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Biomedical subjects

J Giner

Publications and source records attributed to J Giner.

At least 37 records · Page 2Linked to original sources

[Compliance with the "recommendations SEPAR" on spirometry].

The objective of this study was to assess Spanish performance of spirometry and to determine the extent to which practice is in accordance with the 1985 SEPAR recommendations. To that end we formulated a questionnaire with 31 items in two sections, 10 covering basic aspects of compliance with necessary techniques and 21 general questions. The questionnaire was sent to all SEPAR members. One hundred eight responses were received. The results show that the typical spirometric measurement was forced expiration without a bronchodilator test by way of a pneumotacograph, with simultaneous representation of the flow/volume curve. Calibration, when performed, is done daily with a 3 1 syringe and atmospheric data are checked. Spirometric measurements are usually obtained by a registered nurse, who also collects anthropometric data directly from the patient. The patient is usually seated with the nose occluded. At least three and at most eight satisfactory readings are obtained. The criteria for starting and ending the maneuver and the reference values used are those recommended by SEPAR. The equipment is washed weekly with soap and water; calibrations and equipment incidences are not recorded. The level of compliance with 1985 SEPAR norms for forced spirometry is adequate with respect to some technical equipment questions but deficient on basic procedure and quality control.

Data Collection↗

[A new device for measuring occlusion pressure].

Mouth pressure in the first 100 ms of inspiration with the airway occluded (P0.1) is an indirect measure of central airways activity. Few adequately validated devices are available on the market for measuring this variable automatically, impeding wider use of this measurement. Our aim was to determine the validity and precision of a new automatized manometer for measuring P0.1 and compare the device to the apparatus normally used in our laboratory. The newly manufactured device consisted of a semiconductor type pressure transduce connected to an analog-to-digital converter. The usual apparatus used was constructed in our laboratory from a Honewell transducer, an analog-to-digital card (Data Translation DT2801) for an IBM-compatible PC and a standard spread sheet program. Both devices recorded a continuous signal at a sample frequency of 100 Hz. To determine linearity, accuracy, sensitivity and precision, two columns of 5 and 25 cmH2O were used. For clinical assessment, 33 patients scheduled for lung function analysis were tested. Five measurements of P0.1 were performed on each. The sensitivity of the new device was 0.1 cmH2O; precision expressed as a variation coefficient was 0%, and linearity expressed as a correlation coefficient was r = 0.999 between the two columns. The mean difference between the two devices was 0.11 (0.46) cmH2O (p < 0.0001). Analysis of concordance confirmed a reading bias for the new device in comparison with the usual one, although the difference was not clinically significant (0.08 to 0.14 cmH2O). We conclude that the new device gives good results and its availability on the market may allow more frequent clinical application of occlusion pressure measurement.

Bite Force↗

Pain during arterial puncture.

STUDY OBJECTIVE: To quantify the level of pain reported by patients during arterial puncture with or without local anesthesia, and to compare the results with levels reported for venous puncture. DESIGN: Double-blind study of puncture with and without local anesthesia. SETTING: Pulmonary function laboratory, department of pneumology. PATIENTS: We studied 270 consecutive patients undergoing arterial puncture divided into two groups. In group A (n = 210), we assessed level of pain with and without local anesthesia and with placebo. In group B (n = 60), we compared pain of arterial and venous puncture. INTERVENTIONS: The arterial puncture was performed in the radial artery; venous puncture was in the median basilic vein. MEASUREMENTS AND RESULTS: The pain was quantified on a visual analog scale (10 cm). Mean level of pain for all arterial punctures without anesthesia or placebo was slight to moderate (3.01 +/- 1.94 cm). Subcutaneous anesthetic infiltration before arterial puncture significantly reduced pain by more than 50%, to 1.50 +/- 1.54 cm, a level that was significantly lower than the pain level reported after conventional venous puncture (1.80 +/- 1.10 cm). The pain reported by patients who received no anesthesia was not significantly different (p = 0.45) from that perceived by those who received subcutaneous infiltration of saline solution (placebo). CONCLUSIONS: Arterial puncture with prior infiltration of local anesthetic is the least painful procedure among those studied. Use of local anesthesia is indicated whenever conventional arterial puncture is required.

Anesthesia, Local↗

[Arterial puncture in Spain. A follow-up of the SEPAR 1987 guideline. Sociedad Española de Neumología y Cirugía Torácica].

This study sought to evaluate the procedures used for measuring arterial gases in our hospitals and determine the level of compliance with the 1987 SEPAR guidelines. Questionnaires covering the obtention, transport, storage and analysis of samples, as well as familiarity with the guidelines were distributed to 150 pneumology, internal medicine, intensive care and emergency services; 78 centers responded (71% from pneumology departments). General information obtained was as follows: arterial puncture is carried out by nurses without anesthesia and using syringes for gases; the radial artery is used; with post-puncture pressure provided by the patient; the sample is analyzed within 15 minutes and cold storage is used. The department's own automatic analyzer is used. Buffered gases and solutions are used for calibration and quality control measures are rare. Some aspects of the guidelines are unfamiliar. We believe that an effort should be made to extend application of the guidelines in order to improve arterial blood gas analysis.

Arteries↗

Measurement of maximal static respiratory pressures at the mouth with different air leaks.

The effect of two different circuit leaks on the measurement of maximal static inspiratory and expiratory pressures at the mouth (Pimax, Pemax) was assessed in 70 patients with respiratory disease. Patients were divided into three groups with similar anthropometric and spirometric characteristics. The first group (30 patients) had their Pmax measured with a leak of 2.0 mm internal diameter (ID) and 37 mm length (as proposed by T. Ringqvist) and repeated with a second leak of 1.0 mm ID and 15 mm length (as recommended by J. L. Clausen). The two measurements were done in random order. Measurements for the other two groups (20 patients each) were taken with one or another, the two leaks randomly alternated with no leak. Pimax measurements obtained with Ringqvist's leak were 17 percent (p less than 0.005) lower than those with Clausen's leak and 22 percent (p less than 0.005) lower than those with no leak. Pemax measurements performed with Ringqvist's leak in place were 11 percent (p less than 0.005) lower than those with Clausen's leak and 11 percent (p less than 0.005) lower than those obtained with no leak. The comparison between Clausen's leak and no leak showed no statistically significant difference. We conclude that whenever the effect of pressure generated in the mouth is to be avoided in the measurement of respiratory Pmax, a leak of the size proposed by Ringqvist is to be preferred.

Asthma↗

Moclobemide versus clomipramine in the treatment of depression: a multicentre trial in Spain.

The efficacy, tolerability and safety of moclobemide were compared with those of clomipramine in a double-blind, randomized parallel group study over 4 weeks. Patients were suffering from various forms of depression: 33 received moclobemide and 31 clomipramine. The mean score on the Hamilton Rating Scale for Depression decreased gradually in both groups, with no significant differences between them; the final scores showed an improvement of 57% in the moclobemide group and 60% in the clomipramine group, compared with baseline. The investigators' assessment of efficacy at the end of treatment was good or very good for 60% of moclobemide patients and 50% of clomipramine patients, and tolerance was good or very good for 31 patients on moclobemide and 26 on clomipramine. The drugs thus showed comparable antidepressant efficacy, and both were mostly well tolerated, although adverse events were more prevalent in patients treated with clomipramine.

Adult↗

Patterns of consumption of alcohol in Seville, Spain. Results of a general population survey.

The results of a general population survey of the patterns of consumption of alcohol in a representative sample of the province of Seville, Spain, are analysed in this article. The proportions of drinkers and abstainers and distribution by age, by sex and by urban-rural residency are discussed. Frequency of consumption declines as age increases in both sexes but the negative slope is more marked in females. Analysis of the results on quantity of alcohol consumed during the week prior to the interview shows that men drink more heavily than women in all age-groups and young people drink more heavily than other age-groups. The combination of data on frequency of consumption and maximum quantity of alcohol reportedly consumed on the highest drinking occasion shows that the majority of men belong to the High Frequency-Low Quantity typology, followed by High Frequency-Medium Quantity, but in women nearly 60% belong to the Low Frequency-Low Quantity typology, followed by High Frequency-Low Quantity. The highest proportions of both abstainers and heavy drinkers are found in the group of people with the lowest income.

Adolescent↗

Electrocatalytic glucose sensor.

High surface area platinum subjected to the appropriate electrical potential cycling regimes exhibits considerable electrocatalytic activity towards glucose oxidation. We have developed a special data processing method, the compensated net charge (CNC) method, to take advantage of the electrocatalytic activity of platinum. This method involves the determination of the net oxidation charge during one complete cycle of a cyclic voltammogram applied to the platinum electrode in a potentiodynamic mode. Under these conditions, the electrode response is very sensitive to glucose, completely insensitive to urea, and only moderately sensitive to amino acid concentration changes. Earlier work with other endogenous and exogenous potential co-reactants shows little interference. Data obtained in vitro and in vivo will be presented and discussed.

Animals↗

Serum lipid levels before and after vasectomy in men.

The blood lipid profile was determined in sixty-two men, 24 to 62 years old, before and two, six and twelve months after surgical occlusion of the vas deferens. No statistically significant differences were found in mean body weight, blood pressure, serum levels of non-esterified fatty acids, total lipids, triglycerides, total cholesterol and alpha, beta and prebeta fractions of the lipoproteins, which were measured before and after surgery. When the serum levels of the alpha and beta fractions were considered in the same subject, it was observed that 12 months after vasectomy a similar percentage of cases showed a predominance of either one of them. Hence, no modifications on the lipid profile of these subjects were found that could indicate an increased risk of arteriosclerotic disease.

Adult↗

The development of an implantable electrochemical glucose sensor: response to glucose in bovine serum ultrafiltrate.

A glucose sensor based on organic oxidation reactions at a platinum electrode is being developed as the key component for an implantable artificial beta cell for diabetic patients. Sensitivity of a membrane-covered platinum electrode to changing glucose concentration in bovine serum ultrafiltrate has been demonstrated, with current response as high as 60 microamperes per 100 mg/dl change in glucose concentration. Reproducibility of measurements probably will depend on satisfactory mechanical assembly of the membrane-electrode combination. An approach to selectivity based on multiple current measurements is suggested.

Animals↗

Inherited congenital normofunctional testicular hyperplasia and mental deficiency. A corroborative study.

Three 46,XY unrelated individuals out of 84 postpubertal male inpatients with severe mental deficiency in a psychiatric hospital were found to have megalorchidia and macrogenitosomia. One of the cases had a similarly affected brother. Endocrine studies were performed in two of the cases with similar results. Normal plasma levels of pituitary gonadotropins were found. A normal testicular function was demonstrated by the finding of normal: (a) baseline plasma testosterone levels and a significant rise following human chorionic gonadotropin administration, (b) sperm analysis, and (c) morphology and cell architecture of the testes. These results were compatible with normofunctional testicular hyperplasia confirming previous observations and allowing the definite individualization of a syndrome with mental deficiency probably due to an X-linked recessive mutation.

Adult↗

Effect of prolactin on the glycolytic metabolism of spermatozoa from infertile subjects.

The effect of prolactin on the glycolytic metabolism of spermatozoa from married infertile men whose semen had spermatozoal concentrations of less than 40 million/ml was studied. In a respirometry system, spermatozoa were incubated with L-U-14C-glucose as substrate. Glucose utilization and production of 14C-lactate by the spermatozoa in the presence of 100 ng of ovine prolactin were greater than in the absence of the hormone. The production of pyruvate was 2.5 times less than the production of lactate wehn spermatozoa were incubated in the absence of prolactin and 1.6 times less in the presence of prolactin. These results indicate that, in spite of having an increased glycolytic metabolism, spermatozoa from oligospermic men are are able to show additional glucose utilization in the presence of prolactin.

Adult↗

Lactate and pyruvate utilization by the spermatozoa of infertile human males.

In studying the metabolic pathway of lactate and pyruvate in human spermatozoa from fertile and infertile subjects, pyruvate 1-C14 and lactate 1-C14 were used as substrates in a radiorespirometry system. Spermatozoa from patients with 20 +/- 2.0/10(6) spz/ml and decreased motility (group B) showed a more active decarboxylation of both pyruvate 1-C14 and lactate 1-C14 with a higher production of lactate C14, oxaloacetate, citrate, and isocitrate than those from fertile normal subjects (group A). Spermatozoa from fertile patients with normal counts but low motility (35 +/- 2.0% +++ motility) showed a similar rate of decarboxtlation of pyruvate 1-C14 but a greater rate of decarboxylation of lactate 1-C14 than those from fertile subjects. The low utilization of pyruvate by the spermatozoa from group C infertile patients, with intermediate counts and motility could be explained by a metabolic failure similar to that produced by some inhibitors of the respiratory chain. We do not have an explanation for the metabolic behavior observed in spermatozoa from group B patients, and further research on this point is desirable.

Adult↗