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J Casadevall

Publications and source records attributed to J Casadevall.

14 recordsLinked to original sources
PubMed2002

[Survey on the needs expressed by primary care doctors for continuing education in drug therapy].

OBJECTIVE: To describe the aspects of continuing education in pharmacological therapeutics considered as most relevant by the primary health care physicians. DESIGN: Observational study.Setting. Physicians filled-up the questionnaires during 45 minutes at their primary health care centres. PARTICIPANTS: Primary health care physicians involved in the Fundation Institut Català de Farmacologia continuing education activities since 1997 were selected. MAIN MEASUREMENTS: A specific questionnaire was designed to collect the physicians' opinion on different topics regarding continuing education in pharmacological therapeutics. RESULTS: 180 physicians from 21 primary health care centres answered the questionnaire. 68% of the responding physicians considered that continuing education has to be useful to improve routine clinical practice. Regular seminars and methods stimulating active participation administered by primary health care professionels are preferred. Continuing education in pharmacological therapeutics should be focused to health problems rather than being drug-oriented. They referred being more interested in drug selection issues and in the role of new drug in comparison with the existing alternatives rather than in regulation and drug consumption issues. 66,3% of the responding physicians considered that continuing education in pharmacological therapeutics should be compulsory. Public health authorities and primary health care physicians should share the responsibility in setting-up continuing education in pharmacological therapeutics programs, according to the opinion of almost 70% of the physicians. CONCLUSIONS: Primary health care physicians are interested in continuing education in pharmacological therapeutics as far as it is practical and useful to solve problems of their routine clinical practice.

Adult↗
PubMed2000

Intranasal challenge with aspirin in the diagnosis of aspirin intolerant asthma: evaluation of nasal response by acoustic rhinometry.

BACKGROUND: Nasal provocation tests with lysine-aspirin have recently been introduced for assessment of aspirin intolerant asthma. A study was undertaken to evaluate the usefulness of acoustic rhinometry, a new non-invasive technique, in the diagnosis of aspirin intolerant asthma/rhinitis. METHODS: Fifteen patients with aspirin intolerant asthma/rhinitis (nine women, mean (SD) age 54.7 (14) years), eight patients with aspirin tolerant asthma/rhinitis (three women, mean (SD) age 52.6 (7.8) years), and eight healthy subjects (two women, mean (SD) age 32.5 (9.7) years) were studied. All subjects were challenged with saline (0.9% NaCl) and 25 mg lysine acetylsalicylic acid (L-ASA) instilled into each nostril of the nose on two separate days. The clinical response was evaluated based on nasal symptoms (sneezes, itching, secretion and blockage). The nasal response was measured by acoustic rhinometry. Symptoms and rhinometry curves were recorded at 10 minute intervals for three hours, one hour before challenge and two hours after challenge. RESULTS: L-ASA challenge induced a significant increase in symptoms in patients with aspirin intolerant asthma/rhinitis. No differences in the clinical response were detected in those with aspirin tolerant asthma/rhinitis or healthy subjects. L-ASA challenge induced a significant decrease in nasal volume measured by acoustic rhinometry in aspirin intolerant patients. No differences were detected between the challenges in aspirin tolerant patients. If a 25% decrease in nasal volume is taken as the cut off point, the specificity of the test was 94% and the sensitivity reached 73%. The nasal challenge was well tolerated by all subjects. CONCLUSION: Acoustic rhinometry may be used to study the nasal response to L-ASA. Nasal challenge with L-ASA is safe and can be used as a diagnostic test even in asthmatic patients with severe bronchial obstruction.

Administration, Intranasal↗
PubMed1995

Long-term survival in a surgically treated non-encapsulated mediastinal primary liposarcoma. Diagnostic utility of core-needle biopsy for mediastinal tumors.

Primary liposarcomas of the mediastinum are uncommon tumors. Only six cases of mediastinal liposarcomas with survival after surgery longer than five years have been reported and only one of these was a non-encapsulated tumor. We report a new case of non-encapsulated primary liposarcoma of the mediastinum with long-term survival. The diagnosis was carried out using a CT-guided core-needle biopsy. We emphasize the utility of this technique to diagnose this kind of mediastinal tumors. A non-encapsulated primary liposarcoma of the mediastinum surgically treated with long-term survival is reported. We emphasize the diagnostic utility of CT-guided core-needle biopsy for the tumors.

Biopsy, Needle↗
PubMed1994

[3 nonidiopathic forms of bronchiolitis obliterans organizing pneumonia].

Bronchiolitis obliterans organizing pneumonia is the most serious disease of the bronchioli. An idiopathic form of the disease important for differential diagnosis in incipient forms of pulmonary fibrosis has been reported in the literature, along with other forms associated to drug use, infections, and collagen and localized diseases. We describe 3 patients with bronchiolitis obliterans organizing pneumonia, one associated with rheumatoid arthritis and consumption of gold salts, one with HIV infection and one localized form associated with pulmonary hydatidosis.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Dissection of ascending aorta. A new cause of alveolar hemorrhage?

Alveolar hemorrhage is an entity caused by different etiologies. We report the case of a male who was admitted in our Service due to hemoptysis secondary to an alveolar hemorrhage diagnosed by chest X-ray and fiberoptic bronchoscopy. Thirty six hours after the admission the patient died and his necropsy showed dissection of ascending aorta and alveolar hemorrhage.

Aortic Dissection↗
PubMed1994

[CT-guided fine-needle thoracic aspiration puncture. Its cost effectiveness and complications].

OBJECTIVE: To study the profitability and complications of the puncture aspiration with thoracic thin-needle (PATTN). METHODOLOGY: The results of 160 PATTN, performed under TC control in 131 men and 29 women, average age 61.24 +/- 15.17 years were analyzed. The diagnosis obtained by PATTN was compared with the definitive diagnosis made with biopsy (bronchial, thoracotomy, or mediastinoscopy), the evolution or response to treatment, or at autopsy. Factor related to greater diagnostic reliability and risk of pneumothorax were analyzed. RESULTS: For the diagnosis of non-tumoral pathology, the technique achieved a sensitivity (S) of 90 percent, specificity (E) of 96.06 percent, and reliability (F) of 91.71 percent, while in malignant processes, S 72.4 percent, E 100 percent and F 88.52 percent, with a histological correlation of 72.72 percent in the first case and 68.80 percent in the second. The localization in superior lobes, radiological pattern of multiple or cavitied nodules, and size > 2 cm were identified as factors which significantly increased reliability. Pneumothorax was produced in 24 cases (15 percent) and was more common in patients diagnosed of COPD, with a lesion < 2.1 cm, and not attached to the pleura. CONCLUSIONS: The PATTN offers considerable profitability for the diagnosis of thoracic lesions of any localization and nature, at low costs and with few serious complications.

Adolescent↗
PubMedDate not supplied

Use of spirometry to predict risk of pneumothorax in CT-guided needle biopsy of the lung.

OBJECTIVE: Our goal was to assess the usefulness of spirometry to estimate the risk of pneumothorax in patients undergoing percutaneous needle biopsy with CT guidance for solitary pulmonary nodule (SPN). MATERIALS AND METHODS: We studied the results of 51 consecutive percutaneous needle biopsies with CT guidance for SPN obtained between 1988 and 1990. Forty-five men and six women, aged 65 +/- 11 (36-86) years, were included in the study. All biopsies were performed under CT guidance, with 90 mm 25G needles (0.5 mm thickness) fitted into luer-type syringes. The number of needle pass attempts never exceeded three. A spirometry before biopsy was performed in all patients. RESULTS: Pneumothorax occurred in only 10 cases (19%). The patients with pneumothorax showed lower lesion size, forced vital capacity (FVC), forced expiratory volume (FEV1), and FEV1/FVC ratio. The contribution of these factors to pneumothorax was analyzed by a logistic regression model. The FEV1 was most strongly associated with the incidence of pneumothorax. We developed an equation for predicting the risk of this complication. CONCLUSION: We conclude that decreasing FEV1 is associated with a higher pneumothorax rate.

Adult↗