impairments still evident at 190 min. The finding that diazepam did not impair performance on a tonal discrimination test provided some evidence that memory impairments did not result from failures in general alertness.

Acoustic Stimulation↗
PubMed1988

Factor structure of a Spanish version of the Revised Children's Manifest Anxiety Scale in Uruguay.

The Revised Children's Manifest Anxiety Scale (RCMAS) was translated into Spanish and administered to 1,423 pupils in Grades 1 thru 12 in Uruguay. An orthogonal varimax rotation was performed, which revealed three factors of anxiety. These factors are quite similar to those found through factor analyses in the RCMAS for American children. A discussion of the factor structure and possible use of this instrument in Latin American countries is presented.

Adolescent↗