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Biomedical subjects

R Armengol

Publications and source records attributed to R Armengol.

At least 19 recordsLinked to original sources
PubMed2004

Epidemic soybean asthma and public health: new control systems and initial evaluation in Barcelona, 1996-98.

OBJECTIVE: To evaluate the new measures adopted to control the risks from soybean unloading operations in the Port of Barcelona, after an episode of epidemic asthma in June 1996. METHODS: After an initial cautionary suspension of all soybean unloading operations, they were subsequently resumed under restrictive criteria for time, flux, simultaneity, and meteorological conditions. Emission filtration systems based on either micro pore size filters or polytetrafluoroethylene membranes on tetratex filters showed promising results. RESULTS: Allergen emission underwent a very important decrease to levels 95% to 98% lower. Emissions from the two plants with unloading operations are in the same order of magnitude as the processing plant that does not unload soybean. Allergen concentration levels presented fluctuations initially, but the new filters decreased mean values; despite increased unloading, allergen levels did not increase-mean allergen levels on unloading days (67 U/m(3)) and on days without unloading operations (63 U/m(3)) are similar. A panel of patients detected a cluster of increased symptoms during unloading operations on a day with suboptimal meteorological conditions and comparatively low allergen levels (225-415 U/m(3)). Since the June 1996 episode, no further asthma outbreak has been detected. CONCLUSIONS: The evaluation shows the effectiveness of the new filters in the control of soybean dust emission. With a systematic control programme, industrial soybean operations may function near urban centres without public health risks. These data may be useful in the development of future standards for allergenic agents.

Allergens↗
PubMed2001

The molecular epidemiology of tuberculosis in Caracas, Venezuela, with IS6110 DNA fingerprinting.

In this retrospective study we asses the molecular epidemiological situation of Tuberculosis of the city of Caracas, Venezuela in the year 1994, applying IS6110 DNA Fingerprinting of clinical isolates. Fingerprinting of Mycobacterium tuberculosis strains of sixty-four patients TB patients from all the 5 districts of the city revealed fifty-one distinct IS6110 patterns. Isolates from 20 patients (30%) had fingerprints that were shared with at least one other patient. Based on this sampling we conclude that at least a third of the tuberculosis cases in Caracas in the year 1994 were the result of recent and ongoing transmission, indicating micro-epidemics in the town.

Bacterial Typing Techniques↗
PubMed2000

[Comparison of primary care teams in Barcelona according to management formulas].

OBJECTIVE: The aim of the study is to compare, among socio-economically similar areas, the use of medical services, clinical practice and pharmacy costs depending on the how the primary healthcare teams, that provide these services, are organized according to different managemental formulas. DESIGN: Descriptive study of the evaluation of health care services. PATIENTS AND METHODS: The population units (basic health areas) attended by the reformed primary health care services in Barcelona were classified into three levels according to the population's socioeconomic status (high, medium or low). For each level, two primary health care teams were selected representing different primary health care providers: "Institut Catala de la Salut"; and others. The influence of both the provision option and the population characteristics on service use, clinical practice and costs of prescription were compared. MAIN RESULTS: The services offered by the two provision options differ. However, the use of medical services is related to the socioeconomic characteristics and not to the option for service provision. Whilst there are no relevant differences in clinical practice between the different options, we observed variations among different primary care teams, notably in referrals to specialists and influenza vaccine coverage. The greater source of variation in prescription costs seems to be related to an external confounding factor. CONCLUSIONS: Empirical data have not identified relevant differences in the pattern of use, clinical practice, or costs between the different options for service provision within the model of reformed primary care services. Observed variations seem to be associated mainly with the population's characteristics, its pattern of health service use or other external confounding factors.

Clinical Laboratory Techniques↗
PubMed2000

[Vertigo, imbalance and mourning].

It is a well-known fact, and there are several publications on this matter, the links between panic attacks, simulation, anxiety, depression and lightheadedness or imbalance, but in our perusal of the related literature no connection between pathological mourning, dizziness and imbalance was found. In this paper are reported the outcomes of a prospective study of 58 patients suffering vertigo and imbalance as well and psychiatrically assessed. Pathologic mourning shows its predominance among otic vertiginous. This feature, we think, should be investigated when collecting the anamnesis of patients complaining of dizziness and/or imbalance in order to planning the appropriate treatment.

Grief↗
PubMed1994

Neonatal survival after preterm premature rupture of membranes secondary to first trimester chorionic villus sampling.

A case of preterm premature rupture of membranes (PROM) secondary to first trimester chorial biopsy is described. The newborn survived and physical and psychological development was normal at 1 year of age. On review of the literature, different attitudes may be found with regard to the treatment of PROM: some authors prefer expectant management while others defend extraction of the fetus when reasonable maturity is reached. In both cases the outcome is usually poor for the fetus.

Adult↗
PubMed1991

[The differential diagnosis between pleural exudates and transudates: the value of cholesterol].

BACKGROUND: The evaluation of a patient with pleural effusion depends on its classification as exudate or transudate. Many criteria have been established but none has a 100% sensitivity and specificity. The aim of the present study was to assess the value of the cholesterol level to differentiate between exudate and transudate and to establish its utility as compared with other differential criteria. METHODS: 104 patients with pleural effusion of well defined etiology, permitting their classification into 56 exudates and 48 transudates, were evaluated. In all, Light's criteria were established and cholesterol values in pleural effusion and serum were measured and compared. RESULTS: Using the lactate dehydrogenase level (LDH) in pleural fluid (PF) and the ratios of LDH and proteins in PF and serum, 100% of exudates and 83% of transudates were correctly classified. A cholesterol level of 40 mg/dl or higher best separated exudates and transudates, with a sensitivity of 96% and a specificity of 92% for exudates. A ratio of 0.3 or higher between cholesterol levels in PF and serum was shown to have a high sensitivity (96%) and lower specificity (85%) for exudates. The highest specificity (92%) was achieved when the protein ratio in PF and serum was combined with PF cholesterol. CONCLUSIONS: The cholesterol level in pleural fluid and the ratio between this value and that in serum are highly useful parameters to differentiate between exudates and transudates.

Cholesterol↗
PubMed1989

[Heparin-induced skin necrosis, thrombocytopenia and pulmonary thromboembolism. Presentation of 2 cases].

Two patients with skin necrosis in the injection points after subcutaneous prophylactic porcine calcium heparin administration are reported. In addition, both patients had thrombopenia, deep venous thrombosis and pulmonary thromboembolism. The review of similar cases suggests that skin necrosis is another feature of the thrombopenia and multiple vascular thrombosis syndrome associated with heparin administration. Data from the literature suggest that there is a common immunologically-mediated pathogenetic mechanism responsible for these phenomena through the production of platelet aggregates and immune reaction in endothelial cells. Paradoxically, the continuation of therapy with intravenous sodium heparin was not followed in our patients by new complications despite the theoretical risk.

Adult↗
PubMedDate not supplied

[Coping with the toll of heroin: 10 years of the Barcelona Action Plan on Drugs, Spain].

INTRODUCTION: The epidemic of heroin use began in Barcelona, as in the rest of Spain, in the late 70's, to reach its peak by the end of the 80's. In a first period, responsible officers experimented difficulties to define the specific objectives of opiate control policies. This paper reviews the effects of the adoption of an explicit policy on drug dependence grounded on a wide consensus in the City of Barcelona (Catalonia, Spain). SUBJECTS AND METHODS: Over a period of twelve years, from 1986 to 1997, both demand and offer of care and harm reduction services were analyzed, as well as the evolution of the adverse effects of drug use, such as mortality from acute adverse drug reaction, human immunodeficiency virus (HIV) infection, aids incidence, and incidence of tuberculosis. Data for city residents was compared through four different stages in this period. RESULTS: Despite the lack of data in initial years, relevant changes are apparent. Treatment offer changes clearly, with significant increases in initial treatment, coverage of methadone maintenance programmes, and sterile syringes distribution. Therapeutic compliance of tuberculous intravenous drug users IVDU and risk of HIV infection improve. Emergency service use linked to heroin, overdose, or withdrawal syndrome decreases. Mortality rates decline, although this decline does not reach statistical significance. DISCUSSION: Service offer shows a clear increase, reflected in treatment initiation, while harm reduction services expand. With the development of this process, outcome indicators change, both reflecting changes in the toll of the heroin epidemic (cases of tuberculosis and aids among IVDUs, HIV infection). and changes in a more comprehensive care (better treatment compliance of IVDUs with tuberculosis). There is a lower distortion of emergency services. These changes occur although the predominance of white heroin in Barcelona favors parenteral use.

Acquired Immunodeficiency Syndrome↗