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Biomedical subjects

J Armengol

Publications and source records attributed to J Armengol.

At least 19 recordsLinked to original sources
PubMed2000

Algal biomass in a disturbed Atlantic river: water quality relationships and environmental implications.

Benthic algal biomass was determined at 38 sites along the Oria, a river with intense human activity on its watershed. Water temperature, total suspended solids and nutrient concentration affected algal biomass in different ways. Lower values of algal biomass [(chlorophyll-a concentration and ash-free dry weight (AFDW)] were found in the headwaters and forested tributaries, but also at sites receiving high deposition of solids (due to the outflow from paper mills and quarries). Higher values of algal biomass (both chlorophyll-a and AFDW) were common both in the main stretch of the river and in some tributaries receiving urban sewage outflows. Averages and ranges of temperature and dissolved oxygen concentration were compared for two continuously monitored stations. One of them (forested, nutrient-poor) had low algal biomass, while the second (open, nutrient-rich) showed high chlorophyll-a concentration. Accumulation of algal biomass had environmental implications both in water quality and in the fish diversity of the Oria. Diel variations of dissolved oxygen were much higher (and reached hypoxia) at the site with higher biomass accumulation. The abundance of a fish community (dominated by cyprinids) more tolerant to hypoxia at that site can partly be attributed to the influence of algal biomass accumulation.

Animals↗
PubMed2000

Tracheal colonisation within 24 h of intubation in patients with head trauma: risk factor for developing early-onset ventilator-associated pneumonia.

OBJECTIVE: To investigate if tracheal colonisation within 24 h of intubation is a risk factor for developing early-onset ventilator-associated pneumonia (EP) in patients with head trauma. DESIGN: A prospective study in an intensive care unit of a university hospital. POPULATION: One hundred intubated patients were included with head trauma and Glasgow coma score at admission < or =12. METHODS: We took tracheal aspirate samples within 24 h of intubation and performed a protected bronchoalveolar mini-lavage when clinical diagnosis of pneumonia was made. MEASUREMENTS AND RESULTS: On admission time 68 patients (68%) were colonised in trachea, 22 patients were colonised by Staphylococcus aureus, 20 by Haemophilus influenzae, six by Streptococcus pneumoniae and 20 by gram-negative bacilli. The incidence of EP was 26%, and the microorganisms involved were Staph. aureus (44%), H. influenzae (31%), Strep. pneumoniae (12%), and gram-negative bacilli (13%). A multivariate logistic regression analysis showed that the tracheal colonization by Staph. aureus, H. influenzae or Strep. pneumoniae within 24 h of intubation was an independent risk factor for developing EP (odds ratio: 28.9; 95% confidence interval: 1.59-52.5). CONCLUSION: Colonisation of the trachea within 24 h of intubation by Staphylococcus aureus, Haemophilus influenzae or Streptococcus pneumoniae is a risk factor for developing EP in patients with head trauma.

Adult↗
PubMed1999

Safety and effectiveness of hormonal postcoital contraception: a prospective study.

OBJECTIVE: The aim of this study was to evaluate the demographic characteristics of the population attending our hospital requesting postcoital contraception and to determine the effectiveness of the method and its side-effects. METHODS: A total of 503 women asking for postcoital contraception were included in a prospective open trial. After filling in a questionnaire dealing with demographic and contraceptive data, we prescribed an ethinylestradiol-levonorgestrel combination (100 micrograms/500 mg for two doses 12 h apart). RESULTS: Only 487 women were available for analysis of demographic data. A further 77 were excluded because they presented irregular menstrual cycles and 55 cases were lost for follow-up. Mean age was 22.6 +/- 5.25 years and 35.9% of cases came to the center within the first 5 h after unprotected intercourse. Only 18.8% had previously asked for postcoital contraception. Breakage of condom was the most common reason for request (81.9%). Two pregnancies occurred in the remaining 355 women. According to Dixon's method 15.5 pregnancies should be expected being the overall efficacy of 87.14%. There were no serious adverse effects. Nausea and vomiting (16.33%) were the most prevalent and 59% of the users menstruated at the expected time whilst menses were delayed in 6% of the cases. CONCLUSION: The combination of ethinylestradiol and levonorgestrel in low doses is an effective and safe method of postcoital contraception.

Adolescent↗
PubMed1995

[Booster effect in elderly patients living in geriatric institutions].

BACKGROUND: Tuberculinic response is weaker in elderly patients. To know the real tuberculinic reactivity in elderly patients living in geriatric institutions in Catalonia, Spain, and to reduce the probability of false negatives this study was carried out to detect the booster effect. METHODS: Three hundred forty-three individuals with a mean age of 81 +/- 6.5 years, residing in four geriatric centers within the Central Health Care Region of Catalonia, were studied. After performing the first Mantoux intradermoreaction this was repeated at one week in case of negativity. A third test was carried out after one more week on persistence of negativity. Qualitative study was carried out on cell immunity in those patients whose first Mantoux test was negative. RESULTS: The first Mantoux test was positive in 163 patients (47.5%) and the performance of the second and third test in cases of negativity of the previous test increased the number of positivities by 12.5% and 4.1%, respectively, up to a total of 220 patients (64%). In the patients who did not react to the first intradermoreaction and who preserved cell immunity a booster effect was obtained in 57 (52.8%). The prevalence of tuberculous infection in this group of elderly patients calculated in the group with preserved cell immunity was 81.2% while the morbidity of tuberculous disease in the positive cases in the Mantoux test was 1.8%. CONCLUSIONS: Given the high frequency of the booster effect in elderly people, systematic testing is recommended to investigate tuberculinic reactivity in patients who are initially negative on Mantoux intradermoreaction.

Aged↗
PubMed1993

Value of bacterial antigen detection in the diagnostic yield of transthoracic needle aspiration in severe community acquired pneumonia.

BACKGROUND: Transthoracic needle aspiration (TNA) with an ultrathin needle is a safe and highly specific procedure for obtaining a diagnosis in bacterial pneumonias, but its sensitivity is at best 70%. A study was performed to assess whether Streptococcus pneumoniae and Haemophilus influenzae type b antigen detection by latex agglutination from the TNA sample enhanced the diagnostic yield. METHODS: Blood cultures, TNA with an ultrathin needle (culture, Gram stain, and latex agglutination), serological tests, and pneumococcal antigen detection in the urine by counterimmunoelectrophoresis were performed in samples from 18 of 23 consecutive patients with severe community acquired pneumonia. RESULTS: The causative organism was identified in 16 cases (88%): S pneumoniae (10 cases), S pneumoniae plus H influenzae (two cases), Legionella pneumophila (three cases), and Mycoplasma pneumoniae (one case). The investigation of antigens by latex agglutination in the pulmonary aspirate increased the diagnostic yield of TNA from 50% to 78% and provided a rapid diagnosis (in less than two hours) with therapeutic implications in seven cases. Its effectiveness was not modified by prior antibiotic therapy. CONCLUSIONS: A latex agglutination test on the pulmonary aspirate enhances the diagnostic yield of TNA in severe community acquired pneumonia.

Adult↗
PubMed1991

[The differential diagnosis between pleural exudates and transudates: the value of cholesterol].

BACKGROUND: The evaluation of a patient with pleural effusion depends on its classification as exudate or transudate. Many criteria have been established but none has a 100% sensitivity and specificity. The aim of the present study was to assess the value of the cholesterol level to differentiate between exudate and transudate and to establish its utility as compared with other differential criteria. METHODS: 104 patients with pleural effusion of well defined etiology, permitting their classification into 56 exudates and 48 transudates, were evaluated. In all, Light's criteria were established and cholesterol values in pleural effusion and serum were measured and compared. RESULTS: Using the lactate dehydrogenase level (LDH) in pleural fluid (PF) and the ratios of LDH and proteins in PF and serum, 100% of exudates and 83% of transudates were correctly classified. A cholesterol level of 40 mg/dl or higher best separated exudates and transudates, with a sensitivity of 96% and a specificity of 92% for exudates. A ratio of 0.3 or higher between cholesterol levels in PF and serum was shown to have a high sensitivity (96%) and lower specificity (85%) for exudates. The highest specificity (92%) was achieved when the protein ratio in PF and serum was combined with PF cholesterol. CONCLUSIONS: The cholesterol level in pleural fluid and the ratio between this value and that in serum are highly useful parameters to differentiate between exudates and transudates.

Cholesterol↗
PubMed1991

Pulmonary endometriosis: conservative treatment with GnRH agonists.

The lung is an infrequent location of extragenital endometriosis, an exceptional cause of hemoptysis or pneumothorax. Adequate management has not yet been well established. We present two cases of pulmonary endometriosis, parenchymal and pleural. The presenting symptoms were catamenial hemoptysis and pneumothorax, respectively, which were treated with GnRH analogues. The first patient received Buserelin (900 micrograms/day intranasally) for 6 months. After 15 months of normal menstrual activity, the symptoms reappeared. The patient was then treated with Triptorelin (3.75 mg/month intramuscularly) for 6 months and remains asymptomatic and menstruating 14 months after discontinuing treatment. The patient presenting with pneumothorax was treated with leuprolide (1 mg/day subcutaneously) for 6 months and is asymptomatic 1 year after stopping treatment. These results suggest that GnRH analogues may be an acceptable alternative to danazol in the medical management of pulmonary endometriosis.

Administration, Intranasal↗
PubMed1987

Comparison of high-frequency chest wall compression with conventional mechanical ventilation in cats.

Six anesthetized paralyzed cats with normal lungs were ventilated by high-frequency chest wall compression (HFCWC) at 5 Hz using a single-chamber circumferential cuff enclosing the thorax from the axillae to the xiphisternum. PaCO2 during HFCWC + PEEP (3 cm H2O) was significantly (p less than .0005) lower compared with conventional mechanical ventilation (CMV). End-expiratory lung volume (VL) during HFCWC + PEEP was significantly (p less than .001) lower than VL during CMV + PEEP but was higher than VL during CMV without PEEP. After the cats' lungs were stiffened by repeated saline lavage, CMV + PEEP at a mean airway pressure (Paw) of 10 cm H2O was compared with HFCWC + continuous positive airway pressure (CPAP) at an equal or lower Paw. A significant decrease in PaCO2 (p less than .02) during HFCWC occurred but no significant differences were observed in PaO2, VL, or compliance. Arterial BP and cardiac output were similar between CMV + PEEP and HFCWC + CPAP. In cats with normal lungs, VL can be maintained by applying CPAP during HFCWC, and in those with injured lungs, HFCWC + CPAP produces comparable gas exchange at a Paw equal to or lower than that used during CMV + PEEP.

Animals↗
PubMed1987

High frequency chest wall compression in cats with normal lungs.

Ten anesthetized, paralyzed adult cats were ventilated by high frequency chest wall compression (HFCWC) at 3, 5, 7, and 9 Hz by means of a single chamber cuff enclosing the thorax from the axillae to the xyphisternum. The effects of HFCWC in terms of gas exchange, end-expiratory lung volume, and respiratory system compliance were compared to conventional intermittent positive pressure ventilation (IPPV) (30 breaths/mn). HFCWC and IPPV were compared at three levels of matched end-expiratory airway pressure [continuous positive airway pressure (CPAP)/positive end-expiratory pressure/(PEEP) of 0, 2, and 5 cm H2O]. In the absence of CPAP, HFCWC resulted in a marked decrease (up to 50%) in end-expiratory lung volume with significantly lower PaO2, lower compliance, and higher alveolar-arterial oxygen gradient than during IPPV. No differences in PaO2 and a-ADO2 were observed when HFCWC was combined to CPAP greater than or equal to 2 cm H2O. At frequencies below 9 Hz, PaCO2 became significantly lower during HFCWC + CPAP than during IPPV. During HFCWC + 2 cm H2O CPAP, lung volume was lower than during IPPV + 2 cm H2O and similar to the volumes observed during IPPV + 0 positive end-expiratory pressure. Additional studies in six cats at HFCWC + 3 cm H2O confirmed that CPAP greater than 2 cm H2O more than adequately compensated the decrease in lung volume associated with HFCWC alone. Peak cuff pressures between 14 and 17 cm H2O generated oscillary tidal volumes between 4.5 and 2.1 ml/kg. The size of the oscillatory volume was significantly affected by increasing frequencies (decrease in tidal volume) and increasing levels of positive airway pressure (increase in tidal volume). We conclude that in cats with normal lungs, HFCWC can provide for normal gas exchange, provided that it is combined with low level CPAP in order to prevent the occurrence of airway closure associated with HFCWC alone.

Animals↗
PubMed1986

Comparison of high-frequency negative-pressure oscillation with conventional mechanical ventilation in normal and saline-lavaged cats.

We modified a negative-pressure respirator to produce high-frequency, subatmospheric pressure oscillations around the chest. The effects of negative-pressure oscillation (NPO) on gas exchange, lung volume, compliance and cardiovascular variables were compared to those of conventional intermittent positive-pressure ventilation (IPPV) at 30 breath/min, using cats with normal and surfactant-depleted lungs. For frequencies in both normal lungs (1, 3, 4, 5, and 7 Hz) and saline-lavaged lungs (3, 5, and 7 Hz), peak inflating pressures were lower during NPO. Oxygenation was similar for both modes of ventilation. In cats with normal lungs, PaCO2 was significantly lower during NPO at 3 and 4 Hz (mean 24 torr) than during IPPV (mean 30 torr); normocapnia was maintained at the other frequencies. In damaged lungs, NPO and IPPV at 3 and 5 Hz resulted in similar CO2 removal, but PaCO2 was significantly higher during NPO at 7 Hz. Oscillatory tidal volumes decreased with increasing frequencies: in normal lungs, mean oscillatory tidal volume was 4.4 ml/kg at 1 Hz and 2.3 ml/kg at 7 Hz; in damaged lungs it was 6.5 ml/kg at 3 Hz and 3.2 ml/kg at 7 Hz. At 3 Hz and above, NPO was associated with a larger functional residual capacity than during sequences of IPPV matched for end-expiratory transthoracic pressure. There were no significant differences in respiratory system compliance, cardiac output, and pulmonary vascular resistance between both modes of ventilation. Further studies are warranted to investigate the potential clinical usefulness of NPO.

Animals↗
PubMed1985

Pulmonary vascular response to high-frequency oscillatory ventilation in dogs: lack of effect of indomethacin.

The role of prostaglandins (PG) in the pulmonary hypertension associated with high-frequency oscillatory ventilation (HFOV) was investigated in 7 pentobarbital-anesthetized dogs. The magnitude and time course of the mean pulmonary artery pressure (PAP) changes induced by HFOV (20 Hz) was quantified before and after PG-production blockade with 15 mg/kg indomethacin (INDO) i.v. It was found that HFOV before INDO induced a 27.2 +/- 5.6% increase in PAP above baseline and a 30.0 +/- 7.2% one hour after INDO administration. This difference was not statistically significant. The time course of the PAP changes induced by HFOV before and after blocking PG-production by INDO were also similar. Mean airway pressure, PaO2 and PaCO2 during HFOV, before and after INDO were not statistically different. It is concluded that the acute increase in PAP induced by HFOV is not due to PG release.

Animals↗
PubMed1985

Alveolar pressures and lung volumes during high-frequency oscillatory ventilation in dogs.

A constant-volume plethysmograph was used to measure functional residual capacity (FRC) in anesthetized dogs before, during, and after high-frequency oscillatory ventilation (HFO). The phrenic nerves were electrically stimulated to provide the necessary respiratory effort. In addition to FRC, mean alveolar pressure (PA) was obtained from the pressure axis of the static pressure/volume (P/V) curve at FRC. In eight dogs, the first min of HFO at 22 ml, 20 Hz, and a 4 L/min bias flow of air increased FRC by an average of 63.6% above the apneic value, where it remained for the subsequent 15 min. PA values were significantly higher than mean airway pressures (Paw) measured in the endotracheal tube, indicating higher pressure in the terminal lung units. In five other dogs, FRC, Paw, and mean pleural pressure increased as HFO was increased from 15 to 30 Hz with 1 and 4 L/min bias flows of air. We speculate that these increases may account for both the impairment of cardiovascular function and improvements in oxygen tensions often seen with HFO.

Animals↗
PubMed1985

Collateral ventilation during high-frequency oscillation in dogs.

Mechanics of collateral channels during high-frequency oscillatory ventilation (HFOV) were assessed in eight anesthetized dogs, using a modification of Hilpert's technique. Base-line functional residual capacity was measured with a body plethysmograph, with inspiratory efforts induced by phrenic nerve stimulation. The resistance (Rcoll) and time constant (Tcoll) of collateral channels at five lung volumes were measured during HFOV and positive end-expiratory pressure (PEEP). Rcoll and Tcoll were significantly higher during HFOV (P less than 0.001); the differences did not correlate with resting lung volumes. The calculated static compliance of the wedged segment was similar during HFOV and PEEP (P greater than 0.005). Mean pressures measured in small airways during HFOV corresponded to the midline between the inflation and deflation limbs of the static pressure-volume curves, indicating similar pressure-volume characteristics of the respiratory system during HFOV and static conditions. We conclude that HFOV increases resistance to gas flow through collateral channels but that this pathway may still be important in gas exchange.

Animals↗