ABSTRACT
BACKGROUND: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. METHODS: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. RESULTS: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. CONCLUSIONS: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images.
Subject(s)
Attitude of Health Personnel , Bronchoscopes , Bronchoscopy/instrumentation , Disposable Equipment , Health Knowledge, Attitudes, Practice , Pulmonologists , Clinical Competence , Cross-Sectional Studies , Equipment Design , Health Care Surveys , Humans , Learning Curve , Prospective Studies , SpainABSTRACT
Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of acute cardiovascular events, and around 30% die from cardiovascular diseases. Recent data suggest an increased risk of myocardial infarction in the following days of a severe exacerbation of COPD. Disruption in the balance during the exacerbation with tachycardia, increased inflammation and systemic oxidative stress as well as some other factors may confer an increased risk of subsequent cardiovascular events. A number of investigations may be useful to an early diagnosis, including electrocardiography, imaging techniques and blood test for biomarkers. Some drugs that have changed prognosis in the cardiovascular setting such as cardioselective beta-blockers may be underused in patients with COPD despite its demonstrated benefits. This review focuses on several aspects of exacerbation of COPD and cardiovascular events including epidemiology, possible mechanism, diagnosis and treatment.
ABSTRACT
Introducción: el exceso de exudado y su consecuente maceración constituye una de las causas de retraso en la cicatrización en las úlceras de pie diabético. El objetivo de nuestro estudio es demostrar la efectividad en la reducción de la maceración de la piel perilesional en úlceras exudativas de pie diabético aplicando una película barrera no irritante Cavilon® 3M® (PBNI). Material y métodos: estudio observacional que incluye 40 pacientes (29; 72,5% varones) diabéticos con úlceras exudativas de pie diabético y maceración perilesional, en los que se evalúa durante 30 días la efectividad de la aplicación de una PBNI para el control de la maceración y la evolución clínica de las lesiones. Resultados: a los 30 días de tratamiento el 70% de las lesiones presentó unos bordes sanos o con exudado bajo, con una mejoría significativa con respecto a las condiciones iniciales (día 0 n=8 vs día 30 n=28 p<0,05). La evolución de las variables clínicas relacionadas con la úlcera también fue favorable a lo largo del estudio. La presencia de tejido esfacelado mayor al 60% de la superficie de la úlcera en el día cero aparecía en 17 casos frente a dos en el día 30 (p<0,001). La aparición de tejido granulación pasó de 13 casos que presentaban más del 50% de fondo granulado de la úlcera el día de inclusión a 25 el día 30 (p<0,001). Discusión: la aplicación de un PBNI en el tratamiento de la maceración de úlceras exudativas de pie diabético demostró ser efectiva(AU)
Introduction: highly exudate and maceration is one of the causes of delay in diabetic foot ulcers healing. The purpose of our study was to demonstrate the effectiveness in the periwound skin maceration reduction with the use of no-sting barrier film (NSBF) (3M'99 Cavilon'99). Material and Methods: observational study, which includes 40 patients with diabetes (29, 72,5% males) who suffer diabetic foot ulcers with maceration and exudate. It was evaluated the application of NSBF during 30 days and its correlation with maceration control and clinical wounds progress. Results:70% of the ulcers were showed healthy edge or lower exudates after 30 days of treatment (Day 0 n=8 vs Day 30 n=28 p<0,05). Good evolutions of clinical variables were recorded through the study. Fibrin tissues upper 60% of the ulcer area were recorded in 17 cases at day 0 versus 2 cases in day 30 (p<0,001). Granulation tissue presence turned of 13 cases with upper 50% in wound bed at day 0 versus 25 cases at the end of the study (p<0,001). Discussion: the use of NSBF for the maceration management of highly exudates diabetic foot ulcers was demonstrated effective(AU)
