Biomedical subjects

R Guell

Publications and source records attributed to R Guell.

4 recordsLinked to original sources

PubMed2006

Performance of mechanical ventilators at the patient's home: a multicentre quality control study.

BACKGROUND: Quality control procedures vary considerably among the providers of equipment for home mechanical ventilation (HMV). METHODS: A multicentre quality control survey of HMV was performed at the home of 300 patients included in the HMV programmes of four hospitals in Barcelona. It consisted of three steps: (1) the prescribed ventilation settings, the actual settings in the ventilator control panel, and the actual performance of the ventilator measured at home were compared; (2) the different ventilator alarms were tested; and (3) the effect of differences between the prescribed settings and the actual performance of the ventilator on non-programmed readmissions of the patient was determined. RESULTS: Considerable differences were found between actual, set, and prescribed values of ventilator variables; these differences were similar in volume and pressure preset ventilators. The percentage of patients with a discrepancy between the prescribed and actual measured main ventilator variable (minute ventilation or inspiratory pressure) of more than 20% and 30% was 13% and 4%, respectively. The number of ventilators with built in alarms for power off, disconnection, or obstruction was 225, 280 and 157, respectively. These alarms did not work in two (0.9%), 52 (18.6%) and eight (5.1%) ventilators, respectively. The number of non-programmed hospital readmissions in the year before the study did not correlate with the index of ventilator error. CONCLUSIONS: This study illustrates the current limitations of the quality control of HMV and suggests that improvements should be made to ensure adequate ventilator settings and correct ventilator performance and ventilator alarm operation.

Analysis of Variance↗

PubMed1995

Dermatoglyphics in insulin-dependent diabetic patients with limited joint mobility.

Hand and palm dermatoglyphics were studied in 158 insulin-dependent diabetic children and adolescents [85 with limited joint mobility (LJM) and 73 without]. The findings in this group were compared with those in 400 control subjects, with a similar racial distribution. The main dermatoglyphics alterations found in diabetic patients with LJM, as compared with non-LJM diabetic patients and controls, may be summarized as follows: (a) decrease in digital total ridges count (TRC); (b) higher frequency in the number of arches; (c) decrease in the sum of a line and cubital loops, particularly in the women; (d) increase in the number of t'-axial triradii. These alterations suggest a genetic aetiology of this complication. Further studies are recommended in order to provide more insight into the origin of this disorder.

Adolescent↗

PubMedDate not supplied

Histological and histochemical skin changes in insulin-dependent diabetic patients with and without limited joint mobility.

We studied 24 skin biopsies of the hand in 24 IDDM patients followed at the National Institute of Endocrinology (NIE). Biopsies of 7 healthy individuals were used as controls. The diabetics were divided into two groups, with limited joint mobility (LJM) and without LJM. We compared the different structural components of the skin, and their changes; we used quantitative, semi-quantitative and qualitative methods. We found that patients with LJM had a greater levelling, less rete pegs and dermal papillae (p less than 0.05), increased alteration of the mucopolysaccharides distribution (p less than 0.005), higher frequency of alterations of the elastic fibers (p less than 0.05) and collagen (p less than 0.005), vessel enlargement (p less than 0.025) acquiring cord shape, and reduction of the vessel lumen (p less than 0.005) in comparison with patients without LJM and controls. This could be a consequence of the chronic hyperglycemia from childhood that affects the structure, architecture and function of collagen fibers. Genetic and immunologic studies could help to elucidate the mechanisms of this alteration.

Adolescent↗

PubMedDate not supplied

Attentional processing in hyperthyroid children before and after treatment.

To determine whether specific components of attentional processing may be differentially disrupted during thyrotoxicosis, nine children with hyperthyroidism were assessed for intelligence and attention before and after one year of therapy. The attention test allowed for measurement of sustain, disengage, and shift subcomponents of attentional processing. Comparison with pediatric controls revealed lower nonverbal intelligence during thyrotoxicosis, which improved to normal following euthyroidism. On the attention task, an effect was observed during thyrotoxicosis only on the shift and disengage functions of attentional processing but not sustain. Attention results were unrelated to self-reported anxiety at time of testing. Results are discussed in terms of thyroid hormone activation of the prefrontal cortex, which is thought to be the cerebral substrate underlying the shift and disengage functions of attentional processing.

Anxiety↗