Apnea-Hypopnea Index in Chronic Obstructive Pulmonary Disease Exacerbation Requiring Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support.

INTRODUCTION: This study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients. MATERIALS AND METHODS: We designed a single-center prospective study. The coexistence of Apnea-Hypopnea Index and clinical, gasometric, spirometric, respiratory polygraphy, and ventilatory characteristics were determined. The clinical characteristics found were categorized and compared according to the Apnea-Hypopnea Index (AHI) < 5, AHI 5-15, and AHI >15. A p value <0.05 was considered statistically significant. RESULTS: During the study period, a total of 100 patients were admitted to the ICU with a diagnosis of acute hypercapnic respiratory failure due to COPD exacerbation. 72 patients presented with acute respiratory failure and fulfilled criteria for ventilatory support. Within them, 24 received invasive mechanical ventilation and 48 NIV. After applying the inclusion criteria for this study, 30 patients were eligible. An AHI >5 was present in 24 of the 30 patients recruited (80%). Neck circumference (cm), Epworth scale, and Mallampati score evidenced significant differences when compared to the patient's AHI <5, AHI 5-15, and AHI >15 (p < 0.05). Furthermore, patients with an AHI >5 had longer hospital admissions, prolonged periods on mechanical ventilation, and a higher percentage of intubation rates. CONCLUSION: Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require NIV. This association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy.

Dermatosis cenicienta: presentación de cinco observaciones / Ashy dermatosis: a report of five patients

Se presentan 5 observaciones de dermatosis cenicienta en tres hombres y dos mujeres, con edades que oscilan entre 30 y 54 años, evolución entre tres meses y 17 años y crecimiento progresivo. En ninguno hubo antecedentes de consumo de drogas antiparasitarias, vitaminas o antecedentes de infecciones , inflamaciones, inmunizaciones ni exposición al sol por largas horas. La histopatología fue típica en todos ellos, tanto en las porciones centrales como en los bordes activos. El tratamiento con crioterapia parece tener algún efecto beneficioso, pero necesitamos ensayarlo en más casos.

Dermatosis cenicienta: presentación de cinco observaciones / Ashy dermatosis: a report of five patients

Se presentan 5 observaciones de dermatosis cenicienta en tres hombres y dos mujeres, con edades que oscilan entre 30 y 54 años, evolución entre tres meses y 17 años y crecimiento progresivo. En ninguno hubo antecedentes de consumo de drogas antiparasitarias, vitaminas o antecedentes de infecciones , inflamaciones, inmunizaciones ni exposición al sol por largas horas. La histopatología fue típica en todos ellos, tanto en las porciones centrales como en los bordes activos. El tratamiento con crioterapia parece tener algún efecto beneficioso, pero necesitamos ensayarlo en más casos. (AU)

Factores ambientales de la morbilidad infantil : Incidencia de procesos diarreicos entre 87 familias durante 10 meses de observación / Environmental factors in infant morbidity

A study was made on 87 nursing infants and their family contacts to find the incidence of diarrheal episodes and the degree of malnutrition occurring among them according to the living standard of their families, and the type of housing they lived in was taken as the basis for classifying their social and economic status

The study was conducted by personnel trained for this type of researach, and it lasted for 10 months. Each index case was reviewed on an average of 3 times a month, and an interview was held with the mother to complete the data. The children were weighed every month. Coprocultures were practiced in 103 persons among 19 of the families of these children

The average incidence of the diarrheal episode was 41.6 days per child. It was highest in the first 3 months of life and decreased gradually. From age 2 onwards the incidence was similar to that of other age groups. Diarrheal incidence varied among the groups according to its housing, i.e., the poorer the dwelling, the higher the incidence, and the same phenomenon applied to malnutrition

Of the 103 persons on whom bacteriological studies were practiced, 18(17 percent) had some known enteropathogen, but none showed clinical signs of the disease

There was a great variety in the concept of the mothers of these maladies (even in the same person), but all shared a lack of knowledge of the etiology of the infection

The paper con. ...(AU)