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Biomedical subjects

M Sánchez García

Publications and source records attributed to M Sánchez García.

11 recordsLinked to original sources

[Effect of the availability of a medicalized mobile ICU (MMICU) on the hospital admissions after an out-of-hospital cardiorespiratory arrest (OH-CRA)].

Patients admitted in an ICU after OH-CRA before and after the implementation of a MMICU were evaluated. During a period of 11 years, divided into a pre-MMICU period (1988-1993) and a post-MMICU period (1994-1998), 39 patients were admitted in the pre period and 64 patients in the post period. The basal characteristics, the etiologies of OH-CRA and of death in ICU they were similar. The incidence of severe anoxic encephalopathy (SAE) it doubled in the post period. There were not significant differences both to the discharge from ICU and to the hospital discharge. We conclude that after implementing a MMICU more patients are admitted in ICU resuscitated after OH-CRA. The survival does not vary, but the incidence of SAE increases.

Cardiopulmonary Resuscitation↗

[Development of pre-hepatic portal hypertension of the rat].

OBJECTIVE: A long-term study of the prehepatic portal hypertension model by triple stenosing ligation of the portal vein in the rat. METHOD: A cluster analysis of the animals in the different evolutive stages of portal hypertension (1 1/2, 6, 12 and 14 months) has been carried out. This analysis has made it possible to identify three homogeneous groups (A, B and C) in relationship to the liver weight. RESULTS: The animals with liver atrophy (group C) show a decrease of body, splenic and testicular weights as well as a higher development of the portosystemic collateral circulation in relation to the A and B groups. CONCLUSION: The percentage of animals belonging to the group C decrease progressively during the evolution of portal hypertension and those animals corresponding to the group A, in which is superior the liver weight, increase, while the B group does not change.

Animals↗

Effectiveness and cost of selective decontamination of the digestive tract in critically ill intubated patients. A randomized, double-blind, placebo-controlled, multicenter trial.

We evaluated the effect of selective decontamination of the digestive tract (SDD) on the incidence of ventilator-associated pneumonia (VAP) and its associated morbidity and cost in a mixed population of intubated patients. Two hundred seventy-one consecutive patients admitted to the intensive care units (ICUs) of five teaching hospitals and who had an expected need for intubation exceeding 48 h were enrolled and received topical antibiotics or placebo. Uninfected patients additionally received ceftriaxone or placebo for 3 d. VAP occurred in 11.4% of SDD-treated and 29.3% of control-group patients (p < 0.001; 95% confidence interval [CI]: 7.8 to 27.9). The incidence of nonrespiratory infections in the two groups was 19.1% and 30.7%, respectively (p = 0.04; 95% CI: 0.7 to 22.7). Among survivors, the median length of ICU stay was 11 d (interquartile range: 7 to 21.5 d) for the SDD-treated group and 16. 5 d (10 to 30 d) for the control group (p = 0.006). Mean cost per survivor was $11,926 for treated and $16,296 for control-group patients. Mortality was 38.9% and 47.1%, respectively (p = 0.57). In decontaminated patients, the prevalence of gram-negative bacilli fell within 7 d from 47.4% to 13.0% (p < 0.001), whereas colonization with resistant gram-positive strains was higher (p < 0. 05) than in the placebo group. In a mixed population of intubated patients, SDD was associated with a significant reduction of morbidity at a reduced cost. Our findings support the use of SDD in this high-risk group.

Bacteria↗

[The consumption of tobacco, alcohol and other drugs by adolescent Spanish students].

OBJECTIVES: This study was undertaken in the mid-1990s (1994) to describe the use of tobacco, alcohol, and non-institutionalized drugs among pre-adolescent and adolescent Spanish students. METHODS: Information was collected within the framework of a periodic transversal study of life styles among European students, with particular emphasis on health-related habits. In the current study we present the results of the last survey carried out in Spain within the context of this study (1994), which involved a representative sample of Spanish students 11, 13, 15, 17 and 18 years-old (n = 6,711). An anonymous questionnaire was completed by the students in class. The survey sampling uses proportionate stratification and multistage sampling. RESULTS: In 1994, 49% of the Spanish students in this age group had tried tobacco. Twenty-four percent were sporadic or regular smokers. There was a large proportion of female smokers than male smokers (27% vs 20%). The overall proportion of smokers increased from 3% at 11 years to 47% at 18 years. One third (33%) of the 18-year-old students smoked daily. Eighty-four percent of the students of this age indicated that they had tried one or more types of alcoholic beverage. Twenty-one percent consumed alcohol regularly (at least once a week). Regular alcohol use was somewhat more common among males (24%) than among females (19%). Forty-six percent of the 18-year-old students consumed alcoholic beverages regularly and 66% had been intoxicated one or more times. Almost one fifth (18%) of the 13-to-18 year-old students indicated that they had tried some type of non-institutionalized drug, although the current rate of consumption was 8%. Cannabis was the drug most frequently tried (18%) and the drug most often consumed at present (8%), followed by cocaine and heroin. More males than females had tried non-institutionalized drugs. DISCUSSION: Analysis of the data revealed that adolescent tobacco use is increasingly frequent among females. Alcohol use continues to be widespread among Spanish pre-adolescents and adolescents. Alcohol use begins in childhood and becomes consolidated in adolescence. The results suggest, in relation to gender differences in the use of tobacco, alcohol, and non-institutionalized drugs, that there is a strong tendency toward the homogenization of these habits between genders. It is necessary to emphasize the preventive measures of drug dependence among Spanish pre-adolescents and adolescents.

Adolescent↗