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Biomedical subjects

J L Alvarez-Sala

Publications and source records attributed to J L Alvarez-Sala.

At least 19 recordsLinked to original sources
PubMed2006

Noninvasive measurement of the maximum relaxation rate of inspiratory muscles in patients with neuromuscular disorders.

BACKGROUND: Slowing of inspiratory muscle relaxation has been used as an index for inspiratory muscle fatigue. However, maximum relaxation rate measured from oesophageal pressure traces after maximum sniff (P(oes) MRR) has limited clinical usefulness because it requires an oesophageal balloon catheter system. OBJECTIVES: It was the aim of this study to establish whether, in neuromuscular patients, maximum relaxation rate assessed from sniff nasal pressure (P(nasal) MRR) reflects oesophageal MRR and the tension-time index of the diaphragm (TT(di)). METHODS: Twenty patients with neuromuscular disease and 10 healthy subjects were studied. P(oes) and transdiaphragmatic pressure were measured while P(nasal) was recorded with a balloon advanced through the nose into the nasopharynx. Maximum P(oes), transdiaphragmatic pressure and P(nasal) were simultaneously measured while the patients performed maximal sniffs. The MRR (% pressure fall/10 ms) for each sniff, the TT(di) and the tension-time index of respiratory muscles were determined. RESULTS: Neuromuscular patients showed higher TT(di), lower P(oes) MRR and lower P(nasal) MRR than the control group. In patients with neuromuscular disease, the correlation coefficient of P(nasal) MRR and P(oes) MRR was 0.985 (p < 0.001). Regression analysis showed that P(oes) MRR = -1.101 + 1.113.P(nasal) MRR (r(2) = 0.929, standard error of the estimate = 0.208). Indeed, P(nasal) MRR was negatively correlated with TT(di) (r = -0.914, p < 0.001) and the tension-time index of respiratory muscles (r = -0.732, p < 0.001). In the neuromuscular group, the mean difference between P(nasal) MRR and P(oes) MRR was 0.286 +/- 0.217%/10 ms. CONCLUSIONS: P(nasal) MRR obtained from a maximal sniff accurately reflects P(oes) MRR and TT(di) in patients with neuromuscular disorders.

Adult↗
PubMed2004

Effect of exacerbations on quality of life in patients with chronic obstructive pulmonary disease: a 2 year follow up study.

BACKGROUND: A study was undertaken to evaluate exacerbations and their impact on the health related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD). METHODS: A 2 year follow up study was performed in 336 patients with COPD of mean (SD) age 66 (8.2) years and mean (SD) forced expiratory volume in 1 second (FEV(1)) 33 (8)% predicted. Spirometric tests, questions regarding exacerbations of COPD, and HRQL measurements (St George's Respiratory Questionnaire (SGRQ) and SF-12 Health Survey) were conducted at 6 month intervals. RESULTS: A total of 1015 exacerbations were recorded, and 103 (30.7%) patients required at least one hospital admission during the study. After adjustment for baseline characteristics and season of assessment, frequent exacerbations had a negative effect on HRQL in patients with moderate COPD (FEV(1) 35-50% predicted); the change in SGRQ total score of moderate patients with > or =3 exacerbations was almost two points per year greater (worse) than those with <3 exacerbations during the follow up (p = 0.042). For patients with severe COPD (FEV(1) <35% predicted) exacerbations had no effect on HRQL. The change in SGRQ total score of patients admitted to hospital was almost 2 points per year greater (worse) than patients not admitted, but this effect failed to show statistical significance in any severity group. There was a significant and independent seasonal effect on HRQL since SGRQ total scores were, on average, 3 points better in measurements performed in spring/summer than in those measured in the winter (p<0.001). CONCLUSIONS: Frequent exacerbations significantly impair HRQL of patients with moderate COPD. A significant and independent effect of seasonality was also observed.

Adult↗
PubMed2004

[Effect of immunomodulator AM3 on the exacerbations in patients with chronic bronchitis: a systematic review of controlled trials].

OBJECTIVE: Analyze the effect of AM3, an oral immunomodulator, on the exacerbations and on the use of antibiotics in patients with chronic obstructive pulmonary disease (COPD). DESIGN: Systematic search of controlled clinical trials that used AM3 in some treatment group and that included data on the clinical effects of this drug on patients with COPD. SELECTED VARIABLES: Nine studies were detected in which the clinical effectiveness of AM3 was evaluated in relation to the number of infectious exacerbations, their length, and the length of the antibiotic treatment used. RESULTS: In comparison with placebo group, the average number of excaerbations suffered by the patients treated with AM3 declined significantly in 0.31 units (p < 0.001; 95% confidence interval: 0.20-0.42), without heterogeneity among the different studies (Q = 6.62; p > 0.43). With regard to the average length of the exacerbations and the average length of the antibiotic treatment used for the exacerbations, both variables declined significantly in the group treated with AM3 (3.10 days, p < 0.001, and 8.07 days, p < 0.001, respectively) but this positive effect could not be confirmed because trials were close to heterogeneity. CONCLUSIONS: The results of this systematic review show that AM3 has a clinical effect in the prevention of exacerbations of COPD patients because reduces significantly their number. This could be related to a slowing in the progression of the deterioration in the respiratory function with a potential impact on the quality of life of the patients. Furthermore, these data imply a positive therapeutic result and a possible decline in development of bacterial resistances secondary to the frequent and indiscriminate use of antibiotics in these patients.

Adjuvants, Immunologic↗
PubMed2002

Treatment and quality of life in patients with chronic obstructive pulmonary disease.

Treatments administered to patients with chronic obstructive pulmonary disease (COPD), especially when used in multiple combinations, are not free of interactions and side effects that can potentially impair health-related quality of life (HRQL). We studied HRQL and its relationship with treatment in a group of 441 patients with stage II or III COPD (age: 66.6 (SD: 8.3) years; FEV1: 32.4% (SD: 8.1%)) using the St George's Respiratory Questionnaire (SGRQ) and the 12-item short form (SF-12) Health Survey. The most prescribed drugs were ipratropium bromide (87.5%), inhaled corticosteroids (69.4%) and short-acting beta-2 agonists (64.9%). Patients with stage III of the disease were receiving more drugs, particularly short-acting beta-2 agonists (p = 0.002) and inhaled corticosteroids (p = 0.031). The use of theophyllines was associated with a worse total SGRQ score (beta = 4.49; p < 0.001), although this negative association decreased with advanced age. A trend towards worse SGRQ scores was observed with the use of high doses of long-acting beta-2 agonists (beta = 3.22; p = 0.072). Patients receiving three drugs or more presented worse total SGRQ scores than patients receiving fewer drugs (beta = 6.1, p < 0.001; and beta = 7.64, p < 0.001, respectively). These findings suggest that the use of multiple drugs in the treatment of patients with COPD is associated with worse total SGRQ scores. The effect of drugs, their dosages and associations with other drugs on HRQL merit further research.

Adrenal Cortex Hormones↗
PubMed2002

Pulmonary diffusing capacity in chronic dialysis patients.

Patients with end-stage renal disease treated by hemodialysis with bioincompatible membranes are exposed during the dialysis period to acute effects on lung microcirculation, which may result in pulmonary fibrosis and diffusion defects in long-standing dialysis. To investigate the occurrence of these possible chronic pulmonary alterations, we determined lung function in patients with chronic renal failure not undergoing hemodialysis and in patients who had been receiving regular hemodialysis both for short and long periods of time. Forty-three patients divided into three groups were studied: 17 patients before dialysis with a mean (SD) creatinine clearance of 14.1 (6.8) ml/min 11.73 m2, 10 patients receiving regular hemodialysis for a period of less than 12 months (mean 6.4 +/- 3.5 months), and 16 patients receiving regular hemodialysis for more than 5 years (mean 8.3 +/- 3.6 years). First-use bioincompatible cellulosic dialysis membranes were used in all the cases. The following parameters were recorded: forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), total lung capacity (TLC), residual volume (RV), carbon monoxide transfer factor (TLCO), accessible lung volume (VA), carbon monoxide transfer factor/accessible lung volume (KCO- that is, TLCO/VA), and arterial blood gases. Patients receiving regular hemodialysis for more than 5 years showed significantly lower values of TLCO and KCO than patients before dialysis and patients receiving regular hemodialysis for less than 12 months. Seventy-five percent of patients on long-term hemodialysis had markedly reduced TLCO or KCO values (below 80% of the reference value) as compared with 17% of patients before dialysis and 10% of patients dialyzed for less than 12 months (P < 0.001). Differences among groups for the remaining parameters were not observed. In conclusion, patients undergoing long-term regular hemodialysis with a bioincompatible membrane showed a selective reduction in pulmonary diffusing capacity possibly due to chronic pulmonary fibrosis.

Aged↗
PubMed2001

[Analysis of the impact of Archivos de Bronconeumología through the Science Citation Index].

OBJECTIVE: To describe the impact factor of Archivos de Bronconeumología from 1997 until 2000 and to identify the patterns of citation of the journal and topics having the greatest impact. METHOD: SCISEARCH was used to locate citations of articles published by Archivos de Bronconeumología between 1995 and 1999. The following data were collected for each article: year of publication, authors, journal, country of publication, language, specialty or specialties, institution(s), residence of the first author and topic. The impact factor was calculated as the ratio of citations received in one year by articles published in Archivos de Bronconeumología during the two previous years and the total number of articles published by Archivos de Bronconeumología over the two years under study. RESULTS: The impact factor of Archivos de Bronconeumología was 0.107 in 1997, 0.089 in 1998, 0.105 in 1999 and 0.119 in 2000. Citations were found in a wide range of source journals, with respiratory system publications having little weight. Citations were made mainly by Spanish authors (75%) and self-citation was restrained (21.1%). Topics related to tuberculosis and respiratory infections (23.6% of the citations received) and chronic obstructive pulmonary disease (12.5%) made the greatest impact. CONCLUSION: The impact factor of Archivos de Bronconeumología is modest, although higher than those of some other publications included in Journal Citation Reports.

Databases, Bibliographic↗
PubMed2001

Defective natural killer and phagocytic activities in chronic obstructive pulmonary disease are restored by glycophosphopeptical (inmunoferón).

We have investigated both modifications in natural (innate) immunity caused by chronic obstructive pulmonary disease (COPD) and the effects of a glycophosphopeptical immunomodulator (Inmunoferón) treatment on COPD-associated immunoalterations. In a double-blinded clinical trial, 60 patients with COPD received glycophosphopeptical or placebo during 90 consecutive days at oral doses of 3 g/d. Fifty-six sex- and age-matched healthy control subjects were included as a reference group for immunologic parameters. Peripheral blood natural killer (PBNK) cell cytotoxic activity and phagocytic activity of peripheral monocytes/macrophages (Mo/Ma) and polymorphonuclear (PMN) cells were assessed at baseline and then again at the end of treatments. We found both PBNK activity and phagocytic activity to be significantly decreased in patients with COPD compared with levels in healthy volunteers. The treatment with glycophosphopeptical provoked significant stimulatory effects on PBNK cytotoxic activity. This stimulation was not mediated by an increase in CD3(-)CD56(+) NK cells. Further, glycophosphopeptical significantly increased the percentage of monocytes and PMNs that phagocytize Escherichia coli in vitro, as well as increased phagocytic indices. We conclude that peripheral blood cells of patients with COPD show clear defects in natural immunity that are partially rescued by glycophosphopeptical.

Adjuvants, Immunologic↗
PubMed2001

A bibliometric evaluation of European Union research of the respiratory system from 1987-1998.

This study analyses the evolution of the bibliometric indicators of productivity and repercussion of European Union (EU) research into the respiratory system during the period from 1987-1998, describing the geographical distribution. Using MedLine, a selection was made of those articles by EU authors published between 1987-1998 in 38 respiratory system journals (classification from the Institute for Scientific Information). The journals, country of origin, number of articles and the relation to socioeconomic data, productivity index, visibility index, expected impact factor (EIF) and relative impact factor (RIF) were all analysed. The number of EU publications in respiratory system journals experienced an exponential increase, going from 606 articles (14.3% of world production) in 1987, to 2,325 (33.2%) in 1998. During this same period, the EIF increased from 1,258 to 2,111. The greatest gross productivities were those of the UK, France, Italy and Germany, although when corrected for number of inhabitants, Sweden, the Netherlands, Belgium and Denmark headed the list. The countries with the greatest mean EIF were the Netherlands, the UK, Spain and Belgium. In conclusion, productivity and repercussions of European Union research of the respiratory system experienced an important increase during this period.

Authorship↗