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M Rodríguez-Carballeira

Publications and source records attributed to M Rodríguez-Carballeira.

14 recordsLinked to original sources
PubMed2006

The bronchodilator test in chronic obstructive pulmonary disease: interpretation methods.

The objective of the study was to evaluate the best method for interpreting the bronchodilator test (BDT). Five formulas for expressing the BDT results were analyzed and compared: changes experienced by maximum expiratory volume in 1s (FEV(1)) and forced vital capacity (FVC) measured in milliliters, in percentage with respect to the baseline, in percentage with respect to the predicted, in percentage with respect to the possible, and in standardized residuals. Ninety-eight chronic obstructive pulmonary disease (COPD) patients were submitted to a respiratory function test on two different days. On each occasion three spirometries were conducted: basal, post-placebo and post bronchodilator. As a gold standard, a normality interval was defined using the variability experienced with the placebo between the two days of the study. The best formulas according to their sensitivity, specivity and area under receiver operating characteristic (ROC) curve were the "standardized residuals", with a cut point of .3, and the "percentage with respect to the predicted" with a cut point of 6%.

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PubMed2006

Invasive pneumococcal disease among children in a health district of Barcelona: early impact of pneumococcal conjugate vaccine.

This study evaluated the impact of heptavalent pneumococcal conjugate vaccine (HPCV) on invasive pneumococcal disease (IPD) in children aged < or = 5 years in Barcelona, Spain. The incidence of IPD, vaccine uptake and prevalence of nasopharyngeal colonisation were analysed in two different periods: 1999-2001 (pre-licence period), and 2002-2004 (post-licence period). In total, 121 cases of IPD were identified. The overall incidence of IPD decreased from 96.9 cases/100,000 to 90.6 cases/100,000 (OR 0.93, 95% CI 0.69-1.26, p 0.71) between the two periods. The proportion of cases caused by non-vaccine-related serotypes (NVS) increased from 21% to 43.7% (OR 2.9, 95% CI 1.2-7, p 0.01). IPD was diagnosed in seven vaccinated children, six of whom were infected by NVS. There was a trend of diminishing prevalence of resistance to penicillin and macrolides in 2002-2004. The incidence of empyema increased from 1.7 to 8.5/100,000 (OR 4.5, 95% CI 0.91-18, p 0.06). The rate of vaccination ranged from 4.8% to 34%. It was concluded that the rates of IPD in this area did not decrease following the introduction of HPCV. The low uptake of vaccine and the greater proportion of colonisation/infection by NVS probably explain these findings. A trend of increasing empyema was also apparent. A decrease in the prevalence of penicillin and macrolide resistance paralleled the progressive uptake of vaccine.

Anti-Bacterial Agents↗
PubMed2001

The bronchodilator test with increasing doses of terbutaline in chronic obstructive pulmonary disease patients.

There is no uniform consensus on the dose of bronchodilator to be used in the bronchodilator test (BDT). The objective of the study was to determine the dose of inhaled terbutaline that can safely achieve a greater number of positive BDT in patients with chronic obstructive pulmonary disease (COPD). The study was prospective and single blinded. One-hundred and fifty patients with stable COPD were included. Their mean (+/-SD) age was 67.4 (8.8) years. Their mean forced expiratory volume in the first second (FEV1) was 1.14 (0.48) l (41% of the predicted value). A baseline spirometry was performed and a second 20 min after the inhalation of placebo. Three consecutive doses of 500 microg of inhaled terbutaline were administered and a new spirometry was performed after each one. A multivariate analysis based on the comparison of the repeated means was performed in order to analyse the spirometric changes achieved after the different doses of bronchodilator. The increase of FEV1 and forced vital capacity (FVC) with the two first doses of terbutaline was statistically significant; the increase of the peak expiratory flow (PEF) was significant after the three doses administered. The number of positive BDT were 40, 47 and 60 after each dose of terbutaline (P=0.004). The higher dose of terbutaline was more useful in identifying patients with significant bronchoreversibility and, moreover, was well tolerated. We suggest that this dose (1500 microg) should be routinely used in performing the BDT.

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PubMed2000

[The treatment and prognosis of sarcoidosis. Apropos 53].

OBJECTIVE: We retrospectively studied 53 cases of sarcoidosis which have been diagnosed at our service during de last 14 years. The criteria for starting therapy with corticosteroids and recurrences were analyzed. METHOD: The patients mean (SD) age was 42 (15) years old (range 16-76) and the majority were female (72%). 15 patients (28.3%) received corticosteroids. The only differences with respect to patients not treated were the presence of respiratory symptoms (47% vs 18%; p = 0.04) and the abnormality of spirometric parameters (DLCO/VA p = 0.01; CV p = 0.002). RESULTS: 17 (32%) patients recurred. 14 (82%) of them required corticosteroids. This percentage was significantly greater than that of patients treated at first episode (82% vs 28%, p = 0.0002). All patients improved with treatment. The only difference with respect to patients without recurrences were to be treated at the first episode (53% vs 17%, p = 0.007).

Adrenal Cortex Hormones↗
PubMed1999

Emergence and dissemination of quinolone-resistant Escherichia coli in the community.

We studied the evolution of resistance to quinolones in Escherichia coli from 1992 to 1997 in Barcelona, Spain. An increasing proportion of quinolone-resistant E. coli (QREC) infections was observed. QREC strains were more common in patients with nosocomial infections but also increased in patients with community-acquired infections (9% in 1992 to 17% in 1996). Seventy (12%) of 572 episodes of E. coli bacteremia were due to QREC. Factors significantly associated with QREC bacteremia were the presence of underlying disease, recent exposure to antibiotics, and bacteremia of unknown origin. In the multivariate analysis, only prior exposure to antimicrobial agents (P < 0.001; odds ratio [OR] = 2), specifically, to quinolones (P < 0. 001; OR = 14), and the presence of a urinary catheter (P < 0.001; OR = 2) were significantly associated with QREC bacteremia. Among 16 QREC isolates from cultures of blood of community origin selected at random, 13 different pulsed-field gel electrophoresis patterns were recognized, showing the genetic diversity of these isolates and in turn indicating the independent emergence of QREC in the community. The prevalence of QREC in the feces of healthy people was unexpectedly high (24% in adults and 26% in children). A survey of the prevalence of QREC of avian and porcine origin revealed a very high proportion of QREC in animal feces (up to 90% of chickens harbored QREC). The high prevalence of QREC in the stools of healthy humans in our area could be linked to the high prevalence of resistant isolates in poultry and pork.

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PubMed1999

Contribution of ipratropium bromide to the bronchodilator test in patients with chronic obstructive pulmonary disease.

The aim of the study was to analyze the bronchodilator test (BDT) response to ipratropium bromide (IB) in patients with chronic obstructive pulmonary disease (COPD) who do not respond to inhaled terbutaline. Sixty patients with stable COPD who showed a negative response to BDT, defined as an increase of less than 160 ml in the forced expiratory volume in the first second (FEV1) after inhaling 1500 microg of terbutaline, were recruited. Each patients randomly received 200 microg of IB or placebo in a single blinded fashion, and a spirometric study was made at 30 and 60 min. The increase in absolute values of FEV1 at 30 and 60 min after IB was significantly higher than after placebo. The means +/- SD were 126 +/- 93 vs. 70 +/- 96 ml at 30 min and 148 +/- 120 vs. 74 +/- 132 ml at 60 min (P=0.01). The BDT was positive in 57% of patients who received IB, considering a positive response as an increase of FEV1 greater than 160 ml (P=0.01). We conclude that the BDT was positive with high doses of IB in more than half of COPD patients who did not respond to terbutaline alone.

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PubMed1998

Thoracic infection caused by Streptococcus milleri.

The objective of this study was to increase our understanding of the importance of members of the Streptococcus milleri (SM) group as respiratory pathogens, by studying the epidemiological and clinical features of thoracic infections caused by this group and comparing the epidemiology and prognosis of empyema caused by SM with cases of pneumococcal aetiology. The clinical histories and microbiology reports were reviewed in 27 cases of thoracic infection caused by SM over a period of 8 yrs. Cases of pneumococcal empyema that occurred during the same period were also analysed. Diagnoses were made of cases of empyema, including six with pneumonia and one with pulmonary abscess, three cases of pneumonia and two of mediastinitis. In 17 cases, SM was the only pathogen isolated. There was a history of instrument or surgical procedures on the digestive or respiratory tract in 59%. Secondary bacteraemia was documented in three cases. The treatment administered, a combination of antibiotics and surgery, was successful in 22 of 27 (81%) of cases. All strains were susceptible to penicillin. When the characteristics of the empyemas caused by monomicrobial SM infection were compared with those of pneumococcal aetiology from the same period of study, significant differences were found with respect to age, origin of the infection and the need for surgery. In conclusion, thoracic infections caused by Streptococcus milleri are largely pleural. They are polymicrobial in one-third of cases, commonly acquired in hospital and, in most patients, associated with major surgery and/or surgical procedures of the respiratory or digestive tract. The empyema frequently requires thoracotomy for complete resolution.

Anti-Bacterial Agents↗
PubMed1997

[Cerebral SPECT with thallium-201 in the differential diagnosis of focal cerebral lesions in patients with AIDS].

BACKGROUND: The aim of this study was to analyze the usefulness of cerebral SPECT with thallium-201 in patients with the acquired human immunodeficiency syndrome (AIDS) and focal cerebral lesions. METHODS: Six patients with AIDS and focal cerebral lesions in whom a cerebral SPECT was performed with thallium-201 are described. Treatment was initiated with antiToxoplasma drugs in all patients. The clinical response, serology for positive toxoplasma and radiologic improvement were criteria for the diagnosis of encephalitis by Toxoplasma. In the remaining cases, cerebral biopsy and/or necropsy study were carried out. RESULTS: In the 2 patients in whom cerebral SPECT demonstrated enhancement of the lesion, the pathologic diagnosis was cerebral lymphoma. Of the 4 remaining cases in whom no enhancement was observed, three corresponded to cerebral toxoplasmosis and one to progressive multifocal leucoencephalopathy. CONCLUSIONS: Cerebral SPECT with thallium-201 is a simple, specific and useful technique for the differentiation of primary cerebral lymphoma from the remaining inflammatory cerebral lesions which may be present in AIDS patients.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Intracranial mass as single manifestation of sarcoidosis].

Neurological involvement in sarcoidosis occurs in 5-10% of cases and may adopt a great variety of forms, included space-occupying cerebral masses. The presence of these masses as single G manifestation of the disease, with no evidence of systemic involvement, is uncommon. In a review of the literature we found 15 reported cases and we report here the case of a 74 year-old woman with a parietooccipital mass histologically diagnosed with sarcoidosis, with no evidence of systemic involvement. In most cases masses are supratentorial, evidenced by neuroradiological procedures and diagnosed by means of pathological investigation. Corticosteroids are the therapy of choice because of the favorable outcome of cases so treated.

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