ABSTRACT
Objetivos. Demostrar que el frasco humidificador (FH), como sistema de humidificación del gas inspirado, no alcanza los valores mínimos de humedad relativa (HR), humedad absoluta (HA) y temperatura (Tº) recomendados por la literatura. Secundariamente, comparar el rendimiento del FH y dos sistemas activos de humidificación (SAH). Materiales y métodos. Las variables principales fueron T° del agua, HR, Tº y HA del gas entregado. Se realizaron mediciones a diferentes niveles de Tº, volumen de agua y flujos. Resultados. El FH no alcanzó los valores recomendados de HR 100%, HA 30 mg/l y Tº 31ºC. El SAH sin circuito calefaccionado alcanzó valores recomendados en el NIVEL III con flujos de 20-60lpm, y en el NIVEL II con flujos de 20-30lpm. El SAH con circuito calefaccionado logró valores sugeridos en los NIVELES II y III (20-60lpm). Se encontró diferencia significativa (p<0,001 Global) para flujo, Tº y tipo de humidificador. El modelo ANOVA arrojó significación estadística (p<0,001) del término interacción de flujo y tipo de humidificador en cada nivel de Tº. Conclusiones. El FH no acondiciona el gas de acuerdo a lo recomendado. El mejor rendimiento fue con 300 ml y flujo de 1 lpm: Tº 23,92(±0,69), HR 74,02%(±6,53) y HA 16,02 mg/l (±1,86), estos valores apenas superan el 50% de lo mínimo sugerido en la literatura. Los SAH acondicionaron el gas adecuadamente. El modelo ANOVA arroja que existen otros factores involucrados en mantener la HA y que la significación varía en cada tipo de humidificador a cada nivel de flujo(AU)
Objetive. To demonstrate that humidifier bottle (HB) as inspired gas humidification system does not attain the minimum values of relative humidity (RH), absolute humidity (AH) and temperature (Tº) as recommended by the literature. Furthermore, to compare the HB performance with two active humidification systems (AHS). Materials and Methods. Main variables were: water Tº, RH, Tº and AH of delivered gas. Measurements were made at different levels of Tº, water and flows volume. Results. Recommended values of RH 100%, AH 30 mg/l and Tº 31º C were not reached by the HB. AHS without heating circuit reached recommended values in LEVEL III with flows of 20-60 lpm, and in LEVEL II with flows of 20-30lpm. AHS with heating circuit obtained recommended values in LEVELS II and III (20-60lpm). A significant difference (p<0.001 Global) for flow, Tº and humidifier type was found. ANOVA model showed statistical evidence (p<0.001) of interaction between flow and type of humidifier in each Tº level. Conclusions. The HB does not condition gas in accordance with recommended values. The best performance was with 300ml and 1lpm flow: Tº 23.92 (±0.69), RH 74.02% (±6.53) and AH 16.02 mg/l (±1.86) and these values hardly exceed the 50% of minimum recommended by literature. AHS conditioned gas in a proper way. ANOVA model shows that there exist other factors involved to maintain AH and that there are important differences between each type of humidifier and each flow level.(AU)
Subject(s)
Humidifiers , Oxygen Inhalation TherapyABSTRACT
BACKGROUND: Some studies point up the frequent aggressiveness showed by the schizophrenic in-patients. The aim of this research is to know some possible predictors factors of this violence, in order to prevent it. METHOD: A two-year long retrospective study was carried out on acts of physical violence committed by schizophrenic in-patients in a General Hospital. This group was compared with a non-aggressive control group. RESULTS: Twenty-nine (29) patients committed ninety (90) acts of assault. The predictive value for violence has been evaluated using twelve variables (court orders, clinical diagnosis, past history of violence, sex, age, married, single, employment status, profession, cohabitation, previous hospitalizations and recent hospitalization) through Discriminative Analysis of the aggressive group and another control of seventy-two (72) non-aggressive schizophrenic patients. Four significant variables turned out to be predictive of violent behaviour: being clinically diagnosed as residual, having a past history of violence, being unemployed and living alone. CONCLUSIONS: The fact of being diagnosed as residual schizophrenia is always predictive of very aggressive behaviour. Using these four variables, a classification tree for violence prediction in schizophrenic in-patients has been established.
Subject(s)
Aggression , Schizophrenia/diagnosis , Schizophrenia/rehabilitation , Violence/psychology , Adult , Female , Hospitalization , Hospitals, Psychiatric , Humans , Male , Predictive Value of Tests , Retrospective StudiesABSTRACT
Introducción: Diferentes estudios destacan la frecuente agresividad que presentan los pacientes esquizofrénicos hospitalizados. El objetivo de esta investigación es conocer factores predictores de esta violencia, para mejorar su prevención. Metodología: Se realiza un estudio retrospectivo de dos años de duración de los actos de heteroagresividad física cometidos por pacientes esquizofrénicos, ingresados en una Unidad Hospitalaria Psiquiátrica, comparado con un grupo control no agresivo. Resultados: 29 pacientes cometieron 90 actos agresivos. Se evalúa el valor predictivo de agresividad de 12 variables (autorización judicial, tipo clínico, presencia de agresividad previa, sexo, edad, casado, soltero, actividad laboral, convivencia, ingresos anteriores y hospitalización reciente) mediante análisis discriminante del grupo agresivo y de otro control de 72 esquizofrénicos no agresivos. Resultan cuatro variables significativas predictoras de agresividad: tipo clínico residual, presencia de agresividad previa, inexistencia de actividad laboral y vivir solo. Conclusiones: El diagnóstico residual predice siempre el ser muy agresivo. Con las cuatro variables predictoras, se construye un árbol de clasificación pronóstico de agresividad en esquizofrénicos hospitalizados. (AU)
Subject(s)
Adult , Male , Female , Humans , Aggression , Schizophrenia , Violence , Retrospective Studies , Hospitalization , Hospitals, Psychiatric , Predictive Value of TestsABSTRACT
Fundamento: Los pacientes esquizofrénicos no respondedores al tratamiento constituyen un grave problema clínico. Por ello, se desea evaluar la respuesta terapéutica de unas pautas psicofarmacológicas alternativas a los neurolépticos típicos. Método: Una muestra de pacientes esquizofrénicos no respondedores fue asignada aleatoriamente, en diseño doble ciego, a dos grupos terapéuticos: experimental y control. El primero incluía 4 fases: 1) si existen síntomas afectivos asociados: haloperidol y carbamacepina o litio; 2) clozapina; 3) megadosis de haloperidol, y 4) tioridazina y valproato sódico. El grupo control incluía 3 fases: 1) haloperidol; 2) clorpromazina, y 3) clozapina. Se avanza de fase si no hay respuesta terapéutica tras 4 semanas de tratamiento. La evaluación semanal se realizó mediante las siguientes escalas: clínica (BPRS); síntomas positivos (SAPS); síntomas negativos (SANS); ajuste psicosocial (GAF), y efectos secundarios (UKU). Resultados: Diecinueve pacientes han completado al menos una fase del protocolo. Entre los 2 grupos hubo un total de 13 pacientes respondedores: seis con clozapina, tres con haloperidol y cuatro con haloperidol más carbamazepina. El grupo respondedor presentó entre las evaluaciones inicial y final disminuciones medias superiores al 50 por ciento en las escalas BPRS y SAPS (p 40 por ciento en todas las escalas (AU)
Subject(s)
Adolescent , Adult , Female , Male , Middle Aged , Humans , Psychopharmacology/methods , Schizophrenia/complications , Schizophrenia/diagnosis , Antipsychotic Agents/administration & dosage , Antipsychotic Agents/pharmacokinetics , Antipsychotic Agents/metabolism , Drug Resistance, Microbial , Clozapine/administration & dosage , Risperidone/administration & dosage , Chlorpromazine/administration & dosage , Haloperidol/administration & dosage , Triazines/administration & dosage , Prospective Studies , Clinical Protocols , Clozapine/administration & dosageABSTRACT
INTRODUCTION: The schizophrenia is considered an heterogeneous disorder which phenomenological differences could to point to etiopathogenic differences. Negative symptoms are associated with poor treatment response. In the last year different operative criteria of the "refractory treatment" concept has been developed. The association between negative schizophrenic symptoms and neuroleptic treatment response is studied. METHOD: An open cross-sectioned design is made. 50 schizophrenics (DSM III-R criteria) inpatients are divided into 2 groups: one of 25 treatment-refractory schizophrenics (defined as Kane criteria, modified), and a second group of 25 treatments-responders schizophrenics. Negative symptoms are evaluated by the SANS into the five days before the hospital discharge. RESULTS: The two groups showed differences in the number of hospital income and total length of stay (p < 0.01). There were no differences in the subscales: "alogia", "affective flattening" and "attention impairments", although differences were found in "anhedonia-asociality" and "avolition-apathy" subscales (p < 0.05). DISCUSSION: Association between negative symptoms-poor outcome is issued. Possible relation between "anhedonia-asociality" and "avolition-apathy" added to social dimension with refractoriness to treatment is suggested.
Subject(s)
Antipsychotic Agents/therapeutic use , Schizophrenia/diagnosis , Schizophrenia/drug therapy , Adolescent , Adult , Aged , Female , Hospitalization , Hospitals, Psychiatric , Humans , Length of Stay , Male , Middle Aged , Schizophrenia/rehabilitation , Schizophrenic PsychologyABSTRACT
The superposition poliangeitic syndrome involve pathologic aspects of other illnesses. It is superposition of poliartheritis nodose, allergic angeitis, Wegener disease and hypersensitivity vasculitis. It is caracterized to bo ANCA positive with clinical aspects and antibodies of this illnesses.
Subject(s)
Humans , Male , Middle Aged , Antibodies, Antineutrophil Cytoplasmic , VasculitisABSTRACT
The superposition poliangeitic syndrome involve pathologic aspects of other illnesses. It is superposition of poliartheritis nodose, allergic angeitis, Wegener disease and hypersensitivity vasculitis. It is caracterized to bo ANCA positive with clinical aspects and antibodies of this illnesses. (AU)
Subject(s)
Humans , Male , Middle Aged , Antibodies, Antineutrophil Cytoplasmic , VasculitisABSTRACT
The SIDAM, a new clinical structured interview for the diagnosis and measure of dementia according to DSM-III-R and ICD-10, is described. This instrument comprises a clinical overview, several cognitive tests, including the Mini-Mental State, and a section for clinical judgement and information coming from others. Every item relies on DSM-11-R and ICD-10 algorithms. The SIDAM has a hight test-retest reliability on the clinical diagnosis and the different diagnostic criteria. It is a brief (28 minutes), practical screening instrument. Good congruence is found between SIDEM, DSM-III-R and ICD-10, and the corresponding ICD-9 expert diagnosis. Furthermore the SIDAM Total Score (SISCO), allows a good measurement of low level of cognitive impairments and provides quantification of severity of cognitive disorders. The SIDAM has been translated and adapted into Spanish.
