Biomedical subjects

J M Ademà

Publications and source records attributed to J M Ademà.

5 recordsLinked to original sources

PubMed2005

Prognostic factors in laryngotracheal injury following intubation and/or tracheotomy in ICU patients.

The aim of this study was to determine the incidence of laryngotracheal injuries following intubation and/or tracheotomy in intensive care unit (ICU) patients and to analyze their prognostic factors. This prospective study includes the clinical data and endoscopic exploration of 654 ICU patients who underwent oro-tracheal intubation between September 1992 and February 1999. The prognostic factors for upper airway injuries were analyzed using a multivariate statistical study. Endoscopic exploration of the upper airway 6 to 12 months after extubation revealed laryngotracheal injuries in 30 of the 280 patients examined (11%). The most important factors influencing the development of laryngotracheal lesions were the duration of the oro-tracheal intubation and the length of time in the ICU. Patients at high risk of developing injuries were those with pathological background, a non-neurological or non-surgical (medical) admission or upper-airway injuries at an early stage. The length of oro-tracheal intubation is the most important factor in the development of laryngotracheal injuries. Consequently, it is essential to establish a time limit to perform tracheotomy in ICU patients. Such timing should be adapted to each patient and pathology.

Female↗

PubMed2005

[Gastroesophageal reflux and obstructive sleep apnea syndrome].

INTRODUCTION: Patients with mild or moderate Sleep Apnea Syndrome (SAS) need wider therapeutic scope options according to their disease severity. AIM: To consider including proton pump inhibitors (PPI) to the therapeutical alternatives of these patients. MATERIAL AND METHODS: A prospective study was designed, among patients with SAS. Nocturnal polysomnography and double channel pHmetry were performed simultaneously. RESULTS: From the 18 patients included in this preliminary phase, in three (16.7%) nocturnal proximal ph monitoring was positive. These 3 patients were treated with PPI during at least 3 months with a very satisfactory outcome in two of them. CONCLUSIONS: Treatment with PPI may be a useful therapeutical alternative in patients with mild to moderate SAS.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2004

[Adverse effects of continuous positive airway pressure therapy and its relation to the nose].

The main problem in the treatment of obstructive sleep apnea syndrome (OSAS) with nasal continuous airway pressure (nCPAP) is the lack of compliance. One of the most important reasons for no compliance is the adverse effects of this treatment. We analyse, prospectively, 182 patients treated with nCPAP in order to show the relationship between previous nasal problems and adverse effects of nCPAP. Sixty percent of the population developed one o more side effects. Of this group, 69% showed nasal septum deviation at first examination in front of 31% that did not showed this problem (p = 0.001). In the group of patients with nasal side effects we observed an increase of compliance in 80% of patients treated medically and in 89% of those treated by a septoplasty. We demonstrate that the adverse effects of nCPAP are related to previous nasal problems and, also, that treatment of those problems can achieve an increase in compliance to nCPAP therapy.

Female↗

PubMed1995

Endoscopic sinus surgery in sinusitis.

In terms of functional treatment of sinonasal pathologies, endoscopic surgery represents a spectacular advance, offering excellent illumination, views of areas previously impossible to monitor, and the ability to view the main reference points in the surgical field. Over a five-year period (1988-1993), the authors have performed 278 paranasal sinus operations, using endoscopic techniques. The results obtained in 250 patients, with a minimum follow-up period of one year, have been analyzed. The criteria of assessment used include: self-assessment by the patient and the surgeon's assessment, made on basis of the endoscopic data. The best results were obtained in cases of antrochoanal polyps, polyposis not associated with asthma or acetylsalicylic acid (ASA) sensitivity, circumscribed chronic sinusitis, and aspergillomas. The worst results, with a high rate of recurrence, have been obtained with ASA sensitivity and chronic suppurative pan-sinusitis. It is essential to reach a consensus on the staging of polyposis so that treatment can be monitored adequately, even though, in itself, the pathology is difficult to classify as it can vary in a single patient for no apparent reason. On the other hand, there is a difference between the subjective and objective assessment of the condition, and this makes it even harder to explain the results obtained.

Endoscopy↗

PubMed1991

[Endoscopic naso-sinusal surgery. Experience with 150 cases].

The AA. expose their experience drawn out from 150 cases of naso-sinusal pathology, treated through endoscopic surgery after the Messerklinger-Stammberger technique. They emphasize either the advantages of the procedure, in comparison with the classic methods, and the postoperative pitfalls. This procedure call for an exact knowledge of the endoscopic anatomy of the ethmoidal area, which can be gained only through corpses training.

Endoscopy↗