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Biomedical subjects

P Gallar

Publications and source records attributed to P Gallar.

At least 19 recordsLinked to original sources
PubMed2001

Modelling home televisiting services using systems dynamic theory.

A quantitative model was developed to study the provision of a home televisiting service. Systems dynamic theory was used to describe the relationships between quality of care, accessibility and cost-effectiveness. Input information was gathered from the telemedicine literature, as well as from over 75 sessions of a televisiting service provided by the Severo Ochoa Hospital to 18 housebound patients from three different medical specialties. The model allowed the Severo Ochoa Hospital to estimate the equipment needed to support increased medical contacts for intensive cardiac and other patients.

Adult↗
PubMed2001

Impact of a broadband interactive televisit/teleconsultation service for residential and working environments.

The availability of health care attention at the point of need is one of the key benefits of telemedicine. Home environment and working place are the two scenarios selected in this article to evaluate the impact of a televisit and teleconsultation service. 31 users from four different medical and patient groups participated in this study supported by European Commission ATTRACT project. The experiences, carried out in Madrid and Valencia Spanish sites, benefited from interactive broadband access networks to provide cost-effective telecare services. Key areas analyzed encompass systems usability, clinical outcomes, patients quality of care and infoethic issues. Services advantages were verified and compared both from patients and medical staff points of view. Main benefits pointed out refer to displacement reduction, better communication doctor/patient, provision of comfort or friendliness, more precise therapy follow-up and increases in patients sense of well being.

Attitude of Health Personnel↗
PubMed1995

[Treatment of the diffuse and focal proliferative forms of lupus nephropathy with intravenous cyclophosphamide. Intravenous cyclophosphamide in systemic lupus erythematosus].

The objective is to evaluate the therapeutic effect and toxicity of IV Cyclophosphamide on the evolution of diffuse and focal proliferative forms of lupus nephritis. It's a prospective, descriptive and non-controlled study. We treated 12 patients (M/F = 1:11, aged 30.07 +/- 14.15) diagnosed by renal biopsy with diffuse proliferative (n = 10) and focal (n = 2) lupus nephritis. All patients received IV Cyclophosphamide. A dose of 1 g/sg.m of body surface area was administered monthly for the first three months and each three months until two years. The follow-up was 34 +/- 24.83 months (range 6-67). Seven patients completed two years of treatment with Cyclophosphamide with a further follow-up of 18.71 +/- 12.36 months (range 6-67). Renal function either improved or remained unchanged. Proteinuria, hematuria and immunologic markers decreased or normalized at three years. The patients who finished the period of two years with CFIV remained stable. There were neither infections nor hemorrhagic cystitis. We conclude that with the scheme of CFIV used by us good therapeutics effects will be obtained with minimum secondary toxicity in a follow-up of three to five years.

Adolescent↗
PubMed1994

Choice of dialysis membrane does not influence the outcome of residual renal function in haemodialysis patients.

It has been recently proposed that haemodialysis membrane choice may influence the maintenance of residual renal function. The aim of the present study was to prospectively analyse the effect of membrane choice on the outcome of renal function in patients entering a chronic haemodialysis programme. Twenty-two patients from four hospitals have been randomly assigned to be dialysed with either polysulphone (PSF)/polyacrylonitrile (PAN) (group A; n = 9), or cuprophane membranes (group B; n = 13). Basal and monthly serum biochemistry, residual creatinine clearance (Ccr) and urine volume (Vu), pharmacological and dialytic treatment, diet, and haemodialysis-related complications were recorded. A significant decrease was observed in the two most relevant variables, i.e. remnant Ccr and Vu, within 3 months of starting haemodialysis, with stabilization during the further follow-up. Such decrease was similar (P NS) for both groups A and B throughout the 9-month observation period. In conclusion, our results suggest that the choice of haemodialysis membrane does not influence the outcome of the residual renal function. Renal function decreased significantly within 3 months on haemodialysis, independently of the type of dialyser membrane.

Acrylic Resins↗
PubMed1993

Gastroparesis: an important cause of hospitalization in continuous ambulatory peritoneal dialysis patients and the role of erythromycin.

Gastroparesis is a disabling complication in diabetic patients. It has been reported as the second most frequent cause of hospitalization in diabetic patients on continuous ambulatory peritoneal dialysis (CAPD). We analyzed infectious and noninfectious complications in our CAPD patients. We included 31 patients (12 diabetics and 19 nondiabetics) with an average time on CAPD of 14 +/- 7 months. The incidence of peritonitis was 1.68 episodes/patient/year in diabetics and 0.84 in nondiabetics. Nine (75%) diabetic patients had peritonitis, 5 (42%) had vomiting, and 4 (33%) had ischemic heart disease. The hospitalization index (days/year) was greater in diabetics: 11.83 +/- 11.36 versus 4.16 +/- 8.84 in nondiabetics (p < 0.05). Vomiting was the first cause of admission in diabetics. We were unable to control severe gastroparesis with cisapride and metoclopramide in 4 patients. Erythromycin, 100 mg/2-L bag of dialysate, improved symptoms in all of them. We concluded that gastroparesis is an important cause of morbidity in CAPD patients. Intraperitoneal erythromycin can improve symptoms if other prokinetic drugs fail.

Cisapride↗
PubMed1989

Induced changes of the peritoneal diffusion capacity by smoking, intraabdominal hypertension and omentectomy.

UNLABELLED: Peritoneal membrane suffers in some CAPD patients changes which modify its functionalism. In order to know whether these changes could be expected or appropriate, it is necessary to explore the general and particular conditions which can alter peritoneal physiology. Three aspects, smoking, intraabdominal hyperpressure and and omentectomy are situations which have not been included in the studies of peritoneal physiology. PATIENTS: The control group was constituted by 23 patients. Diabetics were studied as a separate group, with their own 10 patient controls. Smokers (1-20 cigarettes per day): 15 were non-diabetic patients, 9 were females. Diabetic smokers: 7 patients. Intraabdominal hyperpressure was determined by two big polycycstic kidneys (PCKD) in 8 patients, none diabetic. Omentectomy was performed in 6 non-diabetic and 9 diabetic patients. In all cases the procedure was prescribed because of an early catheter entrapment. Smoker patients show significant higher MTCs values for urea and creatinine than controls, but the slightly lower ultrafiltration value did not reached significant difference. Polycystic kidney patients showed lower MTCs values in respect to controls. Ultrafiltration capacity was similar. Omentectomized patients did not show any differences in respect to controls. In the diabetic patients group, neither ultrafiltration nor MTCs values presented significant differences between the established subgroups. So, smoking did not seem to induce higher MTC values as in the non-diabetic group. In conclusion, and according to the present results, two more situations should be taken into account in the evaluation of the peritoneal membrane dialyzing capacities: smoking, which increases diffusion capacity except for diabetics and PCKD with tow big kidneys, which decreases this capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMedDate not supplied

Peritoneal sodium mass removal in continuous ambulatory peritoneal dialysis and automated peritoneal dialysis: influence on blood pressure control.

BACKGROUND/AIM: Sodium and water retention is common in peritoneal dialysis patients and contributes to cardiovascular disease. As peritoneal sodium removal depends partly on dwell time, and automated peritoneal dialysis (APD) often uses short dwell time exchanges, the aim of this study was to compare the 24-hour peritoneal sodium removal in APD and standard continuous ambulatory peritoneal dialysis (CAPD) patients and to analyze its possible influence on blood pressure control. METHODS: A total of 53 sodium balance studies (30 in APD and 23 in CAPD) were performed in 36 stable peritoneal dialysis patients. The 24-hour net removal of sodium was calculated as follows: M = ViCi - VdCd, where Vd is the 24-hour drained volume, Cd is the solute sodium concentration in Vd, Vi is the amount of solution used during a 24-hour period, and Ci is the sodium concentration in Vi. Peritoneal sodium removal was compared between APD and CAPD patients. Residual renal function, serum sodium concentration, daily urinary sodium losses, weekly peritoneal Kt/V and creatinine clearance, 4-hour dialysate/plasma creatinine ratio, proportion of hypertonic solutions, net ultrafiltration, systolic and diastolic blood pressures, and need for antihypertensive therapy were also compared between the groups. RESULTS: Peritoneal sodium removal was higher (p < 0.001) in CAPD than in APD patients. There were no significant differences in residual renal function, serum sodium concentration, urinary sodium losses, peritoneal urea or creatinine clearances, 4-hour dialysate/plasma creatinine ratio, or proportion of hypertonic solutions between groups. The net ultrafiltration was higher in CAPD patients and correlated strongly (r = 0.82; p < 0.001) with peritoneal sodium removal. In APD patients, peritoneal sodium removal increased significantly only in those patients with a second daytime exchange. The systolic blood pressure was higher (p < 0.05) in APD patients, and the proportion of patients with antihypertensive therapy was also higher in APD patients, although no significant relationship between blood pressure values and amount of peritoneal sodium removal was found. CONCLUSIONS: The 24-hour sodium removal is higher in CAPD than in APD patients, and there is a trend towards better hypertension control in CAPD patients. As hypertension control and volume status are important indices of peritoneal dialysis adequacy, our results have to be considered in the choice of the peritoneal dialysis modality.

Adult↗