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R Abizanda Campos

Publications and source records attributed to R Abizanda Campos.

9 recordsLinked to original sources
PubMed1984

Initial international use of APACHE. An acute severity of disease measure.

We need objective and reliable ways of measuring the severity of disease of hospitalized patients. This paper demonstrates the international predictive accuracy of a severity of disease measure on 1504 consecutive, unscheduled intensive care admissions to 14 hospitals in the United States, France, Spain, and Finland. Using laboratory data gathered within 24 hours of ICU admission, the Acute Physiology Score of APACHE (Acute Physiology and Chronic Health Evaluation) was a strong and stable predictor of hospital survival and concurrent therapeutic effort. In ordinary least squares and logistic multiple regression analysis, the impact of the Acute Physiology Score (APS) was highly significant (p less than 0.001) and of virtually identical magnitude in the United States and European hospitals. The use of this severity of disease measure should help researchers gain insights concerning the efficacy of medical services and the characteristics of physician decision making by permitting more precise prognostic stratification of severely ill patients.

Costs and Cost Analysis↗
PubMed1981

[Study of 51 cases of disseminated intravascular coagulation with reference to the association with acute renal failure. Results in severely ill patients (author's transl)].

During the years 1977 to 1979 51 patients admitted to a general Intensive Care Unit were diagnosed of disseminated intravascular coagulation (DIC); their clinical histories were reviewed and they form the basis of this report. The diagnosis was made independently of the eventual clinical manifestations and it was based on the platelet count, serum fibrinogen levels, alteration of the prothrombin time and the cephalin-kaolin time, elevation of fibrin degradation products, and positivity of the ethanol test. An attempt was made to elucidate the precipitating cause of the coagulopathy, and to see if there was one or more of them. Particular emphasis is made on the association with Gram negative sepsis. Survival was evaluated in relation to heparin therapy, massive doses of corticosteroids, and association to acute renal failure. In conclusion, severe DIC with or without bleeding appears to be a manifestation of multiorgan failure seen in severely ill patients; the prognosis and mortality of this form of DIC is worse than the usual DIC and treatment with heparin or corticosteroids do not increase survival, while its association to acute renal failure implies a higher mortality (p less than 0.02).

Acute Kidney Injury↗
PubMed1981

[Correlation between the Morris' index and pulmonary capillary pressure in patients with acute myocardial infarction].

The authors study the usefulness of the measurement of the negative area of P in V1 (Morris' index) in patients with acute myocardial infarction. The study was carried out prospectively in 70 patients, 31 of them having a Swan-Ganz catheter inserted permitting simultaneous hemodynamic and electrocardiographic measurements. No overall correlation was found between pulmonary capillary pressure (PCP) and Morris' index (Mlx), but a correlation existed in the subgroup of patients that showed evident variations of Mlx values during the study. On admission a relationship between PCP and Mlx was evident in 68% of the cases, without statistical significance. No PCP-Mlx correlation was found in the patients in whom the Mlx was always normal or abnormal during the study, nor in those with a prior history of arterial hypertension or left heart failure. An intraatrial conduction defect was found in 13% of the cases, no PCP-Mlx correlation being present in those. The fact that the PCP-Mlx correlation is best in patients with changing Mlx values in successive measurements that in patients with a prior history of hypertension or left ventricular failure suggests that Mlx values may vary with changes of left atrial pressure. The measurement of the Mlx to estimate left atrial pressure has little value in patients with conditions that may cause left atrial enlargement and intraatrial conduction defects.

Adult↗
PubMed1979

[Usefulness of creatine phosphokinase isoenzyme, CK-MB, in the diagnosis of myocardial necrosis (author's transl)].

With the objective of evaluating the clinical usefulness of a new immunologic method (Merck-1-Test CK-MB), in the determination of the CK-MB activity, 48 patients admitted to the Coronary Unit for angina pectoris were studied. Samples of blood were gathered upon admission and every 4 hours for 48-72 hours, determining in each one of them the total CPK, SGOT, LDH, and CK-MB; electrocardiograms (ECG) were taken and all possible causes for the increase in the enzymatic activity were recorded. Results were analyzed in order to study the following aspects: in the patients in which an acute myocardial infarction was diagnosed the CK-MB activity was studied, also the relation of CK-MB to the remaining parameters, each parameter's sensitivity and specificity and the relationship of the CK-MB to the prognosis of the patients. The usefulness of CF-MB in the differential diagnosis of myocardial necrosis and variations in the total CKP curve in the clinical course of acute myocardial infarction unrelated to myocardial necrosis were evaluated too. The following conclusions were drawn from the analysis of the data. The immunological method has the advantages of its sensitivity and easily and quickly performance (15 minutes), but it has the disadvantage that it detects CK-BB (elevated in cebrovascular disorders). Twenty-four hours after the onset of symptoms, the negativity of CK-MB does not exclude the diagnosis of a myocardial necrosis. CK-MB is more sensitive than total CPK in diagnosing the extent of the area of necrosis. CK-MB is very specific for myocardial necrosis but less sensitive than other parameters. A positive CK-MB upon the patient's admission confirmed the diagnosis of necrosis in 60 percent of the cases, but in 18 percent error was induced because of false positives. CK-MB permitted confirmations of the diagnosis of myocardial infarction in 33 percent of cases in which there was only a suggestion of necrosis by the ECG. The variation in the curve of total CPK in the course of an acute myocardial infarction is subjected to such a great number of factors intercurrent with time, that caution should be exercised in trying to relate a specific elevation of total CPK to an unsuccessful maneuver or to a possible extension of the area of necrosis.

Adult↗
PubMed1979

[The behaviour of fibrinogen and fibrinogen degradation products in myocardial infarction. Justification of a prognostic index (author's transl)].

The behaviour of fibrinogen and fibrinogen degradation products in 52 patients with myocardial infarction was analyzed with the aim of finding an evolutive prognostic index for these patients. According to the clinical course the patients who developed complications were separated from those who did not develop them; a special distinction was made of those complications classified as being of thromboembolic type. In the same way those patients who died were analyzed differentially from those who did not. When these facts were related to the behaviour of fibrinogen and of fibrinogen degradation products the following facts were observed: 1) There was an increase of fibrinogen which reached its maximum on the 5th and 6th days and which returned to normal limits on approximately the 9th day. The greatest increase was reached in those patients who developed thromboembolic complications, although the study did not allow to establish significant differences between this group and the rest of the cases. A reactive and nonspecific behaviour was suggested. 2) Fibrinogen degradation productes reached its maximum increase during the 48 hours after the myocardial infarction, without significant differences between both groups. Therefore it does not seem that a prognostic and evolutive assessment can be derived from the study of the changes in the fibrinogen time and fibrinogen degradation products in patients with myocardial infarction.

Adult↗
PubMed1979

[Pulmonary function differences in healthy subjects according to postural changes (author's transl)].

The total lung capacity (TLC) and its subdivisions along with the forced spirometric values (FEF25-75 and FEV1) were determined in a group of 44 healthy subjects, composed of 29 women and 15 men. The determinations were carried out in a sitting position and in supine position, breathing air. All the pulmonary volumes diminished when the subject lay down, but the functional residual capacity (FRC) was that which underwent a greater reduction. The residual volume decrease was the only one which did not reach statistically significant levels. Women always showed smaller pulmonary volumes than men. It has been demonstrated that FRC can be exactly measured by means of the closed helium technique. The regression figures of FRC in supine position were determinted for both sexes, with a r = 0,33 (p less than 0,1) in women and r = 0,95 (p less than 0.001) in men. The forced spirometric tests did not undergo any important changes although the reduction of the FEV1 was significant in both sexes. The results obtained were compared with those published by other authors.

Adult↗