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Biomedical subjects

V Plaza

Publications and source records attributed to V Plaza.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Clinical characteristics and morbidity in stable asthma. A descriptive analysis of asthma in a Mediterranean community].

UNLABELLED: Scarce clinical and epidemiological data related to asthma are available in Spain. OBJECTIVES: a) to determine the severity of disease and morbidity among symptomatic asthmatics, and b) to determine whether international recommendations for the treatment of asthma are being followed. A prospective descriptive study enrolling asthmatics older than 14 years of age who experienced symptoms within the past year. The study was performed in the Osona district, a semi-rural area north of Barcelona. Spirometric tests were given and case histories taken, including symptoms caused by the disease. The international guidelines analyzed were those published in 1992 by the National Institutes of Health for the International Consensus Report on Diagnosis and Treatment of Asthma. We studied 333 patients; 214 (64%) were women and 119 (36%) men. Asthma was mild in 140 (42%), moderate in 116 (35%) and severe in 77 (23%). The need for short-term oral corticosteroids, visits to primary care physicians, and missed work days were all significantly greater among patients with severe asthma than for those with mild or moderate asthma. However, 23% of the patients with mild asthma missed work at least once. Drugs used were beta-adrenergic agonists of short duration of effect (76%) and inhaled corticosteroids (66%). CONCLUSIONS: a) in most symptomatic asthma patients, disease is mild; b) although patients with severe asthma have higher rates or morbidity, patients with mild disease also have marked symptoms; c) the drugs used for treatment are in compliance with the 1992 international guidelines.

Adolescent↗
PubMed1997

[Health workers' knowledge and skills regarding the use of the Turbuhaler inhaler].

The aim of this study was to evaluate health care workers' theoretical knowledge and skill in managing the dry powder Turbuhaler. We studied 118 individuals in three groups: 50 nurses, 34 medical residents and 34 staff physicians. Theoretical knowledge was evaluated by a questionnaire specifically designed for the purpose. Skill in managing the device was analyzed by evaluating a practical demonstration of the inhaling technique generally recommended, using a placebo inhaler. Six percent of staff physicians, 3% of the residents and 2% of the nurses answered the theoretical questionnaire correctly. Twenty-one percent of the staff physicians, 15% of the residents and 6% of the nurses inhaled correctly. However, when skill in managing the inhaler was evaluated against the maneuvers recommended by the manufacturer (which do not oblige exhaling before inhaling through the device and then holding the breath), there was significant improvement: 41% of the staff physicians, 23% of the residents, and 20% of the nurses inhaled correctly. We can conclude by saying that: a) our health care workers' general knowledge about how to handle the Turbuhaler device is deficient; b) the proportion of correct inhalation maneuvers observed doubles when these are assessed according to the manufacturer's recommendations, and c) health care workers should receive specific training in the inhalation techniques required for using the various devices usually prescribed.

Clinical Competence↗
PubMed1997

Hyaluronic acid suppresses fibronectin fragment mediated cartilage chondrolysis: II. In vivo.

Intra-articular sodium hyaluronic acid (HA) has been used as a treatment intervention in the management of osteoarthritis. It has been observed that HA can coat the articular surface, and thus, has been suggested to provide a possible prophylactic barrier for the articular cartilage. In an accompanying manuscript (Homandberg et al.), we report that a commercially available high-molecular-weight HA (approximately 800-kDa, ARTZ, Seikagaku Corp.) can partially block fibronectin fragment (Fn-f)-mediated cartilage injury in vitro. Herein we report a study of the effects of intra-articular HA on an in vivo animal model of Fn-f-mediated cartilage injury. Rabbit knees were injected with Fn-f, and after 1 week, the cartilage proteoglycan (PG) content had decreased to 59 +/- 8% of control. In sharp contrast, PG content in knees receiving pre-treatment with HA followed by Fn-f injection had only decreased to 85 +/- 27% of control (P < 0.01). Similarly, the PG content in knees receiving an injection of Fn-f, followed by an injection of HA were significantly higher (74 +/- 18% of control) than Fn-f injured knees with no treatment (P < 0.02). Intra-articular HA alone had no effect on cartilage PG content. The results in this study suggest that HA is effective in partially preventing Fn-f mediated cartilage injury, most likely by coating the articular surface. Further, HA treatment after Fn-f injury may facilitate restoration of matrix components.

Animals↗
PubMed1996

[Bronchiolitis associated with ulcerative colitis].

Inflammatory bowel disease (IBD) only occasionally affects the lung. Noteworthy among the various pulmonary entities related to IBD are chronic bronchitis and bronchiectasis, though reports of bronchiolitis, obliterants bronchiolitis with organizing pneumonia and other interstitial diseases have also been published. Given the rarity of such pneumopathy, we report a case of bronchiolitis in a patient with a prior diagnosis of ulcerative colitis. We discuss the radiological findings and the results of lung function testing, emphasizin the utility of corticosteroid treatment, which usually leads to a good outcome in pneumopathy secondary to IBD.

Administration, Oral↗
PubMed1996

Validity and reliability of the St George's Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example.

We describe the adaptation into Spanish of the St George's Respiratory Questionnaire (SGRQ), a self-administered questionnaire developed by Jones et al. (1991) covering three domains of health in airways disease patients: symptoms, activity and impacts. For the adaptation, the forward and back-translation method by bilinguals was used, together with professional committee and lay panel. Once tested for feasibility and comprehension, 318 male chronic obstructive pulmonary disease (COPD) patients with a wide range of disease severity completed the Spanish version of the SGRQ. The clinical status of the patients was evaluated concurrently with the measurement of health status. Lung function was assessed in the 2 months before or after the questionnaire administration. The Spanish version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.94 for the overall scale and 0.72 for "Symptoms", 0.89 for "Activity", and 0.89 for "Impacts" subscales. Correlation coefficients between the overall score and dyspnoea and % forced expiratory volume in one second (FEV1) were 0.59 and -0.45, respectively, and these correlations were higher than those observed between the clinical variables and the Nottingham Health Profile, a generic measure of health-related quality of life. Results of the study suggest that the Spanish version of the SGRQ is conceptually equivalent to the original, and similarly reliable and valid. Although further studies should complete the adaptation work, results suggest that the SGRQ may already be used in Spain and in international studies involving Spanish respiratory patients. According to the present approach, it appears to be feasible to adapt a specific questionnaire on health-related quality of life in respiratory disease to another language and culture.

Cross-Cultural Comparison↗
PubMed1995

In vitro release of arachidonic acid metabolites, glutathione peroxidase, and oxygen-free radicals from platelets of asthmatic patients with and without aspirin intolerance.

BACKGROUND: An abnormal platelet release of oxygen-free radicals has been described in acetylsalicylic acid (aspirin)-induced asthma, a finding which might suggest the existence of an intrinsic, specific platelet abnormality of arachidonic acid metabolism in these patients. The objective of this study was to evaluate platelet arachidonic acid metabolism in asthmatic patients with or without intolerance to aspirin. METHODS: Thirty subjects distributed into three groups were studied: group 1, 10 healthy subjects; group 2, 10 asthmatic patients with aspirin tolerance; and group 3, 10 aspirin-intolerant asthmatics. Platelets were isolated from blood, preincubated with 3H-arachidonic acid for 30 minutes and then incubated for 10 minutes with platelet activating factor (PAF) and aspirin. Cyclo-oxygenase (thromboxane, PGE2, PGF2 alpha, and HHT) and lipoxygenase (12-HETE) arachidonic acid metabolites were measured by high pressure liquid chromatography. Release of oxygen free radicals after incubation with PAF and aspirin was measured by chemiluminescence. Platelet levels of glutathione peroxidase (GSH-Px) were also measured using spectrophotometry. RESULTS: Platelets from aspirin-intolerant asthmatic patients produced higher quantities of arachidonic acid metabolites than the control group at baseline conditions. This increase was significant only for lipoxygenase products. No differences were found amongst the three groups in the response of arachidonic acid metabolism to PAF and aspirin. Incubation with aspirin but not with PAF caused an increase in oxygen-free radical production in aspirin-intolerant patients whereas in aspirin-tolerant patients PAF, rather than aspirin, was the more potent stimulus for oxygen-free radical production. No differences in GSH-Px levels were found amongst the three groups. CONCLUSIONS: These results suggest that the platelet lipoxygenase pathway is activated in aspirin-intolerant patients and that the production of oxygen-free radicals may differentiate aspirin-tolerant from aspirin-intolerant asthmatic subjects. Our study, however, does not support the hypothesis that an increase in lipoxygenase products may be responsible for oxygen-free radical production. Moreover, a lowered platelet GSH-Px activity does not seem to be involved in this phenomenon.

Adult↗
PubMed1994

[Acute myopathy related to the administration of glucocorticoids and neuromuscular blockers].

Two cases of acute myopathy following the administration of high doses of glucocorticoids in patients requiring mechanical ventilation and who were also administered neuromuscular blockers are presented. The patients were two women of 57 and 73 years of age. The doses of methylprednisolone administered were of 810 and 1,180 mg during the first 7 and 17 days, respectively. With regard to the total doses of neuromuscular blockers the first patient received 76 mg of pancuronium over 4 days while the second received 1,180 mg of atracurium over 17 days. This myopathy is characterized by a clinical and histological picture which differs from that associated to the chronic use of glucocorticoids being attributed to a toxic action of these drugs somewhat favored by immobilization due to the use of neuromuscular blockers. Given the lack of references in the literature on this entity in Spain a review was undertaken with the need for correct early diagnosis allowing differentiation from other causes of weakness such as ischemia of the cerebral trunk, polyradiculoneuritis and polyneuritis of critical patients being of note. Muscular biopsy is therefore very useful since very suggestive signs of this myopathy may be found. The disease is reversible with no effective treatment. An early rehabilitation program is the only method of shortening the convalescence period.

Acute Disease↗
PubMed1994

[Effectiveness of the treatment of spontaneous pneumothorax using small caliber pleural catheter].

BACKGROUND: The aim of this study was to evaluate the efficacy of the treatment of spontaneous pneumothorax (PT) by small caliber pleural catheter (SCPC) carried out by physicians with no surgical experience in the emergency department. METHODS: Forty-eight patients with spontaneous PT (23 total, 4 of them tensional) were included in the study. An 8 French caliber polyethylene SCPC was inserted in all the patients requiring pleural drainage. RESULTS: Thirty-two patients (67%) required pleural drainage. The catheter was carried for a mean of 4 days (1-7) resolving PT in 27 (84%) with no resolution being achieved in 5 (15%) and posterior surgical treatment being required. No major complications were observed during the evolution. CONCLUSIONS: The use of small caliber pleural catheters in the treatment of spontaneous pneumothorax (both total and to pressure) performed by physicians with no previous surgical knowledge is safe and effective.

Adolescent↗
PubMed1993

[Inhalation chambers: an alternative to the conventional inhalator?].

BACKGROUND: Aerosol inhalers constitute the most commonly used form of administration of medication by most of the patients with respiratory disease although incorrect usage is a demonstrated fact in many studies. A previous study demonstrated that, despite correct instruction by health care staff and the patients, 30% of the same use these inhalers incorrectly. In the present study, the efficacy of inhalation chambers (750 ml) and spacers (50 ml) versus the conventional inhaler was evaluated by quantification of bronchodilator response. METHODS: Fifty-six stable patients with chronic obstruction to air flow in habitual treatment with aerosol inhalers (AI) were studied. For this study 27 patients used the chamber and 29 the spacer. The patients using the maneuvers correctly (n = 42) and those that did not (n = 14) were studied together and separately. RESULTS: Patients using the inhaler incorrectly were found to benefit significantly from either of the procedures. Upon comparison of the chambers (750 ml) with the spacers (50 ml) a significant improvement was observed with the former. CONCLUSIONS: The response to bronchodilator treatment in patients not using aerosol inhalers correctly improves significantly upon use of either inhalation chambers or spacers with the former demonstrating the best results.

Adult↗
PubMed1993

Immunocytologic analysis of nasal cells obtained by nasal lavage: a comparative study with a standard method of cell identification.

For evaluation of two methods of nasal cell identification, cell morphology and immunocytologic analysis, nasal lavage was performed in 16 healthy subjects and 29 patients suffering from rhinitis. Nasal lavage smears were stained with May-Grünwald-Giemsa (MGG), and cells were identified according to their structure as epithelial cells, neutrophils, lymphocytes, eosinophils, and metachromatic cells (basophils and mast cells). Immunocytologic analysis was performed with monoclonal antibodies by the immunoalkaline phosphatase method. The following monoclonal antibodies were used: CK1, EG2, and CD3, which identify epithelial cells, activated eosinophils, and T lymphocytes, respectively; CD15, which recognizes mature granulocytic cells; and CD14, which reacts with monocytes and macrophages. A significant difference was observed between the two methods in the number of identified epithelial cells, in both controls (64.6 +/- 7.8% with MGG, 14.2 +/- 3.5% with CK1 analysis) and patients with rhinitis (56.9 +/- 7.6% with MGG, 18.2 +/- 3.7% with CK1 analysis). In contrast, no significant differences were found in eosinophil and neutrophil counts when the two methods were compared. After nasal allergic provocation, a significant increase in the number of eosinophils was observed with both methods in seven patients with rhinitis. The results of this study indicate that: 1) MGG staining is a useful method to identify the cells obtained by nasal lavage, and 2) immunocytologic analysis with monoclonal antibodies accurately identifies granulocytic cells, while only a low proportion of epithelial cells are detected, probably because anticytokeratin monoclonal antibody reacts only with viable cells.

Adult↗
PubMed1993

Cell content and albumin concentration in nasal lavage from patients with rhinitis.

Influx of inflammatory cells in the nose was evaluated in 14 patients with rhinitis and 11 healthy subjects. Nasal secretions were obtained by nasal lavages. Total cell count and differential count were carried out with a Neubauer chamber and in cytospin slides, respectively. Cells were classified according to their morphology as epithelial cells without nuclei (degenerated), epithelial nucleated cells, neutrophils, eosinophils, and other. Total protein and albumin concentration were measured by the Lowry method and a nephelometric assay respectively. A statistically significant difference was found in total nucleated epithelial cells (P < .01), total neutrophils (P < .01), and total eosinophils (P < .05) between patients and healthy subjects. A significant correlation was found between albumin/total protein concentration with eosinophil numbers (r = .83, P < .001) in patients with rhinitis. These findings suggest that eosinophils participate in the inflammatory process taking place in rhinitis. Since the cellularity present in the nose of rhinitic patients is similar to that usually found in the bronchial secretions of asthmatic patients obtained by bronchoalveolar lavage, our results also suggest that nasal lavage may be used in the study of the inflammatory cells involved in airway diseases.

Adult↗